12594 SW 131ST AVENUE ADDRESS:
1:\rcamdsVnicroflm\targclslbuilding.doc
CERTIFIC:ATur OF
CITY OF TIGARD PERMIT #4. . . .00CUPANCY
. . . n M5T93--9564
COMMUNITY VEVELOPMENT DEPARTMENT DATE ISSUED: 02/17/94
13125 SW Nall Blvd.Tigard,Oregon 97223.8199 (503)83C-4171
PARCEL a 2C;104AC'.-0830rL
SITE ADDRESS. . . 12594 SW 131ST AVE
SUBDIVISION. . . . n HORNING WILL .NIS 9 ZONIN8j R-2'_5
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . 1226
CLASS OF WGRK. :NEyW
TYPE OF USE::. . . t SF
OCCUPANCY GRP. 03
3
UCCUPANCY LOAD:c.2 3 4
'TENANT NAW. . . a
Remarks e PATH .1
Owner:
,JAY PIILLER
P 0 BOX 23291
)"I E3NRD OR 97281
Phone #te 684-7543
JAY MH LER
E-'O BCIX 23271
T I GORD OR 97281
Phone ##: 684--7543
Reg 1#. . r• 30109
Occupancy of Lhe above refleretrced building is hereby yi-ien' and certifies
t��p ::omF.:li&ncp with the State Of Oregon Specialty Codes fuer the grouF_11
occupancy, and Lyse under which the referenced permit was issued.
BUI_._ _.' NSP GIR_..._.,___._....__
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POST IN CONSPICUOUS PLACE
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PLUMBING PERMIT
CITY OF TIGARD PERMIT #. . . . . . . : M31-93-9564
COMMUNITY DEVELOPMENT DEPARTMENT DATE SSUED: 11/08/93
13125 SW Hall Blvd.Tigard,Oregon 0722368100 (503)630-4171
PARCEL: 2S104AC-08300
SITE ADDRESS. . . : 12-594 ' I-J l 3 i S1 AVE
SUBDIVISION. . . . . MORNING HILL NO 9 ZONING: R-25
BLOCK. . . . . . . . . . . L01•. . . . . . . . . . . . . :226
---------------------------------------------------------------------------------------------
CLASS OF WORK. . :NEW GNRBAGE DISPOSAL5. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . :0
OCCUPF„ICY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH B^,a1NS. . . . . . . :0
FIXTURES-------------•--- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES— . . . :4 OTHER FIlXTURE9. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :3 WATER LINE ('Ft ) . . . . : 100 '
DISHWASHERS. . . . : 1 RAIN DRFIIN (ft ) . ., . . :0
Remarks : PATH I
OWNER: -----_ ----______ _----------- -----------------FEES---------------
JAY MILLER TIF $ 15PO. 00 PLL 11/Q•8/93 -
P 0 BOX 23291 BFRT $ 440. 50 FILL IJ /08/0>3 -
BPLC $ 286. 33 JLH 11/02/93 93-245660
TIGARD OR 9.7281 B5PC $ 22. 03 PLL 11/08/93
Phone #: 684-7543 SSDC $ 280. 00 PILL 11/08/93 -
PARI'. $ 500. 00 PILL 11/08/9,31
-
Plumbing Contractor:-••----•------------- MPRT $ 45. 0” PLL 11/08/93 -
_ MPLC $ 11. 25 PLL 11/08/93 -
Name : _ (�/ - M5PC $ 2. 25 PLL 11/08/93
Address •_ _- _ PF'RT $ 155. 00 PLL 1 ',/08/93
-
City:_. -V_State :_ _ 115PC $ 7. 75 PLL '. 1/08/93 -
Zip: Phone#:
Reg #:_
------- REQ1_;I RED INSPECTIONS ---------
This permit is Issued subject to the reg-
ulations contained in the Tigard Mi..tnicipal Foot/fou-�d Insp Rain drain Insp
Code, c3tate of Ore. Specialty Codes and all Post/B,,am Struct Water Line Insp
other applicable laws. All work will be dorte Post/Beam Meehan Appr/Sdwlk Insp
in acco�•dance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started FILM/Underfloor Plumb Final
within 180 days of isso-tanLe, or' if work is Mechanical Insp Bui lding Final
suspended for more than 180 days. Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
J r / Gas Line Insp
Insulation Insp
x - _ , i _ GYP Board Insp
F Authorized PIu # ' Cont-actor Signature
-' Call for, inspection - 639•-4175
Contractor Notes : -.
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,INSPECTION NOTICE
City of 'Tigard Building Department
13115 SU Ball :!I -._ Tly--d, Oregon 97223
inspectio:, Line (Rec-O-Phone)s 639-41',5 Business Phone- 639-4171
Inspection:__ (Vf ---
Footing
-Footing :lbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line -JrIN�AL:
Post/Beam Struct. San. Sewer Framing
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line q Gyp. Bd.
Date Regnented: 1 -7 `/� Timet AM
Address,
�Z 7`�^^1,,�,, Ih ^�(n Permit ,J5 I/._e_
Builder:, V
THE FOLLOWING CORRECTIONS ARE REQULRED: 4
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Inspector:_ ✓' Dater
PROVED —__ DISAPPROV3D APPROVED SUBJECT TO ABOVE
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Departaent
13125 Be Ball Blvd_ Tigard, Oregon 97223
Inspec.-tion Line (Rec-O-Phone): 639-4175 Buniness Phone: 639-4171
Inspection:__
Foottnq Plbg. Underelab Mech. Rough-in Appr/8dolk
Pound. Plbg. Top Out Gas Line: CFINAL:
Poet/Beam Struct. San. Sewer Framing -Bldq.
Poet/Beam Mech. Rain Drain Insulation
Plbg. Underfloor Water Line Gyp. Bd. -Hoch..' �
Date Requested: J
I �11M PM
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Address: �2S t �7l(�t � � Permit
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Builders` _&L-
THE MLLE-WINO CORRECTION8 ARE REQUIRED:
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InspectorsDate: Z`
AlPIIDV/D I'--DISAPPROVED APPROVED BUBJECf TO An MX
,` _ C 11 For Reinsp.
JNSPECTION NOTICE
City or Tigard Building Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Lina (Roc-0-Phone): 639-4175 Business Phone: 639-4171
Inspections:-_ — —,—
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation ; -Plumb.
Plbg. Underrloor Water Line Gyp. Bd. -Meet.
Date Requested: � Time AM / (l PM
Address / Z-S 9-// 131 _ Permit
Builder:
,99 FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector,_�f�- ---_ _ Dates_
y APPROVED DISAPPROVED Li APPROVED BURJECT To ABOVE
-
Call For Reinsp.
INSPECTION NOTIcd
City of Tigard Building Department 'A,
13125 nW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:,_ _y —
Footing Plbq. Underslab Much. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Lina vINALs
Post/Beam Struct. San. Sewer. Framing -Bldg.
Yost/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line gyp. Rd. -Mach.
Date Raqunsteds )j. L� / SiMt AM / PK
45t 1 12
Address s 1\2 �'( IL 7-l�7� Permit i s V�
Buildart�! ( _ is j Zd
THE FOLLIDWINO CORUCTION9 AAE REQUIRED:
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APPROIRD DIBAPPROVED '_t4_PPROVED SUBJECT 'ro ABOVE
Call For Reinsp.
NSPBCT�ON NOTICE ��
City of Tigard Building Department
13125 SO Hall Blvd. ^.igard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone; 639-4171
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Inspections
!rooting Plby. Unde_elab Mach. Rough- in J►ppr/Sdwlk
Found. Plbg. Top nut. Sae Line ;FINAL:
Post/Ream .,eruct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Inaul.ation -Plumb.
Plbg. Underfloor hater Line Gyp. ed. /0' leech.
Date Roquesteds_ ___Times
Address: I •i f �«�f _ Permit 1s_�/ '"
Builders..
TAE FOLs..OWING CORRECTIONS ARE RSWIRED#
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Inspectors �" Date!
RPPRO{ISD Di3APPROV6D "APPROVED SUB.IRCT TO AM"
%� Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Departaent
13125 Sq Hall Blvd. Tigard, Oregon 97223
InepeCtion Lina (Rec-O-Phcna)s 639•-4175 Business Phones 639-4171
Inspections
Footing Plug. Underslab Is. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Ls Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mecte. Rain Drain InsulatJ ori -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Koch.
Date Requested: / I� 1�� Time: AM _PM
Address: l L� � � � Permit is r
Builder:
TRF FOIXOWIN, CORRSCTIONS ARE REQUIRED:
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Inspectors � Dato I —%1
APPROVED DIaIlPPROVFD `- APPROVED SUPJECf TO ABOVt
---call For Retnep.
INSPECTION NOTICE
City of 'Tigard Buildil 1 Depart:ant
13125 SR Hall Bled. Tigard. Oregon 97223
Inspection Line (Rec-O-Fhone): 639-4175 Business Phone: 639-4171
Inspection:____
looting Plbg. Underslab ech. Rough- Appr/Sdwlk
Fond. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer ` Framing' -Bldg.
Post/Beam Hoch. Rein Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requesteds /a.� y�� 1^Tuns: AN PH
Address:--- J r /�/C Permit #si3 -91-6 Y
Builder: r
17M FOLLOWING CORRECTIONS ARE REQCIREDs
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Inepsctors
APPROVED DISAPPROVED ACPROVED BUBJRCT TO ABOVE
Call For Peinsp.
INSPECT_'ON.NOTICE
City of Tigard Bsilding Departarmt
13125 Sw Rall Blvd, Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspecti.on:_
Footing Mg. Underel.ab Mach. Rough-in Appr/Sdwlk
Found. �ibq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbn. Underfloor / Nater Lin/e/ Gyp. Bd. -Koch.
Data Requested: l -��f Times AM px
Address: `permit 1= 11173 _`
Builder:
THE FOLLOWING CORRECTIONS MM MQUIP"s
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_APPROVED DISAPPROVED APPRO"D SDR..RC" TO A40"E
Call For Reinsp.
INSPECTION NOTICE
City of Tigard building Depar-taer,
13125 80' Hall 91vd. Tigard, Oregon 9,-23
Inspection Line (Rec-O-Phona)t 639-4175 Business Phone: 619-4171
Inspection:
rooting Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Ream Struct.')/Ban. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Na'f.er Line Gyp. Rd. -Mach.
Date Requestodt i j 1 .) Times AM pN
Address:_1 L� I Permit Et %j
Builder:
THE FOLLOWING CORRECTIONS ARE REQUZRSD:
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Inspectors� (�/ / 1 , Date:_[ �= c;_3
APPf.OVED DI8APPROVRD �. PROVED SUBJECT TO ABOVR
\klk.ck Call For Reinep.
1NSPEr-" ION NOTICF. �\
City of Tigard Building Depactsacnt
13125 SM Hall Blvd. Tigard, Oregon 97223
I.sspection Line (Rec-O-Phone): 639-4175 Business Phcne: 639-4171
Inspections I 1
footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
`foutld. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing --Bldg.
Pos../Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Une Gyp. Bd. -Mech.
Date Requestte✓di ��(D- ( � Tfine: AM ton M
Address I2.��(� I '� I3n1 —jPefyrmit #t:3
Builder; lV�✓IMKJ1 �. �("Y 1 (al I Z
THE FOa.LOWING CORRECTIONS ARE REQUIRED:
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Inspectors Datss_
-APPfA'OVID CIs11PPROVED APPROVED SUBJECT To ABOVE
Call for Reinsp.
LNSPECTION NOTICE
City of Tigard Building Department
13125 RU Hall Blvd_ Tigard, Oregon 97223
Inspection L'_ne (Rec--O-Phone)t 639-417 Buoineon Phone: 639-4171
Inspection: r ll,i ra`7� lot-ti_
Footing Plbg. Underslab dmh. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sorer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underiloor I Water Line�j Gyp. pd. -Koch.
Date Requested s tt II)2I! Z 2 - �/ �igNt u{ pM
Address: Z ' p1 1✓15� -- — Permit -ie
Builders
THE FOLLMIMO (MRRECTIONS ARE REQUIRED:
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� Date:_
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DISAPPROVED APPROVRD SU&T—T TO ABOVE
Call For Reinap.
INSPECTION NOTICE
city or Tigard Building Department V"
L9125 S# Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Rec-o-Phone)r 639-4175 Business Phone: 639-4171
Inspections_
Footing !. Plbg. Underelab Mach. Rcugh-in Appr/Sdwl.c
Plbg. Top Out Cas Line FINALi
Post//Mam $tract. San. Sewer Framing -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line oyp. Rd. -Koch.
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Date Requestedi_ I 17 .j —Timer PN
Addreso: I� I Permitil#e J '
euf Ider i._]A n�
THE FOLLONr NO OORRErTIONS ARF O[RM
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-,APPROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INPPECTION NOT.LCE
City vt Tigard Building Department
13125 8W Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 63S-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lin FINAL:
Post/Beam Struct. San. Sewer: Framing -Bldg.
Post/Beam Mach. Rain nraiAti Insulation -Plumb.
Plbg. Underfloor �Water LaBI� Gyp. Bd. -Much.
Data Requ'e'steds - 0 w _Time: -AM (d"
Q �yA / (d" PH
Adirees: �ct1 7 ✓n1 Permit #t-1�/--Ill
Builder.:' )1A 11 ���Y�-{ 761 1-()-
THE FOLLOWING CORRECTIONS PAR REQUIRED:
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Inrpectort
AFPROVED DISAPPROVED APPROVED SUBJE(.'T To ABOVE
Call For Reinsp.
IN
CITY OF TIGARD
MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . . M S'T93-9564
;3125 SW Hail Blvd.Tigard,Oregon 97223%81?�t4p2�139-fl71 DATE ISSUED: 11/08/93
PARCEL: 2SI04AC--08300
S:.TE ADDRESS. . . . 1:594 SW 131ST AVE
SUBDIVISION. . . . : MORNING HILL NO 5 ZONING: R-25
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :226
BUILDING ----------------------------------------
REISSUE:
---------------------•----------------
RE:ISSUE: DWELLING UNITS: 1 BAGEMENT. . . . . . . . :0 sf
CLASS OF WORK, :NEW BEDR11S:3 BATHS:3 GARAGE. . . . . . . . . . :453 sf
TYPE OF USE. . . :SF FLOOR :4REAS---------- REQUIRED SETBACAS-----•------
TYPE OF CONST. .-5N FIRST. . . . : 12:4 sf LEFT. . : 17 ft RIGNT. : 18 ft
OCCUPANCY GRP. :R3 SECOND. . . :810 sf FRONT. :20 ft REAR. . :36 ft
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED-------
HE I QHT. . . . . . . . :23 ft TDTAL-----•-:2'D-,4 sf SMOKE DETECTORS. :Y
FLOOR LOAL. . . . :40 psf VALUI. . . . . 8 : 102178 PARKING SPACES. . : 1
Remarks: PATH I
_.. ---------------•------------•--- PLUMBING --------- ------------------------------
SINKS. . . . . . . . . . : 1
-------- ----------•-------------------
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . .4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :O
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 1010 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . .- 1 SF RAIN DRAIN3. . : 1
--------- MECHANICAL ------- - -------- --- ------------ FEES ------ --_---- __
FUEL TYPES----------- UNIT HTRS. . :0 type amount by date recpt
/GAS/ / / VENTS . . . . . :0 TIF i 1521. 00 PLL 11/08/93 -
MAX INPUT:O BTL; VLNT FANS. . :4 BPRT f 440. 50 PLL 11/08/93
FURN ( 1O0K . . :0 HOODS. . . . . : 1 BPLC $ 286. 33 JLH 11/02/93 93-24566O
FURN ) =100K . . : 1 WOODSTO.'FS. :0 E45PC f 22. 0:3 PLL. 11/08/93 --
FLOOR FURN. . . . :0 CLO DRYEREi. : 1 SS-C 4 280. 00 PLL 11/03/93 -
B(:)lL/CMP < 3HP:0 OTHER UNITS: 1 PARK 500. 00 PLL 111081'i4
GAS OUTLETS: 1 MPRT f 45. 00 PLL 11!08/93 Owner-: -------- ----_____________.---__..-_MF'LC t 11. 25 PLL 11/08/97
JAY MILLER MSPC $ 2. 25 PLL 11/08/93 -
P O BOX 23291 PPRT 8 155. 00 PLL 11/09/93 -
PSPC $ 7. 75 PLL 11 /08/93 -
TIGARD OR 97281
Phone #: 684-7543
Cant ractor: _______________----------_--.--
JAY MILLER
PO BOX 23291
TIGARD OP 97281
Phone #: 684-7543
Req #. . : 30109
f 32F70. 11 TOTAL
This permit is issued subject to the regulations contained in the --- REQUIRED INSPEC'TION'S ---- -
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Strutt Gas Line Insp
niani. This permit will expire if work is not si.arted within 188 Post/Ream Meehan Insulation Insp
days of issuance, or if work is suspended for morn than 188 days. Plm/undslab Insp Gyp Board In p
�( PLM/UnderfA.00r Rain drain Insp
1 -,,t,mittee Signature% f� _�; L /.Z;;! .�� Mechanical Insp Water Line Insp
`, Plumb Top Out Appr,/Sdwlk Insp
i ,,sued By :� _ Framing Insp Mechanical Final
Call for iI,spection - 639-4175
CITY CSF TIGARD SEWER CONNECTION
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : SWR93-0489
13125 SW Hell Blvd.Tigard,Oregon 97223•81g%41.234j j-1171 DATE ISSUED: 11/08/93
PARCEL: 26104AC-08300
SITE ADDRESS. . . : 12594 SW 131ST AVE
SUBDIVISION. . . . : MORNING HILL. NO 9 ZONING: R-25
BLOCK. . . . . . . . . . . L01. . . . . . . . . . . . . :226
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDJNGS: 1
JNSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Remarks : PATH I
Owner: --------•--------------------•- ------------------------ FEES ------------ --
JAY MILLER type amount by date recpt II
P 0 BOX 23291 PRMT $ 2200. 00 PL.L 11/08/93 -
INSP $ 35. 00 PLL 11/08/93 -
"fIGARD OR 9728)
Phone #: 684-7543
Contractor: ------------------------------
CONTRACTOR NOT ON FJLE
PI-i o n e #: 2235. 00 TOTAL
Reg #. .
------ REQUIRED INSPECTIONS - ------
This Applicant agrees to comply with all the rules and regulations Sewpr Inspection
of the Unified Sewage Agency. The permit expires IN days free
the date issued. The total amount paid will be forfeited if the
permit expires, The Agency does not guarantee the accuracy of the — —
;ide sewer laterals, if the sewer is not located at the measvement
given, the installer shall prospe:t 3 feet in Al directions from
the distance given. if not so located, the installer shall purchase
a 'lap and Side Sewer' Permit and the Agency will install a lateral.
1,er-mittee Signatures`:-
15,sued Bye` — --
ti Call for inspection - 639-4175
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ADDRESS t I L)w I'M 1."►-I'(14LN 1 W4 1 f r ] i
!A-M11IVISIUN
1I,44RD, OR )/2P.3••-
PURPOsr-, OF RA Y MF-N i NMI WN 1 FSA 11.) I-II 11641 F:. 0F PAYMF N i RMt.ItJN f Pi 4,1 1.1
lZJJF..D NG PE:RM 440. 50 PlAIMBINI:i F'F"RM _...__ r1115. 00
Ih1F"CFIANICAL. PE=' 45. AA S'I. BUILD PFR 0,3
i-l. 1 11 (IN CHECK F'FF: 47. '56 SF:.WF R USH f WR9 3•-•11489Pi—loV1. 00
.,I.WF.R I Nc4PFGT• .:35. A0 PARKS 91A, ,'°,v w. AA
ti STORM DRAIN F3i1E:; 2010. 00 1 SIDE.NIIAI.. 1RFIFF- IC: FEES 14tI/I. 00
MASS TRANSIT TIF FF F-,F13 I to. 01A
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1 �`::i94 4;I� 131ST' AV[�NI11
MORNINH H111- 09 /1..111 #i.PE,
f O f 4iF_ $40111111\11 P l 11) - - ) 5^. 5. 1 1
LITY OF TIGARD -- RE-C.'LIPT OF PAYMEN1 J PT NO. 9 3,--.P.4 lif,6 0
l;HV.A;K HMOUN'r v 2.50. 00
NAME MIL.I-.F-Rl JAY 1,A13H AMCK)NI v IA. 1AL4
Pf4YMI--,NI DI-41f I I I VIH/9,�
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TOTAL AMOUNI PAID P-50. 00
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Residential Building Permit_Applieation
City of Yigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
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Jobstte Address:
,Office Use only
Subdivision: ot # 1 l-('
Plan&JRec#
Valuation:
Pen,iit#
Owner: C. Reissue of
Address:
Approvals R-egulred
VIdT �.� p[, r1 �'�k�,1 '
,�.
Planning
Phone:
1 _
Engineering
Contractor: / L
' Other_ _.
Address: !
Items Required
Subcontractors
Phone:
Truss Details
Contractor's License #
(attach dopy of current Oregon license) Other
Subcontractors:
Plumbing: 1-)f- I'1 I,l_^G'_ �"_f` (° �; V 1 ` ;�;. _
—� C/ _
`'r-m0vAt- 7
Mechanical:_ !r9 ;! r i� N I/�G--� ✓Z 7��.ES
(attach copy of current OR G6hiractc s TIcense)
� -biAr, A7 y ' />t�iG/�/7'
ArchitecVEr,glneer.
CL Address:
�- Phone:
J
L
W COMMENTS:
J
17
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Applicant Signature & Phone number
Received by: i �J Date Received: ,// > > j
Permit # Account Description Amount Amt. Pd. Bal. Due
f�fyf y3-_ySG Bldg. Permit (BUILD) •� O.J� 41 /0• )--p
Plumb. Permit (PLUMB) 655, ,' SS. t
Mech. Permit (MECH) 4.5. o� � _ �S• �
Stage Tax (TAX) _.32 .Uj 32-03
Bldg: Ou -U
Plumb: _ ?•7 ?
Mech: .2
Plan Check (PLANCK)
Bldg:
Plumb:
Mech: �- Z
,5(.,g f U Sewer Connection (SWUSA) .22 vU
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSOC) Sd0 / SUo
Storm Drainage Chg (SDSLC) d / •2�U
Residential TIF (TIF-R) v 0
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
LO
Water Quality (WQUAL) _� y
Water Quantity (WOUANT)
Fire District (FIRE)
TOTALS: S O S. C `�� 1z SS di�