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INSPECTION y'JTIG 1�
City of Tigard Bui.ldtog Department
13125 BA Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rae-k)-F:ione)t 639-4175 Bcsiness Phone; 639-4171
inspection: s `�f�//7 _
Footing Plby. Unde .lab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet./Peam Struct. San. Sewer Framing
Yost/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. Bd. -
h
Date Roquestedi Time: AM PM
Address:T[ / cz -2 CJ `Permmt 3 ^/J�%`
Builder:
THE FOLLOWING OORRELTIONS ARE REQUIRED:
770
Inapectori t - Date:
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V APPROVRD DISAPPROVE9 APPRM ED SUBJECT To A8OVE
1 / ! Call For Reinsp.
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INSPECTION NOME
City of Tigard Huildi<g Depewtaent
13125 BO Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
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Inspection: �- � ��=�'— �� ,/iTf/
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Footing Plbg. Underalab Hech. Rough-in_) Appr/Sdwltc
Found. 1�4�! ! Gan Line FINAL:
Poet/Ream Struct. San. Sewer _Framing -Bldg.
Poet/Ream Hdch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested& I r ' _ `—Time: AH _ Ph
Address- I_' HIS)-
_ —11/-"
Permit #t
Builder:
THS FOLI.,(YWTN(i CORRECTIONS ARS RSQUIREDt
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' ct,Gala �ri,t Ltl/` .e .l �..•I+A.H-wwY' t,Ic.4-+.-
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Inspectors Datwt �G r �'/
_-_APPROVED DISAPPROVRD APPROVED SUBJECT To AAOVIt
l call For Reinap.
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jSPECTION NOTICE
Ci .p of Tigard Building Departsent
13125 ON Ball Bird. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion: " �.b W 'J (�. l4b 1V�G c i
Footing Plbg. Underslab (!7h—.
eoh.�Pough-i Appr/Sdwlk
Pound. Plbg. Tap Out a&a L1ne FINAL:
Post/Beam Struct. Sar. Sewer Prma ng -Bldg.
Post/Beam Mach. Rain Drain Insulat:Os7 -Pluni:.
Plbg. Underfloor "star Line dd._ -Nech.
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Date Requesteds 3 / 1:%aI --Am ___PN
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Address: PrroLt OL
Builder: /r r�
THE FOLLOWING CORRECTIONS ARE RNWIREDS
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Inspector: \� Data:
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APPROVED DISAPPROVED ► APPROVRO SUBJECT TO ABOVE
-(, __Call For Reinsp.
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INSPECTION NOTICE
�►s City of Tigard Building Department
cm pall Blvd. Tigard, Oregon 97223
a me): 639-4175 Business Phone: 639-4171
In Ir 4, , 30
PC � Iralaks Rech. Rough-fF, Appr/Sdwlk
r
31
Out Gas Line FINAL:
P Framing -Bldg.
InaulatiOn1' -Plumb.
Pibg. Underfloor ater Line Oyp. Bd. -Mach.
Date Requested: �Q �' Times AH PM
Address: 1 + (� O Permit
Builder: _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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_ ��•-�-�. mac-=3� _
Inspectors Date:
APPROVED ✓ DISAPPROVED __ APPROVED SUBJECT TO ABOVE
LeCa11 For Aninap.
JNSP" ION NOTICE t�
City of Tigard Building Department !\
13125 M Ball Blvd. Tigard, Oregon 97223 `✓
Inspection Line (Rec-O-Phone): 639-4175 Businens Phone: 639-4171
Inspections•_ ,—
Footing Plbg. Underslab Hech. Rough-f71 Appr/Sdwlk
Found. Plbg. Top Out Gas Lina FINAL:
Postiheam Struct. San. Sewer erring l -Bldg.
Poet/Beam Hoch. in brain ?n.71.tian -Plumb.
Plbg. Underfloor Water Line Gyp. Bd.r -Mech.
Date Requested(: \ �"'� 7> Ticae= _AM . /y+ PM
Address: 1 b Permit 1: [ y
Builder:_
rh :OLLOWING CORRECTIONS ARE REQUIRED: �" \
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V�L-2LA. s � ' r o C� Uklj �s
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Inspectors �-"-` Date:! l/
APPROVEL DISAPPROVED APPROVED SUBJECT TO ABOVE
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�,(�Y `X Call For Aainap.
INSPECTION NOTICE
City of Tigard Building Departurnt
13125 SW Ball Blvd_ Tigard, Oregon 97223
Inspection Line (Reu-O-Phore): 63x99--4175 Business Phone: 639-4171
Inspection:_ ..r-
Footing Plbg. Underslab Mech. Rough-in Appr/Adwlk
Pound. Plbg. Top Out Gas Lina FINAL:
Poet/Ream Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg,. Underfloor ater Line
Gyp. Rd. -Mecn.
Date Requestsd: �y! Time: AM PM
t !! � S �,t,), c _ Permit .J12
Address: .i
Builder:___
THE FOLLOWING CORRECTIONS ARE REQUIRM
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Inspectors �~` �� Dat'.
APPROVRD DISAPPROVED APPROVED SUBJECT TO ABOVE
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L'--C—All For Reinsp.
INSPECTION NOTICE
City of Tigard Building Departumni-
13123 811 Bfali Blvd- Tigard, Oregon 91223
Inspection Line (Rec-O-Phone): 639-4175 Busine&2 Phones 639-4171
Inspection: y'.
Footing Plbg. UnderelabMc' eih. Rough-i APer/Sdwlk
Found. Plbg. Top Out Gan Line FIRALi
Post/Beam Struct. San. Sewer tramin _ -Bldg.
Pcst/Beam Mech. Rain Drain Insulation y,.='" -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Hoch.
Date Requested: l? f Time: AM PH
- -
Address: � � � Permit f z t'�
Builders
THR FOIZ,OWINO CORRECTIONS ARE REQUIREDI
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Inspector) Datet ��-/ 2-q- 53
"PROM DISAP,PROY[a APPROVRD SUBJRCT To ABoVa
_ t--Call For Reinsp.
�� fyNI SPECfION NOTICE
City of Tigard Building Dep&rt....nt
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Hech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/R7d.,floor
Mech. Rain Drain Insulation -Plumb.
89 dater Line Gyp. Bd. � -Hech.
Data Requested: �1 ! Timet'--AH --PH
Address: h) fl` Permit t:�_
Builder:
THE RO"43WINd COR CTIONS ARE R19 4 t A,,yy
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Inspectors Dates
APPROVED J11�"DI9APPROVED APPROVED SUBJECT TO ABOVE
,���,�_ ✓ Call For Reinep.
CITY GF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd.Tigard,Oregon 97223.6199 (503)639-4171
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Permit No:
Address:
Issued by: Date:
------ ___FOR OFFICE USE
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
under ORS 701.010(7), need not submit this statement. This statement will be
filed with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313:
1 . I own, reside in, or will reside in the completed structure.
A
2. I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. AJ C I My general contractor is _ ,
Contractor registration number
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. B` I I will be my own general contractor.
If I hire subcontractors, I will hire only . ubcontractors registered with the Construc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the office issuing this building permit of the name of
the contractor.
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�- I hereby certify that the above infnrmation is correct and that I have read and understand
- the Information Notice to Property Owners about Construction Responsibilities on the
o? reverse`side of this form.
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nature of mi plicant _ Da
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CONSTRUCTION CONTRACTORS BOARD
0244) 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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(",,TTV OF TIGARD RrCEIPT OF' PAYMENT RECEIPT NO. :93—Z:42062
CHECK AMOUNT 60. 1.3
AME : JONES, t-01:11 & BERTRAM CASH AMOUNT c 0. 00
DDRESS : 1. 1185 SW 7ATH FlAYMFN'r DOT17 07/07/93
SUBDIVISION
TIGARD, OR 97223—.
LL JRPOSE OF PAYW"Nr AMOUNT PAID PURPOSE OF PAYMENT 01WAINT PAID
CHECK FE
SES IDENT IAt_ ADDITION
O'rAt_ AMOUNT PAID -- — — --1 60. t3
CITY OF TIGARD -- RC-.*rFIPT OF PAYMENT RECEIPT No. :93-242479
CHECK AMOUNT n 50;=:. 83
AME. n JONF:S, DOROTHY CASH AMOUNT n 0. 00
DDRESS PAYMENT DATE n ►7/21/93
SUBDIVISION
I.JRPOS1-- OF mymmcr AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
HILDING PERM 78. : 0 PLUMBING PF-RM 43. 00
CHANICAL. PF 3P. 50 ST. BUILD FIER 17. 81
I-AN CHECK FE 1129. 0
111185 SW 78TH
O-TAL. AMOUNT PAID 83
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'CITY ' TI GC111D ���is sw t�,u uNe. (LNCK/RECT #
COMMUNITY DEVELOPMENT DEVAR7 ;E:.NT TiptAOrc"97M PERMIT
(507)63 171 DATE ISSUED
JOB ADDRESS:� �� •1 _� 1� _ TAX MAP/LOT
SUB: _ LOT: LAND USE:
VALUAT-I W. , °`��1 G
T ,
OWNER SPECIAL Kl ES
NAME '�Y \3 Y�1 C�Y1es REISSUE OF:
NAME r _
ADORE S: \,\`!?� `J �� � [AST REISSUE:
�. FLOOD PLAIN/
PHONE: �y o11 SENSITIVE LAND: _
CONTRAC ORL APPROVALS RE�UIPED
NAME: ef4-- h2-f PLANNING:
ADORE ENGINEERING:
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ _ LIST/SUBCCNTRACIORS:
MECH: BITS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONL:
PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIG UR
Received By:. Date Received: ��
PERMIT k ACCT # DESCKYPTION AMOUNT AMOUNT PD. BAL. DUE
rr1.5 3 v�yj, 10-432 00 Building Permit Fees
10-431 JO Plumbing Permit Fees �� •' %'
_ 10-431 01 Mechanical Permit Fees 34.) .31. 571
10-230 Ol State Building Tax (5Y) ---
Building
Building s , �j
Plumbing _- •Z>— /
Me,,:hanicai 1. 03
10-433 00 Plans Check Fee _
Building
Plumbing Mechanical t Z-
10-230 06 Fire
30-2.02 00 Sewer Connection _
30-444 00 Sewer Inspection _
25-448-02 Commercial TIF Fees _
25-448-04 lildustrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (POC) _
31-450 00 Storm Drainage Syst: Dev Chrg
(SSDC)
2.4-445-01 Water Quality (Fee in lieu of)
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24-445-02 Water Quantity (Fee in lieu of)
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LTOTAL.
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