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14500 SW 92ND AVENUE *� ADDRESS: 14500 SW 4?aov-)A fl: F- N Y J ca r� C.9 isVeuirdslmicro(IriAlargetsVwilding.doc: CITY OF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT 13125 SW Nall Elvd.Tigard,Oregon 97223*8199 (503)639-4171 w fA-.' .J -,�r' / NBPECTION NOTICE City of Tigard Building Dep���Rt 13125 SW Hall Blvd. Tigard, Oregon 9722 Inspection Line (Rec-O-Phone)e 639-4175 Business Pho ej.. Inspections Footing Plbg. Underelab Hoch. Rough-in P.ppr/Sdwlk �l Pound. Plbg. Top Out Lias Line INAL Poet/Beam Struet. San. Sewer Framing Bldg. Vogt/Beam Rech. Rain Drain Insulation -Plumb. Flbq. Underfloor Nater Line /� J Gyp. Bd. _Hoch. Date Requesteds l✓ � r Cl %, `L?�s u( PH Address: •� `> > ✓ C Permli-1/ ! ?r Cr2-(p Builder- THE FOLLOWINC ARF RFgUIREDs c�� I 4d 00 Lie f, L Inspectors Dater ROVLO DISAPPROVED APPROVED SURJEC( TO ABOVt call For Reinsp. Residential Building Permi' application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171 /� a2s//��►; - GSoov Jobsite Address: )Vcc��-oo S� 9 2 1 Ue, '� ---'- OtflCd Use Only Subdivision: _ �C')"r �t'�'1'�QCe Lot # 2 Valuation: Plancki riec# Permit # 5 3 -. �2 #� Owner: � Reissue of_ Address: I` 5DO St,-,) Approvals Required Phone: 2_y-61q 1 63LLID8 Were Planning / Engineering Contractor: /�o�L r ✓�1/ (nT�'1-- Other >>� << Address: Items Required Sutx;ontractors Phone: Truss Details Contractor's License # (attach copy of current Oregon license) Other Subcontractors: Plumbing: AI ,Mechanical: (attach copy of current OR Contractor's License) Archltect/Englneer• ,/IVvhG Address: c. Phone:LD LL: r JVk ooh roc rG �^ ark IIA — 1-Iv w4/1S 6v- f/O°r,_ CC-MMENTS: Applicant Signature R Phone number Received by: � _ _ _ Date Received: Permit # Account Description Amount Amt. Pd. Bat. Due Bldg. Permit (BUIL D) Plumb. Permit (PLUMB) _ Mech. Permit (MECH) State Tax (TAX) 2. Z 3 Z•1-5 Bldg: Plumb: Mech.- Plan ech:Pian Check (PLANCK) 2F. Bldg: 3 Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) _ Parks Dev Charge (PKSDC) Storm Drainage Chg (SDSDC) Residential TIF (TIF-R) Mass Transit TlF (TIF-MT) Commercial TIF (TIF-C) Industrial TIF (TIF-1) F- �" Institutional TIF (TIF-IS) Office TIF (TIF-0) J CG Water Quality (WQIJAL) w J Water Quantity (WOUANT) Fire District (FIRE) f TOTALS: S. G �?' SD. �/i F~—� Permit No: 1�yw :� Address - -- ie h : � ;10 Issued by: Date: __-_ _..._—FOR OFFICE-USE ONLY-------- STATEMENT: NLY—_____STATEMENT: INFORMATION AOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) . requires residential construction permit applicants who are not registered with ;he Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for rec-idential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, axempt frorn registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313: 1 . f 1 own, reside in, or will reside in the completed structure. 2. El? i understand that I must register as a constructio,i contractor if the structure is sold or offered for sale before or upon completion. 3. A.I I My general contractor is -__ -_ Contractor registration number__ I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B. J] I will be my own general contractor. If I hire subcontractors. I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Hoard and I will immediately notify the office issuing this building permit of the name of the contractor. I h,reby certify that the above information is correct and that I have ream and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side-,9f this form. rgnature of Permit pplicant Dat CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT L I I'Y OF 'I I BARD RE.::(::L I U)T' (1F PAYMt N I RL I I,.I PI NO. a 9 3- 9 CHECK AMCIUN 1 a 50. 6;3 NAME a Mc HE I*H, PAUL. CASH AMOUNT' a IA. 170 ADDRESS 14500 SW WIND kvF PAYMENT' DAW a )0/15/93 T I IIARD, OR SUBD I V I S 1 ON a PURPOSF OF VIAYMI NT" AMr1L.1N1 PAID PURr."Of3E. OF r'"YMF:N T' AMCII.IN 1 PAID LILIII_DING VIFRM MST'93-0526 44. 5171 67. BUILD PF14 P. 23 Pl_AN CHE l.K FF: 3. 90 T Cl'tAL. AMOUN r r-�f�r 11 _.. _. _., 50. 63 ully (IV, 1166041) pi 1.1$-4YMF- N I lit-AA-44-If NO. (A4f-'(,K AMoIJNI 1 H, PAUL CASH 14MIKIN T ODDRESS a 141,51710 IbW 9PND AVE PAYMEEN1 DAT+ 10/1 J /93 9IJ 8 0 L V P31 ON T114ARD, OR 97223— W." 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