10873 SW 109TH AVENUE s
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i:\reoords\microhm\targets\buiiding.doc
7-11p
Building Division,
City of Tigard
13125 SW Hall Blvd
Tigard Or. 97223
Dear Building Division Folks,
I recieved your letter for permit#PLM94-0141 regarding an inspection and would like to
request we schedule one whenever your people are available. I was t►naware of the need
for an inspWtion as my wife had filed the original application; I did'nt read the informatiion
adequately.
Let me know what I need to do for the inspection.
Pennit#PLM94-0141
10873 SW 109th Ave
'rigard Or 97223
Tim Estes<Zx
626-4538
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CITY OF TIGARD BUILDING INSPECTION: NOTICE
Inspection Line (Rec-O-Phone):639-4175 Business Phone: 639-4171
Inspection:
Footing cusp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Sough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough in FINAL:
Post/Beam 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: -91/camI-" 'A Time: AM PM
Address: 1 L I
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
tOF
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7
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Inspector: Date:
_APPROVED _DISAPPROVED _APPROVED SUBJECT TOA OVE
ell For Reinsp.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orawon 97223.8199 (503)839-4171 PLUMBING PERMIT
PERMIT #. . . . . . . : PLM94--0141
b05 410 DATE I JUF_D: 07/18/94
PARCEL: 1S134AC-04800
SITE ADDRESS. . . : 10873 GW 103TH AVE
SUBDIVISION. . . . : HART' S LANDING ZONING: R-4. 5 Pl)
BLOCK. . . . . . . . . . . 1-01.. . . . . . . . . . . . . :019
--------------------- --------------
C:,'LASS OF WORK. . :ADD GARBAGE DISPOSALS. . : MOBILE HOME SPACES. :
TYPE OF USE. . . . :SF" WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1
OCCUPONCY GPP. . ; RSI FLOOR DRAINS. . . „ . . . . TRAPS. . . . . . . . . . . . . . .
STOr 7 ES. . . . . . . . ; WATER HEATERS. . . . . . : CATCH BASING. . . . . . . :
FIX :ORES------------- LAUNDRY TRAYS. . . . . . ; SF RAIN DRAINS. . . . . :
31NK ). . . . . . . . . . . URINALS:. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. . . . . .
IUB/SHOWERS, » . . SEWER LIIVE (ft ) . . . .
WATER CLOSETS. . : WATER LINE (ft ) . . . . :
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Remarl(s : BACK FLOW DEVICE
Owner; ------------------------------------------------- FEES -------
TIM ESTES type ammrnt by date r mcpt
10873 SW 109TH PRMT $ 15. 00 SW 07/18/94
5PCT $ 0. 7`) SW 07/18/94
TIGARD OR 07::23
Phone 0:
Contractor: _._.._.-_.-•----_------------.__._______
OWNER
--------------------------------------
Phone #: $ 15. 75 TOTAL
Req it. . . 00000
REQUIRED INSPECTIONS
--
This permit is issued subject to the regulations contained to the RP/Bar-kflow Prev
'igard Municipal Code, Ste.e of Ore. Specialty Codes and all other F=inal Inspection
applicable laws. All work will be done in accordance with
approved plans. This persit will expire if work is not started
within IBB days of issuance, or if work is suspended for sore
than 19P days.71
_-.-
_
=, e r m i t t e e signature :
Issued By :
L
J Call for inspection - 639-4175
RL t I (P T CIV. PAYW 1,1T NFATAI-Ii W. a9 4 f
1.11E.CK PICA R41 I.-J i*LJ
[;Al E% I PI 1 o9H AMC)UNT W. 00
D I I R F'193 IS' c4W .l 09TH PiIYMt`NT' DOIT v O I fk 4)4
I L CiA R 1), 1)14 tiIJBI.)I V I f3 11 JN a
w1oliNi PAID V-11 i tillI 1`+ UF' tlfwvlvhlf (IM111-INI
IM)A I r-11.1 (,I km PI.m9;I -OJ41 Pf P 0. e!'
vis OX I. 1 .1 JW
101,01-
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
N>-..r o.wbwaeM New Single Family Residences Only
«• ❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job �(? _' 5 (� w�J�� ❑ 3 BATH HOUSE $225.00
Address cnr:sle. aP Fee includes all plumbing fixtures in the dwelling and the first 100 feet
of water service, sanitary sewer and storm sewer. See fees below
Nen.(e aen.br au.rl...) FIXTURES QTY PRICE AMT
C��� Sink 9.00
Maeo A" N Phe Lavatory 9.00
Owner %%��s"% 3 5 �� /' c,y`1 Tut: or Tub/Shower Comb. 9.00
CWaft / z► Shower Only 9.00
7 l Z Water Closet 9.00
Dishwasher 9.00
Garbage Disposal 9.00
Occupant M..W.0 A&.- - ve.n. Washing Machine 9.00
Floor Drain 9.00
Gnlf•l• Zb Water Heater 9.00
Laundry Room Tray 9.00
N.- Urinal 9.00
r Other Fixtures (Specify) 9.00
vhm 9.00
Contractor
9.00
CAYIM.l. Zip 9.00
Sewer 1st 100' 30.00
ala.PI yV.U~N. cnr aur T..N. SnWel' ea. Addit. 100' 25.00
Water Service 1st 00' 30.00
I hereby acknowledge that I have read this application, that tha Water Service ea. AL lit. 200' 2L).00
information given is correct, that I am the owner or authorized agent of -
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
I am registered with the Construe ion Contractor's Board, the; the Storm &Rain Drain Addit. 100' 25.00
number given is correct. (If ex ipt from State registration, please - -
give reason below) Mobile Home Space 25.00
Back Flow Prevention
Device or Anti-Pollutlnn Device 9.00
.n.. --w«.oae) p•• Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new ® addition O alteration Q repair Q Catch Basin 9.00
to be done residential O non-residential Q insp. of F-,.ist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
a Existing use of � � Rain Drain, single family dwelling 30.00
building or property _
Residential backflow prevention
to devices / 15.00 i
Proposed use of r
.. building or property - r'
J --� '(Except re Idenflal bac►rf►ow
prevention devices)
c�
NOTICE 'Minimum Fee $25.00 SUBTOTAL
J
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25"i. OF SUBTOTAL
TOTAL
Special Conditions
Date Issuer by ]` - q 1�_
CITY OF TIGARD
CERTIFICATE C)F`
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY
13125 SW Nell Blvd.Tigard,Orason 97223.8199 (503)839-4171 1-' LRM I T #. . . . . . . ; MST9 3 04(:•
+=,y1.1 .a1I1 DATE' ISSUEDt 02/02/94
PARCEL: 1 S 134AC--041300
SITE ADDRESS. . . t 1171137 SW 14?'9TH AVE
'IUBD I V I S I ON. . . , : HART 1 9 LAND I NG Z ON 1 NG t R--4. 5 PD
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . t019
CLASS OF WORK. :NEW
rYP17 OF USE. . . :GF
OCCUPANCY GP%P. .k3
O C.;UPONCY LOAD t 226 4
1 U*01 L NAME=.. . . t
Remarks .' PA STN I
Owner:
RE1,1AISSANC:E DEVFL_L:IF'MENT CVORP
P17 ii'In ca #t
Contrac:tors _.._....__. ._...._...._._._.._ .._.__w_._._._.__.._.._.___...
RENAISSANCE DEVELOPMENT
1672 SW WILLAMETTE" FALLS OP
Wt.31 LINN OR 97068
Phanp #t 57-•8000
ti e.g #. . t 419'.55
OCCU{.lanCy of the ;above referenced bt.ti )ding is Hereby given, aT�Ci Certxfie!.
the Complianre with the State Of: Orego•1 Sper:ialty Cade% for the group,
occupancy, and Lisp under which the referenced permit was xF sued.
FIRE DEPARTMENT IN 1 nISPIEc,TOR
y'-
POST IN CONSPICUOUS PLACE
r
INSPECTION NOTICE
City of Tlgard Building Departswant Ad
13125 BN Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busineas Phon4 2 -4171
Inspection:
Footing Plbg. Undaxelab Koch. Rough-i.n Appr/Sdwlk
Found. Plbg. Top Out Cao Line /"F�INA�L:
Poet/Beam Struct. San. Sewer Framing it ll /
Poet/Beam Mach. Rain Drain Insulation �— umber/
Plbg. Underfloor Nater Line Gyp. Bd. ach.
n,
Date Requested: 2 — .2Times / AM PN
.rL h ,
Address:-1Q y �a i Permit'l.
Buildor:
THE FOLLOWING OnRRECTIONS ARE REQUIRED:
Inep#±(,t_or:� - - -----., Dates � -
—�aFIR�VED i_ DISAPIROVED APPROVED SUBJECT TO ABOVE
Call For Rsinep.
INSPECTION NOTICE
City of Tigard BuildiAg Department
13123 SW Ball Blvd. Tigard, Oregon 972231
Inspection Lina (Roc-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Koch. Rough-in p r/Sdwlk
Found. Plbg. Top Out GaF. Lins rINAL:
Poqt/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lino Gyp. Bd. -Koch.
Date Requeeted: �L -� �Time: _PN
r�Permmitt 08!2.3
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Al or 7'11 of Ad PECLA U L
Inspector:
APPROVED DISAPPROVED ROWD SUBJECT TO ABOVE
Call For einsp.
INSPECTION NOTICE
Cit? of Tig&Lrd Building Department
13125 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Hoch. Rough-+_n Appr/Sdwl.k
Found. Plbg. Top Out G&s Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Y w h. Rain Drain InsulPlumb.
Plbq. Underfloor Water Line Gyp. tid. -Hoch.
Data Requested:_ 121 ,31C
(� ^_TLam s _ AN PM
Address,_ L�S/✓ 0'/ 7 Permit f:----,--
Builder ��—
THE FOLLOWIh. CORRECTIONS ARE REQUIRED:
Inspectors_ i atel
_v/APPROVED DISAPPnOVED APPROVED SUBJECT TO ABOVR
Call For Reinsp.
it
INSPECTION NOTICE
�4
city o4 Tigard Building Depart--t i
13125 OW Sall Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspection:_—
Footing
Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found.
Plbg. Tot) Out Gas Line FINAL:
Poet/Beam Strutt. San. Sewer Framing -Bldg.
Post/Beam Koch.
Rain Drain insulation -plumb.
Plbg. Underfloor Nater Line GYP• �' / -Koch.
Date Requestedt
it
Address:
is �3
Builder:_
THE FOIA-k TING CORRECTIONS ARE REQUIRED:
J
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Dade! / r
Inap*otor:
ROVED 11PPROVEU eUBJECT 7O AON
BE
APPROVED DISAPP
� —_Call For Rainsp.
INSPECTION NOTICE
City of Tigard Building Departannt
13125 811 Ball Blvd. Tigard, Oregon 97223 1
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: -4171
Inspection:
Footing Plbg. UnderslabMeeh. Rough-ln Appr/Sdwlk
Found. �n_
. Top Out as Li FINALS
Post/Beam Struct. San. .'ewer `fam�-> -Bldg.
c
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Undorlloor stater Line Gyp. Bd. -Koch.
Data Requestods L,� Z Time: _ �\�AK `---PK
Address: IL) S,7 Cl) ! P h Permit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
J
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Inspectors
APPRC`11RD DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Relnep.
INSPECTION NOTICE
City of Tigard Building Department
0125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Llne (Rec-O--Phone)s 639-4175 Business Phone: 639-4171
Inspections__
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/seam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -'lumb.
Plbg. Underfloor Nater Line Oyp. sd. -Mech.
Date Requesteds_ r Times AM PM
J10
Builder: T/r/�/)1l�_i "'j
T
THE FOLLOWING CORRECTIONS ARE REQUIRRUt
FNI Y1 kk-r -f 5.,- rvk
v o
Inspectors ' A-�— Data. ( !(q_3 -
ApPROVtf. DISAPPROVED " 11PPROVED SUMMT TO ABOVR
Call For Aelnep.
f INSPECTION NOTICE
GAG 6. City of Tigard Building Department C�
13125 SW Ball Blvd. Tigard, Oregon 977.23
Inspection Line (Rec-O-Phone): 639-4175 Business Pho 171//
Inspections
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post" am Struct. San. Sewer Framing -Bldg.
/Beam Flech } Rain Drain Insulation -Plumb.
Q_ derII water Line Gyp. Bd. -Mech.
Date Requested: 1015_1/213 Tlmes AM _PM
Address:_ �y+4 ( `� / Permit P: •l b C
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIREDs
Inspector: _ Dates_,
ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
call Por Reinep.
INSPECTION NOTICE
City of Tigard Buildisig Department ���� �/�
13125 SM Bail Blvd. Tigard, Oregon 972(1)
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:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poat/Beam Hoch. Rain Drain. -� Insulation -Plumb.
111hy- Underfloor Water Line Gyp. Bd. -Mach.
ante Requested:_ .2 L —Times _AM PM
! y I'
Permit 1i/� -LrV Z
Fl::ilder: 1 P✓ �f i ei���' —
THF. FOLLOWING CORRECTIONS ARE REQUIRED:
inspectors Datat�_(�7�
_ROVED DI8APPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
PLUMBING PERMIT
R 111 T #. . . . . . . - MS 3 04 T 9 ,
-CI1Y OF TIGARD P F
DATE ISSUED: 09/02/93
COMMUNITY DEVELOPMENTOEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 F-10PIEFL.- IS134fil'-1114811111-
I !-. aw 0,11') 1 ('1
)BD YVISION. . . . : Hl'iRTIS LANDING ZONING: R- 4. 5 PI)
0(-';);. . . . . . . . . . . LOT.. . . . . . . . . . . . . .019
OF WORK. . :NEW GARBAGE DTSPOSPLS. . : 1
"PE: OF USE. SF WASHING MACH. . . . : 1 BACKFLOW PREVNTRS. . :0
,CUP.ANCY GRP. . R3 PLOOR DRAINS. . . . . . . :0 T13APS. . . . . . . . . . . . . .
I'ORIES. . . . . . . . WATER HEATERS. . . . . . I CATCH BASING. . . . . . . ..0
LAUNDRY TRAYS. . . . . . : 1 SF* RAIN DRAINS. . . . . : 1.
INKS. . . . . . . . . . GREASE 'rRAPS. . . . . . . :0
i'-1 V A TO R I E S. . . . . .4 OTHER FIXTURES. . . . . .171
.JB/SHOWERS. . . . - SEWER L_INE. (ft) . . . . :171
,ATER CLOSETS. . .,3 WATER LINE
ISHWASHERS. . . . e RAIN DRAIN (ft) . . . . z0
P"As'TH I
OWNER:
DEVE'LOPMENi" CVORP TIF= t 1520. 00 JF` 4'1`:)/0,2 9:3
DFIRT 466. 0111 JF 09/02/93
BPL(, $ 40. 0'a JLI 1 08/20/93 93-24,2
B5Pc $ 23. 110 JV7 09/02/93 -
Phone (,,5? SSDC 1 280. 00 J17 09/02/93 -
Plumbing PARK f, 50121. 00 JF* V19/02/93
MPRT $ 45. 00 JF 09/111i.2/93
MPL C $ 11. 25 JV 09/02/93
J\Iame : C. 2
Y
M5PC ii . C`5 JF 09/171=/9:3
Address ; 4PPRT $ 1`x5. 00 JF' 09/0E/9.3
city: Pic �T S 7. 75 iJF09/0 2/93
Z i p Ph a n e#- Bp!--'L; 41 15. of"I JF' Q'i 1.)/IVA 2/9 3
Ft r
REOUIRED IM'PECTIONS . ......-
rtiit permit j. issi-ted !iubject to the reg-
lilations dbntained in the Tigat--cj MUnicipal Foot/found Insp Pain drain Insip
Code, State (if Ore. Specialty Codes ancl All Post/Beam Struct Water Line Insp
other applicable laws. All work will be clone Post/Beam Meehan Pppr/11-;dwlk Insp
'Li-1 etkc.,curdance with approved pians. This PIm/und%lab Insp Mechanical Fi.nA)
Permit will 1,xpire if work is not -tArted V-1 L M/!j A cl er f 1 a o r Plumb Final
within 160 dAys of issulanC:0, ' or, if wrl4k 'is llecli.Anit-al Insp Buildinly Final
r.,.tspended ('or- more than I80 days. Plkrr!b Top Out Erosion Control
rami n q Insp Crawl Drain
FJ �-eplace Insp
Gins Line Insp
It Sulatiall Insp
CIO (3vo Board Insp
Al-ithurized Plimh � n SiUnatUre
LL" C:a]. J for inspection
Contractor Nut ea—
MASTER PERMIT
CITY GF TIGARD PERMIT #. . . . . . . . M-T93 46 '
CdMMUNITY DEVELOPMENT DOPARYMENT DATE I SSUCD: 09/03/93
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
PARCEL: 1 S 1:_4AC--04800
:)ITE ADDRESS. . ,, : IOB7C SW 10()T11 AVE
`,3UBDIVI SION. . . . : HART' S LANDING ZONING: R-4. 5 PID
BL.00k.. . . . . . . . . . . LOT. . . . . . . . . . . . . :019
__.._________.__.___._______._.._._--•_---______ BUILDING
^E I GSUE:MST9:3--02213 DWELLING UN 1 TS: 1 BASEMENT. . . . . . . . :0 s f
[:LASS OF WORK. -NEW BEDRIrIS:3 BATHS:3 GARAGE. . . . . . . . . . .492 cf
1 Yt"',= OF USF . . . :SF FLOOR AREAS ---__.__.__._..- REC?U I RED
1-YPE OF CONST. :5N FIRST. . . . .- 1095 s f LEFT. . :5 ft R I GHT. :5 ft
.)CCUI`'ANC:Y (SRF'. :R3 SECOND. . . : 1 1(34 s f FRONT. :20 ft REAR. . :35 ft
;TORIES. . . . . . . :` TH I RD. . . . :0 s f REQUIRED
I IE I GI iT•. . . . . . . . : 6 ft T UTAL -------:2279 s f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . .40 ps f VALUE. . . . . $ : 11:111690 PARKING SPACES—:1
Remar-ks ,., PASTH I
PLUMBING
GI.NKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :4 WATER HEATERS. . . : I TRAPS. . . . . . . .
T'UB/5.40WERC. . . . ..3 LAUNDRY TRAYS. . . : 1 f,A'TC,fi BASINS. . . .
WATER CLOSETS. . :3 SEWER LINE ( f•t ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . . 1 WATER LINE (ft ) . : 100 OTHER F"I XT(JRE S. . . . . :IZi
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. 1 SF" RAIN DRAINS. . : 1
MECHIPINICAL _.._.___...____.._._______._.._____._..._.__..________ FEES
FUEL TYRES--•---- _____._.._ UNIT HTRS. . :0 type amo1-int by date r•ecpt
/GAS/ / / VENTS . . . . . :0 TIF- $ 15;"0. 00 JF 09/02/93
Mr1X II\rUT :0 PTU VENT FANS). . :4 BF='R1- 4, 468. 00 JF 09/02/93
!"-URN ( 1.00K . . :0 HOODS. . . . . . : 1 BPLC $ 40. 00 JLH 08/2:0/9.3 93- '43-
f•URN ) =10071 . . : I WOODSTOVE1_i. :0 B PC $ 231. 40 JF 09/02/9:3
r=LOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ :_80. 00 JF 09/02/93
314P:0 OTHER UNI T';_i: 1 PARK b 500. 00 JF 09/02/93
GAS OUTLETS: 1 MPRT $ 45. 00 IF 09/02/93 -
Clwner•: --- -- - _...___.___.__-•__-__________....___MF'l_C $ 11. 2:5 JF 09/02:/93 -
FRENAIS(SANC[= DEVELOPMENT CVORP M5PC $ 2. 2'5 JF 09/0,-1/93 -
1=''PRT $ 15", 0r� JF 09/02/93 -
P5PC $ 7. 7'-; JF 09/02/93 -
Bf''LC $ 15. 00 JF 09/02/93 -
I1hone #:
RENAISSANCE DEVC_LOPMENT
.1672' SW WILLAMETTE FALLS DR
41:97' LINN OR 970E8
Phone #: 557-•8000
Reg #. . : 49955 ___...__---•----•-----___________.__-.---__.- _--
- $ 3067. 65 TOTAL
This permit is issued subject to the regulations contained in the -- -- -- REQUIRED INSPECTIONS --
'igard Municipal Code, State of Ore. Specialty Cedes and all other Foot/fol_tnd Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Stri_Ict Gas Line Insp
-tans. This permit will expire if work is not started within 180 Post/Beam Mechan Inst-rlat ion In-,p
.'ay_ ^' issuance, or if work is suspended for sore t n IE0 days. f='Im/1-incislab Insp Gyp Board Insp
/ PLM/Underfloor Rain drain Insp
`'er,mittee Signati_rre . Mechanical Insp Water Line Insp
Pli.tmb Top Oi.tt Apprr% SdwI)( Insp
Issued By: _ — F"r•aming Insp Mechanical Final
Call for inspection - 639-4175
SEWER CONNECTION
CITY OF TIGARD PERMIT #.ERMIT
. . . . . . : SWR93-0396
CO;JIMIJNITYDEVELOPMENT DMiARIU NT DATE 15'3)(JED: 09/03/93
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171
F"IPPCEL: 1 S 134AC..-04800
SITE ADDRE"SS. . . . 1.017;3 SW I'L RVG
SUBDIVISION. . . . : HART' S LANDING ZONING: R-4. 5 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :019
TENANT NAMr. . . . .
USA NO. . . . I . . . . . : FIXTURE UIQ!T TS. . . :
CLASS ;.1F WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :GF NO. OF BUILDINGS: 1
INSTALL. TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Rom,arks : Fo"m I
lTwner: ____.____..__..._.___._____..._.__.__......___.__.__..__.________._.__.__.._---_._ __...__. FEES
m!*NAISSANCE' —EVEL_OPMENT CVORP type -amol_rnt toy date r^ecpt
PRMT $ ::20121. 00 JF 09/02/9,.3
INSP $ 3`.5. 00 JF 09/02/9..:, —
i"'l-lone #:
LONTRnCTOR NOT ON FILE:
171 1-1(1 n e #: ? 2235. 00 TOTAL
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-- — REOU I REsD INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection _
of Vtp Unifies+ Sewage Agency. The pereit expires 180 days from
he date issupo, The total mount paid will he forfeited if the
ermit expires, The Agency does not guarantee the accuracy of the
gide sewer laterals. If the sewer is ant located at the measurement _
iven, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase —
a "Tap ano Side Sewer" permit and the A,envy will insta 1'a lateral.
er m1fitce ign��t�.1v e :
Call for- inspection
CITY OF TIGARD — RECEIPT OF r-lf)lv*11FNT RFCEIPT NO. :93-243867
CHECK AMOUNT 5262. 65
NAME s RENAISSANCE CUSTOM HOMES CASH AMOUNT s 0. 00
ADDRESS : 1672 SW WILLAMETTE FALLS DR PAYMENT DATE 09/03/93
WEST I_-INN, OR SUBDIVISION
97066—
PURPOSE OF PAYME-NT' AM(AINT PAID PURPOSE OF' PAYMM') AMOUNT PAID
BUILDING PERM 465. 00 PLUMBING PERM 155. 00
INIF-CHANICAL PE 45. 00 ST. BI-111—D PER 33. 40
FLAN CHECK FE 26. 25 SEWER USA 8200. 00
RF WEE? INSPECT 35. 00 PARKS SDC 500. 00
STORM DRAIN SDC- C-1.80. L710 RESIDFNTIAL TRAFFIC FEES 1410. 00
MASS TRANSIT TIF FEES 110. 00
110873 SW 1091H AVE
HART' S LANDING, LOT 19
TOTAL AMOUNT PAID — — — — 5262'. 65
1
-- --- --
r•
uiuswiiaunwd. PLNCK/RECT #CITY OF TIGARD PERMIT N Ms c - U ��y
COMMUNITY DEVELOPMENT DEPARTMENT Tiprd,Oregon97M
(503)63"171 DATE ISSUED
JOB ADDRESS: ��_ �(,� I U��`�'1 t TAX MAP/LUT ;5/ 3i' 9 -SI�pD
SUB: HARTS LANDING LOT: LAND USE:
VALUATION:
OWNER SPACIAL NOTES
NAME: RENAISSANCE DEVELOPMENT CORP REISSUE OF:
ADDRESS: 1672 SW WILLAMETTE FALLS DRIVE LAST REISSUE:
_— WEST LINN,OREGON 97068 FLOOD PLAIN/
111IONE: (503) 557-8000 SENSITIVE LAND:
CONTRACTOR APPROVALS REWIRED IRED s06gZ---6VL 3
NAME: RENAISSANCE DEVELOPMENT CORP. PLANNING:
ADDRESS: 1672 SW WILLAMETTE FALLS DRIVE ENGINEERING:
WEST LINN, OREGON 91068 FIRE DEPT: _
PHONE: (503) 557-8000 OTHER: -fir
CONTR. BOARD #: 49955 EXP DATE: Si16.1?!,
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: EAGLE PLUMBING _ LIST/SUBCONTRACTORS: _
MECH: � TRI-COUNTY TEMP CONTROT. BUS TAX: _
P.�CI ENGINEER CALCULATIOtIS:
NAME: ALAN MASCORD TRUSS DETAILS:
ADDRESS: 1515 NW 23RD OTHER:
PORTLAND, OREGON 972i0
PHONE: -9161
PROPOSED BLDG. USE: SFR
C° OMMENTS: _ Si Fif"r s T 4�A"A,
L1 r
J � IAC IJ rAt�,tIC. 7.�rv�,� sofA�'r3 �►.�E Fatil Rr.ZAA-)5 L41 7' LoT in -*91F
r^�'l+P/fes f�Y ANOu'SE. W17-140,14T ;aLA+C- F�ATi��t�`i C'ti ,> Stui7�f sic
n PL T GNATURE —
Received By: 1. ' Jate Received:
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PERMIT I ACCT I DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
ogle 10-432 00 Building Permit Fee;
10-431 00 Plumbing Permit Fees
I
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5x) / 3J q� / 3.2=-LU
Building Z3.
Plumbing 1. 1 j
Mechanical �- Zj,
10-433 00 Plans (.neck fee/ � °2 r� Z
Building
Plumbing /
Mechanical _ �l- Z, 1
10-230 06 Fire
j 0j 30-202 00 Sewer Connection u 0 J /
30-444 00 Sewer Inspection 3}� ✓ -�' —
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
52-449 00 Parks System Dev Charge (PG;,)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) ? / Lv—
24-445-01 Water Quality (Fee in lieu of)
T 24-445-02 Water Quantity (Fee in lieu of)
J
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TOTAL l� l G7
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