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11775 SW 114TH PLACE-1 11775 SW 114TH PLACE r � m cn ,e d O r o rU C r O cr I\ W � H � J nl \\ Rol r' to w cy c m w w r rn tilt r � Ip CL tr) ANN rn H • t Ln M ^ k INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 v WM Type of Inspection ---- - Date Requested /0 .r---- Time A.M. P.M. Address 7 7-� l _. Permit #� _— Owner CC[l( � "4 t' Lot # _ Builder,f',r(lC�'�, J4S - The following Building Code deficiencies are required to be corrected: Presented to - r i Approved Inspector --.--_-- Disapproved Date _— CALL FOR REINSPECTION 0 YES [A NO t L;I I Y cal- I IUAHL ' MECHANICAL PERMIT = Permit it s- Description Table 3A Mechanical Code QTY PnICE AMT City of Tigard 1) Permit Fee -0- ^0_ 10.00 13125 S.W. Hall Blvd. - ---- P.O. Box 23397 2) Supplemental Permit 3.00 Tigard, OR 97223 — 639-4175 1) Furnace to 100,000 BTU 6.00 incl.ducts&Wr nts 2) Furnace 10O,OOu BTU i 7.50 _incl.ducts&vents __--- Floor Furnace 6.00 Name of Development 3) incl.vent Suspended heater,wall heater 6.00 Job Address _ 4) or floor mounted heater __-_..1 Address 1\l i I c-;` `_7l-'� \A ��-�L� Vent not incl.in Tax l-ol Map No. 5) 3.00 — _ __ Lot Block Subdivision appliance oorm,t 6.OU _Repair of heating,refs ig., Name(or name of business) 6) ^— 11`` ,, ..kkcooling,absorption ung: & t t,1: Mailing Address P1OfQ 7) Boiler or comp to 3 HP 6.00 Owner (,-"2,C: absorp.unit to 100,000 BTU �_,�. _ �1(< ._� ---- - - Boiler or comp to 3 HP-15 HP 11.00 C city/stele Zip 8) absorp,unit to 500,000 BTU -_ T kC�v�I� 7__Z___Z1 Boiler or comp 15-30 HP 15.00 Nacos 9) absorp.unit 1/2-1 million r� ' Buller or comp to 3 J-50 HP 22.50 MaiYntt Address Phart• 10) absorp.unit 1-1.75 million ContractorBoiler or rrr,t,to 5C HP $1.50 cnyrstafe ZIP 11) absorp.unit 1,750,000 BTU - i Bus rax W 12 Air handling unit to 4.50 c Stale Registratkxl No h ) 10,000 CFM 13) Air handling unit 7.50 I hereby acknowllldge that I have rt-ed #w; a(1p11GIthy1 that the information(tIV11n 15 1 0,000 CFM + _- cooed.that;am It*owner or a,at.wizod agent of the~w Rr,that plant,submitted art-In Non rtable norry>lia ve with state I.ws,that I am registered with the State Hullers'FToard,that the 14) Ito 4.50 number given is acral (II exempt Iron+state regrstrat"'please give reawi below) — evaporate Cooler - - -.v �,. - r L�__ 15) Vent tan connected 300 y- - to_a_single duct -t 6) Ventilation system not 4.50 included in appliance permit _ _- - Hand served by =4.50 1�)- mechanical exhaust ne - - lo1 A) Domea'IC type 7 50 incinerator Describe work 17 addition ❑ alteration AZ repair [-I-residential-n - to be done residential noCommercial or industrial non 19) 30.00 - -. _ _-- - - type Incinerator Existing use at Other Le„woodstove,water - 4.50 building of properly- - 20) heater,solar,clothes dryers,etc. a Proposed use of 2.00 building or property _-W -- --- 21) Gas wiping one to tali,outlets Type of fuel- oil I ? natural gas 11 LPG F', rlertric Fl - 22) More than 4-per outlet N_OTIr - SLiF1-1OTA1 THIS PERMIT BECOMES NULL AND VOID if WUiJK Uli ta_ll4 Iai7_5 n SURCHAaCESTRUCTION AUTHC IZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER TOTAI ,S WORK IS COMMENCED. -- - Special Conditions _-_�- 11NIr- is�urr<t t» INSPECTION NOTICE City of Tigard Building Department 12420 S.W. Main St. Tigard, Oregon 97223 Phone 639-4171 Permit # Type of Inspection ----- -� The follcwing Building Code deficiencies are required to be corrected:-:Z Presented to__---.. . - ---------.--—_-_--.— — Inspector --- Date ----- GArL-�L FOR RE11VTECTION W YE'.S ❑ NO BUILDING PERMITAPPL,'CATION TIGARD DATE ' to THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE OWNERBrian & Donna MOOJWADDRESS III il4th Place L.OTNO._9 ._ —_— ARCHITECT - - ENGINEER BUILDER Cl aSsiC Hams Improv- ADDRESS12335 SU Ann Court DESIGNER STRUCTURE ❑ NEW ❑ REMODEL ❑ ADDITION 0 REPAIR C RENEWAL ❑ FIRE DAMAGE E] DEMOLITION a RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO_❑ CARPORT i-' GAHAGE ❑ STORAGE ❑ SLAB❑ FE14CE OCCUPANCY R LAND USE ZONE B"`7 BLDG.TYPE _Sn�FIREZUNE_ PLAN CHECK BY dWlt HEAT�_ 83__` Cu trust family room & kitchen addition to existi_ngsingle family dueliing.. SEE C09RECTION SHEET ATTACHED, SEWER PERMIT# OCC.LOAD FLOOR LOAD 40 HEIGHT 1:3 NO.STORIES I AREA j 6 -1 NO.BEDROOMS --VALUE413, BUILDING DEPARTMEN- SETBACKS FRONT _REAR _^LEFT SIDE'S% RIGHT SIDE 18 Permit x"68.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE Plan Check 34,100 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE C7 �0 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE Subtotal • RESTRICTIVE COVENANT;. CONTRACTOR AND SUB CONTRACTORS rO HAVE CURRENT CITY BUSINESS LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLU BING AND HEATING. State Tax 4" 2..7?. f" • � , Total �104.72 SDC— f / —� PDC# .44PPPLICANT OR A_GA By al �~ A p . b'�S� /f`/-,;, � :- , c Approved duh Receipt NoI i�:'��r'!/ ! 3 �_'• �_ A DRE 8 PHONE DATE INSP. TYPE INSPECTION REMARKS I � . _ PLUMBING DATE I^fi\ -_�__� Contractor Own Q r—. f� rl r Permit No. 27361 �.,�Z /D•3 -QU — '-/� Fixture _ ----- -- - - Final _ HEATING Contractor a _ Permit No. Gas or Oil Rough-in —— Final �— SEWER Final — DRIVEWAY Final -- Storm Drainage (Rain Drain)Final Sidewalk -- __ Curb&Street Final Approach — BLDG. DEPT. FINAL TEMPORARY C :RTIFICATE OCCUPANCY — CERTIFICATE OCCUPANCY Final Landscap{ng Zoning Final BUILDING PERMIT APPLICATION TIGARD DarE� �� t9�0 3113 THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN IN ICATED BUIMER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER, �Q raj 1, ' _�L _ LOT NO. �: -- E:''�^pty� / ' Db Ng,1�0 4 ADDRESS �I ' /,�j SK/ I I' I. se) ARCHITECT �� Qp v�� ___ lii .23��_ ENGINEER BUILDEE(ak I' _ #ne�� ORESS Iy„ .� DESIGNER STRUCTURE [] NELV ❑ REMODELAO __ ' -j REPAIR C1 RENEWAL 13 FIREDAMAGE C7 DEMOLITION RESIDENCE C C0�11A ❑ EDUCATIONAL GOVT ❑ RELIGIOUS C1 PATIO 0 CARPORT 171 GARAGE ❑ STORAGE ❑ SLAEL) FENCE O:.G:irANCY USE ZONE '+`BLDG.TYPE -. _-FIREZONE_- - PLAN CHECK BY HEAT_ _ --- �ls����1 �Qo�► -- -fit U'�'�� -��[ri"� . �k g `' � �,°1 SEWER PERMIT q --- OCC.LOAC FLOOR LOAD / HEIGHT �,3 NO.STORIES V __ _ / AREA 2W NO.BEDROOMS VA.LU" ^�BUIL01NG DEPARTMENT V SET BACKS FRONT REAR LEFT SICE RIGHT SIDE / Permit - G�'d-_. THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOWNC; Plan Check 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 COMPLIANCt- WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WA V_ ISutYtatal X02. OO RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TU HAVE CURRENT CITY BU3INESE State Tax • 2 ,7 z LICENSE.SEPARATE PEt,MITS REQUIRED FOR SEWER,PLUMPING AND HEATING. Total — PDCM By APPLICANT OR AGENT Receipt Na. Approved ADDRESS -- PHONE 0C — DC — S � Z9 x G = .2y7 EWER CONNECTION S 2 >< q = /e EWER INSPECTION S 2GS 33.40 ; 25,0.3`/ EWER SURCHARGE S n14- 4f 6-yq / 3,3'0 O City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT DATE: . ./ i1221727 DATE ISSUED :-- Z CWNERS NAME : /f•, .. .L•-� .ADDRESS: ,// 7 7Jr S!y ;/�T•C �`�'!. CONTRACTOR : — CLh e,,-- TEST : ,, -TEST : Air ❑ , Weter;7 , Visual Q , Laboratory ❑ RESULT: Approved C1 Disapproved LJ , Pending r SKETCH: �_7 - � � 26 I SPECTOR DATE I COTE: Altooh 4upplemontnl test 0nigi J ADDRESS /1774i_ ti. f/,� V ��nc�c_ PERMIT NO. Ug7q PERMIT CHARGE none OWNER CLNNECTIGN FEE y�ib.o PAID BY TYPE OF BUILDING f�.a� t,-. DATE CONNECTED SERVICE RATE INSPECTION FEE aS;ou CONTRACTOR PAID BY Wvvt nawa z DATE SI7.E OF CONNECTION tilt ASSESSMENT PAID City of Tigard INSPECTION REQUEST for INSPECTION TIME : PERMIT NO. : DATE: 1-2-1 7 t! DATE ISSUED: OWNERS NAME : ADDRESS : &10(CONTRACTOR : VIA- TEST* Air O, Water ❑ , Vitiva Laboratory ❑ RESULT: Approved Disapproved ❑ , Pending ❑ SKETCH: l . INSPECTOR DATE [NOTE.: Attach supplemental test data horst, CITY OF' TIGARD MECHANICAL PERMIT DATE PERMIT N0. RECEIPT NO. BY -- -- FEE 1. Permit shall be obtained prior to commencement of installation: 2. Permit shall be obtained for all appliances which are to become a: fixture to the building. 3. Relocation, replacements, alterations, or changes to burners and duct work require permits. 4. All work to be concealed must be inspected before cover vp. New Insta lation Re lace ❑ Relocation ❑ Addition Alteration U CONTR.,_._.&4 OIaNER_ ADDY ;SS ; �� LQ & �,� 13 .t!t WORK ADDRESS --P�J�:�LLjW,- �L!t-j.�_�/`�___� APPLICANT FURNACE - DL4NUFACTURER TELEPHONE NO. -g';�h - TELEPHONE NO. HEAT Input rating (Btu Per,�Hour) reo ) Vent Size 'S_' Flue Size FUEL OIL ❑ GAS L F LECT U OTHER TOTAL SQ. FT. Top Floer Main Flou.• _1'�t n Basement GENERAL ITEM NO. FEE ITEM NO. FEE For Issuance of Permit _ .0 Boilers Over Hp New - Under 100,000 Btu Air'_Randl t--'-E 000 CFM New - Over 100.000 Btu _ -00— Air Randl.tng Over 10 U1 - CF n _ Floor urace - .00 Evaporative Cooler' ..�:.0 Wall - Floor - Suspen-T d T 00 — Vent Fan ^' ""'" Ins a 1 Vends �- D _Vend diem �0 fair - Heat & Cooling 4.00 Hood1 - Boilers Under 3 H 4.00 -�Domest_c Inc HF- p-offers 3 to 15-Hp __. _ 7-.;0 Cmm nerator J4 p Boi ers 1 -"' .^Inc�nera�or �_'U.0 otoU Hsi 10.00~ Otj.CS Doilers�JOo -50 Hp 3:570-0— INSPECTOR'S 5.0 INSPECTOR'S COATIENTS APPROVED BY DATE ISSUED BY _ DATE Signature of A5Aicant i I t City of Tigard INSPECTION REQUEST for INSPECTION TIME: �' PERMIT NO. : DATE: n DATE ISSUED '.— 1. Z OWNERS NAME : - ADDRESS: AME :ADDRESS: /cr 9 CONTRACTOR : TEST '. Air Q, Water[] Visual�k-Laboratory [3 RESULT: Approved Disapproved 7 Pending L] SKETCH. INSPECTOR DATE COTE: Attach supplemental test data Sarr'] / I City of Tigard v63s I INSPECTION REQUEST for - -____ NSPECTION TIME: An -f PERMIT NO. : DATE: 1,4DATE ISSUED :___1_L_ )INNERS NAME .' ADDRESS: --_= ii z ,�t-��� ,E C4Lf-. 0NRACTOR : _u. _ ri,� rE ST ' Air ❑, Water p , Wsua1 Leoratory ❑ RESULT: Approved ❑ Disapprovedle, Pending ❑ ;KETCH. Y I � I INSPECTOR DATE Otff: Attach tupplomental test data beret a] i 1 FILE COPY � City of Tigard INSPECTION REQUEST � for- s ----` cf' . PERMIT NO. ._ -- f 1 INSPECTION TI nAE. DATE: DATE ISSUED :___1-1—.. OWNERS NAME .' ADDR I CONTRACTOR :TEST '. Air C., Water 0 , Visual P , I_ouoratory p I RESULT: Approved G , Disapproved Pending SKETCH: '�vT >f�t�,�'�• ; �064t CIA) I !N Lpf�5C ° I 000;0600A f�Of 4 I F. INSPECTOR DA—E I FNOTV Attoch SUPP1OMN"01 test doto beret?' l 1 / a 6' a City of Ti g r INSPECTION REQUEST for IINSPECTION TIME " PERMIT NO. '— DATE' O. : .DATE' I '%127 BATE ISSUED' 1_Z OWNERS NAME ' I ADDRESS :CONTRACTOR : It TEST'. A r J , Water D , Ntisual La', ,ratory [I RESULT. Apprnved 0 Disapproved _1 , Pending O SKETCH' I I I I I INSPECTOR DATE ICUTE : Attach supplemental test data heret] 1 City of Tigard INSPECTION REQUEST f o r INSPECTION TIME : A-PL- PERMIT NO. . .. DATE��. '�j ')ATE ISSLJED*---,-, J— OWNERS NAME . -- ADDRESS ' 1-07- TES I &-ter ,)<-rj Ln rr, RESULT .- i,-xpprovs,4 n d SKETCH: An INSPECTOR DATE E:N-ITE Attach suppiementa I W as W r s t PLUMBING PERMIT APPLI ATION Jurisdiction of !T e-4 tv-, Cr No. Type of Fixture Fee Permit No. �(� Permit fee '2— Water Closets Toilets -,� Permit Issued Bath Tubs Approved by t LavatoryWash Basin Building Permit. - 93 Shower Receipt No. in s Dishwashing SinksKitchen SinKs, Ordinary Location of Building Sinks Slop �- Automatic DishwasFer --- Disposal Laundry Tri Name & A dr ss o er Drains Floor rains Area _ Drains, e r1�era or Rain Drains Automatic Wa,3her •d Na & Add ess f P1 oun ains Dri.n ntA ---t--- Fountains . oda Hot Water Tank _ Water Service Size Y4 Urinals I Building Old c.r New (Alter, Repair or 7'5 ,! -Bas ins -7—ar — Zns=a Lawn Sprinkler ystem .jw Lmmin (:'l 7 l _� S tnKler System ___ _This permit becomes null and vu.id if work +:r constructs Dn ,authorized is not ^ommenced within 60 rays, or if constructiorI or work .s suspended c:r abandoned for a period of 120 days at any time after work is c .mmenced. All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond I hereby certify that I have road and examined this application and k.nuw the sam 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 permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. 6_'V�_-V-'A JAI Signature of Applicant l[uinIii,r? ��' .heating AP . r. r'rn 155,15 S. f:. N1 11mam Dr. i I i of Tigard INSPECTION REQUEST for lx-, G INSPECTION TIME . ._t _/'Y _ PERM;-f NC .)ATF ISSUED I DATE.- -9--L'S-23 --OWN ERS AAME : --- A D D R E S S: _ 8 --C�'---- - ------- !I O N.TRA rTOR --- ---------- —` ' EST ,4ter❑ c,1(. .�b ►ct �r; '.� (; � , � � d G lRESUI-� _--� r',vec1 _ :uppt �. �•��idi`ir, u I� SKETCH: I� I I I I I INSPECTOR DATE I I CNOTE. Attach suppiementai te®t uatu tieretul 1817 EXHIP.IT "A" CITY OF TICARD He!,Jdenttal Structure Occupancy Restriction KNOW ALL Wlitl BY 71ME PRESENTS, That occupancy of residential structure (a) on the following described lands prior to the recording Of �n occupancy i,ermit releasing the restriction In tLe Deeu Record:; of Washington Cuunty, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: DESCRIMION OF PRO;'ERTY: I-6 9 aF 114 ?L4Lt _a EL. 34 , T VS 'E.)w , w.Nr ADDR].:,: OF YROPER'I'Y: //�7 �•., ¢ rA (ilG NAME OF OWNER: Kl�wC—(_� S ADD';t&;3 OF uWNEft: / 7c) �� t, 144 w7iy IN WITNEuu WItMEOF, the undersigned has caused this restriction to be executed this day of /`AUGUST 1y,74, OWNER: AI'PROVEU: No 0 Tule By: HuildinGUfflclal q-.p��'.._1�7e!�•�1� �pM City of Turd q�r.LR lViOMRRU1. Vto"'el ti.un'ds a t��.,+,,..• OTATE OF OREGON County of Wechington ) '_ /7 19_ Personaily appeared before me the above named mid a:knowledged the foregoing instrument to be�� A. vollu .nract and uetu. t N,:tary,Fubllc 'fdr Oregon Conn ,slop Expires: Milk 045 mE76% f I ago $� Cj CITY OF "rIGARD 12420 & W. AWn shMf TIGARD, OrBOON 1721 APPLICATION FOR BUILDING PERMIT New Construction 11X Demolish Addition Remodel C] Move C7 ZONING R-7 UATE ISSUED___- -- BUILDING PERMIT BUILDING FEE 5 n.QQ No. C.) DATE RECEIVED_ - tiY PLAN CHECK 5�,_ S ' ----_ - -• OTHER 5 :, _�.y°` c,. VALUATION ��l.. ---- TOTAL $ • ��Q 3-° RECEIPT No. TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT 1MAP I CENSUS TRACT y ly_- JOB 1 5L 4G➢__ - Architect or Engineer` AO° mine Address 85:1 S.M. Barbur Blvd. 4, - Phone_._ awn Address Ione-_ _- BUILDING USE Single Res. o� Multi Res. Comm. J Industrial GCCUPANCY GROUPI _ No. of Stories_1 Total Height 15 Area of Lot#i,490_ Type of Construction V Floor Area B_____ 1_1364 Set Backs: Front 2U Back 25 _ L.Side_ __ R.Side` __1(6 Private Sewer Pipe Size 14" Sewer-usa Tigard Septic Tank I_J water Service Pipe SizeStorm Sewer � Ditch ❑ UryweI ❑ Street and Curb Requirementsexisting _-__ -- Driveway Width.- 18' - _No. of Parking Spaces SEPARATE.' PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED!— 11775 A.Y. 114ULyyp< FIELD CHECK BY� _ .�.+.. -__Y___- .__-DATE 8-113 PERMIT APPROVED BY It is underRtood 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 Certificate of Occu c has b en issued by the City of Tigard Building Inspector. nature of pplic t: ¢���_ 1` 1 UNIFIED SEWERAGE AGENCY NO 4879 t WASHINGTON COUNTY DATE clrY OF APPLICATION FOR SEWER CONNECTION PERMIT OWNER atV -- OWNER'S ADDRESS `�0- _5, w__�vLC.__L✓!�_N�,�. .. .._.. -- STREIT �.. r y ----- STATF < BUILDING SITE: LOT � ...__.-_ BLOCK ADDITION TAX LOT NO --- TYPE OF OCCUPANCY 75 �" ADDRESS 11 7 S�_�. //"',' -pC'/GC'L- DWELLING UNITS ------ _- FIXTURE IINITS _--- SURCHARGE IF APPLICABLE � -- � PERMIT FEE q!50ec, � INSPECTION FEE-95—!-TOTAL DEPOSITED INEW) (EXISTING) BUILDING SEWER SYSTEM .us&_ �i6.r�i1l, r Thr! Applicant agree. to comply with all rules and7�- of the Unifi+�r1 S w++eq+ Allem v APPLICANT SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM LINE SIZE 4W 4 -- INSTALLER - - - -- RECEIVED BY-_�r G� ribwrlt?9 UOENCV OR ITS AGENT+ COMMENTS This Application and permit expires in ninety (90) days The amount nald will he forfeited should expiration occu►.