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14977 SW 116TH PLACE r 14 �s I R40j6a I . l . i H • • • z • • •• Page No. 1 CASE HISTORY FOR CASE NO.: MST94-0241 N W HOMES 14977 SW 116TH PL 08/08/97 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Cone Sent Done Done Date ny MSTA007 A.tolication received / / / / 06/2D/94 PASS SW 06/21/94 BLT MSTA010 Plau check deposit paid / / / ! 06/20/94 PASS SW 06/21/94 BLT MSTA020 Plan check by `6/21/94 / / 06/21/94 PASS RT 06/21/94 BLT m,gTA030 Check for prcl. restrict. / 06/21/94 06/21/94 FABS JLG 06/21/94 BLT MSTA092 (F) Issue Combinaticm POMit / / / / 07/06/94 PASS SKW 07/06/94 SW M.STA097 Issue plumb—ng signature form / / / / 07/06/94 PASS SKW 07/06/94 SW MSTA70r Foot/found Inap / / / / 07/12/94 PRIDING- MAINTAIN SEISMIC RESTRAINT PASS RB 07/14/94 RB ACCORDING TO APPROVED PLANS 6 ENGINEERING- HD-2A. REQ'D- VERT REBAR SHALL BE PLACED. MSTA705 Foot/found Innp / / / / 07/19/94 PFNDING- SEISMIC RESTRAINT- SA-3522 PASS RB 0-/19/94 RB INSTA.'..LED INSTEAD OF HPAHD-22- IS THIS EQUIV.7 VENTS REQ'D; TIE STRAPS TO HORIZONTAL BARS. MOTA710 post/Beam Structural / / / / 09/01/94 PENDING-GUSSET BOTH SIDES OF SPLICES; PASS RB 08/01/94 RB POSITIVE CONNECTIONS; HOLD-DOWN ANCHORAGE NEEDED. MSTA711 Poet/Beam Mechanical / / / / 08/03/94 PASS RB 08/01/94 RB MSTA717 PI,M/Underfloor / / / / 07/27/94 PASS MS 07/27/S4 MES MSTA720 Mechanical Inap / / / / 09/23/94 SEE FRAMING THIS DATE FAIL PH 09/26/94 RD MSTA720 Mechanical Inap / / / / 09/26/94 PASS TLP 09/29/94 TLP MSTA722 Plumb Top Out / / / / 09/14/94 water oil FAIL MS 09/14/94 MRS need to test above roof MSTA722 Plumb Top Out / / / / 09/23/94 PASS MS 09/23/94 MRS MSTA725 Framing Inap / / / / 09/23/94 POSITIVE CONNECTIONS; INSULATION MAY FAIL RB 09/26/94 RB INTERFERE WEAVE VENTS; POSITIVE CONNECTIONS; SHEAF BLACKING; B-VENT CLEARANCE AT GARAGE. CL Ce MSTA726 Framing sRRINSP> / / / / 09/28/94 PASS TLP 09/29/94 TLP PASS RB 09/26/94 RB N MSTA'735 Gas Line Insp / / / / 09/23/94 >- MSTA740 Insulation Insp / / / / 09/28/94 PASS TLP 09/29/94 TLP f— J MSTA745 Gyp Board Inap / / / / 10/06/94 PEWING- NAILING WHERE MISSED PASS PH 10/06/94 RB _,C MSTA755 R -n drain Inep / / / / 09/04/94 PASS M.4 08/04/94 MRS � MSTA760 Water Line Inap / / / / 08/04/94 PASS MS 08/04/94 MRs J I4STA765 Appr/Sdwlk Irisp / / / / 11/16/94 i) BE PREPARED TO PROTECT FINISH. PEND IT 11/23/94 3W 2) EXPANSION JOINTS AT 451. Page No. 2 CASE HISTORY FOR CASE NO.: MST34-0241 N W HOMES 14977 SW 116TH PL 08/08/97 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Acme Dcme Date By MSTA765 Appr/Sdwlk Insp / / / / 11/15%94 1) PLACE PIPE IN SIDEWALK TO EXISTING PEN[) LT 11/23/94 SW CURB WEEP HOLE DOWN BY ;TOP SIGN. 2) RAISE CUT-OUT DRAIN LINE. A MINIMUM Or 2" - THERE TS STILL 1 1/2" OF PAVEMENT TO BE PLAT D ON STREET. 3) PLACE ANOTHER '." BOARD ON LIP OF APPROACH OF HOUSE fi 1 1/2" ON LIP FOR NORTHERLY APPROACH. 3) PLACE PIPE IN SIDEWALK TO EXISTING CURB WEEP HOLE AT NORTH END OF SIDEWALK (AT TOP). 5) HE PREPARED TO PROTECT FINISH. MSTA770 Misc. Inspection / / / / 11/07/94 PROVIDE ADEQUATE DRAINAGE AWAY FROM PASS RB 11/30/94 TLP OPENING TO GARAGE. CURB 6 WINGS NOT INSPECTED THIS DATE- ENGINEERING MSTA795 Mechanical Final / / / / 11/29/94 PASS TLP 11/30/1, TLP M.STA797 Plumb Final / / / / 11/29/94 PASS TLP 11/30/94 TLP MSTA799 Building Final / / / / 11/29/94 PASS TLP 11/3P/94 TLP MSTA970 Case Finaled / / / / 11/19/94 PASS TLP 1. /"0/94 TLP CL rt 1— v1 F- J C W J Page No. 1 CASE HISTORY POR CASE NO.: SWR94-0233 N W HOMES 14977 SW 116TH PL 08/08/97 Action Descript.ioi Req/ Schd% End/ Action Notes Disp By update upd Code Sent Done Done Date By ------- ----------------------------- -------- -------- -----•--- --------------- ----- ------- ---- --- -------- - - SWRA007 Application received / / / / / / 06/21/94 HLT SWRA010 Plan check by / / / / 06/21/94 06/21/94 BLT SWRA020 Check for prcl. restrict. 06/21/94 / / 06/21/94 PASS JU3 06/21/94 BLT SWRAovo (p) Issue permit / / / / 07/06/94 PASS SKW 07/06/94 SW SWRA705 Serer Inspection / / / / / / 06/21/94 BLT SWR1720 case pinaled / / / / 08/04/94 PASS MD 08/04/94 MRS 0. ♦-r 0. F-� T J :A CO LIJ J Page No. 1 CASE HISTORY FOR CASE NO.: MEC95-0116 EDWARD WINKLER. 14977 SW 116TH PL 00/08/97 Action Description Req/ Schd/ End/ Actio., Notes Disp By Update Upd code Seat Dane Done Date By MECA060 (F) I—me Iermit / / / / 04/26/95 PASS SKW 04/26/95 SW MECA715 Mechanicai Insp 04/26/95 / / 06/20/96 FAIL RB 06/20/96 RB MECA730 Cooling Jnt Insp 07/06/97 / / 07/02/97 PASS MS 07/06/97 J•H MRCA799 Final Inspection / / j / 06/?0/96 cmidennation trap needed; seal hole at FAIL RB 06/20/96 RB garage- refri.gant linen; seal hole at ext.- condensation line MECA799 Fina Inspection 07/06/97 / / 07/02/97 PASS MS 07/06/97 J•H MRCA800 Cage Finaled / / / / 07/02/97 PASS MS 07/06/97 J-H CL Of F— Y J rJr L.t1 J r CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Phone: 6394171 Date Requested: — 7 oZ 5 7 _ A.M. P.M. MST: _ — Location:-Lg9__7���[j_ =� — -- BUP: Tenant: _ > Suite: __131dg: MEC: Contractor:__ Phone: _ PLM: _ Owner: _� (� _ _ Phone: ELC: f AA 04 ELR: . ( SIT: — — BUILDING BLDG'(con't--)P PLUMBING ( MECHANICAL' ELECTRICAL SITE Site Post/13eam Post/13cam -kosttPeatti' Cover/Service Sewer/Storm Footing Roof UndFl/Slab Rough-In Ceiling Water Line Slab Framing Tcp Out Gas Line Rough-In UG Sprinkler Foundation Insulation Sewer llood/Duct Reconnect Vault 13!;mt Damp Drywall Storm ac 'Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shcrr!Shei.th Fire Spklr/Alm Crawl/Found Dr -Hrd Pump Low Volt Approved Approved ppmved Approved Approved Appr/Sdwlk Not Approved Not Approved ��Nc+ roved Not Approved Not Approved FINAL FINAL FINA1, FINAL FINAL J C!J W ❑Call for reinspection ❑RcinspeCUon ret:of S_ _required before next Inspection ❑I finable to inspect Inspector: S _.--- — Date: -- Page__ or J CAlY OF TI+GARS MEHAN I CA, L PERMIT #.ECPERM I T: MEC93---*011C. COMMUNITY DEVELOPMENT DEPARTMENT 13 A T[7 1 S 3)U E E , r''-+ '22C./'.)5 13125 SW Hall Blvd.Tigard,Oregon 97223. 3199 (503)639-4171 PARCEL: LS110BD-0a400 C 14' ­7 3UBDIVISION. . . . . ;-IELM HEIGHTS ZONING: R-A. 5 . . . . . . . . . . .. _0T'. . . . . . . . . . . . . I A -A OF' Wo RK. . :laprr FLOOR, rURN. . . EVnP COOLERS: -YF-*,E OF USE. . . . :0� UNIT HEATEPS. . VENT FANS). . . JCCUPANCY GRP. . :R3 VENTS W1,10 ArT-T_;, 5,70RIES. . . . . . . . . BOILERS/COPPRESSORS 1-100DE rUCL TYPLS- 0, 1 lP. . . . - 1 00mr-0. INCIN; 3­15 HP. . . . - COMML, INCINi MAX INPUT L BTU I'! 3t7' lip. . . . REPAIP. FIRE DAMPERS—% 30 50 14p. . . . WOODSTOVES. . ., PRE31CURE.. HP. CLO T)RYERS. . '40. OF' UNITe lO AIR HANDLING UNITS OTHEP UNITS. 'URN < 1001, ETU. 10000 cfAl . I-JAG OUTI_CT53. t.)Ml '­100K BTU: 10000 cfm . 1.� ' - '*-l7l'l*TIl1L FEES WIN)':._`R� t ypo am.. 1.-n t, tj y d a t c ',4177 SW 116li-I PL Fl,",L Pr%mT $ .25. 00 SW 04,!-"6 05 SPICT % I. 31 SW 04 iz`6 CY.J T1.0,11IRTI) on PLCI; $ G. C"5 r W 04l 6 �Y� Piiune #: 6k2'4­02')4 1A""1 ,1[4 HE:PTIl1Cj & AIR CCINE -'O BOX 7i2, ,,.ir_,',T LINN OR 1)70('13 u,i tv C,4 $ 3,L-­ C0 TOTAL g nEOUIPED INSr-'ECTIONS -his pqrx.t issued sutjezl to ti-,e re;,'�Iations contaired in the mectlan.lur.Al 'lisp , Tiga,d M o,.Cipal 'ode, State of Ore. Speciaity Saes and all other Final Ins pec: 1 cj aoplicablt laws. All work will be do�*i, in :­-ordance with approved plans. TIM!. pernit will expi, c .,' t,--4 is not started within lot days of iFsualcel v if m,?'k is s"spended fcr sort ;h#rL 182 days. I LJ 1.)4.-,21,-95 10:45 0503 684 i-';)7 r"ITY OF TI(::►RU City of Tigard MECHANICAL PERMIT Planck/Rec. # 13125 SW {-fall Blvd. APPLICATION Permit # r� Tigard, OR 97223 (503) 639-4171 Table 3A Mechanical Code QTY PRICE 1 AMT71 JobAddress Pvrmn FQw l o- a- ro.00 2) SuprAorri until Permit 300 _ umacp Oa"B7T1•"-_ +• i J�) 1) incl.duct%&vents s00 Owner 1` `� 5W L�4`' 2) incl chi;xts a vena 7,30xx ,, -m:in� �Q3) nrJ, vont_ 5.00 i spNn tk 10 8f,w' rEgattiF 4) or floor mounted hsator 6.00 Occupant crit rio ind. in appliance permit 3.00 ` —�— opal tr o?,1'iaani fl reing. - —_ 6) doting,atx;,orptlon unit 6.00 mer or comp, na Bum err con 1Aez�" c 7) to 3 HP;abcorp u tit to 100K TU 6.OQ G pp 65( '71nToramp,p t pump,air co ('on,r,Actor t _3 _-ZZ d) 3.15 HP, absorp unit to 500K BTU 11,00 viler or cramp, ee pump,air con 069 9) 15 30 HP;absorp unit .S-1 mil ©TU - 15.00 W."'w o7Hr or compTeat pump,err con . 000 01-2- 10) 30.50 HP;abccf- unit 1-1 75 mi)1311J 22.50 e e y ac ow edge MOT I flave read is aoo"trcaoon, e �G,ri'er`or wmp-Ties p�'pump,air con. Information given is CO(TBCt, that,am the owner ur authorized agrint 11) >50 HP; abwrp unit 1,75 mil H ni 3;,50 of the ownrr, that plans submitted are in compliance with Sttttning unit tci - — lawc,that I am registorad with the Constntcdon Contractors &,aid 12) 10,000 CFM 4.50 that the number given is Correct lit exempt from State regiStwpon, r an ing uni Plea-so give rw son below] 13) 10,00 CTM+ !50 - -P Rcin` or3�'To— 14) evaporate Cooler 4.50 en a cirni•t9ri`I---' -- 15) to a Single du.t 3,00 eniTaoon systam net _ 16) included in applitvlre pOfMil 4.50 �o''serv'e�Fiy'— - y-�-9� 17) mechanical exhaust 4.50 005c41b@ work new a ition terfation U repair vo AOF-61 Or r�ustnaT` - to be done residential Q non-residential O 18) tsps indriprator 30.00 CL i ng u6's—o u __ �'.""r_ - "_L er t18i g,yyo.'ods ovE3, wa 9r - -- building or property_r 12_:- o.Av� ,t 19) hoatar, solar, clothes dryers, etc. _ 450 u7 T Proposed use of 20) Gas piping one to four outlets 2,00 building or property 5 a`~- _ _ 21) Mnre than 4-per outlet Type of fuel•oil Q natural gas (D LPG rO electric 0 ---- -- U.1 - NQTICE Minimum Fee$25.00 SUBTOTAL PERMIT$BECOME VOID IF WORK OR CONSTRUCTION ` AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5%SURCHARGE= S IF CONSTRUCTION OR WORK IS SUSPENDED Ota - A9ANDONED FOR A PERIOD OF 160 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL AFTER WORK IS COMMENCED. - TO7AL 5-C) SpecialConddono - �_-_.- _____ -_ __ _� Gate issued by PLUM CITY OF T i GARD V'ERMIBT lNG#. PERMITIT. . . . . . : MST94---0241 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/06/94 13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PARCEL: c"31 1013D--02400 SITE ADDRESS. . . : 14977 5W 116TH PL SUBDIVISION— . : HELM HEIGHTS ZONING: P-4. 5 BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1 CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : i TYPE OF USE. . . . :SJF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : l OCCUPIANCY GRP'. . :R3 FLOOR DRAINS. . . . . . . :0 TRAP'S. . . . . . . . . . . . . . :0 '-)'TLIRIES. . . . . .. . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :121 FIXTURES-__.________.__._ L()UNDRY TRAYS. . . . . . : 1 GF RAIN DRAINS. . . . . : 1 SINKS. , . . . . . . . : 1 GREASE TRAP,S. . . . . . . :0 LAYOTORIEG. . . . . :4 OTHER FIXTUREES. . . . . :0 TUB/SHOWERS. . . . : SEWER LINE (ft : . . . . :0 WATER CLOSET S. . : Wt)TER LINE ( ft ) . . . . . 100 DISHWASHERS. — : 1 RAIN DRAIN (ft ) . . . . ..0 Rem --irks : PIATH 1 UWNLR: N W HOMES T I F $ 1520. 00 SW 07/1716/94 P 0 BOX 787 BV'RT $ 4:'4. 00 SW 07/06/94 OP,LC $ 275. 60 SW 06/2L0/94 94-253653 TUALATIN OR 9706C2 BSP,C $ 21. 20 SW 07/06/94 -- P"hone #.- L'45-5940 SSDC $ 2'80. 00 SW 07/06/94 - PARM, $ 500. 00 SW 07/06/9.4 - MP,RT $ 43. 5Q71 SW 07/121U/134 Mk'LC $ 10. 88 SW 07/06/94 N'.-A m e Ill 5 P 1, $ 18 SW 07/06/94 Address : F'P'RT $ 155. 00 SW 07/06/ 94 - City : - 'StAte : P'5PC $ 7. 75 5W 07/06/9,4 Zip: MISC $ 40. 00 GW 07/06/94 Reg Additional fees Ti a t shown here. . . . . . . . REQUIRED INSPECTIONS This permit is issued subject to the t-eg-- fjlations contained in the Tigard Municipal Foot /found Insp Rain drain Insp Code, St-Ate of Ore. Specialty Codes and all I-lost /Beam Struct Water Line Insp other applicable laws. All work wili be done Post/Beam I'lechan Appr/13dw1k Irlsq) i.n accordance with approved plans. This Pllm/'undslab Insp 11 e(-I i a n i ca I Final permit will expire i F work is not started FILM/Underfloor FIlumb FIT-ItIl within 180 days of issuance, or if work is Mechanical Insp Building Final suspended for, more than 180 days. Plumh Top Out Erosion Control LL Framing Insp Crawl Drain Fireplace Insp Gas Line Insp IT,su'lation Insp Gyp Board Insp ilutklorized Pfumbing Contractor Signature CLA11 for inspertion E,39-4175 Contractor Notes : CITY OF T MAgTER PERMIT' PERMIT f#. . . . . . . : MST')4• 0L41 COMMUNITY DEVELOPMENT DEP�Ar�T�I��1T DATE IE 'UED: 07/06/94 13125 SW Hall Slvd.Tigard.Oregon 97223.8199 (503)839-4171 PARCEL: WS 1 1 OBD--O24iZ GJTL-: ADDRESS. . „ : 14')77 5W I16TH PL... .SUBDIVISION. . . , : HELM HEIGHTS ZONING: R-4. 5 SLOCK. . . . . . . . . . . LOT. . . . . . . . . . . .. . : 1 ___. _--------- . _.__.___..._________.__ BUILDING REISSUE: DWELLING UNITS: i BASEMENT. . . . . . . . :O sf CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . . 399 sf TYPE OF USE. . . :SF FLOOR AREOS--•_......_...._.___.__ REQUIRED TYPE OF' CONST. :5N FIRST. . . . : 102:7 s f LEFT. . :99 ft R I GHT. :99 ft OCCUPANCY GRP. :R3 SEGOND. . . :917 s f FRONT. :20 ft REAP!. . : 15 ft STORIES. . . . . . . :2 THIRD. . . . :QI sf I (EIGHT'. . „ . „ . . . :G5 ft TOTAL--•--.•_--•-: 1934 sf SMOKE DETECTORS. :Y I='LOOR LOAD. . . . :40 psf VAL.UE. . . . . $ : 96146 PARKING SPACES. . : 1 Remarks : PATH I PLUMBING SINKS. . . . . . . . . . : :1. 17LOOR DRAINS. . . . :0 BACKFLOW PRE VNTRS. . : 1. L_AVAT•ORIES. . . . . .4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . :C' LAUNDRY TRAYS. . . . 1 CATCH BASING. . . . . . . :0 WATER CLOSET'S. . :3 SEWER LINE 'ft ) . :0 GREASE TRAPS. . . . . . . :0 DISHWASHERS. . . . : 1 WATER LINE= (ft ) . : 100 OTHER FIXTURES. . . . . .0 GARBAGE DISP. . : 1 RAIN DRAIN (ft ) . ;0 WASHING; MACH. . . : 1 SF RPIN DRRAINS— i MECHANICAL ____.___._..___.___.._..........________.___.___._ __.__ FEES _...___.__.._.._____..-..... _ FUEL TYPES-•-----•--•-.-- UNIT HTRS. . ;0 type amoi_tnt by (:fate t^ecpt /GAS: / / VENTS . . . . . :0 TIF $ 15C20. 00 SW 07/06/94 MAX INPUr:O BTU VENT FANS. . :4 BPRT $ 424. O0 SW 0.7106194 TURN ( 100K . : I HOODS. . . . . . : 1 BPLC $ 273. 60 SW 06/,:'0 J4 94--253651.x. -URN ) =1001'. . . :0 WOODSTOVES. :0 B 5 P C $ 21. 20 SW O7/06/'. it - F-LUOR FURN. . . . :0 CL.O DRYERS. : 1 SSDC $ 280. 00 SW O7/f,*/9•. - DOIL_/CMI'' < 31AP:0 OTHER UNITS: 1 PARI; $ 500. 00 SW 07/06/94 GAS OUTLETS: 1 MF-:RT $ 4.3. 50 SW 07/06/94 - 1wrret 10. 88 SW 0-'/06/94 - -1 W HOMES MSPC $ 2. 18 SW 07/06/94 1` O BOX 787 PPR T $ 153. 00 SW 07/06/94 1-15PC $ 7. 75 SW 07/06/94 - I"UALATIN OR 97061; 11 15C $ 4O. O0 SW 07/06/94 "'hone #: 245-5940 MISC $ 13. 00 SW 07/06/94 - Corltt-actor-: -..--___.__._.____.________________. ____MISC $ 13. O0 SW 07/06/94 - NORTHWEST HOMES `T) SOX 787 I LIALATIN OR 9706,F, r'I ante #: ;:--,45-5940 56696 $ 3306. 1. 1 TOTAL_ Thi, permit is issued subject to the regulations contained in the -- -- -- REOUIRED INSPEC'TIONFS -- ---- Tigard Municipal Code, State of Ore, Specialty Codes and all other Foot/found Insp Fireplace Insp applicable laws. All work will be done in accordance with approved Post /Beam Sti,1,tct Gas Line Insp plans, This permit will expire if work is not started within 18@ Post/Beam Mechan Insl.tlation Insp days of issuance, or if work is suspended for more than Iff days. Plm/1.mdslab Ins, Gyp Buard Insp PLM .lndet-fluor• Rain drain Insp Pet"mittee Signati_tr'e : _ _ Mechanical Insp Wafer Line Insp Pl. i_tmb Top Oi.tt Appv,/5dwlk Tnsp l Issued By : v0_� Fr,aming Insp Mechanical F-i;tal. Call f'or in-.pection __ 634-4171, SEWER CONNECTION CITY OF TIGARDPERMIT PERMIT #. . . . . . . : SWR94-0233 COMMUNITY DEVELOPMENT DFWT DATE ISSUED: 07/06/94 , , M�VT 13125 SW Hall Blvd.Tigard,Oregon 97223o8199 (503)639-4171 PARCEL: 25IlOBD--02400 511"E ADDRESS. . . : 14977 SW 116TH F-11- SUBDIVISION. . . . : HELM HEIGHTS ZONING: R-4. 5 BLOCIJ.. . . . . . . . . . : LOT. . . . . . . . . . . . . : 1 TENANT NAME. . . . . : USA NO. . . . . . . . . . : FIXTURE UNITS. . . : CLASS OF WORK. . . :NE14 DWELL I NG Ull I TS. . : I TYPE OF USE.. . . . . :SF NO. OF' BUILDINGS: 1 INSTALL TYPE. . . . ;BUSWR IMPERY SURFACE. . : sf Relnar-ks . PATH I Owner: FEES N W ;TOMES type amoLint by date r-ecpt P 0 BOX 787 PRMT $ C-200. 00 SW 07/06/94 - INSP $ 75. 0''1 SW 07/06/9/1 TUALATIN OR 97062 Phone #: iz:45-5940 Co-t;t-act ora CONTRACTOR NOT ON FILE E2'35. 00 TOTAL REQUIRED INSPECTIONS This Applicant agrees to comply with all the rules and tegulpfions Sewer Inspection of the Unified Sewage Agency. The permit expires 180 days from the date issued. The total amount pail will be forfeited if the permit expires. The Agency does not guarantee the accuracy of the side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospects feet in all directions from the distance given. If not so located, the installer shall purchase a "'lap and Side Sewer" Permit and the Agency will install a lateral. Pet-mi.ttee :;i.gnattArec Call fov- inspection 639-4175 Li J City of Tigard Reo-idential Building Permit Application 13125 SW Hall Blvd. L ✓� Tigard, OR 97223 (503) 639-4171 Jobsit-: Address:/ j 7 �$�W• v ti �� J Office Use Only Subdivision: !��> //i 1 �"l'/�/t 7 S Lot # PlanckJRec it Valuation: I0,, Permit # 'A S Owner: GV _Ncs'�ti� Reissue of Address: > c� 7 .7 Map & TL # Phone: C Approvals Required �� �L f "'r 1 � _ Planning Contractor: A w'l E Engineering _ Address: Other Phone: �.) _.l L� / 7 > j yy2tf Items Required Subr•.ontractors Contractol's License # (attach copy of current Oregon license) Truss Details _ Contact name & phone: 602 S = '7 ?-T f Other Subcontractors: Plumbing: F��G.> 1 � r+ I-� Ji i ►6 i �� !.>� :rfl C-7 s 4f CLL,, 08 4.. Mechanical: 1 7 (attach copy of current OR Contracto ss License) Arch ltect/EngIr*er:�> Address: e, Phone: JOB DESCRIPTION Applicant Signature & Phone number r, / Received by:�_ _ Date Received: Permit # Account Description Amount Amt. Pd. Bal. Due I? I-c'a�(( Bldg Permit (BUILD) _� U �2 Plumb. Permit (PLUNiB) .> _ Mech. Permit (MECH) e13 3:-S State Tax (TAX) 31, 13 Bldg: Plumb: 7• Mech: Plan Check (PLANCK) OC'6,• Ll z _ Bldg.- Plumb: ldg:Plumb: Mech: S� R`t i- 11 Sewer Connection (SWUSA) o v 2 611 Sewer Inspection (SWINSP) � 1/ 3 Parks Dev Charge (PKSDC) 6,0 SaU Storm Drainage Chg (SDSDC) J, riesidential TIF (TIF-R) I U _ / 00 . Mass Transit TIF (TIF-MT) 1 / 0 .�ommerual TIF (TIF-C) Industrial TIF (TIF-1) Institutional TIF (TIF-IS) _ Office TIF (TIF-0) Water Ouality (WOUAL) n. c Water Quantity (WQUANT) _ r Fire District (FIRE) Erosion Cntr1 Permit (ERPR..,,) r w Erosion PlancWSA (ERPLAN) J Erosion Planck/COT (EROSN) TOTALS: S S U I •I c 6. PIc 13 or 10 e2 N. 'Yt-t e s lov. r3vx �'�f7 7`u4 /G 7'1 �7v4Z . Y ' rz 2 11 i Ale ^`t�f vx,�.,, S POS e n r! La Y ujs As u X09 �r i� o .�