14176 SW 133RD AVENUE 176 S 133cd Avenue
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CEPT1171CATE OF
CITY OFTIFARD CfTYOFTWID OCCUPANCY
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COMMUNn'Y DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . A MS191-001(1
13125 SW HWI Bkt P.O.Box 23387.TipM.Oregon 022i'M04W4175
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4.',"'-TE ADDRESS. . . t 14176 GW 1 3R AVE PARCELt 2S109AD---0l'3750,."
SUBDIVISION. . . . THREE MOUHTPIN CISTAYES ZONINGt R--7
BLOCK. . . . . . . . . . .. LCT. . . . . . . . .. . . . . tp&
CLAS'S OF WORK. :NEW
TYPE OF USE. . . 35F
OCCUPANCY (3RP. :R3
CCCUPANCY LOAD:230 4
TEN'ANT IIAME,
Remat-ksi
THE HOULMAN COMPriNY
7@06 SW NYBERRY RD
TUALATIN OR 970Er.:,'
Phone 0: 691-2115
Contr-actorl
THE HOLLMAN COMPANY
7006 SW NYBERRY RD
TUALATIN OR 97062
Phone 0 : 691—S:'115
Rey #. . t 015196
Occupant-*y of the above refervnLed building is hereby givpri, And r-et-tifies
t!,W compliance with thq State Of Oregon Specialcy Godvs FCV' the gV01AP,
rccupar,,—,,, and use undew-, which the i-eferenced pev,mit was issmed.
DEFIAPTMrNT BUILDING INLUICTOR
POI.'*T IN PLACE
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INSPECTIOi1 NOTICE
city of Tigard Building Departssent
131:2S SW Hall Blvd. Tigard, Ore9cn 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing
Poet/Beam Mech. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. <_
Date Requesteds 7- l ` q,- Times _ AN 4--`PM ~
Addresss�/ 7Ci Permit is
Builder: f-�eUlvlj.LI (r�)
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J
Inspectnrs
APPROVED DISAPPROVI►.D _ APPROVED SUBJECT TO ABOVE
_Cali For Rsinap.
1
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INSPECTIOM NOTICE
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-417'
Inspections
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requesteds ( Times _�_<IAM / PN
Address: ��� Permit #6�+/-�a& _
Builder:—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspector �' _ -_
Pen Date: ./
_APPROVED !� DISAPPROVED _ APPROVF.D SUBJECT 7" ABOVE
-Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Departsaent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0- rone)c 639-4175 Buainesa Phone: 639-4171
i
Inspection:—
Footing P1 /Underslab Mach. Rough-in Appr/Sdwl.k
Found. Plbg. TOp Out Gas Line FIN s 1
Poat/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulatior -Plumb.
Plbg. Underfloor Water Line/ Gyp. Bd. -Koch.
Date Requested:_ �� % Time: / AN PM
Address: Z 4/ 39, Permit s! �
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Tnapoctor: i Dates' (e- 2— / ..��
APPROVED DISAPP1lv*) APPROVED SUBJECT TO ABOVE
G)"11 For Rei,nep.
INSPraION NOTICE
City of Tigrrd Buildiag Department
13125 Sit Hall Blvd. Tiqard, oregon 97223
Inspection Line (Rec-O-Phcne): 639-4175 Business Phone: 639-4171
Inspection. --
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
`1
Post/Beam Struct. ,San. Sewer',/ Framing -Bldg.
.r
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. UndarflocrNater Lini Gyp. Bd. -Hoch.
Date Requested: 1Q Time: ,_AMS J) Px
Address: l_1 Pereit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:_, Data: = -
& APPROVED DISAPPROVED APPROVE" SUBJECT TO ABOVE
Call For Reinap.
uuuu . � �U uu U (U
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INSPECTION NOTICE
C cy of Tigard ...,ilding Department c/
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Busi.ness Phone: 639-4171
Inspection: — — —
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out _1_11
Gas Line FINAL:
Poet/Beam Struct. San. Sower Framing -Bldg.
Poet/Beam Mech. Rain Drain insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Nech.
Date Requested: �/' `� / __ Time: AM ro/i. PM
Addrees:� � �� ,(,r% � .!�?J � Permit i:�� �G�✓
Builder:_ ___-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors// —_ .� Data:
APPROVED DISAPPROVED APPROIED SUBJECT TO ABOVE
Call For Reinop.
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwl,.
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requested:�
Addreea' 1411 lG Z 3-
Permit t: z
Builder:__
THE FOLLOWING. CORRECTIONS ARE REpUtRED:
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Inspectors Date:
APPROVtD DISAPPROVED APPROVED SUBJEM TO ABOVE
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Call Pot Rrins;
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INSPECTION NOTICZ
t:ity of Tigard Building pepartnient 1�
t3)2S BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businews Phone: 639-4171
Inspectior:
Footing Plbg. Underalab Mech. Rough-in ` Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. UnderEloor Water Line Gyp. Bd. -Hoch.
Date Requested: �� -���- `% _Times _2 =" PM
Address: I%I26 133"1 Permit #s_e1l
Builder: tFJ L.� 7s�1: J Jam'•
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Vol III , i t ' C':Y, h l`
Inopootor: . C Date:
"PROM -`lIL�IBAPP110V D APPIIOM etldi M 4'O AM"
1 4 "11 Por MiBBp. i
NI SPECTION NOTICE
City of Tigard Building DeparttAmeent
13125 99 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buniness Phone: 639-4171 ,
Inspectiont
Foott.ng Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL: gg
Poet/Beam Struct. Sen. Sewer Framing -Bldg. 9
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line \ Oyp. EA. -Hoch.
i
Dote Requeeteds {�� �— Time: AM PH
/J
Address• 1 G r Permit t:
Builder' �'O�.,L I� C-0
THS FOLLOWING CORRECTIONS ARE REQUIRED:
l� >l of 4d o fz ^'Ccs
L ti1T''1�3,%7�i1J L Lt --_�.:..T=J JZ-AJ
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Inapectort— ---_W ---- --- Date: .���/
APPROVED _ DISAPPROVED APPROVED SUBJECT TO ABOVE
T--Call For Reinap.
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INSPECT ON NOTICE
City of Tigard Building Department r`
13125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)s 639-4175 Business Phone: 639-4171
Inspectlon:,
Footing Plbg. Underslab �Me-ch. Rauqh-in) Appr/Sdwlk
Pound. Plbg. Top Out _ PINAL:
Post/Beam Struct. San. sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. [ -Hoch.
Date yRequesteds L� y' � TLaM/ /- AM PH
/dddrase: r c7 Permit11
Builders__
THE FOLLOWING: WRRECTIONB AM REQUIREDs
__4K - !«;55%ST .'ten �%'S./, �_-
Inspectors — ---- Date 7 �/
#PlRDVED DISAPPROVED _ APPROVED SUBJECT To ABOVE
-----Call For Rainnp.
NS ON NOTICE
City of Tigard '.A:ilding DepartNI..nt
13125 Sw Hall Blvi. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171.
Inspection: —
Footing Plbg. Undorelab Mech. Rough-in Appr/Sdwlk
Found. ��Top Out,
u�� Gas Line FTNALs
Puet/Beam Struct. San. sewer Framing -Bldg. '
Poet/Beam Mech. Rain Dra.n 'tsulation -Plumb.
Plbg. Underfloor Water Line Gyp. Ed. -Mech.
Date Requestedd:_�.el—1 Times X- AM / PM
Address: /J��zeG r Clete Permit
Builder: l
THE FOLLOWING CO IONS AFib REQUINID:
Inspectors.—. ---- -.--- __. Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
----Call For Reinup.
INSPEgTION NOTICE
City of Tigard Building Department
u
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection- __
Footing Plbg. Underslab Mech. Rough.-in Appr/Sdwlk
Found. y�PLbq. Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
i
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lina Gyp. Bd. -Hach.
Date Requested: —Time:
AM PM
Address: L3.L 7� l_3 3 `P6�3 #:
Builder: �-
i'
THE FOLLOWING CO IONS ARE REQUIRED:
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In• 'ctor: /�//n✓'7� Date:_
__APPROVED _ DISAPPROVED APPROVED SUBJECT TO APOV`E"'T—
l`+ Call For Reinap.
KMFAN
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INSPECTION NOTICE
City of Tigard B;tilding Department:
13125 SW Hall Blvd. Tigard, Oregon 97223 r
Inspection LLne (Rec-O-Phone): 639-4175 Business Phor X39-41716
Inspections
looting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
oat/Beam Struct. -, San. Sewer Framing -Bldg.
/Beam Mecn.� Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Nech.
Date Requeated: J Timet PM
Addreaet Permit SIC
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRSDt
�„��j'7IilD /�/2��>; r oi.r .;✓/J[.�� -rz+ udr�iJ S.Gc..
(yJ 1.vSu,.,4jN_e kt a:"5 L� l',7�w�-- /JL S d r'c:vim.✓v �.�
u0 C_ IAd, rz-7�i
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Inspectors Dater
APPiIOVlb DISAPPROVED ROVED SUBJECT TO ABOVE
______Call For Reinsp.
INSPECTION NOTICE
CitY Of Tigard Building Department
13125 M Ball Blvd. Tigard, Oregon 97223
Inspection Line 1(Relc-o-Pho(ne): 639-4175 Business Phones 639-4171
Inspections K
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Pibg. Top Out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beim Mach. Rain Drain Insulation -Plumb.
s
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: �� C1 (
Address s 'J Z`I(y r'` —/ _ Permit f: _
Builder:J\JV�Aa-A,\ o-r
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABM
Call Por Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SK Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone: 639-4175 Business Phone: 639-4171
Inspection: .
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk !!!
found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam !loch. `Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Li Gyp. Bd. `-(loch.
Date Requested: _ f Time: ` AM PN
Address:„_,/L // r — Permit
Builders ��i"-?37 CSL.-��/
THE FOLLOWING CORRECTIONS ARE REQUIP..D:
O f
inspectors Date:_
—APPROVED _ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
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M"!92:ON NOTICE
City of Tigard Building Departenot
13125 EN Hall 07—!. Tigard, Oregon 97223
Inspection Line (Re-'!-O-Phone): 639-4175 Business Ptone: 639-4171
Inspections
Footing Plbg. Undoralab Mech. Rough-in Appr/Sdwlk
-�d• � Plbg. Top Out Cas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lino Gyp. Bd. -Hoch.
Sate Requested: Time: AH c
Address:__ IZ// 7�� 1 r Permit #s
Builder: Lf f(�J
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r
Inspector: . 5 �-- _ -Date t n
APPROVED DISAPPROVED �_ AlPROVDD ECd.fttl TO 11�D1/�
Call Vor Reina(,
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INSPECTION NOTIC
City of Tigard Building Department /I(
13125 ON Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
' ' r
Inspection:
yLF Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Powt/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. n n �VAH
-Kocdr 140
Data Requested: Timet PM
Address: r-d Perm-'.'t
Builder:
TAE FOLLOWING CORRECTIONS ARE REQUIRED:
it! ;c hA�Z.
�' yy ��Ei'.lfJc� r•T,��� '
ever-rz:-
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Inspactors _ — _ Date: AV
APPROVED DISAPPROVED PROVED SUBJECT TO ABOVE
---Call For Reinap.
PLUMBING PERMIT
CITYOFTIFARD PERM TT 1#. . . . . . . : IvIST91-0016
CITYOFTWA
COMMUNITY DEVELOPMENT DEPARTMENT 02100N DATE ISSUED: 02/13/91
13126 SW HWI Blvd. P.O.Box 23397,Tipd,OreWn 97223(503)MAI 76
91TE ADDRESS. . . a t4l:PE, SW i3iRf) 04VE t3109AE3-030010
SUBDIVISION. . . . . THREE MOUNTAIN ESTATES ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2B
CLASS OF WORK. . tNEW GARBAGE DISPOSALS. . : l
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNIRS— :0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 'TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . ..2 WATER HEAIERS. . . . . . : 1 CATCH BASING. . . . . . . :0
LAUNDRY 'TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . t5 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . i3 WATER LANE (ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks :
OWNER-
THE HOLLMAN CrIMPANY PAYM $ 100. 00 JLH 01/29/91 209119
7006 SW NYBERRY RD BPRT $ 548. 00 1,
BPLC $ 356. 20
OR 97062 B5PC $ 27. 40
Phone #s 691-2115 SSDC $ 375. 00
PARK 1 500. 00
Plombinq Contractor---- MPRT $ 40. 50
MPLC $ 10. 13
MSPC $ 2. 03
Addr e s% :1 PPRT $ 162. 50
City : C Stateo P5PC $ 8. 13
Z i p —Ph a n e#s '2-a 3/6 TIF $ 1,350. 00
Rep . . . Additional fees not shown here. . .
REOUIRED INSPELTIONS
This permit is issued subject to the reg -
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Codes and all Post/Seam Struct Water Line Insp
other applicable laws. All work will be Hone Post/Beam Mechon Appv-/Sdwlk Insp
in accordance with approved plans. This PIm/undslab Insp Meuhanical. Final
permit will expire if work is not started PLM/Undprf I oor Plumb Final
within 180 days of issuance, or if work is Mechanical Insp Building Final.
suspended for mora than 180 days. Plumb Top Out Erosion Control
Frokming Insp
Fireplace Insp
Gas Li -ior Insp
Insl;lmtion Insp
Z�( Gyp Board Insp
Authors zov'&'104u46ing ContriVctor Signature
Call for inspection 639-4175
Contractor Notes :
CITYOFTIFARD MASTER P F-RM I T
CITY TIAIRD 1='(c R lel I T tf. . . .. . . .
COMMUNITY DEVELOPMENT DEPARTMENT o�oon o7
13126 SW FWI Blvd, P.Q.Baer 23347,TOW,Oregon 07223(603)630.4176
DATE ISSUED:
I F_" FIDURE-.3S. . . . 141... t•� i :P i, ta',rE PARCEL.
UBDIVISION. . . . : 'THREE MOUNTAIN ESTATES ZONING: R--•7
;31_(JCK. . . . . . . . . . t LOT.. . . . . . . . . . . . . :28
_.______._-_.---------.._____.._______-_.__- BUIL.DING
Rk I SISUE: DWELLING UNIT'S: 1 BASEMENT. . . . . . . . :0 s t
'LASS OF' WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :600 Sf
YP'F_ OF USE. . . -SF FLOOR AREAS-_,_._-__.__.._,_.. REQUIRED SE::TBACKS--.----------
i YP'E: OF CONST. :5N FIRST. . . . : l605 s f LE::FT. . t 15 ft R I GHT. :23 ft
! CCUIDANCY GRP'. :R3 SECOND. . . : 1 u71) ',f FPONT. :20 ft REAR. , : 15 ft
STORIES. . . . . . . :E' THIRD. . . . ..0 sf REQUIRED-____.______
1 it .I GHT. . . . . . . . :30 ft 'TOTAL---_.-.---:-984. S f SMOKE DETECTORS. :Y
I-l.-OOR LOAD. . . . ..40 ps f VALUE. . . . . $ : 145658 PARKING SP'ACE:S. . :0
�?e�mar-ks :
PLUMBING
-T.NKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :4,� PAC"KFL_OW PREVNTRS. . :0
4_P()ATORIES. . . . . .5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
7UP/SHOWE:RS. . . . :3 I.-AUNDRY 'TRAYS, . . : 1 C:OTCH BASINS). . . . . . . :0
WATER CLOSETS. . :3 SEWER I-INE: (ft ) . :0 GREASE TRAPS. . . . .. . . :0
:'I SlAWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTIIER FIXTURES. . . . . .0
rARE3AGE DISP'. . . : 1 RAIN DRAIN (ft ) . :0
WASH I NG MACH. . . : 1 SF RAIN DRAIISIS. . : I
MECHANICAL _-.__. -___._______ _._.._._._____.______,... FEES
i r l.. TYP'E'S-..____-__._.__. UNIT 14TRS. . :0 type .am(II'mt by daat:e r^ecPt.
_As% / / VENTS . . . . . .0 PAYM $ 100. 00 JLH 01/29/91 2@9119
011-J'y INPUT':0 BTU VENT FANS. . : 4 JBPR'T 4 548. 00 / !
t!FtN ( 100K . . :0 HOODS. . . . . . . 1 SP'LC: $ ;56. 20
UR1\1 ) -100K : 1 WOODSTOVES. :0 B`iP'C A 27. 41A J' /
-t_UC7R TURN. . . . 1.0 CLU DRYERS. : I SSUC 4 375. 00 ! /
/CMP ( 311P.10 01'14t.R UNITS:O PARK $ 500. 00 ! /
GAS OU-FLET S: 1 MP'RT $ 40. 50
F r: _ _ _,. _ _.._._.,.... _...._._. .._._.._._......_,. .._ ...._....... MPL.0 $ 1.0. 13 ! I
HE: HOLLMAN COMPANY M5PC t 2. 03 1 I
700f., SW NYPERRY RD I•yF='PT- 4 16,2'. `-i0 /
P5P'C $ 8. 13
1I.101-ATIN OR 97065 TIF=' t 1350. 00
r one #1: 691-2115 BPL_U $ 15. 00 I /
tr,zkot0r,• _,_.._._.._._____ _, _,_-.,._.__..__ ._..,_ _.....__..._ PAYM i 3r_'94. 89 :1LH 02/13/91
+1 HOLLMAN COMPANY
91W NYBERRY RD
L OLP.T IN OR 9706,:
" ,ca n f? t#-: F_,')1-F'115
?r rl #. . 1586
f 33'x4. 89 TOTAL.
This persit is issued subject to the regulations contained in the --- -- PEOUIRED INSPECTIONS ------
?rpard Municipal Code, State of Ore. Specialty Codes and all othew- root/fu-And Insp Fiveplace Insp
anclicable laws. All work will be done i accordance with aper ed Fast/Peam Strt_rr.t Gee, Line Inst
pians. This perotit Mill eNpir! if No started wit 80 P'o5tlE{e!e4m Mecham Inss'_11a►tian Insp
iaYs of issuance, or if work i fine ed ease th @ days. P'1m/,Andslab Insp Gyp Hoard Insp
I0-tJlder•fIaor- Rain dr,axn Iv:ir?
i ,e' mat'tee 1..aiigniat --�►1'erh nrr T Insp Wratp+, L ir,e Trl n
P 11-imb Tap Feat Appr/Sdwlk Insp
ISal.1ed BY : _._._.__-_......__._....___.. F'ra ±rinq Insp Mer_,hanic:Al Final
d4
C_ I f=or i n a�7e�-t .i ort - bey-41 75
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SEWER CONNECTION
CITY OFTIGARD LL f"ERMIT #PERMTT. : 8WR91-001*7
COMMUNITY DEVELOPMENT DEPARTMENT oRmoon
13126 SW HWI Blvd. P.O.Box 23397,TOW,Onigon 91M(6O*6W4175 DATE ISSUED: OE' '13/91
1:
ADDRESS. . . : 14176 SW 133RD AVE: PARCEL: 2SI09AB
'AJBDIVISION. . . . : 'THREE MOUNTAIN ESTATES ZONING: R-7
TALOCK. . . . . . . . . . 91 LOT. . . . . . . . . . . . . :28
TENANT NAME:. . . . .
USA NO. . . . . . . . . . :43174 FIXTURE UNITS. . .
CLASS OF WORK. . . :NCW DWELLING UNII*S. . : l
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
I:NSTALL TYPE. . . . :BUGWR IMPERV SURFPCE. 5 t
Remar-ks:
:1wner,. -------------- FEES
!-FIE HOLLMAN COMPANY type amo%tnt by date Y-0cpf
7006 EW NYBERRY RD PRMT $ 1500. 00
INSP 1, 35. LAO
T uoi A,r1N OR 97062. PnYM $ 1535. 00 JLH 02/13/91
Phone #: 691--4115
CONTRACTOR NOT ON FILE
1'hone #1 1535. 00 12T'AL
Reg #. . 3 REQUIRED INSPECTIONS ------
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewaoo 04ency. The permit expires 120 days from
the date issued. Tnt total amount paid will be forfeited if the
permit erpires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the setter is not located at the measurement
qiven, the installer shall prospect 3 feet in all directions from
I
the distance given. If not so Ijcated, the instal er J:h DUrChar,
al
"Tap and Side Sewer" Permit and the Agency "i* install
a a .?i
i e),Mitt ee Eli gnat'.It-e
Issi..ted Ey : IF
Call or inspection 639-4175
CITY OF TCARD RECEIPT OF PAYMENT RE CF I PT NO. *91---09700
CHECK AMOUNT 48219, 89
KIAME THE HOLI-MAN COMPANY CASH AMOUNT 0. 00
I 'ADDRESS PAYMENT vpm x o2/13/41
SUBD I V I G'f ON
14176 SW 133RD AVF
I PURPOSE or, PAYMENT AMOUNT PAIL) PURPOSE OF PAYMENT OM(.')tJNT' PAID
1--00 16 548. 00
MECHANICAL PL 40. 5, 0 ST. BUILD PER 37. 56
PLAN CHECK FE 281. 33 SEWER USA 1500. 00
SEWER INSPECT 35. 00 RESIDENTIAL TRAFFIC FEES 1250. 00
PARKS SDC 500. 00 STORM DRAIN SDC 37 53. 00
MAS'S TRAN�nll* TIF FEES 100. Q10
-101 AI._ (a110UNT PAfr)
Or TI ` PR #
G
CITY l'O llox 733v7 PERMIERMI If
# C�� 5•� y l� o �'
COMMUNITY DEVELOPMENT DEPARTMENT Tipprd,Oregon 97W
(503)Z9-4171 DATE ISSUED
106 -
JOB ADDRESS: ���' Ste - 3.I*dr 4v-( �-- TAX MAP/LOT,L 7�S l Gr
SUB: CfuLJca _ LOTLAND USE: &
61
VALUATION:
OWNER SPECIAL NOTES
NAME: REISSUE OF:
ADDRESS: _ LAST REISSUE:
FLOOD PLAIN/
PHONE: CG'l l/.`-:� _ SENSITIVE LAND: _
CONTRACTOR APPROVALS REQUIRED
NAME: PLANNING:
�.�1�' l��lllll?/- �-
ADDRESS: `> > ENGINEERING: _
FIRE DEPT:
PHONE: (cell` 2 �L� J OTHER:
CON fR. BOARD : `.�-rZSSG'_�-- EXP DATE: c 2, %� ,/
fLIL-
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: /L;Lc1 7!2-
LIST/SUBCONTRACTORS:
Lit-) MECH: r ' C BUS TAX:
ARCHANGINEER ( CALCULATIONS: _ -
NAME: C` TRUSS DETAILS: _
ADDRESS: I ` _ OTHER: _ --
76' 3S
PHONE: .�_
( � � S
PROPOSED BLDG. USE: ,t Lt L L - ---
COMMENTS: _—
ja
APPLICINt SICNATU E
Received By:
Date Received: .� -1�
fii� � i• i• i• i• i• i i
PERMIT H ACCT # DESCRIPTION
AMOUNT AMOUNT PD. BAL. DUE
r �
10-432 00 Building Permit Fees
S
_ 10-431 00 Plumbing Permit Fees v' 1�2-
10-431 01 Mechanical Permit Fees 4/0.
10-230 01 State Building Tax (5%) J �'S�' 37 S7i
V'
Building
Plumbing u
Mechanical
10-433 00 Plans Check Fee ✓ .3
1/
Building f�
Plumbing
Mechanical 1 U,'�
10-230 06 Fire —'
30-202 00 Sewer Connection
z
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees —
25-448-06 Institutional TIF Fees _
2.5-448-03 Office TIF Fees -
25-448-01 Residential Traffic Fees - 12 )
25-448-05 Mass Transit TIF Fees 00
(1
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
J
(SSDC) ✓'— — --
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL ? -- '---
nm/3581P.WPF
i
C f OF TICARD RECEIPT OF PAYMENT RECE I PT No. 191 -,;?09119
CHECK AMOUNT - 101A. 00
NAINIE 1 ri-w HOLL,MAN CO CASH AMOUNT 0. 00
AT)DRESS 1 PAYMENT DATE 01 I29 1
SUBDIVISION
13346 SW 133RD AVE
PURI-.109E OF PAYMENT AMOUNT PAI D PURPOSW OF PAYMENT AMOUNT PA 11)
Pl..(11,4 CHECK r-E 1--46R 100. 00
1.01
R)fAt.. AMOUNT PAID 100. 00
Building Permit No.
COUNTYWIDE
TRAFFIC IM1DAC,"T FEE Planning File No.
PAYMENT OPTION FORM S':? 2 �, iC l hof
Tax Map & Lot No.
Date
71-� t-L
Project Name
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at ti�is time. Thererore I
request the following (Choose whichever option or options are applicable):
Cash or Check
[ Credit Voucher
ClBancroft or Installninril Payments
and/or
1 The Ordinance allows for deferral of payment of the TIF until issuance of the occupancy permit it the
J TIF i. greater than $5.000.00. If the TIF mee,c this re luirement, I also request this option. I under
stand the TIF must be paid prior to issuance of an occupancy permit. I also understand that the TIF
will be recalculated based on the prevailing rates at time of payment. Please be advised that TIF rates
may increase up to six percent each July 1 st. This rate increase is not subject to appeal.
�� n
( EpAP
- PLICI. OWNER/APPLICANT
C(: Huilding Permd File
Payment Option Notebook form tif02