11423 SW 107TH PLACE-1 I
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CIIYOFT167ARD OF
CrIYOF7WARD
"I
COW"IUNPrf DEVELOPMENT DEPAR'(M ONOM OCCUPANCY
13125 SW Heil Blv&P.O.Sm 233W,TigaM.Or"m I.r4'31 HfvI I I t*. . . . . . . VAV7.150
5 1 1 E ADDRErSO. . . s 114e'-', t:M 107TH wt- PARCF-:L: 151:340)) -01,
4�'ULAD I V I S I ON. . . . : AIT.X LSTWES Cniv1NCn R-4. 5
BLOCK— . . . . . . . . LOT. ,
CLASS OF W(JRK. INEW
T YPE Or-, Us'L". . . -SF
OCCUPANCY QRP. IR3
01"(-'IJPI-)N('Y /4
RT 3 Brix 259 V
SHE-r-tWOOD OR 97140
OWNFIR
!'Ihcjllp 0!
c1ccupancy of 1:11e mbrive ref"rem-'ecl building it hereby piven, wid
the compliance t. the State Of Oveyon Sip"cialty ( wf "; for, the Nro".1p,
r-tpancy, and t. lmdev which the releranced per nil t was In%t'led.
__.._.._........____.._.__ s-fry.
F I RF Dr-PART0,CNI I BUTI U1116 INSPLCTOR
117.4 AL
POS? IN
�NSP�CTIUN.NOTICE ��
City of Tigard Funning Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwl,k
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer framing /y�_/ -Bldq�
L
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloo:c Water Line Gyp. Bd. -Koch.
Date RtK]uos�t�o�d�,—�1 ��- _Times AN ______PM
Address //'7 may _ �O � Permit #3 11U�L
Builders .�. .
TMa FOLLOWING CORRECTIONS ARZ REQUIRED:
d
l
Inspectors
_APPROVED D.'SAPPROVED ?� APPROVED SUBJECT TO A30',E
��Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sit Ball Bled. Tiqard, O-egon 9723
Inspection Line (Rec.-O- hone): 635-4175 Business Phone: 639-4171
Inspection; -- �..-
Footing PL /Underslab Nech. Rough-in C2,L�/Sd-lDk
Found. Pl.bg. Top Out GAs Line P.INAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Pont/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
DAte Reque&tedt /D �i � Times AM —�PM
Permit it
THE FOLLOWING (MRRECTIONS ARE REQUIRED:
,yam ego 8 i�-r►'1 S i i cT EU w i T,9 L ) 1)C L —
Inspector:__ i! H TIfOM�J �— Datet_
APPROVND DISAPPROVED APPROVED SUBJ1'CT TO ABOVE
Call For Reinsp.
LNSP$CTION NOTICE
city .)f Tigard Building Depart—Int
13125 Sit Ball Blvd. Tigard, Oregbn 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection• _ --
footing Plbg. Underslab Much. Rough-in Appr./Sdwlk
Found. Plbq. Top Out Gas Line FINAL-
Post/Beam Struct. San. Sewer. Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation Plumb.
Plhg. Underfloor Wat*r Line Gyp. Bd.
Date Requested:—/ 17.2 Time: //Gice7 --PH
Address-_L� / Permit
Builder: ���//►/tee-Alm—/ _
THE FOLLOWING CORRECTIONS ARE MQOIRROt
.✓✓tom / _ �rM
01
Inspector:� Dates
APPROVSAy DI8"PROWD APPROVED SUBJECT TO ABOVE
call For PALnep.
.._
INSPECTION_NOTICE �'"
city of Tigard Building Department
13125 SM Mal Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171.
Inspections ----- —— --
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
post/Beam Mech. Rain Drain Insulation Plumb.
Plbg. Underfloor Mater Line Gyp. Bd. -Koch.
Date RaTiested:J�v 7 Timet AK _�M
Addrefln:_�/�� �U / �� Permit is !
Bvilder:_----1
THE ., '.LOWING CORRECTIONS ARE REQUIRED:
Inspectort, �i �' —_ Datel
APPROVED DISAPPROVED APPROVED 8U&MCT To ABOVE
Call For Reinsp.
LIN
INsercTION NOTICE
City of Tigard Building Departweuc
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busincon Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out. Gas Ltne FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Ream Mech. Rain Drain �MnlatiOn -Plumb.
Plbg. Underfloor �1 Water Line a". ad. -Mech.
Date Requeotedt / 5- t�-- q, ,^ Times --------AN
PM
Address:,��7��q} ` I Q�+ I`1p /_-Permit is 1",5T-(Z Di
� d
BuiIders Qj- /
THE FOLI.UWING CORRECTIONS ARE REQUIRED:
Inspector: C/�' Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
iNSPECTSU�NOTICE
City of Tigard Building Department
1.3125 SW Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: __
Footing P'bg. Underslab N3ch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cat Line FINALt
Post/Beam Struct.. San. Sower Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plby. Underfloor Water Line Oyp. Bd. -Koch.
Date Requested: AK --M
Address: A-Mv, 7 —/ Permit _J/ �
Builders
THE FOLLOWING CORRtCTIONS ARE REQUIRED:
Inspectors__ Dates / - ' Z�
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
__Call For Reinep.
INSPECTION NOTI=E
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Inupection 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:
poet/Beam Struct. San. Sewer Framing 1
Post/Beam Mech. Rain Drain InWlation -Plumb.
Pltg. Underfloor Water Lime DYp• Bd. _ G -Hech•
le Date Requested: - TWee99L�ry AN --PH
Address•
Builder.: ���`;�!' �
TBE FOLLOWING CORRECTIONS AR6 REQUIRED:
!r/� ,��-""�� yL— ��,^C� til. ,•,.-,.% �.�
Inspectort - r 1 _ net..
APF,h'1VED DISAPPROVED E ArPROVED SUBJECT TO ABOVE
Call For Rel_nsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blwd. Tigard, Oregon 97223
Inspection Line (Rec--o-Phone): 639-4175 Business Phone: 63
Inspection:
Footing Plbg. Underelab Nech. Rouqh-in Appr/S
Found. Plbg. Top Out Gan Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor. /Water
�Line
� Gyp. Bd. -Mach.
Date Requesteds (� X7"7 y�J�_� Timms /'PSN
Addres": � / �1[ Permit /:C- - V
Builder: /h iaee
1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors
JAPPROVED DISAPPROVED XPPROVR6 r,110JrCT TO ABCMZ
_,Call For Reinap.
IMIRCTION NOTICE
City of Tigard Building Departsssrnt
13125 SM Qall Blvd. Tigard, Oregon 97223
Inspection Line (Rec--o-Phone): 639-4175 Buainess Phone: 639-4171
-------
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out GasLine > PINAI,:
Poet/Deem Stnict.. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Pibg. Uncerfloor Water �Lino Gyp. Bd. -Mech.
Date Regr eeteds —I,.�� c�7 —� Time= _ AM _PM
Addreae s Permit 1: L-21 L
Builders
THE FOLLOWING CORRRCTIONS ARE REQUIRED'
Inspector -- -- -.-- Date-4 _�_`� Z
�_APF'ROVED DISAPPROVED APPROVED SUBJRCT TO AROVF.
/
Call For Relnap.
� ase
INSPECTION NOTICE -^J
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oragon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business PhooP• Li5-4171
Inspection:
Pooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Fouad. Plbg. Top Out Gaa Line FINAL:
Po!gt/Oeam Struct. San. Sewer Framing
Poet/Posm Mech. Rein Drain ) Insulation _Plumb.
Plbg. Underfloor water Line Gyp. Bd. -Mech.
Date Requesred: 4�2 Time: _ AM PM
Address:_�� PermltT�: �
-Y
Builder: aa
T
THE FOLLOWING CORR.pCTIONS ARE REQUIRED:
Inspector: -� _ Dats:
APPROVED 018APPROVED APPROVRD 80MCT TO AD
Call 1br Reinep.
s
r..
INSPECTION NOTICE
city of Tigard Buildiog Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 633-41'/S Business Phone: 639-4171
Inspection• _,--_ --
Footing Plbg. Underelab Mech. Rough-in Appr/^awlk
Found. . Top Out J Gee Line FINAL:
Poet/Beam Struct. San.=8---"
Framing -Bldg.
Poet/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Koch.
Date Requested:_- - -` .v Timet JL-� AM _PM
Address: Z4 ,7 Permit #ta_
Builder: -
TNY FOLLOWING OORRECT104S ARE REQUIRED1
1 _
inspector: / �`-�� _— Dates
APPROYLD D'LSAPPRovED _- APPRown sutmRvT To AD(rvE
Call For Relnep.
INSPfiCTZUN NOTICE `'.--y-._..,L�..
City of Tigard Building Department
13]L25 SW Hall Blvd, Tigarde Oregon 97223
Inspection Line Rec-O-Phone): 639-41755 Business Phone:: 639-4171
Inspection:
Tooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. ?lbg. Top Out Gas Line FINALt
Poet/Beam Struct. San. Sewer Framing -Bldg.
Pont/Beam Mech. Rain Drain insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested:` —1� _Time: _ AM _T_PM
/
Address:, �/� � t i� Pe-mit f:
Builder:. _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
inspectort�_ Dltet 1 ���g1
APPROVED DISAPPROVED — APPROVED NUBJRC1' TO ABOVE
Call For Reinep.
.._,.......,.y,.........,.ww...cwra.++.r...., .,..,-...u..uw•.wnawu.rWwrG�.wX+w.oia-e.-as,•^•ufle�MY7dYYyaaltiwawmwoncww�.:aww�,�++�ncwan+w'Ywurwadcwwtwrw.�YMwbrO�IM�Yw.vM
IKare�OR NOTICE
City .:f Tigard Building Department
13125 SN .all Blvd. Tigard, Oregon 97223
InepecCion a (Rgec-O-Phone: 639-43-75 Business Phone: 63'9-417
inspection � f" Z Z
i
Tooting
Plbg. Underslab Mach. Rough-in Appr/ dwlk
Found. Plbg. Top Out Gas tine FINAL:
Post/Beam Struct. Sen. Sower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb. t
Plbg. Underfloor Water Line Gyp. Bd. - ech.
Date Request(edd:_ �_� Time- AN
PM
� ll-7 3 �� � Permit, !:
Address: --
Builder:— /�- -- - �►— —"
THE lOLLOi'.'iNG C.ORRBCTION3 ARE ARQUIRBD: `■-t72�9 n //��_'/c �� �(
Data:inspector:—APPROVED DISAPPROVED APPROVED SUBJECT TO ABOV3
---Call For Reinsp.
INBPECPION NOTICE
City of Tigard Building DepartsOnt
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Lino (Rec-c-Phone): 639-4175 Business Phone: 639-4171
Inspection: ---'
FootingPlbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS I
et/Beam t't�uct.` San. Sews Framing -Bldg.
Post/a; acheaM , Rain Drain Insulation -plumb.
Plby. Underfloor water Line Gyp. Bd. -Mach.
Date Requested: �`Z- — T _ _PN
Address:
Builder:,_ i_r•��r�' --
TRH FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: L-_--- '- — --- - Date:! �2—
!' APPROVED DISAPPROVED APPROVED SURJRCT TO ABOVE
Cm11 For Reinsp.
1K
jNSpX 61LON NOTICE
City of Tigard Building Departsaut
L7125 ON Ball Blvd. Tigard, oregon 97223
Inspection Line (RaC-O-Phony): 639-4175 Business Phone: 639-4171
Inspections -—
Footing Plbg. Underalab 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.
Plbg.�Vnd-.fl Water Line Gyp. Bd. -Hoch.
c.-
Date Requested:_ L,~ �� Z -Timet AN PM
Addrese•_ Permit ':q
Du l.lder: Z ---
TAE FOLI.OWI'AG CORRECTIONS REQUIRED:
Inspectorty�
APPROVED _ DI^APPROVED -� APPROVED SUBJECT TO ABOVE
Cell Por Reinap.
. ._.. .:_.:... y�,+ns+.m.':uw.tis'wkuY:M�:Y�W�.NMxsYllfiibl�. �, 'HfiYmMWt.NN1idVYgYa3YL'fN�>�AI.
jg¢UgXj011 NOTIC
City of Tigard Building Department
13125 811 Ball Blvd. Tigard. Oregon 91223
Inspection Line (Rec-O-Phone)t 639-4175 Buninnes Phone: 639-4171
Inspectiont _
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found./ Plbg. Top Out Gas Line FINAL%
"mat/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Under:loor Wqter Line Gyp. Bd. -Mech i
Date Requested: Time: / AM ,_PM
Address: ��1-4 • armit !s f
Builders—
i
i
THS FOLLOWING CCRRECSIONS ARE REQUIRED:
i
r �
1
Inspect,)r: net P:
APPROVED DISAPPROVED APPROVED SIMIF.CT To ABOVE
_--call For Relnnp.
CITYOFTIGARD rPERMIT Cff � MASTER
� ERPr I T #. . . . . . . : MST9`--14)0`,0
COMMUNITY DEVELOPMENT DEPARTMENT 0111001141
13126 sw Hall Blvd. P.O.Box 29997,TOW,Oregon 97223(edo)639-4175
DATF P t -
ITE ADDRESS. . , 11423 SW 107TH P1_ PARCEL: 1S134DD-ALX&'
UBDIVISION. . . . : ALEX ESTATES ZONING: R-4. 5
11_.00K. . . . . . . . . . . LOT. . . . . . .. . . . . . . :
BUILDING ---- _--
,.E.I SSUE: DWELLING UNIT'S: 1 BASEMENT 0 f
_ASS OF WORK. :NEW BEDRMS:3 PATHS:3 GARAGE. . . . . . . . . . :700 sf
. YF', OF USE.. . . :Sr FLOOR AREAS-•____-__._..___ REOUTRED SETBACKS------
TYPE OF (:ONST. :5N FIRST. . . . - 1074 sf LEFT. . : 15 ft RIGHT. : 12 ft
OCCUPANCY GRP. :R3 SE=COND. . . :B86 s f FFRONT. :i`'Q) ft: REAR. . : 10 fi;
::lORIES. . . . . . . :2 fHIRU. . . . .0 sf REG?UIRED--___.--____.._.______-
HE I GHT. . . . . . . . :21 f:t TOl AI_•- . - --- 1960 s f SMOVE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VAL.UE. . . . . 6 : 102760 PARKING SPACES. . .-0
kemarky : PATH I
--------------------------------- PLUMBING -___.______________._------_.--•---------____.__..
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :V1 BACKFLOW PRE'VNTR . . :0
LOVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
"U8/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :11, CATCH BASINS. . . . . . . a0
WATER CLOSE'TS. . :3 SEWER LINE= (ft ) . :0 GREASE TRAPS. . . . . . . :0
DlGiHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . ..0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH, . . : 1 SF RAIN DRAINS. . : i
--------------- MErCHANICAL --___---____._-.-- _____.____ .______. FEES
FUEL TYPES-•--•-____._._.. - UNIT HTR S. . :0 type amol-Ent by date r^ecpt
/GAS/ / / VENTS . . . . . :0 TIF IF 1380. 00 JLH 03/30/92
MAX INPU7:0 RTU VENT FANS. . :4 APRT a 440. 50 JLH 0;{,/30/92
FURN < 100K . . : I HOODS. . . . . . : 1 FPLC $ 286. 33 JLH 03/17/92 2247.72
FURN ) =100K . . :0 WOODSTOVCS. :0 DSPC $ 2.2. 03 JLH 0::3/30/9c .
F-LOOP FURN. . . . :0 CLO DRYERS. : 1 55DC $ 280. 00 JLH 03/30/92
130IL/GMP ( 31AP:0 OTHER UNITS:O PARK t _500. 00 JLH 03/30/92:
GAS OU7LE-1'S: 1 MPRT s 39. 00 JLH 03/30/92
Owner,: _._____..___-______._.___...__._.._.__.__.___.__.__ IhF4._C i, '). 75 JLH 1113/30/92
FE-RD ALEXANDER M5PC $ 1. 95 JLH 03/30/92
R7 3 PDX 259 1 PPRT $ 147. 50 JLH 03/30/92
P5PC $ 7. 38 JLH 03/30/92
SHE RWOOD OR vi 7140
Phone #: 625-6846
Contractor-; ._._______.___---•-•--
OWNER
I 'Mone #r.
00000 -.----------______ ----—_-------.--_----_---—
$ 31 i4. 44 TOTAL
This permit is issued subitct to the regulations contained in the --- --- REGU.T.RE'D INSPECTIONS ---- -
Tigard Municipal Code, Stote of Ore. Specialty Codes and all other Foot/foL1nd Insp F"ireplar_e Insp
apol icable laws. All Mork will be done in accordance with approved Post /Beam St t• Llct Gas Line Insp
clans. This permit will expire if work is not started within 18p Post/Beam Meehan Inso.rlat ion Insp
days of issuance, or if work is suspended for more than IBB days. Plm/1.1nds;lab Insp Gyp Boar-d Insp
1='LM/Under-floor Rain drain In7la
t'(--.vrnittee Signatt.o-e : � j (1. . �c��--!' Mecchanic-al Insp Waisar line Insp
Plumb Top Out Appr/bdwlk Insp
_1ed
BY: Framing Insp Mec:hanir_al E irra.i.
Call for inspection - 639-4175
FA W'K 1TX IR
SEWER CONNECTION
CI1YOFTIFARD Ai� PERMIT
CffYOFT*A PERM17 #. . . . . . . SWR920121
COMMUNITY DEVELOPMENT DEPARTMENT 01 C
13125 SW HWI Blvd P.O.Bac 23397,Tigad,Orepn 97 (603)6304175
SITE ADDRESS. . . : 11423 SW 107'n-i FIL PARCEL.: 1S134DD—ALX012
SUBDIVISION. . . . : ALEX ESTATES 7.019ING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :2
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF' WORK. . . :NEW DWFL.LING UNITS. . .- I
1-YPE OF USE. . . . . :SF NO. OF BUILDINGS;: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE_ : : tif
Remar-ks : PATH I
Owner-; FEES ----------------
FERD ALEXANDER type anlOtAnt by date v,ecpt
RT 3 BOX 259 T PRMT $ 1900. 00 JLH 03/30/92
INSP $ 33. 00 JL.H 03/30/92
SHERWOOD OR 97140
Phone #: 625-6846
Contr-actor-:
CONTRACTOR NOT ON rTI-F
-
-------------------------------
P[ione #: $ 1935. 00 TOTAL_
Req
REQUIRED INSPECT1ON5
This Applicant agrees to comply with all the rules and reguiationg Sewer, Inspection
of the Unit?ed
;ed Sewage Agency. The permit expires 180 days from
the date is!ljta, The total amount paid will he forfeited if the
permit exei,rs. The Agency does not guarantee the accuracy of the
side sere, la,prals. If the sewer is not located at the vpasurk+mpnt
given, the installer shall prospect 3 feet in all directions from
the dists;,ce given. If not so located. the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
1-1 e Y,m i t;t.e a 5 1 q n A t!.t v-e -
Call for inspection 639-4175
PLUMBING PERMIT
dITYOFTIGARDO WOF 1M Rp PERMIT #. . . . . . . : MST9 0050
COMMUNITY DEVELOPMENT DEPARTMENT ansa+ �•
.3126 8W NO Mrd. P.O.Bac 23397,TOW,O"M 97223(603)B 1W 176 VATF 15)MUED:
'jjITE ADDRESS. . . . 11423 SW 107TH PL. NAkCFL: 1S1 a4DD-ALX0
5L1PD I V 1.;I ON. . . . s ALEX ESTATES ti ON I NG: R-4..5
'BLOCK. . . . . . . . .. . LOT. . . . . . . . . . . . . :2
CLASS Cti- WORK. . :NEW GARBAGE DISPOSALS. , a 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . 31 BACKFLOW PREVNrR5. . :0
OCCUPANCY GRP. . o R:3 FL..LIOR DRAINS. . . . . . . 10 TRAPS. . . . ' . . . . .. . . . .0
SIURIE''D. . . . . . . . s2 WATER HEATERS. . . . . . : i CATCH BASINS. . . . . . . :0
F=IXTURES-_-•-------------- LAUNDRY TRAYS. . . . . . c0 3F RAIN DRAINS. - - . : I
c I NKS. . . . . . . . . . .. t GREASE TRAPS. . . . , . . $0
LAVATURIES. . . . . :�r OTHER FIXTURES. . .0
TUB/SHOWERS. . . ,. : SEWER LINE (ft ) . . . . :0
14ATER CL OSf_1'c:;_ . r WATER LINE (ft ) . . . . 11,00
DISHWASHERS. RAIN DRAIN
Ftem r•kw s �A H II .. .. . ,
OWNF R e
FERD ALEXANDER TIF ♦ 13SQ41. 00 JLV 03/ 30/92
PT 3 BOX 259 T BPRT f 440. 50 JLH 03/30/9,'
BPLC f Rac 33 'JLH 03/17/92 22-4772
%3HERWOOD OR 97140 BSPC: $ 03 JLH 0:3/,:.0/92
Phone #s 625-6846 SSDC: f 280. 00 Jl_FI 03/30/92:
PARK f 500. 00 JLH 03/30/92 .
Plumbing Contractors- --___.________. MPRT 4 39. 00 JLH 03/.30/92
/_ MPLC f 9. 75 JLH 0?/.30/92
Name c ,.iull_p1GC _r �1�1.(�1 Y2 MSPC f 1. 95 JLH 03/;30/92
Adclrless t ��"" _ GPRT $ 147. 50 .JLH 03/30:X32
City: �_._... _ >;tates� _ _...._._. P'rpC f l. 3�1 " LH 03/ 34]/9
Zip.- _._____ _Gh o n e#c_-.._-_....__-.--._.._...
RE:PU I RE"D INSPECTIONS
..This pet-sit is issi.led subject to the req-
ulations contai ,'ied in the Tigard Municipal Foot /fr+ur,ci Insp Rain dram Insp
Corte, State ,.of O.,e.. 13pec:i,alt:y Codes anri all Frost/Beam Struct Water Lino Insp
othefi' applicable laws. All Wor-k will be done Post/Beam Meehan Appr/Sdw1k Insp
in acr_ordan`e with approved plans. This Plm/undslab Insp Mechanical Fi.nai
per^mit will expire if work is not strrted F'LM/Underflout, Plomb Final
within 180 days of issuance, rr if work is Mechanir.al Tnsp building Final.
'44i,twipended for more than 180 days,. plumb lop Out Erosion Control
FrAmxng Insp Crawl Drain
Fir eplar. a Tnsp
Lias Line Insp
�� lnsulation Insp
1c� Gyp Board Insp
PuLhorr: zed Pl,.,mbj .y cunt.) ...t._ tc.r. _3lgnature i
Call for inspection 6,39-4175
Contractor, Notes e
Permit No:
Address:
'N • z Issued by:----,-- Date:
\.• ' --FOR OFFICE USE ONLY�..
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued.This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. 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 boxes 1 and 2, and either box 3A or 3B:
1 . [_ ! 1 own, reside in, or will reside in the completed structure.
2. C -11 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A. 1 My general contractor is__
Contractor registration number_
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. B.F_P `l I will be my own general contractor.
It I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion 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.
Signature iel'rmt Applicarit Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILL
PINK COPY TO APPLICANT
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C I TY OF T I CARD RECEIPT OF PAYMENT RECEIPT NO. .92--C--,253c t
CHECK AMOUNT e 4799. 44 �
NAME s ALEXANDER E:RD F. CA%f AMOUNT 0. 00
ADDRESS s 21820 SW LLWE:RT ROAD PAYME'N'T DATE s 03/ 30i9r
SHEPWOOD, OR SUBDIVISION s
97140—
PURPUSE OF PAYMEr:N7' AMOUNT PAID PURPOSE OF PAYMENT AMOUNT FAIL)
AU I L.D I NG PERM 440. 30 PLUMBING PE RM 1.4 7. 50
MECHANICAL PE 39. 00 ST. BUILD F?N:R 31. 136
PLAN CHECK FF: 46. 08 SEWER LGO 1900. 00
SEWER Y NSPECI 35. 00 PARKS SDC 500. 00
TORM DRAIN SDC 1.30. Q►0 RESIDENTIAL TRAF-FIC FEES i.-Hai. Na
MASS TRANSIT TIF FE-EO 100. 00
f
I
I`C)1'Al_ AMOlINT F1AIU - --> 4799. 44
°lig`-11
e
0-0 It
CITY OF 1GARD — PECEIPT' OF PAYMENT RECEIPT NO. c92-224772 I �
1 v4,il 'tern>:r 'T
CHECK AMOUNT t 0:50. Wo
NAME 3 ALEXANDER, FEED CASH AMOUNT s 0. 00
ADDRESS r PAYMENT DATE n 03/17/92
SUBDIVISION
PURI-)USE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT WMOUNT PP 1 D
F't f�r� Ct'IECKwF E
250. 00
f'
i
10715 P4W TIGARD ST
f t r Al., AMOUNT PA I D �`,y0, tl►0
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