11465 SW 95TH AVENUE ADDRESS:
14�►5 950" Avg 04E
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i:\records\microflm\targets\building.doc
CIV OF TIGAM
June L, 1995 OREGON
RE: BUILDING PERMIT #
We issued a permit for t',-.is project, however we have no record of
any inspection being c�m�lleted.
Permits become void if there has not been an inspection performed
for over 1BO days . In that case, the Building Division may require
a new application and fet:s to commence or ccntinue work. A notice
of noxi-compliance against the propert., may also be recorded by the
City.
Please advise the Building Division, IN WRITING, within 15 days of
this letter, the states of this project . You may request
additional. time to complete the project
Respond IN WRITING to : Building Division, 13125 SW Hall Blvd. ,
Tigard OR 97223 . Be sure to include the following information:
1 . Building Permit # .
2 . Address of property.
3 . Your name .
4 . Your phone number 8 : 00 a .m. - 4 : 00 p.m.
If you are ready to schedule an inspection, please _all our 24-hour
Inspection Recorder at 639- 4175 .
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13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 --
PINES
CITY OF TIGARD
COLIMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (S03)639-4171 PLUMBING PERMIT
1,L R,1111 T it 1--,1 1194-0071.
DOTE ISSUED-. (.15/19/94
1",0 R C E 1--, :1.S 1.3 5 C Ci (a 2 3 0,:i
SITE ADDRESS. . . : 11.465 SW 95TH AVI:::
SUBDIVISION. „ „ . 3 HOETCHERS ADDITION ZONING: R-4. 5
BLOCK.. .. .. ,. . LOT. . . . . . . . . . . . . 13
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QLASS OF WORK. . aALT G A R B A C-)(::. DIS POS A L f*-.)- - 1 11 C)B 1.1 E HOME SPA- C[---S. .
TYPE OF USE. . . . :SF WASHING MACH. . „ . „ ., ,. BACKFLOW PREVNTRS. . ::
9CCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . TRAPS. . .. .. . - - - - - . - -, -, :: I
::;TORIES. . . . . . . . . WATER HEATERS. — . . . CATCH BASINS. . . . . . . .
VIXTURES------------- LAUNDRY TRAYS., . ., . „ SF RAIN DRAINS., . . . ,.
�-.;INKS. . . . . . ". URINALS... GREASE TRAPS— .
LAVATORIES. . . . . :: C)'T1A1:::R 1::*IXJ'1.JRE'1-)'. —'
FUB/SHOWERCS. . . .. : SEWER LINE VmW . . . . N 100
WATER CLOSETS. . : 1-f1TER LINE (ft) . 1111 "!
DISHWASHERS. . . . : R0111 DRAIN
i'%'c,inarl,-sz- REPLACE SEWER I I H[I:
dwnern -------------------------------------------- FLES
CARL KELLEY type amount by date -roc'pt
11465 SW 95TH PRMJ' $ 30. 00 13W 0:'.5/19/944
5PCT $ 1, 5B SW 05/19/94
il.uORD OR 97223
Phone N:
Contractor:
RESCUE ROOTER
7717 SW NIMBUS)
u�.i:AVERTUN OR 97006
Phone Ho 243-11Y2 $ 31. 50 TOTAI
Reg H. . c 44677
------- REOUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Sewer Inspection
Tigard Municipal Code, Nab of Dre, Specialty Codes and all OR" Final Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more ..................
than 186 days.
........................ .........
llt-rnriittee Signaturev!
Uissued BY: ..................................... ............... .................
Call for inspection -- 639-417.9
CITY OF 1113ARD OF-" PAYMENT RECEIPT NO. 9 4—;F,15P P.rp'7 1.
CHECK Fimouttr a 3 1. 50
N CA m[--L t RF--'.'"C IJE INDUSTRIES, INC:: CASH AMOUNT t 0. Oki
ADDRES6 PA655 SW POONES rVRRY PAYMKNT VA tE 005/19/94
WILSONVILLEt OR SUBDIVISION
97070-
[4-IRPOW OF' PAYMFNI AMOUNT PPID PURPM'E OF' VIAYM(-*.NT AMOI.-INT f-',141i)
vi
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I i 461i IBW 95TH
10TAL AMULINI PAID
City of Tigard PLUMBING PERMIT Planck/Rec. #,, /51?
13125 sw Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
escripuon —
ORS 814-21.610 — C)TY PRICEJob
AM�
Address ... � ' FIXTURES
n z� in
1 G�'t_ 1J I Cl f Lavaiory — 7.50
-
I ub or I ub/Sh5;Te-r-C-o-mF--
--7,Tiower Only --
Water Closet —Tu
Owner " ?lq (�) is washesGYffi-a -- - ;
ge Dispos t,,,
_ asing iuie
i
Floor Drain
Water Heater 1.50
aun ry Room ray
Occupant -
nna 7.50
- - — lerr Fixtures(Specify) -
�)_
Contractor ,:�IC (, 2-S92 -- MISCELLANEOUS
-�
L
Uir' ND0
,�. Q G L3 30.00O
7 �,/ /�,,/yl 2U war-ea.`t_ ��f -F'�j-`K-- I S t 0 afar rvice Tsi
re y ac ow a have readis ap rca,ori, Mat Uie Water Service ea. Addit. 200' 15,00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws,that I Storm 8 Rain Drain 1st 100' 30.00
am registered with the Construction Contractor's Board,that the number Storm—& Rain Drain A 0it. 100' 15.00
given is c;or (If exempt from State registration, please give reason
Wow) Mobile Home Space 25.00
Z11; � c ow Prevention--
_
(~W 'I / r ( � Device or Anti-Pollution Device 7.50
nyTra'p o�Pasfe o
Connected to a Fixture 7.50
Descnbe work new a iI 5na teratron r7.50
epair a c assn -
to be done residentia nonresidential Q
" L 1yC' Insp.of Exist. Plumbing I per hr
Specially Requested Inspections per hr
Existing use o} U am rain, singe ami y
building or property dwelling 15.00
"estoemial baCKROW prevention
Propo"Od usA of devices 15.00
v buikfiug of p(olorty -
H xcep rest entre ac ow-
- prevention devices)
NOTICE *Minimum res$25.00 SUBTOTAL ( O(
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25%OF SUBTOTAL
COMMENCED.
TOTAL
Especial Cond i iorm -- —
Date issued by
V M U1�Nr
'APPLICATION — STREET IMPROVEMENEXCAVATIOA( �j( \ COPY TO:
(WHITEI FILE
T/
ORDINANCE NO 74-14 �� � (YELLOW)-INSP.
� (PINK)-OTHER AGENCY
(INSTRUCTIONS ON SEF ARATE SHEET) (BLUE) APPLICANT
APPROVED APPLICATION NO.: ls(z
NOT APPROVED ❑ CITY OI' IIGARD, OREGON FEC AMT.. E 40.M hh
PENDING FEE, PMT. ❑ CITY HALL REC�14 „l.: 94 — ZSZ6"7V
PENDING SECURITY ❑ PUBLIC WORKS OEPARTMENT BYDATE� /t4 I q4"
PENDING AGENCY ''OK” ❑ Application and Progress Record – Y
PENDING INFORMATION ❑
MAINTENANCE BOND
FOR STREET IMPROVEMENT/E`!CAVATION AS weoulraeo
ANNUAL
PENDING VARIANCE ❑ EXPIRATION DATE": J —
PERMIT NO.:
- rDA TE ISSUED:
BY:
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR ANDtI_ _ FAIR REPL.AC BLDG. SIDE SEWER
_(MglTARY) __thATERAL _ AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
PPL I C A N __ -- 1A '/� � ' _ __NAPE ��
IPS Rescue hooter P.O.ADDRESS CITY
Tigard, OR 97281 284-4044E
CONTRACTOR ________
NAME ADDRESS CITY PHONE
PLANS BY _ Per City Starxdar_de
NAME f ADDRESS CITY PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ ,_1,UW.00
DOLLARS
FOR OFFIC U56: MIN,
(2) EXCAVATION DATA: _ 0.04 x S �,Ow.co = s`�U•
STREET DESCRIPTION PROGRESS & INSPECTION .3'rATUS
NAME SURFACE CUT CL'7 CUT MATERIAL, INSTALLED ITEM DATE REMARKS/TYPE BY
_ TYPE LENGTH WIDTH_ DEPTH ITEM & QUANTITY
STREET
OPENED _
95th Avenwia NSPEC-
R TION
E - —
Q
U
ESTIMATED STREET OPENING DATE:—____— I ES
ESTIMATED STREET CLOSING DATE: L ED —
11000.00 _ STREET
(3) SECURITY NO. SECURITY AMT.: $ _. CLOSED
SURETY CO.: ----� FINAL
csr� 1CHECK _ CASH ❑ BOND ' INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL. SPECIAL PROVISIONS/ CONDITIONS.
FEATURES; EXCAVATION LOCATION AND EXTENT,
( ( Z - - I ! •- see atAached .
cups -
I ( 1 1
(.L
S.W. 95th Ave.
! I work aces �.•� :r I
SITE: 1a 465 SW 95th A e.� ! I
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(5) NOTE THE CITY -10RA-ai91f, HF,.-iEBY, t.-RANT PERMISSION TO APPLICANTS TO CONDUCT WORK WH►_F:E
WIGHT-OF-WAY JURISDICTION I, THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPC,SIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE 1 �/ t�' L�' l �, DATE