11013 SW 111TH PLACE 1
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CIT`( OF T I CARD CERTIFICATE' OF
OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PILRMIT #. . . . . . . I MST940256
13125 SW Hall Blvd,Tigard,Orogon 97223#81958 (503)039-4171 DATE 15SUCD: 02/24/95
PARCEL- IS1,34M-115500
GITE ADDRE1,3S. . . : 11013 OW 111TH PL
QBDIVISION. . . . : JEFFREY ES7ATES ZONING.-R--4. 5 PI)
-OCR. . . . . . . . . . : LOT. . . . . . . . . . . . . :011
.-A-9 S_-C)1'-W_ -0 1 t4 I I NEW
r'PE OF USE. . . :SF
.CUPANCY ORP. :R2.
�:ILUPANCY LO1C1rjz22'7 4
N()NT NAMC. . . :
-marks : F-`ATH I
.,net..;
)UR D CONSTRUCTION
0 Wix, 15-77
"AVE
_RTON 017 97075
inne #l: 641-0935
Qntractore
AIR D CONSTRUCTION
A BOX 1577
COVEPTON OR 97075
lonp 0: 641-0935
rt
V. . : 71037
upmncy of the Maya vefprenced building is hereby given, and cevtifi ,
he compliance with the State of otegun Specialty Codes for the qrol.tp,
-r"parluy, and use under which the refprencrd pek- mit vies x A %u e d
FIX
U
PW')) IN CONSPICUOUG PLACE
P,LUIYILAI
CITY OF T I GAR® PIERMITNilG.. FERMI.I. . . . . . . 11 S T9/4—0 2!5 C
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/08/94
13125 SW Hall Blvd.Tigard,Orogon 97223e8199 (503)639-4171 FDARCEL- 11,31:34AC-JEO 11
-ITE-j -1 ADDRESS. . . z 11013 SW 111TH PL
SUBDIVISION. . . . : JEFFREY ESTATES ZONING: R-4. 5 P'D
BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . :011
CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . - 1
TYPE OF USE. . . . .SF WASHING MACH. . . . . . . : 1 BACKFLOW P,REVNTRS. . : l
OCCUPANCY GRP,. . :R-- FLUOR DRAINS. . . . . . . :0 TRAP'S. . . . . . . . . . . . . . :0
S)TORIES. . . . . . . . :2 WATER HEATERS. . . . . . : I CATCH BASINS. . . . . . . :0
F1 LAUNDRY TRAYS. . . . .. . : 1 5F RAIN DRAINS. . . . . : I
3INKS. : 1 GREASE TRAP,S. . . . . . . :0
LAVATOW — ,IE5 :5 OTHER FIXTURES. . . . . :0
-ruB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER
P CLOSETS. . -.3 WATER LINE (ft ) . . . . : 100
DIS14WASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Rema -ks : r-,ArH I
OWNER:
FOUR D CONSTRUCTION TIF $ 1550. 00 KS 07/08/94
P 0 BLIX 1577 BPIRT $ 600. 50 KS 07/06/94
B1-,1._C $ 390. 33 SW 07/01/94 94-253111
BEAVERTON OR 97075 B5PC $ 3 0. 0,3 KS 07/08/94 —
Phone #: 641-09315 ;SDC $ 280. 00 KS 07/08/94 -
P,ARK 4 500. 00 KS 07/08/94
Mr:,RT $ 49. 50 KS 07/08/94
MPLC $ 12. 38 KS 07/08/94
Name : '61CIM-a IY15PIC, 2. 48 KS 07/08/94
0 d d r-e s t; 3BTH $ -225. 00 KS 07/0B/94
City 5-tate : P5PIC $ 11. 25 KS 07/08/94
Zip: U7/ Z3P,hone#: (es('a-a-suEROS $ 64. 00 KS 07/08/94
Rey Additional fees riot shown here. . . . . .
REUU I RED INSP'ECT'IONS
----
This permit is issued subjf?ct to the r-eg--
Ulat .LOT15 contained i7i the 1'igat-d Municipal Foot/found Insp Rain drain iTISP
Code, State of Oi-e. Specialty Code- and all. Post/Beam jtt-uct Water- Line Insp
other applicable laws. Ali work will be done Post/Beam Meehan Appy-/Sdw1P Insp
in accordance with appl-OVed plans. This Pllm/undslAb Insp Mechanical Fi.nal
pet-mit will expire if work is not stat-ted PLM/Under-f 1 oor V-'lamb Final
wit1iin 1B0 days of issuance, or if wow-k is, Mechanical Insp Building 1-incl
suspended for- more than 180 days. F-'lamb 'Top Out Erosion Control
Framing Insp Crawl Ur-ain
Fireplace Insp
Gas Line Insp
1risulation Insp
Gyp Board Insp,
n t
ft'.
hor-ized Plumbing Conti-actor Signatur-e
Call, for inspection - 639--4175
Contractor- Notes -
..........
CITY OF TIGARD L RIIIAST�ER. PERMIT M;ST94 ���6
COMMUNITY DEVELOPMENT DEPART ENT DATE ISSUED: 07/06/94
13125 SW Hall Blvd.Tigaro,Oregon 97223.8194"(903)039.4171
PARCEL. 1 S 134AC--.JE01 1
S I TE ADD RC SS. . . : 1 10 13 SW 1 1 1 TH PL
SUBDIVISION. . . . JEFFREY ESTATES ZONING: R.--4. 5 F'D
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5111
BUILDING
REISSUE: _ _ DWELLING UNITS: i BASEMENT. . . . . . . . :0 s f
CLASS OF WORK. :NEW BEDRMS:3 BATH5:3 GARAGE. . . . . . . . . . :648 sf
TYPE OF USE. . . :SF FLOOR AREAS-- _._____.-_-- REQUIRED
' YPE OF CONST, :5N FIRST. . . . : 1146 s f LEFT. . :6 ft R I GHT. : 10 ft
OCCUPANCY GRP. :R3 SECOND'. . . : 126 VI Sf FRONT. -.30 ft REAR. . :23 ft
':TORIE:S. . . . . . . :2' THIRD. . . . :0 5 REQUIRE:D-----
IE I GI IT. . . . . . . . :27 ft TOTAL - 2406 S f SMOKE DETECTORS. :Y
`FLOOR LOAD. . . . :40 psf VALUE. . . . . $: 166115 PARKING 5PAC,'ES. . : 1
I_emar,ks : PATH I
---•-• PLUMBING
3INKS. . . . . . . . . . .. 1 FLOOR DRAINS. . . . :0 EACKFLOW F'REVNTRS. . : 1
_AVATORIE: . . . . . .5 WATER HEATERS. . . : .1 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH Br.ISINS. . . . . . . :0
WATE R CL0SETS. . :3 SEWER LINE ( ft ) . :0 GREASE TRAPS. . . . . . . !0
I)151 iWA51 iE::RS. . . . : 1 WATER 1-..INF (ft ) . : 100 0THER F I XTURES. . . . . :V7
GARBAGE DISP. . . : 1 RAIN D13AIN (ft) . -'0
WASHING MACH. . . : 1 SF RAIN DRAINS. . s 1
MECHANICAL FEES
FUEL TYE='E5------ - - --- UNIT HTFIS. . :0 type amount by date recpt
/GAS/ / ! VENTS . . . . . :0 TIF $ 1550. 00 KS 07/08/94 -
MAX INF"'UT:O RTU VENT F•AN'3. . : 4 BPRT * 600. 50 KL-- 07/08/94 -
FURN ( 100K HOODS. . . . . . : 1 L-IPL.0 $ 390. 33 5W 07/01/94 94-E531i .!
I•-URN ) =100K . . . 1 4J00D'ST0VE::'.=,. : I B5F'C $ 30. 07) KS 07/06/94 —
FLOOP FURN. . . . :0 CLO DRYERS. : I SSDC $ 2BO. 00 KS 07/08/94
BOIL/CMF' ( 3HP:0 OTHER UNITCI: l F'ARI! $ 50111. 00 11:a 07/08/94
GAS OUTLETS: 1 MPRT $ 49. 517.1 KS 07/08/94 —
Uwner $ 12. 138 KS 07/08/94
/-OUR U CONSTRUCTION I15F'C: R 2. 48 KS 07/08/94
1 0 BCI X, 15; :3BTH $ 2::5. 00 KS 07/08/94
F15PC t 11. 20 Ka 1117/08/94
BE nVE•RTON OR 97075 EROS $ 64. 00 K5 07/08/94
Phone #: 641 0935 ERPC $ ;::0. 80 Ii,B 07/08/94 -
rontrasctor`: __...__._..___-.._•._.__...._...__... ...__..___._.___...._E:C7F'C' $ 20. 130 KS 0.7/0Q/94
FOUR D CONSTRUCTION
p'O BOX 1577
BEAVE.RTON OR 147075
Ptio 1e ft: 641 0935
3757. 07 TOTAL
:his pereut is Issued subject to the regulations contained 1n the - REQUIRED INSPECTIONS ----
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved p:'os;t /Beam Sti-uct Gas Line Insp
plans. This perett will expire if work is not startad ""thin 180 F'ost/Beam Mec:hatn Insuiastion Insp
da s of issuance or if work is s-spends far a tan . Plm/undslab Insp Gyp Sward Insp
' � ---1!'LM/Underfloor• Rairt dv°. Insp
Permittee 13ignatul es Mechanical Itrsp Wader Line Insp
Plumb Top Out Aprpr/Sdwlk Insp
is,.wed By : / Y ____.__ _ __ F naming Insp Mecl-tanical Firtal
// Call for inspection •- 639--4175
:iE:Wf R CONNECTION
CITY OF TIGARD
F'L RMTT
PERMIT #, . . . , . . : SWR94--•02,44
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/08/'.4
13125 SW Hall Blvd.Tigard,Oregon 97223e8194 (603)836.4171
PARCEL-: iS134AC•—JE01I
S T TF nbDRf_;j3". . . 1 1101.3 SW 111TH F'L.
SUBDIVISION. . . . : JEFFREY ESTATES ZONING: R-4. 5 PD
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :011
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNIT'S. . . .
CLASS OF WORE. . . :NEW DWELLING UNITS. . : 1
YF'E OF USE. . . . . :SF NO. OF BU I LD I NGS: 1
INSTALL T'YPE. . . . :BUGWR IMP'ERV SURFACE. . : : sf
Remar~ks . PATH I
Cawner' __-._.._._.________._____._. ..___._._.____..____.______.__.________.._____ __....-.---__--_— FE LU
' OUR D CONSTRUCTION type amol_int by date r•ecpt
0 BOX 1577 1-'RMT i X200. 00 KS 07/09/94 —
INSF' 4 3 ;. 00 KSS 07/08/94 -
BEAVERTON OR `)7075
'hone #. 641--0935
LONTRACTOR NOT ON FILE
1hone #: 2235. 00 TOTAL
'!eg 0. , :
REQUIRED I NSPECT I ONS
This Ppplicant agrer,s to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. T'1e total amount paid will be forfeited if the
permit expires. T►,e Agency does net guarantee the accuracy of the
side sewer laterals. If the :Ewer ;s not located at the measurement
y,ven, the instaAer shall prospec'. 3 feet in all directions from
the distance gisen. If not so located, the instaler shall purchase
a "Tap ana Side Sewer" Permit and the Aply w 1 Inst teral.
I'er-mittee Signature :
Is�il_ied By
Call for- inspection — 639-4175
IF
s
Residential BuiidinF' ication �1 �.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4771
Jobsite Address:
Office Use Only
Subdivision: �eF-EEVV A�-rfirtES Lot#�l�___ )
Planck/Rec #
Vahiation: 1...> OBJ
Permit# t-T sfN- i7 0'-y�+
Corner Lot? Y 60
^ Reissue of_
Flag Lot? Y (-aJ
Map & TL#
Owner: / �p'� ll_ Co/JId-cYtotJ 41proirals Required
Address: r�O �a X l �7 f Planninc
Engineering -- —
Phone: (�_ 4� - �; Other
Contractor: r�aM L �►' ��=ty�`—'-- Items Required
Address: Subcontractors
Truss Details
Phone _ ---- Other
Contractor's l cense # �:1 -
(attach copy of current Oregon license)
Contact Norge & Phone __!_ )U c�-- F�FNg- ii-,51L -r-
7
r7 yy
Subcontractors:
ArchitectlEngineer: j = k- -•
_
Plumbing: k-}--, -�r.t ,+�41N Lo Address: /0C/o �- c..?, /
MQ r ,Mechanical: __. r~r C..r►. l�� �/ H(2 NC2 ,,,:�Ci✓�RQ C�IZ 9 ,1_006
(attach copy of current OR Contractor's License) phone: (4-1 y
JOB DESCRIPTION: //J U � l �� Z(WAC
Applicant Signature & Phone number
Received by: —_�_ Date Received.
N 1WOMCOMDE"E SAPP
Permit# Account Description Amount / Amt. Pd. Bal. Due
S pc, >Z�
u Z.,v Bldg Permit (BUILD)
Plumb. Permit (PLUMB) �`'-�'d �
Mech. Permit (MECH) 3-p- " _
State Tax (TAX) Z 6 3' 7�
Bldg: 30 0 J
Plumb: r/ ✓/
Mech: U ✓
Plan Check (PLANCK) '10 •7 J %7)
Bldg: S
Plumb: /
Mech: /L,3h ✓
�S-G, - Sewer Connection (SWI-ISA) �leV Vv 2 0e)
Sewer Inspection (SWINSP) �J V 3)
Parks Dev Charg (PKSDC) 5610
Storm Drainage Chg (SDSDC) d ✓ '`�7" w
Residential TIF (TIF-R) -� 3_,
,I
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF.-I) —
Institutional TIF (TIF-IS) �!
Office TIF (TIF-O)
Water Quality (WQUAL.)
Water Quantity (WQUANT)
Fire District (FIRE) r r
Erosion Cntrl Permit (ERPRMT)
J
Erosion Planck/USA (ERPLAN) �.�/
Erosion Planck/COT (EROSN)
TOTALS: �7`�' •h17
® r FOUR D CONS„UCTION CO
1 ® POST OFFICE BOX 1571 ■ ��� �('�
BEAVERTON, OREGON,97075 ■ PHONE(503)641-0935
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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES 155 NORTH FIRST,HILLSBORO,ORV97104
COUNTY, INSPECTION REQUESTS: 503/640-3551/693-4415
OREGON
PHONE: 503/648=876'T
-
NOTICE This permit becomes null and void It the work or construction for which It Is Issued Is not commenced within 1110 days Once construction has started.
the permit becomes null and void If construction Is Interrupted for a period of 190 days 1 certify that the Information presented by the applicant And
his agent or agents In support of this permit Is true and correct to the beat of our knowledge 1 acknowledge that the Building Department'*reliance
upon false and misleading Informallon may Invslldale this permit All provisions of applicable Ishvs and ordinances gnveming the construcllon and use
of this building of structure will be complied with whether or not specified on the plans or noted nn the plans correction sheets. I acknowledge that
the granting of a permit dries not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling tof Inspections at various times during the process of construction and the building
Inspection staff verifying compliance with the various codes Use or occupancy of the building or structure pormltted prlor t0 approval by the
Building Department Is solely at the risk of the Applicant and such use or occupancy Is revocable until all Inspection requirements are satisfied and
approval is given by the Building Official I furthef acknowledge that a lien may be placed on the 11110 of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requlrempr.ta
APPLICC IONATURE
WASHINGTON COUNT`! ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Section P LI CATH O�M
155 North First Avenue, #350-12 1–
A.P
Hillsboro, Oregon 971:4
Information: (503) 640-3470 Fax: (503) 693-4412 Project/Permit
PLEASE' PRI14T Number --
Please • 4. Complete Fee Schedule below
Numbe; of inspections per permll allowed
1. Location of installation
Address Service included: Items Cost(ea.) Sum
//O% � _�1_ 1�{/, //.�TN A ✓� --
Building A. Residential - per unit
City G PA KD suite No. — _ 00 $110.00 —,---- 4
10sq.ft.or less
Tenant Name Each additional 500 sq.ft
(if commercial) or portion thereof --- $25.00 - ---
Limited Energy $25.00 t
Tax Lot Map No. Each Manufa Home or Modular
Dwelling Service or Feeder $68.00 —
Thornas Map Book: Page: Section:__
Directions_ PLA µ 'n Q k3LZ* L T-4*N °ic* B. Services or Feeders
TV ftmaaVR WA Sr d'C /fl - Installation,aiterations or relocation
200 amps or loss $60.00 ----
Commercial ❑ Residential[v}' 201 amps to 400 amps $80 00 2
401 amps to 600 amps _.-- $120.00 _ 2
601 amps to 1000 amps -- $180.00 — 2
2a. Contractor installation only: Over 1000 amps or volts - $34000 2
Electrical Contractor �gBEIQ-TS EL-��GT I C- _ Reconnect only - -- $50.00
Address 57 $9 ,5�.►ti�� `�8 '/— p��'TLRIND
Date 'j-1`L-q3 Job Number C. Temporary Services or Feeders
Property Owner oy0. � � _L _ Installation,alteration or relocation
Contractor's License No. — - $50.00 2
G 200 amps or leas
201 amps to 400 amps $75.00 — 2
Contractor's Board Reg. No. j� 401 amps to 600 amps $100 00 2
�� A Over 600 amps to 1000 volts see"B'above
Signature of Supr. Elec'n s� ' G' �l
License No. Phone No. Z q`I_=7 7�` D. Branch Circuits
Jew,alteration or extension per panel
with
2b. For owner installations: al The fee for branch circuits
purchase of service or feeder
tee.
Phone No Each branch circuit $5 00 —
Print Owner's amc b) The fee for branch circuits without
purchase of service or feeder fee.
toss First branch circuit _ $35.00
ILL ^ State Each add'nl branch circuit $5.00
E. Miscellaneous (Service or Feeder not included)
The installation is being made on property 1 own Each pump or irrigation circle $40.00
which is not intended for sale, lease or rent. Each sign or outline lighting $4000
Signal circuit($)or a limited
Owner s Signature _ energy panel,alteration
or extension $4000
F. Each additional inspection over the allowable
in any of the above
3. Plan Review ri,?ction (if required) PPer er inspection $35 GO
hour $55.00
Please check appropriate Remand enter tee In section 5B In Plant $55.00
4 or more residential units In one structure 1.__
Service over 800 amps; feeder 800 amps or morf, 5. Fees
_System over 600 volts nominal A. Enter total of above fees
__Classified area or structure containing special 5% Surcharge (.05 X total fees) $
occupancy as described in N.E.C. Chapter 5 Subtotal $ —B. Enter 25% of line A for
Submit 2 sets of plans with application where any of the Plan Review if required (Section 3) $ —
above apply. Not required for temporary construction Subtotal $ --
services. Lass Bill, Label Fee $ — —
Balance Due $ .�._.-
/�
For inspections call This permit become%null and void d the work autherltM by the part""Is not commenced
64U'3561 or 693-4415 w"hin 160 days hom date of uauancs of oupar
ch mn or"the wM%suthorlted U
suspended or abandoned at any time ariar work is commenced fir a patted of 160 days.
24-hour recorder, one working day in advance of need rieclrtcalpermit*of#non refundable and non translatable 1194
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUN I'Y, PHONE: 503/640-3470
OREGON ; INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
cl-
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone. 639-4171
Inspection: —
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech, Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-inFI /
Post/3eam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation <�
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: —2, CA �SI Time: AM --PM
Address I I O t ?? \ \ \ —
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
L
-- --- c c. ---�-
Inspec -- — ^ Date:_41-1
APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
^� _Call For Reinsp.