15472 SW 82ND PLACE s m �
15472 SW 82ND PLACE
IF-am �
/� �� CERTIFICATE OF
CITYOFTIOARD ( rra� OCCUPANCY
�C"YOFTNARD PERMIT a. . . . . . . s MST90-0118
COMh?PUTTY DEVELOPMENT DE.,P"# a�T OREaoa
7 � PRIM. PERMIT M. i, M�aT'�H--F111.�i .
13125SWlbtllBlvd. P.O.Box 23347,Trard,Oregon 97223(603)63EQt s DATE: IbAUEDV 08/03/90
SITE ADDRESS. ,. . s 1.5472 SW 42ND PL P4RCELs 29112CB -•06400
SUDDIV':SION. . . . n ASHFORD OAKS ZLINTNOs
BLOCK. . . . . . . . . .. . L07. . . . . . . . . . . . . i 1))8
CLASS OF WORK. sNEW
TYPE OF USE:. . . r SF
OCCUP^LACY GRP. s R3
OCCUPANCY Ll1ADs220 4
TENANT NAME:. . . s
Remarks
JAY )MILLER
PO BOX 23291
T I BARD OF 97223
Phone N r 684-7543
Contr.•c-tors
JAY MILLER
PO BOX 23291
TWORD OR 9*7223
Phone Ms 684-•7543
Reg b. . s 301.09
Occupancy of the abode building is hereby given, and vertrifies
the compliance with the St•atw Of Oregon Specialty Codes for the group, �
cirr-upancy, an,', use under wh i r. h the •reforPnced permit was issued.
�
FIRE DEPARTMENT I LDIN[3 INS)P _CIUft�
BUIL NO (I .iCIAi.
POq'F iN CIIN PIC'UOUS PLACE
INSPECTION NOTICE 1„w ly
City of Tigard Building Department \D
P.O. Bax 23J97
Tigard, Oregon 9,'223
Phow 6394175
Type of Inspection --- 16
-- ----- _. -- -- ------
Date Requested __�-3�a Time_�_ A.M. P.M.
Address - _� ��' "�—"`_.-- _.__..__ Permit
Owner ___�._._.-____ __ Lot
BuilderThe following Building Code deficiencies are required to be corrected:
Presrnte.i to _ _ Approved
Inspector _ 'r __ [ � Disapproved
-
Date --
CALL FOR REINSPECTION
E-1 YES ❑ NO
ram
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 972;?3
Phone: 639-4175
Type of Inspection
Date Requested [ 1 nn�3 A.M.
!l� —7 _ v_P.I►!!.
Address Z / � � Permit di • ����
Ownerz _ __ Lot
Builder
The following Building Code deficiencies are required to be corrected:
�.--i i 1.1.r ,y.� � 6a `�;,.- ''x �"• � [_
49 4col
GL
,A0 ,.' / z �
Presented to Approved
Inspector Disapproved
Date _ —L.a-- --
C ' FOR REINSPF,CTION
0 YES EP-960'
"W FW
INSPECTION NOTIOE
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.
Address
Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
1017f,
L401,")
1017f,
/e
A
Presented to oft Approved
Inspector 777 ��Isapptoved
Date
CALL FOR REINSPE(TION
F-P--'ViE9 ONO
■ W1 W1 IR i � W alln
INSPECTION NOTICE
City of Tigard Building Oepartme.zt /
N.O. Box 23397
Tigard, Oregon 97223
�,, Phone: 639-4175 _
Type of Inspection �_�2 ��2- ;,�-- a J�
Date Requested__-- _._-9u 6 12y Time c_A.M. / P.M.
4.72
Address �_ Permit #� L
Owner- _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to rA-Klp—proved
Inspector �_._. Ij Disapproved
Date __
CALL FOR REINSPECTION
�-1 YEa C] NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection --
Date Requested ''� �T� Time_ A.M.�., P.M.
Address /�� �. _`? -� Permit
Owner _ __-�--_ �.--_--- Lot
Builder
The following Building Code deficiencies are required !o be corrected:
Presented to Approved
Inspector +!' Disapproved
Dale
CALL FOR REINSPECTION
YES [:�] NO
— INSPECTION NOTICE /
City of Tigard Build ng Department
R0, Cox 23397
Tigard, Oregon 97223 /1�
Plone: 639-4175
Type of Inspection --
Time
i[ Time A.M.. _P.M.
Date Requested_ -1 --/� Permit
Address _
Lot
Owner ---- — - — —
Builder — - ' — ---
The following Building Code deficiencies are, requ;red to be corrected:
Presented to — -- -- Approved
InspectorDisapproved
-.----_ __
Date Y
CALL FOR REINSPECTION
[] YE= 1:1 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
"igar+ Oregon 97223
Phone: 639-4175
Type of Inspection — /�� n
Date Requested �� 0 Time A.M. P.M.
Address hd Permit oeL e,
Owner Lot #
Builder r�)
The following Building Code def[wenci is are required to be corrected:
Presented to Apprnved
Inspector Disapproved
Data
CALL FOR It E WSPECTION
VES ❑ NO
U II
INS'ECTION NOTICE
City of Tigard Building Department
P O Bo). 23397
Tigard. Ore lon 97223
Phone. 639-4175
Typ9 of Inspection —
Date Requested--.,--- �L�L= Time � A.M.�__—c��,P•M. �>
Address --- — -- -- — — Permit
Owner_,_— --s�,� ---- r� Lot #_ _
Builder �+'
The following BwA=iingdedeficiencies are required to he corrected:
Presented to _ ❑ Approved
Insp•etor �'" ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YE! C7 NO
UUULJ- UuuLi i -io i
CIIYOFT167ARD MASTER PERMIT
CrTYOF TWA 0. . . . . . . ; MST90 01.1.8
COMMUNFTY DEVELOPMENT DEPARTMENT OREGON PRIM. PERMIT, 0. : "IST'90-01.18
13125 SW HeA Blvd. P.O.Box 23397,Tigsid,O"Pgon 97223 75
C, 3`:i 1)A TL 1.S
3UED; 03Z26190
SITE ADDRESS. . . -. 15472 SW 82ND FIL PARCEL: 2511.2CB---0C,400
SUBDIVISION. . . . : ASHFORD OAKS ZONING-,
BLOCK. . . . . . . . . . : LOT. . . . . . . . :78
BUILDING
REISSUE: DWELLING LINIT5: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . .. . . . . :467 sf
TYPE OF USE. . . :SF FLOOR AREAS------- --- REQUIRED SE'T"BACKS.-._.._.._-.-.....-...._....
TYPE: OF CONST. z5N F-IRST. . . . .. 1280 sf LEFT. . :6 ft RIGHT. c6 ft
OCCUPANCY ORP. -.R3 SECOND. . . :852 sf FRONT. :20 ft REAR. . s31 ft,
STORIES. . . . . .. . ,:0 THIRD. . . . ..0 sf
HEIGHT. . . . . . . . 20 ft TOTAL------.12132 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . -40 pf VALUE. . . . . 97950 PARKING �'PACES. . :O
Rema-(+.sc
PLUMBING
SINKS. . . . . . . . . . : . FLOOR DRAIIqS. . , . !O BACKFLOW PREVNTRS. .. :0
LAVATORIES. . . . . :4 WATER HEATERS. . . : 100 TRAPS. . . . . . . . . . . . . . :O
TUB/SHOWERS. . . . :2 LAUNDRY TRAYS. . .. -0 CATCH BASINS. . . . . . „ :P)
WATER CLOSETS. . :3 SEWER LINE (ft) . :.0 GREASE TRAP'S. . . . . . _- o
D113HWASHERS. . . . : 1 WATER LINE (ft) . : 100 OTHER FIXTURES. . . . . ::0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :O
WASHING MACH. . I SF` RAIN DRAINS. . : 1
MECHANICALFEES
UNIT HTRS. . -.0 type amount by date reept-
/GA S/
/GAS/ VENTS . . . . . sO PAYM $ 100.00 JLH 03/,21/90 :101959
MAX INPUT:O BTU VENT FANS. . :4 BPRT $ 427.00
FURN < 100K . . o@ HOODS. . . . . . .. I BPLC $ 277. 55
FURN >=100K . . : I WOODSTOVES. .-0 B517)(1, $ 21. :351
FLOOR FUkN. . . . :0 CLO DRYERS. : 1 STDC $ 600.00
BOIL/CMP < 3HP:0 OTHER UNITS:O SSDC $ 250. 00
GAS OUTLETS: 1 PARK $ 250. 00
Owner: III FIR T 1, 40. 50
JAY MILLER MPLI' $ 10. 12
PO BOX 23291. 115f)(11 41 r.0;?
PPRT $ 140. 00
TIGARD OR 97223 P50C $ 7. 00
Phone #v 684--7543 PAYM $ 1925. 54 JLH 03/26/90
Contrac-tor:
JAY MILLER R
PO PDX 23291
TIGARD OR 97223
Phone #*. 684-7343
Reg O. . c 30109
$ 2025. 54 TOTAL
Thi% pereit is issued subject to tie rejulations contained in the REQUIRED INSFIECIIONS
Tigard Municipal Code, State of Or!. Spocialty Codes and all other Foot/found Insp Plumb Top Out
applicable laws. All work will be done in accordance with approved Wtr Proofing Psm Framing Insp
plans. This pervit will Pipire if io4, is not started within ISO Post/Roam Insp Fireplace Insp
days of issuance, or if work is suspended for more thin 161 days. Crawl Drain Gas Line Insp
PIM/Undslakh Insp IIISLIIati011 Ins f1
PI-M/ lout, Gyp Board Insp
Permittee Signature: 7 ,
Ftng Drain Psin' t RAin drain Insp
Issued Bys
Mechanical Insp Water Line Insp
- Call for _i1i*jLe- L ' ren 639-4175
TIN
SE*..WER CONNECTION
CITY OF TIGA RDCCIlY0F11WARD
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT � PERMIT 4. . . . . . . : 13WR90 01,26
OREGON
-
13125 SW HsWI Bbd. P.O.Box 23397,1 i(Wrd,(Xogon 97223 & -4175 P RIM. !_`V:RMIJ MST9001.18
(�.3'!60�4'1W7.1. 1�_DATE
SITL ADDRESS. . . : 1'j4 /i2. SW 82ND 1`11- PORCEL: 2SJ.1.2CP--0C,400
SUDI)11).1 S I ON. . . . : AGHF`ORD OAKS Z NI N C.)
D L 0 C I/. . . . . . . . . . : L01 . . . . . . . . . . . . . 78
'y'ENANT NAMEK.. . . . . .
I SH NO. . . . . . . 406:)O VIXTURE UNITS.
C _ASS LOF` WORK. NE W DWELI 1.N G) U N I FS. I
'1(F`E OF' JSL. . . . . SF- NO. OF' BUILDINGS: ].
IN('31-ALL TYPE. -DUS411 IMPERV SURFACE. f
Remarks
JAY MILLER type alIMMIt I)y date rec p t
PIC) BOX 23291 PIRMT $ 1250. 00
INSP $ 355. 00
TIGARD OR '97223 PAY11 $ ].20`'. 00 JLIA 03/26/90
Plimie #.- 684-7543
(.'C)NTR0C,*TOR NOT- ON F'ILE
1:11 1-1 c.)vi e 0 1285. 00 TOTAL
Reg 0.
RFOUIRED INSPECTIONS
This Applicant agrees to cosply with all the rules and regulations Sewe-r Iiispeetiori
of the Unified Sewage Agency. The per-it expires 120 days fros ......
the date issued. The total mount paid will be forfeited if the
persit expires. The Agency does not guarantee the accuracy of the
side sever laterals. If the sever is not locatpd at the veasurement
..............
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 Age will instal a lateral.
Permittee
lssmted Byl
Call for iiispe(:tiovi G39-4175
r
,
CITY OF T 1(3ARD - RECEIPT OF PAYMENT REC Was OOI U8028
CHECK AMOUNT 77'210-54
NAMEo JAY MILLER CASH AMOUNT t .00
ADDRESS: PAYMENT DATE: 0.1--26-1�O
TIGARD, OR 9.72 7r SL.l1Ck: NWADDRs
154-12 SW KND PL
PURPOSE OF PAYMENT HeICIUNT PAID PLIPPOSE OF PAYMENT AMOUNT PAID
__-._____..._ ____.._.._.____
BUILDING PERMIT '90-0119) 4;2''.0[1 PLUMBING PERMIT 14 0.00
MECHANICAL PERMIT 40.50 STATE BUILD PERMIT TAX (5i) 30.37
PLAN CHECV FEF 107.67 SEWER LISA (90-0126) 1.250.00
SEWER INSPECTION 37,.00 STREET SOC 6(70.0[1
PARKS SYSTEM DEVELOPMENT CH :,50,Ori ST'OR'M DRAIN SDC 250.00
I
TOTAL AMOUNT PAID - - r.2to- � 1
!Nl Hls HTE ND Nf' ! N1 e
C17YOFT11FARD ��` �,�,.. P_00 CHECK APPLICATION
NT RYIi
COMMMITY DEVELOPMEDEPAENT �w P1.M CHECK • -- r,
UM ay.NO srL s a o..twos.Tlewd.Ompm Cass psa,ae4in PERMIT / in7O-O 77?
DATE ISSUED
JOS AODSESS: 1 S Y 7 S W• �� � � T14X MAP/LOT �� � � z C�; C
Sue: ti1 l O✓5 a C. S LOT: e) LAND USE: _
VALUATION: _
OWNER SPECIAL NDTES
NAS: REISSUE OF: _
ADDRESS: _ LAST REISSUE: _
_ FLOOD PLAIT/
SENSITIVE LAD:
PHONE:
APPROVALS REQUIRED
QONTRACTOR PLAWING:
NAME: Jay Miller Builder,, lnc. ENGINEERIM: _
ADDRESS: PO BQx 2 3 2 91 _ _ FIRE DELT
rigard, OR 97223 _ OTHER:
PHONE: 6 4 1 - 1 9 2 2 ITEMS REQUIRED
BUILDERS BOARD R: 59667 EXP DATE: 3,, i 1 ,OJ LIST/SUBOONTRACTORS:
BUS TAX:
ARCH/ENMNEER CALOJLATIONS:NAME:- TRUSS DETAILS:
ADDRESS: OTHER:
PHONE: -- —
ODMIMENTS:
SUBODNTRACTORS: PLUMS: lean warts. 50878 : Rett Hpatinq nnAa7 Z !o
PERMIT 0 ACCT if DESCRIPTION AMOUNT AMOUNT PD. IAL. DIE
M>t9y•U11`h 10`432 00 Building Perult Foes
10^431 00 Plumbing Permit Foes V - yc
10-431 01 Mechanical Permit Fees - C• Z
10-230 01 Stat* Building Tax (5%) 0.3
Building21. 3�
Plumbing —j 7 o_
Moch _ 2
10-133 00 Plans Check Foe
ry
Ruildirg
P lamb i rg
Mock
20-202 00 Somer Connection
W-444 00 94moer Inspection 3
51--445 00 $trust System Dov Charge (SOC) q
52-449 00 Parks Sys tar Dow CharRs (PDC) t-
31-450 00 Storrs Drainage Syst Dow dvy (SEDC) �3 u
1u--230 Os Fir.
TOTAL _Y < .701 U
NEC • ,�?
ALICANTiiiiiU�
Received Sy: ,� Dsts Received:
Cn/3'S87P/1 SP !
ti
CITY OF TIGARD RECEIPT OF PAYME14T REC Wt 00107959
CHECK WOUNT ZOO.00
H;-PIE: JAY MILLER CASH AWILINT .00
o�`DRESS: FO BOX, 27'2'y1 PAYMENT DATE t 03-21-90
TIGARD, OR 97227, BLOCV NO/ADDRt
�''PPOSE OF P(oMENT AMOUNT PAID PURPOSE OF F'At'MENT AMOUNT PAID
Pi-AN CHEC,' FFE '.-c,'72w,) 100.00 FLAN CHU1, FEE, (Z.-6:7�R) 100.00
TO!f--iL AMOUNT PAID 200.00
ffff
GRADiWEROSiON CONTROL INFORM TA iON
GENERAL CONTRACTOR NAME&ADDRESS: CASEFiLE NO.:
Builder Inc PERMIT NO.:
PQ ?3 9 1 --
='lqar OrPQnn 97221APPLICANT NAME AND ADDRESS:
EXCAVATION CONTRACT Ja i 1 1 ro r R i i i 1 r7 a r T n r
NAME&ADDRESS: po 91
Jim Paulson Excavating Tigard Or 3'7223
Route 1 OWNER NAME.AND ADDRESS:
Hillsboro, Oregon 97124
TELEPHONE NUMBERS:
APPLICANT. 6 8 4 7 5 43 PROPERTY DESCRIPTION:
OWNER, 684 7543 STREET ADD RESSANp.trRO�SS STREET/LOCATED
GENERAL CONTRACTOR: 6 8 4 7 54
EXCAVATION CONTRACTOR:6 4 5-101 1 `
SrrEJJOB: _
LEGAL DESCRIPTiON:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO.:
COLI A1CT PERSON,TTi1E,TELEPHONE: 1/4 SECTION_
a e Eickhof F SiM SIZE,ACRES—
supp
b39-7798 DISTURBED/WORK AREA,ACRES: _
LOCATION&ADDRESS WHERE SPOILS
IEAVING SiTE WILL BE TAKEN SITE RUNOFF DRAINS TO:(CIRCLE ONE)
(NOTE:PERMTTS MAY BE REQUIRED) (CATCH-BASIN DITCH PIPE CREEK
Stumps & brush to 1 i srenred
fill area. Dirt to license_
dump site. (CIRCLE ONE) PRiV_A_TE PR(A-ERTY
T I E A 2l7 gA"t) � L R AV t;L u_ RIGHT OF WA
�R S10N/SEDIMENTATI0N CO OL (ESM MEASURES
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DURIrIG CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION 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 AND DEBRIS
COVER PR,ACrICES ENSURE OPERATION OF PERMA:QT FACILiTffS
CONSTRUCTION SEQUENCE OTHER
OT HER �—
PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED iN ACCORDANCE WTrn"TECIITIiCAL GUIDANCE HANDBOOK".
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HA PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY
PHONE NUMBER, SCHEDULE/STAGING FOR INSTAL .ATION AND REMOVAI.OF EROSION CONTaOL MEASORES.AND
APPLICABLE STANDARD NOTES.
I HAVE DEAD AND WILL.COMPLY WTTTI THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
'
TO CONTAIN SEDIMENT ON 77IE CONSTRl1CT10 SiTE.
i
SIGNA R SIG
OFFICIAL USE ONLY.
RECEIPT DATE ACCEPTED
FEE NUMBER_ RECEIVED BY