14750 SW 81ST AVENUE ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Reques.ed: -d_d—`cn A.M. P.M. _ MST:
Location: LUp:
Tenant: Suite: Bldg: — MEC:
Contractor:—_`� _i Phone: t'� �— ? _ PLM:
Owner:_____ Phone: ELC:
ELR:
SIT:
BUILDING IELI)G icon't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Postr3eqm PostIl earn Post/13cam Cover/Service Sewer/Storm
T!49 g_� Roof UndF1/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Linc Rough-In IIG Sprinkler
Foundation Insulation Sewer Ilood/Duct Reconnect vault
Mat Damp Drywall Storer Furnace
Temp Service MISC,
Masotti), Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Foand Ir I feat Ptunp Low Volt
imroved > AppmvLd Approved Approved Approved
Appr/Sdw1k 1 at Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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Inspector - - -- — Date: Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: //� D 7 1� A.M. P.M. MST: 7-
Location: / 7`J n- s�1/// 8/,4,t C,L,c _ BUR —
Tenant:_ Strite: Bldg: MEC: _
Contractor: naz Phone: 3 .J 3 _ PI,M
Owner: �i Phone: _ ELC:
cz-t / _ �,G�C�C/ ,- ELR:— --
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BUILDING LDG ►n't) PLUMBING rCTRICAL SITE
Site PostlPLcant Post/ltcam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Top out Gas Linc Rough-In I Tf,j Sprinkler
Foundation Insulation Sewer ilooW'7uct Reconnect Vault
Bstt.t Damp Drywall Storm Furnaca. Tcmp Service MISC.
Masom), Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire S klr/Alm Crawl/l ound Ih l lent Pump l,ow Volt
'-hplmwod- Approved Approved Approved Approved
Appr/Sdwlk n Not Awed Not Approved Not Approved Not Approved Not Approved
SINAL FINAL FINAL FINAL FINAL
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In�lxxtor _- - _ —•--
Date - -_- -- Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection. Linc: 6394175 Business Phone: 6394171
Date Requested: .�— / �— D j
� A.M. N.M. MST:
Location:__ 14756 ~ Gu� MAP:
Tenant: Suite: Bldg: MEC:
Contractord��,��!� �L_iC/ Phone: trJ PLM:
Phone: ELC:_
— -- L — ELR: -
- _ 00 1PC17_m(1'5 SIT: —
BUILDING LDG(con' PLUMBING MECHANICAL — ELECTRICAL SITE
Site Pos eam Post/Beam Post/Beam Cover/Service Sewer/Ston
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Ll:ywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire S x k1AIm Crawl/Found Dr Heat Pump Low Volt _
�FtN �
Approved Approved Approved Approved
Appr/Sdwlkd Not Approved Not Approved Not Approved Not Approwd
FINAL FINAL FINAL. FINAL
74
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Inspector: / Date: Zlz( � -- Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour `nspection Line: 639-4175 Business Phone: 639-4171
Date Requested: 1 / 7
_ . r _ J � A.M. , F.M. MST:
Location: g, T
IUP:
Tenant:—___ `_ Suite: Bldg: NEC:
Contractor: _ Phone: PLM:
Owner: 24c Phone. ELC:
ELR:
SIT: _
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beatn Cover/Service Sewer/Storm
Footi-,g Undl'1/Slab Rough-In Ceiling Water bine
Slap• �Insmuation
Top Out Gas Line Rough-In UG Sprinkler
Fo,..ndation Sewer Ilood/Duct Reconnect Vault
I,!ant Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain IVC UG Slab
Shear/ cath Fir IcM Crawl/l oumd Ih ileal Pump Low Volt
eq
v Approval Approved Approved Approved
Apt -/Sdwlk o Approved Not.Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
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❑Call fn.rein., t t73 Reinspection fee of Smyuiied befole Acv in,lpck 01,11 rl t Inable to ifispe t
Inspector -- -- — -- - — Ihdc _ Page of
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A CITY OF TIGARD
DEVELOPMENT SERVICES MA" fER F'ERMTT
13125 SW Hail Blvd., Tigard,OR 97223 (503)639.4171 F'E RM I T #. . . . . . . : MST!-)7-0 i 38
PATE TSSUED: 05/08/97
F'ARCEI.: 2S 112BC-08800
STTE ADDRESS. . . : 1.4750 SW 81ST AVE
SI-IBD T V I S I ON. . . . :DLJRHAh1 ACRES 70N I NG: R-4. 5
I31.._OCK. . . . . .. .. . . . I.._OT. . . . .. . . . . . . . . :57 .JLJRTSDTL"TION: TIG
Remarks: Construct 171X34' attached garage.
---- --- ------------------ BUILDING - -------- --------------------------------------------
REISSUE: STORIES.......: 1 FLOOR AREAS--------- BASEMENT...: 0 sf REQUIRED SETBACKS---- REQUIRED---- -------
CLASS OF WORK.-ADD HEIGHT........: 12 FIRST....: 0 sf GARAGE.....: 578 sf LEFT•„•..„.. 41 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD....: 50 SECOND...; 0 sf FRONT.........: 0 PARKING SPACES: b
TYPE OF CONST.:SN DWELLING UNITS: 0 FINBSMENT: 0 ;f RIGHT.........: 0
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL------: 0 sf VALUE..$: 10219 REAR..........: 42
---------—--------------------------_------------------------ PLJMBING ------------------------------------------------- --------------
SINKS.........: 0 WATER CLOSETS.: 0 WASHING MACH—: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft; 0 TRAPS.......... 0
LAVATORIES....: 0 DISHWASHERS...: 0 FLOOR DRW NS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB/SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 rAl<< ' TNE ft: 0 BCKFLW PRFVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
--------------------------------------------------------------- MECHANICAL ---------------------------------------------------------------
FUEL TYPES---------- FURN ( INW ..: 0 BOIL/CMP ( 3HP: 0 VENT FANS.....: 0 CLOTHES DRYERS: 0
FURN )=100►: ..: 0 UNIT HLATERS..: 0 HOODS.......... 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.......... 0 WOODSTOVES....: 0 GAS OUTLETS...: 0
------------------------------------------------------------- ELECTRICAL ---------------------------------------------------
--PESIDENTIAL UNIT--- ---SERVICE/FEEDER---- --TEMP SRVC/FEEDERS-- -- -BRANCH CIRCUITS--- ----MISCELLANEOUS---- --ADD'L INSPECTION9--
1000 SF OR LESS: 0 0 - 200 asp..: 0 0 - 2" ago..: 0 W/SVC 9R FDR..: 0 PUMPIIRRIGATION: 0 PER INSPECTION! 0
EA ADD'L 500SF.: 0 201 - 400 asp..: 0 201 - 400 amp..: 0 1st W/O SVC/FDR: 0 SIGNIOUT LIN LT: 0 PER HOUR......: 0
LIMITED ENERGY.: 0 401 - 600 asp..: 0 401 - 6!w asp..: 0 EA ADDL OR CIR: 0 SIGNAL/PAWL....- 0 IN PLANT......: 0
MANF HM/SVC/FDR: 0 601 - 1000 aso.: 0 60t►asas-10(10 v: 0 MINOR LABEL -!0: 0
1000+ alp/volt.: 0 ------------------------------------ PLAN REVIEW SECTION -----------------------------------
Reconnect onl,,,.: 0 )=4 RES UNITS..: SVC/FDR)-z225 A.: ) 600 V NOMINAL: CLS PREA/SPC OCC:
--------------------------------------------------- ELECTRICAL - RESTRICTED ENERGY -----------------1-- -----------------------------
A. SF RESIDENTIAA_.------------------------ B. COMMERCIAL-----------------------------------------------------------------------------
AUDIO d STEREO.: VACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARM.....: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM... 0TH: BOILER.......... HVAC............ LANDSCAPE/IRR16: PROTECTIVE �TGNL:
GARB'-- OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL........: OTHR:
HVAr ..........: DATA/TELE COMM.: NURSE ;ALLS....: TOTAL N SYSTEMS: 0
Owner; ------------------------------------Contractor: ------------------------------ TOTAL FEES:$ 167.06
DAN MACK!NNON OWNER
14750 SW B1ST AVE
TIGARD OR 97224
Phone N: �-� 1 7.�-' Phone N:
Reg N...
This permit is issued suhiact to the regulations contaimld in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180
dans of issuance, or i.f work is suspended for more then 180 days.
` -�--��----'�---------------------------------------------- REQUIRED INSPECTIONS ------------ -------------------------------------- ---
Building
------------------------------------ -
Building Final
Footing Insp
Fravinq Ingo
Shear Wall Ingo
Rain drain Ingo
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1 ermattee 5ignat _.re : �'at__ ^Y���� Isso-led By . !` �_C
COI I for inspect i on -- 639-4175
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TY OF TiGARD Residential Building Permit Application Recd Plan Chay ^
25 SW HALL BLVD. New Ccnstruction Additions or Alterations Date Recd 1 -''50 7
_•CARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P E.C_2
',03-639-4171aDate to DST C�.S- ^ y
�03-684-7297 Permd M ,4i5T T— of-7S
Print or Type Cilled - '
Incomplete or illegible applications will not be accepted
Name of Project Name
Job 1/� " f`��IN/v Orr C C' L /V E
Address S)a Address Architect 'lading 'lddress
e — City/State Zip one
ap
Name
Owner Mpding Address
Engineer Marling Address
Ci rlstate rhone
_ �.9 " f _
7 C � � -� ��� � �I'1)
Name City/Stats Zip Phone
3eneral 7/�} - �'r `� �! Describe work New O AdditionAlteraWn O Repair O
JntraCtOP Marling Address to be done:
_'4L, �• _�
Additional Description of Work:
Cityrstate Zip Phone
Oregon C nst.Cont. Board Ltc.0 E-p. Date
tach Copy of
Current COT B siness Tax or Metro M Exp.Date PROJECT
_Licenses VALUATION
Name
echanical _14A NEW—CONSTRUCTION ONLY:
Sub- Mailing Address Sq. Ft House: Sq. Ft. Garage
.ontractar Comer Lot YES NO Flag Lot YES NO
c�tyrsnte zip Phone (check one) (check one
Oregon Const Cont. Boar!Lr-# F.xp.Date — Restricted Audio/Stereo Burglar
rich Copy of Ei:ergy System Alarm _
Currant COT Business Tar,or Metro a Exp. Date Installation Garage Door HVAC
Licensee Opener S stems
Name
(check all that Other.
Plumbing N apply)
Sub- Mailinq Address Will the electrical subcontractor wire for all YES NO
'ontralctor restricted energy installations?
C.tyrState zip Phone Has the Suodivislon Plat recorded? N/A YES NO
1tUrn copy of
Oregon CansL Cont Board Lir,.# I Exp. Cate Reissue of MFT* Solar Compliance
_ Exp_ (Calculation Attached)
m
2 Current Plubing Lic S EDate
I hearty ackn,jwledge that I have read this application, that the
N Licenses information r,rven is correct,that I am the owner or authorized
COT Business Tax or Metro k Epp. Date
agent of the owner,and that plans submitted are in compliance
Name ----- wnh Ore otr State taws.
S:isaature o�C1rtgr/Age Date
:i Electrical C'l' ,� / ) /
L 57 h
�� Sub- Mailing Address Contact Person Name Pon e
J
'ontrartor _
City/State zip Phone FOR OFFICE USE QNLY:
_ Plat tit_ Me".
Oregon Const Cant Board Vc.x Exp.Date
Tach Copy of Setbacks: 1 � Zone: t Solar.
Current E!ecti;-al L,c, 0Exp Date ,/
L'un Engineenng Approval: Plann ng Approval: TIF:
COT Business Tax or Metro a Exp_ Gste �,•.
iasfapp doc(dst) 1,197
permit # Account De5cri tion 6moun Ami Sal, Due
' MST. Permit BUILD _
Plumb. Permit (PLUMB)
Me,-h. Permit (MECH) _
ELC/ELR Permit (ELPRMT)
State Tax TAX) YJ
_—
Bldg:
Plumb:
Mech:
ELC/ELR:
Plan Check
MST: (BUPPLN)
Plumb: (PLMPLN)
Mech: (MECPLN) _
CDC Review (LANDUS) PL
Sewer Connection (SWUSA)
Reimbursement District
Sewer Inspection (SWINSP)-
narks Dev Charge (PKSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Water Quality (WQUAL) _
Water Quantity (WQUANT)
Erosion Control Permit (ERPRMT) _
Erosion Planck/USA (ERPLAN)
Erosion Planck/COT (EROSN)
Fire Life Safety (FLS) ,
TOTALS: __--
Wapo.doc cwt 1W I'
Permit #: S�►�1 a(
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.9
Issued by: Date:
1�g9
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7)•
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
/Z 1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
❑ 3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
313. I will be my own general contractor.
If I hire subcontractors, I will 'hire only subcontractors registered with the Construction Contractors
Board. If 1 change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I ha,-e read and do understand the Information
Notice to nroperty Owners about Construction Responsibilities on the reverse side of this form.
( o c - —�--
(Signature of permit applicant) ( ate)
(White copy to issuing agency permit•ile,
pink copy to applicant)
C'I`I'`( I:IF I1C:ilkl7 k►_l.k.I1, 1 (it 1IOYMVNI Hkr.(,E)1'•'1 NU. sY". 294;54')
CHL'L:!�; I)MUUN t' 1 +11.
NAME a (MACK I NNON, UAN CWA 4 14MOIJN(' : 131 a.
1)U)DRE6a a t4'!!A SW E1•lbl AULNUL PAYMLIN'1 UWE: c v►�r�+�r�+ r
SUNr')IVI'SIUN c
PURPOSE UP VAYM NT nPiclUa1 PAID PUFtV'U'iL I:1F PAYMLNt t't'tll)
i7iM.,6INa I'ErkMll B6. fi'1 . BUILD H:R 1►. 33
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INSPECTION NOTICE_
City or Tigard Building Depazlceent
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)e 639-4175 Pusineea Phone: 639-4171
Inspection-
Footing
nspection:Footing Plbg. Underslab Mach. Rough-in �1ppr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Qyp. Ed. -Koch.
Date Requested%_/�Z.]L) Time: __—AN PM
Address:-- —�4_ � I bPermit
Builder: LLLlb� M G1G �1 o ry
THE FO►.I.OWING CORRECTIONS ARE REQUIRED%
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APPROVED DISAPPROVED _J/APPROVED SUBJECT TO ABOV2
Call For Relnep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businena Phone: 639-4171
i
lnspectior: _ -_-
Foottng Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requestodi .. C 13 fame: AM ` -_41M
Addroae: /c� ,l/5/ U '5t',� 'y S+ Permit f:
Builder: /IV]t '= K/f- /AJ0AJ
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: LCL f 1�/� X77[ A or
APPROVED DISAPPROVED _ /A PRU"D SU&MCT TO ABOVE
Call ror Rainep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: --
looting Plbg. Underslah Mech. Rough-in Appr/Sdwlk
Round. Plbg. Top Out Gas Line FINALS
Post/Beam Strutt. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Neck.
nate Requested:—� Z� Time: —_ AH _ PM
Address: 14-1750 Sw cJ Q/ S� Time:
1: _
:Iuilder: M 0-KjtA/N�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors itit Date: -
� p DISAPPROVED PPROVSL SVWNCT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 BM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections.
Footing Plbg. Underelab Mach. 4ugh-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL-
Poet/Beam Struct. ean. Sewer`) Framing -Bldg.
Pont/Beam Mech. Rain Drain' Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requested: �,�`�1 Tim4 AM�f PM
Address:
Builder•
THE FOLLOW RRECTIONS ARE REQUIRED:
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'A,—APPROVEO DISAPPROVED APPROVED SUBJECT TO ABOVE
-`—Call For Reinap.
SEWER CONNECTION
CITYOF TIGARD PERMIT
Cf1YOFTNMRD P-E:RMIT #. . . . . . . : SWR91-0196
c6MMUNITY DEVELOPMENT DEPARTMENT 0100M
1312bSWHdIBNd. P.O.Box M97,Ted,a. , o)NIe 417s 7 DATE ISSUED: 10/23/91
S.1 iF: ODDR SS. . . . 14750 SW 81ST AVE PARCEL: 2 S112BC-00400
SUBDIVISION. . . . : DURHAM ACRES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5-7
TENANT NAME. . . . .
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORE'.. . . :ADD DWELLING UNITS. . : .l
TYPE OF USE. . . . . :SF NO. OF BIJILDINGS: 1
INSTALL TYPE. . . . :BUSWR IIrIPERV SURFACE. . : e sf
Remarks: ConileC_t existing SFD to sewer. Septic tank ml.rst be p+_rmped and filled
with gravel. Insp of filled tank r-egl_rired. A hol_rse existed prior to 7-1-70
Owner: -__.___.___---------__.___.__.________.___.__ ____._.___._..___.___._._..__ FEES
DAN MACKINNON type amol_rnt by date t-i? t)A:
14750 SW 81ST AVE PRMT k 300. 00 ECR 10/23/91
1N3f1 it 35. 00 DCR 10/23/91 -
TIGARD OR
Phone #:
Contractor: -----------------_---------------
FONTRACTOR NOT ON FILE
Phone #: $ 335. 00 TOTAL_
Rets #. . .
------ — REQUIRED I NSPECT I ONS --------
This Applicant agrees to comply with all the rules and regulations Sewer Inspection _
of the Unified Sewage Ngency. The permit expires 120 days from Septic lank Fill
the date issued. The total amount paid will ha forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given. the installer shall prospect 3 feet in all 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.
r 1-,.mittee 5ignati.rr,e:�-��1�` 1vr►-��__
1. •5s1-led Dy ,
c~r Call for- inspection - 639-4175
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"` y, c rrN, OF T I GnRD - RECEIPT OF PAYMENT REC:E I PI NCI. :91-218908
CHECK AMOUNT 337P. LAO
NnME : MACK i NNON, D(TIV I E L CAS14 AMOUNT o IA. 00
'AbDRESS 14750 SW BIGT AVE PAYMF:hIf mak:. 10/23/91
SUBDIVISION
TIGARD, OR 97224--
PURPOSE OF POYMEN T PMOUNT PAID PURPOSE: OF PAYMENT' (1MOUNT V,A I D
cr
,F, WE.R USA_..___.....__ _..... 300. 00 SEWER INSPECT 35. 00
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SE-WE R PERM I T
TOTAL AMOUNT 110 I U
11,E I
r,ll,y or-* TIGARD RLCEIPT or PAYMENT RECEIPT NO. :90-205540
CHECK AMOUNT - X5.50
NAME t MACK INNON. DANIEL -& MAC LE CASH AMOUNT a 0.00
AI[)F-,F S 8 : 14750 SW GISI AVENUE ll"AYMENT DATE a 10/05/90
SUBDIVISION
TIGARD, OP C�-7 2'174- 14750 SW :31ST AVE.
F'LJRr`Jl)SE Or- rAYMENT AMOUNT PAI D rURPOSE OF* PAYMENT AMOUNT PAID
—PER—-1-90-0301 I GT. BUILD PER "75
PERM 9. 75
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TUTAL (-)MOUNT PAID 25. 131)
CITYOF TIGARDPUILD:I NG P1::.'R11*.[J
D1--.1ER11111- .. .. :: B U 1:.,9 0 030:!.
COMMUNITY DEVELOPMENT DEPARTMENT one" PRIM. it., ., BUF,90 0301
13125 SW HWI Blvd. P.O.Box 23397,Tigard,Onigon 97223(15P3)A.04147t C DAI'E 15 S U 1H*D. 1.0/0 5/9 0
' 04(
ODDRESS. . ., 14750 SW 8iSl' AV PARCEL: 2S112K,.-0 d0
,(.j1:1DlV1S'1ON_ ,_ :: DURIAP11 ACR1-.(.3 ZONING.- R---,(+.. 5
_.__...._•__.._..__.........._....._...._.....................
RliISSUE: FLOOR' EXTERIOR WALL CONS'TRUC'T:[ON—
CLASS OF' WORK. -.1110V F- I R S'r. 19"2 sf N: S E: wn
f"YPE OF USE. . . -SF SECOND. Sf PROTECT OPENINGS?._..__..__..._..._._.._._.
1"Y
PENINOS?-----
Y'Y P E OF' C 0 N S)'T. .514 'THIRD. « . . . S f N. E E W;:
OCCUPANCY GRP. :IT11 10 1-AL.._._.._..._.._.... : 192 sf ROOF CONc.)'T'- F':[R[-.:'. RE'T?!:
XUPANCY LOAD'. 1:(A Cj 1:7 1111':JqJ'. s AREA SEP. R('e-i ED::
':)7*OR. c1 HT. -. ft GARAGE. .. . . Sf OCCU SEP. RA'TED:
I-JSMT?-. ME"l..Z?» RECD
':-*LOOR LOAD. . . . » risf LEF7T 6 ft RGHl'-. —ft, FIR SPKL.- S11OK DEI . .
DWELLING UNTTS-. F:'RNT» ft RE AI:: f tR Al I AHDTC,1!:'
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N
DEDRMS: BAI'HS: IMP SURF,-A(,E: 'S
C
VALUE. $n 200
Renia-6r.sc move exisittig 12x 6 shed onto cat, iiiC� t.tdiriqe J.titing :1.0x16.OxIG overhaviq.,
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OwIler: F'EES
DON MACKINNON type a In 0 U Il t by date
1.4750 SW 81ST_ AVE PR11*T q; 115. 00
C
5PCT 0. 75
TICARD OR 97 22 F.,L C K 1; 9. 7 5
Pliorie 0: PAYM $ 25. 50 DCI; 1.0/05/90
0 11 t VAC't0 r
C)W N E R/C 0 N T'R'A C",T'O R
r'.=,. 50 T111"AL
Req OWNER
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the F-00t/fOL(rid Irisp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing Irisp
applicable laws. All work will be done in accordance with Ficial 11-14;pectiorl
approved plans. This permit will expire if work is not started ...... .........
within 189 days of issuance, or if work is suspended for more
than 188 days.
...............................
...........
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is s Li e d Ry n ................................. ............. .......
Call for iiispectiaii 639-4175
CITY OF Tuos�� PUCK/[= #r�CX�0M3 —
COMMUNITY DEVELOPMENT DEPARTMENT PE144r # '�� O 9b c`�0�
p DATE ISSUED
JOB ADDRESS: TM MAP/Tfn _� 2 e4C' / 0 y �-
�s: DOT: IAND USE:
VAILUMON: ?E'
OWNER � SPDCIAL NOTES
NAME: _"L")/)N /U R,'r./L/ RELS 9M OF:
ADDRESS: rld / AL?Sr REISSUE:
AL FLOOD PLAINT/
_ / Z 7 SENSITIVE IAND:
PHONE: /? Y, 77 Z 1 v , Z`' 7-Z./.2 Y.
APPRDVAT-S
NAME —
ADDRESS: FIRE DEPT
dII1ER:
PHDNE_ I'I'EKS RDQDIl2ID
BUILDERS BOARD 1: EXP DATE:
YZ TAX:
ARCH/ENGINEER CM1.13E=oNS:
NAME: A" /. r _ TRUSS DET11T1`i:
ADDRESS: _ fit:
1'f IONE:
Ci-4MENTS: I�'J D ve /J_',v
- : Ply: UAl mom:
PNI2MLT if AOCT if DE9CRIPITION AmouRr AMA= PD- BAL- DUE
,X10-432 00 Buildirxq Permit Feces _ -
___� 10-431 00 Plumbing Permit Foes
10-431 01 Mechanical Permit Fees _
lO-230 01. State Building Tax (5t) S
Building
Plumbing
Mech
10-433 00 Platte Check Fee
Building — -
Plumbing
Mech
30-202 00 Sewer omrKi ction
30-444 00 Sewer Ism ian _--
51-448 00 Street System Dr v Cl arKje (SDC) - -`
52-449 00 Parks System De-v CMXW (PDC) -- - -
31-450 00 Storm Drainage Syst Dev owg (SSUq
`� 10-230 06 F.ft-e
Co
L _
W
APPLTCMM SIGNA11 RE --
Reoc-ived By: - ----- - Date Reoei.ved:
,eP/3587P-WPF -----_- -
URADING/EROSION CONTROL INFORMATION
GENERAL CONTRACTOR NAME&ADDRESS: CASEFILE NO.:
PERMIT NO.:
APPLICANT NAME AND ADDRESS:
EXCAVATION CONTRACTOR —
NAME&ADDRESS:
OWNER NAME AND ADDRESS:
TELEPHONE NUMBERS:
APPLICANT: PROPERTY DESCRIPTION:
OWNER STREET ADDRESS AND CROSS STREEET/LOCATED I,
GENERAL CONTRACTOR: —
EXCAVATION CONTRACTOR: —
SFfE/JOB: LEGAL DESCRIPTION:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO.:
CONTACT PERSON,TITLE,TELEPHONE: 1/4 SECTION:
SITE SIZE,ACRES:
DISTURBED/WORK AREA,ACRE'S:
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAINS TO:(i'!R(:LE ONE)
(NOTE:PIRNM MAY BE REQUIRED) CATCH-BASIN DITCH PIPE CREEK
_ (CIRCLE ONE) PRIVATE PROPERTY
PUBLIC RICHT OF WAY
EROSION/SEDIMENTATION CONTROL (ESO MEASURES
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DURING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERINIETER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE PLL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES
CONSTRUCTION SEQUENCE OTHER
OTHER— _—
N PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH•TECHMCAL GUIDANCE HANDBOOK'.
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PI.:N CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY
i PHONE NUMBER. SCHEDULEISTAGING FOR INSTALL lloN AND REMOVAL OF EROSION CONTROL MEASURES,AND
J APPLI(:'ABLE ST,,,.NDARD NOTES.
a�
I I LAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON TFIE CONSTRUCTION SITE.
OWNER SIGNATURE APPLICANT SMNATURE
OFFICIAL USE ONLY,
RECEIPT DATE ACCEPTED
Ila: NUMBER RECEIVED _� BY
I
I
t x
f I ,
El
-77
00
A.-L-441
00
47
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