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is\rcacords\rnicrotlm\targets\building.doc
CITY CF TIGARD CERTIFICATE C1F
COMMUNITY DEVELOPMENT DEPARTMENT t :'K OCCUPANCY
13126 SW Hall Blvd.Tigard,Or Don 07223.8101 (503)830.4171 t 1 4*. . • • • : MC;Tn 4 0
ISSLIED9 0-9/1'-/94
a
SRL L.L: 2S 1 1 1 BD . 0444 171
ci I T C !ADDREE33. . . s 11191:i,��'7 SW PLPPE:RTR[J-- L.N
SLIHI}1VIS10'4. . . . 0N1NG:R- 3. 5
DI_OLK. . . . . . . . . . ... 1-01.. . . . . . . . . . . . . .
C:LIIP"i Orr WORK. s NEW I i
CV'r* OF lJSf`. . . a;3F
I
ncC;Ur:-ANf.;Y GNP. -P3
OCC:UPONCY LOAD 1 ".27 r,
fC::.NANT NAME. . . a +�+
I
R mArks : PATH I
C:Iwr•a r- : ___. _-__.... __._.____ _.. . _ ._.__ ...._-----.._.....
ROYAL- C1AKS DEV CO
1a8r5 '3W PLPPEPTREE
TIGARD OR 97024
Phone #: 639-•4869
Cantractora _-__.. ___._ .. ._ ....._..__ ..._ _.._......._ .. ._......._......__ _.
ROYAL OAKS DEVELOPMENT
96155 '-.)W PEV'r-IERTREE LN
T"PARD ClR 97F24
Phone #: 639--•4669
Reg #b. . E7111
Occt.tparsr.y of the A- ,.love r,eferenr.ed building is her-eby givers, ::nd certifies
the c.omPO- iancP with the State Of Oregon Specialty Codes for the group,
occupmri:,y, And use ttnder which the refer,anc:ed ppy-mit Was tssued.
I<l I L. 03 I N PE:C:T O R
UIL_ . fN FF"IGIAL-
.)'7F
L-.):7I IN CONSP I G"LIOUS PI-AC"-*:
1'
fir` h•• � + •
4M0 nMfWTON NOTICE y! +:•L:.':•. t
city, r�i (Building Depa1U'eeot
13125 p Blvd.. ligand, 'Gi:egon 97223,
IBepectiYn 41ne (- ac Pfic: 1sr% fiJ-4175 Business Phone: 639-4171
Inspections _ �—
Footing , Plbg. Underelab Mach. Rough-in Appr/Sdwlk
•
Fou%d. Plbg. Top Out Gas Line
Rost/Beam Struct. San. Sewer Praaing
Post/Beam Koch. Rain Drain Insulation -Plumb. J "
Plbg. Underfloor Water 'Line Gyp. Bd.V /I `
C
Date Requested: Tilmes PN
Address:^` -f— Bec�it I,_1 _
Bui;ier:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: V `� �� —_-_— Date:
PROVED DISAPPROVED APPROVED SUBJECT TO AAOVE
Call For Reinsp.
INSPECTION NOTICE.
City of Tigard Building Departownt
13125 SW H.i: Blvd. Tigard, Oregon 97223 \'-
Inspection Line (Rec-0-Phone): 639-4175 Husiness lohone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line CFIN Lq
Pilot/Ream Struct. San. Sewer Framing eT q
runt/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. - ec
Date P-equestedt_ 1 `� AM PM
Address: f' Permit t:. VYr d f
Builder: � ' /
THE FOLLOWING CORPECTIONS An REQUIRED:
A a� `vx
vw\,
--- �-
nv_A-x `'tom-=—
Inspector:! `' V" Date:
APPR0l-.0 DISAPPROVED APPROVED SUBJECT TO AROVP.
�_ /�
--Call Por Reinsp.
INSPECTIOd NOTICE
City of Tigard Building Departaent I
17125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buslness Phone: -4171
Inspection:__ -- —
Footing Plbg. Underslab Mech. Rough.-in (Appr/Sdwlk
Found. Plbg. Top Out Gas Line eINAI::
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Ream Hoch. Rain Drain Insulation
Plbg. Underfloor Water L1 /,inne // Gyp. Bd. -Mech.
Date Requested: / I T" ( TbMe! _AN PM
AddressscN /� QP—IU�JPermit f:�/
BuLlder:42 )L - -� �{✓
THE FOLLOWING CORRItCTIONB ARE REQU1REDs
Inspectors Date:_ _
APPROVED DISAPPROVED APPROVED 808JECT TO ABOVE
Call For Reinap.
INSFECTION NOTICE
City of Tigard Building Depsrtmwt
13125 SA Ball Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phonet 639-4171
Inspection: --- -
Footing Plbg. Underslab Hoch. Rough-in � ppr Sdwlk)
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Fram.ng -Bldg.
Post/Beam Hech. Rain Drain Insulation -Plumb-
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requestedt_ '� Time: AM PM
Address: 9 V ? 7 a0 Permit
Builder:
THE FOLLONING CORRECTIONS ARE REQUIRED:
__�-- �_....a._ -- --- --
i
Inspector• _ Datet
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp.
i
I_N1MCTION NO'S ICE
City of Tigard Building Depaz'taent
33115 SN Ball Blvd_ Tigard. Oregon 97223
Inspection Line (Roc-O-Phone): 639-4:75 Business Phone: 639-41'!1
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Founl.. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. Ban. Sewer) Framing -Bldg.
Post/Beam Mech. -Riinn Drain ,J Insulation -Plumb.
Plbg. UnderfloorNat' er Line Gyp. Bd. -Mech.
Date Requestedi__ P - L Time: AM
.�Address: ( )K3 I aPoe'f' lam. .Permit #_,��l�.�L
Bullder:-Y_�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: / � Date:
/ APPROVED DISAPPROVED T APPROVED SUBJECT TO ABOVE
_ _Cell
For Reinsp.
INSPECTION NOTICE
City of Tigard Building Departswint
13125 It Ball Blvd. Tigard, Oregon 972236
Inspection Line (Rer.-0-1)hone): 639-4175 Business Phone -4171
Inspection•------_�_—_��—_�--- ---------- --
Footing r'"bg. Underelab Mech. Rough-in Aplu/Sdwlk
Found. Plbq Top Out Cas Line FINAL:
Poet/Beam Struct. San. S"wer Framing --Bl.dg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Hater Line <Gyp. 8d. -Mech.
Date Requested: I 911 Tim.: AM P!1
Address: C �� L UL Perm it #t/�i
Builders ��[ `
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date• r
PPGOVED DISAPPROVED hPPRO'!ED SUBJECT TO p VE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Lire (Rec--o-Phone): 639-4175 Business Phone: 639-4171
Inspect ton:___ --- -- --- --- --- —
Pooting Plbg. Underalab Meeh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lkne j FINAL:
Poet/Ream Struct. Sar.. Sewer cFraming �✓n� -.Bldg.
Post/Beam Mech. Rain Drain Insulation r' -Plumb.
Plbg. Underfloor 'later Line // Gyp. Bd. -Hoch.
Uate Roquestod:— ) -_ C) ��' �7 Timer TT ( AM _ PH
Address: /Pe itlf�l�i��
Builder: De lf)f--, 'd, I
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: nam:
DISAPPROVED APPROVED SUB.IEr_T To ABOVF�
For Peinnp.
INSPECTION NOTICE C��
City of Tigard Building Depar-tstent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Pec-0-Phone): 639-4175 Business Phone: 639-4171
Inspection: _-_-_-
^j,oting Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out FINAL:
Poet/Beam Struct. San. Sewer ;r-in,-' Bldg.
Poet/Beam Mech. Rain Drain Insulation --Plumb.
PIN. Underfloor Wates Line Gyp. Rd. -Meeh.
Date Requestedi !! ��- �C/ Tibet -_'&_AM PM
e/
Address: %_3 /'Jf��,', /17<e/ / �e CZ1. Pstmit�i=._L_ O�
Builder: (�UQJ� o� KV 4 r�' C/' 4 _- —
THE FOLLOWING CORRECTIONS ARM. REQUIRED:
24-41
f
5 .
kA
Inspector: '.� _ _ �_- Date-_�:�.� ^Ci4
,APPROVED _,L_e-DISAPPROVED __ APPROVED SUBJECT TO ABOVE
J� ___Call For Reinep.
V
INSPECTION NOTICE �
City of Tigard Building Department
13125 SN Ball Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone- 639-4171
Inspection:
Rooting Plbg. Underalab Mach. Rough-in Appr/6dwlk
Round. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requested: Time: h►�-AN/L PH
Address: Permit /: A '/-i —y
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
0� 0
Inspector: Dater
_APPROVED^ ✓DISAPPROVED APPROVED SUBJRcT TO ABOVE
For Reinsp.
�. C
INSPYQTION NOTICE
City of Tigard Building Department.
13125 811 Ball Blvd, Tigard, Oregon 97223
Inspection Line (ROC-O-Phone)s 639-4175 Busineas Phone: 634-4171
Inspection:__ - `SL f,c-, -;----------
Foot 2ng Plbg. [Inde slab Mech. Bough.-In Appr/Sdwlk
round. '_Gas line 'FINAL:
Poet/Beam Struct.i n. _wer Framing_' -.Bldg.
Post/Beam Me-:i. Rain Drain Insulation -Plumb.
Pl.bg. Underfloor Wafter Lino C� / Gyp. Rd. -Hoch.
Date Requested: G �' / Time: T AM PH
Add C0813: �J 7 PPa�,- tp c eA, Per f1
Buil.dar: ck _ elff
THF. FOLLOWING CORKS ONS ARE REQIIRED:
L1AS /Aeee
S
Innpect_or:
____ Date•
_APPROVEC _— DISAPP L APPROVED SUBJECT TO ABOVE
CallFor Reinsp.
INSPECTION NOTIc?
City of Tigard Buildl.ng Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buninese Phone 4-4171
Inspection:_ k_�__„__�
Fout7ng Plbg. Underelab Mech. Rough-in Appr/Sdwlk
FGund. Plbg Top Out Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Dd. -Hach.
Date Requestedds ``�^rl,�q Timet . AM PN
Address: C'-j77rJ �Lyf�/— l✓e e Permit Is
Buildert ✓b b n !� Tr�/trP) Z, 9 9
THE FOLLOWING OORRErTIONS ARE REQUIRED!
Inspector:_ Date:
(/ PPROVED DISAPPROVED _ APPROVED SUBJECT 14) ABOVE
--Call For Reinsp.
INSPECJON NCTICE
City of Tigard Building Depsrtannt
13125 SN Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): x.39-4175 Business Phoney 639-4171
Inspection•_— _�_�_._ --
Footing Pltg. Undersla.b Me.�h. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Po B�-Str-ct San. Sewer Framing -Bldg.
ost/B Rain Drain Insulation -Plumb.
Plbg. Underfloor Na(toer-Lime Gyp. Bd. -Mach.
Date Requestedt / -�`' / 7 _ `` Time: AM PN
PerititAddress: 9,floil/
Builder: LL/t r�C
_ �q� —
THE FOI.I,ON NG CORRECTIONS ARE REQUIRED:
Inspertor: Date:
PROVED DISAPPROVED APPROVED SUBJECT TO A11IV?
Call Por Reinsp.
INSPECTION NOTICE
City of ZLgard Building
13:125 8V Ball Blvd. Tigard, Oregon $
Inspection Line (Rec-O-Phone): 639-4175 Business P o 639-4171
Inspection:
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
ound� Plbq. Top Out Can Line FINAL.:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lin
/e Gyp. Bd. _Meeh.
Date Request,•d: - 1/7 77 "/---T Lines PM
_AM Q
Address:`) 7 P�.QfJQI�//C C 14'- elder it #:,
Builder:,AVVy- 359
THE FOLLOWING CORRECTIONS ARE REQUIRED:
c_�_ccrk
Inspector: -
- — nate:
PROVED DISAP'ROVSU —_ APPROVED SUBJECT TO ABOVE
---,--Call For Reinsp.
7�
INSPECTION NOTICE r
City of Tigard Building Department
13125 SR Bill Blvd. Tigard, Oregon 97223 �`/
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
I=F—ti-g
nsspection& _
Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rait, Drain Insulation ��`(��-PPlumb.
Plbg. Underfloor water Line Gyp. Bd. _YMech.
Date RAquested s 7� —s 13-c7�_ —T.me:<\\(]�1�V.-*M PM
Address:-9 �C �I�C-I � -- Permit
Builder: �GL_�h__
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: — _ DatetC_ C
APPROVED DISAPPROVED APPROVED SUBJ r,,T TO 4BO,r
_ Cel1 For Reinep.
— --- PLUMBINU PERMIT'
C"ITY OF T DATE PERMIT ISSUED: •04/11/944-@ 1 1
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hail Blvd.Tigard,Oregon 07223.8190 (503)839.4171 PARCEL: 2S 1 1 1 BD•-04400
.l r L ADDRL:SU. . . : 09837 SCJ I'EPPLk I I,F_L LIq
SUBDIVISION. . . . : ZONING: R-3. 5
BLOCK.. . . . . . . . . . . LOT. . . . . . . . . . . . . .
CLASS 01 WORK. . :NEW GARBAGE DISPOSALS. . : 1
TYPE I - :'E=. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . :@
OCCUi~.'NC'. GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STf'?IWS. . . . . . . . 12 WATER HEA•TERS. . . . . . . 1 CATCH BASINS. . . . . . . .0
F I • f .r'.ES----------------- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
Slir. ._ . . . . . : 1 GREASE TRAPS. . . . . . . :@
LAVATORIE•S. . . . . :5 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CI_OSFTS. . :3 WATER LINE
DISHWASHE::RS. . . . : i RAIN DRAIN (ft) . . . . :0
Remarks : PATH I
UWNFR: --------------------------------- -------------- -FEES-
ROYAL OAKS DEV CO BPR T' $ 548. 00 SW 04/11/94
9855 SW PEPPERTREE BPLC $ 356. 20 JLH 03/14/94 94-: 50003L
B5PC $ X27. 40 SW 04/1. 1/94
TIGARD OR 97224 SSDC $ 280. 00 SW 04/11/94 -
0hone #: 639-4869 PARR $ 500. 00 SW 04/11/94 -
MPRT $ 49. 50 SW 04/11/94 -
P•1umbin Contractor:---- ------ MP'LC $ 12. 38 SW 04/11/94 -
/ M5PC $ 2. 48 SW 04/11/94 -
Nam •ai
� � _ lG/ ._...._____ PPRT $ 162. 50 SW 04/11/94 _
Address .-___ _ - P5PC $ 8. 13 SW 04/11/94
C:- -
ty : _ � State: v TIF $ 15�-20. 00 SW 04/11/94 -
ip:� Phone#•_�
Reg #
------- REQUIRED INSPECTIONS -
This permit is issued subject to the reg-
ulations contained in the Tigard MI.lnicipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Codes and all Post/Beam Strur_t Water Line Insp
other applicable laws. All work will be done Post/Beam Meehan Appr/Sdwlk Insp
in accordance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of issuance, or if work is Mechanical Insp P_iilding Final
suspended for more than 180 days. Plumb Top Uut Erosion Control
Framing lnsp Crawl Drain
Fireplace Insp ------
Gas Line Insp
Insulation Insp
x "�[ -Q�1� _.____.... G Y p Board Insp
Authori` a Plumbing Contractor Signature
[,all for inspection - 639-4175
Contractor Notes :
MASTER PERMIT
CITY OF TIGARD PERMIT #. . . . . . . : MST94-0111
COMMUNITY DEVELOPMENT Dr:0ARtWkWT DATE ISSUED: 04/11/94
13125 SW Hall Blvd.Tigard,Oregon 97223*6199 (503)639-4171
PARCEL: 2S111BD-04400
SITE ADDRESS. . : 09837 SW PEPPERTREE LN
SUBDIVISION. . . . : ZONING. R--3. 5
BLOCK. . . . . . . . . . ." LOT. . . . . . . . . . . . .
---------------- BUILDING
REISSUE: DWELLING UNIT15: 1 BASEMENT. . . . . . . . :0— :0 sf
CLASS OF WORK. :NEW BEDRMS:4 BATH3:3 GARAGE. . . . . . . . . . :621 sf
TYPE OF USE.. . . :5F FLOOR AREAS------------ REQUIRED SETBACKS----------
TYPE OF CONST. :5N FIRST. . . . :2022 sf LEFT. . :30 ft RIGHT. .-42 ft
OCCUPANCY GRP. :R3 SECOND. . . :900 sf FRONT. :50 ft REAR. . ."23 ft
STORIES. . . . . . . :2 THIRD. . . . .0 sf REQUIRED-------------------
HEIGHT. . . . . . . . :27 ft TOTAL-- ••-•-:2922 s f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 145590 PARKING SPACES. . : 1
Remarks : PATH I
-------------------------------------- PLUMBING -----------------------------------------
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) . -.O GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . .-@
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . -.0
WASHING MACH. . . sl SF RAIN DRAINS. . : l
MECHANICAL -------------------------------------- FEES
FUEL TYPES-------------- UNIT HTRS. . :O type amount by date recpt
/GAS/ VENTS . . . . . :0 BPRT $ 548. 00 SW 04/11/94 -
MAX INPUT:O BTU VENT FANS. . -4 BPLC $ 356. 20 JLH 03/14/94 94--250003r2
TURN ( 100K . . -0 HOODS. . . . . . : 1 B5PC $ 27. 40 SW 04/11/94
FURN ) =100K . . - I WOODSTOVES. .- J. SSDC $ 280. 00 SW 04/1. 1/94
FLOOR FURN. . . . :0 CLO DRYERS. : I PARK $ 500. 016 SW 04/11/94
BOIL/CMP ( 3HP:0 on-IER UNITS: 1 MPRT $ 49. 50 SW 04/11/94
GAS OUTLETS: l MPLC $ 12. 38 SW 04/11/94
Owner: $ 2. 48 SW 04/11/94
ROYAL OAKS DEV CO PPRT $ 162. 50 SW 04/11/94
9855 SW PEPPERTREE P5PC $ 8. 13 SW 04/11/94
TIF $ 1520. 00 SW 04/11/94
TIGARD OR 97224
Phone #: 639-4869
Contractor: ---------------------------------
ROYAL OAKS DEVELOPMENT
9855 SW PEPPERTREE LN �� N 5� ,�
TIGARD OR 97224
Phone #: 639-4869
Reg #. . : 67111 -------------- --------------------------
$ 3466. 99 TOTAL
This persit is issued subject to the regulations contained in the RE:QUIR7-D INSPECTIONS ----
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accord& v with approved Post/Beam Stcuct Gas Line Insp
pans. This persit will expire if work is not star ?d within 180 Post/Beam Mechan Insulation Insp
days of issuance, or if work is suspended f r norp t an 180 �aye. Plm/undslab Insp Gyp Board Insp
PLM/Underi-1 a or- Rain drain Insp
Permittee Signature : /7' -Z P—
Mechanical Insp Water Line Insp
,1 u m b T1,eP LI u t Appv,/Sdwlk Insp
I s s u e rl B y - -44) Framing Insp Mechanical Final
Call fur, inspection — 639--4175
Residen_tial_Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 63.9-4171
Jobslte Address: ci ''3 3 7 Sul, P L P Pi:R T R e Z- LN
rAR ,-u4 c v rIA.14+ Office Use Only
Subdlvlslon: Jq�� /951- oy Lot # a. ,
Valuation: Pianck]Rec#
� � ��� � J411q
Owner: Reissue of
Address: Map & TL# r/ /. (, D 6 N q0
Phone: Appivvals Required
Planning
Contractor: S1 RQVf}L C�-W 1,5 01-0- LC) _ Engineering
Address: 193L Pf:PPz RTR t� L-rt) . Other
Items Required
Phone: it (y39 -yb`i ; .._
Subcontractors
Contractor's License # r✓'7 )
(attach copy of current Oregon license) Truss Details
Subcontractors: Other
Plumbing: ►°1-v,r1 IV
Mechanical: T i 1v C-
(attach copy of current OR Cont or's Licence) ,
Architect/Engineer: r}Vn [.-C r2
Address:
Phone: EVC-,(Vs I2 933- Lt 349
COMMENTS:
Applicant Signature & Phone number
K,!ceived by: _ _ Date Received:
Permit # Account Description Amount Amt. Pd. Bal. Due
h1'>fy� OJII Blr'.g. Permit (BUILD) 5_
Plumb. Permit (PLUMB) -/&,moo ,z
Mech. Permit (MECH) lam" ` 5.0
State Tax (1 AX) U I
Bldg:
Plumb: I ✓/
Mech: <<
Plan Check (PLANCK) � �' �_
Bldg: J 5G. 2,e
Plumb: /
Mech:
Sewer Connection (SWUSA) _
;r
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) _.-�
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
fi
TOTAL;:
i
5036846121 ROYALORKSDEU 361 P02 APR 11 '94 12:31
WASHINGTON COUNTY DEPARTMENT OF
HFALTH AND HUMAN SERVICES--SUSSURFA T SEWAGE SYSTEM
CERTIFICATE OF SATISFACTORY COMPLETION/CORRECTION NOTICE
►�P: —3.51-���_�.�1514 � ca t'��.?�,�a
Properly Owner: Installat �S"Ayu,%�
Loc/Road/Addrrss � D ���a.
Type of Use (ADS Id./Com./Indust,) _Sewage clow/GR/
3E TIC 7AHK: ca atitA(= materiel ( distance to .tell
distance to foundaticA bkL, manufacturers//
miscol laneous�AK�,r4 i_ `-(.�, '[r 1 �I
Kw/SQW: p,rnp menufecturer _ '�'-mode /
scrap diameter/cep- y^`
ORAI.NF1ELD: type of system
dlsfsRoe frau+ veil s!(st. from foundationsvi t, ffan prop.
Iine �? distance between IInesyp total IIne Iength jw,fIIter
natorJat -&&- oepth, top of t Ile to fImisnea grede Is -"
Remarks, Reports- 000,Of
PUBLIC HEALTH SANITARIAN D►,T1.
7/1 N/07
.t�,. •..y�•'i;;�r►`"'i, � �,; lh.�'n!i°">�;�)13 t,1....�.^r,+Y..:;�..•a,..+� 'r...,1i"»,+'?•*y" w.t►�•`^�'k gvi,.e�'eAw y �. �"r`�?f7c1f'"'" �:; J`"'�:�����'*'�`IR��
WASHINGTON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES j
ENVIRONMENTAL, HEALTH AND SANITATION
155 N. First Avenue
a Z/ — Hillsboro, Oregon 97124
CR# a �
64+8-8722 l\ /
'Fax Map #, �� ,
Road Name Name � .:r
I
i
New Construction PERMIT
f ] Repair
Alteration j
An On-Site Sewage Disposal Permit is issued
for a period of one year from the date below.
I
(This Permit is not transferrable)
All septic systems must he installed as indicated on the approved plot plan. If any changes are
anticipated, a revised plot plan must be submitted to the Washington County Department of Health
and Human Services For approval. 1'hc plot plan is part of the permit.
Before a drainfield can he backfilled, a pre-cover inspection must he made. The inspection will
he made within 7 working days after it is requested.
DATE
/ -- —
------ --- -
Envirown a Health Specialist
(I y I'l 1 1,1 1 IM ')4 'Pt`p 10 4
01101JI'll r P-1.6 ,5 9
C30
(•IYllf,111, 1)W I
YWARD, (!,k la1.1Y4W.V 1.14 1:()III
9 W,4-
iittI 111" 1 Ifl Y 11IF:N-1 It IN I 1,01(' 1IN I 1-1'0) 1)
. . . ...........
l."I'l 14 0 P) I'l I11•11: 1 1-11 PI 1 1,1
k-0 I IA fit I.q 01.
ii i IV(All 1, 1. (tll00
CITY OF TIGARD RECETPT OF PAYMENT REGE.1 PT NO. :y4-25x0032
AMOUNT s 250, 00
AIIF ROYAL UJAKS DEVELOPMENT GO GASH AM01INT 1 0. 00
D I)R E SS t 9855 SW PFPPERTI?r.F LANP P A Y M N'r DATE 1 03/ 14/94
TWARD, CIREGON- 1.()N 7
917223—
OF PAYMENT AMOUNT PAJI) I-,IlkPII!;K LIP I'AYMPNI' Al'ItIUNT PA11)
...........
FF LOT #2 PEP 25m. 00
OTAL AMOUNT PAID 25-0. 00