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11755 SW 114TH PLACE G G ul V JJ Vy A 0 t4 _ _ _._ rzf �7 `7 f► >1 r ` y (ci F-1 � (� a lzj tcl) fit. Aj , t I � \ � n t j > nn t � th ►-3 � IY I I,J fit= W s J� Ln i ' I N' In I_n V }J lu r W y V M i 11755 SW 114TH [LACE s City of Tigard INSPECTION REQUEST _ for �PECTION TIME : PERMIT NO. :---- DATE .' O. : --_DATE : DATE ISSUED :Z OWNERS NAME : ADDRESS: ke 7- CONTRACTOR CONTRACTOR TE ST >ir Cj, Water Ill , Visual 0 , Laboratory p RESULT: Apnroved ❑ Disapproved,g" Pending U SKETCH.' �ISPECTOR DATE 50TE Attach supplemental test data heretu� /�, MECHANICAL PERMIT CI OF TIGrARD ! A PERMIT NO. : ME892288 COMMUNITY DEVELOPMENT DEPARTMENT CI TY ` 13125 S W Hall Blvd.P O.Box 23397.Tigard.Oregon 97223.(503)639-4175 TE ISSUED: 10/30/89 -- _—- IM.PMT.N0. 892288 JOB ADDRESS: 11755 SW 114TH PL TAX MAP/LOT SUP: LT: PK: LAND USE: LOT SIZE: WORK CLASS: ALTERATION ITEM: NO: NO: FURNACE (100K AIR HANDLR 00 USE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDLR 10K CONST.TYPE: FLOOR FURNACE EVAP.COOLER OCCUP.GRP• : HEATEk VENT FAN DENT VENT,SYSTEM PLR/COMP 0HP HOOD NO.STORIES: PLR/COMP 3--15HP INCINERATOR(DOM DWFLL.UNITS: PLR/COME' 15-30HP INCINERATOR(COM FL'F.L TYPE WOOD PLR/COMP 30-54HP REPAIR UNITS MAX. INPUT PLR/COMP 50+14p OTHER FIRE DMF'RS ) 1 GAS PIPING OUTLETS HIGH PRESS? REMARKS: Install wood stove - owner to do work. wFurne'r K>aul FEES: - -------------------- PERMIT $10.00 N 11755 SW 114;,h PL FLAN REVIEW R Tigard OR 97223 FIXTURES PHONE (563) 684-9170 STATE TAX $-73 —----- —- - --- -- OTHER c 0 N T R A C T R 1 TOTAL: $15.23 This pq►mlt is Issued subject to the regulations contained in Title 14 RECEIPT NO. of the TMC. State of Oregon Specialty Codes.toning regulations and all other applicable codes and ordinances, and It Is hereby REQUIRED INSPECTIONS agreed that the work will be done In accordance with the plans and FINAL specifications and in compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city ! business tax permits This permit will expire and become null and void If work is not startee vithin 18o days,or If work Is suspended or 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 and approved. Pe mittee Signature Issued By --- FOR_.L1dSf�ECIU]N-615.- 175 SEPARATE PERMI i REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE 1 I City of Tigard i INSPECTION REQUEST for I INSPECTION TIME : `�% �� PERMIT NO. . . I DATE.* Z-Q1 DATE ISSUED'__/_ Z 6 OWNERS NAME I ADDRESS : ITES Y k r .3, 'Wnter L"] , lli:+,'wf u , Ln RESULT: Approved n Discpprover+ 1 -:ndimg SKETCH: e—, o7— 8 INSPECTO DATE [OTE: Attooh eupplemen',ol teat ,iota hereto 1 City of T:gord i INSPECTION REQUEST for INSPECTION TIME ' PERMIT DATE: 1/22 DATE ISSUED :___ . OWNERS NAME : ���6-CoyS ADDRESS: -- C ON'TRACTOR : T E S T ' ` 0,3r�d , V:su a!,(] , Laboratory I7 RESULT : 4p -roved k4 , )!<wpp�oved ii Pending O SKETCH.' s o7 INSPECTnR DATE NOTE: Attoot; supplemental test data beret r PLUM3IYO T �APPLI�"=�ONJurisdiction of 1, _ T}rpe of Fixture Fee Permit No. 3; Permit fee _ Water Closets Toilets• Permit Issue -s-� Bath Tubs Approved by LavatorrWas 3asin Building Perm Shower Receipt No. yfr&S! b. rx s I)1ohwas ing 'in s Kitchen in .s Ordinary Loc tion of Building nnks�ar r - _ - — .__ Sinks. Slo119w Au+ oma ciI5 shwasher -. Uiscsa � Laundry Trays Name & Address r.i Drain" Floor _� 'j� Drains. Area rdir�a.� 170—r00 o Rhin Drains r -" Automat1c Washer Nam h Adrress of P umber _ Fountains, Drinking. ri ��� as ` ountains � Hot Water an - orw' MA water Service Size _ - L".L,` Urinals Building Old or New', ( ter, Repair or qa h- asins -Yard ' -" Lawn r�i�k "System - - �P 171:mm_Ing_000l Fier --- —sprrikler mem w This permit becomes null and void if work or constructicti authorized is not commenced within 6.0 days,, or if construction or work is suspended or abandoned for a period of 120 days at any time after work is c -,mmenced, All plumbing firms must be lirer.sed by the City of Tigard and post a $1,000 bond I hereby certify that I have read and examined this application and know the sea to be true and correct. All provisions of laws and ordinances governing this ty of work will be complied with whether, specified herein cr not, the granting of a per-nit does not presume to give authority to violate or cancel the provisions of any other rotate or local law regulating construc-;ion cr the performance of construction, ignature of Applicant �1 a City )f T ; Bard INSPECTION REQUEST for gIX NSPECTiON TIME : &--ZT_L,7E PERMIT NO . . . DATE OATE ISSUED-_ Z OWNERS NAME ' ADDRESS ' / -S a C-)N1 R A C T 0 R :.�_ - --- ------ — -- i FS l J . water �� , w� Ln - re, RESULT Apprv�ed L7 -Ji: rpprorelll)e SKETH: ct i i I IS-PECTOR DATE IL' -17E : Attach supplemental !e•st ., o- rereto I PLUMBING PEkMIT APPLICATION Jurisdiction of No. Type �f Fixture Fee Permit No. 73 1 7o lD Permit fee OLI—W, ater Closets Tcllets Permit Issueed ?4 Bath Tubs Approved by _ Lavatory (Wash Basin_ Building Permit � Shower Receipt No. � in Dishwashin S.r.nks. Kitchen Sink_; , Grdina_y Location of Building // 7S5 SyU . 1A Aut(.mati.c 01s washer Laundry lrav�; Name & Address of Owner, _Atta s Dr,a-, ns , Floor Dra:.n:i Ares: _ I Aut,,mat:. _ Washer Na c " idress of umber nunLa.i rl.>,, t'1 rl 1 n�, �.� +l� t 44,/r Fountains. Soda �r� /A/4 / I Hat WatE::77k �__,C�'!'-`��X� •, �._ 5'�/�€ WatF'r SerV.i^e ' :CJl7e Building 'old �r New Alter, Repair or t F-�s: :s - at i S Ea Tm� -- _ chis permi � c -mei null and void if work cr constructi:n auth;)rized is not ,cmmen^.d w: ,"t�:n 60 days, or if construction or work is suspendecr car abandoned .:f 1,�G dayo at any time after work is c,_mmenrt4r?" All plumbing farms must be licensed by the City of Tigard and post a $1,000 bond, I hereby certify that I have --ad and examined this application and knew the same to be hut- and rjrrec,t. All provisions of lows and ordinances g-verning this type .;f work wi1j be :,_mpl ied with whether specified herein c r not, the granting of a permi. t. dues ii�.t presume to give authorityto violate t r cancel the provisi.ns of any ether iiAte _ r local law regulating construction •-r the performance c,f �ons true ti,. n. Signa �cf A .� :-. t gn �� an E UNIFIED SEWERAGE AGENCY NO. _ 4876 __ WASHINGTON COUNTY DATF CITY OF—-.----------Turd --– APPLICATION FOR SEWER CONNECTION PERMIT OWNER: -- llui_AoupLl -- __ OWNER'S ADDRESS:__ STREET Bg[I1 T $TAT ZIP BUILDING SITE: LOT 8 BLOCK- —_ ADDITION U4thFlaae TAX LOT NO. — TYPE OF OCCUPANCY_ .R!iaidenee ADDRESS 11755 S.M. 114th Plaae __. DWELLING UNITS___._—._1____ FIXTURE UNITS_________-�_� EUMCHARGE IF APPLICABLE PERMIT FEE—44--.r INSPECTION FEE TOTAL DEPO`'ITED EWI (EXISTING) BUILDING SEWER SYSTEM —_Tlaud_ The Applicant agrees to comply with all rules and r tions of the Unified Sewerage Agency. APPLICANT _. C7 �'Z��_ SEWER PERMIT THIS HERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM LINT SIZE -------4n---- INSTALLER RECEIVED BY- ��--- -- - -- N 0 ITe AOeNTI I COMMENTS T - Tj/G7 icuex h This Application and permit expires in ninety (90) days. The amount paid will be forfeited l should expiration occur. I EXHIBIT "A" CITY OF TICARD Residential Structure Occupancy Restriction KNOW ALL MEN BY THESE PRESENTS, That occupancy of residential structure (s) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the Deet Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: DESCRIPTION OF PROPERTY: Tan Map Lil 341)C, 10% 0 ADDRESS OF PROPERTY: —OvIiew. NAME OF OWNER: ADDRESS OF OWNER: IN WITNESS WHEREOF, the undersigned has mused this restriction to be executed thi; 231-rd � day of 19-43 OWNER: Name APPROVED: By: T.tle Building Official City of Tigard STATE OF OREGON ) as. Cointy of Washington ) , 19, Persone,ll.; -ippeared before me the above named _ and acknowledged the foregoing instrument to be v01ui-ary 9ct and deed. Notary Public for Oregon My Comm'nsion Expires: _ I CITY OF TKGZARD 11440 S. W. Mein SI so! TIGARD, ORIGON 1744 APPLICATION FOR BUILDING PERMIT New Construction xa Demolish ❑ Addition ❑ Remodel ❑ :Hove❑ ZONING ii-j DATE ISSUED 7- 3-73 BUILDING PERMIT DATE RECEIVED BUILDING FEE $ INo-73 -IJG7 �_?�'�j — ( .JG BY PLAN CHECK $ ---- --- OTHER $ 10.UY) VALUATION $ 1jp3.� TOTAL $ �1._ix� RECEIPT No. TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT p 13 MAP p 1:,1 j4DC CENSUS TRACT W-1. JOB p Architect or Engineer 3 (telaVin Address­_------- -----Phone— Owner Phone_Owner Ron Dot.iula_•, Address r)�21 S.W. Barbur Blvd.) Portland, Oregon Phone Builder Address _ __Phone____ _ BUILDING USE Sinr,le Res. ❑ Multi Res. ❑ Comm. ❑ Industrial❑ OCCUPANCY GROUP i No. of Stories 1 Total. Ileiyht Li Area c Lot '3500 Type of ConstrLction XWJ*fF V Floor Area B___---Set Backs:Backs: Front Back - _ L.Side__�y- R.Side_�_f�� Private Sewer Pipe Size-4"_- ^— Sewer .�aT Baru Septic Tank ❑ Water Service Pipe Size�/4_ Storm Sewer © Ditch ❑ Drywel l ❑ Street and Curb Requirements &4 A0 Driveway Widtt LuI No. of Parking Spices` _ SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMHIN! SPECIAL INFORMATION ADDRESS ASSIGNED FIELD CHECK B'-'—`� ---h'NC_—_ __— _____--_—DATE 7-23-73 PERMIT APPROVED BY It is underecood that all work will conform with applicable codes and ordinances of the State of Oregon and the City of Tigard, Oregon, and that the building will not be occupied until a Certi'-irate of Oc ncy hagA, n tae ed by the ::ity of � C Tigard Building Inspector. . gnature of Applidgnt� - __Y fit! • 13800 ' EXHIBIT "A" CITY OF TIGARD Residential Structure occupancy Restriction KNOW ALL MN BY THESE PRESENTS, That occupancy of residential structure (a) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the Dee6 Records ,. of Washington County, Oregon, is probibited by the ordinance of the M rr', City of TiSard, Rkegon: r DESCRIPTION OF PROPERTY: v Tax Map 131 34DC, lot 5 ADDRESS OF PHOPEHTY: 117511 3-W. 114th Place NAME; OF OWNER: Ronalu Douu.la; ADDRESS OF OWNER: 8921 A.W. Hprhur Blvd. IN WITNESS WHEREOF, the undersigned han caused this restriction to be executed this, _ day of r„1y 19 . OWNER: ill^.s/ Name APPROVED: by: _ T.tle /,_ / I.k By: B��dinfTtcU�C � .....�` y ;....R'�MI eml Mod City of Tigard WM” STATE OF ORYGON County of Washington Personal.iv •%ppeared before me the nbove named -5 _ and a.knowleuRett the fr r,gr�ing instrument to be (�s voles ,.ary n,:t and need. Notary Public for Oregon My Comm'r,alon Tree: s1�L�= do�� 038 1AL:545 Z p3 d di t o o fi \G I� C�o-1 93 _s s'7 4 i City of Tigard INSPECTION REQUEST for INSPECTION TIME . 7S PERMIT RSO. ._ DATE: 7 f / DATE ISSUED :__J OWNERS NAME : � `' -- ADDRESS: - B /175 x. 11 CONTRACTOR TEST : Alr LI . Water[] , Visual K, Laboratory D RESULT : Approved , Disapproved D , pending L] SKETCH: INSPECTOR DATE COTE /Attach supplemental test data beret a] I r 1 i 1 City of Tigard INSPECTION REQUEST for INSPECTION Tlf.,IE: -L00 PERMI r NO. : -- DATE. �L '` DATE ISSUED : i OWNERS NAME .' A D D R E S S: _1L C 0 N T R A C TOREST : Aif U, W,,terp , V;suai , Laboratory r:] RESULT: Ap-,roved. , :)iaupproved G Pendioq [� SKETCH'. I SPECTOR DATE NOTE: Attach supplemental to-it data berel01 Oar . Addre88_(f 55����, 11t�N• ���`� Permit No. -------- Permit r,h a r g e Owner ��p^ �� �. Connection fee Paid by —L01 ( J Type of building Date connected Service rate a,� InspActijn fes of-� �', Contractor 1=� �� �, ""-- paid by �-..� d a t e Size of connection ��� Assessment paid 110 8521 S. W. BARBUR BLVD. PORTLAND, OREGON 97219 ............., N N x .�h CITY OF' TIGARD MECHANICAL PERMIT Receipt#_�_ 13125 SW HALL BLVD. Permit # ,--S P. O. BOX 23397 Description TIGARD, OR 97223 Table.3AMechanicalCode QTY PRICE AMY (5 03)63 9-41 75 1) Perri!;t l=ee -0- -0- 10.00 f— Name of Development 2) Supplemental Permit 3.00 Jobfe: — Furnace to 100,000 BTU Address 1) inct.ducts&vents _ 6.00 Tax Lot �! Map No. 2) Furnace 100,000 BTU 1 7.50 incl.ducts&vents Lot Block Subdivision — — — -- - Name(or name of business) 3) Floor Furnace 6.00 -, incl.vent Mailing Address Phone 4) Suspended heater,wall ht .ier 6.00 Owner (1 -1 -/ ( I I �f, ���7O or fluor mounted heater—„ City/State Zip I 5) Vent not incl.in 3.00 Tl(*w S) Com'- -1-7 2.2 appliance permit _ - Name(or name of business) 6) Repair o1 heating,refr ig., 6.00 cooling,absorption unit _ Mailing Address Phone 7) Boiler or comp to 3 HP _ 6.00 — Occupant absorp.unit to 100,000 BTU City/Slate Zip8) Boiler or comp to 3 HP-15 HP absorp.unit to 500,000 BTU _ 11.00 -- Name 9) Boiler or comp 15.30 HP 15.00 absorp,unit 112-1 million Mailing Address `J Phone 10) Boiler or comp to 30-50 HP 22.50 - _ absorp.unit 1 -1.75 million Contractor City/St ac zip 11) Boiler or comp to 50 HP 31.50 absorp.unit 1,750,000 BTU Slate Registration No. City Bu:, Ta.No 12) Air handling unit to 4.50 10,000 CFM 13 Air handling unit 7.50 1 hereby acknowledge that I have read this application that the information given is ) 10,000CFM + correct,that 1 am the owner or authorized agent of the owner,that plans submitted are in -- compliance with Stair taws,that 1 am registered with the Stale Builders'Board,that the 14) Non portable 4.50 number given is cowcl.(It exempt from State registration please give tea:on below). evaporate Cooler 15) Vent tan connecic-J 3.00 to a single duct --— _—i- 16) Ventilation system not 4.50 _ included in appliance permit �� �/, ---- _- --- ----- 17) HmI served by 4.50 mechanical exhaust Signature(crAmer or a3en1) Date 18) Domestic type 7.50 Describe work ❑ addition ❑ alteration [] repair ❑ incinerator _ to be done _,residential ❑ non-residential O 1 g) Commercial or industrial 30.00 Existing u.3e of type incinerator -v building or properly 20) Other i.e.,woodstove,water i 4.50 heater,solar,clothes dryers,etc. Proposed a se of _ building or property—__ — 21) Gas piping one to lour outlets 2.00 Type of fuel- oil O natural gas U LPG ❑ electric 0 22) More than 4-per outlet NOTICE ----- i sur 'TAI. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON --- -- - - J '- STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCN_. uE DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUES-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -- WORK IS COMMENCED. TOTAL special Conditions --- ---- -- Dale issued. - - by