16438 SW 109TH PLACE U 1, iU1 U . 1f11Ll1 I 1 11 : 1_ �
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164380•
- n
CITYOFTIrwA
RD , CE:kT:C F 11.Ai ! OF
OCCUPANCY Y
�CCTYOFTIGA D PERMIT #. ,. . . . . . a MST90-•0001$
COMMUNITY DEVELOPPRENT DFPaAR1 E'1�T "GWD+ PRIM. PERMIT M. MSTsa0--0130:3
13125 SW Hall Blvd. P.O Bax 23397,Tigaid,Oregon 97723"(5.13) 4175
DATE ISSUEDa 06/26/x0
SITE ADDRESS. . . a 16438 5W 109111 4,1- PARCELa 2S115AA--
SUBDIVISION. . . . a DCVLP LANDING 11 ZONINUo R-4.5 PD
BLOCK. . . . . . . . . . s LO Y . . _ . . . . . . . . ,, . a 59
CLASS OF' WORK. aNEW
TYPE OF USE. . . s Sr"
OCCUPANCY GRP. vl3
OCCUPANCY LOAD►22e 4
TE'NANT NAME. . . c
F1Fina r F-.w a r. l. r. homes
RL.R HOMES
14655 '-iW 141S"Y'
TIGARD OR 9?204
Phone 0:
Contractors
CONTRACTOR NOT (IN F'11...E
Phoney I.-
Reg ". . c
Occupancy of they „above referenced building is hereby pivmn, and certifies
the compliance wit:1, the StaLe Of Oregon Specialty Coders: tar the grasp,
acclApanr..y, and use under which the referenced permit was issued.
FIRE DtPW TMENT HUI1_E 13IN�'013
BUILDINOKOVALYAL
POST IN CONSPICUOUS PLACE:
I
I
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INSPECTION NOTICE
City of Tigard Building Department
( / P.O. Box 23307
Tigard, Oregon 97223
Phone: 639-4175
Type of inspection
Date Requested _ Ti M. P.M.
Address
Owner_ Lot #
7
Builder _.__—d
The following Building Code deficiencies are required to be corrected:
J 1
Presented to Approved
Inspector �/ i �� —__ Disapproved
Date
CALL FOR REINSPECTION
❑ YEIt ❑ No
INSPECTION NOTICE n
City of Tigard Building Department
P.O. Sox 23397
Tigard, Oregon £7223
Phone: 639-4175
Type of Inspection
Date Requested/l�� Time A.M. P.M.
Address �� 7 __���_G ? _— Permits
Owner _ _____ Lot # _
Builder
The following Building Dade deficien:ies are requires to be corrected:
14 1- kfA
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Presented to r ❑ Approved
Inspector
Nate
CALL FOR REINSrYCTION
❑ YES ❑ wo
INSPECTION NOTICE
City of Tigard Building Department
P.C. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection __
- �-
Date Requested �7 � Tire@..4 IS .M.
Address Perm
Owner –__ —T — _–�- Lot tk
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _- Approved
Inspector _ _– UU Disapproved
Date �� ____ --- -
FT—
CALL FOP REINSPECTION
Cll 'VEE C7 FAIO
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XWKWAMPULN
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C11YOFTIGARD
(C"YAORWA
COMMUNrFY DEVELOPMEN-f DEPARTMENT PERMIT
13125 SWHWIBlvd. P.O.Boz 23397,Tigard,Oregon 97223(503)639-4175 RMIT #/. . . . . . : MST90-0003
:[xxx _—__ MST 90-O003 - -
i� 639-4171 DATISSUED: 02/01/90
'TF ADDRESS. . . : 16438 SW 109TH PL PARCEL: 2S11tAA-
UBDIVISION. . .. . : ZONING:
LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
-------------------------------- BUILDIN,; -------------------------------------
ISSUE: DWELLING UNITS:1 BASEMENT. . . . . . . . .0 sf
LASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . 550 sf
YPE OF USE. . . :SF FLOOR AltAS---------- REQUIRED SET'3ACKS----------
YPE OF CONST. :5N FIRST. . . . :1154 of LEFT. . :S f . RIGHT. :5 ft
�CCUPANCY GRP. :R3 SECOND. . . :863 of FRONT. :25 f,� REAR. . :34 ft
TORIES. . . . . . . :0 THIRD. . . . :0 of REQUIRE) --------------------
'1GY.T. . . . . . . . :20 ft TOTAL------:2017 of SMOKE DF.Tt '1'URS. :Y
LOOR LOAD. . . . :40 psf PARKING SPACES. . :O
emarks: r.l..r. . homes
- ----------------- YIUMBIN; -------------------------- -----------
E1VA-T-*0-R--I-E-S-.-.-.-.-.-i4
NKS. . :1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O
WATER HP1'.ThRS. . . :l 'T'12APS. . . . . . . . . . . . . . :0
UB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CAT"!: BASINS. . . . . . . :0
ATER CLOSETS. . :3 SEWER LINE (ft) . : ) GREASE TRAPS. . . . . . . :0
ISHWASHERS. . . . :1 WATER LINE (ft) . :1 OTHER FIXTURES. . . . . :1,
ARBAGE DISP. . . ;I RAIN DRAIN (ft) . :0
ASHING M1'.CH. . . :1 SF RAIN VRAINS. . :1
-------------- MECHANICAL ------------•-- ----------------- FEES ---------------
llEL TYPES----------- UNIT HTRS. . :O type amount by date recpt
fU
AS/ / / VENTS . . . . . .0 PRMT $ 416.00X INPUT:O BTU VENT FANS. . :4 PLCK $ 271.70RN < 100K . . :0 HOODS. . . . . . :1 5PCT $ 20.90RN >=100K . . : 1 WOODSTOVES. :O PRMT $ 45.00
FLOOR FURN. . . . :0 "LO DRYERS. :1 PICK 11.25
OIL/CMP < 3HP:0 OTHER UNITS:1 5PCT $ 2.25
GAS OUTLETS:1 PRMT $ 147.50
ner: ---------------------------------- 5PCT $ 7.38
LR HOMES PAYM $ 100.00 DEW O1/03/90 106706
4855 SW 141ST PAYM $ 0.00 O
STDG j 600.00
IGARD OR 97224 SSDC 150. )0
hore #: PARK $ 250.00
ontractor: -------------------- ----------- PAYM $ 1923.98 JLH 02/01/90
LR HOMES
1.4855 SW 141ST
IGARD OR 97224
hone #:
kegi . . 7 ------------------------------•------
$ 2023.98 TOTAL
hie permit is issued subject to the regulations contained in the ------- REQUIRED INSPEC
igard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Insul.
pplicable laws. All work will be done in accordance with approved Foot/found Insp Gyp B
lane. This permit will expire if work is not started within 180 PuFt/Beam Ines Sewer
aye of issuance, or if work is suspended for more than 180 days. Plm/undslab Insp Rain
Mechanical Insp Water Li.n,l Insp
ermittee Signature: _ Framing Insp Appr/Sdwlk Insp
� Fireplace Insp Final Inspection
ssued 9y: �y*�1! -� /` '�� Gas Line Insp `_
WLW
VIM 19111"A
CINOFTIGARD
COMM�,;�vlTX DEVELOPMENT DEPARTMENT OREGON R
13125%W Hall Blvd. P.O.Box 23397,Tigard.Oregon 97223 (503)&19-4175 CO TION
-- ---- xxxx._- - -- - -�PE. IT. _ - ---
639-4171 PERMIT #. . . . . . . : SWR90-0002
PRIM. PERMIT !, : MST90-0003
DATE ISSUED: 02/01/90
i
ITE ADDRESS. . . : 16438 SW 109TH PL PARCEL: 2S115AA-
UBDIVISION. . . . : ZONING:
LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
----------------------------------------------------------------------------------
ENF.NT t'kME. . . . .
I
SA NO. . . . . . . . . . . FIXTURE UNITS. . . .
LASS OF WORK. . . :NEW DWELLING UNITS. . :1
YPE OF USE. . . . . :SF NO. Or BUILDINGS: 1
NSTALI. TYPE. . . . :BUSWR IMPERV SURFACE. . : :sf
�emarke.: r.1. r. ',omes
ner: --------- --•-------------------• -- ---------- ------ ?EES --------------
R HOMES type amount by date recpt
4855 SW 141ST PRMT $ 1250.00
IN'SP $ 35.00 /
'IGARD OR 97224 PAYM $ 1285.00 JLH 02./01/90
Phone M: i
ontractor: -------------------------------
ONTRACTOR NOT ON FILE
--------------------------------------
hone M: $ 1285.00 TOTAL
eq M. . .
-------- REQUIRRD INSPECTIONS --•-----
his Applicant agrees to comply with all the rules and regulations _
f the Unified Sewage Agency. The permit ex?ires 120 days from
he date issued. The total amount paid will be forfeited if the _
Permit expire. The Agency does not guarantee the accuracy of the
bide sewer 1p.terals. If the rawer is not lt.,cated at the measurement
r iven, the installer shall prospect 3 feet in all directions from _
he diHtance given. it not so located, the installer shall purchase
"Tap and Side Sewer" Permit and the Agency will install a lateral.
ermittee Signaturst
esued By:
Call for inB"ection - 639-4175
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l CITY OF T I GARD - RECEIPT Cr- PAYMENT RF'C NO: 00107184
CHECK AMOUNT : 77108.PS
IJ�tMr. s F;I_R HOMES CASH AMOUNT .00 i
AUDkECS: PAYMENT DATE
TIGARD, OR g7224 BLOCK NO;ADDRo
1 '. '78 5W 109 Th PL
UPPOSF OE PAYMENT AMOUNT PAID PURPUSE. OF PAYMENT AMOUNT PAID
BUILIllor) PERMIT 118. oG PEUMFIING F'E";MIT' _.._...._14-.50
MECHANICAL_ PEPMIT 45.00 STATE BUI(_D FFF'MIT' T'AX 05%) -,Q. ',
PLAN CHECL: FEE' 182.9 SEWER USA (90-0002) 1. 115'0.00
SEWER INSPECION '5.00 STREET SDC 000.00
PARb'S .;Y TE:M DEVELOFME:NT CH 250.00 STORM DRAIN SPC 250.00
TOTAL_ AMOUNT PA L D - - :, '08.98
CITY OF BOA RD11, ���A� 1 PLAN r�IECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT ` PLAN CHECK #
17125 S.W.HaN 64A..P.O.Box 23397,Tiga,a Ofegon 97:21,(56.3)639-/17{
PERMIT b
O� DOTE ISSUED
JOB ADDRESS: S�✓ / O 9T��4 ` TAX MAP/LOT
SUB: LCi: _ _ LAND USE:
VALUATION: e_ _
OWNER _ SPECIAL NOTES
NAME: ` 7`�/yG�"r __— REISSUE OF: —
ADDRESS: / -!r 0-0 !✓ LAST REISSUE:
G- .)o p 7 FLOOD PLAIN/
SENSITIVE LAND:
PHONE:
APPROVALS REQU1RE0
CONTRACTO1 �� r-� PLANNING:
J
ADDRESS: / l / -19 S � �'�_ ENGITIEERING� —
FIRE DEPT
PHONE: ITEMS REQUIRED
BUILDERS BOARD q: _ EXP VATS: LIST/SUBCONTRACTORS:
BUS TAX: _
ARCH/ENGINEER CALCULATIONS: —_
NAME: Ms �S" R C VQ� G'`= TRUSS DETAILS:
ADDRESS: OTHER: ----------�_
PHONE: -
COMMENTS:
SUBCONTRACTORS: PLUMB: r — MECH: _
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
n 10--32 00 Boiilding Permit Fees -
10-431 00 Plumbing Permit Fees 14 Z,r) —_ /(47. Su
10-431 01 Mechanical Permit Fees 14.5 - _ " -
10-230 (:1 State building Tax (5%) _3US-3 %JS 3
Building 2U, [U
Plumbing I �k
Mech 2 �`
10-433 00 Plans Check Fee 9S 9S� X71) l 2 •
Building
Plumbing
Mech
30-202 00 Sewer Connection 1 -5 0
3'1_-444 00 Sewer Inspection I 3 �"
51-448 00 Street System Dew Charge (SDC) C, 0 U 4p�3
52-449 00 Parks System Dew Charge (PDC) 0
31-450 00 Storm Drainage Syst Dew Chrg (SSOC) �S OS L)
10-230 OG Fire --
TOTAL
APPLICANT SIGNATURE
Received By: _ Date Received:
cn/3587P/18P
GRADING/EROSION CONTROL INFORMATION
GENERAL CONTRACTOR NAME- & ADDRESS: CASEFILE NO.:
'L f/�yye PERMIT NO.: ajr-T C%G -066-3
APPLIQAW NAA AND AIPJ ESS:
EXCAVATION CCNU'.TRACTOR
NAME&ADDRESS: TA,
OWNER NAME AND ADDRESS:
TELEPHONE NUMBEPI:- -- -
APPLICANT_ o� PROPERTY DESCRIPTION:
OWNER`__ GM STREET ADDRESS AND CROSS SIREE1,17.00ATED
GENERAL CON'TRAC7"JR:- ' -f' 4.-7- 2 2 "9 L
EXCAVATION CONTRACTOR: o re.Z-'
STI E/JOB:
LEGAL DESCRIPTION:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO.:
CO CT P SON TLE T.LEPHONE: 1/4 SL-..TION_
L c_ Al SITE SIZF",ACRES:
DISTURE ED/WORK AREA,ACkES:
LOCATION&.ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE-R+F DR;LNS TO:(CIRCLE pNg")
r�
(NOTE.:PERMITS MAY 9E REQUIRED) -ewrcTv Y"f1Q' ITCH PIPE' <gREE
(CfRCLE'O PKLYATE,PR PL;
EROSION/SEDIMENTATION CONTROL (ESCI jEA URES
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DURING CONSTRUCTION: FGi-LOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE_EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE fEMPORARY%SC
PERIMETER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE.ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES
CONSTRUCTION SEQUENCE OTHER
OTHER
PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCF!':':TH TECHNICAL.GUIDANCE HANDBOOK".
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLLTE,INCLUDING EMERGENCY
PHONE NUMBER, SCHEDULE/STAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASI/RE.S,AND
APPLICABLE STANDARD NOTES.
I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUC'f AND MAINTAIN ESC MEASURES AS NECESSARY
} TOT/O'CONTAW EDI M EP IT ON''AE CONS IRUCT10y,S
-& -./ ,
APP
OWNER SIGNATURE LJCA SIGNATURE
• • • • • • • • • • • • a • • • • • • • • • • • • • • • • • • • N • • • 41 • a • • • • • • • • • • • • • • • • • • • • • • • • • • •
0M- CIAL IJSE ONLY.
RECEIPT DATE ACCEPTED
FEE NUMBEk RECEIVED BY