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12612 Ski 114TH TERaCLc:L —
CITY'OF TINA RD PLUM811.4c, PEFiMIT
CnYOFTMID
COMMUNITY DEVELOPMENT DEPARTMENT Oftaft PERMIT # MST91-0284
13125 SW Holl 8W. P.O.Sm 23397,TlqsM,Or"m 97223(6031630.4176
0Q_1'P I 1: Q1 ILI w 4 Q/Qi.
S I I'E ADDRESS. 125.1 R SW .114TH DR s PARCEL... 8'S103AC-03600
SUBDIVISION— . : WALNUT GROVE BUDD ZONING! R-4. 5
BL..QCK. . . . . . . . . . I LOT. . , . . . . . .. . . :5
L'LASS OF WORK. . :NEW BARBAGE DISPOSf)L.S. . 11
TYPE OF USE. . .-SF' WASHING MACH. . . . . . . : 1 BACKFt..DW PIPEVNTRS.'. sO
OCCLIPA14CY GRP. . I R3 F' )OR DRAINS. . . . . . - a0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . 12 WATER HEATERS. . . . . . % I CATCH BASINS. . . . . . . 10
FIXTURE ---- LAUNDRY TRAYS. . . . . . 90 SF RAIN DRAINS, . . . . . I
Sr- - ' PS. . . . . . . IB'
INKS. . . . . . . . . . il GREHL" I RA
LAVQTORIES. . . . . 14 OTHER FIXTURES. . . . . �0 ,
Wb/SHOWERS. . . .: SEWER LINL ift ) - :O
iWATER CLOSETS. . :4 WATER LINE (ft ) . . . . : 100
E)1 al WASHE RS. 11 RAIN DRAIN (f t) .
Fi e in ez!,k s
0,0NERs V L
(- I P'NACLE HOMES T1 F $ 1 -;,80. 00 J1 H 03/04/92
SW GLACIER LILY CIRCL,.E 1AP0 $ 400. QW0 JLIA 03/014/92
DPLC $ i.-.6 0. 0T Ji.-H 12'/3L/91
TIGARD OR 9/223 B5pc $ 20. 00 JI-H 03/04/92
Phone 0: 6,+4-4017 SSDC 4 280. 00 JLH 0310'rl�12
PARK $ 300. 00 JLH 03/04/42
f'.1lumbing Cant or a 01FIRT $ 31). 0111 JLH
11VILC It, 9. 73 JI-H 03/0419P
Nam" 145P[; $ 3. 95 JLH 03/04/92
Address tL&I
t)jc._,3Jr_ Lt,.A- rP F'{. KT t 14(b. 00 JI-14 O�k,104/92
i t Y Iate : p5pc $ 7. 00 JLH 0l1/04/92
i ippz lion v#:
9 #: iff I
REUL)TOED 1Nb'FT..( (IONS
This permit is kli%U )d vAbj1,?ct to the reg
"lations contained in the Tigard Mtmicipal Fact/found Insp insulation Insl
Codog Gtatp of Ure. Specialty Codes and all PoqL /Spam gtt'Lft:k (Jyfl BOAt'd InSp
ether applicablo laws. All work will b& clotty Povt /14eatll btrurt Pain drain Insi
in accordanoe with approved plans. This Post. /Beam Methan Water Line I ii F.1:
p t 'dw I k Insp
,pritit will expire if work is not stArted Fo /Bpom Merhan Appr/5
within 180 clays Of issuance, or if work is Underfloor i.n%Ltl ()ppr/Sdwlk Insp
SUSpunded for more than 180 days. V11 M/Underf I nor Pippr/Fidwlk Insp
Mechanical Insp Appr/gdwlti Iii-.;p
Pikimb lop O'-it Mechanical F=in;
Framiti4 Incip Plojmb Final
Framing iREINGP) Bu) Idintl Final
Gas Line Insp Additional.
horized Pli..imbing Contractor
Carl I fat, i Tim pet:L i ort - 639-4175
Lai
CITYOF TIGARD CERTIFICATE OF
CIIYOF TMPD OCCUPANCY
COMMUNITY DEVEI *IPMENT DEPA"FN;T 0010m r PERMIT ii. . . . . . . z W.jT91 -0284anc
131258W HNI Blvd. P.O.B 2339),Tipad,Or"m 9r22�,(i�p3),"-l.1l6
L,rJF I SSUkD a 09/11#/9;-,
'i l't - ADDFtFa'','S. . - : 12512 5W 114TH DR I�ARCE'La r'f3i+D3AC 0�fala0
SURD I V I S 1014. . . . a WALNP T GROVE SUBD ZONI NG a R-4. 5
BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . $5
CLASSY'tlF-WORK. aNEW��._.___.___.._.__.____.____.__---...__._______.......___.__..____..._._.._._._.__.__.____._�.__
TYPE OF USE:. . . a SF
OCCUPANCY GRP. a R:3
OCCUPANCY i_OAU t c i'. : 4
7f_N,-)N1- NAME. . . i
kemarkaia
Ownero
PINNACLE HOMES
t c',7 35 €.W GLACIER LILY CIRCLE
I IUAND OR 97223
Phone aka 64,+-.4017
1 ontractura
PINNACLE HOMES
);='735 SW GL!-1CIFW LILY CIRCLE
r
T l9AkD OR 97223
■
Phone #t 644 4017
Rsg 0. . .- 16t 77
Occupancy of the above referenced L,�lildinq i i her-pby t;iven, :Ana C'QV'tifi*lb
the compliance with the Mata Of Oregon Spec,.ialLy Cuctes for the IWv,oup,
or--c upanc:y, and use under, which the Y�pfer•enced permit was issu".l.
1=IRf: DE'P'ARTMENT BUIL.UI�1 41SP CTOR
BIJI k
welWF,
C1f-'F
POST' IN CONSPICUOUS PLACE
I
INSPECJOY4''�'710E
City +I Tigard Ruild.o ug DepMr*mmDt
13125 SW Hall Blvd. Tigard, oregoc 97223
Inspection Line (Rec-O-Phone): 639-4175 Busi:.ess Phone: 639-4171
Inspect ion --
Footing Plbg. Underslab Mech. Ro,:gh-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing
Post/Beam Mech. Rain Drain Insulation
Plbg. Underfloor Water Line Gyp. Bd. Neth 1 p
�(�� Timex AN /•,
Date Requested: __ —PM
/
Address: � 2 Z/4� 4�� Permit }s" T/
Builders_,
TNS FOLIOWING CORRECTIONS Al 6 RF.QUIRF.D:
Inspectors • � ----- - _ 'mate:_ �- �,�,9 ��
Z- APPAOM DISAPPROVED &PRO'lP1 SUBJECT To ABOVE
Call For Reinsp.
ar(OFTIGARD
MASTER PERMITCny TW
COMMUNrrY DEVELOPMENT DEPARTMENT oRmvas �
PERMIT #. . . . . . . : hIS'T92-@199
13126 SW HWI Bh-d. P.O.Bar 23347,TOM,r-*wjon 97223 603)830-4176
6 4171 DATE ISSUEDa 09/10/92
SITE ADDRESS. . . : 12612 SW 114TH 9ff Torr PARCEL: 2S 1 O3AC-WG 10
SUBDIVISION. . . . : WALNUT GROVE SUBD ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 10
----------------------------------- BUILDING --_-----_._-_--------_____--------.____-__
FEiSSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :923 sf
GLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :400 s f
TYPE OF USE. . . ;SF FLOOR AREAS------------- REQUIRED SF'TLC,CKS-•-------- - -
TYPE OF CONST. :5N FIRST. . . . :923 sf LEFT. . : 17 ft RIGHT. :7 Ft
OCCUPANCY GRP. :R3 SECOND. . . :838 sf FRONT. :2O ft REAR. . :50 ft
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED--_._._.__.___.______.__.._..._
HEIGHT. 27 ft TOTPL-------: 1761 sf SMOKE DETECTOR. :Y
FLOOR LOAD. . . . :4O psf VALUE. . . . . 1 : 99097 PARKING SPACES. . - 1
Remarks: PATH I
------------------------------------ PLUh1BII4G
SINKS. . . . . . . . . . . i FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . ..0
TUB/SHOWERS. . . . :2 LAUNDRY TRAYS— : 1 PATCH BASINS. . . . . . . :0
WATER CLOSETS. - :3 SEWER LINE (ft) . -O GREnSE TRAPS. . . . . . . :0
DISHWAGHERS. . . . : 1 WATER LINE (ft) . : 1O0 OTHEk FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :O
WASHING MA.:H. . . sl SF RAIN DRAINS. . : 1
---------------- MECHANICAL --------------- ________.______ __. FEES - --- -----__-_-_
FUEL TYPES------------- UNIT HTRS. . :O type amoklnt by date recpt
/GAS/ / / V,-_NTS . . . . . :0 TIF L 1460. 00 JH 09/10/92 X
MAX INPUT':O BTU VENT FANS. . :5 BPRT $ 433. 00 JH 09/10/92 X
FURN ( LOOK . . : 1 HOODS. . . . . . : 1 BPLC $ 281 . 45 JLH 09/0E/92 2312::'6
FURN ) -LOOK . . :0 WOODSTOVES. :0 B5PC 4 21. 65 JH 09/10/92 X
FLOOR FURN. . . . -0 CLO DRYERS. ,- i SSDC $ 280. 00 JH 09/10/92 X
BOIL/CMR ( 3HP:0 OTHER UNITS: 1 PARK $ 500. 00 .IH 09/10/922 X
GAS OUTLETS: 1 MP< 1" f 46. 50 JH 09/10/92 X
Ownrr s - ---- - _____.-._.__.________. __.____.__.._._ HPLC t 11. 63 JH 09/ 10/92 X
FOUR D CONST MSPC f 2. 33 JH 09/10/92 X
PPRT A 155. 00 JH 09/10/92 X
P51'-'C f 7. 75 ,;W 09/10/92 X
Phone #:
Contractors ---------------------------__.
FOUR D CONSTRUCTION
PO BOX 1577
BEAVERTON OR 97075
Phone Ms 641-0935
Reg M. . : 71037 ___-._---------------------._-__.__._....____
$ 3199. 31 TOTAL
This permit is issued subject to 'he regulations contained in the ------- REQUIRED INSPECTIONS -- -
Tigard Municipal Cade, State of Ore. Specimlty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Struct Gas Line Insp
plans. This permit will #Mpire if work is not started within 1B1 Post/Beem Mechan Insulation Insp
days of issuance, or if work is suspended for morn t�p IBB days. Plm/undslab Insp Gyp Boar-d Insp
PLM/Underfloor Rain drain Insp
permittee Signatures ill- Mechanical Insp Water Line Insp
Plumb Top OL1t Appr/Sdwlk Insp
Issued By: _ Framing Insp Mechanical Final
Call for inspection - 639-4175
SEWER CONNECT I ON
PERMIT
CITYOFTIGARD PERMIT #. . . . . . . : SWR92-0283
COMMUNITY DEVELOPMENT DE� �+
13+26 SWHr!Blvd. P.O.Boo23397,TOM,a.pon1T �
DATE ISSUED: 09/10/92
SITE ADDRESS. . . : 1. 612 5W 114'14 DR PARCEL : 2SI03AC—WGIO
SUBDIVISION. . . . : WAI._Nur GROVE SURD ZONING: R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 10
---------------------
TENAINT NAME=. . . . . :
USA IVO. . . . . . . . . . : FIXTURE: UNITS. . . :
CLASS OF WORE. . . :NEW DWELLING UIN I T S. . : 1
TYPE OF USE. . . . . :SFNO. OFF BU T LD I NGS: 1
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Remark : PATH I
Owner: ------________._----__.___.______..__.__.____ __ __________.___.-- FEES -------------._
FOUR D CONST type arr o1_;nt by dat e recprt
PRMT $ 2100. 00 JN 09/10/92 X
INSP `6 35. 00 JN 09/10/92 X
Phony #:
Contractor:
CONTRACTOR NOT Ohl FILE
#: $ 2135. 00 'TOTAL
-- - -- — REQUIRED INSPECTIONS
— —This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 188 days from
the date issued. The total amount pard will be forfeited if the
permit expires. The Agency does tot guarantee the accuracy of the
!ide sewer laterals. If the sewer is not located at the measuremer'.
given, the installer shall prospect 3 feet in all direct o os •-os
the distapce given. If not so located, the installer shall pin ch- a _•_� M�.__— __. --
a "Tap and Side Sewer" Permit and the Agency will install a lmtr,a',
V'r-r mi.ttee
r s s _r z rJ R y =
Call for inspec'. ion — 639-4175
MEA%
CITY OF TIGARD RECEIPT OF P(IYMENT RECElPT NO. 892-231519
14 CHECK AMOUNT 5 5084. 31
NAME c FU(JR D CONSTRUCTION CASIA AMOUNT c 0. 00
A f)D R E'S 8 : PO BOX 1577 PAYMENT DATE c 09/10/92
SUBD I V I cn,I ON
BEAVERTON OR 9'7075—
PURPOSE OF PAYMFNT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
433. 00 F"LlIMPING PERM 1515. olwl
MECHANICAL. Pl---' 46. 50 ST. st.111-D PER :,1. 7:3
PLAN CHECK FE 43. 06 5EWFR LIS0. C1,100. 00
SEWER INSPECT 35. 00 PARKS SD(. 501-A. 00
STORM DRAT14 SDC 1280. 00 RESIDENTIAL. TRAFFIC FEES 1350. 00
MnSG' TRANSIT TIF FEES 1 10. 00
1.8612 SW i14TH TERR, I-OT 10
TU)TAL AMOUNT Vlillr) _. ...y `3084. ;31
CITY (IF TIGARD RECEivr oF RECEIPT NO. 02-231e26
CHECK AMOLINT a 500+. 00
FOUR D CONSTRUCT ION CASH AMOUN r 0. 00
ADDRFSS PAYMENT W" TE t 09/02'/92
1
SUBUIVISION i
F-NJRPOISF OF PAYMENT AMOUNT PA I D PURPOSE (IF PAYMENT AMOUNT P►41 D
ALAN ('HECK FF- 250. 00 PI-AN CHECK FE 250. lo
LOT L' O W01-NUT GROVE 1,"*^,�',:-'l SW 114TH TERR
LOT 16 WALNUT GROVE IP501 :'W 11ATH TF RP
TCVTAI.. ONOUN1 PAID 00, 00