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` 1.5550 SW 104TH AVENUE
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AGREEMENT TO CONNECT TO PUBLIC STORM DRAINAGE SYSTEM
The undersigned owners ( including purchasers) of. 13150 SW 104th Avenue,
WCTM 791 2CC, Tax Lot 3301, Permit #881132, as a condition of ap!. :oval of
an Occupancy Permit, agL_e to:
I. Connect to a public storm drainage sewer when constructed, if
feasiOle.
2. Upon demand by the City, provide a 15-foot permanent storm drainage
easement along the south and east property lines to the extent
necessary to accommodate the new storm drainage sewer, together with
the necessary construction and permanent access. Building
encr.o&chment will be excepted.
Reroute outfall as directed, if feasible.
Date Name of Corporation
By:
l
Title: _ L _cik� :- Pe cr-. DT —
pct .
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N'
INSPECTION NOTICE
City of f igard Building Departatent
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type
Type of Inspection *, 1 ---
Date Requested Time_�,_ A.M. P.M.
Address alq_5 O _'+ C /A/U 1�74,6 1 k-e Permit #A83
// L
Ownet 2C•O/ /`//7�7�iJi i'irn i/7 C. Lot
Builder lel zl:h —
T he following Building Code deficiencies ere required to be corrected:
r-
lY
Presented to KApproved
Inspector _ _ _ _ n Disapproved
Date
CALL FOR'RGINSPECTION
❑ YE! 0 NO
■ ■ xw
APPLICATION — STREET IMPROVEMENVEXCAVATION COPY TO:
❑ (WHITE)-FILE
ORDINANCE NO. 74-14 ❑ (YELLOW)-INSP.,,91
(INSTRUCTIONS ON SEPARATE SHEETI ❑ (PINK)• APPLICANArB'Eff�f
❑ (BLUE)-APPLICANT
APPROV E D APPLICATION NO.: 3 -
CITY OF `I IG^RD, OREGON f
NOT APPROVED [; FEC AMT.: f -
PENDING FEE. PMT, [j CITY HALL RECEIPT NO.:
PENDING SFrJRITY C PUBLIC WORKS DEPARTMENT BY __ _ DATE_ �_
PENDING AGEN::Y "OK" (_j Applicatiun ana. P* A�ess Record MAINTENANCE BOND �t -1
/ "it11�` L
PENDING INV ORMATION Cl FOR STREET 'N,,'f3OVEMENT/EXCAVATICN As RE(JUIREU
4N N UAL 1
PENDING VARIANCE ❑ EXPIRATION DATE: .
PERMIT NO ----- -__-- DATE ISSUED. L __1___..___�. BY: -
(1) APF -ICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL_ r
AS DESCRIBED HEREIN, IN FULL ArCORDANCE�WITH CITv REQUIREMENTS.
APPLICANT
NAME AD EssIST - - IPMONE
CONTRA( i OR c NAME
PLANS BY __ _ —
NAME 0�1:2IDRESS CITY PHONE
�1
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ Z. / _
DOLLARS
FOR OFFIC[Uf[: MIN.
(2) EXCAVATION DATA: _ 0.04 X s s
STREET _ DE SCRIPTI OVPROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT 14AT'E41AL INSTALLED ITEM GATE RE'AARKS/TYPE BY
TYPE LENGTH _WIDTH DEPTH ITEM & OUANTITV
STREET
PENED -
INSPEC
R 'T101.
E
O
ESTIMATED STREET OPENING T
1"�-- ------ --- -- ---
ESTIMATED STREET CLOSING DATE: - F-
5114ECT
(3) SECURITY NO, SECURITYAMT.: S L05LD
SURETY CO. FI"Ni AL
- - ---
CERtI FI[O CNECIS �.� CASH ❑ INSPEC
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL -� 3 -,PF_CIAL PROV,91ONS r CONDITIONS
FEATURES; EXCAVATION LOCATION AND EXTENT.
I
I _
-owµ --
CURB -
-CURS �• - - - - -- - - - - - - - - - -
It
(S) NOTE THE CITY fJF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TC APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WAS14INGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECUr.IT1ES, 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 SIGNATtME,. ` �'-r" DATE
BUILDING Pl;:,PM*I'.T
CIT OF TWA RD IJEWMIF NO. : 1131-jwwl.l—se
C11YOFTIGARD
COMMUNITY DEVELOPMENT DtPARTMENT DATE ISSUP-J): 6/ 0/6"
13125 S.W.Hall Blvd.P.O.Box 23397,Tigard,Oregon 97223,(503%639-4175 PRII + 'IT.NO . (38.1.1.32
'1013 A1011011411::,SS : 3.3950 SW 1.U/4'1+4 AVE
1AX MAP/LOT SUB: LT : 1
LAND USE:
I OT 51ZE: VALUATMN: $ 7-11-150 S ET r.-.4 A C1(Si
F'PON 1*: 22 PEAl'-4: :'.)/I
WORK CLASS : NEW DWELL.UNJ:TS : t LEFT: 17
USE: TYPE : SI.NGAJ-:: 1::'AM:I:l Y NO. BEDROOMS : .5 E:'X*I' .WALL CONST :
CONST . TYPE: VN NO . I.3A*T*H!-.i : N:NW S : E :NP W:NP
OCCUP.GPP. : P'13 PRO T .OPEN 3:M..',S :
OCCUP.LOAD N:NA S :NP E - NA W:NP
TOTAL AI:4k;-'A 1.H!.')0
NO. STORMS : I J'ST : 1.w,*`o Pucw-- ccms,r : C F-1PE PET7 YES
12 2ND: AREA SE,PAP7 NO WATEU:
BASEMENT'? NO 311- D: UC(",i SCA:)AP7 NO r4A'1'1--*:D:
MEZZANINE7 NO BASEM"T
FA OUP LOAD; 440 GAPAGE: F-114E SPPKLP7 N('.) ALAWM7 YES
FLOW DETECT7 Y F-S
Y'YPE: ELEC . SS,,? YES COPP7 NO
11-4Y : ih,j
l*-'!l:.:MA14KS :
PEISS-st-Ai: OF' NO .
- FEES : LAST PEISSUr-i — --
0Slyctic�itn'.I.:i.rwd 1:;E AM 11, *358. 00
W SteLte. St PLAN REVIEW $P3Z.1.70
N fft I
E UP 973 0 1 FA:PE DEPT
R (503) STAK AX 1
. . )u
OTHER
1AF-VI:A,.UPMEN*1 CHAPGL.S :
C SIX(STORM)
$250 . 000WAIJi- CONSTPUCT11JN CO , SDC 1 STPEF.T 1
$600 . 00
T 303.15 S W 1S T S T* PUC(#2 11
R P c I r,-r,:1.fit 1-1 d 0 P 49 1 f.?0 1. $250 . 00
A PREPAII) < $1.00 . 00)
C 303) 222-4si!5
I
0 WET.,15TPATION ND, Wiitligh 'i OTAI $,1 606 60
R
RECEIPT NO.
This permit 0t i-isued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes, zoning regulations WI.LII1NSPECT311INS
and all other applicable codes and ordinanLeg, and it Is hereby C.T.Ty APPPCHISW
agreed that the work will be done in accordance with the plans and F(XITIM.,
specifications and in compliance with all applicable codes and GI—AH
ordinances The issuance of this permit does not walve restrictive
covenants Contractor and subcontractors shall have Current city 1: HAMING
busine!,a tax permits This permit will expire and become null and WOOFNAII T N
void if work Is not started within 180 days,or If work Is suspended or IN!11-11 AT I ON
abandoned for a perio
,A of 180 days any time after work has (.';Yl:) . BOAM.)
commenced I II b t e responsibility e permitteet0assure F I NA11-
all requi nap 1i Fi requested id p ved
Pe e Signature/
11
I F-OP INSPECTION e, 19-417,1s
lssu�d By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TIFA RDMI�.C�aAN3:CAI— PERMIT'
7�T-.4% V'EPMIT NO. : MEIE1181135
k WYOFTWARID
COMMUNITY DEVELOPMENT DEPARTMENT ORlOON
DATE ISSUED: 6/ B/68
13125S,W 1-1,11181vd PO Box 23397.Ticiaid,C'rPqon97223.(503)639-4175
PRIM. PM1 -NU MR;_1 3P
JOH ADDRE`.iiS : 13950 SW 10'(11,11 AVE
'TAX MAP/L.OT SUD : LT: UK :
LAND USE:
LOT SIZE:
I'VEM: NO: NO :
WORK CLASS : NEW FU14NAC.E 0.00K AIR HANDLA (10
USE TYPE: 9INGA I'-- FAMILA F1JPNA('1,E 1.0010+ AIP HANULA 10K
CONST .'TYPE:: VN ir-1-001*-4 F't.Jl4NAC',I::-' EVAP.COOLER
Oct'NiP.GPIn'. : 1:43 HEA,rER VEN'T' FA-N :i
VENT Vl--'Nl* .
HLII/COMP <31-11P HOOD
NO. STORIES : i BI.-P/COMP 3-1151-11P I NL.I NERA'TOR(DOM
DWF.-I-I- . UNITS : I 131LA/COMP 15-30HF) INCINERATOR(COM
FUEL. 'TYPE FA-FX . DI-.P/EOMP 30-501,11V, REPAIR LINIA'S
MAX . J:NiL*,t.j*r BL.A/COMP 504-HP OTHEA
FJRE' DMPA57 (.,A5 PIPING OLJTI-E'TS
III GH PRESS?
' uw
fir.r" --- I
14F,MANKS :
0 FE:r--.S
W S-I*1eCAI&1J.Z*!(1 H%1I19:[nt-- . I PEAM11, 1.0 . 00
N 1.7 A G t ta,t it.,,- S1, r)LAN RE-VIEW
E +4'/ . 00
R G Lit 1.0 1"k 1:4 Y f 0 J. FIXIAMIES $10 . 00
PHONE it."A3) STATE TAX 1 . 40
D T H I-.:R
C
0
N
T WALSH C,0NS7'RUGT XON
R
A 301.113 51W IST ST
(7 P n I,t 3.ct n cl OP 97F201
r
0 PHONE' (503) P-2'r2---A3Y!5
R PEA'.11CII'T'PATION NO. Waf,Imh TOTAL" :
This permit Is issued subject to the regulations contained in Title 14 PEci-"-*rr'1T NO.
of the TMC. State of Oregon Specialty Codes.zoning regulations
and idl other applicable codes and ordinances. and It Is hereby I NSPEXI-1(INS
agreed mat the work will be done in accordance with the plans and MECHANCL.. SYLSTE:M
speciticdtions and In compliance with all applicable codes and
ordinances The Issuance of this permit does not waive restrictive FJ.N A L
covenants Contractor end subcontractors shall have current city
business tax permits This permit will expire and become null and
void it work is not started within 180 days.or if work Is suspended or
abandoned for A period of 180 days any time after work has
commenced It shallbe the Eorlb Siffile pernlitlee,to assure
all required It A, n 9t 5 a 111iid a
i
Permittee 9 att
Issued By f.All.-L F:0A INSPE"ClION 6.39-41173
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLUMBING PERMIT
CITY OF T167A RD FIT
NO. : I-N-86113,41
CITY&TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT DATIE ISSUED: 6/ 13/88
13125 S.W.Hall Blvd..11 O.HoK 23397,Tigard.Omgon 97223,(503)639-4175 PR I'll. PMT ,NO, as 11�3c'.
JOB ADI)PESS ; 13950 '-iW 10,ell*H AVE.
TAX MAP/LOT SUB : L.T : DK :
LAND USE:
LOT SIZE:
ITEM NO: N(:1
WORK CLASS : NEW WAI*['-:.P C1 OSET 2 TPAP
USE TYPE: SINGLE FAMILY UPINAL BKF'I-OW PPVNTP
CONST .TYPE::: VN I AVOPATOPY 2 TRAP PRIMER
(*.,Pl:) . P3 TUB !SHOWEP TPAPri
DINHWASHER I
DISPOSAL J.
NO . STOR]FES ; i WASHING, MACHINE I
DWELL.UNITS : 1. LAUNDRY TRAY I EILDG. DRAIN (DIA
FLOOR D14AIN
"'INK
S I SE WE14 (FT)
WATEP HEATEJ.4 1. STORM i'RAIN (F*T
OTHIEW 2
�FiF::MARK':i7
Hall . d 4.1 e a 1.1 1-.)et r M i t a 06, j3j.t.l!:;
v1Jr*e4iLdk
r-cic.,eived and in vi:kttlt .
W S11:111F.A0.JAIL].i zed Htiinglnc•! . PERMIT $12!-5 . UO
N 1.•7-?45 StaLte St
",lit 1.0
R 5 in UP 91'-5 1. F I XTI J P E'S
1:11-10NE (303) 501.....R'726 STATE: TAX 14 6 .
IS I (:)'THEIR
N WIESE W K
r P�*.'.NXNYJI A PLUMBING CO .
R
A 1:1.0. BOX 16307
C Pcir-t.1m,nd Or 9721.6
T
0 PI-K.)NE. (503) 0500
R PE'(',;T%TPATI(1N NO. is TOTAL $1.31. .2.5
This permit 19 1990ed Subject to the regulations contained in Title 14 PFCEIPT NO.
of tho TMC. State of Oregon Specialty Codes,zoning regulatlons
and all other applicable codes and ordinances. and it Is hereby ALQUIPIED INSPE(,-1 IONS
ayreed that the work will be done in accordance with the plans and PLD UNDER51 AS
Specifications and In compliance with all applicable codes and 11OUGH-1*N
ordinances The Issuance of this permit does not waive restrictive PLE4 . 'I
covenants Contractor and subcont actors shall have current city
business tax permits This permit will expire and become null and PAIN DPATN%
void If work is not started within 160 days.or If work Is suspended or STORM DPA TN
abandoned for a periu! of 180 days any time after work has WATER LINE,.
commenced 11 shall be 11e rest r, Ilifyofthetter UeeloassumF]NAL
all required inspec Ions are feda oved
i ee Signs re
Issued By �*A ) CALL. F($M—TWjwPY('�4TT(TR--"57--741-75
SEPARATE PERMITS REQUIRED FOR WORK OTHER r!!A'.'#' iJESCRIBED ABOVE
INESEENI&.. =
5F:U-:;-J4 PERMIT
C17Y OF TIFA RD !�4 1--li:JIMIT NO. : SE F481136
cryoFTwAm
COMMUNITY DEVELOPMENT DEPARTMENT 0020WDN L DATE ISSUED: 6/ O/M.)13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 57223 (503)639-1175 114114TIVII PMT N(*) RUI 1 1 AP
,.JOB ADDRESS : 13950 SW 1.04"I'l-4 AVI::*. LISA �4' 111`18EIQ: 3592-0
TAX MAP/L.OT SUI, L T : RK :
LAND LISE:
11-01, SIZE :
bEC'rION: 'TWI::, : 1.1 N G,
WORK CLA'55 : NEW
us E 'TYPE': SINGI-.r-*-' F-AlITLY
nigi- eft; ':i c:c)inply witt-i all ri.ilvm% at.r1 r,egul.at.tiorivi, c)f the Lfiiif:Or.�(J
Scilwivar,ta.gio Agericy . Thelaerm:l.t. expirton; IVIG clmyq; fvc)in the (W..e :Lm•imr-cll . Th*A t ce t a I
RUnc)t.iiit 1:)likiLl W13.1 t)e for'f(li.v d if thc, F.Yer,mit e.xjj:)ir-ei3 . Tho c1c)ew not
111-1-ItPM? thea 11--�CUr-jitc-y cif T.hcA Tcicntiori cif 0-10. lili(jo %C�W(el- litter-atlfl; . If thvi+ flisew"J" J'%
ric)t lcic�attc.-�d utt the-i J.I'lgltlt .1 e c� 0,�#.-� .11
k:l' JR1.1flL :1 P , t 3 + �. t I
I I
aL3.3. (ii i—.4siticiriq 4'1,aln thee, cli.iisturic-,e gi.vieri . If riot vii3 t,h*h tahall.
ni "fiar- and !-.iiclol P*P1,111:11.t iaiicl thi- AS3ivr)--; -w.i.11 :Lrivit.11011, R 3-81tivi"all. .
INSTAL-L... TYPE: BUILDING SLWF-'P IMPERVIOUS ARF.-'A:
FIXTUNE UNITS : TF.NANT IMPM)II)EMEN'T NO
I)WEI LANG UNITS : 1.
NO I OF' F11-00S . I
w Spec-i F.0A.;r.iocl Husiit.'Ilno. PERMIT 111111315 . 01)
N 17A5 S t at t o.? St COANECTION CHARGE $1 too . 00
E
S la.].f-)M 11,11141 9,7301. I..INF-: TAP INSTALL
PHONIE. (.503) 561-2726
OTHEP
Cl
0
W WIESE 61 E
T PE:NINL.'v!JL.A PL.LIMBXNU CO .
R
A P .O. BOX 16307
C pril-t1lallcl Of- 97216
1
0 r)HONE" (503) *761--0500
RI REGISTRATION NO. 22AA 'TOTAL.. : *1. , 135 oo
This permit is issued subject to the regulations contained in Title 14 PECEIPT NO.
of the TV,;. Stale of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinancep and it Is hereby PEQIL1Ir4ED INSPECT IONS
agreed that the work will be done In accordance with the plans and CIEWER
specifications and in compliance with all applicable codes and F INA1-
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 of 180 days any time after work has
rerivoiriplibility of f
V-e permittee to assure
:YJ e q u es t
111�required insp s e d Znr
ved
Per
�e
"g
er ee Signature
1, tied(113 By ``� ,c�� _-__ - J
CAI. 1. r:OA TNSr)1.1:'JT0N 639--A175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOF Ti6ARD
OREGONMay 23, 1.988 /
Spec'al_ized Housing, Inc
1745 State St
Salem, OR 97301
RE: WCTM 2S1 2CC
TL 3301
The address for the above d.scribed property has been approved by this
office. The new address is:
13950 SW 104th Avenue
Tigard, OR 97223
We have notified the postal service, utilities, and city and county agencies
of this address and Pave amended our. records.
If you have any questions, please feel free to contact this office at 639-4171.
Sincerely,
Laura Freeman I
Engineering Technlcian/Cartographer
ht/49461)
13125 SW Hall Blvd.,P.Q Box 23397,Tigard,(dragon 97223 (503)639-4111 — – ------ -- -
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