InitiallyGood t�
ADDRESS:
(ti
H
N
.J
GJ
C'
LL1
J
I: records\microtlm\targels\building.doc.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: A.M. ``� P.M.!_, MST:
Location: h� _UJ 03A0(- BLIP:
Tenant:- _v Suite: _131dg: _ _ MEC:
Contractor: _ Phone: PLM: L7— o)
(homer: [/? L– Phone: `6 _ 2z?�"1_ ELC: - -
''-� QCh ELR: _ -
_ STI':
BUILDING BLDG(con'() ��LUM MECHANICAL ELECTRICAL SITE
Site Post/l3cam Post/13cam Post/l3eam Cover/Service Sc%%,!r/Storm
Footing Roof 1lndF1/Slab Rough-In Ceiling Water Line
Slab Framing Top out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Ilood/t)uct Reconnect Vault
13smt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Shcath Fire Spklr/Alm Crawl/Pound Ih Ifeat Pmnp Low Voll _
Approved rove Approved Approved =Approved
I Appr/Sdwlk Not Approved vcd Not Approved Not Approved FINAL C�A� FINAL FINAL
yr
�L)
-J
C1 Call for rein ti 13 Reinspection f-ec of S rcuumcd bef re next inspection n Unable to inspect
Page
Inspector. Dale:— — _ --of—
RD
Atz") PLUMPING PERMIT
PERMIT #. . . . . ��.77��. : PLM97-0157
DATE ISSUED: 5/05/97
PARCEL: 2911 4BB--20400
SITE ADDRESS— : 16463 SW 103RD AVE
SUBDIVIS70N. . . . RIVERVIEW FSTATES NO. 2 ZONING: R-7 PD
BLOCK. . . . LOT. . . . . . . . . . . . . :048 JURISDICTION: TTG
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES, : 0
TYPE OF USF. . . . :SF WASHING MACH. . . . . . : L71 BACKFLOW PREVNTRS. . : I
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . , . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES------------- LAUNDRY TPAYS. . . . . : 0 SF RAIN DRAIN'S. . . . . : 171
SINKS. . . . . . . . . : 0 URI"AL5. . . . . . . . . . . : 0 GREASE TRAPS. . — . : NO
LAVATORIES. . . . : 0 OTHER FIXTURES. . . . - 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
DISHWASHFRS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Install residential backflDw prevention device
Owner: FEES --------.---__—_
SUZAN BROWN type amount by date recpt
16463 SW 103RD PRMT $ 15. 00 TSD 0-5/05/97 97-294105
TIGARD OR 97223 5PCT $ 0. 79 JSD 05/03/97 97—i:-,.94105
Phone #: 684-2821
Contract
OWNER
Phone Q 19. 75 TOTAL
Req #. . : 139999
REDUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Backflow Prev
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable lasts. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
----------
1 ,r�rmittee Signa
Call for inspection 639-4175
,TY OF TIGARf3
Plumbing Application Recd By
3175 SW HALL BLVD. rc•-,mercial and Residential OateRec'd 0S2S S
'GARD, OR 97223 Date to P E.
503) 639-4171 Date to DST�_
Permits L.sef' 97-OI s7
Print or Type Related SWR s
Incomplete or illegible applications will not be acceptad Called OTC
Name of Developmenuproteci Icy4�Tl
FIX,URE3;(lndlvidwl)
h sink rl1�+t 1,'sa T t 6l..�r _ill
Job ry ✓p-C e, i
5 "c r— 9.00
Address Street Address Stute Lavatory 9.00
Tub of Tub/Shower ComU. 9.00
Bldg 0 /State ZIp Shower Only 9
,00
Water Closet A.00
Name _ _
Si.ti 2 Cit^ 1,�j('"U L✓u D+shwaaher 9.00
Owner Marling Address1 � Suite Garbage Disposal --
9.00
,
i (- L t--) I (22 F Waarwrg Marfilne9.00
i Coy/Slate zip Phone Floor Drain _
1 �C r,/LC ct7jN �•c � i z� _ �_ 9.00
Nafrts i 3- 9.0i
S cl rr.jL, 4'
9.00
Occupant Ma"Address Suite )Nater Heater ---
900
Laundry Room Tray ---- 9.00
I qty/stare Zlp Phone Unna) —� —_"i — 9,00
Name Other Fixti"s(Sp) 9.00
9.00
Contractor Mailing Address Suite ,-- 9.00
(Prior to issuarr)o City/state zip one
4.00
applicant rtnnt -- g 00
provide all Oregon Const. Cont.Board Luc.! Exp.Date 9.00
contractors 9.00
Ivirls
r
ortmatkn ptumbinp t.lc.! Exp,Date Sewer-tst 1 00 --
Sower-each additional 10(y 25.00
for COT COT Business Tax or'hetro I Exp.Date
database). Waw Service-1st 100'
30.00
Name Water Service-each additional 200' 25.00
Architect 'ylf Stone 6 Rin Drain-1st 100- --� 30.00
or ►NAng Address Suite Stam&Ran Drain-each additional 100* 25.00
Mobde Home Space 25.00
Engineer GtyrState Zip Phone Conrnernal Back Flow Prevention Device or—Anti- 25.00
Pollution Device
Casrnbe work New Addition O Alteration O Repair O Residential Badtftow Prevention Device. -- 15.00
•o be done: Residential O Non resdentla! O
Aadrtronal desanptkxt of work — Any,
Trap or Waste Not Corrected to a Fixture g 00
—
Catch Basin 9.00
Insp.of Existing Plumbing 740 00
"xisting use of / f Specially Requested Inspections 40.00
-wilding or property--LrS I �01. T1 rt- i. _ per/hr
Rain Dram,single family dwelling 30.00
proposed use of Grease Traps 9 L0
urlding or properly_
QUANTITY TOTAL
w =ve you capping, moving or replacing any fixtures? Yes❑ NOS 130 On or riser dograrr,is maimed(f Ouandy Twat is >9
J 'If yes see back of form) `SUBTOTAL
'hereby acknowledge that I have read this application,that the information
7rven is cores.that I am the owner or authorized agent of the owner.and 5%S JRCHARGE
,.tat clans submdted are in compliance with Oregon State Lios. 7
Signa of Owner/Ag"t Dow PLAN REVIEW 25%OF SUBTOTAL
QeCureA mh r'brttis !ut1�l ro>'9 r
/ cry
t .'� r �.k��y S1 S f.9 7 TOTAL
.onaci pemoh Nanw Photw Cr
'Minimum permit fie is S25-5%surcharge.except Residential Backflow
Prevention Device.wt idn is 415*5%surcharge
Pphnapp.doc 11,96 (dst)
SE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced
Sink
Lavatory
'Tub or Tub/Shower Combination
Shower Only
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
4r$
Water Heater
Laundry (Room Tray
Urinal
Other Fixtures (Spec&,!)
'OMMENTS REGARDING ABOVE:
L\plmapp.doc 12/96 (dst)
PEMT
CITY OF TIGARD PERMITI##. ELC?G10Ql78
Ct,,MMUNITY DEVELOPMENT DEPARTMENT TATE ISSUED: 02/06/96
13125 SW Hall Blvd.TigLrd,Oregon 97223.8199 (503)839.4171
1='AR1:EL.: c:S! 14DE-2040r11
TE (aIiDRESS. . . : 19463 SW 1.0- AVF
3UBUIVISION. . . . : RIVERVIEW ESTATES NO. ZONING: R--7 PD
3L.0CK. . . . . . . . . . . LOT. . . . . . . . . . . . . :04B
�`'ro.ject I>escription: Installing first branch circuit
---RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS-___ --_.---MISCELLANEOUS-
iOOO SF CSR LESS. . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/lRF.lGfaTION. . . . :
EACH ADD' L 500SF. . . : 10 201 - 400 aimp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401 900 amp. . . . . . . : 0 :GNAL/PANEL.. . . . . . . : ii�,
"11ANF. HM/ SVC/FDR. . : 0 601•+amps-11 00 volas,. : 0 MINOR LABEL ( 10) . . . : 0
HRANC;I C I f2Cl l'I TS- - - -- ADD' I_ i NSIDECT I ONS -
i� - 200 amp. . . . . . : 0 W/SERVICE Ofc FEEDER: 0 PER INSPECTION. . . . . : C
x:01 - 4010 amp. . . . . . : 0 1 st W/O SRVC OR FDP. : 1 PER HOUR. . . . . . . . . . . : u
01 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 :N PLAN-f. . . . . . . . . . . .. o
01 -- 100@ amp. . . . . : 0 _______..__. _.__._._.._._._F'LAiJ REV IrW SECT ICIN ------
1000+
- -.1000+ amp/volt. . . . . .. 0 > -4 RES UNITS. . . . . . . . : > 600 VOLT NOMINAL. . :
Reconnect nnly. . . . . : 0 SVC/FDR > = 025 AMP'S. . : CLASS AREA/SPEC OCC. :
Jwner: _____________.___._._ ..__....__________ F r:ES
rLFF BROWN type amount by date rec--pt
16463 SW 103RD f."RMT $ 35. 00 B 02/06/96 96-1::7567:
5PCT $ 1. 75 l? OL/06/`36 96-27567L
TIGARD OR 97223
-'hone #:
_'ontrac:tor.
)ANDER STOOP ELECTRIC; $ 39. 75 TOTAL
23765 THIRD .iT WJE
- _---- REQU I f;E F) INSPECTIONS -
IAURORA OR 97002 Ceiling Cover Elect' l Service
'hone #: Wall Cover E1ect' I Final
'ley #.
This perait is issued subject to the regulation- contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other Per'Mlt.tee SfynatUre
3ppiicable laws. All work will be done in accordance with
approved plans. This perait will expire if work is not started
oitnin 180 says of issuance, or if work is suspended for sore _, ti� _ V� �L-
than i80 days. I s sed Py
._....-... ..........____. _. _.__._.__._._.._.______.... ..DWNE R INSTALLATION
"he installation is toeing made on property I own which is not intended for
.,ale, lease, or- 'sent.
N JWNER' G 5IGNAIUR : DATE=:
INSTNA_ATION
,.L,.,idiATLJRE OF SUPR. ELCC:' N: ov_ ( Q�./ ad _ DATE:
f `.
.ICENSE: NO:
Call for inspection 639--4175
I11 11t Iki I;1 11. 111 it lyll HI Ifl I .I. I P I rilt 1,
Hmoljoll
1-114(1Ul"ll 1. 11.
III Wit, 4 y INO m I Yht IF r
11"I It 1.,11 111 1 1Wv 141 IAI IIA I I I III I I t 1,11 111 11111 1 I'll I I I
lit CkII 'III III PH 1 110 I . 1 1 111 o 11 Ii
1 96 -0078 - Uofo'i !.iw IO-i) (-Ivf--
it (-0111IN1 PA 11)
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hai. ivd. ,
Tigard, OR 97223 Permit # 1%%tz
Date Issued (4?
Phone (503) 639-4171
CITY OF TIGAaD FAX (503) 684-7297
TDD No. (503) 684-2772
Inspection (503) 639-4175 _
1. Jcb Address: ". Complete Fee Scheduie Below:
Name of Development U�c✓L'�t/ _ Number of Inspections per permit allowed
AddresS_L� �/ ��f_} r� __ Service included Items Cost(ea) Sum
City/State/Zip / f1r�t !- <f 4a. Residential -per unit
1000 sq. ft. or less $1 In oc ^
Name (or name of business) _ Each additional 500 sq ft or $25.00
_ portion thereof ---
Commercial U Residential Limited Energy $25.00
--
Each ManurHome or Modular
Dwelling Service or Feeder $68.00 7
2a. Contractor installation only:
4b. Services or Feeders
Installation,alteration,or relocation
Electrical Contractor t/�yd r'./ fn en [� 200 amps or less $60.00 z
Address Z 3 ) ; f4 f i 57- N 201 amps to 400 amps $8000
/►
��)r Q State �`I / 401 amps to 600 amps $120.00
city A_ a pq� - 601 amps to 1000 amps $180.00 L
Phone No, "Z,3 N-OSDI7 - --_ over 1000 amps or volts $340.00 2
Job NO.
Reconnect only $50.00 _ 2
_ --�
contractor's license NO. Z 3 4c. Temporary Services or Feeders
Contractor's Board Reg. No.t39 1417 Installation,alteration,or relocation
Signature of Supr. Elec'n 2.00 amps or less ,
License No.-2 7 2—S one PhNo-72,0 -741`75- 201 amps to 40r)amps $50.00
�( 401 amps to 600 amps $75.00 z
Over 600 amps to 1000 volts $100.00
2b. For owner installations: see„b„above.
4d. Branch Circuits
Print Owner's Name New,alteration or extension per pane
Address a)The fee for branch circuits with
-- purchase or service or feeder leo. 2
City State_ Zip Each branch circuit $500
Phone No. _ b)rhe fee for branch circuits witnouf
The installation is being made un property I own which is purchase of service or feeder feeFirs .
not intended for sale, lease or rent. Each
branchh addadditionalonal �. $3500$ S,c C
acal branch circuli r $
500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) '
3. Flan Review section (if required): Each pump or Irrigation circle $4000 ---
Each sign or outline lighting $4000
Signal clrcud(s)or a limited energy
Please check appropriate item and anter fee in section 5B. panel,alteration or extension $4000
4 or more residential units in one structure Minor Labels(10) S10000 _
Sr,,v ce and feeder 225 amps or more
4f. Each additional Inspection over
Sys',em over 60U volts nominal
_Classified area or structure containing special occupancy the allowable In any of the above
as described in N.E C Chapter 5 Per Inspection $5500
Per hour $55 00
In Plant $5500
Submit 2 sets of plans with application where any of the above
apply. Not required for temporary construction services. 5. Fees:
5a. Enter total of above fees $ 3 .r,Y'
NOTICE 5% Surcharge (.05 X total fees)
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS, OR IF 5b. Enter 25% of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review If required (Sec.3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ _
COMMENCED. =omaw+= Trust Account N
M m Nx+
Balance Due $
BUILDING PERMIT
�I1Y OF TIGARD DATEIIT)SUED: • 02/02/960 4�,:,..,..
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL : 2S 1 1.4BB--; 0<+00
:3125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
VIS
..3UBDIION. . . . . RIVERVIEW
,' �^ (' ESTATES N0, c: ZOIti I NG t R-7 PD
;LOCI.. . . . . . . . . . . LOT. . . . . . . . . . . . . :040
!RCISSUE: FLGOR EXTERIOR WALL CONSTRUCTION
I .ASS OF WORTS. :RE<P FIRST. . . . : 0 sf N: S: E: W:
1'FE OF USC. . . :WF Sf COPED. . . : 12) sf PP'OTEC1'
TYPE OF CONST. :SN 0 sf N: S: E: W:
=URANCY GRF,. ;R3' 0 s f ROOT' CONST: FIRE RET":
UC~UPANCY LOAD: 0 BASEMENT. : L71 sf AREA SEF'. RATED.
_;TOR. : HT: 0 ft GARAGE. . . : 0 s f OCCU SEE='. RATED".
:IGMT": ME"ZZ?: REDD REQUIRED-
FLOOR, LOAD. . . . : 0 p s f LEFT: 0 ft RGHT: 0 Ft F'I R SPK!_: 50101 DET.
DWELLING UNITS: 0 FRNT: 0 ft REAR: lel ft FIR ALRM: HNDICP ACC:
i1EURih1— 0 laATbiS: 0 IMP SURFACE: �T PIRO CORR: PnRK:ZNG: 0
)ALOE. $ : 4500
Remarks . fire damage repair, reb.(ild file place chase, interior, inst.rlation etc
Uwrrer. : _,._.._. ._.__.... ...___..__._._..._..._._._.._._ . .._....__._... .__.__._.._._____..___ _._____.__._._._.__.. FEES __...___._..---...___.... ._ ..
JEFF BROWN type amount by date r^ecpt
' r,463 SW 103RD PRMT $ 50. 5k) J130 0 :/02/56
PLCK $ 32. 83 DON 01/31/96
I CARD OR 97223 5F'CT It 2. 52 JCP 02/0Z/96 96-2756 J—
l''hone #:
Contractor
;ENNEDY CONSTRUCTION
315 BE 7TH AVE
'ORTLAND OR 97214
hone #t Z:34 -0501 85. 8G TOTAL
Reg #. . 003402
REQUIRED I NSFIECT I ONS __...--- ......
This permit is issued subject to the regulations contained in the Footing Insp
?igard Mur+..;al Code, Wte of Ore. Specialty Codes and all other 1-o.(ridat i un I r,s p
applicable Taos. All work will be done in accordance with Me0hanic_at1 Insp
approved plans. This permit will expire if work is not startod F t-am i n g Insp
within 180 days of issuance, or if work is suspended for more Gas Line Insp
hon 180 days. Insulation Insp
Gyp 0(Ja1-(J InypFinal Inspection
i1 :,er-mittee Sigf�
4- 35—.`.._....._..
Gull for- inspection - 6:39--417:r
J
CITY OF TIGAIND BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone). 639-4175 Business Phone: 639-4171
Inspection:
Fooling Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Dra':i Framing -Plumb.
Alarm Water L roc Insulation -Mech.
Underflr. Insul, Shear Wall GyP_ -Elect.
Dale Requested: v? - 3 J S� _ Time M PM�
Address: y j
` � hBuilder: i13te
9,6 -c c)
THE FOLL WING C,ORFl CTIONS ARE REC�JIRED: /-�•� —
n_
F--
tn ----
Qn
t
J
Inspector: Qate;�!/=���
,, - P mUVT7b DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE /
Inspection Line (Nec-O-Phone): 639-4175 Business Phone:639-4171
Inspection: ( L- 0r-1
Footing Susc Ceiling Sprin . Rough•in App c�'v�lk
Founc ition Plby. Underslab �ech--------------ough-in Fireplace
Post/Beam Struct. Plbg, Top Out E1—ec. ougn-in FINAL:
Post!Beam Mech. San, Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain flanni Plumb.
Alarm Water Line Insulation �/24 -Mech.
Undertlr. Insul. Shear Wall / Gyp. Bd. /•Elect.
Date Requested: /���" r Time. AM PM
Address:
Builder:_ Permit #: �—OC) 3
THE FOLLOWING CORRECTIONS ARE. REQUIRED:
Inspector:__ _ _ _ _ Date: Z L
kfK,P'P'ROVED -,DISAPPROVED ,APPROVED SUBJECT TO ABOV
`Call For Reinsp.
CITY OF TIGARD BUILDING IN4ECTIOM NOTICE
Inspection'Lin
e (Rec-O-Phone: 639-4175 Busiw, Phone: 639-4171
' Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Founda ion Plba. Underslab Mech. Ro_ighhin Fireplace
Post/BeLm Struct. Plbg. Top Out 'Aough in FINAL:
Post/Bear i Mech. San. Sewer Gas Line �n -Bldg.
Plbg. Undarfloor Rain Drain Framing (OZ { -Plumb.
Alarm Water Line Insulation e,4ti_�-Mecn.
'nderflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested/: _ Time: AM _ PM
Address'. ! !� (E' 3
T 1/
,dey� Permit #: U
THE FOLLOWING CORRECTIONS ARE REQUIRED: &-zr`l oc)`.53
IYLA-
Iris actor:.! �j—
PPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp. /�
Y
(J It, t.J" l,it'll P 04 1
II o,:1 I.."I oy I..1 0*1 1 to it 1.11' , I t-W-11 ll JI'l 1 4
j I 41 `,F• ( I I I W)i., I If i f I'll 1.1 1 t)f I I F 4 1.,1. 1 i,
HINII) (11t !-it Mt I Q 1 3
14 1 1 1; 1 1 1'1 11 I1
un
__j
cn
0
tjJ
__j
I it It
Illllit 1 11 It it 114 1 1
City of Tigard Residential Building Permit Application
i
13125 SW Hall Blvd.
Tigard, OR 9722.3
(503) 639-4171
Jobsito Address: /1 Ll_ 3
Subdivision:
f Lot# ��r Office Use ok.iy
�i c'e� �Nwi res f<< 's �
Contact Date / Z /t'!(- _Initials
Valuation: `� �� Result
New Construction Only: (Square Footage) Planck/Rec it_ 1)
Permit #-2h r ELI
House: garage: Reissue of
Corner Lot? N Flag Lot? { N Zo P& TL# " f f J 5—
A
Owner. <_ TA 0 i cl i-t IV
Plat #
,_r( Approvals Required
Address: / L-�/6 3 S�t— /� 3 _
Planning Setbacks -- Solar
Engineering _
PhoneOther
: ( ) — —�-- --
Contractor: _L r. Vgzg41,1 CoVf-tr rItems Required♦
Subcontractors
Address: _3/_ S 7-'' 7Jve — Truss [retails _
cl .� Other_
Notes
Contractor's License # '—
(attach copy of current Oregon license)
Contact Name:
Contact Phone: Lau 3 ) "_3
Subcontractors: Architect/Engineer:
Plumbing: Address:
Mechanical: &,:t)A.- Pe&t. ,=r
(attach copy of current OR Con rentor s License)
Phone: ( )
N
JOB DESCRIPTION: Elrs 4',fc03/n, ' l AAfcQ -
1
Applicant Sip ature Applicant Phone numter
Date Received:
Received by: L
Permit x Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) Ste„ -Sa ,)-z"
Plumb. Permit (PLUMB)
Meeh. Permit (MECH)
State Tax
Bldg: --sem-._ � � 12d j_-
Plumb:
Mech.
Plan Check (PLANCK)
Bldg: 324 3
Plumb:
Mach:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charges (PKSOC)
Residential TIF MF-R)
Mass Transit TIF MIF-MT)
Commercial TIF MF-C)
Industrial TiF (TIF
Institutional -11F (TIF-IS)
Office TIF (TIF-0; _
Water Quality (WQUAL)
Ln
Water Quantity (WQUANT)
-+ Fire Life Safety (FLS)
r�
Erosion Cntrl Permit (ERPRMT)
rasion Planck!USA (ERPLAN)
Erosion Planck/COT (EROSN)
TOTALS:
i
' Go.v-t�Q�tor �'c,,,.►.e�fy Co�s��v�'�►o,✓ Sob- Se-�'f (�roit��v
3IsS,5 7t- AVe &,V63 SW /o3ra-
• O/'E 772?N T�arA OtcJoA, 97ZL4
flepoit div Ar-ra /ore cc,A-,sC,
Re- vest L�xist�� ��t{rko- Gas Farr p/nG�
CL
rx
of
tl,��c�c��rtic�c•, '�
FOR
pi�..
i
(\(oo K
-7x ►DX9
j � v
/ Z
I�"ir•►INc; ROOM 1� i-TCHE rJ FA\M
s'
14 x 10 x I Svc,
I x13 x � ( IS�x ►o� x �
HAL►- 3` x 2lxq f3AT ►+
LI�J iTJC-� ROOM 3TAi2g LAuNoray
� x5�x9
3(0,r ►?x ►q AVC) x !o K
13 x 12 x I C) A V -4 �c 5
�� ENTRY o��'set
IlxloAM
G ARMC-IE
Z7-3 x Z 1 x ICS
tA
J
rr
G]
t7
ti.
f
wall,fl4sh►'�S + -
3-r�;6 Ga..►� �.
'lzff GU1( ply W404 !"
f
• "1�� ;�x/z, Rf/If, Twist
` Gellr,vd J�c1S"r Zx/2 R#ml7s1
2x� TSP f'Mtc� 2Xrt 726i"PArres
N �oNa ci _
7/v W.1-rer Ifyi.0
Cafkt" 's
ZX6 .S-rA" s r Z&f
I l tell _�in?la�rk owt ZK6 �'innnw�
I "r0l' 7rr�p►A c< t/w'tfNQ
l.xs rec -FIrC plgcc sirs o•v
It Gurb _ — _ I4-�r��p/��c Plw-l{�r�►t
..--- GX/.S"t/.v� fi Yw�jC�lyN ''2ll •rOyvP 1l'!/P N_.�.J
Slee Uic w
•
rrt pin�c G�i�lxc f.1/dl Comi ple-fele l?e 6v,%t w• th ZxG
TI'AY►ll�vg Ci had Clr✓Arn ,.Gil' TG �»t eco' -F/r�p/�c� ,�yS'f� l/af��v
COr�CS
Paksc fr omilv'I will de rooloce. cis /VecCj nrcl T`o �IQ�meLo'Cr>�
CL
Ckeir-recC rn.n� ��,�� Thil Tc Itis/r.C/e Z X v S+`�o(S
rx
Ln
`lX /d Aeorfer• - 7- 7000 fol.Ycs
J
f]
Chase w;/l 40.10 /V-' 111 ZAP 13-ot New S fd r.v6 w111 4?e
4
C-1)
4 ex .T L t,� h e is e S l A/'
��.a /l xYSa/.cf/e ,• will u3e ReulAf:c p.v �xfer►or Wal( o�v
• s r ti�
-Pper 0. 41 v4lue
\ (r
ol
11 \PJ
wJ � \
CO
t
`\ r` , \
Af
.n
J
G] t
v `4.Al 1
R;atvJ�tto
iG y&-3 S w io -°
CITY CSF TUGARD
COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE c,cC u�ANor
lv�Y
13125 SW Hall Blvd.Tlaard,Oropon 07223.8189 (503)839,4171 PEFiM I hF. . . . . . . . M5T94
639-•4171 DATE_ ISSUED: 04/27/95
PARCEL : 2S 11400 -c.040ITl
31TE ADDRESS. . . : 1646.3 5W 103RD AVE
3U1_SDIVISION. . . . : RIVERVIEW ESTATES NO. ZONTNGtR-7 PD
3LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :048
C"-ASS OF WORK. :NEW
fYG'E OF USE. . . :Sr."
OCCUPANCY GRP. :R3
C1GLUPANCY t_.UAIi:230 4
I'ENANT NAME. . .
Remarkao
Owners
MTN SHADOW ENT6'RPR I SE INC
7C*5 SE HANNEMAN CT
13LADSTONE OR 970c"_'7
Phone #: 656-0096
Contractor: _.______.._....._._ .___._.....___.._,_._.._.._..._.___._..._
14TN. SHADOW ENITEPPRI,r- S, INC
17245 SE HANNEMAN CT.
I LADSTONE OR 9701:27
phone #: 656-0096
Rey ,#. . : 45428
'kc,upranuy of the above referenced GI_lildiny- is hereby given, atnd ,tifies
the compliance with the State Of Oregon Specialty Codes far- �e1 Ir,oUPI
occupancy, and use Under which the referenc_eci permi� was i �5l_ d.
1 TLDIN6� 5 ,ECTOR BUI 6 MJF F IC IAL
i P-01T , IN CON'3RIf.;► OUG pl-ofF
L '
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-417
inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/S k
Foundation Pibg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing - Iumb.
Alarm Water Line Insulation "lVech
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: 31, J (l�� l ime: AM PM
Address: / q6, 3 kl�-.
Builder: Permit #: %y - �� 75—
THE
]-THE FOLLOWING CORRECTIONS ARE REOIJIRED:
00,�
In M- 1kor, Date:
PPROVE D ISAPPROVED PROVED SUBJECT TO ABOVE
or Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41
Inspection,: _
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-inA :��_�
Post/Beam Mach. San. Sewer Gas Line - Id
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr, Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �' Time: AM �PM
Address: ���
Builder: Pe mit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
V) --.- - -
LLl
J
Inspector: Date:If
L—Af15_ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD PLUMBING PERMIT. . . . .
PERMIT #. , MSI-94--0`%'�;
DATE ISSUED: 07/21/94
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 07223.6199 (503)639-4171 PARCEL: 251 1 4bL!--i 'lZ;)400-
SITE ADDRESS. . . : 16463 SW 103RD AVE_
SUBDIVISION. . . . : RIVERVIEW ESTATES NO. 2 ZONING: R-•7 PD
BLOCK. . . . . . . . . . , LOT. . . . . . . . . . . . . :048
CLASS OF WO RE/.. . :NEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
S'TG(tIES. . . . . . . . : WATER HEATERS. . . . , . : 1 CATCH BASINS. . . . . . . :0
F.IX'TURES----___._._._....__._......_ LAUNDRY TRAYS, . . . . . :0 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINA: (ft ) . . . . :0
WATER CLOSE TS. . :3 WATER L'.NE ( ft ) . . . . : 10111
DISHWASHE:RS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remark-, : PATH I
IYITIV SHADOW ENTERPRISE INC TI.F $ 1520. 00 JG 07/2) /94 -
17245 SE HANNEMAN CT BPRT $ 458. 00 JG 07/21/94
BPLC $ 50. 00 JF 06/20/94 94
t:;l_ADSTONE OR 97027 B5PC $ 22. 90 JG 07/21/94 -
I-hone #: 656-0096 SSDC $ 280. 00 JG 07/21/94 -
PARK $ 500. 00 JG 07/21/94
Plumbing Contractor•:___-_._...__._...._......_..__..-.-•- MPR'T $ 45. 00 JG 07/:=1/94
MPLC 11. 25 JG 07/21/94 _
Name: Y2_-_ .1 y.__��, __ m5pC $ 2. 25 JG 07/21/94
Address : d0 r _ PPR7 $ 155. 00 JG 07/21J94 -
City: C(44'0A - 1 _ 5tate :_C1 v P5F'C $ 7. 75 JG 07/21/94
Zip: ' T Phone#: 7- 7y EROS $ 64. 00 JG 07/21/94 -
Reg #:���.. _.._ .. Additional fees, not shown herr. . . . . . . . .
------- REQUIRED I NSPECT I ONS
This permit is is,.iued subject to the reg
uiations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of Or-e. Specialty Codes and all, Post/Beam Struct Water Line Insp
other applicable laws. All work will be done Post/Beam Mechan Appr/Sdwlk Insp
in accordance with approved plans. Chis Plmiunds ) ab Insp Mechanical Final
permit will expire if work is not started FILM/Underfloor Plumb Final
within 180 days of issuance, or if work is Mechanical Insp Building Final
su!!pended for more than 180 days. Plumb Top 0,_1t Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
1, Insulation Insp
x %� _ 1_� � Gyp Board Insp
Authorized Plumbing Contr rtor Signature
10 Call for- inspection - 639-4175
Contractor Notes :
CITY OF T I GARD CERTTL OCCUPIFICAUV
ANCY
COMMUNITY DEVELOPMENT DEPARTMtNT PERMIT #. . . . . . . : MST94--0i27!-
13125 SW H,%ll Blvd.Tlgmrd,Oregon 97223*8,109 (501)639-4171 DATE ISSUED: 04/27/95
PARCEL: `--S1141BB-20400
ITE ADDRESS. . . : 16463 SW 103RD AVE
'JUDIVISION. . . . ; RIVERVIEW ESTATES NO. 2 ZONINGsR-7 Pri
OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . s048
CLASS OF WORE;. :NEW
'TYPE OF USE. . . :SF
OCCUPANCY GRP. :R3
OCCUPANCY L.C)AD:230 4
TENANT NAME. . . :
Ppmarks : PATH I
Owners
MTN 51-IADOW ENTERPRISE INC
17245 GE HANNEMAN CT
OLADL33TONE OR 9701.1-:,7
Phonp #: 656-0096
Contracturc
MTN. SHADOW UNTERPRISES, INC
17e45 SE HANNEMAN CT.
CILADSTONE OR 970,'.,7
Phone *- 656-0096
Rey #. . .- 45428
This Certificate certifies that the above referenced building of- pa-tiun
hereof has bean inspected for compliance with 1%he Tigard Building Code
w the group and division of occ-l..tpancy And use for which the above
t-ferenced permit wAs issued, avid OCCIApancy is hot-eby gran,t ed.
SUILE)llqt' IN5,PF-CTOR L D ING 1OFF C I At..
POST IN CONSPICUOUS PL.ACE
—_ fINSPECTION
NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —
Footing Plbg. Underslab Hach. Rough-ink' w
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam !loch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line // f Gyp. Bd. -Mech.
Date Requested: 0 3 U 1 / Time: ___AN PH
Address: C� Per-:it #:
Builder: ,1 — Z 2---:7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
DZA 7-6 sr
Ar
_ �-l. M�4S7r oR- --
I ALL �4�D_Fate L/P OX- ---
.
Inspector:_ L - ----------_---_Data: --- --
"PROVED nTSAPPROVED r— APPROVED SUBJECT TO ABOVE
Call For Reinsp.
NS ECPION NOTICE
City of Tigard Bulld.iag DePartment
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 63 71
Inspection: _ --
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
P1b9. Underfloor Water Line 0ayp. Bd.) -Hoch.
hnto Requested:._ Z -"-I Time: � AH 7PH
n7 trees: �0L1�a 5 I OBJ Permit h
nui.Ider:
TPM FOLL(KIINO CORRECTIONS ARE REQUIRED:
L/
F-
J
ra —
C7
J
Inspector: _ _____ Date:_
APPROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE
Call For Reinap.
INSPECT ON NOTICE
City al Tigard Building Department
13125 Sw Ball Blvd,. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-41'
Inspection-
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain l Insulation' -Plumb.
Pl.hq. Underfloor Water Line Gyp. Rd. -Hoch.
ti
Date Requested: L Time: AM PM
Address:_ /(�' � Ze) 3 .41C Permit
Builder: �V 2 -7— —--- —--
THE FOLLOWING OORRACTIONS ARE REQUIRED:
e.
Owl- IeZ
Inspectors Dat
�s
DISAPPROVED APPROVED SUBJECT TO
__
—Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 9W Hall Blvd. Tigard, Orogon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection•
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
`oat/Beam Str.0 San. Sewer Framing --Bldg.
oat Beam Mach.-� /Rain Drain Insulation -Plumb.
-Wrderflr ( Waterer Lina Gyp. Bd. -Mach.
v �v <z
Date Raquentedt �f2/ 1 Time: AM PM
Addrnss:1L, --=� / � �� Permit #12(_
Rulldwr:
TIM FOLLOWING CORRECTIONS ARE REQUIRED:
Itin V�.-t -rr: Uate:
VbD DISAPPROVED _, APPROVED SUBJECT 7'0 ABO
For Reinap.
INSPECTION NOTICE `I
City of Tigard &A .ldioq Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0-Phone): 639-4175 Business Phone: A44171
Inspections__ _
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
1
Found. P Top Out Gas Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requested: _T[mes AM PM
Addresas & J G Permit fs
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
lq
f1
r-.
n: -
rn
YL-
03
r•
W
.J
Inspectors --- - - --� Date:_
ROVED DISAPPROVED APPROVED SUR.M7T TO ABO
,Call For Reinsp.
1 •-
INSPECTION N(r_:
223
City of Tiga.'a Building 7X
1312S SM Ball Blvd. Tigard, n 97
Inspection Line (Rec-o-Phone)t 639-4175 sinees Phone: -
Inspection: C!/�/, - C � ( Gc�
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. ( an. Sewer Framing -Bldg.
Poet/Beam Mach. ain Drain Insulation -Plumb.
1�
Plbg. Underfloor Water Linel Gyp. Bd. -Mesh.
Date Requestedt (�I L T AM PM
Addreass ) PelN= `} -
��,� �k
Builders
THE FO.LOWING CORRECTIONS ARE REQUIRED:
d
O.:
H
H
J
U'
�l)
J
Inspector Dater
PROVED DTSAPPROVED __ APPROVED SUBJECT TO ABOVR
___Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sw Ball Blvd. Tigard, Oregon 97223
Insper+ ion Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Undersl.ab Hech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hech.
/ C
Date Requested:-`-`� I Time: AN PN
Addrees:�z�--4- Gc/ 3 Permit
Builder:
J THE FOLLOWING CORREEAL0*ff-A E REQUIRED:
ti
N
F-
J
r-w
C9
111
J
Inspector: Date-
PROVED DISAPPROVED APPROVRD SURJXrT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tiga.-d, Oregon 97223
Inspection Line (Reec-O-(Phone)s 639-41;'5 Business Phone 639-4171
Inspections -A`A lei A Q— � ---.---
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line G� Gyp. Bd. Mach.
— r
Date Requested: I / `�I,/ _Tie a: AM PM
Address: 1 LO L1 3 V31 ~ P`nnitis
lluiIdor: ",\ (Aa�,? ("tI `1 - I ) � --2�
THE FOLLOWING CORRECTIONS ARE REQUIRED,
i
Inspector: Date:_ 7
APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOY6
---Call For Reinep.
CITY OF TIGARDASTER PERMIT
PERMIT #. . . . . . . : MST94-0275
COMMUNITY DEVELOPMENT DWARTNU
xkJT DATE ISSUED: 07/21/94
13125 SW Hall Blvd.Tigard,Oregon 97223*81199 (503)639-4171
PARCEL: 2S114BLA-20400
5 ITE ADDRESS. . . : 16463 SW 103RD AVE
SUBDIVISION. . . . : RIVERVIEW ESTATES NO. 2 ZONING: R-7 PD
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :048
BUILDING
REISSUE:MST04-0266 DWELLING UNITS: l BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. .NEW BEDRMS:4 BATHS.-3 GARAG... . . . . . . . . . :500 Sf
TYPE OF USP. . . :SF FLOOR REQUIRED SETBACKS----------------
TYPE OF CONST. :5N FIRST. . . . .- 1110 s LEFT. . . 19 ft RIGHT. :5 ft
OCCUPANCY GRP'. : R,3 13ECOND. . . : 1080 of FRONT. :2:'0 ft REAR. . :25 ft
STORIES. . . . . . . ..2 THIRD. . . . -0 Sf REOU I RED------------
HEIGHT. . . . . . . . :3121 ft TOTAI------ -:2190 s SMOKE DETECT ORS. :Y
FLOOR LOAD. . . . :40 psf VAL UE. . . . . $ 109741ZI PARK ING SPACES. . : i
Remarks : PATH I
PLUMBING
S 1.NKS. . . . . . . . . . : 1 FLOOR DRAINS. . . , :0 BACKFLOW r-REVN TRS. . - I
LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . .. . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPIS. . . . . . . .0
DTSHWASHERS. . . . ; 1. WA,rc..R LINE (ft ) . : 100 OTHER FIXTURES. . . . .
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
W0!3HI1\1G MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL FEES
FUEL UNIT HTRS. . :0 type amount by date r,e(::pt
/GAS/ VENTS . . . . . ..0 TIF $ 1520. 00 JG 07/21/94
MAX INPUT :O BTU VENT FANS. . :4 BPRT $ 1158. 00 JG 07/21/94
FURN ( 100K . . :0 HOODS. . . . . . : 1 BPLC $ 50. 00 JF 06/20/94 94
FURN ) =100K . . : 1 WOODSTOVES. :0 B5PC $ 22. 90 JG 07/21./()4 —
FLOOR TURN. . . . :0 CLO DRYERS. : 1 SSDC $ L'.'80. 00 JG !hl/21/94 —
BO L/CMP
B0'.11L/CMP ( 3HP:0 OTHUR UNITS: 1 P fi R K $ 500. 00 JG 07/21/94 —
GAS OUTLETS: 1 MPRT $ 45. 00 JG 07/21/94
r1,nV,-: ------------------------------------MPLC $ 11. 25 JG 07/21/94
MTN SHADOW ENrERP,RisE INC M5PC $ 2. 25 JG 07/21/94
17245 SE HANNEMAN CT PPRT $ 155� 0121 JG 07/21/94
F15PC $ 7. 75 JG 07/21/94
GLADSTONE OR 970,17 EROS $ 64. 00 JG 07/21/94
Phone #: 656-0096 ERPC $ 20. 80 JG 07/21/94
Contv-Actor- : $ 2171. 00 JG 07/21/94
MTN. SHADOW ENTERPRISES, INC BPLC $ 50. 00 JG 07/21/94
17245 SE HONNEMAN CT.
GLADSTONE OR 97027
Vlhune #: 656-0096
Peg #. . : 45428
$ 3207. 75 TOTAL
This persit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/fOlAnd Insp Fit-eplace Insp
applicable laws. All work will tr done in accordance with approved Post/Beam Stt,uct Gas Line Intip
plans, This persit will expire if work is no ' n 180 Post/Beam Meehan Insulation Insp
days of issuance, or if work is suspe d * 1=4 11Hit iPost/Beamda Plm/undslab Insp Gyp Board Insp
PLM/Umler•fl out- Rain drain Insp
`)ei,mittee Siqriatur-eii- chanical Insp Water- Line Insp
Plumb Top Out Appt-/Sdwlk Insp
lssi..ted By : Ft-timing Insp Mechanical Final
Call for inspection 639-41'7!5
CITY O F T !GARD FEWER CONNECTION
PERMIT
PERMIT #. . . . . . . : SWR94-02`59
COMMUNITY DEVELOPMENT DWW, T
. Ar;NT DATE ISSUED: 07/21/94
13125 SW Hall Blvd.Tigard,Oregon 97223s8199 (503)639-4171
PARCEL: 2S114BB-10400
:,ITE ADDRLS5. . . . 1.6463 SW 103RD AVE
SUBDIVISION. . . . : RIVERVIEW ESTATES NO. L ZONING: R-7 PD
BLOCH.. . . . . . . . . . .. LO-f.. . . . . . . . . . . . . :1214;3
*TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
Cl-ASS OF WORE;. . . :NEW DWELLING UNITS— : 1
IYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
'I INSTALL *TYPE. . . . :BUSWFR IMPERV SURFACE. . :
Remarks: PATH I
Cjwnet-: FEES
MTN SHADOW ENTERPRISE INC type amol-Int by date t-erpt
17245 SE HANNEMAN CT PRMT $ 2200. 00 JG 07/21/94 -
INSP $ 33. 00 JG 07/21/94 -
GLADSTONE OR 970-2-7
Whone #: 656-0096
Contv-actot-.
CONTRACTOR NOT ON FILE
------------------------------------------
I 'lionp It: $ 2235. 00 TOTAL
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewev, Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit 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 shail prospect 3 feet in all directinns from-
the distance given. If not so located, the installer s 11 pu �,e
the
, 11 pur ase
I y w,
located,
a "Tap and Side Sewer" Permit and th�w ncy wi er 1.
Pet,mi. LLee
.1 sst-ted By
("'a I I f c)t- in�nppct ion 639-4175
J I
------------
INSPECTION NOTICE
City of Tigard Building Departaent
13125 SII Ball Blvd. Tigard, Oregon 97223
Inspection Line )Rec-O-Phone): 637-4175 Business Phone: 7
inspection
Footing Plbg. Underelab I1h Appr/Sdwlk
Found. Plbg. Top OutC� as"Line 1� FINAL-
Post/Ream Struct. San. Sewer �1 p, ' -Bldg.
Poet/affam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Linen Gyp. Rd. -Meeh.
Data Requesteds, CJ .�G�� Tiases AM � PM
Address: �j /C/ Permit �: 6 ,2L
guilders /�,tC/ �1 ^�F'Z 2
THE FOLLOWING =CORRECTIONS ARE REQUIREDs
ZZ
coo
V)
G]
11;
Inapector: I Dates 0
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call for Reinsp.
INSPECTION NOTICE
City of Tigard Building Dsspartmen4t223
/
13125 ON Ball Blvd. Tigard, Oregon 9Inspection Line (Rec-O-Phone): 639-4175 Busineee -41 11
Inspection: ��------- --
Footing Plbq. Underslab � oc Rough-in Appr/sdwlk
Found. Plbg. Top Out GasLineFINAL:
Pner/Steam Struct. San. Sewer filSminq� -Bldg.
Pnst-/neam Mech. Rain Drain Insulation -Plumb.
P1txl. Underfloor Nater I.i.ne/ t Gyp. Bd. --Mech.
ante. Requested: ! � 71/ e1 ( Times AN —y PH
�cldrf3as:-1 VJ Permit f: 2Y`V
Builders_ �'.��—�' Z' J � <
THE FOLLOWING CORRECTIONS ARE PEQUIRED:
i
Inspector r = _. _ Dates
APPROVED UiSAPPRovED APPROVED SD&ECT TO ABOVE
--Call For Reinep.
C:) I Y OV 'I'I WARD - RF(::L I PT OF PAYME:NT Rk: In I P'l NO. i 94•-RS4 795
CHECK AMUI,IN C s 5392. 75
NAME, n MOUNTAIN s7-IADOW E N'T k=.W 1.:A13H AMOUNT' s 49. 1110
ADDRESS s 17245 BE HONNF:-MAN Gl PAYM1-.N I Df-I I i:-.'l/ 4
(:iL.ADS T CINE:, OHI-.0014 1.30A 1 I V I S I ON e
PURPOSE OF PAYME:N I' flMOUN I I-IfI 1 1) PC.IIZF LOLL• CIV PAY111-_N I AMOON T PAID
NCJII._IJINI 1'E.RM ME31'y4-0r:"7�,T +SN. VSA PLUMBINU PFRM
MECHANICAL Ph 45. 010 Vii% BUILD PER
PLAN CHE'C,K Fl`' 61. c15 fikWFR USA F,WR94--IllrbL) P2.1110. LAOGEWI✓R t NSPECT 35. 00 PARKS SAC 54'10. LAW
STORM DRAIN SDC 11180. 00 RF_SlDFNTIAI_ T'RAFf IC FFFS 14141. +1141
MASS TRANSIT 'TIF FEES 114'1. 00 F-ROSICIN CONTROL PERM ITFEE: 64. 1710
EROSION CONT ROI.. PI-AN CK P0. A41 FROS I ON CONT,401- 20. 84'1
t6463 13W 103RT)
H I VF RV IFW E=ST'A'T'E'S TWO/1_0T 48
TU f t-W AMOUNT' PAW — -- — —1 5:39c:. 75
Residential Building Permit Application
City of Tigard L
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
F) D
Jobsite Address: /�`I�.3 -5
Subdivision:
Subdivision: Office Use Only
Valuation:
Planck/Rec # (D
J Permit # � 5 �V G p
Owner: � � � - i, i �,_,��, ,�Z---
1 Reissue of Ms 0 7.41
Address:—L7,2 (_I `� ` 7 r�`� l� 1 E'[rl r'r��� /� Map& TL lt�
Phone: --- -� �; -{ ,��'. Approvals P.equired
Planning _
Contractor: _� `t.1Q Engineering
Address: Other
Phone:
Items Required
Contractor's License #
L ( � C ' Subcontractors
(alta copy of current Oregon license) Truss Detai:s
Contact name 8. phone. c;,`/,� l -(,,��� /
� Other
Supcontractors: :> :..:. .. ::
i
Plumbing: �/r�
fir- r:
,Mechanical:_'''1 (. I r'-
1 I _
o.
(attach copy o/current OA Contractor's License)
N / Jr L� . ✓�J�
Archltect/En9 sneer:
Address. 7 � ` lel CC, 3 /�
' � /Phone O� l
JOB DESCRIPTION: .) �r)
/`
Appi' rK Signature Phone nu r
Received by: Date Received:
Permit # Account Description Amount Amt. Pd. Bal. Due
/ 58
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) 55
Mech. Permit (MECH) 3
State Tax (TAX) .3Z.f u v
Bldg: oR1.go I/
Plumb: -7.7 5' J
Mech:
Plan Check (PLANCK) ,
Bldg: S U ( S U
Plumb:
Mech:
Sewer Connection (SWUSA) ? / �, U
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) S�� ✓/ _ �—
Storm Drainage Chg (SDSDC)
/
Residential TIF (TIF-R) Zq/ U /q 1 0
Mass Transit TIF (TIF-MT) /I u
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-0) _
Water Our' .y (WOUAL) _
Water Ouanthy (WOUANT) —
Fire District (FIRE)
Erosion Cntr1 Permit (ERPRMT) 6
Erosion Planck/USA (ERPLAN) ��J� -a0'y
Erosion Planck/COT (EROSN) %fl TV
TOTALS: 4F ��
�i
CITY OF TIGARD
BUILDING DIVISION
RESIDENTIf., PLANS SUBMITTAL.
1 �
APPLICANT NAME:� � ` � 1 P L1 N CHECK # _
ADDRESS: I�L� ,'/� ("Y- PHONE # ` C`,� >`% ,
DATE RECEIVED: T RECEIVED BY:
CHECKLIST (ATI items must be in packet before plan ,gill be reviewed)
YES NO N/A
1 . [ 9- [ ] [ ] 3 FULL SETS OF BUILDING PLANS (No red line revisions
or tape-ons).
2. 5 SITE PLANS (includingtax lot and tax map number,easements,
erosion control provisions, floor elevation of garage and mairl
floor, set backs, drive-way location, north arrow, scale, location
and termination of rain drains, corner elevations, and contours
if over 15% grade).
3. [ l [ J [ J BUILDING PLANS SHALL REFLECT TOPOGRAPHY OF LOT
(if house is designed for a flat lot and the lot is not flat, revised
drawings are required. No red lines accepted).
4. REVISION TO PLANS MUST BE FOLLOWED THROUGH
FROM ROOF TO FOUNDATION (detailed sections may be
different from the originals as a result of your changes. These
portions of the structure that are affected by the change need to
be reflected on the plans. No red lines will be accepted).
5. [/� [ J [ J FLOOR PLAN(S)
6. [1 -]' ( ] [ ] FLOOR FRAMING
7. [ ] [ ] [ ] TRUSS JOISTS (engineering, details and layouts)
8. ROOF FRAMING PLAN (all hips and valley supports indicated
and detailed).
IV 9• l 1 l j [ j ROOF TRUSSES (engineering, details and layouts)
r
10. [ ] ( ] [ j COMPLETE CROSS SECTION(S)
11 . [ ] [ ] [ ] ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
ADDITIONS AND REMODELS
12. [ ] [ ] ( ] BASEMENT WALL, FOUNDATION AND RETAINING WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
13. [ ] [ ] [ j WALL BRACING (structure must meet table R-402.10, revised
J� alternate method 93-7, or a lateral design shall be provided)
ry!� 14. [ ] [ ] [ j ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. (Attachments must be
clearly legible and fully referenced in the plans).
Led
15. [ 1 [ 1 [ ) BEAM CALCULATIONS (all beams over 10 ft. in length or any
beam that supports a point load).
16. [ ] [ ] [ ] ENERGY CODE PATH IDENTIFIED
DO NOT MAKE CORRECTION IN REED
RED WILL ONLY CAUSE DELAYS
bk.suew