12110 SW 123RD AVENUE . f
i
INSPECTION NOTICI�
City of Tigard Build.iml Department
13125 SW Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-0-Phones i:39-4175 Business Phone: 639-41;1
J
Footing Plbg. Underelab Mech. Rough-in Appr/Eiwlk
Four Plbg. Top Out Gas Line FIN"t
Poit/Beam struct. San. Sewer Framing Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Urate Re(pieeted:_ 1 L tl TJAGI AM __PM
Address s /'V�-// L) �� r PatFl�f t •- �E 15_1��_
t
i
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r f�
Inspector: Data F=q OF
AAVZVM6��'
DISAPPROVED APPROVEr SUBJECT TO ABOVE
call For Rainep.
I
--A
M_ M
INSPECTION NOT.CE
rity of Tigard Baildinq Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Ine!,ection Line (Re--.�cc-moo.�-Phone):
/ 639-4175 Ilueiness Phone: 639-4171
Underslab Hoch. Rough-in AppI:/Sdwlk
Footing
Plbg• q
Plbg- Top Out
Gad Lias FINAL:
Found.
Poet/Beam Struct. Sen. Sewer
pramknq -Bldg.
post/Beam Hoch. Rain Drain
Insulation -Plumb.
PLbg. Underfloor Water Line
Gyp. Hd. -Mach.
PM
Data Aequeated=_
r�
Addreae:
' r
Builder:�,r �
TILE IroLLOWTNG oORUCTIORD AM 'MW'REOc
I
-----------
-------------
Dates J
inspector:
APPROVED DISI.PPROVED APPRO'!ED SUBJECT TO ABOVR
Call For Rains,i.
-BUILDING PERMIT
CITYOFTIGARD
PERMIT #. . . . . . . : BUP91_01 BO
,OFTFD
COMMUNTY DEVELOPMENT DEPATMENT cmO
13125 SW F W I BNd. P.O.Hag 23397,T4)wd,C-agon 97223(d9:f{,�9-�t'7�r I DATE ISSUED: 07/29/91
SITE ADDRESS. . . . L2110 SW 1,---'3RD C`1 PARCEL. 'S1O3DD- 10!00
SUBDIVISION. . . . : YE--OLDS WINDMILL "ZONING:
BLOCK. . . . . . . . . . . LO'... . . . . . . . . . . . . :`7
REIST,UF_: FLOOR ARE:AS••__.--------- EXTERIOR WALL CONSTRUCTION.
CLASS; OF WOPK. :ADD FIRST. . . . : sf N: 5: E: W:
TY'"'E OF USE. . . :SF SECOND. . . : sf PROTECT OP'ENING�?-__.____.-_
TYPE OF CONST. :5N THIRD. . . . : sf N: S: E- W:
OCCUP'ANC'Y GRP'. :R d TO'TAL---•-------: 0 5f ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: BA5EMENT. : s f ARr--) SEF'. RATED:
STOR. : HT. : ft GARAGE. . . : sf UC-u SEF'. RATED:
B:iMT?: MEZ Z?: READ SETBACKS, REQU I RED-------
FLOOR
ED-- _----FLOOR LOAD. . . . :40 p a f LEFT: ft RGHT: ft F i R 5P'KL: SMOK DET. . :
DWELLING UNIT,: FRNT: ft REAR: ft FIR ALRM: HNDICP ACC:
BEE)RMS: BATHS: IMF' SURFACE: PRO CORR: PARKING:
VALUE. $ : 3000
Remarks : adding a new deck
Owner: - -- ----------------_____.____ ___.___ _.___._..__.__---_.____ FEES -_._.-__-------_
MARTY LEE.. type amol_rnt by date recpt
IL11O SW 1213RD CT PRMT $ 38. 50 JLH O7/29/91 215785
P'LCCK t `5. 03 Jl .i-1 07/29/91 215785
TIGARD OR 97223 5P'CT $ 1. 93 JLH O7/29/91 215785
P'horrt- #:
Contractor:
CONTRACTOR NOT ON FILE
-----------------------------------------
I-1hone 65. 46 TOTAL.
-------- REQUIRED I NSc.ECT 1 ONS ------This permit is issued subject to the regulations contained in the Foot/found Insp
Tigard Municipal Code, State of Ore. Specialty Codes ar d all other Framing Insp
applicable laws. All work will be done in accnr•dance with Final Inspection
approved plans. This permit will expire if work i; rot started
within 180 days of issuance, or if Mork is suspended for more
than 18N days.
1:'ermittee Signature:_
T s s i_ted By
Call for inspection 639-4175
CITY OF -rIGARD RECEIPT OF POYMFNl' RECEIPT NO. :91 -215785
CHECK AMOUNT : 65. 46
NAME L-EE, MAPTIN A CAROL CAS14 AMOUNT 9 0. 00
ADDRESS 12110 4 IF3RD COURT ;:-PYMFN,*r ()A,rE 07/29/91
SUBDIVISION
T IGARD, OR 9722,3-305t SAME AS CHECK
PURPOr�'E OF V,AYMENT AMOUNT PP" PURPOSF OF F-IAYMF.:NT AMOUNT v,A i D
38. rief TUALATIN VALL 1. 93
PLAN CHECK FE 7-298 25. 03 ST. SUTLD PER 0. 00
ODD ING A DECK
TOTAL AMOUNT PAID
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LIABILITY: The City of Tigard, Oregon, or it's
employees, 11 not be responsible ID,
'i"idih►�ei : -: :_V_._:_:.__._ discrepancyt fij:�.,; may appear herr+-)n
Ld1r Z7 _
_1V�►'sN I N t,�olJ__ Go._ _ . APPROVED FOR CONS i RUCTION
CITY OF TIGARD
b ,a gib
AVO t 4"14. S.F. I._s: i�t.gl I IJ'' �PI�Q-ird SITE ADDRESS J;Z)A.D-w �_-
.
13125 SW Iiau LM. PLNCK/RECT #
CITY O T I GARD F'n Box 23397
PERMIT #
COMMUNITY DEWELOPMENT DEPAR'T'MENT Tigard.Oregon 97213 +C
(503)6,39L-4171 DATE ISSUED
JOB ADDRESS: t� c �_�� 3�i r� TAX MAP/LOT LDl } Ye- -Old c tJ+hdhl,,�
SUB: _ % — _ LOT: -1c -v Id,,; �'���d/ � LAND USE:
VALUATION: _,.��, 0aa_"'
OWNER N / SiIECIAI NO1�ES
NAME: / L -- REISSUE OF: ---
ADDRESS: i,,.?_La-3rJ C--4 _ LAST REISSUE:
FLOOD PLAIN/
PHONE: —, 5-0 (o C� — SENSITIVE LAND:
,3 �
CONTRACTOR // APPROVALS REEOUI_RED
NAME: Ci Nel - Sec �� hum_-- -- PLANNING: ---ADDRESS: ENGINEERING:
_. ENGINEERING:
FIRE DEPT: _ __--
PHONE: — —_ _` OTHER: --- _ _-----
CONTR. BOARD #: EXP DATE: -- _
ITEMS_P.EQUIRED
SUBCONTRACTORS: PLUMB: — LIST/SUBCONTRACTORS:
MECH: BUS TAX: —__--- —_ —._-_--
ARCH.LERr,INEER CALCULATIONS:
NAME: _ — —_--- --- TRUSS DETAILS: _ _--- ----_--_.
ADDRESS: —_ __ OTHER: —
PHONE: ----- ----- ---- ----
PROPOSED BLDG. USE:
COMMENTS. _ —.._- ------- - -- ------ -----------
APPLICANT SIGNATURE
Received Bye �. _— Date Received:
Effiffirm F1 Nil W1 N F i
PERMIT # ACCT # DESCRI ION AMOUNT MOUNT PD. -BAL. DUE
10-432 00 Building Permit Fees rZ
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee
Building
PI umbi rig
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
25-448-01 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 lien of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL -�(r J–S `�...�"
nm/3587P.WPF
at
CITYOFTIFARD
t17YOF116AR0 PLAN CHECK APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT / PLAN CHECK 11 � /)
13125 S W.H&H Blvd..P"o.Box 21397,T1gsa1,Oregm 97221,(SQ3)6394175 PERMIT #/ j '?-;i 9
DATE ISSUED _
JOB ADDRESS: (Z( IO �, lt.�, I Z3 TAX MAP/LOT
SUB: ' pt°' u101 /�f/(.(� _ L01 ; — —�� LAND USE:
VALUATION: —
OWNER SPECIAL NOTES
NAME: //VwI- CG REISSUE OF : _
ADDRESS: ._..�/IP s � '� �+? � AD LAST REISSUE: _
FLOOD PLAIN/
-—— SENSITIVE LAND:
APPROVALS REQUIRED
CONTRACTOR G PLANNING:
NAME: irg�G)ENGTNCERI�IG —
ADDRESS: /?-S.S•O aAIJI /FIRE DEPT
OTHER:
PHONE ITEMS RE 1(�UIRED
BUILDERS BOARD M: ., l _ EXP DATE: � LIST/SUBCONTRACTORS: —_
BUS TAX:
ARCH/ENGINEER CALCULATIONS: _
NAME: �3 ^ Lr _ « �� TRUSS DETAILS: _
ADDRESS: — _ OTHER:
PHONE: ---_-----
COMMENTS: ly�-�-b�-"- ��--=-7 F I.::)
SUBCONTRACTORS: PLUMB: _ MEC (c e7' ;,
i
PERMIT p ACCT N l DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
10--431 00 Plumbing Permit Fees — _
10-431 01 Mechanical Permit Fees
10-23( 01 State Bl1 i ld ing Tax (5X) _
Building
Plumbing
Mech
10-433 00 Plans Check Fee
Building
Plumbing
Mech _
30-202 00 Sewer Connection
30-444 00 Newer Inspection
51-448 00 Street System Dev Charge (SDC) _
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg (S MQ
10-230 �6 Fire
TOTAL _
�' RUC N
APPt TCANT Si", ATUR
Received By: __. _ Date Received: J
c:n/3587P/18P
INSPECTION NOTICE
City o; Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection C'� -- --
Date Requested
r_.LL-- Time _ A.M._ ( c,
Address
cam- tJ /,� 3 tc� C Permit *Jji —
Owner — __...
Lot
Builder _The following Building Code deficiencies are required to be corrected:
Presented to j -roved
�-►
Inspector L_I Disapproved
_ —'
2
Date —.._ -
CALL FOR REINSPECTION
EYES ❑ NO
1
f
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Gh� Tigard, Oregon 97223
1� Phone: 639-4175
i of Inspection _ -L C
r
^c Requested �r nme _.. A.M. P.M.
Address IL Y I
— Permit #.FLL40yY
Owner Lot #
Builder .--_-- 43 4 Z C
The following Building Code deficiencies are required to be corrected:
Presented to _ [ proved
Inspector '��- ❑ Disapproved
Date !
CALL FOR REINSPECTION
❑ YE= 0 NO
INSPECTION NOTICE
City of Tigard Building Department "J
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested l/ Jct 1: Time A.M. _ P.M.
Address !�� /U �� �t Permit #
Owner // '/ / Lot #
Bulkier 6'1/11 f� zr`f•3� �
The following Building Code deficiencies are required to be corrected:
I
I
Presented to _ [kl�Approved
Inspector „C _ .� [_ Disapproved
Data
CALL FOR REINSPECTION
L 1 YES f:] NO
INSPECTION NOTICE
City of Tigard Building Department
,r P.6,Boz 23397
Y �_T ►d, Oregon 97223
Phone: 639-4175
Typu of I
Date eq et
C ,Time A.M. P.M.
Permit #
AddressL' � � � -
Lot # --
Owner
Builder
The following Building Code deficiencies are required to be corrected:
Presented to �pproved
1
Inspector Disapproved
Date
CALL FO REINSPEC77ON
0 YES ❑ NO
i
INSPECTION NOTICE_
City of Tigard Building Department �v
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639.4175
Type of Inspection
Date Requested 0- C14- Time A.M._�P•M•
Address Z5r ' Permit JT
Owner -
Lot #
BuilderLt.�-yam---
The following Building Co& deficiencies are required to be corrected: _
F
p4
Presented to ❑ Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
0 VE3 O No
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested
A—)
/—��_���_t �L Time A.M._._._P.M.
Address !�L(L __——_.�c�.�r� Permit
Owner Lot
Builder
The following B ing Code deficiencies are required to be corrected:
a
--------- -- -- ----------
Presented
-------Presented to Approved
Inspector isapproved
Date = -- ---
CALL FOR REINSPF,C7YON
[] YES I. ) NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175 �(
Type of Inspection
Date Requested Time A.M. _P.M.
Address z ,-3r dC2Z ; Permit #-J�V�-1
Owner __ _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to ____ F) Approved
x'
Inspector _ ❑ Disapproved
Date - 11 - 2—, 7-
CALL
" L7"CALL FOR REINSPF;CTION
El YES L7 NO
i
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
i
Date Requested f _ Time A.M. (,cZ-P.M.
Address Z /U -'� , Permit ?,2 9 y
Owner_ Lot # _.
Builder -,zar"^tet
The following Building Code deficiencies are required to be corrected:
Presented to J! Approved
Inspector ___ (� Disapproved
Date _
CALL FOR REINSPECTION
❑ YES NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone. 639-4175
Type of Inspection
Date Requested ___ P Time P.M.
Address ______/ // '3 h d --- Permit #
Owner _____ _—___ ___ Lot #_
Builder — ----�
The following Building Code deficiencies are required to be corrected:
ev
Presented to _� "T __ _- --_.. —_._.—_ Ap roved
Inspector __ -___ ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
I
CITYOFTIGARD
BUILDING PERMIT
�� PERNIT NO. : BUB92294
cmotr flA /
COMMUNITY DEVELOPMENT DEPARTMENT °1NO°" TE: ISSLIED: 11./ 7/89
13125S.W.Hall Blvd.,P.O.Box 23397,TIgard.0region97223.(503)639A175 1M.PMT.NO. 892294
JOB ADDRESS: 12110 SW 123RD CT
TAX MAG/LOT 2S13BB10700 SLIP: YE OLDE WINDMILL LTs27 BK.
LAND USE: R4.5
LOT SIZE: VALUATION: $ 34. 104 SETBACKS
y FRONT: REAR:
WORK CLASS: ADDITION DWELL.UNITS: LEFT: RIGHT.-
USE
IGHT:USE TYPES SINGLE FAMILY NO.BEDROOMri: r FYT.WAI.I. CONST:
CONST.TYPE: VN NO.BATHS: ] N: S. E: W:
OCCUP.GRP. : R3 PROT.OPENINGS:
OCCUP.LOAD N: S: Es W:
TOTAL AREAS 677
NO.STORIES: 1 1ST: 677 ROOF CONST: FIRE RET7
HEIGHT: 13 2NDs AREA SEPAR? RATED:
BASEMENT? 3RD: OCCUP.SEPAR? RATED:
MEZZANINE? BASEM'T
FLOOR LOAD: 40 GARAGE: 315 FIRE SPPKLR? ALARM?
— FLOW(GPM) DETECT? YES
HEAT TYPE.- GAS HDCP.ACCESS? ?
PLAN CHECK BY: bcr
REMARKS:
Garage and House addition REISSUE OF 140.
LAST REISSUE
FEES:
Lee Marty PERMIT $215.50
12110 SW 123rd Ct PLAN REVIEW $140.08
Tigard OR 97223 FIRE DEPT
STATE TAX $10.75
OTHER
DEVELOPMENT CHARGES:
LOVE DAVID SDC(STORM)
f SORRENTO CONSTRUCTION SDC(STREET)
A 12550SW 2ND PDC(# )
Cl beaverton or 97005 PREPAID < )
1 PHONE (503) 643-9602
0
R REGISTRATION NO. 6884 TOTALS $3LS.35
p I 9 ------------------ -
This permit is Issued subject to there .Ilatlons contained in Title 14
of the TMC. State of Oregon Specialty Codes, zoning regulations
,and all other applicable codes and ordinances. and It Is hereby RFOUIRED INSPECTIONS
agreed that the work will be done In accordance with the plans and FOOTING
specifications and In compliance with all applicable codes and FOUNDATION WALL_ RAIN DRAINS
ordinances The Issuance of this permit does not waive restrictive POST d BEAM WATER LINE
covenants Contractor and subcontractors shall have current city PLB.UNDER5LAP FINAL
business tax permits. This permit will expire and become null and
void if work Is not started within 180 days,or If work is suspended or
abandoned for a period of 180 days any time after work has PLB.TOPOLIT
commenced It shall be the responsibility of the permittee to assure FRAMING
Fill required Inspections are requested and approved FIREPLACE
GAS LINE
(� L� ,lure Vy I,� 1NSULATION
Perrnlitee S
`-�� `( GYP. BOARD
ignaII
Issued By 7v �4-634-4174-- —'- -- - —---
SEPARATE PERMITS REQUIRED FOR WORK 0 rHE 1`1 THAN DESCRIBED ABOVE
ITY
OF
TIVA
(CITY01FTIGARD MECHANICAL PERMIT
p.� , PERMIT NO. : ME892406
COMMUNITY DEVELOPMENT DEPARTMENT 00/90N TE ISSUED: 11/22/89
125 S W Ha!!Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)8394175 —� /)_F T M.PMT.1`10. 892294
JOB ADDRESS: 12110 SW 123RD CT
TAX MAP/LOT 2S13BB10700 SUB: YE OLDE WINDMILL 11:27 BK:
LAND USE: R4.5
LOT SIZE:
ITEM: NO: NO:
WORK, CLASS: ADD ITTON FURNACE <100K AIR HANDLR (10
USE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDLR 10K
CONST.TYPE: VN FLOOR FURNACE EVAP.000LER
OCCUP.GRP. s R3 HEATER VENT FAN 1
VENT VENT.SYSTEM 1
BLR/COMP <3HP HOOD 1
NO.STORIES: 1 BLR/COMP 3-15HP INCTNERATOR(DOM
DWELL.UNITS: BLR/COMP 15-30HP INCINERATOR(COM
FUEL. TYPE GAS BLR/COMP 30-50HP REPAIR UNITS
MAX. INPUT BLR/COMP 50+HP OTHER
FIRE DMPRS? GAS PIPING OUTLETS
HIGH PRESS?
LOW PRESS^ _
REMARKS:
Garaqe and House addition
FEES:
W Lee Marty PERMIT $10.0111
N 12110 SW 123rd Ct PLAN REVIEW .VP
H Tiqard OR 97223 FIXTURES 51c.00
STATE TAX $1. 10
_- --- --_ OTHER
C
0 HEDIN ROBERT
N
T HEDIN'S HEATING
A pa BOX 584
A
C hillsboro or 97123
o PHONE (503) 648-1159
R REGISTRATION NO. 47211 TOTAL: $28.60
/LTThis permit Is Issued subject to the regulations contained in Title 14 RECEIPT NO. A-e ,_ --- -_ )
of the TMC. State of Oregon Specialty Codes, zoning regulations -�r-
and all other applicable codes and ordinances and it is hereby REQUIRED INSPECTIONS
agreed that the work will be done in accordance with the plans and OAS LINE
specifications and In compliance wilt, all applicable codes and POST & BEAM
ordinances The Issuance of this permit does not waive restrictive ROUGH--IN
covenants Contractor and subcontractors shell have current city FINAL
husiness tax permits This permit will expire and become null and
void it work is not started within 180 days or if work Is suspended or
nhandoned for a period of 180 day!, any time after work has
commenced It shall be the responsibility of the perrmttee to assure
Fill required Inspections are requested and approved
Perlee SicinAture
Issued By -
SEPARATE PERMITS REQUIRED FOR WORK OTHER 'KHAN DESCRIBED ABOVE
PLUMPING PERMIT
CIIYOFTIFARD PERMIT NO. : PL892405
Cmof fl6A110 l/
COMMUNITY DEVELOPMENT DEPARTMENT 011100" p E ISSUED: 11/ 7/89
13125 S.W.Hall Blvd..P.O.Box 2339i, igard,Oregon 97223.(503)63c.)-4175 IM.PMT,NO. 892294
JOB ADDRESS: 12110 SW 123RD CT
TAX MAP/LOT 2S13BB10700 SUP: YE OLDE WINDMILI LT:27 BI':
LAND USE: R4.5
LOT SIZE:
ITEM: NO: NO:
WORM. CLASS: ADDITION WATER CLOSET 1. TRAP
USE TYPE: SINGLE FAMILY URINAL BKFL.OW PRVNTR
CONST,TYPE: VN L_AVORATORY 1 TRAP PRIMER
OCCUP.GRP. : R3 TUB SHOWER 1 GREASE TRAPS
DISHWASHER 1
GARBAGE DISPOSAL 1
NO.STORIES: 1 WASHING MACHINE
DWELL.UNITS: LAUNDRY TRAY BL.DG,DRAIN (DIA
FLOOR DRAIN
SINK J SEWER (FT)
WATER HEATER STORM/RAIN (FT
OTHER
REMARKS:
Garage and House additioo
-- -------- --------
FEES:
W Lee Marty PERMIT $45.00
N 12110 SW J23-rd Ct
E Tiqard OR 97223 FIXTURES
STATE TAX
OTHER
O
T JIM'S PLUMBING
A 5955 SW TARALYNN
tl beaverton of. 11,005
T
R REGISTRATION NO. 19752 TOTALS $47.25
This permit is Issued subject to the regulations contained in Title 14 RECEIPT 140.11),57V/- C)
of the TMC. State of Oregon Specialty Codes, zoning regulations _________—_REQUIRED INSPECTIONS
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done In accordance with the plans and F'LB.UNDERSI_AP
-.pecifications and in compliance with all applicable codes and POST A BEAM
,rdinances The issuance of this permit does not waive restrictive WATER LINF
ovenants Contractor and subcontractors shall have current city PLP.TOPOIJT
Business tax permits This permit will expire and become null and
old If work is not started within 180 days,or if work Is suspended or RAIN DRAINS
+bandoned for a period of 180 days any time after work has FINAL
ommenced It shall he,the responsibility of the permittee to assure
M required inspections are requested and approved
12, Skt�
1'„'rmttlfe Signah
,.sued By `'; F-UIQ-LhI.SL=1:LIl0ill--b33-4175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
Cr is s Jw
188 03/24 1310S s 206 892 0017 EVERGREEN 01
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BUILDING PEIiMITAPPLk3ATION TIGARD DATE`a/?J -_119 83 4607
THE:UNDERSIG JED HLREBf APPLIES FOR A PERMIT FOR fHE WORK HEREIN INDICATED BUILDER PHONE _—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE627-7-341
LOT NO.
12110 SW 123rd tcourt
t1arl:y L%:e JOB --- ---
OWNER — -
'" -- - ARCHITECT
ENGINEER
BUILDER
SV" ADDRESS DESIGNER
_ _ - -- -—
STRUCTURE ❑ NEW _Ll REMODEL f ❑ ADDITION ❑ REPAIR ❑ RENEWAL U FIRE_DAMAGE T ❑ DEMOLITION
P RESIDENCE ❑ COMM [J EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORTY❑ GARAGE El STORAGE ❑ SLABO FENCE
OCCUPANCY h:3 LAND USE ZONE R-7 __BLDG.TYPE ', _FIRE ZONE PLAN CHECK BY bcT HEAT -
IFnclose oxistinf r_avrrtnl atia
(Solarium, ;ion—lat:,itable)
SEWER PERMIT M — --
OCC.LOAD FLOOR LOAD 'onc HEIGHT NO.STORIES 1 - AREA 140 NO.BEDROOMS - VALUE 1,000
BUILDING DEPARTMENT SETBACKS FRONT REAR - LEFT SIDE RIGHT SIDE
Permit 17.5 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
11.3 REGULATIONS AND ALL AnPLiCABLE CODES AND ORDINANCES. AND IT IS AEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABIE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
70 1 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,FLUMBING AND HEATING.
State Tax it
SDC-
Total _�--_--_-
i PDC# APPLICANT OR AGtNt
By - I
Receipt No. ADDRE88 -^ MIONF
4pproved Lt
r
I
DATE INSP. TYFE INSPECTION REMARKS PLUMBING DATE
Cont..ctor
Permit No.
� --ice---- -- ��
- --- II flou&-in
F,xture
Finqi
HEATING
�Contrectormit
-- — Gas or Oil
Final
— — ---- ---- --- � SEWER
--� Final
— _— ---— DRIVEWAY
final
Stam Drainage
(Rain Drain)Final
Sidewalk
Curb R Street Final
Approach
SLDO.DEPT.rlNAL TEMPORARYT CERTIFICAT[ OCCUPANCY —
CC,iTIFICATEOCCUPANCY ---- —` _— Final
Landscaping
_- -- — Inning Final A --
ter.•
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BUILDING PERMIT APPLICATION TIGAi?:) DATE is
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PriONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.
LOT NO. — -
OWNER JOB AODRESS —
ARCHITECT
ENGINEER
BUILDER __ '_ _ _ ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE Cl DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑:� GOVT C3RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE C1SLAB❑ FENCe.
OCCUPANCY !' _.,.LAI ID USE ZONE lam-BLDG.TYPE FIRE ZONE PLAN C ECK BY HEAT _
111a
SEWER PERMIT K
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA _NO.BEDROOMS VALUE i
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SICE RIGHT SIDE
Permit _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE -:UILOING CODE,ZoWNG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY '.GREED THAT THt
Plan Check / WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCI
�- �— WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV:
Subtotal > Rr RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSIhtS
UCENSF-SEPARATE PERMITS REQUIRED FOR SEWER,PLUb1BING AND HEATING.
Stats Tax
—
Total - --- - ------- —
PDCN APPLICANT UR AGENT
By
Receipt No. -- -----
ADDRESS r''MONE�------------
r
,AppSDC
PDC
SEWER CONNECTION Sl_
SEWE=R INSPECTION S
5EWER SURCHARGE S —_
r _
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address Permit
Type of Inspection
The following Building Code deficiencies are required to be corrected:
Presented to Inspector
Data
CALL FOR REIAISPECTION
❑ YES ❑ No
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address Permit
Type of Inspection
The following Building Code deficiencies are required to be corrected:
Presented to Inspector
Date
----------------
CALL FOR REIWECTION
❑ YES ❑ NO
INSPECTION NOTICE
%ity of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address �a//� Permit #_
Type of Inspection
The following Building Code deficiencies are required to he corrected:
2~ •`da1I T''6�T�" /L A•�.,�r ,�.r.�.w �.--�iQr` e r y� f i ^Tli.++.�•�
7 Ls..��we4• R � e�•��1
+� ifPwrwr.r•' 'a.K..C..6i�i..{ra. yf--'4 �...� I' ,rrQ�tg ,��.1 sl�i"+ r1,.
��.\ ri;,.. .•• r-- Ile'
Presented to _ Inspector may
Date
CAL!_. FOR REIAGPECTION
LJ YES [] NO
i
BUILDING DE PAR i HENT, TIGAR' d
PLUMBING PERMIT M
�_, holder of a va.ld plumbing contractors license is hereby
authorized to cause plumbing work � herein noted�t0 be installed in accordance with the plUmbing code of
Tigard. Such installations require inspection by the City inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owner �-11 C' Address- 1.�: t •< C.r 4 Date
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT IOfhre ll:a Only)
Sin la Family-1 both-each AddU,j
itional
ba 1 bathrooms
-nit __-- 1025.00
Additional bathroom.-each_ _ 10.00 CI-0 11 ~�
Mobile Horne Sga.g2-each 15.00
INDIVIDUAL FIXTURE FEES _
1 to 50 Fixtures in 1 buildinZeach _ 3.00 s
51 to 100 Fixtures in 1 building-each 2.50 #
101 to 200 Fixtures in 1 building-each 2.00
2G1 or more Fixtures in 1 buildin -each 1,50
MISCELLANEOUS
Building Sevvur-1st 50 ft. 10.00 1—i
5awer-each additional 100 ft 10.04_
Water Seivice to building 5.00 -
_Private Water Systems-each 100 ft, 10.00_ —
Other 5 ecif �- ---
PERMIT_ C' for Plumbing Inspection Phone 639.4171
_ "o State Plumbing Contractor By
70TA1 RECEIPT NO. Issued By
BUILDING PERMIT APPLICATION TIGARD DATE 19_ lid 3694
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 3UILDFR PHONE 640=b714
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING;PLANS AND SPECIFICATIONS. OWNER PHONE ___—.�_-
LOTNO. 27—Ye i11dra
OWNER ► 1.zzr�cisor, Cunstr,JOBADDRESS 12110 SU 123rd �,ourL Windmill-
ARCHITECT
i ndmiARCHITECT
INEER
BUILDER sarnO ADDRESS 1326 SE 29th,C t. ,Hll8i&9GNER Knight's Bldg. Design
STRUCTURE _KNEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE 17 DE.nJLITION
IMMESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS 1_7 PATIO D CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY __.LAND USE ZONE-_ R-7 BLDG.TYPE _ SN FIREZONE — PLANCHECKBYdWh HEAT___y�iQ.-.
Construct single family dwellinct w/attached aa,rage. 3 Bedrooms 2 Baths.
SEE CORRECTION SHEET ATTACHED.
► SEWERPERMITN ;3-127- - $750.00 yarn a 4% sU• ft•
OCC.LOAD FLOOR LOAD 40 HEIGHT 13 NO.STORIES 1 AREA 15'J3 N0.BEDROOMS 3 VALUF'• 62 9100.
BUILDING DEPARTMENT SETBACKS FRONT ?L REAR LEFT SIDE ' _
RIGHT GIDE
Permit _ 511�•OU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check lou, [) REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFI^.ATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF TH;S PERMIT DOES NOT WAIVE
Subtotal 319„ :A) RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax E3�, �2
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
4`
soc— V,400.00 r,.�
By Pl
Total 93211.0) ''
PDC# { Z100.00 APPLICANTORAGEi-Mr'— �r_+tL>tcf�.Jr
_
Approved duh Receipt No, ADD ESS l r }4r `�'��}t (may ON - � ,,�
p
DATE INSP.I TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No
Rough-in
Fixture
Final
---HEATING
Contractor /
Permit No.
Gas or Oil
Rough-,n
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Siclevalk
Curb Street Final
TEMPORARY CERTIFICATE
BLDG. DEPT. FINAL iR"eY ��
Etl I-IFICATE OCCUPANCY Final
74-91
Tc �Lvridst piny
IZonina Fii,al
77-71 71r
73
Rv,
BUILDING PERMIT APPLICATION TIGARD DATE 19je
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND S ECIFICATIONS. OWNER,PHONE
G� (.:�670fJOB — *5�: LOT No.
O:":PJER 'f' qN �� . ADDRESS I�II(,a SCJ I23 _ ��.
, r 2L `�'i C . ARCHITECT 1
BUILDER „e ADDRESS 132& -2qC 1 ES ENGINEERGNER (~Nr k4i G)
STRUCTURE NEW ❑ REMODEL !J ADDITION -0 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE Cl DEMOLITIC"w
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS G PATIO ❑ CARPORT Cl GARAGE ❑ STORAGE ❑ Si_AB❑ FENCE
OCC,6PANCY � LAND USE ZONE a '.l-__BLDG.TYPE -� . FIRE ZONE "' PLAN CHECK SY HEAT
SEWER PERMIT N ''''^^� :7 JJ~ —
OCG.LOAD _ FLOOR LOAD 'Y,_ HEIGHT /a' NO.STORIES AREA / - ,3 NO.BEDROOMS 3_ VALUE Cs I00
BUILDING DEPARTMENT SET BACKS FRONT _,21_REAR ?Z LEFT SIDE ZD RIGHT SIDE J;2-.
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOWNG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check ����gyp^' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV7
Sub-total JI—) RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE_SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax •_
Total — �, U 2 soc- ,7�e_a Lom n --
POCS APPLICANT OR AGENT
By
-- Receipt No.
Approved ADDRESS PHONE
IOC
# 1
EWER CONNECTION S �--���'-�
EWER INSPECTION $ ��
EWER SURCHARGE $ _
JYV �.Ta .2 7 ' Ypi Olk_PillttllVLlAa/�f��
Gos-
.20 2.io
0/3
r5.s3 33. � Sz,�q r
.2o x 14o
&lP 5-Ito
Cot loo
i
City, of Tigard Mechanical Permit NO.
New`4 ns allation Replace El Relocation Addition E] Alteration DATE.
HEATING
CONTRACTOR T OWNER_
ADDRESS � ���� r�CJOB ADDRESS
PHONE 1 — _ APPLICANT_ /��
r'- _y
Heat Input Rating(BTU per Hour) ,��— Vent Size Flue Size
FUEL OIL[-J GAS tst ELECT OTHER _
ITEM` N0. FEE ITEM NO. FEE
for Issuance of Permit SEE BELOW Each Air Handling Uit nor Duct te
Sysm
New-up to & incl. 100,000 BTU .00 Commercial Hood System 7.50
New 100,000 BUT's & over 7,50 Other E ui ment - E_ach 4.50_
Woodburn ing Stove _ 4.50 1 Trip Inspection 211.50
Wall-Floar- Suspended 6.00 Air Condition Compressor - up to& incl.3 H.P. 6.00
Vent System w/Fan 4.50Air Condition Compressor•3.1 to 15. H.P.Pincl. 11.00
Repair-Neat Cooling 6.00 -�- -
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! ! _
PEnMIT ISSUANCE 10.0 Comments:
FEES
SUB-TOTAL_ `------
_ % STATE _ Issued n 7
y-----
2536 PLAN CHECK - ;.>>c-ti44ruRE