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CITYOFTIFARD BUILDING PERMIT
CIT1f OF 1N►ARA
COMMUNniY DEVELOPMENT DEPARTMENT ORIG M PL:RM I I
13125 SW Hr!Blvd. P n.Bax 23397,Tgwd,Oregon 972231(503)63"175
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::,ITL" ADDRESS. . . . i c-22'5 SW 122ND AV PnRCEL: 2—103BB-111890101
SUBDIVISION. . . . LAKE TERRACE ZONING: R-4. 5
ILOCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 16
t I`•:SUc: FLOOR AP AS-.__.__.__._..__._. EXTERIOR WALL CONSTRUCTION-
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.:LASS OF W(:)RK. :ADD F I RCY. . . . : =f N: S: E:: W:
'-YPE OF USE. . . -5F 173F170ND. . . : sf PROTECT OPENINGS?
FYPE CF CONST. :5N THIRD. . . . : sf N: S: Et W:
OCCUPANCY GRP. :R3 rorA1_-----_: 0 sf ROO-' CONST: FIFE FLET? :
OCCUPANCY LOAD t BASEME NT. : s f ARTA SEC'. RATED:
'])TOR. : 1 IAT. : 13 ft GARAGE. . . :2 601 sf OCCU 9E.P. RATED:
BSMT?: MEZV: RECD SE-rBACKS--- --•---- REG?UIRED---____.____._.___.._._.... . _.
FLOOR LOAD. . . . r p s f' 1.J--_F'11'- ft RGIiT 24 F1: FIR SAKI_: SMOK DET. .
DWELLING UNIrS: FRNT:27 ft REAR= ft FIR AL.RM: HNDICP ACC,
BE7DWS: BATHS. IMP SURFPCE. PRO CORR: PARKING:
)ALUE:. S 46801
,•�emarl<s : L60 SC! FOOL ATTALH GARAGE (NONHADIIABLE SPACE)
Owner- : FEES
BE14NE KFRLER type amount by date recpt
12225 >W WALNUT 5T PRMT b 501. 501 JL_H 05/;w0/r?r' --
PL.CK $ 32. 83 RT 04/21/92 226,.:38
T ICiAFCU OR 972123 5PCT $ 2. 53 JLN 05/'20/')2
1-'hone #t 620-6161
Contractor:
0ERAI_1) (SNOW
98OLA SE CAR- 1 COURT
GRESHA OR 80 _________.__.________•--___________._.__..._._.._--.
Phone It: $ 65. 86 TOTAL
Reg #. . - 68852
------- RE W I RLD INSPECTIONS
- ---- - -
Th's pereit fs issued subject to the regulatiuns contained in the Fout/foLlnd Insp _-_......._._._-.......
_.__�_ ,_.____
Tigard Municipal Code, State of Ore. Specialty Codes and all other Frost/Beam Insp
applicable laws. All work will be done in accordance with Framing I n s p
} approved plans. This permit will expire if work i� not started Rain drain Insp
i4ithin 180 ,ays of issuance, or if work it .,.spended for more Final Inspection
nan j20 days.
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-� CaI1 for inspection 639-4175
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INSPECTION NO_TiCE
City of Tigard Building DepartAwnt
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Plbg. Underelab Mech. Rough-tn AppriSdwlk
Found. Plbg. Top Out Gas Line FINAL:
wt/Beam 8t' San. Sewer easing -Bldg.
oat? Hoc Rain Drain Insulation -Plumb.
P1 . Underf oor Water Llne Gyp. Bd. -Hoch.
Date Requested: -` _�_ Tiimmes�_�AH PH
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Address:__ �AYm�t •t `vL— ?�U��
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRRn:
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Inspector:��/-1-� Data:
APPOOvEO 018RPPrAIM -z"PROM SUBJECT TO ASMS
Call Por XOJAOV.
INSPECTICV NOTICE
city of Tigard Building Department
13125 Sit Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Paone): 639-4175 Business Phone. 639-4171
Inspection: -—
Footing Plbg. Underalab Mech. Rough-in Appr/'Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/ am Mech. ltsfo Drain Insulation -Plumb.
-Mech.
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Hater Line
GYP. ed. t.
ate Requested:_
7 L, Time: AM PM
Ac'drese:1
Builder:
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inapector:��� --- Deter_
APPROVED DISAPPROVED APPROVED SUBJ7,CT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE .�
City of Tigard building Department
13125 SW Ball Blvd. Tigard. Oregon 9722
Inspection Line (Rec-o-Phone): 639-4175 BBusinyes• Phone: 639-4171
inepection: �//c/f G>.i CF l`J
Footing Plbg. Undersiab Mech. Rough-in Appr/Sdwlk
Found. ) P!b.,,. Top Out Gan Tine FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line > Gyp. Bd. -Mach.
Date Requested:_ ' « i MP Times _,-/--, AM PM
Address: Permit fe 9z
Builder: (1'Co -c//c,lG i
TBE FOLLOWING CORRECTIONS ARE REQUI^_'9s
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Inel actor:
APP?A*70 DISAPPROVED APPROVED SUBJECT TO AROVE
`_Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building DepartJent
13125 SSS Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _ �__.— - --•
�-�
Footing , Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Foisnd. Plbg. Tep Out Gas Line FINAL:
Pont/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Und9rflo,3r /-water Line Gyp. Bd. -Hoch.
Date Requested:
(!� - Time: _ AN PN
Address:
Builder: ) Z U (O
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: SLI Dr.te:(6_,ti - �-
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^--� APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Roinap.
INSPECTION NOTICE
City of Tigard Building Departinent-
13125 Sit Pall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4 75 Business Phone: 639-4171
Inspection: -- --- ---
Footing Plbg. Underela Hoch. Rough-in Appr/SPwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Hoch.
Date Requested: / _-3 D -Ee /Time- _AM /2_- j PH
Address:- �� wqgim-z �Peftlf� __��co
Builder: 1
:HE FOLLOWING CORRECTIONS ARE REQUIRED:
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ArPR(,VED DIrAPPROVRD APPPOVED ti11B.IFCT TIO ABOVE
Call For Rninnp.
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CITY OF T I GARD RECE✓r r,T OF '',OYMENT RECEIPT NO. ,W�_,
MAECK AMOUNT a 53. 03
NAMES a itEc:Rl_E R, SEr'NNf4 CASH AMMANT IA. 00
Almw,cus a IP22-5 SW WALNUT PAYMENT DATE: a 05/P@/9,
SUDD I v i s i 7N a
TIGPRD. OP72'2 -
PURPOSE OF PAYMENT AMOUNT PAID PURPOOE OF PAYMFN'T AMOUNT PA I Ii
rtUIt_ �_.__.. . _....__._ 50.50 0"r. BUILD PER._.._._.__ 2. `i3
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TOTAL_ AMOUNT PAID
ror "r T(':jnPD - RE(T T PT OF PAYNEWT RECETPT WO.
CHE.CK AMOUNT X? 8J,
NAII(l r KE.PLU-11, f,4--IqNL:- cf)SH AMOUNT a 0. 01.,q
W)1)fqf: I 11W WAI.NI 11 ;..l PAMN'r DATE o 04/21 /9t.
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PUI-I 109C OF, nivicluNr rvur) PUPPOSE OF POYMENr A.MOUNT Pri T 1)
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TOTAL AMOUNT PAID I?
13125 sw siau Blvd. °l_NCK/Rg' —4
ECT # /
CITY OF TIGA.RD PO Box 23397 PERMIT #
CONINIUNM' DENELOPMLAT DETARTMENT Tiigard,Oregon 972D
(503)639-4171 DATE ISSUED
JOB ADDRESS: ��°Z`2 �C/ A/iJ� rl'lAfV TAX MAP/LOT 2 51-03 66 4)Yi00
SOB: LOT: �g'g� y�Q LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: ��.�/iN� �� R_ISSUE OF:
ADDRESS: � � u>, �-r✓��� LAST kEISSUE: _.-------
T����� FLOOD PLAIN/
PHONE: — ��" off/ — �—� 'L PI•SENSITIVE LAND: --
APPROVALS RE UIRED Mw�r Esc ' {�rrr1
CONTRACTOR —__�
NAME:
PLANNING: -S^—.—
ADDRESS:
LANNING: -ADDRESS: cl-�lf phr ENGINEERING: _ ---
_� FIRE DEPT: _
c, 1 b gv OTHER: PO _----
PHONE: _ —
CONTR. BOARD #: -LL- _ EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: __ L I ST/SUBCONTRACTORS:
MECH: BUS TAX: _ —
ARCH ,.NGI_�,fLR CA!_CULATIONS:
NAME: 1 /1 -��,� •�-rj ��� TRUSS DETAILS: —
ADDRESS: _ __ _ OTHER: _
a pf10NE:
PROPOSED BLDG. USE:
COMMENTS:
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APPLICANT SIGNATURE
Received By: _ ___ ____. Date Received: Z-
PERMIT # ACCT N DESCRIPTION AMOUNT AMOUNT PD. SAL. DUE
10-432 00 Building Permit Fees .5 0-1 _5u. >v
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees _
10-230 01 State Building Tax (5%) • % �7
Buiiuing ,�5
Plumbing
Mechanical
10-433 00 Plans Check Fee 3
Building Z•5_-
Plumbing _
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection _
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
2.5-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) _
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) -- _—_
24-445-01 Water Quality (Fee in lieu of)
"' 24-445-02 Water Quantity (Fee in lieu of)
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TOTAL
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