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INSPECTION NOTICE '
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 v
Phone: 6399-,4175
Type of Inspection ---
Date Requested l Timor'1an�Z. A.M.—P.M.
2 r
I
Address Perm4_ 1
Owner- _ Lot 4-
Build r _Builder �J
The following Building Code deficiencies are required In bd corrected:
kof
Presented to _ __ ❑ ,A,,ppproved
Inspector — [=7`wMpproved
Date
CALL FOR REINSPECTION
YES 13 NO
I IN OWCITYOFTIGrARD
CITY RD
COMMUNITY DEVELOPMENT DEPARTMENTOplaoN BUILDING, PERMIT
13125 S W.Hall Blvd.P.O.Bax 23397,Tigard,Oregon 97223.(503)639-4175 \\ PERMIT NO. : BU880482
- - DATE ISSUED: Ili/12/69
PPIM, PMT.NO. e8o4TB2
JOH ADDPF-:S! . 1.6069 SW 1.0/11TH AVE
'TAX MAP/L.OT 251.1413H SUO : SiWANSi(7N5 GI.J."-'N I-T : A BK :
LAND USE : 1-1'2-P1)
LOT SIZE : VALUATION : ut -50 ,96"7 SETBACKS
KS
FRONT : 20 RFKAR :
WORK CLASS , NEW DWELL. . UNITS : 1. LEFT : :5 rtIGHT : 1:8
USE: TYPE:: SINC31...E E'AM1I...Y NO . EtE::L)re1JOM!5 : 3 E.XI' . W ... CONST :
:
C:ONS'T .TYPE: : VN NO , F3AT'I I':r : P. N: S : E : W:
OCC:UP.C7P. : P3 PRO T . 0PFw'NIN(.,
0C:CUP. ...OAD N: S : E . W:
TOTAL AREA: 1.09
NO. STOPIE'S : 1 IST : IOY2 POOF" CONST : C F1Pla: RE::T7
HEIGHT : 13 2ND: AREA SEPAR7 RATED:
HASEME.NT7 3nD : OCC:UP . Sil•-::PAR7 RATED :
ME::;l..;'T..ANINE'? DASE.M'T
— F_'I OQ1 I. (.1A_ 40 — _-_ GARAGE: 360 -.,1AL_r.P'RKLR'7 _ AL AIRM'7 _
L0WTTT-- —
I' EAT TYPI-K : G.AS HDCP.ACCE:55? COI PI?
r'L.AN CHECK 13Y: kyr.:r
REMARKS :
LAST REISSUE.
W
F V
q
BLEAK MORGAN' r'I:RM:I: i' $1.'d6. 00
r1 r.) BOX Ae39 PLAN RE.VIEV $11"5 .90
beaLvertan ar' F11-41:.: 1)CN'T'
C
STATE 'T'AX *I A , 30
O UTHEl7
N
T DEVE;.C.0PMEN'T C:HAAGE Si
R BLEAK MORGAN 5DC(STORM) 111121.50 . 00
C TITIN PROPER'T'IES INC. SDC( STREET) $600 . 00
T pa BOX 6833 PDC 11*2 ) 1111250 .. 00
O
R k)Pir,vmrtan rar, 9700'7' 6835 PREPAID < >
RE U I:Si'TRAT ION NO. TOTAL : *1 ,.586 . RO
This permit is Issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes,toning regulations
and all other applicable codes and ordinances. and It is hereby RECEIPT NO.
agreed that the work will be done in accordance with the plans and
specifications and In compliance with all applicable codes and REQUIRED INSPECTIONS
ordinances The Issuance of this permit does not waive restrictive FOOTING: M SEWF•R
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and E'OUNDA'T rC7N WALL IgAIN DRAIN:;
void it work is not started within 180 days,or if work is suspended or POST A F.)H'AM WATER L.INF.
abandoned for a period of 18 days any time after work has PL.H . UNDE:R SLAB CITY APPRCH/SW
commenced. Itshall be tt a res risibility of the permittee to assure aL..AFi F I NAL.
all required Inspections are 4wested and approved PL FT TOPOUT
FPAM I NO
r•V IREFL.ACE
GAS LINE
P ittee4,qn, INSULATION
r;YP . BOARD
Issued By
SEPARATE PERMITS REQUIRED FQ��t' R1�„Ol rr Q,� �f §G,nq§D ABOVE
■
CITY OF T117A RD
MYOF TISARD
COMMUNITY DEVELOPMENT DEPARTMENT `111100"
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,"gon 97223,(503)639.4175 MECHANICAL PH.RM I T
-_-- -- --- - --_..— PEfiMT'T' Nb. : ME(300484 -_--
DATE ISSUED: A/12/F3H
PRIM . PM�.Nb. 880.4482
jOB ADE)RESS : 16069 SW 1.0-111-1 AVE
i
TAX MAP/LOT 851.:1.-1RF:3 !iUF3 : SWANSONS E_N l..T : Al E)K
LAND IJSE. : 1+1.iPC)
I..OT STYE::
ITEM: NO : NO:
W01:4K CL-ASS : NE'114 FURNACE:: <:LOOK I AIP HANDLR <10
lJ!iilr 'TW`E:' : SINGLE: FAMILY FURINACE 1.0OK+ AIP HANDLP 1.OK
CONST, 'TYPE:. : VN F L_O(:)P F:'I.)RNA(»E EVAP .COOI...E'R
O'C C.L)F' .G14P . 113 HEATIF'P VENT' FAN )?
VENT VENT . SYSTEM
1'31._R/CIOMP <3HP HOOD 1
NO. c;'T'(Jfa TE::S : 1 ULR/(::OMP :3• 15HP INCINERATOR(DOM
DWELL . UNITS : 1 SLP/COMP 15 301-I1.) INCINERATOR(CUM
_
FUEL TYPE:: GAS 8LI.1/C:OMP 30-50HP REPAIR UNITS
CRE: I:)MPRS 7 CTAS PIPING OUTLETS 1
HIGH PRESS7
LOW PIaE:SS'7 YES
HE.MARK. .
W
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F1
FE I-:S
BLEAK _ MORGAN - - - PE11- MIT +111.0 . OO
p13 RC)X 1.939 PLAN RE:V IEW >kH . "V3
O bour.vbar„t13n r3In FIXTURES �F�3 . OU
N
T STA'T'E: TAX
A OTHE:!1
C
T E)R1GHT BIL.I...
r1
Iil SY!;TEM•-Alla„
ti quird nr 9 71223
This perR7114"Wiie q ro( )to#lp{�igrgrr�lg�ca 'alned r"Ills 14
of the 1,MCu t p bl"d,Sue llty C��ltgnr , „�yulatfons TOTAL : ItAP . �
and all o ner app is ble co s an or ul nc and it is hereby
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and RECEIPT NU.
ordinances. Tho Issuance of this permit does not waive restrictive _._.„,__._„_ ,,_
covenants. Contractor and subcontractors shall have current city gEECJLITNEa TN1SiF>k:C'TICJNS
business taw! permitr. This permit will expire and become null and
void if work s•lots' rted within 180 days,or If work Is suspended or CAS LINE:
abandoned for a period of 180 days any time otter work hes POST R BEAM
commenced It shall be the re bnsibiltly of the permittee to assure POL)GH--IN
all required inspections are r quested and approved. FINAL
I'er ee .,Ignature
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
' UUU UUUU C 1110711,
A
C11YOFTliVARD �4,
CITYOFTIGARD
t
�RD
COMMUNITY DEVELOPMENT DEPARTMENT OREGON
13125 S.W Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223.(563)61j-4175
PLUMBING PERMIT
PEPMXT NO. : PI-11380483
DATE ISSUE.11: 4/12/88
PQIM. IDMT .NU . e80482
JON 6DII)PESS 1.6069 SW 1.04TH AVF.:-'
'TAX IAP/I 0 T 2S 1.1-'(1 H H !-5 U B : SkJANSOW-5 LT : di BK :
I ANI) : III R P D
L-OT SIZE :
ITEM NO NO
WOI-?K ('."I AS!-" NEW WA"VEP C11 0 S E,., 2 TP A P
LJ15F 'T*'Yl-.)I::: : S.ING.L.F.' AMTI Y U PT NAL Bl<l::'I-.(:)W PI-WINIJ-4
*TY0E--: : VN Le'.(;0PATORY P. TPAI'-" Pr4:(Ml-:P
(JC C 1.)P . (3,"P N:3 SHOWER R TPAV'S
DISHWASHER .11
GARBAGE; DISPOSAL I
1140 . 5'f OPIF.5 : 1. WASHING MAC;HINE 1.
DWELL. . UNITS : 3. LAUNDRY Tll'-7AY EALr)(,.. URAIN (DIA
BRAIN
SINK I SEWER (F-T)
WATER Hi--:A*TE-:I:l I si*aRm/nAIN (FT 1.00
OTHER
REMARKS :
0
W
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E
FI
FEES
1.17 . "50
C PEnmrr
0 HOX 603n
N
T hvukvt-.i-tciri
R STATE TAX as
A
C OTHEP
T
0 WATTS K r-i'N
R
11461111i WATTS P11-UMHP4Q--
pa BOX 230925
This perrtijigdLjwVV stjW T hlpct to the iequlabrs apip in Title 14
1 Q S914-LyItt C I z.ining regulations
of the T 0 �
and all I� and o nd it Is hereby
co Mth the plans and I OTAL 1111111.23. 30
agreed t U
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does riot waive restrictive PF—(:.E1PT NO .
covenants Contractor and subcontractors shall have current city
business thir permits This permit will expire and become null and
void if work s riot started within 180 days,or if work issuspended or PEQUIPED INSPECT IONS
abandoned for a period of 180 days any time aftir work has PLB.UNDFPSLAB
commenced It shall he the re.4pon"ility of the permittee to assure POST & REAM
all required inspections are reque ed and approved, WATER LINE
required Inspections*aareque ed and 9,
PL8 . TOPOU
PAIN DRAINS
FINAL.
.a Sig ur,
i e Signature
issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
WWI WX WMff Wil TIWPIIIIIIFAMIIII�fflff�
CITY OF TIOA RD �"�}� PERMIT
01YOFWARD PlIt'P.M1, T NO . : SE880AE-115
COMMUNITY DEVELOPMENT DEPAHTMENT OGEooN
13125 S.W.Hall BlvJ..P.O.Box 23397,Tigard.Ore or,97223.(503)6394175 DATE ISSUED: 4112/88
PP1M . PMT .N0 . IBB04182
JOB ADUPESG : 16069 SW 1041TH AVE. USA NUMBEP: 3510A
TAX MAP/L-OT 2SI.IABB SUB: SWANSON':') L.T : ZI BK :
LAND USE: P12PD
L-OT S3:ZI-.: :
SiECTION: 1.A TwP : is nN(3: w
WORK C'I ALiS : NEW
U 5 E TY r)l::-' : (:i T.N('A Ii., FAMILY
to cc)Mj-):I.y witv) sat 1.7. I"LlICP11; in,rt of ti-ioUrii-Fici(I
S*:%W(- rntgC;? Age.rlcy Tl-iop por-init *�ixr)ir,fotn 120 claylif fi-olft ti-IC4 clate imint.10(d Th v,? t o T,is.1
likiricli'll'i'll, WI.:I.]. 11.-M fol--Fkeitolcl J.T Vito pe)i-rnit expir,am . '! fiat f)geri(-.!y (1110111i 1-10t 1.41.111LI--
all-Itee t1livp ac.-r_L11-ac-'y c)T ti-14? loc--littior) n-l? tl.)e !lticic,) iffl(pwor 1-F tl*lo oirift woir, im
Icic2atcicl el.t ti-le 1n4??111mil-ement qiveri , the. J.rimtirt*L'l.*i%r, niVinl..I. pr,riii;p1oc-!t 3 foiet J-1
(iii-em..-ticirim -ri-oin tl-,e given . If riot so ..(ac-iator,)ci , tl,i(-.) iniati&11e�r, itil-i.101
Sowtir," Pormit likii(A ttitp Aclon-:!q wi.11 iritati)L11 of, Iattcll-U.L .
INS'T'ALL. . TYPE DUTI DING 13EWEA EMPEPV."OUS AREA:
FIXTUPLE.' LINI.TS TENANT ):MF*,:)OVEMf-,'.N*Y'
DWELLING UNITS : I
---- --WO OWO
W601144-1.
W FEES :
N SLF.AK ML)PGAN PERM]".1, 111:311 UO
E
Rp1aBOX 683,15 CONNECTTION CHARGE $1 1.00 00
l:)vaLvertori oil LINE TAP INSTALL .
C OTHER
0
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A
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0
R
TOTAI 1111111 135. C
This Permit is Issued subject to the regulations contained In Title 14 RECEIPT NO .
of the TMC, State of Oregon Specialty Codes,zoning regulations 2 ITI
and all other RPPIILable codes and ordinances, and It Is hereby
agreed that the work will be done In accordance with the plans and REQUIRE-0 INSPECTIONS
arjecifications and in compliance with all applicable codes and ROUGH-IN
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 It work is suspended or
abandoned for a period of 180 days any time after work has
,commenced It shall be the respob Iyof
I t the permittee to assure
all required Inspections i 'equl 19-ted and approved.
tee Signature.
Issued By
0W
A 69'01RID ABOVE
SEPARATE PERMITS REQUIRED F&141dii &P
PLAN CHECK APPLICATION
PLAN CHECK #
PERMIT # EE2o _
DATE ISSUED
,TOB ADDRESS: ��Q G rf' '� tel/' �C9 /%t' --- TAX MAP/LOT
SUB: LOT: �'*' — LAND USE:
VALUATION: y SETBACKS: FRONTS 2,n REAR: LEFT: .--5- RIGHT:,S
WORK CLASS: HEIGHT: 3 TOTAL AREA: !�- •`
USE TYPE: FLOOR LOAD: IST: >
CONSTR TYPE: _ HEAT TYPE: 2ND:
OCCUP GROUP: � DWELL/UNITS: 3RD:
OCCUP LOAD: NO BEDROOMS: BASEMENT:
NO STORIES: - NO BATHS: GARAGE:
IMP SURFACE:
APPROVALS REQ'D SPECIAL NOTES ITEMS REQUIRED
PLANNING: REISSUE OF: _ I,.IST SUBCONTRACTORS: _
ENGINEERING: LAST REISSUE:_ BUS TAX: _
FIRE DEPT. : _ FLOOD PLAIN/ CALCULATIONS: _
0' 'HER: SEN LND.: TRUSS DETAILS:
PARKING P—AN:
LANDSCAPE PLAN:
PLAN CHECK BY: OTHER:
COMMENTS:
ACCT T DESCRIPTION —�� kotmT
OWNER 10--432 Building Permit Fees ¢ 2 eq�
NAME.: y,—Tt� ,t, 10-431-600 Plumbing Permit Fees qc"' IRS ¢ /J 37
ADDRESS: s 10-431--601 Mechanical Permit Fees q130,191/ ¢ 3,
10-23'. -001 State Building Tax (5X) y ° �'';� ¢
10-433 Plans Check Fee
PHONE: �_. _ 30-443 Sewer Connection (20%) ¢
30-202 Sewer Connection (80X)
CONTRACTOR 30-444 Sewer Inspection ¢ -
NAME:: T,9
In., � 51-448 Street System Dev. Charge (SDC) ¢
ADDRESS: 52-449-610 Parks I Syntem Dev. Charge (PDC) ¢
— - 52-449-620 Parka II Sy„i.^m Dev. Charge (PDC) t .Z6 0
_- 31-450 Storm Drain+qe Syst Dev Chrg(SSDC) ¢ �+
PHONE,---- 10-230-5G5 TRFD (95X) ¢
— 10-435 TRFD (5X) ¢
ARCH/ENGINEER 10-230-506 Washington County Fire #1 (95X) ¢
NAME: _ 10-435 Washingt•.m County Fire #1 (5A) ¢� _
ADDRESS:_ — 10--220 Amart/Wedgewood ¢�
TOTAL 7 G> y g
PHONE:
PREPAID /
REC N
y,H
BALANCE DUE,
APPLICANT SIGNATURE
Received By: Date Received:
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