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12130 SW TIEDEMAN AVENUE 121.30SW TIEDEMAIV AVENUE c JZm ti L3 c4 m 0 cr c M E m "D M F- 3 O M r-1 N .-1 BUILDING IJERMITAPPLICATION TIGAHD DATE9J4/ -1985 5577 THE UNDERSIGNED HEREBY APDL IES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _ 620-9689 OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_ OWNER Ed Uddiard JOB ADDRESS 12130 SH Tiedeamn LOT NO. ARCHITECT Lill-One Fairway Builderq 5414 SM 167th ENGINEER BUILDER ADDRESS DESIGNER STRUCTURE —_❑ NEW ❑ REMODEL ❑ ADDITION_ ❑ REPAIR - 11 RENEWAL IJFIRE DAMAGE ❑ DEMOLITION F3RESIDENCE Cl COMM 11EDUCATIONAL ❑ GOV'T ElRELIGIOUS ❑ PATIO 11 CARPORT ❑ GARAGE ❑ STORAGE O SLAB❑ FENCE OCCUPANCY LAND USE ZONE '�T',PE _FIRE ZONE_- PLAN CHECK BY -!'!!—HEAT —_ Corrugated Root 16 x 19 and Pole type bldg. 12 x 26 x 13 - 6 -- SEWER PERMIT# No Hach. or Plutubing required OCC.LOAD FLOOR LOAD _ _ HEIGHT 13 NO,STORIES Y AREA 312 NO.BEDROOM_ S VALUG 4OL100 BUILDING DEPARTMENT SET BACKS FRONT REAR 15' LEFT SIDE _ RIGHT SIDE _ Permit 44.50 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERE13Y AGREED THAT TL3: Plan Check _ 28.93 WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE 13.43 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE Subtotal — RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESF State Tax 1•�S LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. _ Total 2 I SDC- PDCq -i—PPLIG Nt OR A4ENT By - -- .- .- --- Receipt No. ( (. Approved ----- - - A0D-AFS8- PHONE DATE INSP. TYPE INSPI:CTION REMARKS PLUMBING DATE 00, Contractor Permit No. Hough-in Fixture Final HEAT 14G Contractor No. Gas or Oil Rough-in Final SEWER Final Final DRIVEWAY Final Storm torm Dia0nige (Rain Drain)panel Curb&Street Final ...... Approach DEPT.FINAL TEMPORARY CERTIFICATE i(7rr?TIllCATE OCCUPANCY Final Landscaping Zoning Final ll,VY- BUILDING PERMIT APPLICATION TIGARD o^rE--- �IC THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK H_REIM IN OWNS8UILDR PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAINS AND SPECIFICt,TIONS. OWNER PHONE LOT NO._ OWNER /gin J08 ADDRESS ��y_1 _ �I v aARCN TI EC'T ENGINEER DESIGNER BUILDER A i �(,`Mj0_RS.S • �r.. STRUCTURE (] NEW n RE DEI C7 ADDITION _J REeAIR —_O RENEWAL Q FIRE DAMAGE O DE�Aa C] RESIDENCE 0 COMM 0 EDUCATIONAL U GOVT Ea ^FUGIOUS O PATIO O CAR?ORT ❑ GARAGE G STORAGE O St-A.80 i r PLAN CHECK BT HF-Ar� GCCU?ANCY A LAND USE ZONE - BLDG-TYPE .—•FIRE I.ONE� ---.-- — s 2 dao !J SEWER PERMIT/ ./, NO.eEOROOMS -•- •- VALUE UCC 10.W FLOOR LOAD - HEIGHT ,` NO.STORIES _ AREA S �- - BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE 'RIGHT SIDE Pprmlt S6, TIIIS PERMIT IS ISSUED SUBJECT TO THE EMULATIONS CONTAINED IN THE RVTLDING CODE.] p REGULATIONS AND ALL APPLICABL:COVES AND ORDINANCES.AND IT IS HERF3Y AGREED TH Pfau( ck d ` WORK WILL LIE DONE IN ACCOROANCE'lInTH THE PLANS AND SPECIFICATIONS AND IN COUP' WITH ALL APPLICABLE ODOES AND ORDINANCES.THE ISSUANCE OF THIS PERMIT DOES HOT S�S•fofal llCSEt4SE SEPAMIPERIAtTS R t U1RE0 FOR SEWER, LUI qICTOR AND SUB HG AND HEATING ORS TO"AVEE CURRENT CITY BU Slitb Tax t SOC— — --- Total G T Appt/(,AHr OA AGENT PO By AVORCSS -- �. FWC*IP(No. - RfONE Ap S 0 C - POC - tom..... SEWER CONNECTION SEWER INSPECTION $ _— SEWER SURCHARGE S r Bo i Id i ng Ver"i l I NO 55 Location Cert if icat ion of Reg strat ion With the Builders Board doing business as (dba) , A-- am registered under the provisiorv. of ORS Chapter 101 Oregon Homebui lders Law) . Fly Builders Board Registration Number is � !�7,!-A I Ply registration is in full force and effect and expires on ignature i' IV--7,- -.W--'-W. STATEMENT La Rue Construction Excavation and Sewer Construction P.O. BOX 417 BEAVERTON, OREGON 97006 (503) 646-4983 DATC DATE DESCRIPTION AMOUNT j T-- .......ww� TOTAL -'do— n► �r City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. :--- DATE: O. : —...._.DATE: io DATE ISSUED :--J--z'— OWNERS SSUED :-__1-1OWNERS NAME ADDRESS: CONTRACTOR :TEST * Air p, Water Visual, Laboratory 0 RESULT: Approved,,, Disapproved ❑ Pending E, S K ET::H. t a, ;.t -� Q c•-.��'k, INSPECTOR DATE �NOTF Attach supplementoi 'est data beret 01 -5 7-A i c k P�eoJ City of Tigard INSPECTION REOUEST" �- for . .. I NSPECTION TIME :A PERMIT NO. : -,,. . DATE:J i DATE ISSUED:__z OWNERS NAME: -- _ AI ) L ADDRESS: x.72 /3t1 `a"c✓ /% L� r CONTRACTOR :_ TEST:Air ❑, Water [] , Vieual 0 , Laboratory ❑ RESULT: Approved ® , Disapproeed ❑ Pending [] SKETCH- y� INSPECTOR DATE 1010-E: Attach supplemental test data heret� !f i that a,aidctionbe brought. thehcontractorhandAmountothe contractor'rs suz: touch shall be required to promiae and agree to pay, in addition to the amOunts accurtnq and allowable, ouch sum as the court shall adjudge reasonable as attorney's fees and cost incurred by the City, both in the Trial court and Ahpallate court, if any, or the City may at its option bring proceedings to enforce against the contractor and/or contractor's surnty, c1pecific performance of the contract and compliance with the standards adopted by the city of Tigard, and in any ©vent, in a like manner, the City shall be entitled to recover such sums as the Court may Adjudge reasonable for the City's attorney's fees and cost, both in the Trial Court and Appellate Court, if any. 4. petitioner, concurrent with the execution hereof, agrees to pay the following fees as required by Unified sewerage Agency pesolution and Order No. 70-121 a. ) A plan rheck fee to cover the cost of review and approval Of construction plans and inapcction of sewer construction (except house connections) in the amount of b. ) A permit fee to cover the cost of processing roc sing the permit application and perfcrminq P property connection(*) in the amount of c. ) A connection charge to connect directly to an exietlnq sanitary sewer, which was installed Z�.+ without (9trike inapplicable word)jIMWt-vpt "✓' t� petitioner, in the amount of to the pe t d. ) A monthly sewer service charge for the use of the public sanitary sewer nystem. 4�. 5. petitioner, concurrent with the Axe t� sot. also • as agrees to pay a surcharge in the amount of ra- t e Cit with quired by that certain cont;act entered intra y Y 7-or-�®r—eTZuiatart;en!or�ne�wer construe on costs per- t�-Hent ere�o. 6. The City agrees to make and provide periodic inspections as, in the City's judgement. is necessary to assure compliance. 7. The petitioner agrees to insure that the City receives 49 hour advance notice of c_orrrencement of construction and, 8190, � , 12 hour advance notice for all requested field inspections. A. The petitioner agrees to ir:sure that the Petitioner's 1. enginr�er obtains accurate Ag-built (field) construction records of c_. said newer Installation and. also. agrees to insure that the City it furnished with one accurate as-bsi ►t mylar thereof. 9. At such time as all public improvements have been com- pleted in accordance with the City's requirements petitioner shall be required to notify the City of the readiness for final inspertioni upon affirmation by the Department of public works that all requirAments of the city have been met, the Petitioner will submit to the City a 9cood and sufi+c a rat maintenance bond in the form Approved by the city in a sum equal to fifty per cent (50%) of the contract price to provide for orrectiongof any defective work or maintenance becoming apparent year after final acceptance of the public improvements by the City. t~%'l' �r f ._'+ J, / � �. .� . �,t'� f r_ r✓. . raj ,,� f Atter @r!diCatiOh j„PN�e �..of 3 1 � 3S0 - 3u ADDRESS _ fa?( y ,Qcv-r>/cv�.��c'>c- PERMIT NO. _5Oy$ PERMIT CHARGE none � OWNER CONNECTION FEE o� PAID Ely TYPE OF BUILDING ��C�csc�4 � DATE CONNECTED f� SERVICE RATE c.Cz_� INSPECTION FEE �5 �y CONTRACTOR PAID HY DATE SIZE OF CONNECTION !/ ' ' _�� ASSESSMENT PAID