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9415 SW 74TH AVENUE � Imo' � � �► � � � R - 9415 SW 74TH AVENUE - AL ., CITY®E TIF R CERTIFICATE OF COMMUNMY DEVELOPMENT DEPARTMENT CMOFTWARD OCCUrANCY 13126 SW Hodl Blvd. P.O.Sm 23397.Tigmm,Or"m 9=16031 an.4,176 R- M.T.T +#. . . . . . . . MS- T9 )--&-?03 D. T37 1.5711 't4)5 !3W 74i1-1 AVE PARCEL: ISi1251-,18-12100 SUBDIVISION. . . . : PARTITION PLAT 90-6 Z(:)141NGc R-4. 5 BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . CLASS OF WORR. xNEW T'Y;-'-'E OF USE- 35F OCCLJPA19CY ORP. :R3 OCCUPANCY LCOAD: 116 4 TENANT NAME- R e ma 1,k s Ow FERNWOOD DEV. INC 8150 SW MAPLELEAF ST PORTLAND OR 9722M t:11ro11ot 0' (1'1.4A,-12.!,3 Cant ractor.: FERNWOOD DEVELOPMENT, INC. rll'50 5W MAP'-FLEAF ST i-'ORTLAND OR 97223 Phulle #1 ..44-1233 49276 Lh.t.,LIPWILY Of the abc)-.,p r0fPV-eT)Led bkAj Idl fig is hereby given, avid cortifies the compliance with i,"J-1e pit,Atp r)f OV-QY(31-) Specialty Codes for the group, ot-4--upotnuYl and U-SP Wider which the -9fVt'er)uod permit was js%#-sed. F1 'qL DEPARTMENT Mt DING INSr-'ECTOW--'­--"" PaL i)I'l 4G F I C 1.AL PO!:",l' IN CONSP11--tJOUG) ,r. INSPEC.ION NOTICE City of Tigard Building ase,artment. 13125 SII Pall Blvd. Tigard, Oregon 9722.3 Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171 Inspection: �— ----- - '- Foot Inq Plbg. Underalab Mech. Rough-in Appr/Sdw]k round. Plbg. Top Out Gan Line FINAL: Poet/B.aam 3truct. San. Sewer Framing /� Aldg. Post/Beam Mech. Rain Drain Insulation -Plumh. Plbg. Underfloor Water Line Gvp. Bd. -Koch,. Date Requested: [� --- _. -_T � ��- PN Address:,-� Builder _, , I �7?1Gtr ---- _ i THE FOLLOWING WRRECTIONS ARF. REQUIRED: �Zfy ��NC:c L7 �r,��• c: f-�-^�rY rc 5. �PYI2c�ilk„ A r"i� , ---- -'t'- - - - Inspector: -%' r _ — ate:� ��. --iAPPROVZD DISAPPROVED — APPRh"/P.D SUBJECT TO ABOVE Call For Reinsp. �a► w w w w w w w INSPECTION NOTE City of Tigard Building Departament. 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (RecfO-Phone): 639-4175 Busi.neee Phone: 639-4171 I nsp.3ct ion: Footing bg. Underslab hech. Rough-in Appr/Sdwlk =._ Pound. Plbg. ':op Out Can Line FINhLt Post/Beam Struct. Ban. Sewer Framing -Bldg. Post/Beam hech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. Date Requested/c, - 'time: i__AM _PM Address• Permit 0: flu ldor• /LAG•• THE FOLLOWING CORRECTIONS ARE REQUIRED: r 1 � IVAO 17 ) ALjij (0- 1 � "-A Pcd- 1 /' LQ 1 417 V' Inspectors._. ♦ __—APPROVED ^ `DISAPPROVED APPROVED SUBJECT TO ABOVR. _Call For Rainsp. W w INSP$CTYON NOTICE Y�' ' City of Tigard Building DePArtment 13125 SN Ball Blvd. Tigard, oregon 97223 Inspection Line (Rer_-O-Phone): 639-4175 Business Phones 635-4171 Inspection: ------•-- --- -- — --- Tooting Plbg. Underalab Hoch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINALa Poet/Beam Struct. San. Sewer Framing -Bldg. -Plumb�� PoetInsulation./Beam Hoch. Rain Drain plbg. Und.arfloor Nater Line Gyp. Bd. -Hoch. Dater Roqueeteds �� - _ Time: Permit 1: Addrwee• t �j �/ THE FoLLONINO CORRECTIORS ARE REQUIRZD: Inspectors APPROVED — DISAPPROVED !T APPROVED SUBJECT TO Ago" r Call For Rainap. IN P-$BCTION N(YrICE city of Tigard Building Department 13125 Sit Bell Blvd. Tigard, Orego n 97223 Inspection Line Rec-o-Phone): 639-4175 Business Phones 639-4171 I nspec:t ion z_ Footing Plug. Underelab Mach. Ro•gh-in Appr/8dwlk p To Out Gas Lino FINAL% Found. Plbq. Post/Beano Struck. San. Sewer Framing -Bldg. Pon�!Aeam mech. Rein Drain Insulation -Plumb. Plbq. Underfloor Nater Line Gyp. Bd. -Meeh. Time: AM ---PN Date Requeetedt, Permit ft Addreta4z � -- Builders„ TB1: FOLLOWING CORRELR'-ONB ARE REQt:IREG: ( 2 , � �� � VUc.�C L\ —l� v►�C`r'� �1.�1"�'C tic, .� j4t1_`- -4, �_� �� APPROVED 01 PROVED AVItOVED SUMMIT TO ABOVE 11 For Aeinsp. M W W ! ' 1! w HISTORY: VIEW UPDATE DELETE ESC View comments for selected iters 6AMASTER PERMITaArfiAAAAAaAAfiAAa3aAAAAaaaaaaaaaaAAaaaaaaaaaaaaaAAaaaAaAAaaAAaAAC • :MST90-•0203: PROJECT:BOULEVARD HEIGHTS : STATUS:I : UPD:01/16/91: :LDP; ° • PERMITTEE:FERNWOOD DEV. INC PRIM. . :MST90-0203: e • SITE ADDRESS:9415 SW 74TH AVE 66 CASE. HISTORY &5&&Aa€is614&dh&aAhahadSAReq/SentfiSchd/DueSEnd/DoneaaByAStat&b$C A705 Foot/found InBp 08/22/90 KS APP e A705 Foot/found Insp 08/23/90 GS PASS ° • A707 Wtr Proofing BBm't Walls ° A710 Post/Beam Insp 09/20/90 KS DIS a ° A710 Post/Beam Structural 09/21/90 KS APP A711 Post/Beam Mechanical 09/21/90 KS APP ° A71.3 Crawl. Drain 11/22/90 MS PASS ° A715 Plm/undBlab Insp 09/18/90 MS PASS o A717 PLM/Underfloor 09/18/90 MS PASS A718 Ftng Drain Hsm't Walls A720 Mechanical Insp 12/7.6/90 KS APP ° A722 Plumb Top Out 10/29/90 MS PASS A725 Lraming Insp 12/06/90 KS DIS ° A726 Framing <REINSP> 12/26/90 KS APP e ° A730 Fireplace Insp 12/26/90 KS N/A aaaAAaaAAafiafiafiAAafififiAfiaAAfiaAfiaAAAaa3aaAaaaafiadfiAAafiAaSaaaaAfi3AAfifiaaAAA5Afia: aa:: HISTORY: VIEW UPDhTE CELETE ESC View comments for selected item UMASTER PERMITfifiAfi�fiAfififiAfifiAfififi$AfififiAaAfiAAAfiaEiAAAAfiaaaAaAfiAafiaaAAfifiaaaaA3AAaAC • :MST90-0203: PROJECT:BOULEVARD HEIGHTS STATUS:I : UPP:01/16/91: :LDF: ° • PEPISITTEE:FERNWOOD DEV. INC PRIM. . :MST90-02.03: • SITE ADDRESS:9415 SW 74TH AVE 6A CASE HISTORY AAafifififiaAhhhh&&Ahghhhh&hReq/Sent&Schd/DueAEnd/DoneaaByAStatb$Al� ° A735 Gas line Insp 12/03/90 KS APP A740 Insulation Insp 12/26/90 KS APP ° ° A745 Gyp Board Insp 11/19/90 KS DIS A755 Rain drain InBp 11/22/90 MS PASS A760 Water Line Insp 11/22/90 MS PASS A765 Appr/Sdwlk Insp 03/08/91 CWV PAIL ° A770 Misc. Inspection 09/24/90 KS APP ° A795 Mechanical Final 03/08/91 KS DIS A797 Plumb Final 03/06/91 MS PASS ° ° A799 Building Final 03/08/91 KS DTS ���A�5fifiAF�f g�hFif�Sat�hk�AgSf�b�iF�4FiAfififi53fif�S�Aa�A�F�bb6t45b�1�3fifibt�3a�bfibfifidAfififi.5b8b�fii INSPECTION NOTICE City of Tigard Building Department 13125 BW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41, Inspection:_ — -- Footing Plbg. Underalab Mech. Rough-i„ Appr/Sdwlk Found. Plbg. Top Out Gas Lina FINAL: Pont/Beam Struct. San. Sewer Framing -Bl�lg i Poet/Beam Moch. Rain Drain Insulation -Plumb. Plbg. UndF,rfloor Water Lina Gyp. Bd. -Mech. (� y/ Date Requegtedd: Z��Ie `/ -/ Timet /\�A�M) �PM Address: S / }!2 Permit -�(/ Builders TBE FOLLOWING CORRECTIONS Nn REQUIRBDt 12, Inspectors 'i / _ Datet / �_APPROVBD ^_ DISAPPROVRD APPROVED SUBJIICT TD ABOVE Call For Rainsp. INSPECTION NOTICE 1 City of Tigard Buildiay DOpartment l 13125 SW Ball Blvd.. Tigard, Oregon 97223 Inspection Line (Rea-OAPhone): 639-4175 Business Phone: 639-41 Inspec:iion= -- Footing Hlbg. Undsralab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out OasLine FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line uyp. !d. -Mach. Date Requested: /,;w '-3 _TiAatS AM PM nddreon._ �L 1 i�?L- Pir�mi£ It ��' �� U•� Bu i Lder: THE FOLLOWING CORRRCTIONS ARE REQUIREDt Inspsotors . oats:_/, APPROVED DISAPPROVED Z___AMPD SUBJECT TO ABOVE Call For PoLnsp. qw INSPRCTION NOTICE city of Tigard Building 6epa-tgw-nt 13125 SW Hall Blvd. Tigard, oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 ---- Footing Plbg. Undurslab Moch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Lino FINALt Post/Beam Struct. Sewer Framing -Bldg. Post/Roam Mech. Rain Drain insulation -Plumb. Plbg. Underfloor Nater L Gyp. Bd. -Hoch. Date Requested: Timet _4_AM _PM Addreeat / z/� Permit r:�G Builder: �D - THE FOLLOWING CORRECTIONS ARE REQUIUD: U/ 7 Inspectoe� AP}A011=D DISRPPPOVRD __- APPROVRD SUBJECT TO ABOVE V Ca:1 For Relnsp. I INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested Time A.M._ P.M. Permit Address - Owner Lot # .—____ —"� BuilderThe following Building Code deficiencies are required to be corrected: -- i I Presented to /Approved i Inspector/ Disapproved Data CALL FOR REINFACTION El YES 0 NO INSPECTION NOTICE City of Tigard Building Department j P.O Box 23397 1 igard, Oregon 97223 / Phone: 63E!-4175 Type of Inspection _ ���� ;�_____ Allay- Date Requested '<�y '- � Time� Address ---- r // —__�1 Permit Owner .�__ Lot # BuilderThe following Building Code deficiencies are required to be corrected: Presented to �KApprov,d Dat ecto► __L" [IDiv. pproved Date � �^ CALL FOR REINSPECTION Cl YE• C7 NO W W1`W � tir INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 f fes,4-- Type of Inspection --- !/)) ,5.�.�/*� Date Requested Tim/L� .M. _P.M. Address / ? �/ -- ----— -- --- Permit #_ 3 P/), Owner - Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to R-Approved Inspector _ / ❑ Disapproved Date Ty CALL FOR REINSPECTION ❑ YES ❑ NO X s�L INSPECTION NOTICE S� BGG City of Tigard Building Department LC�l� IP.C. Box 23397 Tigard, Oregon 972.23 ( Phone: 639-4175 Type of Inspection Date Requested- 7 -`y Time _A.M._ P.M. Address ���� 7 �.:' Permit Owner_ Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to _ -------__ -- y(J Approved - Inspector [\� Disapproved Date — CALL FOR REINSPECTION ❑ YES ❑ NO 1W Wto t isM' INSPECTION NOTICE City of Tigard Building Do�,arlment P.O. Box 2?397 Tigard, Oregon 97223 Phone: E-9-4175 Type of Inspection Date Requested 3 ��_ Ti P.M. Address ._ i Permit *—L;Ie c� Owner _ Lot # BuilderThe following Building Code deficiencies are rpquired to be corrected: Presented to _ 0 Approved Inspector ___—.___ _ -_. ❑ 01lnpproved Date _ CALL FOR R, ;N'PECTION YES J NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 ✓� "- Phone. 639-4175 Type of Inspection Date Requested. Timv-6', -)q P.M. Address -- -e Permit *a Owner ------ Lot # Builder . The following Building Code deficiencies are required to be corrected: dLe ZM0 IaLIC 7Z CIL;f A i Z- Presented to Ai-xpproved Inspector y L j Disapproved Date CALL FOR REINSPECMN El YES 0 No 'TY MASTER PERMIT COFTIGARD C1i1f OIF TIGAIgD PERMIT #. . , « . „ . : M 5 r':l 0-0 t'03 COMMUNITY DEVELOPMENT DEPARTMENT aeEoon PRIM. PERMIT #. : 115T'1t!i i%ls:?�7:3 19125 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon 97223.{W3ISN417s � DATE ISSUED: 06/26/90 ).[TL 01)DRE5S. . . : ':/41C, SW 7 4 1 i 1 0 V L - - - PARCEL: IS125DB-•4300 SUBDIVISION. . . « : BOULEVARD F•IEIGHTS ZONING: DI...00K. . . . . . . . . . : LOT. . « . . . « . . . . . . : 1.8 _._._......._....._._......_........._.................__.._._ BUILDING .._._.._._._..._.. _..._. ....._....._.._...__- -__...__._..._.._._._.._........ R%:::I SSUE.- DWELLING UNITS: 1 BASEMENT. . . . . .. . . 40 Sf C11I_013S OF WORK. -NEW 11-DRMS:3 BATHS:(2 GARAGE:. . . . . . . « :400 sf• T'Y1::'E:. OF' USE. SF FLOOR REQUIRED -- TYPE OF CONST. .-5N FIRST. « „ « : 1620 sf LEI::T. ., : 15 ft RIGHT. :20 ft OLC,UPANC:Y GRP. :R3 SECOND. . . -.0 sf FR0NT. :20 ft REAR. . :26 ft STORIES. . . . . . . v I 'THIRD. . . . : 1620 Sf REQUIRED _.._......_..-_....._._ .._ ._... HEIGHT. . . . . . . . .. 1E1 ft TOTAL.-••_•••••••.•.•••••.:0 sf SMOKE. DF:T•E (,TDRS. :Y FLOOR LOAD. . « . :40 psi f VAI...UE . . . . . $: '75240 PARK I.NG SPAC:Ei:S. . :0 Fiema'rFr.s: ..__.._._._. _._...__._.._. _.._.._...._._..__. PLUMIfIN[i _._..___.__....._.._.....__....__ ...._.._._..._....._._....__.___....._,...._._.__.. G T N K 7. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFI-014 PRE:.VNTRS. . ::0 1 (-)VATORIES. . . . . ..2 WATER HEATE:RS. . . : .1. 'T'RAPS. . . . . . . . . . . . . . ..0 'rl.11x/SHOWERS. . ., . :2 L..A1.)NDRY TRAYS. . . .0 CATCH BASINS. . . . . ,. . :„0 WATER CLOSET S. . :2 SEWER LINE: (ft;) . :0 GREASE: T'RAPS. . ,. . . :0 1)1'311140 SHE RS. . . . . 1 WATER L3:NI.:: (ft) .. - 100 OTHER FIXTl.1RE:(:),, GARBAGE" DISP. « . : .1 RAIN DRAIN (f•t) . :0 WASHING MACI•i. . . : 1 SF' RAIN DRAING. . : :I. ME:C H A N 1 C.A l_ __...__.._ ___. ._._. __.._.._.._ .....___......- FE:E::c, ._....._........ _...._......_.... FUEL TYPEr;_........_...._.__.__...__ UNIT HTRS. . -.0 ty fie ant04.111t by d�At •rec pt /GAS/ / / VENTS . . . . . :0 PAYM $ 1.00.00 ,I'LH 06/0.1/90 201;:375 MAX !NPI.I'T :0 1:+T U VENT F:ANS. . ::3 BPR'T• $ 361. 00 F'URN < 10011, « « : 1. HOODS. . . . . . : 1 BPLL $ 234. 65 F•URN ) -1.0014 . . :0 WOODST'OVE S« :0 B5E•'(: $ 18. 0'°i FLOOR TURN. . . . :0 CLO DRYERS.. : :i. STDG $ 600. 00 ! ! LOIN._/CMP < 3HP:0 OTI••IE::R UHTTf:i:O SSDC $ 250. 00 GAS OUTLETS: 1 PARK 4 250. 00 Owl-ter: _...._.._._.._..___.._. .__......___._.__.._....._._._._..._._.._....___._.__.. MPRT $ 36. 00 I E:1--�NWOOD DEV. INC I*IPLC; $ `1100 11150 SW MAPI...E"L..EAF ST M':PC: $ 1. 80 PPRT $ 117. 50 I'OR t'LAND OR ':372 2;.•t E151."(., $ 5. 88 Ptiolte #: 244 1233 PAYM $ .1.*783. (:l6 ,ILH 06/26/90 C'olttriAc:to•r: ___...__._...._._.._.__..._......._.....__._.._...._.._.. ._._._.._ W.I.LL.IAM 60DW3:14 F'ERNWOOD DE::V. INC, 1''(:) BOX 2:31 :07 T:I: 1ARD OR 97223 0000 F'I•tcine #: 503- 244-1233 Req #. . : 49276 _....__......._.._...._..__...._......._........._..... -___._._...............__._..__. $ 1.883. 88 TOTAL This permit is issued subject to the regulations contained in the - - REQUIRED INSPLC;TIONS --- Tigard Municipal Code, State of Ore. Specialty Codes and all other F urat/ 's;'t7d Insap P11.1nib 'Tap O(.(t applicable laws. All work will be done in accordance with approved Wtrr Bsm Framirtq :Crisp plans. ]his permit will expire if work is not st�-ted within 180 F'(:xwt/E'-;nm I11sp F: i-replar--e .[lisp days of issuance, or it wort• is suspended for more than bB days. Crawl Drain Gas L.i.t•te Inssp F'Im/(.(ndslab Insp Irist.11atioii I1-1sp I•'crmi.ttPe 9i1411r:11,11Y'k? � F'I...M/Uriderflaor Gyp Braa•r(l ]:lisp I triq Dra:irt Bsm' t Rain dratirt Inssp I si s L1 er d B y: w_____....._.._.._.....__._.._._.._......__.._..._........_.... I*I a r_h a t-t i.c_a 1 :[lisp Water 1-111L- t n st p Call flat :irxs;pect:iori - 639•-•4115 -- I SEWLR CCINNECTION HERMIT CITYOFTIGARD ., _ ., . �. . .._ . CrtYOFTg i�4RD FERMI T a» . . . » . .. : SWR70 0218 COMMUNRY DEVELOPMENT DEPARTMENT + r-�R1M. �FRMT'T ti» : MS'T'`30- (��?03 13125 SW Hell Blvd. P.O.Box 23397,Tend,Oregon 97223�)e�9 j 76 ��` DATE ISSUED: E36/26/ 9 SITE ADDRESS. . . : 9415 SW 74TH AVE:: PARCEL: 31il.251)B 4300 SUBDIVISION.. . . . : BOULEVARD HEIGHT:) ZONING: BLCICK. . . . . . . . . . : TI: NANT NAME. . .. . .. : USA NCI. . . . » . . ,. ., . :k1G28 FIXTURE. UNITS— . -, CLASS CIF' WORK. ,. ,. ::NE:W DWELLING UNITS. .. -.1 TYP,E OF USE. . . . . ..SF NO. OF BUILDI.NGS: 1 INSTALL TYFIE. . . . :BUSWR IMF,ERV SURFACE. .. c :gf Renia-rks: (:I w ri e r: ..._._...______........._---_..._._... ._.._.._._.._.. _.._.._._.._...._._.._. ...................._..___...___ .. FEES F :.'RNWCICID DEV. INC tyl:ae amocc11t by cute rec-pt 8150 SW MAFILELEAF ST N,RrIT $ 1250.00 1:N13,F, $ 35. 00 I'CIRTLAND OR `:3722:3 F,0YI'I $ 1285. 00 JI-Irl 06/26/90 [)licayie N: 244-••1233 Cont-ra ctor: _._._._-.____.._.._....._.._......._____...._.______ _._.._......_._.._. (::(JNTRACTOR NOT ON FILE r:lhone+ 1.285. 00 'TCI'TAL _. ....__-._.. REQUIRED INSt)E:CTIONS ._.__.._..._._ this Applicant agrees to comply with all the rules and regulations Sewer Iiispec,'ctioyi of the Unified Sewage Agency. The permit expires 126 days from the date issued. The total amount paid will be forfeited if the permit eti'pires. The Agency does not guarantee the accuracy of the side sewer laterals. if the sewer is not located at the measurement qiven, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" Permit and the Agency will install lateral. VIP—reit{ ,,„ SirTnattccr +: � 1 t,15 u et d .._ _ __....___.._...__.__. _._.._-_..__�_........._._.._ ..... _._......._....... Cu11 fo-r ivisiper..tic:in 63'i--4175 -IT CES Of- PAYMENT RECE I PT NO. :9 "a 0 A" 4 7 OF` ['IGAPD R[7 CHF::C' l; AMOUNT t :7)(.)ej 0.G 8. F'ERP WOOD DE VE CASH AMOUNT s PAYMENT DATE : 06/26 1 9f. SUSD V IS 1 ON c PORTLAND. OP 1'7'22,-;..... 9415 5 W 7 41H AVE, F-,i_1r;1_ 0GE OF F"AYMENr PA 1: F'L1PF`-'0!L3E OF- F'A'eMENT' Ar101..)NT PAID M 9 0-0 2 0"' _.-6t-.00 PL LJMBI NG PERM 117.rj(.) MECHANICAL PE 36. . 5J. BUILD PEk 25. 73 Fl-All CHECt✓. FE 14•'.65 SEWED IDSA 1250. SEWEP INSPECT STREET SDC 6(:)(,).0() PAPT s 5DC STORM DPA[N SDC 250.Qcl II _f0Tl:-4t_. AMOUNT P�7411. 306G. 06 QIZADING/FR )SI )N CONTROL INFORMATION G=NERAL CONTRACTOR NAME&ADDRESS: CASEFILE NO.: i ) PERMIT NO.: sz i1r� APP i ANT NAME AND AppDRESS: FIcl c'� actw� �� , EXCAVATION CONTRACTOR 1 NAME&ADDRESS: OWNER NAME AND ADD - S; TELEPHONE NUMB RS: � 1 --7 S I'�.*3 96 - -r-1 c%u�. cm nAPPLICANT l,� �� 1 c!tvl �t �l'C!'(C/ I ) PROPERTY DESCRIPTION: f e vl `� C 3 STREET ADDRESS AI`1D CROSS STREET/F�QCATFD OWNER" S V D I-10C( 3" �I� c1 7 q 2� s'� `� 7�! GENERAL CONTRACTOR: C u ' 4 4-I Z �3 EXCAVATION CONTRACTOR: ' 0 '? v�s G-:. l�l 4=2 SITE/JOB: (^-qU i7 -- F5LEGAL DESCRIPTION: 24 IFR/AFTER HOURS EMERGENCY TAX LOT NO.- CONTACT PERSON,TITLE TELEPHONE: - 1/4 SECTION. t \,c� SITE SIZE,ACRES:_ 7 Vic b, DISTURBED/WORK AREA,ACRES__ LOCATION&ADDRESS WHERE SPOILS LEAVING SITE WILL BE TAKEN SITE RUNOFT DRAINSJO:(CIRCLE ONE) (NOTE:PITMM MAY BE EQUIRED) CATCH-BASIN � DITCII. PIPE CREEK (CIRCLE ONE)�I'RIVATE_PRQFERTI(�� -' PUBLIC RIGHT OF WAY EROS,I N EDIMENTAT9N CQNZRQL (ESC) MFASUR.F.S MINIMUM ESC REQUIREMENT'S MINIMUM ESC REQUIREMENTS DURING CONSTRUCTION. FOLLOWING CONSTRUCTION: SEDIMENTAL LUN FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC PERIMETER RUNOFF CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT t ND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES CONSTRUCTION SEQUENCE OTHER--- OTHER _ PLAN FOR EROSION CONTROL.PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK". EROSION CONTROL PLAN DRAWING,AS REQUIRED.HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY PHONE NUMBER, SCHEDULEJSTAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND APPLICABLE.S'T'ANDARD NOTES. I HAVE READ AND WILL COMPLY WTfll THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY TO CONTAIN SI:DIMENI'ON THE CONSTRUCTION SI'Z'E. I OWNER NATURE APPLICANT SIGNATURE . . . « . . . . . . « « « « :: « « « « « « « « « « « « J « « • • • « • Y1 • « • • « . . « « « « « « « « « « « « « « « « « « « . . OFFICIAL USE ONLY. RECEIPT DATE ACCEPTED FEE NUMBER RECEIVED---- BY CITYOFTIGARD ���5 S.W.Hol 9 PIAN afx : APPLICArICx� � r,�- r.o.Box 23397PrAN CIiDCfC I3° '7, ,1 PE0,11T I t%)- (J _ COMMUNITY DEVELOPMENT DEPARTMENT DATF: ISSr.IM JOB ADDR 3S: 015 9 1W ;7-v Gni , 0 TAX MAP/IDT � :?u o SUB: _ IAT: _ ll r _.�- "Z- IAND USE: VAILU7ZON: Tom' f:7,s ,?u cl - -- OhtNIR f - N=SPB JAL N NAME: k Joc REISSUE OF: ADCRESS: sst§ s= lis 1 LAST REISSUE: Y t( Z L FIDOD PLAIN/ SI21SITTVE IAND: PHONE: 74 A- Z12, AUNP VALS 1MU11M CXWrRACTUR P'iANNING: — -- NAI-IE: x'l/1'1 EAG: ADDRESS: FIRE DEPT OIHF-R: PHONE: _ 2 _ RD(7fJIREfl BUILDERS BOARD f: Z-7 ^ EXP DATE: /d 9l-9'0 =/SUDOCNIFAI IUC S: BLIS TAX: _ ARCHIENGINEER CALCULATIONS: -- NAME: c TMW DETAII.S: LL' ADDRESS: -- _ OTHER: 11IUNE: Z 3 _ CY-1IMENTS: /YIGP 4918 /t uta u u�rs.c,Qvx.k �1G?)�u ` (l�o.) l lr _ . r PIM: ! :c i, > MDC3I: l C /U S /h - Pl�aalT 7�1 DESCRIPTION i 3 PD �BhL. DUE Inn -OA0 3 10-432 00 Building POermit Fees _ _ _`�ZL/ 10-431 00 Plumbing Permit Fees f 7,. � _ 1 7. 10-431 01 Medianical Permit Fees ��G, -- 10-230 01 State Dailding Tax (5%) T ��_'� _ �,�.�_1 Buz laing /e . u I'lumbb-bg 5-1 E Medi /, -n 10-433 00 Plans Check Fee -3- 6:5- AD / 3. Building PlI.nnbing Medi _ 3w U a�►S' 30--202 00 Sewer Omnec'tion 30-444 00 Seer Inspecticn 51.-449 00 Street System Dev CharW (SDC) _ 52-449 00 ParkS SySteM Dev ChatVe (PDK:) S U S z 31-450 00 Stf3m Dra 1 naW Syst Dev (1wq (SSDC) _--2--s-Z) 10-230 OG Fire - `* �>a- �.�,,• -�-- RDC if APPLICANT' SIGNAZ[M — -Y lbeoeived By: Date Pwcpdved: of/3587P.WPF