15425 SW 81ST AVENUE i
i
-- 15425 SW 81ST AVENUE
urw"M
CERTIFICATE OF--
C111111111111YOFTIGARD Ai�� OCCUPANCY
A
WYOFTWAND PERMIT Il. . . . . . . a MS['90--oo3j?
COMMUNFY DEVELOPMENT D
13125 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon 97 "*ON PRIM. PERMIT H. MS'190--0032
DATE-.. IS43UED: 06/19/90
SITE ADDRESS. . . 2 15425 SW 8113T AVL 2S112CB-6900
3WIDIVIIS'10N. . . . : ASHFORD OAKS
Ef L 0 CK. . . . . . . . . . a LOT.. . . . . . . . . . . . . mA3
CLASS OF WORK. rNEW
TYPE OF USE:.. . . -6F
OCCUVIANCY GRP. aka
OCCUPANCY LOAD:220 4
TENANT NAME. . .
keniark s a
JAY MILI-EIR
CIO BOX 23291
TIGARD OR 97223
Phone 44n 684--7543
C"ontractor:
JAY MILLER
PO PDX 23291
TIGARD OR 9'1223
Phonw Na 684-7543
ket.1 ff— C .30109
OCCUpik)-iVy Of the above referenced building is hereby given, and rertifies
the compliance with the State Of Oregon Specialty Cadeta for the group,
occupancy, and use under which the refsenced permit was inamod.
F71RE DEPARTMENT LDING INSPECTOR
1; OFFffIAL.
POST IN CONSPICUOUS PLACE
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection — -- —
Date Requested___ 6 Time A.M.— P-M'
Address �S.lrJ 4� – Permit
Owner _
Lot #
Builder 2A--�--71 0=�D1
The following Building Code deficiencies are required to be corrected:
Presented to __ - Anf'"^ved
Insnector _-_____ _ Disapproved
Date — - _ ---oma-----r- —
CALL �GIR REINSPEC770N
L-1 YES ❑ NO
� IS It a eI� ear � ear
C� INSPECTION NOTICE
7 ' City of Tigard Building Department
G' P.U. Box 23397
Tigard, Oregon 97223
Phone. 639-4175
Type of Inspection
Date Requwster' _ ` /S Ijme A.M. P.M.
AddressPermit #� -
� —
Owner -_- -) _�- -----_—� Lot #_
Builder
The following Buildinq Code deficiencies are squired = corrected:
t
--
Presented to Approm
Inspector --- _— -- ❑ Disapproved
Date.
CA L FOR REINSPECTION
❑ YEB ❑ NO
I
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
5"Type of Inspection
Date Requested Time A.M._ P.M.
Address _ �� -- T'---- Permit
Owner__— Lot # _
BuilderThe following Building Code deficit:ttcies are required to be corrected:
3 �r ^ .._
- " _�;L_��" �1',t�_ /ter ✓�G��V�
001)
1
G!? />vt
Presented to L� F+WP-
Inspector _ / f LI Disapproved
Date _—.� ' Z J
CALL FOR REINSPECTION
[] YEAS fLLMO
or W1 W1 Wz
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone. 639-4175
r
Type of Inspection
Date Requested_ '5- 7-1! / Time �__. A.M.. p P.M.
Address 191— -___-- Permit #1wll'if_
Owner / - --_--..— --___� Lot —
BuilderThe following Building Code deficiencies are required to be corrected:
- / - "'
f
- V
Presented to Approved
Inspector _ ✓ _. Disapproved
Date � —
CALL FOR REINSPECTION
YES ❑ NO
INSPECTION NOTICE (/ '
City of Tigard Building Department
P O Box 23397
T gard, Oregon 97223
Phone: 639-4175
Type of Inspection
r
Date Requested `� O 11me A. . P.M.
Address ? _�— Permit
Lot #
Owner � _ _� —
Builder
The following Building Code deficiencies are requitad to he correGtod:
Presented to -- _----_----- Fj'�Jhpproved
Inspector -_- — Disapproved
Datel
CALL FOR REIPISPFCTION
❑ YES 0 NO
UMANWIF
INSPECTION NOTICE
City cit Tigard BUIIding Department
P O Box 2337
Tigard, Oregon 9?223
Phone: 639-4175
Type of Inspection —'—
Date Requested_�Z1 '~ Time F,.M. P.M•
Address —_-- Permit V'/
Owner_ --— __ Lot #_—_--
Builder
The following Building Code deficiencies are required to he corrected:
Presented to/ Approved
Inspector ��—T� ❑ Disepproved
Date Ta-
CALL FOR REINSPECTION
El YES 0 140
rj INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested ' �O/ r� ime x A.M. P.M.
Address Permit #
Owner Lot #
Builder '
The following Building Code deficiencies are required to corrected:
All
EXC' �aT r x•07 �v cj S -�z �v r� t�b ;1,
_ .rQ�'i�tlCVcV A 5
Presented to Approved
Inspector � _ [_] Disapproved
Date
CALL FOR REINSPECTION
DYE= ONO
INSPECTION NOTICE
Oity 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
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _ ❑��Wovw Approved
Inspector
Datf
CALL FOR REINSPECTION
J YES ❑ NO
CITYOFTIFARD CRYOF>�A
R
COMMUNITY DEVELOPMENT DEPARTMENT OR'Qobp CTION
13125 SW flail Blvd. P.O.Pox 23397,Tigard,Oregon 97723(503)639-4175
xxxx --- PE IT
639-4171 PERMIT #.... ...: SWR90-0055
PRIM. PERMIT #. : MST90-0032
DATE ISSUED: 02/05/90
SITE ADDRESS. . . : 15425 SW 81ST AVE PARCEL: 2SI12CH-6900
SUBDIVISION. . . . : ASHFORD OAKS ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :83
--------------------------------------------------------------------------------
TENANT WAME. . . . . :
USA NO. . . . . . . . . . :39191 FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELLING UNITS. . :I
TYPE OF USE. . . . . :SF NO. OF BUILDINGS:1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : :sf
Remarks:
Owner: ----•------------------------------
- -------------- FEES --------------
JAY MILLER tfpe amount by date recpt
PO BOX 23291 PRMT $ 1250.00
INSP $ 35.00
TIGARD OR 97223 PAYM $ 1285.00 JI.H 02/05/90
Phone N: 684-7543
Contractor: ----------------•-------•--------
JAY MILLER
PO BOX 23291
TIGARD OR 97223 ---------------•-----------------------
Phone #: 684-7543 $ 1285.00 TOTAL
Reg t. . : 30109
-------- REQUIRED INSPECTIONS -------
This Applicant agrees tot comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 120 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the _
aide 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 "Tap and Side Sewer" Permit and the Agency will install a lateral.
Permittee Signature: y'/ley-,��—
Issued By:
Call for inspection - 639-4175
C17YOFTIFARD cmr
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT yIT t
13125 SW Fall Blvd. P.O.Boz 23397,Tigard,Oregon 97223(503)639-4175 F""" f • = MST90-0032
xxxx PRI.{-.- PERM T #. : MST90-0032 —
639-4171 DATE ISSUED: 02/05/90
jSITE ADDRESS. . . : 15425 SW B1ST AVE PARCEL: 2S112CB-6900
SUBDIVISION. . . . : ASHFORD OAKS ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :83
-------------- BUILDING ---------------
REISSUE:MST90-0031 DWELLING UNITS:l BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :410 of
TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS----------
TYPE OF CONST. :5N FIRST. . . . :864 sf LEFT. . :5 ft RIGHT. :10 ft
OCCUPANCY GRP. :R3 SECOND. . . :726 of FRONT. :20 ft REAR. . :40 ft
STORiRS. . . . . . . :0 THIRD. . . . :0 sf REQUIRED-------------------
HEIGHr. . . . . . . . :20 ft TOTAL------:1590 of SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 pef PARKING SPACES. . :O
Remarks:
--------------------------------- PLUMBING ------------------------------------
SINKS. . . . . . . . . . :1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :4 WATER HEATERS. . . :100 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :2 SEWER LINE (ft) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :1 WATER LINE (ft) . :100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . :1 RAIN DRAIN (ft) - :0
WASHING MACH. . . :1 SF RAIN DRAINS. . :1
--------------- MECHANICAL -------------- ---------- _----- FEES --------------
FUEL TYPES----------- UNIT HTRS. . :O type amount by date recpt
/GAS/ / / VENTS . . . . . :0 PAYM $ 40.00 JLH 01/17/90 106920
MAX INPUT:O BTU VENT FANS. . :3 PRMT $ 358.00
FURN < 100K . . :1 HOODS. . . . . . :1 PLCK $ 40.00
IFURN >=100K . . :0 WOODSTOVES. :O 5PCT $ 17.90
FLOOR FURN. . . . :0 CLO DRYERS. :1 STDG $ 600.00
,BOIL/CMP 4: 3HP:0 OTHER UNITS:O SSDC $ 250.00
GAS OUTLETS:1 PARK $ 250.00
Owner: ------------------------------------ PRMT $ 36.00
JAY MILLER PLCK $ 9.00
PO BOX 23291 5PCT $ 1.80
PRMT $ 132.50
TIGARD OR 97223 5PCT $ 6.63
Phone t: 684-7543 PAYM $ 1661.83 JLH 02/05/90
Contractor: ----------------------------- PAYM $ 0.01 JLH 02/05/90
JAY MILLER
PO BOX 23291
TIGARD OR 97223
Phone f: 684-7543
Reg V . : 30109 ------------------------------------
$ 1701.83 TOTAL.
This permit is issued subject to the regulations contained in the ------- REQUIRED INSPEC
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Gyp B
applicable laws. All work will be done in accordance with approved Post/Beam Insp Rain
plane. This permit will expire if work is not starL-ed within 180 Plm/undelab Insp Water
days of issuance, or if work is suspended for more than 180 days. Mechanical Insp Appr/
Framing Inap Final Inspection
Permittee Signature: � !. u� Fireplace Insp — -
Gas Line Inap
Issued By: Insulation Inap
CITY OP TIGARD RECEJFf OF P'AiHENT EIEC NCI: 0010'7231
CHE0, AMOUNT 2q 4 o.a
NAME: JAY MILLER CASH AMOUNT a .00
ADDRESS: PAYMENT DAY[.-*.
TIGARD. OR 97'22--% PLOCI;' NO/ADDP-.
I` 475a S W tSl' AVE.
POPHISE. OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMLIU14T PAID
EUILPING PERMIT f"-0(532) 75e.00 PLUMPING PERMIT
MECHANICAL F'EFtll'( 36.00 STATE BUILD PERMIT TAX (5%,
PLAN CHECF FEE 9.00 SEWER USA (90-0055) 1.
SEWER IN5PECION Sai.00 STREET 50C 600.011
PARKS SrSTEM DFVELOr'IIENT CH 4250.00 STORM DRAIN -,riC 250.00
TOTAL AMOUNT F A I D 946.S
CITYOFT167ARDUCaffTYOFn6MRDCOMMUNITY DEVELOPMENT DEPARTMENT PLAN CHECK APPLICATION
13125 S.W.Mdl Blvd_P o.Sm 23397, PLAN CHECK p �
T+y..d,oro�on s7m,(sa+)s39-1175
ATE ISSUED _
JOB ADDRESS: j S y� 5 S :V�i 6 1 S�a v. 1 AX MAP/LOT S/ - /'� �U' _ ��D U
SUB S V, >: �, a S LOT: LAND USE:
VALUA CION: ���/ / Gu �' _
OWNER SPECIAL NOTES
NAME: _ _ REISSUE OF:
ADDRLSS: — LAST REISSUE:
-_-- _ FLOOD PLAIN/
SENSIIIVE LAND:
PHONE:
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME : ,TaMiller nui1de r Tnr- _ ENGINEERING:
ADDRESS: 'P_.—O. Box 23291 TIRE DEPT
Tigard , Or 9722'; OTHER:
PHONE.: 684-7r.43__ � ITEMS REQUIRED
BUILDERS BOARD N: 3n iIlqEXP DATE: 1 2_1 R_gA 2ic.• LIST/SUBCONTRACTORS:
BUS TAX:
ARCH/ENG.INEER CALCULATIONS:
NAME : TRUSS DETAILS:-----'----
ADDRESS: OTHER:
PHONF .
COMMENTS:
SUBCONTRACTORS: PLUMB: _Ken Watts Plmh. r3n87B MECH: e11 Heatin OQ447 _
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10--432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
_-_ 10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5X) 1
Building
Plumbing
Much
10-433 00 Plans Check Fee _"'
Bili!ding J
Plumbing
jWa d•4- Mech
30-202 00 Sewer Connection �� / j
30-444 00 Sewer Inspection , 5-
51-448 00 Street System Dev Charge (SDC) , -
52-449 00 Parks Systpm Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg (SSDC)
10--230 06 Fire "�- -----J
TOTAL RFC N
APPLICANT GjGNARI)Q!• - --
Received By: Date Received:
cn/3587P/18P
GRADING/EROSION CON'T'ROL, INFORMATI�I
GENERAL CONTRACDOR NAME& ADDRESS: CASEI=ILE NO.:
j")1 /1,14 PERMITNO.: )''}T ST Cf-U co,j 2.
zz_,
�— APPLICANTNAME AND ADDRESS:
EXCAVATION CON'T'RACTOR - -T, ti
NAME&ADDRESS:
PcjX L OWNER NAME AND ADDRESS:
12�
TELEPHONE NUMBERS: - — -
APPLICANT;____ ( PROPERTY DESCRIPTION:
OWNER: STREET ADDRESS AND CROSS STREET/LOCATED
GENERAL.CONTRACTOR:
EXCAVATION CONTRACTOR:
S ITE/IOB:
LEGAL DESCRIPTION:
24 HR/AFI"ER HOURS EMERGENCY TAX LOT NO.: �_Ii 5hfUrzn c,A, i
CONTACT PERSONS TITL '',TELEPHONE: 1/4 SECTION:
7c��.( " i�- �L)S 1- SITE SIZE,ACRES. - -
l.'�I-j I I j DISTURBED/WORK AREA,ACRES:
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAWS TO:(CIRCLE ONE)
(NOTE:PERMITS MAY BE REQUIRED) CATCH-BASIWDITCH PIPE CREEK
(CIRCLE ONE) PRIVATE PROPERTY
PUBLIC RIGHT OF WA
EROSION/SEDIMENTATION CONTROI.. (ESQ MEASURES
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DURING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE D RESTORE TEMPORARY ESC
PERIMETER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES
CONSTRUCTION SEQUENCE OTHER
PLAN FOR EROSION CONTROL.PREPARED AND SUBMIiTL"D IN ACCORDANCE WITH'TECHNICAL GUIDANCE HANDBOOK".
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PIAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY
PHONE NUMBER, SCHEDULEISTAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND
APPLICABLE STANDARD NOTES.
1 HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON T'HE CONSTRUCTION SITE.
OWNER SIGNATURE APP ANT SIGNATURE
OFFICIAL USE ONLY.
RECEIPT DATE A('CF.I'1T D
NUMBER_ RECEIVED BY