13644 SW TAMAWAY LANE y0,
ADDRESS:
-Tamawa�j Lane
Ii:\records\rnicroflm\targets\building.doc
l
CITY OF TIGARD CERTIFICATE OF
-OCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . s MST94-0447
13125 SW Hall Blvd.Tigard,Orpon 97223.6199 (503)639.4171 DATE ISSUED: 12105195
PARCCL_: 2S 104CA-09300
SITE ADDRESS. . . : 13644 SW TAMAWAY
SUBDIVISION. . . . : HILLSHIRE ZONING:R-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :093
CLAfiS OF WORK. :OEW
TYPE= OF USE. . :SP
OCCUPANCY GRP. N+k g'�
OCCUPANCY LOAD:2
Remarks; ! POTH I
Owner•.
BRUCE ALLEN
16890 NW WATERFORD WAY
PORTLAND OR 97229
r°hone *: 614-0545
Contractor-:
BRUCE ALLEN WOOD HOMES INC
168 `0 NW WATE=RFORD HOMES
PORTLAND OR 97229-1876
Phone Is 220-1175
Rep #k. . : 9A821
Th i. s Certificate chants occupancy of the above referenced building or^ port ion
thereof and confit-ms that the building has been inspected r compliance with
the f:9tate of Oregon Specialty Codes for the grou,�, cec�.,pancy, -1 1. se imder
which the referen ed permit was issued.
BUILDING INSPE OR BUILDING OFrICIAL
POST IN CONSPICUOUS PLACE:.
rr
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-)-Phone): 639-4175 Business Phone: 639-4171 3�
Inspection: �
_ _
�Ik" II
Footing Susp. Ceiling Sprink. Rough-in 5 r ppr/Sdwlk
Foundation Plbo. Underslab Mech Rough-in Fireplace
Post/Beam Struct. Plbg, Top Oui Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line �d , 'f�
Plbg. Underfloor Rain Drain Framing �� Plumb.
Alarm Water Line Insulation ec f
Underllr. Insul. Shear Wall k-3Yp. Bd.
l /
Date Requested:__ Z�)., ( ' ( 4' S _Time: AM PM ,
Address_ ��� F� ✓!�L 4'' e "
Builder: _Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector._ ' r �-�- Date:
APPROVED DISAPPROVED _APPROVED `.'�;B)FCT TO,A3OVE
Call For Reinsp.
K
WASHINGTON COUNTY INSPECTION CARD PROJECT NO.
DEPARTMENT OF LAND USE /SND TRANSPORTATION PERMIT NO. y11(2
FOR INSPECTIONS CALL: 640-3561, 24 HOURS
FOR INFORMATION CALL: 640-3470 DATE Z
ADDRESS _��J / 1 S /f�i� �r1` PERMITEE >C(-J�/ U7fj��
DIRECTIONS _ _ _ PHONE NO. jO Lr / /Z7
PjUILDING _ MISCELLANEOUS PLUMBING _ ELECTRICAL
ftq post/beam nail mobile home around rain drain temp service
fdn frame apron/ wood stove post/beam storm sewerrover 6 ser
sidewalk
slab insul FINAL HVAC top-out FINAL FINAL
(JAS test sewer IDSA No
OTHER
APPROVED RDA A NPPROVEDECT DANPEPROVEDPRESTEH INSPEOWEVER CTION E] WORK UNTIL:
INSPECTED BY !�/ / �1 `��" -�._ DATE
DEPARTMENT OF LAND USE 8,TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INGPECTION REQUESTS: 503/640-3581/693-4415
OREGON -,XXXXXXXX o41.) 3,ti0
I.,al.4F a 1 U.h 1
Urate c 02/2 /', 5
I iris(_- a 08aa9
Fc iinit Type a E.Etx+ idc:itt '. I l: ler. tr ic,cil f't I PlornOt # o 05064404
HFPRU', h..0 Rp I Ie,-1 a U�./ 21"Y5
[111ljI 1.'+h44 :,W I fil"II1WWI` LN 1 .1 1r; ;ue11 a 02/17/'2l�
1'tt2r riiit 1 t t Ie a :-i I• R L.LLL/11LW I•IU(J5I. I:c)n)p Iet•trzrJ a
I-'I:�rIII it Ur:� cI, TU (exp •ire _ 0EJ/Z6 Y!.)
1-'1 U je:rr..t 1 I -t. Ie ,I. 1•i I:.I..E L./N1. „I hiI1U:1L Pr u iec^ t 4 a 1"004/862
1'rU je(rt: 1.)e ,cr a I:_RU51lJly
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Leila a I llesur , is
lJWIitz,r a I HIJlILL I L L;''I 1 I.G,I-IRU Curi:.truct i Ori a U 1 11
I I p p I i c a n t Wattle e 5(.,11L1) 111*1F11IA, L . EI. (:f: Ih1C UIaM:,sii iceit •iUn + ` 00
[.11,,1., I icarit 11ddr , e 568U til:. I-`ULI.;I...0 0c::cuparic5i a li 3
I111.1_FJ:I1JR(J , OR y/I Z3 Vial idated tiv KI.
111 1. I I carit, Ph(lne 6,41) • 4V/ I ri pec for Arc.-?a
Ire sae •c,r II..#tic)n IIri ''It: Fee/Uriit L x t tllle D ata
:),:luare h Ootage L_ri'tt r '11:1 . 1 t . J 300(: 1 a U , U
ubt,uta i L le:ctr i c:a l F e ez. . ' 210 . 0(1
Ic)'tCil L Iec;tr Ic,a1 1— ens Z20 50
e 3 ti m q i_I i t t:•!.:J u n ► * it.r. I'a F,.,*, 1,o I I e r.:t e,i:1 N 11 r e g i t,
I`It Lc:)0 I.,Best.:k tl h'c,, t: i 1 't Nu , I.1t9t.e Paviiieri t
111IHi- IIA1 `.i 1)ILIIL. 220 , IJ;0
al ra 'I L.I t;riI v rl t x, a . U t) I r, t,run I L.,I`ell i r: 00
ICil:ill I1".t;?;e;l O (1 Iott91 Priyrrit.:11"It,5a 22U , 1)0
H' a I a r I c e DuF 00
NOTICE This permit becomes null and void If the work or construction for which It is Issued Is not commenced within 180 days Once construction has started,
the permit becomes null and void If constructlon is Interrupted for a period of 180 days. I certify that the Information presented by the applicant and
his agent or PU- t-In support of this permit Is tr•a and correct to the best of sur knowledge. I acknowledge that the Building Department's reliance
upon false and misleading information may Invalidate this permit. All provisions of apullcabie laws and ordinances governing the construction and use
of this building or structure will be compiled wlt:i whether or not specified on the plans or noted on the pians correction sheets I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the-tructure or building permitted depends upon my calling for Inspections at various times during the pror.oss of construction end thn building
Inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the a,ollcant and such use or occupancy Is revocable until all inspection requirements are satisfied and
approval Is given by the Building Official. I furthe P-knowledge that a lien may be placed on the title of th,t property upon which the permit Is israed
specifying that the use or occupancy of the bulldin, or structure Is provisional and revocable until the satisfaction of all Inspection requirements
,ti c,t (ftptf?A•tt tx
�/.PPUCAJ S SIGNATURE
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section APPLICATION
155 tJorth First Avenue, 1!350-12
Hillsboro, Oregon 97124
Information: (503) 640-3470 Fax: (503) 693-4412 Permit '�J
NPLEASE PRINT ". umber ��nc/ Date •�" �` ( - !C
1
Please coniplete all sections, I through 5. 4. Complete Fee Schedule below
1. Location of Installation Number of Imoectlons per permit allowed
Address 1 3 t,'>''>< , Lc, Tet hod Wct Service included: Items Cost(ea.) Sum
Build' g A. Residential- per unit
City T I t( f;(� Suite oo,
-- — .-- 1000 sq.n.or less — { $110.00 _ �//� — 4
Tenant Narne Each additional 500 sq.n
(if commercial) or portion thereof — $25 00
Limited Energy $25.00 1
Map No.. Tax Lot Each Manuf'd Home or Modular
Thomas Map Book: Page' Section:
')welling Service or Feeder _— $66.00 —. 2
—
Directions —._—_ —_—_ __—_ _ B. Services or Feeders
Installation,alterations or relocation
200 amps or lass -- $60.OU — 2
Commercial ❑ Rosidential 201 amps to 400 amps —__ 5,60.00 --_—._ 2
401 amps to 600 amps $120.00 —. — 2
2a. Contractor Installation only., 601 amps to 1000 amps --- $160.00 -- 2
Ya Over 1000 amps or volts -- $340.00 2
Electrical Contractor '1�-1 1l ci i T M ANN E'eC R I(, Reconnect only -- $50.00 2
Address E U lit
City t-1 I i_l.S jjci►t'ti State ZIP� 7 C. Temporary Services or Feeders
Date_. /I Job Nurn r Installation,alteration or relocation
Property Owner V�a(C Lit a c-D 200 amps or less $50.(0 2
Contractor's License No. 2.1- 3 7 t� 201 amps to 400 amps $75.00 _ 2
Contractor's Board Reg. No 11 /_S 401 amps to 600 amps $100.00 _ 2
Over 600 amps to 1000 volts sea'B'above
Signature of Supr. Eleun ,, t ;, Y1- D. Branch Circuits
License No. 'L- ; Phone Wo. (st1 y - %11 7 New,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase or service or feeder lee.
Each branch circuit $5.00 2
fsrint caner s ame — --Phone No. — b) The fee for branch circuits without
purchase of service or feeder he.
Address---- — _--- -- ---- First branch circuit $35.00 2
Each add'nl branch circuit $5.00 2
-- ----- �--�-- --- --- - E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle $40,00 _ 2
The installation is being rnade on property 1 own Each sign or outline lighting $40.00 _ 2
which is not intended for sale, lease or rent. Sig ial circuits)or a limited
energy par at,alteration
Owner's Signature _--_—.`—_—A—_____.____________-._- or extension $4000 2
F. Each additional inspection over the allowable
in any of the above
3. Plan Review section (if required) Per inspection _ $3C 00
Per hour $55.00
Please check appropriate Rem and enter fee In section 5B. In Pent __ $5500
4 or more residential units in one structure
Service and feeder, 800 amps or more 5. Fees
_System over 600 volts nominal A. Enter total of above fees $ Z�•
.--Classified area or struraure containing special 5% Surcharge (.05 X total fees) $ _1f
occupancy as described it N.E.C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review it required (Section 3) $
above apply. Not required for temporary construction Subtotal B
services. ❑ Ti usl Account a
--J Balaace Due $ 23l,
For inspections call This permit becomes null u,d void If the work authorized by the permN Is no!commenced
640-3561 or 693-4415 -vithin 160 days from dale of iesusnca of such pot mil or It the work authorired Is
suspended or abandoned at any time after work Is commenced fw a period of t:,n day&
24-hour recorder, one working day in advance of need Elecirical permits e ,non refundable and non-tranderable.
6"94
Page No. 1 CASE HISTORY FOR CASE NO.: MOT94-0447
BRUCE ALLEN
13644 SW TAMAWAY ?
08/25/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MSTA007 Application received / / / / 11/28/94 PASS KAR 12/08/94 BLT
MSTA010 Plan check deposit paid / / / / 11/28/94 PASS KAR 12/08/94 BLT
MSTA020 Plan check by 12/08/94 / / 12/08/94 PASS RT 12/08/94 BLT
MSTA030 Check for prcl. restrict. / / 12/08/94 12/08/94 PASS .JLG 12/08/94 BLT
MSTA092 (T) Issue combination permit / / / / 12/12/94 JF 12/12/94 JF
MSTA097 Issue plumbing signature form / / / / 12/12/94 JF 12/12/94 .IF
MSTA705 Foot/found Insp / / / / 12/30/94 USA INSPECTION; POST ADDRESS; HORI7.CjN',AL FAIL RB 12/30/94 Re
FOOTING PARS NOT IN PLACE; CRAWL LRAIN
PLACEMENT REQ'D; PROVIDE ADEQUATE
VENTILATION; PLACE GROUND ROD; MAINTAIN
SEISMIC RESTRAINT.
MSTA705 Foot/found Insp / / / / 01/03/95 PASS RB 01/03/95 RB
MSTA710 Post/Beam Structural / / / / 01/12/95 DIS KS 01/13/95 KBS
#-1- see inspections nuces
MSTA720 Post/Beam Structural / / / i 01/13/95 0-1 submit to building dept revised A/N KS 01/13/95 KBS
plans from
structural enginneer indicating that
ledger
supporting floor and roof load.
this needs to be
approved prior to framing inspection
MSTA711 Poet/Beam Mechanical / / / / 01/12/95 APP KS 01/13/95 KBS
MSTA717 PLM/Underfloor / / / 01/1C/44 PAS Me 01/11/91 MRS
MSTA720 Mechanical Inep / / / / 02/15/95 exhaust. ducts need to be hooked up PASS MS 02116191, MRS
MSTA720 Mechanical Insp / / / / 02/15/95 SOFFIT DUCTWORK IN GARAGE, UTILITY, EAST FAIL RB 02,15/95 RB
LIVING/DEN; CHASE DUCTWORK IN EAST
LIVING/DEN; EXHAUST VENTING INCOMPLETE;
FIREPLACE NOT INSTALLED AT THIS TIME;
GYP, BD. REQ'D DIRECTLY BEHIND FURNACE
MSTA720 Mechanical Inep / / / / 03/10/95 seal exhauxt vent at fan housing PASS RA 03/3:/95 RB
MSTA722 Plumb Top Out / / / / 02/08!95 PASS MS 02/09/95 '4RS
MSTA726 Framing <REINSP> / / / / 03/10/95 pending mech approval PASS RB 03/14/95 RB
MSTA735 Gas Line Inap / / / / 02/15/95 PASS MS 02/16/95 MRS
MSTA'740 Insulatiin Insp / / / / 03/17/95 BONUS RM NOT INSUL, I DON'T KNOW IF THIS APP GS 03/17/95 GES
RM IS UNFINISHED OR NCT
rN(
i
Page No. 2 CASE HISTORY FOP. CASE NO.: MST99-0447
BRUCE ALLEN
13644 SW TAMAWAY LN
08/25/98
Acton Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent lone Done Datt By
MSTA745 Gyp Board Inep / / / / 03/20/95 0-1- glazing above jacuzzi ( appears not DIS KS 03/20/95 KBS
tempered)
M-2- 7 if bonus rm is unfinished ( walls
adjacent to condition
space needs insulated
# 3 seal open space between furnace
plenum and fdn
provide min; of one inch clearance
nt to b vent penetrating
ydrage ceiling
MSTA745 Gyp Boar] Inep / / / / 03/23/95 #-1 glazing above jacuzzi ( fixed A/N KS 03/24/95 KBS
panel) nerd¢ to be
tempered
0-2- if bonus room ii unfinished walls
adjacent to
condition space needs to be insulated
M 3- seal open space between furnace and
fdn wall
MSTA755 Rain drain Insp / / / / 01/09/94 PAS^, FIS 01/10/95 MRS
MSTA760 Water Line Inep / / / / 01/09/94 PASS MS 01/10/95 MRS
M.STA765 Appr/Sdwlk Inep / / / / ;,3;18/95 1. Remove 3" pvc pipe and replace with PEND LT 05/23/95 NL
4" and replace street sign.
2. Expansion joints (1/2" felt)
required at all cold joints and every
40'.
7. Sawcut curb on west sides cf aplor.dch
completely through.
4. Be prepared to protect finish.
MSTA770 Misc. lnepection / / / 02/15/95 SHEAR- STUD MISSING AT KITCHEN; 4X6 FAIL RB 02/15/95 RB
POSTING FJR HD'S ARE TKIMMERS AND NEED
TO BE AT'T'ACHED TO PLATE ABOVE; MISSING
HD S'S FWD EAST CORNER; IIAIL SHEATHING
IN ACCORDANCE W/ ENGINEERING- MAIN 'FLOOR
AND UPPER LEVEL; C, D, E WAIL NAILING
INADEQUATE NAIL ACCORDING TO SPECS;
INTERIOR 671EAR PANEL REQ'D AT KITCHEN.
MSTA770 Misc. Inspection / / / / 02/22/95 GEE RE°ORT S 15 RB 02/24/95 RB
MSTA770 Misc. Inspection / / 1 03/10/95 PASS RB 03/14/95 RB
MSTA795 Mechanical Final / / / / 06/29/95 0-1 see correction notes UIS KS 06/29/95 KBS
MSTA795 Mechanical Final / / / / 06/30/95 see report FAIL RB 06/30/95 Rb
Page No. 3 CASE HISTORY FOR CASE NO.: MST94-0447
BRUCE ALLEN
13644 SW TAMAWAY IN
os/25/9B
Action Description Req/ Schd; End/ Action Notes Disp By Update Upd
Code Sent Done Done Dare By
MSTA795 Mechanical Final 12/05/95 / / 12/05/95 PASS RB 12/05%95 V.B
MSTA797 Plumb Final / / / / 06/19/95 access to jucussi FA 11, MS 06/19/95 MRS
no hot water
clean nut C,jr L4ewer'7
MSTA797 Plumb Final / / / / 06/29/95 PASS MS 06/29/95 MRS
MSTA799 Buildino Final / / / / 06/2H/95 #-1- see correction notes DIS KS 06/29/95 KBS
MSIX799 Building Final / / / / 06/30/95 see rr ,ort FAIL. RB 00/24/95 RB
MSTA799 Building Final 12/05/95 / 12/05/95 PASS RB 12/05/95 RB
MSTA960 (F) Issue Cert. of Occupancy / / / / 12/05/95 JF 12/11/95 JF
MSTA970 Case Finaled / / / / 12/05/95 PASS RB 12/05/95 RB
MSTB706 Erosion Control / / / / 96/30/95 :ASS USA 06/30/95 RB
i
CITY OF TI GARD
COMMUNITY DEVELOPMENT DEPARTMENT PIASTER PERMIT
13125 SW Hall Blvd.Tlga►d,Oregon 97223*8199 (503)838.4171 PERMIT #. . . . . . . : MST94--044 .
* 171. DATE ISSUED: li°/12/94
PARCEL: 2S 104CA-09 300
>11'E_ ADDRESS, . . : 13644 SW TAMAWAY LN
3UBD. VISION. . . . : HIL-L.SHIRE ZONING: R--7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :09;3
BUILDING
RE I SISUE: DWELLING UN I'T-S: 1 BASEMENT.. . . . . . . . :0 s f
CLASS OF WORK. =NEW SEDRMS:3 BATHS::3 BARAGE. . . . . . . . . . :462 sf.
TYPE OF USE. . . :SF FLOOR ARi_AS REOU I RE_D -----
l'YI-'E: OF L:UNST. :5N FIRST. . . . : 1236 r- f LF:F T. . :20 ft F?IGNT. :5 ft
OCCUPANCY GRP. :R3 SE=COND. . . : 1390 s f FRONT. : 30 'Ft REA t. . :24 ft
STORIES. . . . . . . :2 FINBSMENT:O sf
! rI:.IC3HT. . . . . . . . :30 ft sf 5MOKE" DETECTORS. Y
FLOOR LOAD. . . . :40 p s f VALUE. . . . . f : 177314 PARKING SPACF_5. . : 1
Remav-ks : PATH I
INKS. . . . . . . . . . : 1 F--l_OOR DRAINS. . . . :0 BAC:I'.FLOW E'I,EVNTRS. . : l
LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
IUB/SHOWERS . . . . :3 LAUNDRY 1"BAYS. . . : l CATCH BASINS. . . . . . . ..0
WA I LR CLOSETS. OLWER. LINE:. ( ft ) . :0 GREASE 'TRAP'S. . . . . . . :0
DISHWASHERS. . . . : 1 WATI•_R I__INE ( ft ) . : 100 OTHER FIXTURES. . . . . .0
(3AHBAUE DISP. . . el RAIN DRAIN (f't ) . :0
WASH I NO MACH. . . : 1 SF= RAIN DRAINS. . i1
MECHANICAL ___.__..__.._._._.--___._____.._.--_-_.______..._._._._____ FEES
l=1JFL TYPES-_..._____._.._-.._. UNIT HTRS. . :O type amot_int by d,-.At recpt
/GAS/ / / VENTS . . . . . :fit TIF= f 1`50. 00 JF 12/18.'/94 -
lr)AX INF'UT:O BTI VENT FANG. . :4 SWM f 1,30. 00 JF 1x'/1.2/94 -
r-URN: ( 100K . . :0 HOODS. . . . . . : 1 5WM $ 100. 00 JF 12/12/94
i URN ) -i 00K . . : ) WOODSTOVES. :0 BPR T t 6,.'B. 00 JF 11:/18_'/'34 -
I LUUR FURN. . . . :0 CLU DRYERS. : 1 BPL.0 f 408. 20 KAR 11/28/94 94•--2509"3.
Lilt_/CMP' ( 3HF-':0 OTHER UNITS. I B5PC f :.31. 40 JF 12/liR/94 -
GAS OUTLET'S: l PARK f 500, 0111 JF 12/18,/94 -
]wner : ....._ -.-•---..._. ..__________..__.__.--M1'RT f 45. 40 JF 1;:_/ 12/94
3RUC[_ ALLEN MPLC 11. 25 JF 12/12/94 -
16E390 NW WATERFORD WAY M5PC f 2. 25 JF le/12/94
:3BTH f 225. 00 .JF LE/12/94 -
PORTI_ANI-) OR `371:29 F-15PL f 1 1. E5 JF 12/ 12/'34
Phone #: 614-0545 EROES f 64. 00 .TF 12/lE/94 -
Corltr•ar_tot-: -- -_- -__.._____._ ...___.___._.__..___..._ _._._ERPV f ."0. 80 JF 121/12/94
BRUCE ALLEN WOOD HOMES INC ERPF..; f . 12. 80 JF' 12/12/94
:_.927 5.1 TIERRA DFL MAR
W--AVERTON OR 97007
1hone #:
98£3c1
f 3797. 95 TOTAL
his pereit is issued si,blect to the regulation, contained in the - ------- REOUIPE D INSPECTIONS - -- -
`igard Municipal Code, State of Ore. Specialty lodes and all other Foot/for.lnd In�-10 Fir,eplac-e Insp
aoplievIe lawt. All work will be done in accordance with approved Post /beam Str!'ct bas Line Insp
plans. This pereit will expire if wo-k is not stared within 188 Pact/Ream Mecman Inst.ilation Insp
days of issuance, or if work is suspended for Bore than 1�0 days, Plm/'Ancis;lab 111sp Gyp Soar-d Insp
PI. M/Underfloor Rain drain Insp
t'er•mitteanicaI InRsp Water 1_ine Insp
r - pl,.imb lop U!1t Appr/Sdwlk Insp
F. raminq Insp Mechanical F incl
MITI ret !Mt-pect !011
CITY OF TIGARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PERM I T
13125 SW Hall Blvd.Tigard,Oregon 97223481199 (503)639-4171 PERMIT SWR94-0-401
--41 1 DATE ISSUED: 12/12/94
PARCEL: 2SI04CA-09300
TE ADDRESS. 13644 SW TAMAWAY LN
SUBDIVISION. . . , : HILLSHIRE ZONING: R-7 PI)
LAI UCV1.. . . . . . . . . . : LD T. . . . . . . . . . . . . :09 31
TENANT NAME- - :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORK. . . :NFt4 DWELLING UNITS. . : I
I-YPE. OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. -.sf
I-lemarkst PATH I
Uwner,: FEES
BRUCE ALLEN type AMOIAnt by date v,e c.,p i
(181io Niel WOTERFORD WAY PIRMT $ 2200. 00 JF 12111 /94
-
INSP $ 35. 00 JF 12/
V,OHILAND (-.;IR 97229
Pl-iorie #: 614-0545
CONTRACTOR NOT ON PILE
---------------------------------------
#- $ 2235. 00 TOTAL
REGMIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewet, Ir)spection
of the Unified Sewage Agency. The permit wires 160 days from
the date Issued. the total amo-int paid will be forfeited if the
cervit expirps. The Agency does not guarantee the accuracy of the
side sewer laterals, If the sewer is not located 6t the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given, If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
Oev—riittee biijt ,ti.tv,e
isslie(I t3y :
Call for inspection 639-4175
INU
City of Tigard Residential Buildina PermitVp�licatic a --
13125 SW Hall B;vd. l/(� I �l��
Tigard, OR 97,'23 `j
(503) 639-4171
Jobsite Address: 12. TAr-Aw fY I-A
Subdivision: Lot # _ 93 Office Use Only
Planck/Rec # _
Valuation: I /V
Permit #
Corner Lot? /-�� N
Flag Lot? Y N Reissue of
Map & TL
Owner: /3,eucAE /aeC.r.-j w000 AI&M,-s, z,..c . — Approvals Required
Address:
Plannin
o.�T �dr1O O/- �-
Engineering
Phone: G `/ - 0,)~Y-) `_.� _ Other
Contractor: A s
— -- ------ Items Required
Address. — Subcontractors
- ------- --- Truss Details
Phone: Other
Contractor's License #
(attach copy of current Oregon license)
Contact Name & Phone: 132u CSC GJ000
(12(
j 0 CPI l'e'i � 2 1
Subcontractors: Architect/Engineer: d-x,)7A
(Plumbing: T�^ 1 �'� ^��Z-J� _ _ Address: a�
lYMechanical:S",-3G4
�_._.
(attach copy of current OR Contractor's License)
Phone.
JOB DESCRIPTION •5/::X
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�- l�pplicant Signature & Phone cumber
Received by: L4,�U,� Date Received:
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N WORDTOMDW MESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) 6.2Y -,(./ /1
Plumb. Permit (PLUMB) 2)' 71� ✓
Mech. Permit (MECH)
State Tax (TAX) N o
Bldg:
Plumb:
Mech: Z
Plan Check (PLANCK) /q' S 1(P.3"'.
Bldg:
Plumb
Mech:
Sewer Connection (SWUSA) u�� `� pZc� U
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) D $vu
Storm Drainage Chg (SDSDC) _
Residential I-IF (TIF-R) _
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) " j aqv_
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Y
Water Quality (WQUAL) _ A-V
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPLAN)
Erosion PlanckJCOT (EROSN)
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