12740 SW 111TH DRIVE 12740 SW 111TH DRIVE
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23W7
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection01
--
Date Requested ~ 2 TimeA.M.__P.M.
Address _ �
�7 7 10 _43z")/ r*e Permit
—
Owner _ ___ Lot
Builder Ally, -- —
The following Building Code deficiencies are required to be corrected:
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L1-6�Lvk _
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Presented to oved
Inspector ,, ❑ Disapproved
Date Y
CALL FOR REINSPECTION
❑ YES [._ NO
- 811,L.U:INC• PF-I-.?Ml, T
CITY OFT167ARD h�� PERM11' No . BLA381'36�?
C11'YOFTWARD VATE 0/ 1.6/88
COMMUNITY DEVELOPMENT DEPARTMENT PP:rM . PM*T.No . 11301.562
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223,(503)639-4115
ADOPE:SS : tV.7,40 5W 1.1.1-T-1-4 PL.
AX MAP/I 0T 51JU.- WILDEPNEESS I T : BK :
LAND USE :
LOT STZE . V A. L.UATION: 16 21 000 SE THACKrii
F'PONT : PEA174: f)
WORK CLA55'5 ' ADDIT':rON DWELL IJN:LT!5 : 1-11H "T-. 9 Ricw: -10
1-115E: 'IYI:'E: : STNC•;L.E FAMILY NO, UL UP(: OMS ! E-XI WAL L CONST :
GLIINST . Vy'PI::, : VN NCY BATHS : N G : E' : W
OCCUP . GFM PROT - UPENINGC5 .
C)CCUP.LAJAD N S
TOTAL APEEA : 5:31
N0 . STOPlES : 1 1.ST P(J0F C(JNST : (:
".:!N1:) ARFL--A SEPAR7 PATLO:
HASEMIEN I"? 3PD : C)CCLIF"- 5EPAP? PATEM:
MIEZZANXISIE:7 13A!A-:M'1*
I';i-ow7 I.-OAD: 40 C-,A R A G F. SPAKI-141? AL.APM'?
F1 0W(GPM) t)e:'rEC;T'?
IAEAT TYPE : 111.)CV-1 . ACCESS?
WLAW L'14�11`14 6Y .
PIEMARK!5 :
I-'4E:r.551.1E CIF NC.).
LAST RE.15SUE
PPI'-'E:N DAN PERM V 1111111.5 12...150
0 .1-2740 .,W 11.1th P:1 PI AN PF-.:V1VW $99. 1:5
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E ':i'T'A*T'E: I AX
R 11117 .
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C HAX TAiiAl
:)AV T D SEXII( S 1*01-1m)
0 PAPPUT T M(')LIN'IAJ.N CC)N%'j'N11C,"1J.0N SOC.,115TRIE14:1,11
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A PHONE.'. 1503) 60-3-6963
C
T PL11;.1STPA1A'('.)N NO . 22318 1*01 OIL: *160 . 13
0
PF.,(A—:JPT Ps 0— 00 3 1
This permit is issued Subject to the regulations contained in Titic. 14
of the TMC. State of Oregon Specialty Codes. zoning regulations
and all other applicable codes and ordinances. and it is hereby
agreed that the work will be done in accordance with the plans and
specifications And in compliance with all applicable codes and t:PAM I.NG
ordinances The issuance of this permit does not waive restrictive T INIGULA T*.r(1N
covenants Contractor and subcontractors shall have current city (110yp . DOARI)
business tax permits This permit will expire and become null and
void if work is not started within 180 ujys.or if work is suspended or I- MAL
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested a approved
Permittee Signature %J
- i.12)e .()I I F C)I,' I I`4SPr-:r: I I (IN 639-4111.73
Issued By . -- f—) ---
SEPARATE PERMITS REQUIRED FOR WORK OTHER THA14 DESCRIBED ABOVE
um
- - #
� � 18'
CITY OF TIGA RD m-OFnc�aRn PLAN CHECK PLAN CHECK APPLICATION
Sc� - /y
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW wj B". P.O.BOX 23-�g7,T-Vwd,Oregon 97M(503)639-4175 cOREGON PERMIT # K # ( S(o Z_
DATE ISSUED
JOB ADDRESS: TAX MAP/LOT -
SUB; , Gt�n << L01 : _ $(L CL LAND USE:
VALUATION:
OWNER — :;,nECIAI_ NOTES
NAME: f�-)ez.N �C:,V� _ REISSUE OF:
ADDRESS: _('Z-7,Y 0 .C, //(' LAST REISSUE: —
'� FLOOD PLAIN/ ^—
SENSITIVE LAND:
PHONE:
APPROVALS REQUIRED_
CONTRACTOR PLANNING: _
NAME: -� �c- !" col,II c� / _ ENGINEERING: __—
ADDRESS: /&,z(.�U c L� c FIRE DEPT -W
��L.c.•.-�rc��—�"�1Z ------- — OTHER: —.�_—.------ --
PHONE: ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER (( BUS TAX:
NAME: CALCULATIONS:
ADDRESS: E t:- > �� -- TRUSS DETAILS -
- t!x < - ^-.�`s ---- PARKING PLAN:
_-- LANDSCAPE PLAN - — -- __
PHONE: 4 I _ C/C OTHER: -- -
i3OMMI"NTS:
PLRM11 # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
�) l 10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees -
10--230 01 State Building Tax (5%)
Building
Plumbing
Mech /
10-433 00 Plans Check Fee
Building TY.L� _
Plumbing
Mech
30-.-202 00 Sewer Connection
30--444 00 Sewer Inspection _
51--448 00 Street System Dev Charge (SDG) —
52-•449 01 Parks I System Dev Charge (PDC)
52--449 02 Parks II System Dev Charge (PDC)
11--450 00 Storm Drainage Syst Dev Chr•g (SSDC)
10--230 09 TRFD
10-230 06 Washington County Fire #1 (95X) — —�
10--220 00 Amar•t/Wedgewood
TOTRSCA# Z004
APPLICANT SIGNATU
R
E
Received By: J ` („)—�� —
ht/3587P/18P Date Received:
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
fol owing item(s) rt squire correcting:
L, dL4�
s
v
Date:4Z -�-�:-�' _ - Permit No.
Inspect/"' -
CALL FOR REINSPECTION
KWUNUM
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
- L- en C' LzJ�.Li7�F
- L/ � �F ��'�L��t ,�. _ .,,etc. •C��� �_'r�3�-1
Date: �'- -"s-�' Permit No.
Inspect4
CALL FOR REINSPECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting: TW
pc. . A-& BINS -r AIN l y .
�-os'1 -
k-
Date: / !:c'-7f _ Permit No.
InspectcSGe�_ - __-
CALL FOR REINSPECTION
City, of Tigard Mechanical Permit N° Per mit_ S3.Oo
( Fee Q�
New Installation Replace ❑ Relocation ❑ Addition ❑ Alteration ❑ 47.State_
TOTAL
HLATING
CONTRACTOR �Uitg!4.� OWNER �&&L "LI"✓IJ(L �a�T1¢a+ci`1
A��DRES,!�a_�1:! °-41sT �l�t A �_;�^ WORK ADDRESS -
PHONE (c'�(c – �+32,(ie_ _ APPLICANTS '
Haat Input Rating (BTU Per r) I&Y1 r�r Vent Size —� Flue Size
FUEL OIL C] GAS Ifs ELECT ❑ OTHER
I
ITLM NO. FEE ITEM NO. FEE
For Issuance of Permit EE ABOVE _Air Condition Compressor 15 to 30 HP 10.00_ 14,?
New -up to & inc1.100s000 BTU _ 4.00 Air Handling 10,000 CFM 3.00Ix
Flew_I00,001 BTU s d over 5,00 Air Handling Over 10_000 CFM 5.00
Floor Furnaco4.00 Evaporative Cooler 3.00 };`'
_Walt • Floor -�Suspanded 4,00 Range Vent Fan –` 2.00 :
Instill Vents Only 2.4 _ Vent System_ _ _ _ 3.00 {{
Repair• Heat K Cooling4.00_ _Hood Commercial — _ 3.00
Air Condition Compressor Under 3__HP 4.00_ Commercial Duct System _ 10,00 "
,Air Condition Compressor 3 to 15 HP 7.50 r
INSPECT'OR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY _ DATE ISSUED 4Y DATE --
RECEIPT
TE_RECEIPT NO.
114 Signature of App!' ant �iL"�p –
i
E
i
-+a'f`t-.cro^i Ntf'1/'ry T6'�'F�F�I"�''!'•_' ny•-p>3f'lir--v-p1►7lI4MN�{���Iy�AI�'H'°'7n't-w•-r....^.--•..�....,--„-----�T �'^r*1
N? 2
BUILDING PERMIT APPLICATION CIT TIGARD DACE - t9 7C�
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
I OR AS SHOWN FIND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNERPHONE
I LOT NO.- 1. erngr,
':
OWNER jam Go t.t ur '%'.'.0 I3t•1 JOB ADDRESS 12740 SU 111th Irl• HOME ADDRESS �! _
ARCHITECT
ENGINEER
BUILDER £3 Pa 611 t4 ADDRESS 1263 ' SU Beef fiend lid. DESIGNER
STRUCTURE ❑'NEW ❑REM(1DEL ❑ADDITION OREPAIR _ ❑RENEWAL [:]FIRE DAMAGE ❑DEMOLITION
❑RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO []CARPORT ❑GARAGE ❑STORAGE❑SLAB LJFENCF
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPFIOVED [:]SIGNS
OCCUPANCY +��”'LAND USE ZONE___'_4 BLDG.TYPE_ `DN FIRE ZONE PLAN CHECK BY fJfxJf' _ HEAT t___
l'onatruct eifigle family dwelliny wfatteched garayfr. 3 Budroums UaLhs.
,EC r.ORPECTION SNE ET ATTACHt*D.
",ewcr L�a�xmxt ,. 203u9 - %70,:1.0(,
t,0 i1 1 1,,91 s X49 frClll.
�C Q FLOOR LOAD 4._.��E1CiN.s_._ ___.._— .IQBIE$_�_ — N_Q.HEPRQQMS
BUILDING DEPARTMENT SET BACKS FRONT '0 REAR 6"� LEFT SIDE }� _RIGHT SIDE
Permit\ �i1ks7.00 —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Chea. 93• !J0 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
NORK WILL BE DONE IN ACCORDANCE WI TH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal 2600 bO ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax'k ?• �� LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total -?.9t3 a )C - t 400.Un
PDC 1 9,100.00
ev rel `, ------- -- --- --
,� APPLICANT OR AGENT
Approved �`� Rerelht No 411139
i�
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
7�� 00�I - Contractor - -
���q ZSr (Y&,L � Permit Nobut .
Fixture
901.2 /11 r4 O ----- --- Final _ --
1_ HEATING
Contractor
clf/f-s�Oita—14t
ra mit No,
,p Gas or Oil
.I-G- S- Ole /t/se./s Tie.., { -
0,.vrNa c " O I� _-- Nough-in
3� O BL !� ----_ - Final ---
w SEWER L
Final,�_/y_ LO O/C /s L//
DRIVEWAY
Final
Stom Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TtMPORARY J CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY —
M4' Landscaping
Zoning Final
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BUILDING PERMIT APPLICATION SOFIC,�,RD DATE_ .,9�._ No 213E?
THE LINDE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE OJ92j_92__
UR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICAT IONS OWNER PIioNE_
(�
/s ^ LOT NO
cR SO*% GC
O J4lr O If
JOB ADDRESS I M�] 4 0 s_1s1, 1114 HOME ADDRESS f266j6: jrr—A�.�( air, �L -A
ARCHITECT ' ''
'^ �n ENGINEER
DER !_SSM C. ADDRESS{, 160J �' 1CLT DESIGNER
UCTURE—XNEW nn0I,,EMODEL_ ❑ADDITION ❑REPAIR `-ORENEWAL ❑FIRE DAMAGE CIDEMOLITION
F.SIOfNC ❑COMM LJEDUCATIONAL DGOV'T ❑RELI�IOUSOI'ATIO ❑CARPORT ❑GARAGE ❑STORAGE�SLAB ❑FENCE
k �3HOND ❑MOVING ❑CONDITIONAL USE ODLSIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
k ..CU,PANCY R�_LAND USE ZONE. R-*.-_—BLDG.TYPE—6iL _FIRE ZONF3— PLAN CHECK BY��—+� — HEAT
:::4-LQ-sp—.—1-LQDRJ.QBD�_A_----_HEIGHT --_t4.Q._IlQLIE;z_sA�EA !YSZ @E12RD�M5�S VALIIF `Op
rBUILDING DEPARTMENT SET BACKS FRONT��JQ REAR (,S LEFT SIDE RIGHT SIDE S
� i Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check �0 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN�;OMPLIANCE WITH
Subtotal ♦�d� ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATINcs.
Total — B
BV
----- - --- - -- APPI iCANT OP AGF NT -- - -
Approved J� Receipt No Sw
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—'� ADVAt 55 PHON
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too Red 'q-IL
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Sty
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1703,
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