11401 SW 107TH PLACE CL
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- C=ERTIFICATE OF'
CITY OF TIGARD
gGCUPANC 7
COMMUNITY DEVELOPMENT 6600RTMENT DATE ISSUED: 10/02/95
13125 SW Hall Blvd.Tigard,Oregon g7,e23.61 sr: (503)630-4171
PARCI�.L a 1 S 134Dll---0 19fD0
SITE A[)DRESG. . . : 1. 1401 OW 107TH FAL
SUBDIVISION. . . . : 'I.ON I NG:R--4. 5
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . :
CLgSS OF WORK. a NEW
TYPE OF LISE. . . :SF
OCCUPANCY GRP. �R3
OCCUPANCY LOAD a a2:; 4
TENANT NAME:. . . a
Remarks : PATH I
Owner--
CARL
wneraCARL AND JENNIFER HULGE
713CA 5W DARBARA LN
PORTLf-IND OR 970-23
Pthnre #s 231-721213 NO C
Contractor: _ ......_...._...._........._..._._...._ ____.._._.. _.._____.__..._.
I..YNR! TOAUS
123 CAME L.OT
QUR-(
PORTLAND OR 97225
Phone #a 297-0829
Ir,g #. . : 00 01210
This Certificate cCertifies that the .above referenced building or portion
Hereof has been inspecteri for- compliance with the Tigard Building Code
or the group and division of occupancy and use for which the above
i efe-renr._ed permit w,:is issued, and occl.ipancy is hereby granted.
BUILDING INSPECTOR BUILDING O ICTAL.
POST IN CONSPICUOUS PLACE
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CITY OF TIGARD Ei LNLDINGrINSPECTION NOTICE
Inspection Line (Rec-O-Phorn?): 639-4175 Business Phone: 639-4171
Inspection:�lJ '�
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundatioo Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas LineId .
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation - ec1 F)
Underflr. IngL?I. Shear Wall Gyp. Bd. -Elect.
Date Requested: p/—Time: AM K PM
Address:— / 1 ` L' '7
8laikfer':
�py ,
1 'l�C?J2 �� — -- Permit aY: 2o2'
THE FOLLOWING CORRECTIONS ARE REQUIRED:
✓/�s.I F;ti�a�,:=v S-s--9 y/ ,A�:.-,� ,-arNn
Inspector. T Date:-/z S
APPROVED DISAPPROVED FIOVFD SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE <�
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 39-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. 'lop Out Elec. Rough-in FINAL:
Post/Bearn Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain FramingulL,r.b
Alarm Water Line Insulation -N'ech.
Under(Ir. Insul. Shear Wall Gyp. Bd. -Elea. v
J o G-
Date Requested:_ � Time:—AMP __PM
. cls ^ Z Permit #:
THE FOLLOWING CORRECTIONS ARE REOUIRED:
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YIn actor._ _—_ Date.
-
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceilinr Sprink. Rough-in ppNSdt7
Foundation Plbg. Underslab Mech. Rough-in Firepl ce
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FIND
PostiBpam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: fy �Z ('� Timp: AM�PM
Address:_ 1 �% _ Z& j lc
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Pjl C�- 'Q_
Builder: Permit #: f-� — Oce If 7 S_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector- J ,__ `^ - --, Dater
_APPROVED _DISAPPROVED APPROVED SUBJECT TO Pn—%/F
Call For Reinsp.
INS E
City of Tigard Building Department
1.3145 SW Bill Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —_
Footing Plbg. Underslab Mach. Rough-in AFpr/Sdwlk
Found. Plbg. Top Out Can Line NI AL:
s e t ig San. Sewer Framing
6eea Rain Drain Insulation -Plumb.
PIbg. Underfloor ,X�Water Ltne Gyp. Bd.
Date Requ`est/e�dsCv 4 4
Time: AM C PM
Addrese: ` 1"� , 7� lJ� _ _ Permit �: — ()�C1J
Builder:, '
THE FOLLOWING CORRECTIONS ARE REQUIRED:
CL yc� �,-.� �. C�Ve a X _sem _
R \ n
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Inspectort_T `✓ �� /'
APPROVED / DISAPPROVED APPROVED SUBJECT TO ABOVE
1 ` n / G11 For Relnsp.
July 13, 1994
Carl Hulse
7130 SW Barbara Ln
Portland, OR 97223
11401 SW 107TH PL, BUILDING PERMIT #MST92-0095
The last inspection conducted on this project was a water line inspection on
7/13/92. We have no record of any subsequent or final inspections for this
project.
Please advise the Building Division as to the status of this project within 15
days from the date of this letter. At that time, you may schedule the next
required inspection.
Please note that permits become void if there has not been an inspection
performed for over 180 days. In that case, the Building Division may require
a new -application and fees to continue the work. Also, a notice of non-
compliance against the property may be recorded by the City. If you need
/ additional time to complete the project, please contact the Building Division
so that an extension can be discussed.
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• Notice.a
August 8, 1994
G �
David Scott Y V'
Building Official, Community Develops.n ent Department � V
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
Re: 11401 SW 107th PI, Building Permit#MST92-0095
Dear Mr. Scott:
Upon inquiry at your office coi.cernirg the above referenced permit and letter
relative to such, we were informed that a written request for extension of this
permit was required by you. We hope this will suffice.
Because we are building this home ourselves, we have miscalculated the time it
takes to accomplish such; we both work full time jobs outside the home. We did not
want to request a premature final inspection, because we rnew there were certain
items requiring completion prior to such an inspection--decks, etc. We have nearly
come to closure on most items--please note attached copies of recently received final
electrical inspections dated 8/5/94, but we will require another few months before
we can request a final building inspection.
We respectfully request an extension of the above Building Permit in order to
complete decks, shower door installation, and a few other odds and ends. Thank
you in advance for your consideration. We will await your reply.
Sincerely,
i�
Carl & Jennifer se
1140i SW 107th Place
Tigard, OR 97223
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON N�"DEVELOPMENT SERVICES DIVISION #350-12
5 NOR''H FIRST, HILLSBORO, OR 97124
COUNTY, NE: 503/040•-: 470
OREGON I SPECTION REQUESTS (24 hours): 503/640-:;561 or 693-4415
Permit # : 05038455 Project # : P0029732 Status APPROVED Page 1 of 2
Applied : 03/!6/93 Issued 03/16/93 Expires( : 01/15/94 08/05/94 01--- : 31
RESELEC
Permit Title SFR -- ELEC/NEW HOUSE 0TH
Description Begun : 03/16/53
,ob Address 11401 SW 107TH PL TI
(Jwner Name ALEXANDER, FERD F AND Region D
Applicant Name HULSE CARL & JENNIFER
Phone number 245-5121 Valuation: CApproved
1 rispector Conunants : Rejected _,__
IVR-RESULTS
REQUEST ERROR )
Y
1 '
i aspected by : Date • �'- --
Inspection Requeste 'ce�'
{ Final Electrical 0499 E AP DN IVR
08/05/94 RI JS
08/05/93 RI DA
08/05/93 DN WJB COVER WAS PREV APPVD BY KP
DEPARTMENT OF LAND USE &TRANSPORTATION
LAND DEVELOPMENT SERVICES DIVISION #350-12
WASHINGTON 155 NORTH FIRST, HILLSBORO, OR 97124
��••� COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
Permit # : 05U40057 Project # : P0029732 Status PPROVED Page I of 2
Applied g5/U3/93 Issued 05/03/93 Expire 10/30/93 RESELEC4 U5 31
Permit Title SFR - ELEC/VACUUM & LIGHTING QTHBegun 03/16/93
Description LIMITED ENERGY
Job Address 11401 SW 107TH PL TI Region D
Owner Name ALEXANDER, FERD F ARID
Applica,it Name WESTPHAL DISTRIBUTING 0 Approved
Phone number 635•-4851 Valuation: -I —�
__-f'
Rejected —_
inspector Comments :
IVR-RESULTS
REQUEST ERROR ,
LL) /C
J - — ---- — — Data : --
1 nspectad by --- —
I113pectiori Requssted: v
+ Law Voltage Final
0411 E AP DN IVR
08/05/94 RI JS
INSF-MION NOTICE
City of Tigard Building Department
1.3125 SM Ball Bled. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Business Phones 639-417.1
Inspections C-1 _�_-_
LAi
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lina FINALt
Post/Beam Struct. San. Sewer Framing -191dg.
Poet/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor dater /Line Gyp. Rd._) -Koch.
Date Regveatedt �) ( �113
_Times AM ___PM
Address t.�� (D f fi �1n. Permit
Builder: / CJI \.a IJ Y�Q_Q 1�C Yl1
TRE FOLLOWING CORRECTIONS A" REQUIRED:
Le-
Inspector t Dated `+ 3---
,_APPROVED DISAPPROVED APPROVED SUBJECT TO ABOV=
Call For Reinap.
INSPECTION NOTICE ��I
Ci t7 of Tigard Building Departnewt i
131":5 Sw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Re((c-O-Phone): 639-4175 Busi.nees Phone: 639-4171
Inspection= ---+ ('J S lJ-\ y �'
looting Plbg. Dnderslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL►
Post/Beam Struct. San. Sewer Fr=Lng -Bldg.
Post/Beam Mach. Rain Drain lnaulatlen -Plumb.
Plbg. Underfloor Water /Line 9". ad. -Koch.
Date Regvestodt_ D CI 3 �1 ms AK 2 pl(
_ Q 7 �_L�
Addresst �"�O� i`� (' �1 i Pat7tlit �tNlST _ct
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIREDi
'+
AJ
c' ✓•G =2
APV PROVED DISAPPi"nm "`- APPROVED so"CT TO anovs
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department // v
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections_ ---
Footing Plbg Underslab Mech. Rough-in Appr/Sdwl.k
Found. �bg. Top Out 1 Gas Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulations -Plumb.
Plbg. Underfloor Water
?Line Gyp. Bd. -Mach.
Date Requested: J Time: 1Ali f PH
Address- T` Permit
Builder:_ ��-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
(L
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InapeCtOY DflYR:
_,APPROVED DISAPPROVED APPROVED SUBJECT TO ADO"
^ell For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businege Phone: 639-4173
Inspection•._ _ /)l � �[ _
Footing Pl Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Ream Struct. San. Sewer Framing --Bl.dg.
Pont/Beam Wech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -lech.
Date Requested:__ C Z _Time: AM __PM
Addreea: � _ Permit #:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectorsy _ Date
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Depaztaent
13125 SII Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —_
Footing Pibg. Underslab ( Mech. Rough-in ) Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Ed. -Mach.
Date I1equented: `� -� Time: AM —__PM
Addrees:_�/ `� ����lJ/ � Permit #:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
4- V.W.JA,
S� at GG./S S ---- -
2
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IM-^.
LLLl
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Inspector -. / --- Datet y7i y
APPROVED -� DISAPPROVED--:A APPROVED SUBJECT TO ABOVE
Call For Relvap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec•-O-Phone): 639-4175 Business Phone: 639-4171
Inspections _
Footing Plbg. Underal Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Linc, FINAL-
Poat/seam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Dra'n n.ul.tion -Plumb.
Plbg. Underfloor Hater Line Gyp. Bd. -Mach.
Date Requested- / 2- Timet AM PM
Address: l O ` Permit /:�
Builders-
THE
uilder: ,THE FOLLOW'�oG CORRECTIONS ARE REQUIRED:
-n
v
Inspectors nate:_
11PPFA)M nISAPPROVRD APPROVED SUBJECT TO ABOV8
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 B�ujsine��/s��,s P///h���onee: 639-4171
Inspection:_,_ _y-
Footing Plbg. Underalab Mech. Rough-in Appr,/Sdwlk
Found. Pllb_.g. Top Out Gan Line FINAL:
Poet/Beam Struct. *San. Sewer Framing -Bldg.
Poet/Beam Mech. insulation -Plumb.
Plbq. Underfloor Gyp. Bd. -N chDate Requeeted ^ _
Time- PM
Address:�1 ` L I {:`)" 2: � Permit #I SF C.,
Builder:_
THK FOLLOWING CORRE%-TIONS ARE REQUIRED:
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Inspect:ors / �"' n,t_01
APPROVED _ OISAfiPROVRD APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Bisilding Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: G39-4171
Inspections_
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beasa Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -M ch.
Date Requested: /� AMS) PM
Address:.��� 1L/ 1 �,J�
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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LL)
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Inspector: -.G.J2=1L� Dates - i
4/"PROM _ nISAPPROVEn APPROVED SUBJECT To ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bunineae Phone: 639-4171
Inspection:
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain insulation -Plumb.
1'1 1bg Underfloor� Water /Line Gyp. Bd. -Hoch.
Date Requnateds
`at _/ Z2 �R-1 �21� Times
_AH PH
,/
Address: _14 /7 Pe mit M s �p� "�[/'f,`7
Builder:
, [/��/
THE FOLLOWING CORRECTIONS ARE REQUIRED:
d
Inspector bate:
APPROVED DISAPPROVED APPROVRD SUBJECT TO ABOVE
Call For Aoinap.
CITY OF TIGA RD My RD
COMMUNITY DEVELOPMENT DEPARTMENT one" ��:�":RMIT
13126 SW�Wl Blvd. P.O.Box 23397,TOW,Orion 97223(603)&-44175
T4t7 RMIT #. . ., . . . . : MGT');__-00I)-
639-4171 DATE ISSUED: 05/29/92
)ITE ADDRESS. . . : 11401 'GW 1.07TH r.,L P,(--4RCE1_.- 1S1131+DD—ALX0
EUBDIVISION. . . . : ALEX ESTATES ZONING: R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 1
BUILDING ---------------------------------
REISSUE: DWF L L I NG UN 1.17": 1.
BASEMENT. . . . . . . . CA
CLASS OF' WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . •784 s
TYPE (?F USE. . . -SF FLOOR AREAS PrHQ1J1RED
i'YPE OF CONST. :5N F'I RST. . . . : 1791 s LEFT. . . 13 ft RIGHT. :6 ft
OCCUPANCY GRP,. : R3 SECOND. . . : 11'18 Sf FRONT. :2'0 Ft; [REAR. . :3 0 ft
5TORIES. . . . . :2 THIRD. . . . -0 5f RE QU I RED------------
I IC I GH T. . . . . . . . ...1"?3 ft TOTAL- -2936 S f SMOKE DETECTORS. tY
FLOOR LOAD. . . . :40 psf VALUE. . . . . $: 149168 PARKING SPIACES. . :0
Remav,kst PIATH I
------ P,LUMBING
T N K S. . . . . . . . . . .. I FLOOR DRAINS. . . . :0 SACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :4 WATER HEATERS. . . - I TRAP'S. . . . . . . . . . . . . . :0
TOB/SHOWERS. . . . 14 LAU11DRY TPAYS. . . : 1 CATCH PASINS. . . . . . . :it)
WnTER CLOSETS. . :3 SEWER LINE (ft ) . :0 (3 R E A 15 E T R A PIS. . . . . . . .0
D r SHWAY3AE RS. . . . : 1 WATER LINE (-Ft ) . : 100 OTHER F I XTURES. . . . . .171
GARBAGE DISP5. . . : 1 RAIN DRAIN ( ft) . :O
WASHING MACH. . . : 1 Sr RAIN DRAINq. . gt
----------------- MEC14FINICAL- ---------------- FEES
FUEL UNIT 14TRS. . -Vj type amol.-tnt 13y d'it to V-ecpi
/GAS/ VENTS . . . . . ..o TIF $ 1380. 00 JLH 05/29/92 -
MAX INPIUT :O 1A T[J VENT FANS. . :4 IRPRT $ 53J8. 00 JLH 05/29/92 -
F URN
FURN 100K . . .,0 HOODS. . . . . . .. I BF'LC $ 362. 70 JLH O!i!r--'@ 9 2 2:27481
FURN -I 01AR . . : I WOODSTOVES. :0 13115PIC $ ?7. 90 JI-H 05/29/9? —
F1._OOR FURN. . . . :0 CLO DRYERS. : I SS D C 5 280. 00 JLH 05/29/92 -
1"()IL-/CMP ( 314P:0 OTHER UNITS:0 PARK 1, 500. 00 JL1 1 05/29/92 -
GAS OUTLETS: 1 MP'RT 40. 50 JL.H 05/29/92 -
Owner- :
Owner- r Mpj_C .1 10. 13 JLH 05/29/92 —
CARL, AND JENNIFER HULSE m5PIC $ 2. 03 JLH 05/29/92
11300 SW BARBARA LN P,PRT $ 16 50 JLH 05/29/92
P15PIC $ 8. 13 JLH 05/29/92
-
PORTLAND OR 97223
Phone #: 231-7203 NO C
OWNER
N e q 00000
$ 33 89
3` 1. TO rAL
This persit is issued s-jbiect to the regulations contained in the REQUIRED INSPECTIONS -------
igard Municipal Code, State rf Ore. Specialty Codes and all other Foot/found Tnsp Fireplace Inso
applicable laws. All work will be done in accordance with approved Post/senm Sttuct Gas Line Insp
plans, This persit will expire if work is not started within 160 Plost/Pemm Mechan Insulation I t)Is V.
days of issuance, or if Mork is susoended for sort than 180 days. Pllm/undslah Insp Gyp Board Insp
r,i_m/undet-f i oat- Rain drain Insp
V Pl.'M it 11 P E? t4t) 'It-! e c ti a n i c,:.i I In p Water Lime T?-,-,p
Plumb Top Out Anpr/9dw1k Insp
l ,4I;I,1PH Ay ! rt,aminq Tnsm
Mechaniral F i ne i
L_ t t U I 1 6,2 9 4 t III n
CITYOFTIFARD ciffy
IO SEWER CUNNEC T IqN
COMMUNITY DEVELOPMENT DEPARTMENT moon pl=Rht.I T
13126 SW H �Blvd. P.O.P.o.eaK 23W,np M,Orpw,97223(5W)s39-4��5 �7 F N R M I"f #. . . . . . . SW R 9 2— 1 87
6.39--4111 DANE ISSUED: 051/29/9,
i I TE ADDRESS. . . 1 1401 qW 1 rZ17"rH I:11_ PARCEL: 1 S 134DD—AL X01
3UBD I V T S I ON. . . . : ALEX ESTATES ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1
1ENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . .*
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
I YPE: Of USE. . . . . :SF 140. OF RU I LD I NGS: 1
'NRJALL TYF'E. . . . :BUSWR IMPERV SURFACE. . : :sf
remarks: PATH I
Uwner: ____________•---.___.___._____.____—_-__-- ________________.__. FEES -----_—_—_—.—_..
;'ARL AND JENNIFER HULSI_ tyf)e amoint tly date r-erj-)t
130 SW BARBARA LN F'RMT R 1900. 00 JLH 05/29/92 —
TIVtiI=' 4 -35. 00 JL1- 05/2'9/92 —
PORTLAND (DR 9722.3
1=1I-r o n e #, 231-7203 NO C
-UNTRACTOR NOT ON FILE
$ 19 35. 00 TOTAL
--------- REQUIRED I NSPIECT I ON5 -------
This Applicant agrees to comply with all the rules and regulations Sewer Inspect i ori
-f the Unified Sewage Agency. The perait expires 1W days from
the date issued, The total aeount paid will be forfeited if the
perait expires. The Agency does not guarantee the accuracy of the
ride sewer laterals, if the sewer is not located at the eeasureaent
Ayen, the installer shall prospect 3 feet in all directions frog
-.he distance given. If net so located, the installer shall ovrchase
"Tap and Side Sewer" Permit and the Agency will install a lateral.
'e r m it tee
ssi.led By :
Call for, inspection — E39-4175
L�
Clll'Y (IF' TIGARD RECEIPT Clr-' Pl(WMI'Wr RECCE IP*rNa. t 9.='--212.74 1
CHECI1 AMOUNT 0. Wo
14 ML. ALEXANDER, FE-RD CASH 011OUNT 250. 00
ADDIMESS r PAYMFN,r DATE 05/20/92
SUIADIVISION
PUPPOSE OF PAYMENT 0MOLINT PAID PURPOSE OF PAYMENT AMOUNT PAID
G]
LU
11401 SW WTH PL.
LAIT 01 ALEX r.STATES
CUTAI_ AMOUNT PAID a!50. 00
Cl Ty nr VIGARD wmror OF PAYMENT RECElPf NO. :92-0,27853
CHECI-l� (-)M(:ILJI\IT 5016. 89
NAME s Al—EXANDER, FERT) CABIA AMOUNT IA. OLA
ADDRESS s c.'1320 SW ELWERT RD PAYMENT DATE s 05/29/98
0
GUBD I V I IS I ON
5141::.RWOOD, OR 9-71,40—
PURPOSE OF PAYMENT AMOUNT PA I D PURPO�.'* OF PAYMENT AMOUNT PA 11)
BUILDING VIFRM 558. 00 PLUMBING PERM
MF:CH(-)IqICAL PE 40. 50 ST. SLJIL-D PFR 38. 06
PLAN CHECK FE 12—2. 8 3 SEWER LISA 19 00. ofif
SE"Wr-H INSPECT 35. 00 RESIDENTIAL TRAFFIC FEES t i=-180. ofil
PARKS SDC 500. 00 STORM DRAIN GDC P80. 00
MAriS TRANSIT '1'1.F' FIFES 100. 00
LOT #1 Ot.FX E'gT(-)TES
I1401 SW 107TH PL
FCJTAL AMOUNT PAID `517110. 89
F Permit No:
Address: A2
H A •.�G /
Issued by: '1^-� _ Date: �1g- Z
�'• '•� __--FOR OFFICE USE ONLY--
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:
1. Y 1 own, reside in, or will reside in the completed structure.
2. A. My general contractor is
Contractor registration number
I will instruct my gener;il contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B. I will be my own general contractor.
v
If i hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and do hire a general
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor.
I hereby certify that the above information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
J
Signature of Per ppli t Date
CONSTRUCTION CONTRACTORS BOARD
0244) 1/90
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
13125 SW ll,u uM I PLNCK/RECT # _
CITY OF TIGARD Tgard.�`s snv PERMIT A
COMMUNITY DEVELOPMENT DEPARTMENT (50))639-4171 DATE ISSUED _--
JOB ADDRESS: l=1 C -1-=—�`--�--- TAX MAP/LOT x/ l
SUB: C(�� �5���1�is LOT:
LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: �'����� ���' '� REISSUE OF: _—
ADDRESS: 7/ 3U ���'U1�' !q LAST REISSUE:
oz k`*,NQ 0G��,y 7 Z j FLOOD PLAIN/
PHONE: 2 '— 7 _C�JO SENSITIVE LAND:
4/0
�jrZitl7't--e���
CONTRACTOR APPROVALS REOUIs2ED
,
NAME: [`ck x�u Fp� PLANNING:
ADDRESS: _ /�'^ " ENGINEERING:
Z. Q .J FIRE DEPT: —
_PHONE:�- Z J OTHER: T v G
CONTR. BOARD #: _ EXP DATE:
).TENS REOUIREO
SUBCONTRACTORS: PLUMB: > LIST/SUBCONTRACTORS:
--- - MECH: LU Ll BUS TAX: — ---
ARCH ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS: ----
ADDRESS: OTHER:
'Y
t
PHONE:
J
PROPOSED BLDG. USE: 0
AJ COMMENTS:
A/3�l y Dit/ f�f'/G'/�>c E'Ofl�. F�'ON���L• - ----
Zee
PPLICANT SIGNATURE
Received By: Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees S-s�'• "� __ • S �0
_ 10-431 00 Plumbing Permit fees jG2 •S u i /fiZ• 5 v
_ 10-431 01 Mechanical Permit Fees USS u U• ��
10- 230 01 State Building Tax (5%) L �
Building Q
�.J
Plumbing 3 �
Mechanical �t •O3 '�
i
10-433 00 Plans Check Fee 3%Z, Y,3 ZZ Y 3
Building �Le, 70 ,z".
Plumbing
Mechanical 10.1-
10-230 06 Fire
'it Jo V 30-202 00 Sewer Connection Yc,U
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees _
25-448-06 Institutional TIF Fees _ —
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees d
52-449 00 Parks System Gev Charge (PDC) Sa S vo
31-450 00 Storm Drainage Syst Dev Chrg
(SSD.) z1_'. �W
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL5 s? G(� y c-225-0
nm/3587P.W111