12755 SW 138TH PLACE i
I
i
ADDRESS:
7456—o'c m3 W /3 g7h
Q
J '
t I:Veoordslmtcrof(niVargetsV)ui(ding.doc
c�
w
J
■
)
G $ LC) § $
r ) ) ) a a
�
V _
}\
a)
_
�
�
J C
W 0
) \
@ z/
\
L g @ G _m
p t § \ § ®
%4.- o a a a \
m
> k
v
Q - $
k f
2
�
@
�
2 �
\
/ Q f k 2
° s k
/ / / ƒ E m
/ Ni u ) u \ §
« j w w d j
N
O1
O
z
o tn o Ln o Ljr)
am am am rn am r, rn r,
NN N N N Cn N
a a a a a a � a
a a a a Q. a rr a X
a m
CL
0
10 v
o >
= J
0 w uU z cn co
x a a a a
N
C m
-i c Ir
WCD
o z
c w
m O
M a
s 0 c1n) 109 a
W a a ai a as
,o o o a
N
i� N
>
_
Y
V
Q r 1n
N a n a
G
a o o a
LL
it
N
r
F-
Jo ami o
'u _� ( (n LL j c
v�
N cc0 N N N�' d
Q d U m I1J llJ m
NM o 0 0 0 0 0
Ln co
i w w w w w w w w
i c
O x �'�p d iV c
c
° ��"oSmpod) oEn
ac (`vcc o
m ° $ (DEQ - € � a�
o m a.� aOiNcma Nn3u) Ln 2-a
M
t9 N me �� C DAD °r c dmm.
V)
4J - to Va mm In
U 'C d N (° E 2� c c� c
LO c° v, 0 ) C Oa N E R D n 0 Q II y (° N a °
CL
Z A fin D) N U)A: M n Y .�.A in (°I m T7'a A N.c
lfI )[) to In In to 0 to 0 in In to to U) N ul to to to
O) O O O) O) O 0) Q) O) O, Q, m O, O) C)
N g tb za N N N;Z: 4
N
CL N N N N� N N Q d O O O C� a O O
F- F- F- F- F- F- V) (1) V) V) (f) (n (1) (n V) V) V) (7 (r) (n
V ca J J J J J J m m W W W IL m (If m m m m r
Q m m m m CO m Y Y C7 C7 C7 U' Y Y Y Y Y
v y
O >
=J
LO
M
Nn 0 0 0N (n (n a a a a Z a s (n w
_ V) 0
�+ o CLa-a a a a a ° ° Q a Q Q ° i ° d a a a a
tf7
CD m
d
C 0 p F- F- (n H F- V) (n (n (n 0 (n 0 (f) (n (n (n (n (n (n
of m In m w Y Y U' ( C7 U' Y 1 Y Y Y Y 2`
'C M
d
C O
f-
N
d) O) ` N a N N
r
N
V
r
d
(o
O
G ` V)
F- c Ex H
'/7 E 1L O
o _
CL T
d a D Q ° -5 n n a
� 9 w in 28 c a 4
C c f9 n �i o n N c c E O N c
J c. a V O n C 'A N N L° O .0 On C C c
(n g a c � � E E c R
LO N to m O N t0 O to (D O r (2 h O N (n in O Ln t()
O O
N O O N M O N (V N (7 of * to t0
0 0 0 0 0 0 n t- (. r- � p- N r. n t- N I. I.
Q a a a a a a a a a a a a a s a a a a a
QF- F- F- F- H F
V) 0 0 V) V) to V) N y m V) V) V) N y to 0 V) 0 0
m
'O N ro
0. O.�C a) a ro m 7 >
O d t6 27 _ O r v b �j - R1 >
V ro C O a) ro O� O rL C ro-5 ro ro O a a p`
a) C ro 8 c (a Q C C a) N 7 0-0 al = C S C 0.
'(O O G C (7 0 't L tp V U ro O ly o
O C al= :tl O Y7 `o U
V Q7 E z U '� p c O C p N N N C N N O a c N
3 oqq VaatN N c roa7 ro 19o `arotw�� °o
0 C%].d U N.N C C C 2] C N O p �N m E `7
m c ro ro 0 w W c "v n a �.v "�� Em y y� ,E $ a
a a rn�o o CD m > -0 ��tk c a E on E ia�l
ak , N� ro
a c CO N C N.c N N O S S Q c C ro p d C a ILI S al Q)N.0
O �c •a N N O .l9 0. i al I m O C S C U .� IA
zxk v4 amEcioXka (mOL 1)) f4n> CMD :Y.=
Unrn rn rn 0 n n m u) In n In co cD 'n
aQ T T 1al O7a) (j) a) m0)
u� in n Ir, ao a Cv C2 (2 0 m co cn cD a3
N N N N N N
0
CC N fn Cn N N =
>' W W W W F- m m m m m f- -7 F- m m F-
CL m U LD r,' C7 U ' Y Y Y Y m m Y Y m m U
M
�d
O
=J
O d a a a a vNi cn zz n v`ni cn cn z z CL
p Q a ¢ a a a a o o a a a a a CL o s d a a s
U)
(7) m
H a
cn v) w Y) m Cn U) U) (f) U) N
c z
U' U' U U` m
M
cO
(� N( N
47
�
U O7 O7 Qf (JI Off] � (T 01 [T 13) O7 O7 0l D1 O Q1 47 w (P (P 01 (L
:: In In In 3 a a r C� ao 63 V C-) rn
0
N N N
0 rn N
a a o a r a a a a s
rj
> o
V
QLO LO In In vl In
N N N N N
O €
ti
y a a
� � O
ro O
C h /
..... N yy�77 In ro CL Cl
In Cf)
ti. C C VI Cpl SCN O Of a z z
c m E a w w c
LIJ EcQ aCn a C
-j cc o ro s v �
_ N
C
Y
L 'v In U. 1:1) ro 0. 7 a ro pl ro 3 G � S N 0, Cpl CI 0
LO d m ani a vUi Ea E n an
p Cl)
g Q c' LL LLU. o t t° Crn w m 5_ W LL tl C7 Q
In t- m o r` N In to In (O o U c7 v Ca In (D (O In In
CV 0) (n 00 07 Q7 O O O O In N N N N N e4 to
ti t- n � O O O Iv t.- I, t- P- 1- t- P t- h tl h h
>_ a a a a a a a a a a t m a a a o a a a a s
F- F F- F F- F- F F F F- F- F- F !- F F F N ►- F- F-
in
2 2 i. 2 2 2 2 2 z Lo ZF 2 z 2 2
V)
al
0
z
3 s O1 6i
m cu in co
C N N
CL N
v
a ui
'o m
CL
vv
_ .J
CD
M
ua, nn- a
O o a
tf)
O) m
0 (7 0 �
7 M
c O O
�F co
N Q Q1
� Q
0 M N N
r
cn
N
�1_ N
U
Q <D
� cb
ui
R
br
CIC }�
vi U
C
>-
7-1 1 O
o
(7 C CC}}
W LL <�
dC ii
OO M LLJ ` LL
Np O
Q F C.
�
)
� LO
k \ \ N/ 0
a a a a e §
S t t t g )
CO m m m m 2
D
,a$
m
ce)
_
�
f y S q
�
6 ƒ ± ±
m
� L \ }
\0 \
2 # \
o
\ / � § /
� $ a
�
@
> j
2
k
k /
C I
E
�
3
1:3 t
§ §
§ / / CL L
{
R % \ ) 6 ) L J
LO A » 2 2& / 2 q
LO w
\ 7 % 7 7 %
A
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-n-Fhcnt): 639-4175 Bucincss Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
r-%.'steam Struct. Plbq. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Lined
Plbg. Underfloor Rain Drain Framing lu
I cr.
Alarm -Wate-014 Insulation Mec
Underflr. Insul. Shear W 11 Gyp. Bd. lect
Date Requested: Time: AM PM
Address:, __ l3 S
Builder: Permit #: 31a:�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
C -
LL
v;
r
J
L -
41
J
ln,p,ntor: Date:
/'-A'PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
`Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation P!bg. Undernlab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb,
Alarm Water Line Insulation -Mech.
Underflr. lnsul. Shear Wa1 ll Gyp. Bd. ect
Date Request9d:: S \ Time: AM PM
Address:
Builder. - �1 q S �2 SL_Permit #: Cis-
THE FOLLOWING CORRECTIONS ARE REQU!RED:
11
L _ _
L
V
J
Inspector:
1_
D
ate: /
_
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Relnsp. J'�
G ERTIFICATE OF
CITY OF T I GAR® OCCUPANCY
PERMIT MST95)-0365
COMMUNITY DEVELOPMENT DEPARTMENT :GATE ISSUED: 01/25/96
13125 SW Hall Blvd.Tigard,Oregon 97223981 P9 (503)639-4171 PnRCEL - :IS I CA4BD--RM026
`311-E ADDRESS. . . : 1,:2755 SW 138T1( AVr-..
SUBDIVISION. . . . : ROSE MEADOWS ZONrNG:R--7
SLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :026
CLASS OF WORK. cNEW
TYPE OF USE. . . :SF
OCCUPANCY GRP. 5 5N
'31CCUPANCY LOAD32
'',-marks : PATH I
JAY MIL!-EA
�, 0 BOX 2:130459
iWARD JR 97281
Phone #.- 684-7543
Contractor:
FAY PITLLER
1---'0 BOX 230459
1 ILGARD OR 97251
"chane #t 684-7543
,,,eq 0. . : 300109
this Lertificate qt-ants occupancy of the above referenced bmildiiig or portion
hhereof and confirms that the 1:),-;ildi,T,y has been inspected for compliance with
he F;tate of Oret
gor) Specialty C.ode, for the gr-otip, occup.Rnay, and ...Ise tindet-
which the referenced per-mit was issui4d.
;IUILDING - r.>u-.I I D X� 6 r;-
� F Ii r_10 1
As PEC
POSiT IN CONE'*I CI OUS PLACE
u.
Ln
MASTER PERMIT
CITY CSF TIGARD PEFMIT #. . . . . . . : 11ST95-01,:3
COMMUNITY DEVELDPMENT DEfCF#'FWNT DATE ISSUED: iiZI/0 :/95
13125 SW Hell:dvd.Tigard,Oregon 97223.819P (503)839-4171
PARCEL: 2S 104BD--RM(bE:6
SITE ADDRESS. . „ . 1"2755 SW 138TH AVEC.
SUBDIVIS7ON. . . . ROSE MEADOWS ZONING: R-7
BLOCK. „ . . . „ . „ . LOT. . . . . . . . . . . . . :026
BUILDING
REISSUE: DWELL ING UNITS: 1 BASEMENT. . . . . . . . :lb S
CLASS ". F WORK—NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . -480 sf
US c- FLOOR AREAS--.__._-__--- REQUIRED SETBACKS--.---___._._.__-
.I-ypiE OF U �E. . . :�F
S LEFT• • :E� ft RIGHT. : 14 ft
F'E OF CONa'F. :5N F'1 RST. . . . :7-��
iiYY SECOND.
sl FRONT. :3,0 ft RE=AR. . :31 ft
b-CUPANCY GR R3 F•1 NBSMENT s 0 5f REQUIRED
STORIES.. . . . . . . :2 : 1704 s f SMOKE DETECTORS. :Y
HEIGHT. . . . . . . . :26 ft TOTAL_.._ _._.___._
FLUOR LOAD. . . . :40 pFf VALUE. . . . . $ : 17991 PARKING SPACES. . : 1
Remarks : PATH I
PLUMEING
SINN.S. . , . . . . . . . : 1. ._.._ FLOOR DRAINS. . . . :0
BACKI=1_OW F='f2EVNTRS. . : 1
TRAPS. . . . . . . . . . . • . . :0
L.AVATORIES. . . . . :4 WATER HEATE:RS. . . : 1
l'UB/SHOWE_RS. . . . :3 LAUNDRY TRAYS. . . :0
CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :1?r GREASE TRAPS. . . . . . . :0
WATERA LOSE . , : 1 WATER LINE ( ft ) . : LOO OTHER FIXTURES. . . . . :0
GARBAGE DISE'. . . : 1 RAIN DRAIN (f'; ) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL -----_______.._____._______._._-----_..-..- FEES
c�- _ UNIT HT!�5. . :0 type amol_ant by date recpt
FUEL 'TYPES------------
/GAS/ / / VENTS . . . . . :0 TIF 1590. 00 JSD 141/01c_'/95 55-: 711 ;9
MAX INPUT- BTU U VENT FANS. . :4 SWM 1130. 00 .JSD 10/0L/9c 95-2-711,31)/93 95-271139
FURN ( 100K . . : 1 HOODS. . . . . . : .1 SWIVI 100. 00 JSD 10/0
FURN > =100K . . :0 WOODSTOVES. :0 BPRT 4722 0101 JSD 1.0/02/9` 95-27113(7'
709341
FLOOR FURN. . . . :0 CLO DRYERS. : i BPLC 310. 70 JD 09/c'S/9r n�-`_711 `'
y
BOIL/CMP ( 3HF':01 OTHER UNITS: I LA5PC 1• 23. 9'd JSD 10/02/9,3 ..,--c �
GAS UUTLETS: i PARK ;P .,Q10. 00 JSD 10/02/95 95-271139
Owner : --IHr'Rl' $ 4.3. 50 JSD 10/02/135 95-27113"')
- -- - MPLC $ 10. 88 JSD 101/02/95 95-271139
.;AY MILLER
P U BOX :.30459 M51-"'C $ 10 JSD 101/thy/95 95-�71 1:�`
3STH 4, 225. 00 JSD 10/02/95 95-2711.39
TIGARD OR 97*2181 P5PC $ 11. 1=.'5 JSD 10/0,P)3 95'271139
Phone #: 684-7543 EROS $ 64. 00 JSD 10/0='/95 95-271139
--
-E P' - $ 20. 80 JSD 10/0.-'/95 95-27113�-,
JAY MILLER --_ _ E:RPC $ 20. 80 JSD 101/0::'i95 95-271139
PO BOX 230459
TIGARD OR 97181
PIhone #: 684-7543
Req #. . :
300109 _-____._.___»._________________.___
$ 3`81. 01 l"OTAL
n This permit is issued subject to the regulations contained in the ------- REQUIRED INSPECTIONS -------
':yard Municipal Code, State of 0Ne. Specialty Codes and all other Footing Insp F'll_tmb Top Ur_tt
applicable laws. All work Nill be ':one in accordance with approved Forrndat ion Insp Framing Insp
paans. This permit will expire if work is not started within 188 Post/Beam 5tr�tct Fir-eplace Insp
days of issuance, or if work i- suspen el! for more than 188 days. Post/Seam Mechxn Gas Line Insp
Crawl Drain Insl-rlation Insp
Permittee Signatr"are : �I PIM/1_ancislab Insp Gyp Board Insp
F'LM/Under•tlour- Rain drsin Insp
15 5 i_t e d
,lei. manical Inst, Water Line Insp
.J
Call for inspection - 639-4175
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Flail Blvd.
Tigard, OR 97223 Planck/Rec. #
Permit # LL1-1
Phone (503) 639-4171 Date Issued 1 E�(1, �
CITY Af TIGARD FAX (503) 684-7297 Issued by
TDD No. (503) 684-2772 — -
Inspection (503) 639-4175
1. Job Address: —� 4. Complete Fee Schedule Below:
Name of DevelopmenI"LI''aL��ows Number of Inspections per pennit allowed
Address 12-ISS 5sw [!� nV c, Service included. Items Cost(oa) Sum
City/State/Zip j ,(Nd VP, 4a. ResidenJol-per unit r 4
1000 W ft or less: $110 u0 ►d l!
Name (or name of business) � _ Fach additional 500 aq It or
portion thereof $2500
Commercial El Residential Limited Energy $2500
Each Manuf'd Home or Modular
Dwelling Service or Fae&r Ebb 00
2a. Contractor installation only:
4b.Services or Feeders
Installation,alteration,or relocalion 2
Electrical Contractor l L 200 amps or leas sea 00 2
Address�33 N E ✓� 201 amps to 400 amps $80 00 2
i �- fo .State ZI 'l12 40' amps to 100 ampmps $18000 2
city kp � 6„7 amps to 1000 amps E1000 2
Phone No. Over 1000 amps or volts $34000 2
Contractor's License No. - 1tiF>C_ Reconnect only Es000
Contractor's Board Reg. No. e1 _ 4c.Temporary Services or Feeders
Installation,alteration,or relocal— 2
Signature of Supr. Elec'n c 200 amps or less Eso(jo
License No. oZ �a�15 Phone No. ( 201 amps to 400 amps EIS 00 2
401 amps to 800 errlpit $10000
over 000 amps to 1000 von@
2b. For owner installations: see•b•above
4d. Branch Circullis
Print Owner's Nac i New,alteration or extension per panel
Address a)The fee for branch circuits with
City i _ State Zip purchaaa of aarylee or 6-L44 r Are.
Each branch circuit $5 00
Phone No. b)The lee for branch circurin with mr
The Installation is being made on property I own which is purchase of smvice or leader.W 2
Est breech circum
not intended for sale, lease or rent. Each
_ $ 00 _ 2
ch additional branch circuit $5 it E5 OC
Owner's Signature 4e.Miscellaneous
(Service or feeder not included)
3. Plan Review section (if required): Each pump orirngationcrrcte $4000 2
Each sign or outline lighting $4000
Signal cucuit(s)or a limited energy
Please check appropriate item and onler tae In section 58. panel,alteration or extension $4000
_4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
System over 600 volts nominal 41. Each additional inapeclion over
_Classified area or structure containing special occupancy the allowable in any of the above
Per inanectron $36 o0
as described in N.E.C. Chapter 5 Per hour -- $s5 on
n In Plant E55 00
isjumll 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
0�
So. Enter total of above foes $
NOTICE 5%Surcharge(.05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtohl $
A AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME. AFTER WORK IS Subtotal $
COMMENCED. ❑ Trust Account# $
Balance Due $op
r
5 - f
Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
13125 S1W Hall Blvd. S r t CZ/
' Tigard, OR 97223 PERMIT# JL—
Phone(503) 639-41710
FAX(503)684.7297 DATE ISSUED_ �� S
TDD No. (503)684-2772 c �
CITY OF TIGdRD Inspection (503)639-4175 ISSUED BY
PLEASE COMPLETE ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
1�-755 svi 13$41" Nit,
Arida; RESIDENTIAL—Restricted Ener Fee. . . . . . . . . 540.00
I G1 �7rr��3 (FOR ALL SYSTEIviS)
Cit State Zip ork Involved:
PERMITS ARE NON-TRANSrERABLE AND NON•REFUNDABLF +,ND EXPIRE IF WORK 2/Audio and Stereo Systems*
IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WC): 'IS SUSPENDED FOR
180 DAYS. urglar Alarm
2. CONTRACTOR APPLICATION Garage Door Opener*
Heating,Ventilation and A'r Conditioning System*
Contractor ✓ YvV ype Vacuum Systems*
•D, a�i f 61161
❑ Other
Address - L 1ss 1
COMMERCIAL—Fee for each system . . . . . . . S40.QQ
(SEE OAR 918-260-260)
Properly Owner _ Check Type of Wok Involved:
Contractor's Board Reg. No. 0 ❑ Audio and Stereo Systems*
1 J C ❑ Boiler Controls
Phone# 1�$v'—�J ❑ Clock Systems
3. OWNER APPLICATION ❑ Data Telecommunication Installations
❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No
❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
City State Zip ❑ Medical
This permit is issued under OAR 918.320.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy Installations(100 vnit amps or less)under thls permit and to do the ❑ Outdoor Landscape Lighting*
following:
1. Only use electrical licensed persons to do installations where required.(Certain ❑ Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other
asterisks(*).All others need licensing). ----
2. Call for an inspection when all of the inslallatinns under this permit are ready
for inspection at 503-639-4175.
' 3. Purchase separate permits for all Installations that are not ready(or inspection ❑ — Number of Systems
when the inspector is out to Inspect under this permit. •No licenses are required. Lice;rus are required for all other Instalhtions
i
4. Assume responsibility for assuring that all corrections required by the inspector
are dnne,and - --
' 5. Assume respnnsihility for calling for a final Inspection when all of the corrections 5. FEES
are completed.
The person signing for this permit must he the applicant or a person a. voter Fees $
a horized to bind a ap licant.
b. 5% SurcEarge(05 x total above) $1� —I"1111A lina®re
TOTAL $ 4
Authority if other than applicant
ENERGAP.CHP
SEWER CONNF_CTION
EIT
CITY OF TIGARD PERMIT #I . ... . . : SWR95--0413
COMMUNITY DEVELOPMENT DEPARTWISIT DPTE. ISSUED: 10/02/95
13125 SW Hell Blvrf.Tigard,Oregon 97223.8199 (503)839-4171
PARCEL: 2SIO'SBD—RM026
SITE ADDRF_S; . . . 12755 SW 138TH AVE-
SUBDIVISION. . . .
VESUBDIVISION. . . . ROSE MEADOWS ZONING: R-7
131-OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :02'6
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITci. . . .
CLASS OF WORN.. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . -SF 1\10. OF BUILDINGS: 1
INSTALL TYPE. . . . :BUS14R IMPERV SURFnCE. . : : sf
Remar-ks : PATH I
Owner-: ----------------•------------------------•-------------- FEES
JAY MILLER type amol_Int by (Date rec_pt
F' O BOX 230459 F'RMT $ 2200. 00 JSD 10/02/95 95-2171139
IhISP $ 35'. 00 JSD 1.0/02/95 95--271139
TIGARD OR 97281
Phone # : 684-754,3
Cont ract ar : -------__________._—_--_--•---_-.—_-
CONTRACTOR NOT ON FII-E
Phone #• 2235. 00 TOTAL
Rey #. .
-- -- -- REQUIRED INSPECTIONS ----- - -
Tl-.is Applicant agrees to comply with all the rules and regulations .Sewer- Inspection
of th, Unified Sewage Agency. The permit expires 180 days from
j ike date issued. The total amount paid will be fog fnited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement _
given, the installer shall prospect 3 feet in all directions fromthe distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and thy Nency, will install a lateral. --
i
F'�r m i ttee Si. 11 at1_Ir'e:
/ Call for inspection — 639--4175
n
J
r
LJ
J
I
a
} Residential BuiIjing permit Application
City of Tigard �(�(�,01, r'-`r �—,v
13125 SW Hai 1 Blvd. S q�{•z5 c
Tigard, OR 97223 y ,
(503) 639-4171
Jobsite Address:
Subdivision:iC)a Meadow_ Lot# �P Office Use Only
y Contact Date / I Initials
Valuation: // 7 �1 (�, Result
New Cnnstruction Only: (Square Footage) �_
Q FlanckiRec # �V �C
House: Garage: 4j8 in Permit # t_�;S 0 (o S
Reissue of
Corner Lot? Y N Flag Lot? Y Map & TL # �� —��,Nly�
it S/r/
Zone
Owner: C,
�I ll r 4 Plat# 31
i _ 11` 1 _If/l
Address: 01 Approvals Required
Planning Setbacks Solar
Engineering
Phone: j�r ,����5�{�" �5 y�
Other
Contractor: Items Required
Address. - �1vY Subcontractors
Truss Details
Other
Phone: L i Notes
Contractor's License # �I�1 --
,dttach copy of current Oregon license)
Contact Name:—
Contact Phone: I -)
Subcontractors:: n , L Architect/Enlyineer:
Plumbing. W v` �(� ,��)`�,`Z7 Address-PD&N_
CL
J�
Mechanical: &
cc
N (attach copy of current OR Co ractor's License) / /,
Phone: j ) (G-�`�l �o " ;0,z3g
I B DESCRIPTI�,N.
W
Applicant Signature i Applicant Phone numbp
Received by __ - ,, Date Received:
Permit# Account Description Amount Amt. Pd. Bal. Due 111111R
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) _ -22S-- -
Mech. Permit (MECH) 43-5-
y3 •S�
State Tax (TAX)
Bldg: _3.q U
Plumb: L _1Z.
Mech: �9,,
Plan Check (PLANCK)
Bldg: _ ��'70 _3�U.1l� -. a-
Plumb:
Mech:
Sewer Connection (SWUSA) Uc>
Sewer Inspection (SWINSP) .3
Parks Dev Charge (PKSDC) - 5610
SUy
Residential TIF (TIF-R) /(� y6)
1 Mass Transit TIF (TIF-MT) ) Z 0 /2�
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0) i
Water Quality (WQUAL) � /Sy
Water Quantity (WQUANT)
11 Fire Life Safety (FLS)
--
Erosion Cntrl Permit IERPRMT) G �y
Eresion Planck/USA (ERPLAN) _
:c
J Erosion Planck/COT (ER:SN) o C14-2
TOTALS: SS(� � , ul
C'ir l
S;l
�- -
k
zo
C3 .
j
.. FF
tj
.. f
rN
lol _ ' I
r � v
4Z.
vi
M 'I
w U
a ui
i
PLUMPING PERIMIT
CITY OF T I GARD PERMIT #. . . . . . .
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 10/02/95
13125 SW Hall Blvd.Tigard,Oregon 97223e6199 (503)6,19-4171 Plf)RCEL:
SITE ADDRESS. . . : 127c'5'-j SW 136TI-1 Co,!-
SUBDIVISION. . . . : ROSE MEADOWS ZONING: P---7
BLOC K. . . . . . . . . . : LOT. . . . . . . . .
CLASS OF WORE:. . :NEW GARBAGE DI5POSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . . 1 BACKFLOW PREVNITRE). I
OCCUPANCY GRP'. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATEP HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :ID
FIXTURES------------- LiAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : 1
SINKS. „ . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :3 WATER LINE (ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN! (ft ) . . . . :0
Remarks : PATH I
OWNER: ------
JOY MILLER TI1= 4, 1590. 00 JSD 1.0/02/95 95-27.113,9
P 0 BOX 230459 SWM 11 180. 00 JSD 10/02/95 95--271139
SW1111 4 100. 00 JSD 10/02-1/95 95--271139
TIGARD OR 97281 BPRT f 476. 00 JSD 10/02/95 95-271139
Phone #: 684-7543 BF-11--c $ 1.-110. 70 JD 09/25/95 95-270930
B5PC $ 23. 90 JSD 10/02/95 95-271139
PARK 1, 51710. 00 JSD 10/02/95 95-271139
MPRT $ 43. 50 J)D 10/0.x/95 95-1217l. 139
Name ,Xer) k�)95 <J-r u A'zw,Iti MPLC $ 10. 88 J531) 10/02/95 95 271139
Address :Lr'.-8e'e --S0q1.2S- 115PC $ 2. 18 JSD 10/02/95 95-271139
C i t y :_1140-f-a_ ---St at e : 3BTH $ 2 C2,5. 00 JSD 10/OE/95 95-271139
Z i P..,-. 7�
— 2
9 1. Phone# P5PC $ 11. 25 JSD 10/02/95 95---271139
R e q #-_._Z.,o
Additional fees not shown here. . . . . . . . .
REQUIRED INSPECTIONS
This permit j.s issued subject to the reg--
ulAtions contained in the Tigard Municipal Footing Insp Insulation Insp
Code, State of Ore. Specialty Godes and all Foundation Insp Gyp Board Insp
other applicable laws. All work will be clone Post/Beam Strurt Rain drain Insp
in n accordance with approved plans. This Post/Beam MechAn Water Line Insp
permit will expire if work is not started Crawl Drain Water Servire In
within 1.80 days of issuance, or if work is Plffl/lAndslab Insp Appt-/Sdwlk Insp
suspencled fov, more than 18171 days. PLM/Underfloor Mechanical Final
Mechanical Insp Plumb Final
Plumb Top Out Building Final
Framing Insp Erosion Control
Fireplace Insp
Gas Line T n s p
t ure
Call for inspection 639-4175
1-0fitrautor Notes :