10930 SW 109TH AVENUE 1
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CITY OF TIGARD ,�-
C,OUMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.8199 (603)839-4171
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CITYOFTIGARD i�2�
Cmc YWAVX
COMMUNITY DEVELOPMENT DEPARTMENT UNGOn 01A'STER F'ERN11
13126 SN FWT Blvd. P.O.Bax 23397,Tiprid,Oregon 97223(603)83!1.4176
P'F RN I T 1t. . . . . . : hlLi"F93--0065
0,39-41 i J. DA FEE ISGLJL!D: 03/1.0/93
il'FE:E ADDRE.55. . . : 109.30 UW 1091H AVEC F'ARGEI_: 1S134AL:--HLQ4._':
SURD IQISION. . . . : HART LANDING I.ONING:
BLUCK( . . . . . . . . . . LUJ.. . . . . . . . . . . . . ..29
__..._.... .._._.._.....____.._.____ BUIL..DIN1i ._.__...._..__.____.._....._.____.__._ ._........ _________.. .____.__._....
R I SSUE DWELL. NG UN I r5: 1 BASEhILN-F. . . . . . . . :o s f
CLASS OF WORK. r•iW1.W B EDRI'15:3 BATHS: UARAUE:. . . . . . . . . . ..529 s,f
TYE,E OF USE:. . . :SF FLUOR AREAS-.._.-.--.__.----- RE UU 1 HLD SEI BACKS----•••-------
TYF'EE OF C;ONSI. :51\1 F.'IFtS1. . . . :944 sf LEFT. . : 1C ft RIGHT. . 15 •rt
UCGUPANC'Y URP,. :R3 SECOND. . . :632 s f F=RQNI . :cls) f t RLNR. . :.313 f f
STOR T ES. . . . . . . :2 'I'H I RD. . . . :0 5f REGJU I
HEIGHT. . . . . . . .. :;_: fL TOTAL---_-.-...---: 17' 6 c{. 1,r)Iyl0KL DE:TEC TUR Ps. :Y
FLUOR LOAD. . . . -4170 PSF Wil..UF. . . . . iF : (.-).L�:l 6 PARK I NG SPACES). . 1
Remarks : F'f1TH I
f:INKS. . . . . . . . . . : F-LUOR DRAING. . . . :0 BACKFLOW 6'RC VnIrRS. . :o
1..AVAT0RI ECT. . . . . .. W01 F.R HEATERS. I 'I R(WS. . . . . . . . . . . . . . .G+
FUB/GHOWERS. . . . :2 LAUNDRY T'RFiy":?. . . a+1+ CATCH BA13IN i. . . . . . . sob
WATER CLOSETS. . :3 S1:WE:R LINE (ft) . :0 GREASE TRAF='S. . . . . . . :0
DISHWASHERS. . . . .1 W01 ER LINE (ft ) , : 100 OTHER F IXTIJIiIRS. . . . . 10
L:ORBAGE. DI'3i!. . . : 1 RAIN DRAIN (-ft ) . a 0
WASHING ITIACFI. .. . - 1 SF RAIN D"A I NS. . : I
__.___. _,.._.._......._...... I+IEUH0IV1COL __. .__--............_..._._. ._._•._.....__..._.__. .._. _._.-_.. FEES .__.._ _ • __.
FUEL 'TY'r'E'.I _.........._._.... I-JIUI 'F LITHS. „ :0 type amount Fey date r-ec:pt
i _Ia`3! ! VENTS . . . . . ..lb TIF" $ J46+11. 00 JH 0.3/10/93 -
Iy:F'iX Tial='UTe+ZI B'1 U VEEN'F FAN13. . .4 13P-1R I' $ 41719. 00 JI I OE. /.10/9,3 -
I'-URN < 100K . . a I NUODfl. . . . . . . 1 EWI._1. b a65. 65 JLH 01/26/93 93--
PURN .> -I 00K . . :0 WOODS']OVE.S. :0 B5F`C, is 2'LA. 45 ,.JI1 03/ 10/93 -
F-L_OOR TURN. . . , ail! CLO DRYERS. a l SSDC $ 280. 00 JH 03/1111/93 -
BUIL/Cl',IF' ( 3HF':QI OTHER UNI'T5: 1 P'F4'<I: $ 500. 00 JII 03/10/9,3 -
UAS OU'TLE.TS: 1 IVIVIR1 4 43. 50 JH 0,3/10/93 -
Owner^: _....__.._....._____.____..________.___..___._.__.....__-..___ hlRl._(_ $ 10. Sita Jit Q13/10/9: -
REENAISSANC:E: DE=VEEL.OPlIENT CORP' 1151='L. $ 2. 18 JIA 03/10/93 -
1672 SW WILI_.AME1l'E FALLS DR Pr-'RT $ 140. Q10 JH 0.3/1.0/93 -
F15F='C_ 4 7. 00 JVI 03/10/93 -
WEEIT I....iNN OR 97068
,'horle fit: 6''57-57'39
?H:NA i SsFaNC,E: DEVk_L01--,+ILENT
16'7& r_--iW 1411._1 11111 f IE F _LS DR
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•lEGIF I_J:IVIq LIR 97068
'_ ' 'Flarle f1: '.,ci7-E3QIIZ►Qt
Pert #i. . . 499''5
f; :31;30. 86 rOT'AL_
i us pet-sit is issued subject to the regulations contained in the -- --- -- RE CIUI RE:D INSF'EC:T IONS - -
Tigard Municipal Code, State of Ore. Specialty Codes and all other F=oot/f'ot.tnri Insl:r Firc!plar:e Inal)
applicable laws. H11 work will be done ►n accordance with approved �'truct Uss Line Inelo
plans. Thi: pet-sit will expire if work is not started within I8@ F'ostlGteam IvIer_hati, lne+_taat i on lnssl
days of issuance, or if work is susprnJed rov- enre than IEP days, F'1 m/t.tnci s 1 ab Ina 17 Gyp Boar-c1 Ins 1'
1-11_I1.%LlntJer•f- !aur Ra:tn dr-a.in InsN
hler.hanic.al. lnsp Water Line lt,
Plumb Tap Out Apwr^/5dw11( Ire
Framir)q Insp Mechanical Final
ITYOFTIGARD
WYOFTWA.0 SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT 01110M
13125 SW Wi tel.-4. P.O.Box 23397,TVerd,Or*Wn 97223(603)6�94176 PIER 11 IT
PIE R 1Y1 I'T" It. . . . . . . : SWR93-100611�"
639----41 11 DATE ISSUED: 03/10/93
SITE ADDRESS. . . : 10930 SW IV19-FH AVE F-IORCEL:
S)UBD I V I S I 01\1. . . . . HART AN D I NC-13 Z ON I INIG c
B L 0 .:K. . . . . . . . . . . LOT.. . .. . . . . . . . . . . ..29
TENANT NOME".. . . . .
USA 110. . . . . . . . . . : F I XT U PE UNITS. . .
CL0`3 OF:' WCJ-RK. 1\1LW DWELL I NO UN I IS. I
lYr,L. OF. USE. . . . . .SF' N(). OF DUILDIN65ul
INSTALL TYPE. . . . 9 BU5WR 111PERV SURF:*W1-'E.
(JWTIer— F-7EES
�?ErAAIISSANCE DEVELGF".111ENF' CORP type aniount by date vecpt
167L BW WILLAMETTE FAILS DR PIRMT 4 2100. 00 JH 03/10/93
INGP" 6 35. 00 JH 03, IQ'/r)3
WEST LINN OR 97068
I'-*+ione #: 657-5739
Lontt-ac-L-cii-t
CONTROCIOR NOT 01\1 FILE
r1loTle it: $ 00 TOTAL
Heil It. .
REWIRED INSPL`11 ONS
This Appiica, ; agrees to comply with all the rules and regulations Sewer Inspertion
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Pyency does not guarantee the accuracy of the
side sewer laterals. If the -.-wer is not lucated at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
.i "lap and Side Sewer" Permit and the Pgen( will r 11 a lateral.
ev-m i t t e e S i qvi:at 1.tv-.e
hall. fore inspect ion 639-•4175
T�~ A13125 SWifallBlvd. PLNCK,/RECT # �v.�CI j-g�;� OF T RD PERMIT # 5 9:3 - �o6S
COMMUNITY DI-,'VF,I,OPM.;NT DEPARTME'17T Tigard Oregon972Z3
(503)634-4171 DATE ISSUED
JOB ADDRESS: TAX MAP/LOT /.S/ 3�/�c — 02-1
SUB: �1 ,LOT: _ � LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: �Pna�s��� /��ye���i,Tc,.� REISSUE OF: _
ADDRESS. . w' 7t S ev Cvdf oyl e#-P fl, D✓ LAST REISSUE:
61) ,l (j . _ '7 C) FLOOD PLA IN/
PHONE: .lv5 7 ' S Jj __- SENSITIVE LANG:
CONTRACTOR_ e APPROVALS REQUIRED
4- 4/t-Ce/> PLANNING:
NAME: S /r . /�,, --
ADDRESS: _ ENGINEERING: __—
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: EXP DATE: _.
ITEMS RE(L IRED
SUBCONTRACTORS: PLUMB: ��� -- LIST/SUBCONTRAI TORS:
MECH: BUS TAX: --
ARCH ENGINEER T� CALCULATIONS: _
NAME: TRUSS DETAILS:
ADDRESS: _ _ OTHER:
Ln PHONE: --
J
PROPOSED BLDG. USE: _ ---- _ _----- — -- ---- -
`.L COMMENI-S: --
--- - —
APPLICANT SIGNATURE -
Received By: _ _.��___ — Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. SAL. DUE
III, voG�� 10-432 00 Building Permit Fees /o F, S,0 / �/01�
10-431 00 Plumbinc, Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building �
Plumbing ,c,U
Mechanical
10-433 00 Plans Check Fee „3" % r °-26'' �3
Building A4( , Y.)
Plumbing
Mechanical 10, d'
10-230 06 fire
Syoloo 30-202. 00 Sewer Connection
30-444 00 Sewer Inspections
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 13,50 _ ,35o
25- 148-05 Mass Transit TIF Fees 1l0
52-449 00 Parks System Dev Charge (POC)
31-450 00 Storm Drainage cyst Dev Chrg
(SSDC) a _
n
N 24-445-01 Water Quality (Fee it lieu of)
i 24-445-02 Water Quantity (Fee in lieu of)
TOIAL
—C64'o'D�,
nm/358%P.WPR
INSPECTION NOTICE
City of Tigard Building Department
13125 SW IIrell Blvd. Tigard, Oregon 9722
Irspection Line (Rec-O-Phone): 639-4175 Bunineee Phones 639-4171
Inepe.,t ion: _
Footing P1bg. Underelab Mech. Rough--in Appr/sdwlk
"ound. Plbg. Top Out :as Line INALs
Pont/Ream Struct. San. Sewer Framing -B1� dd��)
Poct/Beam Hach, Rain Drain Insulatirn -Plu
Plbg. Underfloor Water ine Gyp. Rd. Mach.
Date Requanted: 7 !2 _ _ Time: AMy _PM
Addreea:1�/C� 0!2�— Permit 6- Q0
Builder:__,
THE FOLLOWING CORRECTIONS ARE REQUIRED:
R.
to
CO
CD
tl:
J
r
Inepectoes / Dates-
_APT- DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinep.
'CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE OF
13125 SW Hall Blvd,Tigard,Oregon 972'-228199 (503)639-4171 OCCUPANCY
PERMIT #. . . . . . . : MST9.3-0065
639-41"71 DATE ISSUED: 07/09/93
PARCEL. I5134AC-05800
SITE ADDRESS- 4 10931 SW 10')rH AVE
SUBDIVISION. . . . : HART" Q' LANDING ION INGz
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . 101C9
CLASS OF WORK. :NEW
TYPE OF USE. . . :SF
OCCUPANCY URV,. ll R3
OCCUPANCY LOAD:222 4
TI:'NANT NAME. . . :
Remarks: PATH I
Owner-
RENAISSANCE DEVELOPME".1NIT CORP
1672 SW WILLAMETTE FALLS DF?
WEST I.-INN OR 97068
Phone #: 657- 5739
Cor4tractor:
REINA IGSANCE
DEVELOPMENT
1672 SW WILLAMETTE FALLS OR
WEST LINN OR 97060
Phone Ot 557-43000
Reg 0. . : 49955
Occupancy of the above referenced building is herpby givelli, and certifies
the compliancf, with the Gtatp Of Us-ogrin Gjpei.^.ialty Codes for the pral-1131
occupancy, and use 1mider which the referenced 1);!r-mit was issued.
W4.T MIj
:F t�BLU - If NG I iSiVIELT01)
rt
I ICIAi..
PLST IN CONSPICUOUS PLACE
DEPARTMENT OF LAND USE 6 TRANSPORTATION
WASHINGTON LAUD DEVELOPMENT SERVICES DIVISION
155 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 503/640-3561/693-4415
� PHONE: 503/648-8781
OREGON Page 1 of 1
Date 08/02/93
Time 15 : 00
Permit 'Type Residential Electrical Permit Permit # 05043166
Permit Status APPROVED Applied 08/02/93
Situs Address 10930 SW 109TH AV TI Issued 08/02/93
Permit Title SFR - ELEC/ONE CIRCUIT Completed
Permit Descr. To Expire 01/29/94
Project 'Title 5F'R - ELEC/UNE CIRCUIT Project # P0033413
Project Descr, * EROSION
Parcal Number ZS1TI - Land Use District
Va? uation 0
Legal Descr.
Owner INSPECTION - TIGARD Construction OTH
Applicant Name REDS ELEC'T'RIC Classificat' on 900
Applicant Addr. : 2002 SE CLINTON Occupancy R3
PORTLAND, OR 97202 Validated by KF
Applicant ehone : 233-6467 Inspector Area
CONTRACTOR : RED'S ELECT. CO. Lic . C 26-152C 233-6467
Fee description Units Fee/Unit Ext fee Data
------------------------------------------------------------------------------
1st Branch W/out Feeder [Enter #] 1 35 . 00 35 . 00
Subtotal. Electrical Fees : 0 35 . 00
State Surcharge of 5% 0 1 . 75
Total Electrical Fees : 0 36 .75
*** Fees Required *** *** Fees Collected & Credits ***
---------------------------- ---------------------------------------------
Receipt No . Date Payment
08/02/93 36 . 75
TOTAL THIS DATE ********* 36. 75
Fees: 36 . 75
Adjustments : . 00 Total Credits : . 00
'total Fees : 36 . 75 Total Payments : 36 . 75
Balance Due: . 00
J
NOTICE: This permit becomes null and void Il thr work o.construction for which It Is Issueu Is not commenced within 160 days. Once con•9•11cY,n hes started,
the permit becomes null and void II construction Is Interrupted for a period of 160 days. 1 certify that the Information presenia?oy the applicant and
his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
apon false and misleading information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use
of this building nr structure will be compiled with whether or not specified on the pians or noted on the pians correction shoats. I acknowledge that
the granting o!a permit does not grort authority to access private property or to use easements. I further acf oowledge that the use or occupancy ct
the structure or building perndtted dope,de upon my calling for Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with vie various codes. Use or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requiremanis are satisfied and
approval Is given by the Building Official. 1 further acknowledge that a Ilan may be plcced on the title of the property upon which the permit is Issued
specifying that the use or occupancy of the building or structure Is provlslonal and revocable unfit the c•tlstaction of all Inspection requirements.
APPLICANT'S SIONATURF
WASHINGTON COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section APPLICATION
155 North First Avenue,#350-12
Hillsboro, Oregon 97124
Information: (503)8403470 Fax: 1r503) 893-4412 Project/Permit ?
PRINTPLEASE
Number Date �— -J
Pleasd complete- e 4. Complete Fee Schedule below
1. Location In to Vton_p Number of Inspections per perms allowed 4
Address—= ,U/ —'- Service Included: Items Cost(ea.)_ Sum
Building A. nesidential-per unit
City at ct r Surto No.
Tenant N e 1000 sq.ft.or lase 565.00 a �
(if commercial) _ Each additional 500 aq.ft
or portio,thereof $15,00
v ---
Tax Lot Map No. limited Energy $20.00 1
Each Manufd Homo or Modular
/� Dwelling Service oc Fseuer $40.00 2 t
Thomas Map Book: Pag :l�_,L. Section:-S--
Directions- L, ��N,dr syt��l?` B. Services or Feeders
Installation,alterations ar relocation
-- --- 200 amps rr lees $50.00 2
Commercial i Residential 201 amos to 400 amps $60.00 2
40. amps to 600 amps $100.00 _ 2
60' amps to 1000 amps $130.00 — 2
2a. t;ontractor re7E
Iflatio_n on y•
Over nec COO amps°��°'� __ X00 00 —�— 2
� � Reconnect only $40.00 — 2
Electrical Contractor �y
Address .O,CZ, —sem_ ' —7--- C. Temporary Services or Feeders
Date 1 =}— Job Number .�Z Ytf Installation,alteration or relocation
Property Ow!ler N(2&) (2 _�-�i G/`�_ 200 amps or bee $40.00 2
_ 201 amps l0 400 amps $55.00 2
Contractor's License No. —) 6 401 amps to 600 amps $60.00 — 2
Cortractor'i Board Reg. No. __— Over 600 amps to 1000 volts see•B'above
Signature of Supr. Elec' �" D. Branch Circuits
License No. 2�-`� hone N G Now,The
or extension con per panel
a) The Ise for branch circuits with
purchase of service or feeder tee.
2b. For owner installations: Each branch circuit $2.00 2
b) The fee for branch circuits without
__ purchase of servkv or f r fee.
Print ne aflame --��one O. First branch circuit 07_ $35.0( 2
_ _".— __ _ Each add'nl branch circuit $2.d) 2
Address E. Miscellaneous (Service or Feedr-,�not included)
City _ State -- 7ip –-- Each pump or Irrigation circle—__ $40.00 2
Each sign or outline lighting $40.00 2
Signal circult(s)or a limped
The installation is being made on property I own energy panel,alteration
which is not intended for sale, lease or rent. or extension --- $40.00 -- 2
Owners Signature _ _ F. Each additional Inspection over the allowable
In any of the above, per Inspection
3. Plan Review section (if required) °° -�
5. Fees
A. Enter total of above fees $ 3s-
5% Surcharge (.05 X total fees) $
Subtotal $ '
B. Enter 25% of line A for
For Inspections call Plan Review if required (Section 3) $
640-3561 or 693-4415 Subtotal $ -34�,-
24-hour recorder, Less Bulk Label Fee
one working day In advance of need Balar►ce Vue
This p•rmlt becomes null and void If the work authorized by the permit Is not commenced wfthin 180 days from date of Issuance
of much permit or If the work authorized Is suspended or abandoned at any 'e atter work Is commenced for s period of 180 days.
Electrical Permits are non-refundabl i and non-transferable.