15698 SW 82ND AVENUE I� ht R A!f
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15698 SW 82ND AVENUE ..,.
CITYOFT167ARD
CE:RTIFIrATE OF
CCTYOFTWARD OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT _ MGM PI-P1n I T #. . . . . . . : 149T90 -W99
131253W FW!Blvd. P.O.Bac 2W97,T)p",Onpcm 9=,J5WA6,19-4175
--- — DATE -T TSuF D: 03/ .tl l91
SITE ADDRES:a. . . a 15698 W (1.'ND AVE:: PARCEL : r_S I 1 CC—12100
SURD I V I S!nN. . . . a L ANr-jTPEE CS TPTES' ZONING: R-12
BL.00K. . . . . . . . . . . LOT. . . . . . . . . . . . . 153
CL.AGG OF WORK. :NEI-!
T'YV'f_ OF USE. . . c SF
(:)CCLIF,AIVC Y GRP. a R3
OCCUPANCY I_.OAD: 1 18 4
TENANT NAME. . . a
Fie m trk 5 : REAR STEPS TO LIVING ROOM SLIDER TO BE COMPLETED BY i_)WNIFIR
Owner :
TITAN PROPERT I EE.?
PO Box 6835
OL-OWN OR 97007
Phone #: 643#6477
cunt:raat<tor.
TITAN PrtOPERTIES
PJJ BOX 68,3a5
0L.014A OR 97007
Phone #a 6456477
Occupancy of the Pbove referenr. ed bi..tilciing ie hereby given, and certifies
the (_omplianc-W with the State Of Oregon SpeciAlt,y Codes for the group,
ocCupancy, and ose under which the t-Pferenc.-Pd pe.r mit WAS i55uoC.I.
07
FIRE DEPARTMENT fa IT-7ING 1NSt''F—C:TOR
or
DUTL' IC,!AL.
POST IN CONSPICUOUS PL.AC E
IN PEC.'TION_NO'fICF
City of Tigard Building Department
1.3125 Sit Ball Blvd. Tigard, Oreqon 97223
Inspection Line (Rec-O-Phone): 6.39-4175 Buwineen Phone: 639-4171
Inspection:_
Footing Plbg. Underelah Mech. Rough-in Appr/Sdwlk
t
Found Plbg. Top Chit Gas Line FINALt
Poet/Beam St:ruct. San. Lewer Framing
Post/Beam Wwh. Rain Drain Insulation �V Plumb.
Plbg. Underf;.--, Water Lina lyp. Bd. h.
Date Regn,_atodt �c� --Timet
Addreee:_.�/_/!� /1Cr_ Permit ♦i
Builder
THL: FOLU:NiNQ OCIRRBCTIONE ARC REQUIRED:VIP
"^�...-..
W/57 LA Y
---r-
LIZ
f
e. M
Inspect.ort _-_ Data: LOL_
APPROVED DICAPPPAMM APPROVED SUBJECT TO RRM
Call Por lhinsp. i
City of Tigard Buildfnq Date t:oent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone, G.9-4171
Inspection:-- --
Footing Plbg. Underslab Mech. Rough-in APpr./S_ ilk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -181',dg,
Poet/Beam Mech. Rain Drain Insulation —YIUmb.)
?lhg. Underfloor Water Line Gyp. Bd. h.
/� -�/
Date Requested: � Time: AM PM
Address:_ h Permit : tJ� 1
guilder:
THE FOLLOWING CORR'.CTIONR ARE REQUIRED:
Inspector: Date:
APPROVED DI8APP,"5VED — - 4PPROVEn SUB.IRCP TO ABOVE
Call For Peinnp.
INSPECTION NOTICE /fes_
City a! Tigard Building Department
1312S = Blab s1vd. Tigard. Oregon 97223
inspection Line (Roc-0-P nsjt 639-4.175 Suni.neds Phone: 639-4171
Innpection:�_ - -
F oting P1 Underslab s Mech. Rough-in Appr/Sdwlk,
Found. Plbg. Top Out
Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain
Insulation -plumb.
Plbg. Underfloor W+ter Ling Gyp. Bd. -Mech.
Date it,
Addreeo: �,J 101 --- Permit : s�
Builder:
TF[E FOLLOWING ODRRSCTT.oNS ARE REQUIRED:
S
-Z- C,
Lf� -
Inspectort
"PRpy=D DIShPPROVED i'/APPROVRD SUR.7E^T 74] ABOVE
Call For Reinap.
INSPECTION NqILIC
City of Tigard Building Department 7
13125 ON Hall. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-J-Phone): 639-4175 Business Phone: 639-4171
Inspect ion:.— — -----_----___—. —
Fcotinq Plbg. Underalab Mech. Rough-'u Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
PoW ,'Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line (� Gyp. Bd. -Mach.
Date Requested: ) U�� —�--- Times � �AM —PH
Address: j2 e57
Permit #:
Builder: __—
THS FOLLOWING COi(RBCTIOHS ARB RIQUIRBD:
09
Inspect. r
IiPPROVRD DISAPPROVED API'RtWFr) 3UBJlCT TD ABM
Call For Reinsp.
INSPE-_`T ON NOTICE
City of Tigard 1juilding Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone: 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underelab Mach. Roug'a-in inppr/Sdwl.k
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. S- . Sewer Framing -Bldg.
PosttP.eam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Meth.
Date Requests.-A: , a —11`„/ — Times AM PH
Address. !C /d C) y Permit 0:
Bu i l der:-------_--
THE FOLLOWING CORRECTIONS \RE RSQUIREDs
7
Inspector: /� I Dai e s
APP DISAPPP.om APPROVtD SUBJRC- TO ADM
. 9 ( Y Call For Rainsp.
i
.7(SPECTION N7CICE
City of Tigard Building Department 1�I�
13125 SO Rall Blvd_ Tigard, Oregon 97223 � 1
Inspection Line (Rec-O-Phone): 639-4175 Rusinese Phones 39-4171
Footing Plbg. Underslab !tech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation
N -Plumb.
P'.g. Underfloor Water Line Gyp. Bd. -Mech.
nate Requeste'i:— 7 Time= AM - ,PM
Address:—___1,`i7 Permit i:_ �i
Builder:— ;62"L - --
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector, ___ Datet Z_- /
APPROVED DISAPPROVED Y APPRoVRD SUBJECT TO ABOVE
Call For Reinep.
l
INSPECTION NOTICE
City of Tigard 131-ilding Departmeht! %
P O. Box 23397f/t..i
Tigard, Oregon 97223
Phone: 639-4175
' !
lype e
of Inspection _.-___- � c�1__�/Q'S,_ _
Date Requested '�_� // ime_— A P.M.
Address Permit #
Owner _ Lot
Builder. ,—
The following Building Code deficiencies are required to be corrected:
Presented to Evpproved
Inspector OlUpproved
Date
CALL FOR REINSPECTION
C7 YF8 O NO
RNA1W !_ Rel W i W-A-11-1
jAP6CTI0N NOTICF-
city of Tigard Building Department:
13125 SN Ball Blvd. Tigard. oregon 97223
Inspection LLne (Rec-O-Phone): 639-4175 Business Phone: 639-41.11
inspection:_---------
plbg. Underslab ech. Rough-in Appr/Sdwlk
--
Footing
Found.
Plbg. Top Out Gas Lin � FINAL:
Framing -Bldg.
Poet/Beam Struct. San. Sewer
Post/Ream Mect:. Rain Drain
Insulation -Plumb.
Plby. Underfloor Wetor Line Gyp. Bd.
-Mech.
Time: ��1U4 PN
Date Requeeted:
Addrean:, /`] (O _ Permit 1:_a__S1J1_
Builder
THE FOII.OWI CTIONS ARE REQUIRED:
_ VCS
Inspectors ____ -------
Date=
�pEpVEp 018AFFWVED APPROVED s"WICT TO ABOVE
—ka11 For lleinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sil Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businens P .n16'3'tt4171
Inspection:
Footing Plbg. Unders'.ab Hoch. Rough-in Appr/Sdwlk
Found. �Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. Ban. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Innulation -Plumb.
Plbg. Underfloor water Line Gyp. Bd. -Hoch.
Date Requoated: Timet �LAH PH
Address: —,r, e-1 '� �r s __ � Permit ft r�- i rr 9
Huilder• / � Tom.+. `_
THE FOLLOWING CORRECTIONS ARE REQUIRED-
Inspector:
EQUIRED:tnspector•��� Dates
APPROVED A DISAPPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INS PEC'r_ONNOT
City of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 635-41-,5 Business Phone: 539-4171
Inspection: _ — ------- ---
Footing Plbg. Underelab Mech. Rough-in Appv/Sd41k
Found. Plbg. Top Out Gas Line FINALt
i
Post/Beam Struct. San. Sewor Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -P 411
Plbg. Underfloor Water Line Gyp. Bd. 46och.
Data Rekr.eeted s �!/ �✓d - C ----.__-----._T ime:Addreau: _AN PM
Permit 1 /!a
Builder:__
THE 'FOLLOWING CORRECTIONS ARE REQUIRED'
Inspector:_��L
APPROVED -DISAPPROVED APPROVED SUBJECT TO Awn
Call For Reinep.
U1ff-AW-M
INSPECTION NOTICE
City of Tigard Cuilding Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
—` —�
Type of Inspection —�—
Date Requested------ /� _�s---- Time__ - A.M.-. �� P.M.
AddressZ� d — Permit #.71�__�?
Owner Lot # —
BuilderThe following Building Code deficiencies are required to be corrected:
/�1d � �� ,r ?� 1.`1"'7
Presented to __ _— �"pprnved
Inspector -_ � Disapproved
-/G
Date.
CALL FOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 839-4175
Type of Inspection ---
Date Requested - 9d Tune A.M. P.M.
Address _ l.5 d',� h __ Permit #1�
Owner Lot #
v
Builder
The following Building Code deficiencies are required to be corrected:
-
1-7
r
Presented to - - — •�App►oved
Inspector _ ,____ ❑ Disapproved
/C, '�';
Date -
CALL FOR REINSPECTION'
❑ YEt ❑ NO
4F W
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 22:197
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested �� �� Time .M. P.M.
Address G _.. Permit
Owner_..__-- Lot #t
Builder f The following Building Code deficiencies are required to be corrected:
/77
Presented to _ Approved
Inspector Disapproved
Date d� _
CALL FOR REINSPECTION
❑ YES (_] NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 l
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
P —
Date Requested Time A.M. P.M.
Address �� / [ Permit
Owner. _ Lot # __
Builder )
The
The following Building Code deficiencies are required to be corrected:
Pre!Pnted to Approved
Inspe.tor _� '�� � �____�. ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES Cl NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 839-4175
Type of Inspection
Date Requested. "l� — Time__ A.M. P` P.M.
Address Permit #
Owner _T Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented toX Approved
Inspector Disapproved
____
Date
CALL FOR REINSPECTION
YES 0 NO
N NW FV�W -TXRS W, W
CI7Y OF TIGA RD
CITY IID MAS rE.R P E R M IT
COMMUNITY DEVELOPMENT DEPARTMENT �wn F"EFINIT 0- 11ST90 0199
13 125 SW Hall Blvd. P.0 Box 23397,Tiglud,Oregon 97223(503)6394175
F'ERNIT 0, Irl ST90-0199
7.1 DAIL. ISSUED: 07/03/9
)-1T1-:! ADDRESS. 15i98 '3W 82ND AVE PARCEL: 2SI12C
U D 1)1 V I 1 310 N. . . . L A 0 T R LE ZO1,,11NG.-
C 1-C)(..K. . . . . . . . . . .. L UT', . . . . . » . . . . . . :53
...............
I-,A::J.13 S U E /GA DWELLING UMITSn '.13 EIASENENT. . . . . . . . (d 3 Sf
(A ASS OF* WORK. .NEW BEDR111S-2 wriis- 1.2 GnRn(31:-- '740 5 S f
TYPE OF USE. . . MSF FLOOR REOUI RED SE
TY1'-`E OF CONST. 15N F1:RS 1'. 4 S f L E FT. . .52 ft RIGHT. -02 -f I-,
0 C'I C,'U P A N C Y 6 RP. *.R 3 SE(,OND. . . :0 1i-f FRONT. 34Y ft REAR. . : ft
ST JR I E S. . . . . . . .. 1. THIRD. . . . .0 12 sf REQUIRED............-
Ff L IGHT. . . 1E3 ft TOTAL .74 S f SMOKE DETECTORS. :
I' l ()OR LOAD. . . . -.40 p f VOLUE-1. . . - 60240 1-"'A R K I N G S Fl A(,E S. .
e ni a r l.".S-
PLUMEIING ................
IN K S. . . . . . . . . .. ..2 FLOOR DRAINS. . .. . -0 DACKFLOW PREVNTRS. . .-
V OTO R I E13. 2 1 WATER FIEATE'RG. . . - I TRAVIS. . . . . . . . . . . . . .
I UP/SHOWERS. . . 11 LAUNDRY TRAYS. . . :i 0 0 ATC H BASINS. . , . . . .
WATER CLUSETS- :0 SEWER LINE (ft) . .00 GREASE TRAPS. . . . . . . .
1)ISHWO'SHIH:RS.. . . . -. 10 WATER LINE ( ft) . -.0 0 OTHER F'ixTURES. . . . . .0
GARBAGE DISP. . . -.0 RAIN DRAIN (ft) . - 1.0
WOSIAING MACH. . . SF RAIN DRAINS. . -
ME.CHAMICAL ....................... FEES
UNIT HTRS). -0 type anioLklit by date r e c-,p t
VENTS -.31 PAYM 100. 00 JLH 05/31/90 201271
NOX INPUT.-010F) D T U V E N*I' F A N 13. -.01. ri r:,RT $ ;31c,» 00
I URN < 100K . .. .0 140ODS. . . . . . ..0 D PL C $ 205. 40
F U R N )=-1.00K . .. .0 WOODSTOVES. . B51-'C- $ 1 15. 80
1-1 0 0 R F,1.)R N'. . . C:L.0 DRYERS. . 1 STDC: $ 600. 00
1401L./CMP < 31AP"
OTHER LINITS: 1 SSDC 1i 250. 00
GAS OUTLETS-.2 PARK * 250. 00
Owrierc M P R T $ 136. 00
T 1 'r AN PR 0 V1 E RTI E S MPL.0 $ 9. 00
DOX 6835 M5PC $ 1. 80
117. 50
11 1.1 A OR 9*700 7 P5PC $ 5. 88
IIic)v)p N. 6456477 PAYM $ 250. 00 JLH 06/2E/q6
(,orltractcir.. PA Y 11 $ 145'/. 38 J I H 07101--lip-,
I I ION FIROPE.RT I E S
PO BOX 681*35
ALOHA OR 9'7007
11-lorie N. C6456477
J 807. 38 TOTAL
This permit it issued subject to the regulations contained in the REOUIRED INSPECTIONS
Tigard Municipal Code. State of Ore. Specialty Codes and all other VoOt/fOUrld Irisp Mechanical 1115p
Applicable laws. All work will be done in accordance with approved Wtr Proafiriq 14sni PiLimb 'Top Ot.tt
plans. This permit will expire if wore is not started within 189 Post/Beanl 11-isp F'raniiriq Irisp
day: of issuance, or if work is sus�peded fo ore than 80 days. Crawl 1),I,A
. i 11 Fireplace Insp
Psin t 6 1.a b Gas L-014- .II-)S p
PCa'('111itt0e P I ni t.t ri d e r s 1.a b i.ii Iiist,kiaticivi
&ore t I 41a n
PILM/Under f I oar Gyp Board li-isp
F*triq Drain Bsml t Rairi draii-i J:114--p
.............. .................
UA.1.1 Tor i.iispec.,ttars
JAL
7-ITY OF' TIGARD RECEIPT OF rrivictrT F-,'['CETPT NO. 9 f)--21i)2 29
CHEC.*lt:' AMOUNT a 17-57. 36
11, ME z TVAN PROPEPTIES CASH AMOUNT
PAYMENT DATE
SUED 1:V 151 ON
ALOHA. OP 15698 `SW 82NE
PUR*POSE 13F N) MENT AMOUNT PAID PURPOSE OF P(4YMCTlT AMOUNT F."AID
FTTfi7DfNL; FlE ,-M M13T 9 1:)— 1919 f)() PLUM01 NG FERM
IIEC.HANICAL PE -36. ST. BUILD PER 27. 48
LAN CHECIh. FE 14. 4 C ',5TREET SEK
VIARKS SN'll 25C). ()s,�
tlit-10UNT RAID t 7. S
A
SEWER CONNECTION
CITYOFTIGARD V)ERMIT
cn RD I..,E:R MIT ##. . . . . . . s SIJR90---0214
COMMUNITY DEVELOPMENT DEPARTME11.7oReooN VoIRIM. FI1::RIT11T it. : MST91.9
0� 0. 9
13125 SW Hall Blvd. P.O.Box 23397,Tom,Orggon gF2 p°q)46 175 71
DATE" ISSUEDv 06/2t,./90
11 E: ADDRE.SS. SW 82ND AVE r.1 A R C E L-. 2 S 112 C C 1.EI.J.001
::;LJf4I)IVJ.'Cj1ON-, - ., - * LANGTREL ZONING:
LOI... . . . . . . . . . . . . ..53
I EH A N'T NAME. . . . . s
LJ S)A N0. . . . . . . . . . :4:1685 FIXTURE UNITS. . .
CLASS OF WORK. . . -NEW DWE'LLING UNITS. . -. 1
T'Y P'E OFF' USE:. . . . . s SF NO. OF BUILDINGS cl
ENST01 L `fP'E. . . . :RUSWR IMP'ERV SURFACE'. . c. ssf
;,:e ni a r k -- c
'ITTAN P'RUPERTIES type 1.k ni(:)t.t ii t by date -r e c.,1-.)-t
1:,0 BOX 6835 F:IRVIT $ 1250. 00
I N S P, $ 35. 00
Gil 01-10 OR 97007 1"'AYM $ 1.285.00 JLH 06/28/90
H-ic)rie Oc 6456477
(.','01ATRACTOR NOT (IN FILE
1.)C)1.1 e #V 9 12 K.'). 00 TOTAL
Rell
REQUIRED JNSPIECTIONS
This Applicant agrees to comply with all the rules and regulations
of the Unified Sewage Agency. The permit expires 129 days from ...............
the date issued. The total amount paid will be forfeited if the
Melt 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 "Tap and Side Sewer" Permit and the Agency will install a lateral, ............. ......
1"e-rolittee ...............................
I...-iscled By:
CAIN f c)'r i"I si P e e t I a ri 6:39-••4175
Jam"-7 7/� S• 3/ "�/'
CITY OF TIGA RD 4 � 57� 0 1,?q
C ranaxRD FLAN CHECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT `"�"� PLAN CHECK N 6 - ��,C'-
13125 S W.Hall Blvd-!`.0 Bu■7!397,TlgTnl,Oregon97m,(503)639 175 PERMIT N _
DATE ISSUED
Y,JOB l 4tESS: < ?� ) � TAX MAP/LOT
l
SUB: . _�XLOT : __ _'� LAND USE:
ALUAfION: —
OWNER l SPECIAL NOTES
NAME: REISSUE OF:
ADDRESS; LAST REISSUE: _
FLOOD PLAIN/
- -�� SENSI1IVE LAND:
APPROVALS REQUIRED
CONTRACTOR PLANNING: _
NAME : ENGINEERING:
ADDRESS: FIRE DEPT _!
—� OTHER:
PHONE: ITEMS REQUIRED
BUILDERS BOARD N: __ EXP DATE LIST/SUBCONTRACTORS:
BUS TAX:
ARCh/ENGINEER CALCULATIONS:
TRUSS DETAILS:
ADDRESS: — OTHER:
COMME-NTS:
a
SUBCONTRACTORS: PLUMB: _ CH:
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
1C•-432 00 Building Permit Fees
10-431 00 Plumbing Permit: Fees
10--431 01 Mechanical Permit Fees
_ 10-230 01 State Building -fax (5%)
Building
Plumbing
Mech
1%%-433 00 Plans Check
Building
Plumbing
Mech _
_ 30-202 00 SaWO P Connection
30--444 00 Sewer Inspection
51--448 00 Street System Dev Charge (SDC)
52- 449 00 Parks System Dev Charge (PDC) _
31 -450 00 Storm Drainage Syst Dev Chr•g (SSDC) _
10--230 06 F ire _ y
l TOTAL _
/ � Lj _ --- ---- REr N
APP ICAN SIGNATURE
Received By: _-._. Date Received:
cn/3587P/18P
CITY OF TIGARD RECEIPT CIF= F.,AYMF*tl'f' RECEIPT No. : 90--2`012
CHECK AMOUNT 221 .CJO
TITAN PROPERTIES C',,Al:N AMOUNT 0. Oo
('J4 J:t-:, PAYMENT PATE Ot-V311, 140
f SUBDIVISION-
BEAVE,VJON, OR '7700-,--
I UV,FATA-'. 0F"' F"A Y ME N T L AMOUril P� I Ti F-IliPf"LISE 0fy F-A Y 11 ANDIRAT PAID
FU-'&I CHF-Cf; FE '19R 1.:1 6*6 CHECK FE w5. 7 1F, 100.00
II
TOI-' L. AMOUNT F-AID 2 1 0 Q
C17YOF TIFARD
�o►ncoW PLAN CHECK A
COMMUNITY DEVELOPMENT DEPARTMENT "�"°"" / PLAN CIIEC
13125`S W Hall Blvd..P.O Box 23397,Tigard,Oregon 97223,(503)6394175 /
PERMIT
DATE ISS
Y JOB .[ RESS: _ TAX MAP/LOT
LAND _ / ��C. G 1g2100
SUB: _XE.01 : _ S� USE:
VALUA_I TON: _� �
OWNER � _ — SPECIAL NOTES
NAME: _ REISSUE OF:
ADDRESS: LAST REISSUE: — ~--
'r� FLOOD PLAIN/
_ SENSITIVE LAND:
` PI LONE: --
Zi
APPROVALS EQUIRED 1
CONTRACTOR _ ' ,, PLANNING
NAME: - - — IRE
GINEERIIIIG; _
ADDRESS: v V_ DEPT
%T11ER:PHONE: MS RE UIRE6
BUILDERS BOARD #: _ _— EXP DAT LIS /SUBCONTRA TORS: —
BUS AX:
ARCH/ENGINEER CALCULATIONS:
NAME :_ _ TRUSS DETAILS: _
ADDRESS: -- — —` — —+ OTHER:
PI ION[
SUBCONTRACTORS: PLUMB: MECH: .. >`t T:2c�
PERMIT ACCT M DESCRIPTION ' AMOUNT AMOUNT PD. BAL. DUE
10- 432 00 Building Permit Fees �.ov
10-431 00 Plumbing Permit Fees
` 10 431 01 Mechanical Permit Fees
10--230 01 State Building Tax (5%) r
Building a
Plumbing
Mac -
10-433 00 Plans Check Fee p;t J
Building _ 24, c1�" -
Plumbing
Mech -
0 ol01 30-202 00 Sewer, Co—
nnection 0 I
30-444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC)
52-449 00 Parks System Dev Charge (PUC)
31-450 00 StO-m Drainage Syst Dev Chrg (SSDC)
10--230 05 Fire `
\ i � TOTAL
RFC M !d 7:26 'S
APP ,TCAN SIGNATURE
Rareived By: _�� - - Dare Received:
CITYOFTIGrARD
CH Mow�w PLAN CHECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT % PLAN CHECK N
131S.W.
35 all Blvd., Bo.23397,1'igartl Oregon 97223,(50.7)6391175 PE RMI F N A
!. a o DATE ISSUED
� Q
JOB IN KESS: I rJ u U TAX MAP/LOT - /•-2('G /-1/00
,
SUB: ,�) - XL0 i : _ -- LAND USE:
/VALUAFION:
OWNER /� I ` �— �— SPECIAL NOTES
NAME: _ _ REISSUE OF: _
ADDRESS: LAST REISSUE-
7 FLOOD PLAIN/
SENSII IVE LAND:
PHONE:
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: M�_ _ ENGINEERING:
ADDRESS: FIRE DEPT
OTHER:
PHONE. _ - ITEMS REQUIRED
BUILDERS BOAP"i N: EXP DATE: (3s LIST/SUBCONTRACTORS:
BUS TAX:
ARCH/ENGINEER CALCULATIONS: _
NAME : TRUSS DETAILS: _
ADDRESS: OTHER:
PHONE.: --- --- - -- _
CuMMENTS:
SUBCONTRACTORS: PLUMB: �(L___ �. y/ MECH:
PERMIT M ACCT Al DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10- 432 OO Building Permit Fees =�314
� f
10-431 00 Plumbing Permit Fees - )V
10-431 01 Mechanical Permit Fees v ' , u 3(0 -
10-230 01 State Building Tax (5%)
Building $Ptll " t-
Plumbing
Mech
10--433 00 Plans Check Fee M2/ 4 0 7o
Building � 4' q u �Z
Plumbing l /�
Mech `77", .1
,tu/2 JO (1a2Acr 30---202 00 Sewer Connection 1 S 0 /L
30-444 00 Sewer Inspection J
51--448 00 Street System Dov Charge (SDC) ✓ 400 • u
52--449 00 Parks System Dev Charge (PDC) a
31-450 00 Storm Drainage Syst Dev Chrg (SSDC) aSU 2 r "L I'
10-230 06 Fire
TOTAL
R[C M
API-h CAN SIGNATURE 'S
Received By: - - _ _--- - -- - ---- Date Received:
cn/3587P/18P _
■I i i i i i i i
1�5 3
GRADIN(;/EROSION CO,ITLZ L INFORMATION .
GENERAL CONTRACTOR NAME& ADDRESS: CASEFILE NO.:
cjltj�j PERMITNO.:
I Am 7
APPLICANT NAME AND ADDRESS:
EXCAVATION CON"IRAC'I'OR T17An1 PRC,) ' fl 1:ll�
NAME& ADDRESS: Rox-� 13T
OWNER NAME AND ADDRESS:
TELEPHONE NUMBERS:
APPLICANT: c 1 1 PROPERTY DESCRIPTION:
OWNER` E . _ STRFET A SS D CRO2 TEST TED
GENERAL CON"IRAC'1UR: 4 . 1 `1 LuI
EXCAVATION CON'1'RACTOR: ' (1
SITE/)013:
LEGAL DESCRIPTION:
7.4 1!R/AFI'F7.R HOURS EMEi'GENCY TAX LOT NO.:
Co ACiC PERSON,-4'IH.E,1.',E.EPIIONE: 1/4 SECTION:
TCt� SHL:SIZE,ACRES:
DISTURBEDIWOIRK AREA,ACRFS.—
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL HE TAKEN SIZE RUNQI-F DRAINS TO: (CIRCLE ONE)
(NOTE:PERMITS MAY BI:RE"OUIRED) 1'CA'TCIf-BASIN D1TCEi PIPE CREEK
(CIRCLE ONE) FgLMD PROPERTY
CfiUHLIC RIGf1T OF WAY
J.R05 O J EI)1MENTAT1QN CONTROL (ESC) MEASURES
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DI IRING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRl1CTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIMETER RUN011T CONTROL FACILITIES
CLEARING AND GRADING RI S'IRIC'I IONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES
CONSTRUCTION SEQUENCE OIIIER
0'111 ER __--_"-----._--"
PIAN FOR EROSION CONTROL PREPARED AND SUBMTED IN ACCORDANCE WITH"TECHNICAL GUIDANCE HANDBOOK".
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION 140TES COMPLETE,INCLUDING EMERGENCY
PHONE NUMBER, SCIIEDULFISTAGING[-)R INS'1'AI.I.ATION AND REMOVAL OF EROSION CONTROL.MEASURES,AND
APPLICABLE STANDARD NOTES.
1 HAVE RUAD AND WILL COMI'LY WITH THE ABOV` SND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TOCONTAINS .n MENTONTHECONSTRUCTIONSTTE.
_fir
OWNERS ATTIRE APPI.I A NATURE
OFFICIAL USE ONLY.
RECEIPT DATE
11:E NUMBER RECEIVED BY
R
v
GiZADINGIFIt SION CON'rg0l, INFORMATION
GENE-RAI.CONTRACTOR NAME& ADDRIISS: CASEFILE NO.,
PERMIT NO.:
APPLICANT NAME AND ADDPESS:
EXC'AVAT'ION('ONl'RAC'T'OR r11Apj_ PftuPZk
NAME& ADDI'.ESS: - O
DO '1
OWNER NAME AND ADDRESS:
TELEPHONE NUMBERS:
APPLICANT: I " 1 PROPERTY DESCRIP'T'ION:
OWNERS _ 1sl-REP'ADD �$iS AND CROSS STREET/L ORATED
GENERAL CONTRACTOR: j'
EXCAVATION CONTRACTOR: 11-2 (Z— - —
S IT I:/1013:
LEGAL DESCRIPTION:
24 tIF/AF-I LR HOURS EMERGENCY TAX LOT NO.:
CO ACT P "ERSON, T'1'LE,'TELEPHONE: - 1/4 SECTION:
C� E v SITZ.SIZE,ACRES:
_ VHS' `j
DISTURBED/WORK AREA,ACRES:
LOCATION& ADDRESS WHERE SPOILS
LEAVING SITE WILL BETAKEN SITE_.RQN FF CkAINS TO:(CIRCLE ONE)
(NOTE.PERMITS MAY BI:RI:Ql11RI:1)) �A.jg BASIN DITCH PIPE CREEK
(CIRCLE ONE) PajyAjL PROPERTY
01 5 ;C RIGHT OF WAY
EROSION/ ES QJMENTATION CONIR01, ISO MEASUM
MINIMI IM ESC RL'QUIREMFiNT'S MINIMUM ESC REQUIREMENTS
DI JRING CONSTRUC ION: FOLLOWING CONSTRUCT10'is
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRIK'1'I0N ENTRANCE REMOVE AND RESTCRE TEMPORARY ESC
PERIMETER RUNOIT CON'11t01. FACILITIES
CLEARING AND GRADING RESTRIC'T'IONS CLEAN AND REMOVE ALL,SILT AND DEBRIS
COVT:R I'RAC-FICES ENSURE OPERATION OF PERMANF Ft\CILITIES
CONSTRUCTION SEQUENCE OTHER___
anwit
Tilt
PLAN FOR EROSION CONTROL PREPARED AND Sl1BMITTED IN ACCORDANCE WITH-TECHNICAL GUIDANCE HANDBOOK".
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING EMERGENCY
PHONE NUMBER, SCIIF.DULGSTAGING Foil,INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND
APPLICABLE:STANDARD NOTES.
1 HAVE READ AND WILL COMM Y WTI'il THI:ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SL•DIMENTON THE CONSTRUCTION SITE.
_lOWNFR S1 ATTIRE A PPI It Allrj ,NATURE
01 1CIAL USE ONLY.
RT C111'1' DATE ACCEPTED
n.1. NI!WWII It RECEIVED BY