11967 SW 125TH COURT-1 . � F w w
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11967 SP: 125th Ct
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MECHANICAL
PERM I T
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�CITY '��F TR!) PERMIT #. . . . . . . : MEC9 114300
COMMUN, ,
rry DEVELOPMENT DEPARTMENT (Cd OF TWA RD
13125 SW Bail BW. P.O.Boy.23397,TiqsM,Or"m 0223(603)634-417S \ ,,7 DATE ISSUED: 12/13/91.
SITE ADDRESS. . . : 11967 SW 125TH ::T PARCEL: IS13,-,,DD-10600
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 0
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 143
CLASS OF WC)RK. . :NEW FLOOR FURN. . . . EUAP COOLERS:
TYPE OF USE. . . . -SF UNIT HEATERS. . VENT FANS. . . r.
OCCUPANCY GRP. VEN,rc. W/O AP,P,L-. VENT SYSTEMS:
STORIES. . . . . . BOILERS/COMPREr-CORS HOODS. . . . . . :
FUEL 0-3 HP. . . . : DnMES). INCIN:
. /WOD/ 3-- 1':5 HP. . . . : COMML. INCIN:
MAX INPUT: BTU 15-30 HP. REPAIR UNITS:
FIRE DAIYiPERS?. . : 3050 HP. WOODSTOVi-:G. . :
GAS PRESSURE. . . : 50+ HP. . . . CLO DRYERS. . :
NC;. OF AIR HANDLING UN I TS OTHER U11--ITS. : 1
FURN ( 100K BTU: 10000 c f m: GAR OUTLETS. -
FURN '1.001-'\ LTU: > 101100 efin:
Remiarks : Install new pellet stove. Model FS Whitfield
Owner— FEES
MICHEAL UVEGES type aniciLint by date recpt
1 1.96 7 SW 125TH Cl' PRMT 4. 25. 00 BCR 12/13/91 -
5PCT 1. 25 BCR Ir_--/13/91 -
T I GARD
TIGARD OR 9722:3
Phone #: 503-524-1164
tont r-actors
OWNER
---------------------------------
26. 25 TOTAL
peg
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Wocifjstove lnsp
Tigard Municipal Code. State of Ore. Specialty Codes and all other I- anal Inspection
applicable law-. All work will be done in accoroance with
approved plans. This permit will expire if worl, is not started
within IN days of issuance, or if work is suspended for enrc
than 180 days.
P-;ev-mjttee
JssLoad Bye
CAll for inspection 639-4175
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CITY OF TIGARD RECEIPT OF PAYMENT REC'EIP'T NO. 8e
CHECK AMS 3l, ;-,6. ar..,
NAME UVEGES,, NANCY C,W-Al AMOUNT 0. olb
11.335 S. W. J J'1ST PAYMENT DATE-'.: 1 t.3/91
-
TIOARL), On SUBDIVISION
97223--
PURPOSE (IF PAYMEmT AMOUNT PAID PURPOSE OF PAYMEN'r AMOUNT i,n i D
A
3�
91-0 7). 00 ST. BUIL.D PER
IL pl� c
it
TOTAl . AMOUNT PAID ;:.'5
� it• is � �
r
Permit No:
�: •. � Address:
•• = Issued �y� ��� Date:
1 85 L - FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, QRS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractor; Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under URS 701.010(7), need
not submit this -'atement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:
1. [,�6 1 own, reside in, or will reside in the completed structure.
2. A. My general contractor 'Is
Contractor registration number
1 will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Con!:iiuction Contractors Board.
OR
B. I will be my own general contractor.
If i hire subcontractors, I will hire onlyy subcontractors registered with the
Construction Contractors Board. If 13ange my mind and do hire a general
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor.
I hereby certify that the above information Is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
Slgnatur o�erm QFCant Dat6
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE; This Information Notice to Property Owners About Const,,oution
Responsibilities was developed by the Construction CoWractors beard in
accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature.
If you are acting as your own contractor ;o construct a new hoine or make a substantial improvement
to an existing structure, you can prevent many problems by being aware of the following responsibilities
and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire per;,oris not registered with the Construction Contractors Board to do labor in constructing
or assistir in he construction or improvement of a residential structure, you will, in most instances,
be ruler] to be an "employer" and the people you hire will he "employees". As the employer, you must
comply with the following:
Oregon's WithholdiggJax Law: As an employer, you crust withhold income taxes from employee wages
at the Tree employees are paTc- You will be liable for the tax payments even if you don't actually withhold
the tax from your employee,,. For more information, call the Oregon Department of Revenue at 378-3390.
UnemT oyment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of allemployees, For more information, call the Oregon Employment Division OHR
at 378.3224.
Workers' Cog1pensation Insurunce: As an employer, you are subject to the Oregon Workers' Compensa-
tiori Law, and must obtain worker.' compensation insurance for your employees. If you fail to obtain workers'
compensation insurance, you may be subject to penalties and will be liaole for all claim costs if one of
Your employees is injured on the job. For more information, call the Workers' C,ompensatio- Divrsiu^ DIF
at 3737434.
U.S Internal Revenue Service: As an employer, you must withhold federal income tax from employees'
wage-fou will be Iia 1P -r the tax payment even if you didn't actually withhold the tax. For more informa
tion, call the Internal Revenue Service at 221.3980.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code Cum liance. As the permit holder for this project, you are responsible for resolving any failure
to meet coda requirements that may be brought to your attention through inspections.
Liability and Property Damage Insurance, Contact your insurance agent to see if you have adequate
incoverage (n►arc�'denfs ani omissions such a5 fa'ling tools, pp'nt ovFrspray, water damage
from pipe punctures, fire, or work that must be re-done.
Time to Supervise Employees. Make sure you have sufficient time to supervise yuur employees.
Eg(,rtlse: Make sure you have the expertise to act as your own general cuntractar, to cuordinate
iFie worol rough-in and finish trades, and to notily bullding officials at the appropriate times so
they can perform the required inspections.
If you have additional questions. write to: Construction, Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
0244.1 10/24/89 Phone 503-378.4621
INSPBCTIO14 NOTICE
city of Tigard Building Department
13145 all Ball Blvd. Tigard, Oregon 972
Inspection Line (Rec-O-Phone: 639-4175 Business Pho - 1
Inspections
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINALS
Post/Beam Struct. San. Bower Framing - ldq.`�
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requesteds �� '�� - / m Ti : /�N
Address: (/!Y,c/a 7 Permit i s E/
Builders� � ! ��
THE FOLLOWING CORRECTIONS ARB REpUIRBDs
Le
Inspectors Dates _�Z
APPROVED DISAPPROVED APPROVl0 BUEJEM TO "M
Call For Rainsp.
C.ER*rlF'lCnTE OF
CITY OF TIVA RD OCCUPANCY
CrTYOFYWARD PERMI # ..T . . . . . . . MST91- 2-
01
COMMUNITY DEVELOPMENT DEPARTMENT rMi
13125 SW HWI BW P.O.Bar 23307,rigwd,Orwgon 97223(603)639-4176 Q19TE Tqq-ULUE 12/11 /91
SITE ADDRESS. . . 3 11967 SW 125TH CT IDARCELt IS133DD -10900
:UBEII V!SION. . . . a VILLAGE AT SUMMER LAKE PARK 4 ZONINGt: R--4. 5
BLOCK. . . . . . . . . . s LOT.. . . . . . . . . . . . ; 146
CLASS OF WORK. ;1-,IEW
TYPE OF' USE.. . . :Sv-
OCCUPANCY G3P.P. :R3
LOAD.-220 4
FENANT NAME. . .
Qemarkss
Owner?
DON MORIOGETTE SLE)ERS, INC.
t 1 0 BOX 19524
;-,�-ff%1TL.AND OR 97219
�-'hovte -#: 503-244-9314
Contractor: - ---
DON MORISSE'rTE BUILDERS, INC.
15765 SW BANDY RD.
#2ef 1
L-(.II*L, W-3Wr-C30 OR 97035
Phone #: 620-7530
#. . 1 35533
ijQcup&rjcy of the above refer-ionced building is hereby giveti, and certifies
the compliance with the Statr Of Oregon Specialty Cod*4 for the gra,jpq
and use under which the refPrPn(-,Pd permit wag itSued.
rlRr.. DEPARTMENT BU I i-7 NG INSPECTOR
BU I L D I Nf, �7Mwf C I AL
POST IN CONSPICUOUS PLACE
Moab..
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INSPECTION NOTICE
city of Tigard Buildiig Department
1.3125 SN Ball Blvd. T ard, Oregon 97223
Inspection Line (Rec-O-Phone): -4175 Buninens Phone: 639-4171
Inspection:
Footing Plbq. Und ab Hoch. Rough-in App /Bdwlk
Found. Plbq. Top Out Gas Line FINALt
Port/Beam Struct. San. Sower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
P1.bq. Underfloor 'Nates Line Gyp. Bd. -Nech.
Date Requestedt —1ime. MI PN
Address: r�lL�(p '2 /mo �5 fes- �t Permit 1: ZZ����
Builder:---
TM
uilder:_TBS FOLIAMINO CORRECTIONS ARE REQUIRED:
Tnspectorc_ ��(
_APPROVED DIB APPROVED SUBJECT TO ABOVE
_Call For Reinap.
i
i
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 47223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i
Inspection:
Footing Plbg. Underslab Nech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain I)rain Insulation Plumb.
Plbg. Underfloor �7Water Line Gyp. Bd.
Date Requested: 7 Time:
Address:
el Permit
�/ f..�"�S �" C�? Permit
Builders_4Q221 Dzv:3 CSS (f 7
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
1,1e^e
E'c� •��C. �-
Inspectors Date:__
APPROVED DI PPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
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INSPECTION NOTICB
City of Tigard Building Departments
(
13125 SW Ball Blvd. Tigard, Oregon 97223 �.
Inspection Line (Rec-.O-Phone): 639-4175 Business Phone: 639-4171
Inspection:.__
Footing Pibg. Underslab Mech. 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.
Pxbg. Underfloor Nater Line Gyp. Ed. -Meeh.
Date Requested: PM
Address:— Z Ile. y/ 42L - L__c__! Permit
Buildert—z2Z221
i
THE FOLLOWING CORRECTIONS ARE REQUTRF.D:
1�
f
f
r
4
0
i
Inspector _ Date:_ i
/ �7— `/
TTT---
AP VED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rein#Rp
�t
MOM
INSPEE-TION NQjICE
City of Tigard Building Departtaent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
I.nspectiont_ — — --
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Beam Struck. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line/J yp. Bd.� -Mach.
Date Requestedt_ 1/-4 _41 Timet I1N PN
Address: 7 �G� � 5 Permit iz
Ruildert,��____
THE FOLLOWING CORRECTIONS ARE REQUIRED:
L --
Inspectors �_ Dates
APPROVED DISAPPROVED APPRMD MWECT TO ABOVE
Call For Rainop.
INSPECTION NOTICE
City of Tigard Buildir7 Department
13125 ON Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain lrsulatlonl -Plumb.
Plbg. Underfloor 11Water Line Gyp. Bd.
(l -mech.
Date Rsquestedt _ TimaT-% . PM
Address: G Z_ a 5 ( _ Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: -- -- Date
APPROVED DISAPPROVED APPROVED SUBJECT To AROVE /Y
---Call For Rainep.
INSPECTTON NOTICE
City of Tigard Building Departwent
13125 RM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ruc•-O-Phone): 639-4175 Business Phone: 639=trl<
Inspection:, __ I
Footing Plbg. Underslab Mech. Rough-in Appr/Edwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framin -Bldg.
Post/Beam Mech. Rain Drain Insulation . `lumb.
Plbg. Underfloor Nater Line / Gyp. Bd. -Hoch.
Date Requested:_ -�� ( / Timet AMMl PM
Address 1'192& P.-it Permit
Builder•-__ � �
_ Q �7 ���U 0/1'j_ �e'C_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors _ Dater c� _
Inspectors
DISAPPROM) APPROVED SdBJ6CT TO ABOVE
-_ _ _Call For Pei nap.
I
INSPECTION NOTICE
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phones 639-4175 Business Phones 639-4171
Inspection: _
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out aas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water
'7Line
% Gyp. Bd. -Mech.
Date Requested: /'O���7� l Time: AM _PM
Address: yC 1/ Permit #3-
Builders—
THE
sBuildersTBE FoLLoWINa oommarions ARE REQDIRED
Inspector:_ _ Date: ,s0 - F' Y` r'
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For 021nsp.
! MW w
lam
INSPECTION NOTICE
City of Tigard Building Oepartment
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plb�_Qndare.jab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out i Cas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam !!ech. 'fain Drain Insulation -Plumb. �
Plbg. Underfloor Water Lina Gyp. Rd. -Hoch.
4te Requested: (r - r 1��J/ Time: /f AM/ _PM
Address: 11 �7 Permit 1:�! �L�! 2- 2—
Bu i 1
eullder _ ��Lz --•-,
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Tnspectorr_ Dfitel!L 1 i
APPROVED DISAPPROVED APPROVRD SUBJRCT TO ARO';c
— call For Reinap.
of # I� t ■f ! � i
INSPECTION ,NOTICP.
City of Tigard Building DepartJent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inepe,tion Line (Res.-O-Phone): 639-4:75 Busineas Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Pound. Plbg, Top Out
Gas Line FINAL:
*.yet/Beam Strutt. San. Sewer Framing -Bldg.
ort/Beam Mech. Raln Drain Insulation
-Plumb.
`P
Plbg.
Underfloor Water Line Gyp. Bd. -Mach.
AM PM
Date Requested: y
Address �! l� 7 _ � Permit # —
Builders �f
T= FOLWWING CORRECTIONS ARE REQUIREDs
r
a
i
4
--- �_ Dates
Inspectors
APPROVED DISAPPROVED APPROVED SUBJECT TD ABOVE
Call For Aeinrp.
INSP&CPION NOTICE
City of Tigard Building Department �t
13125 Be Hall Blvd. Tigard, Oregon 9727.3
inspection Line (Rec-O-Phone): 639-4175 Bus inesa Phone: 639-4171
Inspection: ----
Footing Pibg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Koch. Rain Drain Inaulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Dare9Requeetedt ""L^���`�� Times AM PM
AddreeesT�!/ L � Permit f t (*7/ 12-2—
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Iz
r '
Inspector..�e `==---- ------ --- Date:. �7
APPROVED DISAPPROVED - _ APPROVRD SUBJECT TO ABOVE
call For Reinsp.
INSPECTION NOTICE ✓�gf���/
of Tigard Building Department L
1312_ fA Ball Blvd. Tigard, Oregon 97:23
Inspection Line (Rec-O-Phone: 639-4175 Business Phc,ne: 639-4171
Inspections
Footing Plbg. Undersiab Mach. Rough-in Appr/Sdwlk
Pound. Plbq. Top out Gas Line FINAL:
Past/beam Struct. ltan. Bower/ Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor ;- 7
ter Line
1 Gyp. Bd. -Mach.
Date Requnsted: 'rims ZiL- Ay pM
Address:_1 / - P•rmit
Builder.:__
THE FOLLOWING CORRECTIONS ARE REQUIRED:
E
r
Insp•otor �� ' - //
oat•t �
APPRDVlb DIAAPPPAMD APPROM Bosom To ASA
Call Por R•insp.
t
1
INSPECTION NOTICE
City of Tigard Building Departaent
13125 ow Ball B'_Ad. Tigard, Oregon 97223
Inspection Line (Rec-G-Phone): 639-4175 Busineus Phone: 639-4171
Inspection• --
Tooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
ground. Plbg. Top Out Gas Line FINAL:
Poet/Beam fitruct.. San. Sewer Framing -Bldg.
Poet./Ream Mech. Rain Drain Ineul.ation
-Plumb.
Plbg. Underfloor Water
Line Gyp. Bd. /-Mech.
Date lieq•:estedl / / Time: � _AM
i
Addcees:__
�_. . _� _ Permit is
Builder:,_—_-__.--_—-- - -
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors Date:
APPROWD DIBAPPROVRD APPROVED SuRiNCT TO ROOM
Call For Reinep.
� t
MASTER PERMIT
C17YOFTIGrARD C11YOF11 ;4RD PERMIT #. . . . . . . :
COMMUNITY DEVELOPMENT DEPARTMENT MGM
13125 SW HWI stvd. V-0.80x 23397,T401d,a.a+n 07{�1¢(K+116?974176 DATE ISSUED: 08/20/91
5 J TE ADDRESS. . . . 11967 SW 125TH CTPARCEL: 15133DD-1 0 9 171171
UBDIVISIO1\1. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5
LALOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 146
BUIL.DING --•_____________..__.______._..__. ____._____.___.
RF_I SGU1.=:MST'90--0029 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 5'F
Cl-ASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :451 sf
TYPE OF USE. . . :SF FLOOR AREAS- _.____ -_____. REQUIRED SETBACKS-.----- -- - -
TYPE OF CONST. :5N FIRST. . . . : 1149 s f LEFT. . :5 ft RIGHT. :6 ft
OCCUPANCY GRI"'. : R3 GE_COND. . . : 1219 s FRONT. :20 ft REAR. . :30 ft
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED-
HE I rHT. . . . . . . . :20 ft TOTAL-------:2366 , t SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :421 ps f VALUE. . . . . $ : l 17O46 PARKING SPACES— :121
Remarks :
PLUMBING
SINKS. . . . . . . . . . : 1 FL.00R DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAF'S. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :3 I....AUNDRY TRAYS. . . :0 CA1•CH BASINS. . . . . . .
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE: TRAF'S. . . . . . . :0
DT SHWASHERS. . . . : 1 WATER LINE. (ft ) . : 100 OTHER FIXTURES. . . . . :0
GORBAGE DISP. . . : I RAIN DRAIN (ft ) . :0
WASHING MP.CH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL ----------------- ________.._-•_----------•_ FEES
FUEL�TYPES----- --_.._.__.- UNIT HTRS. . :0 Cype amol_rnt by date r' e, i i
/GAS/ / // VENTS . . . . . :0 TIF' A 1350. 00 JL_H 08/20/91
MAX IN['UT:O BTU VENT FANS. . :4 BPRT 1 478. 00 JI_1-4 08/20/91 -
F•URN ( 1O0K . . :0 HOODS. . . . . . : 1 BPLC: $ 40. 00 JLH 06/27/91 214809
TURN ) =1O01i . . : I WOODSTOVES. :0 B9PC 91 '.3. 1)0 .JLH 08/=0/91
FLOOR FURN. . . . :0 CLU DRYERS. : 1 BPLC $ 30. 00 JLH 08/20/91
8OI1-/CMR ( 2HP:0 OTHER UNITS: 1 SSDC 1, :375. 00 JI..-ll 08/20/91 -
GAS OUTLETS: 1 PARK $ 250. 00 JLH 08/20/91 Owner-it -- --- --------------_._____.__.__..___..__._ MPR1• s 45. 00 JL_H 03/2O/91 -
DON MORISSETTE PLDERS, INC. MPLC $ 11. 25 JLH 08/20/91
P 0 PDX 19524 MSPC $ 2. 25 JL_H 08/20/91
PPRT t 140. 00 JLH 08/20/91 -
1TIRTL_AND OR 97''2'19 DSPC A 7. 00 JLH 08/20/91
F'Irune #: 503-244-9314
DON 01ORIS SETTE BUILDERS, INC.
15555 SW PANGY RD.
#201
LAKE USWE00 OR 97035
Phone #s 620--7538
Reg #. . : 35533
♦ 2752. 40 TOTAL
This oersit is issued subject to the regulations contained in the --- -- -- REQUIRED INSPECTIONS -------
Tigard Municipal Lode. State of Ore, Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laps. All work will he done in accordance with approved Post/Pearn Strutt Gas Line Insp
plans, This pet-sit will expire if work is not started within 188 Post/Pearn Me-chan Insulation Insp
jays of issuance, cr if work is suspended for sore than 180 days. Plm/1_rndslab Insp Gyp Board Ir�sp
�l1i��....,, �, II��' �,, 1 PLM/Underfloor Rain drain Insp
E- r mittee i�1nat1_1r'e : C .L�!_l.L,I_.WL44=d Mechanical Tnsp Water Line Insp
plumb Top Out Appr/Sdwlk Insp
Tysued By : Framing Insp Mechanical Final
Call for inspection -- 639-4175
XI W 'W IIIlf !i
CITY OF' TIGORD RECEIPT OF PAYME'N'T RECEIFIT NO. a 91 164 74
CHECK AMOUNT a 2712. 40
NAME s MORISSETTE, DON CASH AMOUNT s 0. 00
ADDRESS a PAYMENT DATE s 03/20/91
GUSE,I V I S I ON
PIJRI--.ILISE OF' r-,AYMF,.:.NT AMOUNT PAIL) PILIPPOSE OF PAYMENT AMOUNT PA I D
UILDING PERM 478. 00 PLUMBING PF'RM 140. 00
MECHANICAL PE 45. IAO ST. BUILD PER 33. 15
PLAN CHECK FE 41 . 213 RESIDENTIAL TRAFFTC FEES 1250. 00
TRANSIT Tlr, FEES 100. 00 PARKS SDC ipso. 00
STORM DRAIN SOC 375. Oel
1. 196*7 SW 12'511A CT
llf[Al- AMOUNT POID P712. 40
SEWER CONNECTION
CINOFTIGARD PF:RM I r
IYOF
COMMUNITY DEVELOPMENT DEPARTMENT Rao E"--7 RM I T #. . . . . . . : SWR91—OiZl�
13125 BW Hd Blvd P.O.Boor 27,Tlp&M,Oregon 97 (503)630-4175
SITE ADDRESS. . . 11967 SW 125TFI CT PARCEL: IS133DD-1090(el
IUBDIVISION. . . . VILLAG7E AT SUMMER LAKE PARK 4 ZONING: R-4. 5
t3LOCK. . . . . . . . . . LOI. . . . . . . . . . . . . : 146
TENANT NAME. . . . .
USA NO. . . . . . . . . . I FIXTURE UNITS. . .
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
:*YPE OF USE. . . . . :SF= NO. OF BUILDINGS II
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : s f
,lemar,ks.
)Wrer— ------------------------------------ FEES
OON MORISSETTE BLDERS, INC. tvpe ama..kmt by date V-P-Cpt
0 BOX 195214 PRMT $ 1500. 00 JLH 07/05/91
I NSP $ 33. 00 JLIA 07/03/91
I-)ORTLAND OR 97219
Ohnne #: 503-244--9314
NPcToR NOT ON FILE
------------------------------------
#: $ 1535. 00 TOTAL
RLUU1HkJJ I NE&F—UT I ONS ------
7�M Applicant agrees to coonly with, all the rules and reaulations Sewer Inspection
of the Unified Sewage Agency. The persit expires 129 days frog
the date issued. the total mount paid will be forfeited if the
otrait expires. The Poency does nrt guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the neasurement
given, the instiller shall prospect 3 feet in all directions frof
the distance given. If not so located, the installer shall ourchase
a `Tap and Side Sewer' Pereit and the Agency will install a lateral.
...........
Call for inspection t,39-4175
CITY OF' TIGARD RFCEIPT OF f-'AYMFNT RECEIPI' NO. :91-214809
CHECK AMOUNT 40. 00
PlAMF MORISSETTE, DON G'ASIA AMOUNT 0. 0W
ADDRESS e 15555 SW RANGY ROAD PAYMENT DATE 06/27/91
SUITE #201, SUBD I V I b I ON
LAKE 00SWEG&I, OP 97035- �E I SS-,LJFS ,5
PURPOSE OF PAYMENT ()MOUNT PAID PURPOSE OF PAYMENT AMOUN 1' PA I P.
4'4NF5 F-r-:7-77-i-io R __.40. 0
I-OTAL. 0MOUNT PAID 40. 00