12498 SW 114TH DRIVE I
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12496 ON 114TH MM
CITYOFTIFA RDOF CERTIFICATE
crnraF n�a�m
COMMUNRY DEVELOPiJENT DEPARTMENT ormaoN OCCUPANCY
13125 SW FWI Blvd. P.O.Boot 23307,TlOad,Orpwi 07223(U*)609-4176 / PERMIT *. . . . . . .
DATE ISSUE:Ds 05/29/92
SITE ADDRESS. . . s 12490 SW 114TH DR PARCE::l_: 2S I03Ar- W1,114
Si.a.mm V I IfIN_ - _ - LIA(_NUT GROVE SUED ZONING s R-4. 5 �
BLUCK. . . . . . . . . . a !.OT. . . . . . . . . . . . . s4
CI_Aa5 OF WOf?ES. sNEW
T'YFIEw OF USE:. . . i SF
OCCUPANCY GRP. s R3
OCCUPANCY LOAD o 225 4
TF:NANT NAME. . . n
W,NmQu^ks s
`OUR I), CONSTRUCTION
Pf) BOX 1577
BEAVERTON OR 97075
Phone #e 641-0935
Contractor-s
r-OUR D CONSTRUCTION
PO ,B0X 1577
f)EAVE ETON OR 97075
PhUrne Nn 64J. -09.36'
Reg *. . s 71037
Or_r_upeincy of' the Abovw, i,efe►-enc:ed build.iny is hereby given, arld cer•ti fies
the compliaanc.e with rhe estate Of Oregon Specialty Codes for' thW gr,00lp,
,tpe►ncy, and Lisp cinder which the r'efs►'ernce cl permit wAs i sak.1pd.
F X RE DEDAR7,•IE'NT I L.b I NC I NSP[;•
7;
RUIL.1)1NYFFICI _
POST IN CONISP I CUGUS PLACE //
INSPECTION NOTI.;P_.
7•, City of Tigard Building Department
13123 ON Bali Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspection:__ — J_
Footing Plhg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg
Poet/Beam Mach. Rain Drain Insulation -Plumb
P1bg. Underfloor Water Line // Gyp. Bd. -Mech. j
Date Rog:ested:_ �L _!Times AM —APM
Address L/ !� L!L� 1-• /LZ�Ifm.it i3J7/ �
Builde: :,.� -- ---
THY. FGLIOWIMG CORRECTIONS ARE MMUIRED:
9
Inapectur: Date: ,• �_ / 1,,,,.
APPROVF.n DIFAPPROVRD A.'PROVRD SUBJECT TO ABOVE
I
_Call For Rainap.
INSPBCTION NOTICE
City of Tigard Building Department
13125 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-•Phone): 639-4175 Business Phone: 639-4171
Inspection:
r-�
Footing Plbg. Underelab Mech. Rough-in `Appr/Sdwlk J
Found. Plhg. Top out Gas Line FINALt
Post/Beam Struct. San. Sewer. Framing -Bldg.
Pont/Beam Mech. Rain Drain insulation -Plumb.
Plbq. Underfloor water Line Gyp. Bd. -Mech.
Date Requested: p y!�$�'�/� __ Time: �%�L_AM PM
Address: 7 /gyp 5 c✓ Y� zl-� larmit �A,-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
+-AIL
/
C
3_ -
Inspector: 1: `y Date:_ -Z I
APPROVRD DIBAPP D APPROVED SUBJECT TO ABOVE
Call For Retnep.
i
INSPECTION NOTICS
City of Tigard Building Department
13125 RW Ball Blum. Tigard, Oregon 97223
Inspection Line (Rec-4-Phone): 639-4175 Business, Phone: 639-4171
Inspe^tion:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out 6..s Line FINAL:
Poet/Beam Struct . San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor /Wsterl Line yp. Bd. t Mech.
Date Requested:
Address:��. I_/Permit #t
Builder: L ! i
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:! Dates
APPROVED nISRPPROVED APPROVED SUBJECT TO ABOVE.
i—Call For Re!nsp.
INSPECTION NOnTCE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspectio,i Line (Rec�_Phone)t 639-4175 Business Phone: 639-4171
Inspections_
Footing Pi.bg. Underelab Mech. Rough-in Appr/Sdwlk
Found. PLbg. Top Out Gas Line FINAL:
Post/Ream struct. Sin. Sewer 1r��Inulati-n
ainq 1 -Bldg.
Post/Ream Mach. Rnin Drain ` .-Plumb.
Plbg. Underfloor Nater Line Gyp. Ed. -(Hoch.
Date Req:,anted: N �L- Time: AM �_PN
Addresn:lL��`Iel
II U I\ '"ff1 {r��'C� Permit
Buildersr.iLW�
THE FOLLOWING CORRECTIONS ARE REQQIREDs
Inspector:__._ Data
APPROVED DISAPPROVED APPRCPMD SUBJECT TO ABOVE
_Call For Reinap.
INSPECTION NOTICE
City of Tigard Building DepatAkent
13125 ON Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bueineus Phone: 639-4171
Inspection:,_,
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gori Line FINAL:
Poet/Beam Struct. San. Sewer / ! aat inq -Bldg.
Post/Be, - Mach. Rain Drain J� Inaulat ) -Plumb.
Plbq. Underfloor Water Line Gyp. ad. -Mech.
i
Pate Requested:. ��d�_Z_ Tim:: AM
Address- L� � '. ��✓t_/L rmit #
BuildersV__
i
rHE FOLLOWING CORRHCT?ONS APE RF.gUI_.SU:
i
Inspectot: � � Date:
APPROVED DISAPPROV=D P.PPROVED SUBJECT To f.BOVR
Call For Reinep.
INSPECTION NOTICE
City of Tigard aullding Department
1125 SA Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Fo•,nd. Plbg. Top Out Gas Lina FINAL:
Post/Ream Struct. San. Sewerlraminq -Bldg.
Post/Beam Mec..l. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. 8d. -Koch.
Date Requenteds "l - 1 Z- Time: A/M PM
Address yy�,~.l U�p 1I tY Va Permit. 7
Builder: 1��V� - 6135
THN FOILOWING OURRdCTIONL nni IMMIMS
ti 4
V
APPROM.) DISAPPROVRO APPROVED SUR.7ECT TO AROVS
Call For Rofusp.
r
INSPECTION NOTICE
City of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inupection:__,��
Footing Plbg. Underslab 4re;cch. Rouq�h Appr/adwlk
Found. Plbg. Top Out des Line FINALt
Post/Beam Struck. San. Sewer Framing -Bldg.
Post/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line
�7 Gyp. Bd. -/Meeh.
Date Requestedt / (�`, _Tiloe�%� PN/
Address:_ „c= Permlt �t
Builder-
THE FOLLOWING OORRECTIONS ARE IRED:
Inepwctorc_ !"�J Date:__.__ _
APPROVED DJSAPPROVRD APPROWD SURJRC* TO ABOVN
G11 For Rei:imp.
�NECTION NOTA _
City of Tigard Building Dprts et
13125 SM Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 634-4171
Inspe4:tion: Y_
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found_ plbg. Top Out Gas Lire FINAL:
Poet/Beam Struct• San. Sewer Freming -Bldg.
Post/Beam No.:•h. Rain Drain Insulation -Plumb.
Plbg. Underfloor "atter Lina Gyp. Bd. a Mach.
Date P,equested:_
Address:`1� rmit •�'�—�t=s.�--�
3u lder:.-- 7U a;k--3/Z ——
THE FOLLOWING CO 1'398 ARE RMQUIPAMs
I
i
r
/i
t
Inspectors //!/ , - Dates 1'
Art Raven n13APl1P0vEn APPROVWn ',n AP0VF
Call R'or P.einsl,.
INSPECTION NOTICE
City of Tigard Building Departnesst
13125 SW Ball Blvd. Tigard, Ori^^ 01773
Inspection Lina (Rec-O-Phone): 639-4175 Rus.tness Phine: 639-4171
Inspections
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwl_:
Found. Plbq. Top Out Gas Line FINAL-
at/swam I uCt. San. Sewer Framing -Bldg.
st/Bess Heoh. ) Rain Drain Inaulation -Plumb.
Plbg. Underfloor Mater Line/ Gyp. Bd. -Hoch.
Data Requenteds_ A �L/ /(� T'Loov H�)___PH
Addressi
Bnilders__ Z-
TPE FOLLOWING '>>RAECTIUNS ARE REQUIRED-
Inspectors J _ Datas_T_
MPIKIV=O D1.,A.-rROV9D _ APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
�NaP�CTION NgKICE
City or Tigard Building Departoent
13125 SW Bal, Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phcne): 639-4175 Buaineas Phone: 639-4171
Inspection:._`_ ---.---_. _-_---
Footing Plbg. 7ndoralab Meeh. Rough-in Appr/Sdwlk
Found. Plbg. Top Out GAs Line FINAL:
Poet/Be-,m Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain DreLn Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requeuteds dTime: AM PM
Address: jA � erwit #s�_� _
A,-7 7�
Builder:_—
1110 FOLLOWING/ RBRCTIONS ARE REQUIRED+
Inapeotor+ � --Dates
7`�' AgppCytp DISAPPROVED APPRnVED 8VBJECf TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
1312S BN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Ineps3,7ti,,,,
Footing Pl.by. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
poet/Beam Stria) Sat. Sewer Framing -Bldg.
C /Beeft xeoh:1 RAin Drain Insulation -Plumb.
Plbg. Underfloor W+,ter Line Gyp. Bd. -,ech.
Date Requesteds Time: AM PM
Address: !Z1, //// ✓v�P/rmit Ot����JG��7.7
Builders L/ KU 2d
IRE FOLLOWING OORRECTIONS ARE REQUIRED:
Inepertore Dates
APPROVED ✓DISAPPROVED A?PROVED SU839CT TO ABOVE
Call For Reinep.
s
F
ry
INSPECTION NOTICE 7
City of. Tigard Building Department
1J125 M Ball Blvd. Tigard, Oregon 97223
Inepection Line (Rec-o-Phone)! 639-4175 Buuiness Phone: 639-4171
Inspection:
looting Plbq. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plug. Top Out Gas Liae FINAL:
at/as" 8truct.�' San. sewer Framing -'dldg.
kos /Beam Naoh. 1 Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Meeh.
Date Requestedt 1;17 /�/� TLess
//
Address: `7l� 7 Permit #_�/
Huiidar:
TNR FOLIAWINO 0DRRECTION8 ARE ABQUIREDi
� J
Impactor
APPROVED DISAPPROVRD APPROVED SUBJECT TO ABOVE
i'_� Call Por Reinsp.
h
...•. •.• .•« .._ — _- - YYrrn... -...-....... . ............ •...r-.....•.+..rw..•...�nwmwfY1W/Yiaa.w+..wn.rn.......x... ....._.nom.u,..Www..waxau�in.nv.eYlYY1191MI4�MI
INSPECTION NOTICE
Citi :�jf Tigand building Department
13125 ON Ball Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-PhonA): 639-4175 Business Phones 639-4171
Inspection:
Footing Plbg. Underelab Hoch. Rough-in Appr/Fdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Bower Framing -Bldg.
Post/Beam Hoch. in Dr Insulation -Plumb.
I
Z��
er Line Gyp. Bd. -Mwh.
Date Requested: - / ! cad-/ Time PM
Addrees: �����iT L// Permity�a-
Builder: L� �f ��! v 9
THE FOLLOWING C30RRICCTIONS ARE RROUIRED:
t
--L
qqs
I
Inspector: 7
-- Dates '7" ' ",7 e
i
� - APPROVE" - `- RISAPPROVRD _ APPROVED SUBJNM TO ABOV=
____Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 ON Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:__ _-
Footing Plbg. Underelab Mach. Rough-in App%jSdwlk.
Found. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. 3°ewer.' Framing -Bldg.
Post/Beam Nech. Rai in 1Tr&' _n- Insulation -Plumb.
Plbg. Underfloor Water Lime'-) Gyp. Bd. -Mach.
Date Requested: �- 2 Time: AN � PN
00,
Address:_ t-� l -'" �_ Tom_ Permit- �s
Builder:
THE FOLLOWING CORRECTIONS ARE REQUi-7—
i
Inspector: ly � ----- ----- Date:
APPROVtD DISAPPROVRD APPPOVRD SUM71r.Cf TO ABOVE
Call For Rainap.
INSPR^1,10" NOTICE
City of Tigard Building Departaent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspectior Line (Rec-o-Phone)s 639-4175 Business Phone: 619-4171
Inapection:
!Doting �- Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Wnter Line C-p. Bd. l -Mach.
Date Reoaeated: _�/ _ Time /,d ' PM
Aeeres�'���je� /��1�� �1�L rmit 1:/7 2— 2--��
Builder:_ L�L� G 411
THE FOI:.OWING CORRECTIONS IRE REQUIRED:
_ _ I
Inspector: 1! O�1/jly1�►.S'✓•--
Date:
___APPROVED DISAPPROVED -� "PROVED SUBJECT TO AROVF
Call For Reinep.
IM�
CITY OF T I l'•ARD KEUV PT OF PAYMF'NT Rk:CE I A'r 1\10. 3 plc--•2t_'i A41
CWE CI-; AMOL.IN T s 4761. 10
Nr MF. 0 POUR D. C:ONSTRUC1 IGN CASH AMOUNT 0. 0@
ADDRESS p O BOX 1577 PAYMENT DATE 01 /1.:3192
BEAVE RTM OR SUBDIVIs1014
i "-)7075--
PURPOSE OF t PAYMENT AMOUNT PAI I) PURPOSE OF C'AYMENT (aMOUN'F AA I D
BUILDING PERM 418. 00 r'i l-IMB I NG F."E RM _ 147. 50
hiC�')aAN f CAI_ PE 39. 00 IS;'. BUILD PER :30. 23
PLAN CHECK FE: 31. 45 <;EWEP USA 1.900. 00
SEWER INSPECT 35. 00 PARKS SDC" 500. 00
�:;TWWM DRf)lN 8DC: Pao. 00 RESIDENTIAL TRAFFIC FEES 12E.0. 00
IYIASIS TRANSIT TIF FEES 100. 00
i
T('11 ::11 f4MOUNT PAID - _ - > 4761. 19
CITY OFTIFARD MASTER PERMIT
COMMON TY DEVELOPMENT DEPARTMENT IDR M I T #. . . . . . . : MST91-0227
13125 SW Holt Blvd,P.O.Bm 23307,TIPA,Oregon 97223(503)M4176
L, il e'.( f)ATE, T5;�;IIF_I)* 01z1iA/C)r_,
:SITE ADDRESS. . . : 12498 SW 114TH DR PARCEL. 2,S103ACWG4
SUBDIVISION. . . . : WALNUT GROVE SURD ZONING: R-4. 5
BLOCK. . . . . . . . . . : L.01.. . . . . . . . . . . . .4
BUILDING
RE I SSUE DWELL I NG UN I*r,,:-,).. 1 BASEMENT. . . . .. . . . :0 Ef
CLASS OF WORK. :NEW BEDRMS:3 BATHS GARAGE. . . . . . . . . . :440 s f
TYPE OF USE. . . .OF F-L-OOR AREAS- REOU I RFD SETBACKS__...._._...____.
TYPE OF CONST. :5N F I RS;`1-. . . . :9 35 sf LEFT. . :7 ft RIGHT. :c, ft
OCCUPANCY (3RP. :R, 13 E C 0 N 1). . . :941) S f FRONT. ft REAR. . :57 f
;TOR I ES
TORIES. . . . . . . :2 THIRD. . . . :0 s f REQU I RED_________________._._
i-iE
ED-------------------
iIE I GHT. . . . . . . . ..2-5 f t TOTAL.-----: 1884 S-f SMOIKC DETECTORS. :Y
FLOOR LOAD. .6, D psf VALUE. . . . . $ 945A4 PARKING SPACE15'. . :0
PLUMBING
5 1 N K S. . . . . . . . . . : 1 FLO1`)R DRAINS. . . . :0 BACKFLOW PREVNTRS. . -0
LAVATORIES. . . . . :4 WATER HEATERS;. . . : l TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . : 3 LAUNDRY TRAYS. -.0 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . 3 SEWER LINE (f;; ) . :V, GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE ( ft ) . : 100 OTHER FIXTURES. . . . . .0
GARBAGE DISP. . . : l RAIN DRAIN (ft) . :O
WASHING MACH. . . : .1 SF RAIN DRAINS. . : 1
MECHANICAL. FEES
F'UEL TYP,ES-----.-------- UNIT 14TRS. . :0 t ypp antol-int by r1at F reept
/GAS/ VENTS . . . . . :0 T I F $ 138@. 00 JLH 01/,!9/92
-4 -1 01 /09/9;?
HAX 1NPUT-0 BTU VENT F14NS. . . BPPT $ 41 E. 00 JLI
FURN ( 100K . . : I HOODE : 1 BPLC 1, 271. 70 JLH 12/18/91 220896
PORN ) ---100K . . :0 wooDs*rovEs. :o B5PC $ i_0. 9 0 J I..H 01/09/92 -r'LOOR FURN. . . . .1 0 CLC DRYERS. : I SSDC * 280. 00 JL.H 01 /09/92 -
BOIL/LMP ( 314171-0 OTHLR 11NITr);0 PARK 41 x;00. 00 iLH 01/09/901 -
GAS OUTLETS: 1 NIPRT $ 39. 00 JLH 01/09/92 -
Mr-11-C 1, 9. 75 JLH 1x1/09/92
WOUR D CONSTRUCTION M5PC $ 1. 95 JLH 01 /09/92
1-.,0 BOX 17577 PPRT $ 147. 51n JLH 1211 /09/92
P5PC $ 7. 38 JLH 01/09/9c-"
BEAVERTON OR 97075
[,hone #- 641-0935
Contractor-:
FOUR 1) CONSTRUCTION
PO BOX 1577
13EAVERTON OR 97075
-'hone #g 641-0935
71037 ---------------------------------------
3076. 18 TOTAL
t-is permit is issued subject
lect to the regulations contained in the REQUIRED INSPECTIONS
7igard Nunicipal Code, State of Ore. Specialty Codes and all other Foot/foLtnl Insp Fir-eplace Insp
applicable laws. All work will be done in accordance with approved Rost /Beam Strktct Gas Line Insp
plans. This permit will expire if work is not started within IN Rost /Beam Mechan InS1.1lation Insp
days of issuance, or if work is suspended for NOV than IN days. Plm/l.incislab Insp Gyp Board Insp
PLM/Undev-flcot, Rain drain Insp
Permittee Signal Mechanical Insp Water, Line Insp
I'll umb Top Out Apur,/Sdw1k Insp
islAed 13y: Fv,Aminq Insp Mechanical Final
Call for inspection - 639-4175
CITYOFTIGARD
SEWER CONNE:C-r ION �-
F
PERMIT # ERMIT SWR9200 6
COMMUNITY DEVELOPMENT DEPARTMENT (CM!0E-T7W4
13125 SW HIM Blvd. P.O.Baw 23397,TOW,Oregm 97w;�wAdf"I7s DATE ISSUED: 01/10/92
SITE ADDRESS. . . : 12498 SW 114TH DR PARCEL. : S103AC-W:,4
SUBDIVISION. . . . : WALNUT GROVE SUED ZONING: R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :4
-----------------------
TENANT NAME. . . . . :
USA NO. . . „ . . . . . . . FIXTURE. UNITS. . . .
CLASS OF WORK. . . :NEW DWELLING UNITS— : 1
TYPE OF USE. . . . . :SF NO. OF BU i LD I NGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Remarks:
Owner,: ---_..________.___.__.---___----___..___.____ ____---.__._..-__-_-- FEES
FOUR D CONSTRUCTIOkl type amol-int by date r-ecpt
PO PDX 1577 PRMT 1900. 00 JL.H 01/09/92 -
INSP d :15,. 00 JLH 01/09/921 -
BEAVERTON OR 97075,
Phone #: 641-0935
Contractor,:
CONTRACTOR NOT ON FILE
Tone #: $ 19:35. 00 TOTAL
eq #. . .
REDUIRED INSPECTIJN5
This Applicant agrees to comply with ail the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires IBB days from
the date issued, The total amount paid will be forfeited if the
oermit expires. The Agency does not guarantee the accuracy of the
c,idi sewer laterals. If the sewer is not located at the measurement
givtn, the installer shall prospect 3 feet in all directions from
the distance given. If not so lor-ated, the installer shall purchase _
a 'Tap and Side Sewer" Permit and the _ cy will i stall a lateral.
1 n, 1:tee Siyna.t -ire
Call for- inspection - 639-4175
I
C'TM OF TI��RD PLUMBING PERMIT
t:I11lOFTK4
1
D I-ERMIl- #. . . . . . . : MST91-0 27
COMMUNrTY DEVELOPMENT DEPARTMENT oeeoo«
13126 SW Hrl BW. P.O.Box 23397,TigeM,Oregon 97223(SM)639-4176 DATE 15;L)E D: 01/10/92
_JiTE ADDRL7S. . . a 12498 SW-r1147H DR PARCELt 2Sli�:sAC WG4
SUBDIVISION. . . . : WALNUT GROVE SUED ZONING: R-4. 5
TAL OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :4
CLASS= OF WORK. . :NEW GARBAGE DIBGOSAL5. . : 1
TYPE OF USC. . . . :SF WASHING IrIACH- . . . . . . 11 BACKFLOW PREvri-rR a. . :0
6CCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :k'.,
61 OR I ES. . . . . . . . ..2 WATER R HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES-----_-.__..-._-___._ LAUNDRY TRAYS— . . . . :0 SF PAIN DRAINS. . . . . : 1
S INI;S,. . . . . . . . . . .. 1 GREAGE TRAP'S. . . . . . . :0
LAVATORIES. . . . . :4 EITHER FI XTLIRES. . . . . :0
TUE►/6HOWERS. . . . : SEWER LINE: (ft) . . . . a0
WAI R CLOSETS-3 WATER I_-INE: (ft ) . . . . : 100
DISHWASHERS. . . . al RAIN DRAIN (ft ) . . . . :0
Remarks:
nWNLR: _ ----FEES------------------- ,
FOUR D CONSTRUCTION T I r f 1380. 00 JLH 01/0992 w
PO BOX 1577 BPRT f 418. 00 JLH V�; /09.✓92
13PL..0 f r_'7 1 . 70 JI..H t2/1.6/91 2-20896
BEAVERTON OR 97075 L35PC f 2W. 90 JLH 01/0S/9i?
Phone ft: 641--0935 S►'!0C $ 280. 00 JLH 01/09/92 –
/ Q PARK $ 300. 00 JLH 01/(17/92 –
i ) �. mbing Contract ora �5U- _ _ MPRT f 31). 00 JLH 01/09/92 --
Q_ MPLC $ 9. 75 ,JLH 01/09/92 -
�Namea._ _-�. 1E' __-_... ._ M5PC i, 1. 95 JLH 01/09/92 -
i-ddi-•ess: f., �.a5�/YJ'-. PPRT $ 147. `0 JLH 01/09/9E' –
C it Y ____ ..._.St ag+ : PSI-'Cs 7. 30 JLH 01 /09/92 –
ipa �/ L.- _.--. Phone
R Q y #
...----- -- REQUIRED [N ;F`ECTIONS
TRi-s permit is i.sesupd aubjer..t to the rrag .
ulations contained in the Tigard M1..ani%:ip�1 Foot/found Insp Rain drain Insp
C:arde, State of Ore. Specialty ("odes and all Poet/Beam Struct Water Line Insp
other applicable laws. All work will be done post/Beam Meehan Appr/Sclwlk Insp
in eaccordanrp with apps-oved plans. This Film/undslab Insp Mechanical Final
per-mi-t will exl. ire if wav-k is riot started PLM/Under-f.IolJr• Plumb Final
w thin 180 days of issuance, or 1f wo.,k is Merhanic_.al Tnsp Ba.ailding Final.
�; _awpendpd for- more than 180 clays. Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace irisp
Gas Line Insp
_. Insolation Insp
Gyp Board Insp
Authorised Plumbing Conti-mLtor Signatl..-rp
Call for inspect iorr - 639-.4t7"i
Contractor Notesa__�
•
CITY Of TIGARD RECEIPT (if- PAYMENT RECEJPT NO. 9] -2-206W,
CHECK Pmol Nva 750. 00
NHM1 t FOUR D CONSTRUCTION CASH AMOUNT 0. 00
ADDRESS t PAYMENT DAIL li'/1A191
SUED I V I',:i!ON
PUW-,Of9E OF PAYMENT AMOUNT PAID PURPOGE OF PAYMENT All(IIJINIT PAID
GK 751A. 00
2., 3, 4 WALNUT r3ROVF
'rmfu- 0MOUNT P$111/' '750. 00