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12414 SW 134TH AVENUE 12414 SW 134TH AVENUE . I x F �r M 3 u, �r N N 1 CERTIFICATE OF CITYOFTIGrAp4v! OCCUPANCY CIiYOFT16r71RD PERMIT N. . . . . . . a BUPS91424 COMMUNITY DEVELOPMEHYT DER*Fa4 f o�noow PRIM. PERMIT N. : 891424 13125SwFWI8W. P.o.8=2M97.Tipad,%Upon o72Y (6W)6394176 �- / DATE ISSUED: 04/12/n0 SITE. ADDRESS- ,, !Ph 14 SW 134TIl AVE. PARCEL_R ''S184AB-13600 SUBDIVISION. . . . a ZONING& BLOCK. . . . . . . . . . : LO1 . . . . . . . . . . . . . 1164 CLASS OF WORK. tNEW TYPE OF USE. . . aSF OCCUPANCY ORP. aR3 OCCUPANCY LOADa TENANT NAME— it it Reamarkst 3 bedroom house plum Jen Owners _.._�__.._____._._..._..._..._........_.__.._..______...__....._. DAN E ANDERSON I 9363 SW AE:AVERTON--HILLSDAL.E: M HWY. BE.AVE FUTON OR 00000 -0000 Phoney N: 000­860­0090 Contractors -______..._._.._._.___....._._.. _..........._._...__. ..__. D. E. ANDERSON INC 936.3 SW BEAVERTON HIGHWAY BEAVERTON OR 97005 Phone N: 297-7666 Rej 0- 1 46344 � Occupancy of the above referenced building is tie-rob), given, and ce•rti f irs the compliance with tho State Of Oregon Specialty Codes for the group, orci.tpanr.y, and use under which the refere red permit was issued. _ - FIRE DEPARTMENT OUILDINf ..SNCVfEi;!'gR AUI NO OF'F'ICIAL POST IN L;ONSPICUOUS PLACE INSPECTION NOTICE Q� City of Tigard Building Department (I�) P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of inspection _ /- i.v Date Requested `J Time--- A.M. _p M AddrPsa Permit #e"t Y `� Owner Lot # Builder 122c A t' p cxj {,h:! +i iC The following Building Code deficiencies are required to be corrected- Presented to _ Approved Inspector -- Disapproved Date %t CALL FOR REINSPECTION EJ YES 0 NO INSPECTION NOTICE City of Tigard Building Department �7 P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 ryp, Ins llion Date Requested_ y_ �'/ Time A.M.�s P.M. Address —�� �J`7 1.� Permit #_ L _ Owner--- A Lot # C�1=�•�-�_ BuilderThe following Building Code deficiencies are required to be corrected: Presented to � � _ _�— Approved _ ;, Inspector f,, � ____ Disapproved Date _ CALL FOR REINSPECTION ❑ YES 0 NO I I i i i i .......... I (- �,✓ INSPECTION NOTIEt OG,,/-J�V � l^ � City of Tigard Building DepartmentL� P.O. Box 23397 Tigard, O!pgon 97223 Phone: 639-4175 Type of Inion - Date Requested—�. �`t'[� Time y.M. P.M. Addressmit Owner__— — Lot #— — Bnilder_ The following Bulling Code deficiencies are required to be correctud: i I Presented to '7 r Approved Inspoctor _ 'Disapproved Date CALL FOR REINSPEMON �( YES I.] NO w I INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397J� / Tigard, Oregon 97223 C C/ Phone: 639-4175 L Type of Inspection Date Requested `�`� Time A.M. P.M. Address Permit # _ Owner Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to P Approved Inspector _ .i [J Disapproved Date CALL FOR REINSPECTION 1-1 yes 0 NO INSP,$CTION NOT! E City Tigard Building partment P.O. Box 2W7 Tigard, Orep6n 97223 Phonw 4139-4175 Type s ction 11 N -U,--L Date Requested Time A.M. P.M. Address -3V Permit Owner Lot Builder The followi,ig Building Code deficiencies ar-i required to be corrected: 4�F A 4d/— 17E;,4 FrJ,6-ES Presented to Approved Inspector F Disapproved Date CALL FOR REINSI ;''TION O YES "j vo INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection 1 — ---. .-- -- ---- Date Requested �/ " C > Time A.M. P.M. Address y�`� �� — Permit Own-r / Lot # Builders r ��Z -- Thfollowing Building Code deficiencies are required to be corrected: _�'r_w(a�sC. .tf t el - e a Presented to _ _ rT"Approved Inspector _ ❑ Disapproved Date CALL P'OR I" 'INSPECTION ❑ Y28 ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested. 'O q Time_ A.M. P.M. Address �17 �y��'r _--_.__ Permit Owner _ Lot # _ Builder The following Building Code deficiencies are required tc be corrected: i' Presented to _ _ --�' � � Approved Inspector r _ Disapproved Date �/' CALL FOR REINSPECTION 1 YES 0 NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested ��� Time_,L� A.M. P.M. Address L�7_-�, ~--- ---_�— Permit Owner_ — Lot # Builder The following Building Code deficiencies ara required to be corrected: f j-v Presented topp A p roved Inspector _ ❑ Disapproved Date — CALL FOR REINSPECTION ❑ YES fl NO fi I Wff INSPECTION NOTICE City of Tigard Building Department P.O, Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection 't ) Date Requested A./ - 26 Time X/-- A.M. P.M. Address Permit Owner Lot Builder The following Building Code deficiencies are required to be corrected: A4 Presented to e. rApproved Inspector 0 Disapproved Date CALL FOR REINSPECTION El YES 0 No I� I INSPECTION NOTICE C;ty of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 L Type of Inspection '1921 �� / tt- , ��) Date Requested -..z Z/`(f rime. ti A.M. P.M. Address Penait Owner_ Lot # BuilderThe following Building Code deficiencies are required to be corrected: Presented to Inspector _ ...y. Approved L1 f�---11 Disapproved Date —_ l<� - CALL FOR REINSPECTION YES Ll NO I INSPECTION NOTICE City of 1 igard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested !� Time A.M. P.M. Address �.c�_�!/L�__f �r/�� Permit # 1 Owner_ Lot # Buildar 22L'd'zCe'rz The following Building Code deficiencies are required to be corrected: Presented to _—_ i Approved Inspector ,� _ Disapproved Date CALL FOR REINSPECTION ■ INSPECTION NOTICE City of Tigard Building Departr.gnt P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested 'e'6�- Time G7 P.M. Address Z' !Zlz!!� Z3 Permit Owner Lot Builder The following Building Code deficiencies are required to be corrected: Presented to Plipproved Inspector EJ Disapproved Date CALL FOR RErk-spaTION 1-1 YES I I NO — BUILDING PERMIT CITYOFTIGARDPERMIT NO. : BU891424 CITY OF TWA RD COMMUNITY DEVELOPMENT DEPARTMENT OREGON TE ISSUED: 9/15/89 13125 S.W.Hall Blvd-0.0.Box 23397,Tigard,Oregon 97223,(503)639-4175 P I M.PMT.NO. 891424 JOB ADDRES: 12414 SW 134TH AVE TAX MAF'/LUT 2S14AB SUB: MORNINGHILL LT:164 PK: LAND USE: R25 LOT SIZE: VALUATION: $ 90,232 SETBACKS FRONT: REAR: WORK CLASS: NEW DWELL.UNIT9: 1 LEFT: RIGHT: USE TYPE: SINGLE FAMILY NO.BEDROOMS: 3 EXT.WAI_L CONST: CONST.TYPE: VN NO.BATH: : 2 N: S: E: W: OCCUF'.GRP. : R3 FIROT.OF'ENINGS: OCCUP.LOAD N: S. E: IOTNI_ AREA: 1926 NO.5TORIES: 1 1ST: ROOF CONST: C FIRE RET? HEIGHT: 14 2ND: AREA SEPAR? RATED: BASEMENT? 3RD: OCCUP.SEPAR? RATED: MEZZANINE? BASEM'T FLOOR LOAD: 40 GARAGE: 689 FIRE SPRKLR? ALARM? FLOW(GPM) DETECT'? YES HEAT TYPE: GAS HDCP.ACCESS? CORi,? PLAN CHECK BY: bcr nEMARY,S: bedroom house plias den REISScE OF NO. LAST REISSUE FEES: w O ANDERSON DAN f PERMIT 1406.00 N 9363 SW BEAVERTON-HILLSDALE PLAN REVIEW $263.90 R beaverton Or FIRE DEPT R STATE TAX $20.31 OTHER C DEVELOPMENT CHARGES: N FINDERSON DAN F. SDC(STORM' $250.00 T ML2DOWBROOK DEVELOPMENT SDC(STREI '600.00 R '9363 SW BEAVERTON-HILLSDAL-E PDC(N1 ) $250.00 A C beaverton or 97006 PREPAID ( t10H.00) T PHONE (503) 297--7666 n R REGISTRATION NO. 46344 TOTAL: $1,690 .20 L_ - RECEIPT NO. This permit is Issued subject to the reg.11atlons:onteined In Title 14 �F of the TMC. State of Oregon Specialty Cudes,zoning regulations and all other applicable codes and ordinances, and it Is hereby REQUIRED INSPECTIONS agreed that the work ,Ill be dodo In accordance with the plans and FOOTING SEWER specifications and In compliance with all applicable codes and ►FOUNDATION WALL RAIN DRAIN'S ordinances The issuance of this permit does not waive restrir.tivE , covenants Contractor and subcontractors shall have current city POST x BEAM WATER LINE huslness tax permits This permit will expire and become null and PL B.UN DERSLAB CITY APPRCH,"5W void if work is not started within 180 days.or If work is suspended or SLAM FI NAL ahandoned for a period of 180 wys any time after work has PLB. 1OP0U1 commenced It shall be the responsibility of the permittee to assure FRAMING all required inspections are requested and approved F IREPLACE GAS LINE INSULATION GYP. BOARD Permittee Signature lss,led By EALL FOR TMSPEETi43 4-639-4 ---- 1 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE fair W WSf Wlm CITY OF TIFA SEWER PERMIT RD PERMIT NO. : SE8914:;3 CITY TWARD COMMUNITY CIEVEL OPN�ENT DEPARTMENT "'� TE ISSULD: 9/15/89 13125 S W.Hall Blvd.,PLO.Sox 23397',igard,Orogon 97223,(503)639-4175 P I M.PMT.N0. 891424 f JOB ADDRESS: 12414 5W 134TH AVE — USA NUMBER: 39057 TAX MAP/LUT 2G14AB SUB: MORNINGHILL LA :164 BK: LAND USE: R25 LUT SIZE: SECTION: 4 TWP: s RNG: w WORK CLASS: NEW USE TYPE: SINGLE FAMILY The applicant agrees to comply with all rules and regulations of the Unified f�ewerage Agency. The permit expires 120 days from the date issued. The total amount paid will be forfeitpr+ if the permit expires. The Agency does not guar- antee the accuracy of the location of the side sewer laterals. If the sewer is not located at the measurtvt_nt given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the i •stalle•r shall purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral. INSTALL. TYPE: BUILDING SEWEK IMFI RV10US AREA: FIXTURE UNITS:T ': TENANT IMPROVEMENT: NO DWELLING UNITS: 1 NO. OF BLDGS. : 1 [FEES: O W ANDERSON DAN E PERMIT N 9363 SW BEAVERTT'-NILL-SDALL CONNECTION CHARGE 41 ,150.00 R beavertan or LINE TAP INSTALL. _---_--_-_ -- - OTHER C O N ANCERSON DAN E T MEADOWPRUOK DEVELOPMENT A 9363 SW BEAVERTON-H1LL.SDALE C beaverton or 91006 T PHONE (583) 297-7666 RI RLGISTRAIIUN NO. 46344 TOTAL: $1,285.00 This permit is issued subject to the regulations contained In Title 14 RECEIPT NO. cX .3574 of the TMC. State of Oregon Specialty Codes. zoning regulations and all other applicable codes and ordinances, and it Is hereby REQUIRED INSPECTIONS agreed that the work will be done In accordance with the plans and ROUGH—IN Ispecifications and In compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive Icovenants Contractor and subcontractors stall have current city business tax permits.This permit will expire and become null and volu if work Is not started within 190 days.or f work Is suspended or abandoned for a period of 190 days any time after work has commenced It shall be the responsibility of the permillee to assure all required inspections are requested and approved f PAMea at Signure Issued B - i �rr�tt r(� r �r7s�----- _ SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE C17Y OF TINA PLUMBING PERMIT PERMIT N0. : PL891451 UTnP COMMUNITY DEVELOPMENT DEPARTMENT TE ISSUED: 9/15/89 13125 S.W.Hall Blvd.,P.O.Box 23397,Tigare Oregon 97223,(503)639.4175 I M.PMT.NO._ 891424 JOB ADDRESS: 12414 SW 1341H AVE TAX MAP/LOT 2S14AB SUB: MORNINGHILL LT:164 BK: LAND USE: R25 LOT SIZE: ITEM: NO: NO: WORK CLASSe NEW WATER CLOSET 2 TRAP USE TYPE: SINGLE FAMILY URINAL BKFLOW PRVNTR CON,T.TYPE: VN LAVORATORY 4 TRAP PRIMER OCCUP.GRP. : R3 TUB SHOWER 2 GREASE TRAPS DISHWASHER 1 GARBAGE DISPOSAL 1 NO.STORIES: 1 WASHING MACHINE 1 DWELL.UNITS: 1 LAUNDRY TRAY BLDG.DRAIH (AIA FLOOR DRAIN SINK 1 SEWER (FT) WATER HEATER 1 SFORM/RAIN (FT 100 OTHER REMARKS: 3 bedroom house plius den FE _5: 0 w ANDERSON DAN E PERMIT $132.50 N 9363 SW BEAVERTON-HILLSDALE Rbeavertorl or FIXTURES STATE TAX $6.63 - --__._---_-___-- OTHER C 0 N WOLCOTT PLUMBING CONTR5 1NL. A POBox872 C Gresham OR 97030 PHONE (503) 667--1781 a REGISTRATION NO. 23841 TOTAL: $139. 13 RECEIPT N0. �/.' 1 his permit is issued subject to the regulations contained in Title 14 _ of the TMC. State of Oregon Specialty Codes.Zoning regulations REOUIRILD INSPECTIONS and all other applicable codes and ordinances, and it is hereby agreed that the work will be done In accordance with the plans and PLB.UNDERSLAB specifications and in compliance with all applicable codes and POST K BEAM ordinances The issuance of this permit does not waive restrictive WATER LINE covenants Contractor and subcontractors shall have current city PLB.TOPOUT business tax permits This permit will expire and become null and void if work is not started within 180 days.or if work is suspended or RAIN DRAINS abandoned for a period of 180 days any time after woik has FINAL commenced It shall be the responsibility of the permittee to assure all required inspections are requested and approved Per r ttee Signature _ Issued By eAtt. FOR INSPEC"tw SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE CITY �� TIVA � MECHANICAL PERMIT � , PERMIT NO. : ME891452 GW0f n6ARG COMMUNITY DEVELOPMENT DEPARTMENT �ar'o« TE ISSUED: 9/15/89 13125 S W Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223.(503)639-4175 P I M.PMT.N0. 891.424 JOB ADDRESS: 12414 SW 134TH AVE TAX MAP/LOT 2S14AB SUB: MORNINGHILL LT:164 BK: LAND USE: R25 LOT SIZE: ITEM: NO: NO: WORT; CLASS: NEW FURNACE (100K AIR HANDLR (10 USE TYPE: SINGLE FAMILY FURNACE 10OK4 1 AIR HANDLR 10K CONST.TYPE: Vf" FLOOR FURNACE EVAP.COOLER OCCUP.GRP. : R3 HEATER VENT FAN 4 VENT VENT.SYSTEM BLR/COMP (3HP HOOD 1 NO. STORIES: 1 BLR/COMP 3--15HP INCINERATOR(DOM DWELL.UNITS: 1 BLR/COMP 1C•-•30HP INCINERATOR(COM FUEL TYPE GAS BLR/COMP 30­50HP REPAIR UNITS 1AX. INPUT BLR/COMP 50*HP OTHER 1 IRE DMPRS? GAS PIPING OUTIETS i HIGH PRESS? LOW PRESS? — ---- _— r REMARKS: 3 bedroom house plius don FEES- IN ANDERSON DAN E PERMIT 110.00 N 9363 SW BEAVERTON-HILLSDALE PLAN REVIEW $10. 13 R beaverton or FIXTURES $30-50 SLATE 'FAk $2.03 ---- - --- --— OTHER C 0 r: T FOUR SEASONS HEALING AIR GOND. A POBox66469 C Portland Or 97266 T PHONE (503) /15-5913 REGISTRATION NO. 48283 TOTAL: ♦52.66 RECEIPT NO. A)J ,i,:s—6 This permit Is issued subject to the regulations contained In title 14 _ __ of the TMC, State of Oregon Specialty Codes, toning regulations kEOUIRED INSPECTIONS and all other applicable codes and ordinances, and It is hereby agreed that the work will be done in accordance with the plans and GAS LINE specifications and in compliance with all a,,plicable codes and POST R BEAM ordinances The issuance of this permit does of waive restrictive ROUGH-IN envnnants Contractor and subcontractors shall have current city FINAL business tax permits This permit will expire and become null and void If work is not started within 180 days.or if work Is suspended of abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permillee to assure all required inspections are requested and approved Permittee Signature Issued By — I SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE RF W wffw�w ff-xla���W-AWA CITY OF TKA RD jt PLAN CI(LCK APDLj�CATION 1 cmo�r�cAFM J PIAN CHECK 11 (,�- '`� 3/ ' COMMUNITY DEVELOPMENT DEPARTMENT / PERMIT tt ,r `/ 1yay uer;sw.Faeai.a r.o.ao�zzsv�.1�«do.�o�9�r�•C1��'n / DATE ISSUED JOB ODRESS�� /_'—� S �- I AX MAP/LOT _ SU �.f (OT: LAND USE: V LUATION: - OWNER SPECIAL NOTE'S NAME REISSUE OF:- ----_— ADDRESS: LAST REISSUE: FLOOD PLAIN/ ---- fLb SENSITIVE LAND: PHONE: APPROVALS REQUIRED CONTRACTOR PLANNING: NAME: ENGINEERING: AFIRE DEPT ADDRESS: OTI(ER: �_... PHONE: ITEMS RE UIREO LIST/SU(3CONTRACTORS: AROVENGINEER BUS TAX: CALCULATIONS: ADDRESS: TRUSS DETAILS: PARKING PLAN: —. - LANDSCAPE PLAN_ PHONE: OTHER' -- _ _-- COMMENTS: ---- -11"Awaoe,111162 PERMIT H ACCT N DESCRIPTION AMOUNT AMOUNT PD. (IAL. DU(. 10-432 00 Building Permit Fees v ------ 1.0-431 00 Plumbing Permit Fees ------- _�— 10--431 01 Mechanical Permit Fees _ — - 10-230 01 State (luilding Tax (5X) Rui ldirr) _ Plumbing Mech 10-433 00 Plans Check Fee _ 1 ---- Building Plumbing _ Mech 30-202 00 Sewer Connection — - 30-444 00 Sewer Inspection - 51-448 00 Street system Dev Charge (SOC) __-- 52--449 00 Parks System Dev Charge (POC) 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 10-2.30 09 TRFO _ --- - - - 10-230 06 Washington County Fire NI (95X) 10—VO 00 AmarC9rwood O nPPLlCAN GNAtuRE. Received By: _ ` -- -- Data Received: - co/3587P/l8P U I Y VI• I IUAHU MECHANICAL PERMIT Permit M Description City of Tigard able 3A Mechanical Code _ CITY PRICE AMT - 13125 S.W. Hall Blvd. 1) Permit Fee -0- •0• 10.00 P.O. Box 23397 -- -- Tigard, OR 97223 2) Supplemental Permit 3.00 639-4175 Furnace to 100,000 BTU 1) incl.ducts&vents- 6.00 f�>. Furnace 100,000 BTU + 2) incl.ducts&vents 50 Name of Development Floor Furnace 3) incl.vent 6 00 Job Address - Suspended heater,wall heater Address �� yJy ��,/, /lc�rs f� f��^�� 4) or floor mounted heater _— 800 Tax Lof Map No Vent not incl.in Lof f G Block Subdivision 5) appliance permit 3A0 Name for name of business) 6) Repair of heating,refr ig., 600 cooling,absorption unit Mailing Address Phone 7Boiler or comp to 3 HP Owner ) absorp.unit to 100,000 BTU 8.00 _E'—1y slate Zip Boiler or comp to 3 HP•15 HP 8) absorp.unit to 500,000 BTU t 1 Name - Boiler or comp 15.30 HP _9) absorp.unit' -1 million 15.00 h Mailing Address Phone — 10j Boiler or comp to 30-50 HP 22.50 absorp.unit i -1.75 million Contractor City State ZipBoiler or comp to 50 HP 11) absorp.unit 1,750,000 BTU 31.50 Stele Reg strehon No City Bus fax No 12) Air handling unit to 10,000 CIF P.4 4.50 I herebv acknowledge that I have read Ih s application that the information given is 13) Air handling unit ' SO 1 correct,that I em the owner or autfanted agent of the owner,that plans submitted are m 0,000 CFM + compliance with State laws,that I em registered with the State BuildersBoard,that the 141 Non portable 4 50 numbu,,.van is correci (if exempt from State registration please give reason below) evaporate cooler Vent fan connected -- -- 15f to a single duct y !PO 1(') Ventilation system not included in appliance permit 4 so Hood served by - - - - 17) 4.50 mechanical exhaust Signature towner rx agent)_ Dab Domestic type Describe work Cl addition Cl alteration LI repair O 18) Incinerator t.50 -to be done residential (J non-residential Ll 1 b► Commercial or industnat mr 3000 Existing use oftypeIncinerator--___ - __ __ building or property _ Other i e woodstove,water 20) heater,solar,clothes dryers.etc 4 50 Proposed usu of _ building or property __ - 21) pas piping one to four outlets 2.00 Type of fuel- oil I natural gas LPG ❑ electric ❑ �-' '• 22) More than 4-per outlet NQT!_QE — - - SU&TOTAI THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 SURCHAMN DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF 9111111111-TOTAL 9 4P ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - ----- WORK IS COMMENCED TOTAL Special Conditions ---- - -- -- -- Date issued - --- - - by . r Is t ■r a ItWA P.O.Ibx 23397 CITY OF TIGARD PLUMPING 13125 _cWIbU Blvd. 2�� CR 97723 Applicants must hold Oregon R.glstration to conduct a plumbing PERMIT 639-9175 business or must be property owner/operator not hie ing outside.help. Name of Development ALOI� '. Plumbing Permit No. Address Description .z V/� _(1 V¢=_L�___ �r/f�7(} ORS 814-21.010 DUAN. PRICE AMT. Job Tax Lot Map.No. Address __ -- FIXTURES Lot Hkx:k Subdivislon - - -- -- / Sink 7.50 7 SD Name or name o sines Lavatory _ 3 7.50 7�.`SV Tub or Tub/Shower Comb ' 7.50 ing-A3dross ----_---- Shower Only 7.5u Owner Clry/State - Znp Water Closet -- 7.50 Dishwasher _ Y I 750 7 -----_--�- _----. Pe Garbage Disposal -� _ 7.50 Name Washing Machine_ I 7.50 L� Floor Drain _ _ 7.50 T�aTng A(T�rass - Phone_.. Water Heater _ 7_50_ -2 - f _ Laundry Room Tray 7•.0 Cc,�upant City/State Zip Urinal _ 7.50 --- ams Photie Other Fixtures(Specify) 7.50 - 7.50 ar ingA Phoria 7.50 Contractor City/State - -_---Zip — - - 7.50 MISCELLANEOUS --- City Hue TTax iJo Sewer 1 at 100' 30.00 tate !. tate Sewer-ea.Addd 100' 15.00 (Residential) Water Service 1st 100' _ 20.E I herel,y*(.'knowledge that I have read this application,Hut the 6 dormation Water Service ea.AoiitMr 15.00 --- - grven is correct,that 1 am registered with the State Builds s Hoer J.and also Storm g Rein Draln 1 tp.100' 30.00 nsr have a Stale Plumbing license that the numbers gtvn aro oonrd.Moat all - -- glue.!r+nng wr.-k wie on done in accordance with appacar io provisions of Ore- Storm b P!-tin Drain Addh.100'- _ 15.00 --- gon Revised Statutes Chapters 447 and 693 and sppllc rble codes and that Moate!•tune Spm 25,00 no help will be employed unless licensed urxirw ORS 093 (H exempt from ----- — - State registration,please give reason below) Back Flow Prevention HOMEOWNERS -1 hereby owtify that I am the ownrw of the property de- Device orAnti-PollulionDevice 7.50 embed above,at which location 1 propose to maks a pkrrt*v Installatlon for Any trap or waste Not my own use and thio property In not being corglnxaed for sale,tease or ren" Connecled to a Fixture 7.50 Ca"Basks ^ - ----- -_ - 7.50 kW.of Exist.Pluirnbmg 40.00 Par Hr. Specialty Requaated Inspections t 40.00 Per Hr. -_- -- -- Altar.of Pkxnbkq within _ _—_ -- --- an Existing Bldg 15.00 min - _-- ---- AUTHORIZED SIGNATURE Dal"- Now Bldg.or Build.Addition 25.00 min — ' )DLain,sUU1e famil Describe work new{_I addition(] alteration{-J repair f I r3.ell' 15.00 IQ be dorle resldentialL1 non-reskiential[J Exch ng use of Sue-TOTAL btllldtrlp rx prr>Ewrty ._..- P1tppMd u"of - - Ik KOCHANN t: y ix"g or pmpetty -- - _- TOTAI _ NOTICE - ThM penma beoomos null antivoid M warn or oonwuoticn with"":ed la m1 con mum W*Mhln 190 days w 11 oerrdnictkxu or work is*upend or abandoned s perkxl d 190 dayr alt any sme ellen wok is arxnrnenowl 8MCuu.OONO(T/ptttl Data Isetre•1 by - Meadowbrook Development D.E. Anderson, Inc. 9363 S.W. Beaverton Hillsdale Hwy. • Beaverton,Oregon 97005 • (1503)297-7666 -� Fart i 10 -; nO �� (0 Cir �dy - ,dyK�/r� I , JP 1 rl'-p N 19 1 ,k��[.:� �a.. _ � •'�' .., a .. ,. .r r.....rwrr�.,.�t �ri� 1_n�F,r'-`1•,.hft 1 "•"`'1,.f::`I '_t�•�W N�1� ,' , '# - III! W Aim t `` l Hutt-ac � VI` � i I11 '•��,� to 2 S W m Qww CA x CKuIIIy, > 11 Cr Cr�Zo • r. f c u 0IL ~ NFuj M►.I�`'` u R�y' r ,11InQ[�u v .1 In Al DID Aim Wn It 41f LL � a,N '�. 'iii �`��5��� � [IWM� I I \ '`' I, •i Ari ', • -to W1 Sli 41 a; ' h 1 •,t �'J , ft t ,.�.', J CK 41, n 1 r:a I --1,0•f O (I C1 K n < HCI r. r� �' \ � ;t•! -tit. ,07 Q.u t* I'¢}� !1ll ..of N'I 4-� �rtit0— ^ • ! � 1,/ lei `�' y�� /111 1!4 �n o•-i0 �n .�� �n�r � r r G ko ,. ..at •,n s,. Nu M Wei ►Wny rrt rr i1 r 1[r■ ' � y�, i ��� � •i�►• ¢Nt•,a�N CW+ 1ls�aM�f'• Ff'1M � .�