16082 SW 93RD AVENUE ■� if w fa
16082 SW 93RD AVENUE
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CITY OF T167ARD BUILDING PERMIT
�,��
PERMIT
T NCl :s B1.1870 a 5b
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT GATE ISSUIEW 12 a to
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)8394175 FP I M.PMT.NO. S-71"11 c f:
r-- - - - 3� a1b0
JOB ADDRESSs 16t e2 SW 93RD AVE 116197
j TAX MAP-LOT 2S114A6 1130"'1 SUBS Vneall nd estates L*: N► ;
LAND USEt R4.5
LOT SIZE.: VALUATIONII 4 7().60(1 SETBACKS
'=PONT: 20 REARS
WORK CLASS: NEW E)WELL.UNITSs 1 LEFTs 5 PIGHTs ~1j
USE TYPES SINGLE FAMILY NO. EIEDROOMSs 4 EXT.WALL CONSTs
CONST. TYPEt VN NO. AATHSs 2 Ns NR Ss E/NR Ws NP
OC rUP. fJF'F'. 1 P' PPOT.OPE N I NGS t
OCCUP.LOAD Ns NR Ss NP FsNR 1411Ir
TOTAL. AREA s 155f)
NO.STOR I ES s :' 1ST 1 e3O ROOF CONST t C F I E'E PET",
HEIGHT: ;N1). 720 AREA SEPAR'? RATED:
BASEMENT 11RI)1 OCCUP. SEPAR 7 RATE:E)t
MEZZANINE-' BASEM'T
FL.nOP LOAI)1 q1'1 GARAGEt 361:.1 FIRE SPRk'LR', ALARM''
FLOW(GPM) DETECT YES
HEAT 'T i PE t E.L.E(' . HDCP.ACCESS-' COPT".--
�PLAN r_HEI71 P c t
F'E.M A P I S t
PE I S'SUE OF t-lO. 613x3.:,
LAST RE I F1SUE
O meadowbr nok dev PERMIT 1111117 46.00
1N
N 9367 benverton hilldele hwY FLAN REVIEW $40.(10
E beaver,ton or 971'►r_r!y FIRE DEPT
R
PHONE (507.1 297-'1666 STATE TA* 1117. 10
17 THER
'DEVELOPMENT CHARGESs
C
AtIrIEPSON DAN E SDC(STORM) 11
N
T DHA MEADOWEIPOOt• DEVELOPMENT SDC (STREE'T y
R g363 Sol HEAVERTON-HILLSDALE PDC(M2 ) 11 t 7,1 1'.11.1
A t?c?&verton Of- CV71"If.16 PREPAID ��i.1, f"11.1
C
T PHONE (50'!) 297-7666
R PEG I STFAT I ON NO. 46744 TOTAL t !t 7.61. . :.(1
RECEIPT NO. 27768
This permit Is issued subject to the regulations contained in Title 14 _.,.,.._..._... -- .---
of the TMC. State of Oregon Specialty Codes. toning regulations REQUIRED I NSPECT I GINS
and all other applicable codes and ordinances. and It is hereby FOOT I NG SEWER
Agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and FOUNDATION WALL RAIN DPA I NS
ordinances The issuance of this permit does n,t waive restrichv, POST 4, BEAM WATER LINE
covenants Contractor and subcontractors 0-.RP have current city PLEI.UNDERSLAS CITY APPPCH Slal
business tax permits This permit will >xrlr, and become null and SLAB F INAL
void it work is not started within 180 days. i1 I work Is suspended or Tt1F0UT
abandoned for a period of 180 days at •y time atter work has FLS•
commenced, It shall responsibilih W the perm ee to assure FRAM I NQ
all rgy ilr a are Tested 1, approvegr FIREPLACE
r _ .��/• ' GAS LINE
mfr' INSULATION
.00 GYP. PETARD
Pprrnitter,SrgnAturn
Issued By
—.--
SE ARATF PF'9MIT'1 REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
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A �Y2
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6:�XD
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MECHANICAL PERMIT
CITY OF
�I��RD PERMIT NO. : ME87f:)15E3
C IYOFTWAM
Cl
COMMUNITY DEVELOPMENT DEPARTMENT ORIGON DATE ISSUEDt 12/ 4/87
13125 S.W.Hall Blvd. P.O.Bo,(23397,Tigard,Oregon 97223.(503)639-4175 PRIM.PMT .NO. 870156
09 AI UIRESS: 16o82 SW 97.7 'DAVE
TAX MAP/LOT 25I 14AS 11700 SUB- kneeland e5tateill, I-Tol B"I
LAND Uc;El;
LOT SIZEo ITEMs NOs NOo
WORK CLASS NEW FURNACE <:1001" AIR HANDL-P <10
USE TYPEit SINGLE FAMILY FURNACE 1001K+ AIR HANDLP 10K
CONST. TYPEs VN FLOOR FURNACE EVAP.COOLER
OCCUP. GRP. t R3 HEATER VENT FAN 5
VENT VENT.SYSTEM
BLR/COMP <3HP HOOD
NO.STORIESs 2 BLR/COMP 3-15HP INCINERATOR (DOM
DWELL.UNITSi I BLR/COMP 15-30HP INCINERATOR(COM
FLIEL. TYPE ELEC. BLR/COMP 30-50HP REPAIR UNITS
MAX. INPLJT BLR/COMP 50+HP OTHER
FIRE DMPRS7 GAS PIPING OUTLETS I
HIGH PRESS?
LOW PRESS 71
REMAPI, So
FEESs
meadcmb rook dev inc PERMIT
VV $
rJ
x"!;63 beavet-ton hillgd-?IR hv)',, PLAN REVIEW
hevet,tc)n 0 t- FIXTURES i 1 5
II 1 AL3
PHONE (507) 297-7666 S1 ATE TAX
OTHER
A
G
T
C, TOTAL v $40. 95
R
RECEIPT NO. 27768
This permit is Issued subject to the regulations contained In Title 14
of the TMC, State of Oregon Specialty Codes,zoning regulations REQUIRED INSPECTIONS
and all other applicable codes and ordinances, and it is hereby GAS LINE
agroed that the work will be done in accordance with the plans and POST BEAM
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive ROU3H—I N
covenants Contractor and subcontractors shall have current city F I NAL.
business tax permits This permit will expire and become null and
void If work is not started within 180 days.or It work is suspended or
abandoned for a period of 180 days any time after work has
commenced all b esponqibility of the peg in ee to assure
all requ 'Vr
Permittee 5igt);J111", CALL. FOR INSPECTION 63,9-4175
1��Sskjed By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
N Mimi w
CITY OF T'FA SEWER PERMIT
PERM IT NO. : SE137016()
RD
CITY01IFTWARD
f0010ON
jC_IJQQ"PNT-X DfW t4T:PPP4�9LTMENT
lltf�P.11_�PxfMjj".OF-?-1 3 0 �q
.(1 3 i
_3t�ljl --neeia an 0 e S LT i
LAND USE:
LOT SIZE:
SECT'ION:
TWP: Is RN6: 1 w
WORK, CLASS: NEW
USE TYPE: SINGLE FAMILY
The applicant agrees to comply with all rules and regulations -3f the Unified
Sewerage Agency. The Permit expires, 120 days from the dck ,e iSSUed. The tot,a]
amount paid will be forfeited if the permit expires. 'The Ageri_-y does not guar-
antee the RCCUI-ar_�' of the location of the side sewer latorris. If. the sewer- is-
not located at the measurement given, the installer shall proSpF.--ct 7 feet in
all directions from the distance given. If not so located, the installer *hal )
PUrchasu., a "Tap and Side Sewer" Permit and the Agency will install a lateral .
INSTALL. TYPE: BUILDING SEWER IMPERVIOUS AREAS
FIXTURE UNITS 3 12 TENANT IMPROVEMENT:
MtYIFS, i
---
N(). OFBL.D(3S. - I
FEES:
r.16RM r
Po PDX 6712 CONNECTION CHARGE 1,(.)1). 1_)f)
0 port I ac�d ar LINE TAP INSTALL.
W
N OTHER
E
R
ANDERSON ARLEN
H A Ar-IL)ERSON CID
C PC F`10k 6712
0 p cr t-t I a In d or 97228
N
T PHONE (503') 281-6712
A R PEG ISTRATION NO. andervit TOTAL 1 , 135. 00
C
T
0 RECEIPT NO. 27768
1191 --------------------
REQUIRED INSPECTIONS
ROUBH-IN
This permit is issued subject to the regulations contained In Title 14
of the WC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It is hereby
agreed that the work will be done In a.-cordance with the plans and
specific itions and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not started within 180 days.or If work Is suspended or
abandoned for a period ofdays any time after work has
<
commenced It shall be es of the permittee to ure
e
all re re ar Iles nd approved
CALL FOR INSPECTInN F,7P-417`,
Permittee Signature
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
UINININ I--
PLUMBING PERMIT
PERMIT NO. c F'LB7(:)15-,'
CITY �� TIFARD
CRYOFMARD
COMMUNITY DEVELOPMENT DEPARTMENT OREGON PATP. 9-101API 061AI' 87
13125 S.W.Hall Blvd.,P.O.Box 23397.TgLd,Ore oq,9722,3.�!P3)639-4175 L
jnp :! D _E
TAY MAF',-LOT 2SI 14AD 1130(-) SUB: kneeland estatp-s; 21 I-Tif SKIT
LAND USE:
LOT STZE:
ITEM: NOs
WORK CLASSn NEW WATER CLOSET 3 TRAP
USE TYPE: SINGLE FAMILY URINAL BKFLOW Pr,VNTP
CONST. TYPEi: VN LAVORATORY :1 TRAP PRIMED"
3CCUP. GRP. 1 R3 TUB SHOWER 2 GREASE TRAPS
DISHWASHER I
GARBAGE DISPOSAL I
NO. STORIES:
WASHING MACHINE I
DWELL.UN1 -. Ss I LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRAIN
SINI'-* I SEWFR (FT)
WATER HEATER I STORM/RAIN (FT 1 (:)(')
OTHER
-----------
REMA-PT 5:
FEE94
meadowbrool dev PERMIT $1:(2. 51)
0 8763 beaverton hillsidale hvj-•..
W beaver ton
FIXTURES
N PHONE 0�i(Y!,) 2q-7-7666 STATE TAX 6.
E
R OTHER
igni rnil r-1111LIVIT14115
C SAME AS ABOVE
0
N pa DoX a 7 2
T qt-,esharfri or 97(*)3()
R
A PHONE (507) 667-171131,
C PEO ISTRATTON NO. 23847 TOTALS $139. 12
T
0
R RECEIPT NO. 2776e
--------------------
This permit is issued subject to the regulations contained in Title 14 RFRYPRDO§LhTIONS
of Vie TMC. State of Oregon Specialty Codes, zoning regulations POST & BEAM
and all other applicable codes and ordinances, and It is hereby WATER LINE
agreed that the work will be done in accordance with the plans and PLB. TOPOUT
specifications a.:i+ in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive PAIN DRAINS
covenants Contractor and subcontractors shall have current city F I NAL
business tax permits This permit will expire and become null and
void if work Is not started within 180 days,or if wort, 1%suspended or
abandoned for a period of 180 days any time after work has
commenced It shall he the responsibility of the permigae to MUM
all Ired inspect p!7 are requested and appro
to,Slo"W", -417!j
Per too SIq iature CALL FOR INSPECTION 6!q
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLAN CHECK APPLICATION
PLAN CHECK # // -4 C ti..
PERMIT # 8*7 D /S5
DATE ISSUED
JOA ADDRESS: ! `J.4/. � g�`�� y' '-_ '�41 zl 1 TAX MAP/LOT,�J l�I Al 13u U
SUB: .Izz, gT-?A72 LOQ: F „ LAND USE: 'u,
VALUATIOSETliACKS: FRONT: a REAR: -'�-.� LEFT: RIGHT:
WORK CLASS: - ,� HEIGHT: 2-[ TOTAL AREA: /S.Sc%
USE TYPE: t FLOOR LOAD: 1ST: 30
CONSTR TYPE: .;M HEAT TYPE: F'Lt„<. 2ND:
OCCUP GROUP: DWELL/UNITS: —_ 3RD:
OCCUP LOAD: _ NO BEDROOMS:_ BASEMENT: _
NO STORIES: '2 NO BATHS: '�-_ GARAGE:
IMP SURFACE:
APPROVALS REQ'D SPECIAL NOTES ITEMS REQUIRED
PLANNING: REISSUE OF: LIST SUBCONTRACTORS:
ENGINEERING: _ LAST REISSUE: _ BUS TAX:
FIRE DEPT. : _ FLOOD PLAIN/ CALCULATIONS:
OTHER: SEN LND.: TRUSS DETAILS:
PARKING PLAN:
L r LANDSCAPE PLAN:
PLAN CHECK BY: V (S> =' OTHER:
COMMENTS:
ACCT # DESCRIPTION AMOUNT
OWNER 10-432 Building Permit Fees 1 .3
NAME: a / 10-431-600 Plumbing Permit Fera 7
ADDRESS: .i 10-431-601 Mechanical Permit Fees 3 3 ,5 0
ZLIZZ, -�� �_ 10-230-501 State Building Tax (5z)
/ t r 10-433 Plans Check Fee - `)
PHONE: 277- y . v .30-443 Sewer Connection (20%)
30-202 Sewer Connection (80X) J y
CONTRACTOR 30-444 Sewer Inspection
NAME: i�jylj� 'ta/y -� 448 Street System Dev. Charge (SDC)
ADDRESS: 52-449-610 Parks I System Dev. Charge (PDC)
52-449-620 Parka II System Dev. Charge (PUC) s-Z
31-450 Storm Drainage Syst Dev Chrg(SSDC) _5 y
PHONE: - 10-230-505 TRFD (95x) t __
10-435 TRFD (5X)
ARCH/ENGINEER 10-230-506 Washington County Fire it (95X) _
NAME: V.0.,[�,p,�;F_�� 10-435 Washington County Fire I1 (5X) �
ADDRESS: 10-220 Amart/Wedgewood
.t-
TOTAL o? G, 9 0
PHONE.: _��J- 7��—
�� /. / 5 � PREPAID
l O BALANCE DUE ! A/
/.
A .ICA( SI A M E
Received By: Date Recel.ved:
P.O.Ebx 23397
CITY OF TIGARD PLUMBING 13125 EW fla.0 Euvd.
Applicants must hold Oregon Registration to cwnduct a plumbingPERMIT
L'R n� 11garrl CR 97223
business or must be properly owner/operator not hiring out E i`�•�ide he I I T (x399.9175
Name of Development _ —
Address ------- Plumbing Permit No. ���-'�
��a Z .54� 7`:�. �� c. kFIXTURES
n
Job 21.610
Tax Lot Map,No. DUAN. PRICE AMT.
Address //�3 0 C � eS / /
Block sloe
�—------ x.50 "� S
V
ame or name o s ness oocic'( t�.'i� nl�v. --� 7.50WSix>wer Comb. Z 7.50 —
Owner e/tih• L� ShawerOnly ----- - �__7.50 -
M Zlp� Wrler Closet
Di911W8S11ef __ 7.50 J )4
al
e D
Photo Garbagispos
- 7.50 ,z
Nems Washing Machine - _- 7.50xPiess ) 1Z
Floor Drain 750
Wale,Heater -`�_ 750
Or cupani Cyly/State — -- Laundry Room Tray 7.50
_- Urinal T 7.50
ams — e Other Fixtures(Specify) 7.50
Fri toss phone �.�_--.� — 7.50
--- 7.50
Cofitractor Clfy/SWfe'-- - ------ �p - _ -- ----- _� 7.50 --
---—. _
ie MISCELLANEOUS
City& Tax No
Sewer 181 100, � 30.00
M814. t-'--M, r s _ s7k � Sewer ea.Addit.100^- 15.00
(Residential) Water Servkm 1st 100' / _
20.00
I hereby acknowledge owl I have read this app"tion,that the information Water Service ea.Addil.�f -- - 15.00
plwn is anrecY,Mtel I am repisiw nd with tfte ritale Bk�ilden's Board,and also g �,Rein Dram 1st.100'— —
hays a Stale PkxnbkV license that the numbers given are correct,that all _. _ 30.00
Plintbirtg worts wig be darts In a000rdanoe with.ppacabie provisions of ore Storm a P:Jn Drain Addit.100' 1500
gon Revised Ststutes Chaplem 447 and 693 and applicable oodes and mal
no help will be errpld.ed unless Iloensed under ORS 803 (h exempt from Moab Ho::ti Space_ _ 25.00--- -
Stale reglswen
tration.pease give reason b41ow). Back Flow Prlicn - _
HOMEOWNERS-I hereby owWr t w I am the owner of the property ds- Devivte rx Mt'•Pdkttion Device 7 s0
embed above.at which to atirtnt I Propove to make a pkwnnbhp insiallabon br Any Trap or Waste Not
my own use and title Property is not N*V consbucted for sale,baso or rend. Connected to a Flxhxs
7.50_
Catch Basin — 7.50 - �—
_.___ kw.Of Exht.Pkattbhtg 40.00 Per Hr.
-- malty Roqussted inapskAtp>, 40.00 Par Hr
Abler.M PMntarp wIt Mn ~_ - -- ---
an Exteang Bldg 15.00 mon.
AUTHORIZED SIQkATURE — — -- - Deft New Bldg.or Build.Addltlon Op i1wn.
Dearxibw work rww addition alteration9airl,sinale tAnil --
O D C) J7 15.t�p ---
repair residkxtNal rl rlok-reeidential –1 --- �—
Exbtirt0 use of -
bl N*V or Pr"lly -
IP71�u" — MUS-TOTAL 'Z 3 U
Woptlitty
This PrMnMI beContes null and Wold r woAk Of cor»xruo0on aWwrtiad Moot oorrt. —_— ____ ---
TML
nw"d w filn 100 dayars►if onrairun*m orwok M tuapsrttlsd or abartdorted for ••••�■
a period of 100 days M any rine OW wok Is oofrrn cad
by
Date IaetfkM
Oct)440(/l rah ter i
�,yx►
MEW =M
CITE( OF TIGARD MECHANICAL PERMIT Receipt#—
C
Permit#
Description r
City of Tigard
Table.3A Mechanical Code CITY PRICE AMT
— -
13125 S.W. Hall Blvd, 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 -—
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BILI
1) incl.ducts&vents 6.00 .
Furnace 100,000 BTU +
2) incl.ducts&vents 7.50
Name of Development Floor Furnace —
3) incl.vent 6.00
Job Address _ Suspended heater,wall heater
Address 2 W �.� v Q, 4) or floor mounted heater 6.00 -^
Tax Lot Map No. 2 _ /y Vent not incl.in
1o Block Subdivision ii 5) appliance permit
_ 3.00
F
Name(or name of business) Repair of heating,ref rig.,8) cooling,absorption unit 6.UJ
Owner Meiling Address Phots 71 Boiler or comp to 3 HP 6.00
0297 ,G absu;p.unit to 100,000 BTU
City;State ZipBoiler or comp to 3 H P-15 H?
9) absorp.unit to 500,000 BTU 11.00
Name �9) Boiler or comp 15-30 HP
absorp.unit 1/2-1 million 15.00
Mailing Address Fraena Boiler or comp to 30-50 HP
10) absorp.unit 1-1.75 million 22.50
Contractorcity/State Zip Boiler or comp to 50 HP
11) absorp.unit 1,%50,000 BTU 31.50
State Registration No City Bus Tax No 12) Air handling unit to 4.50
10,000 CFM
I hereby acknowledge that I have read this application that the information iven is 13 Air handling unit
g ) 10,000 CFM + 7.50
correct,that I am the owner or autMsubmittedzed agent of the owner,that plans submitted are in
compliance with State laws,that I am registered with the State Builders'Board,that the Non portable
number given is correct ill exempt from State registratir o plena@ give reason below) 14) evaporate cooler 4.50
Vent fan connected
1 to a single duct 3.00 ,u
Ventilation system not
16) included in appliance permit 4.50
Hood served by
17) mechanical exhaust 4.50
Signature(owner or agent _ pate Domestic type I
7.50
Describe work F] iddition El alteration L] repair ❑ 18) incinerator
to be done residential [] non-residential ❑ Commercial or industrial
Existing use of 19) type incinerator 30.00
building or properly __. Other:.e.,woodstove,water
Proposed use of 20) heater,solar,clothes dryers,etc. 4.50
building or property 21) Gas piping one to tour outlets 200
Type of fuel- oil ❑ natural gas I I LPG ❑ electric ❑ �-
22) More than 4-per outlet
NOTICE SUB-TOTAL ,� )
THIS PERMIT BECOMES NULL AND VOID IF WORK OP CON --- - - --- �'
£TRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5% 06 SURCHARGE
TAL
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOf
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER --
WORK IS COMMENCED. TOTAL
Special Conditions q U C �—
----- -- Date Issued.�, by