14441 SW 125TH AVENUE W WRW
14441. SW 1251.h Avenue _.
M
1
L
Ln
CR FTIGARD CERTIFICATE' OF
COMMUNITY DEVELOPMENT DEPARTMENT WYOFTWARDI OCCUPANCY
on
13125 SW 14WI Blvd. P.O.Box 23397,Tig*W,Oregon 07223(6W)W*4175 00" PERMIT #. . . . . . . .
C
—
te/'j6j-)t
144,41 SW 125TH AVE PARCEL: 1'7-Sl09AA---Q)Vl90V
EbUSDI V I G I ON. . . . 3 ZONING: R- 1
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . . .
CLASS OF WORK. :N[
TYPE- OF USE. . . '.9F
OCCUPANCY GRP. :R:3
OCCUPONCY LOAD:2eO 4
TF114ANT NAME. . . :
Remarks : on septic system
'TIM AND ALICE PFRRINE
46i25 FIPWOOD RD
LAKE OGWFGO OR 97035
Phone #: 6,20-731.5
contr,ixCtor .
OWNER
Phone 0 :
Req
OCCUPWWY Of the above v,eferpnced bmildinu is hereby given, and certifies
the coatplian(---a with the State Of Oregon Specialty Codes for the qv-O,-,Pq
tiuvi4panvy, and Use under which the referevir-eci ptv-mit wEks is%�.jpcj.
FIRE: DFPAPTMENT BUILDING INSPEP.
BI)I LD I NX OFF' itYGi!
POST IN COWjPICUOUS, PLACE
7
INSPECTION NOTICE
City of Tigard Building Department
1317.5 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41'!1
Inspections
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -plumb.
Plhg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Reque
�s�t
�e
�d
�:J� _d��__ Timet _ 1 AM PH
�L?4-�J.---`S�/ / ^ 1 r Permit 1: ►�ST 9t9�u 2__
Address: ---—
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I
Inspectors c_I __ _a� __ Dat":
APPROVED DISAPPROVED APPROVED SURJ?rr T TO ABOVE
__-Call For Reinsp.
W
INSPECTION NOTICC
City of Tigard Building Departs►`nt
13125 SN Ba11 Blvd. Tigard, Oregon 97223
Inspection Line (RAC_O-Phone): 635-4175 Buoineso Phone: 639--4171
Inspection: — — --- --
Footing
Plbq. Underslab Mach. Rough-in Appr/Sdwlk
Found. 1'lbg. Top Out Gas Line FINAL:
-Blc
Poet/Beam Struct. San. Sewer Framing
Poet/Beam Mach. Rain Drain
Insulation -Plumb•
Plbg. Underfloor Water Lina Qyp� Bd.
-Meeh.
_T1roet 11M _ PM
Date Requested: _.�//i�r r71
7
..-
Permit t:
,J =
Address:
'
THE FOLLOWING CORRSCTIOMS ARE REQUIRED:
Z� ti-
o-
Date:_
Inspector:
DISAPPROVED �— APPROVED SUBJECT TO ABOVE
_40Call For Reln::p.
SMIKU
INSPECTION NOTICE
City of Tigard Building Departaent {
13125 SW Ball Blvd. Tig rd, Oregon 97223
Inspection Line (Rec-O-Pho ): 639-4:75 Business Phone: 639-v171
Inspection:_ -�
Footing pllqpfderslab Mech. Rough-in ApprrSdw1k
LL
Found. P;bq. Top Out Gas Line FINAL:
Poet/Be ' Struct. $an. Bawer Framing -Bldg.
Post/9eam Mech. Rahn Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requested: / ( f __YAM __PM
Address: Z Yr`1 y� S_ �.1_�/�'�_Permit E: �Q —03e1.=.)—
Builder: �,�/u7tQ J
THE FOLLOWING CORRECTIONS ARS NMIRSO:
i
Inspector:_ 1� Date:.
APPROVED DIe" APPROVED SUBJECT TO ABOVE
�11 For Reinep.
C C,F T'BARD TEMPORARY CE:RTIFIGATE
COMMUNITY DEVELOPMENT DEPARTMENT CPYOFTWARD OF OCCUPANCY
7 PERMIT #. . . . . . ,
13126SWHWIBlvd. P.O.Box 23397,Tigard,O"pgon 97223(59"176
---------
------- -- lm,�- ). 8 "22 "91
,3IT[- ADDRESS— s 14441 SW 125TH AVE PARCELS
iUBDIVISION. . . , a -'ONINC;i P- 1
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..
CLASS OF WORK. cNEW
TYPE OF USE. . . ISF
OCCUPANCY ORP. mR3
00".11PANCY LLAD 2220 4
TCMANT NAME. . . :
rqelAAI'k . '(EM OORARY OCCUPANCY FOR 60 MYS FROM DATE OF lc.sSLJf4N(,I-.-.
on geptiL SyStOM
TIM AND ALICE PERRINE
46ccb FIRWOOD RD
L-AKE OGiWE0O OR 97035
Phovie #: 6PO-7315
Cont rectors
OWNER
Phone 0%
Ucc,upancy of the atuve refpl-c-
need buildinp ie hereby given, acid zertifies
the compliance with the State Of Otregon s;pecjajty Code-3 for- the group,
UuclipanCy, And use utider which the referenced permit was i vj rj e c-1.
fee.
FIRF DEPARTMENT ritj 6 INSPECTOR
NUI 1, r
NO 1 1 AL.
POc')"T IN Pl-i-kCE
�r a �e ■r w � e
/ 1NSPECTION NOTICE
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Oregon 97223
InspectionLi (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections— �1 -- -----T — `�
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINALt
Poet/Beam Struct. Sar.. Sewer Franking Bldg.
Pont/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Ed. 1
Data RaquPnte/d s/ �fTi�sost� �) AM PM
Address:__ ^-� 5 �{�, " Permit
Builders_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
/5l
117
w
Inspectors Datet ^1'Z
_APPROVID DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPEI.TION NOTICE
C-ty of Tigard Building Department
13125 Sit Hall Blvd. Tigard, ttrAgon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: ---
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Pltg. Top Out Gas Line FINAL:
Poet/Beam strut. San. Sew++r Framing -Bldg.
Poet/Ream Mech. Rain Drain Iieulation -Plumb.
Plbq. Underfloor Water Line Gyp. ed. -Mech.
Date Requested:_ �-l Time: AN PM
// /
Address:-._ ��L71 S � Pnrmit #:'%
Build(t:
THE FOLLOWING CORML-TIONS ARB REQUIRED(
InspectT;:�PROVND
_ DISAPPROVRU _T APPROVED SUBJECT TO AB.wE
— Cnll For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SH Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Budinese Phone: 639-4171
Inspection: —
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Moch. t-fain Drain ) Insulation -Plumb.
Plbg. UnderV oor er Lina GYP•
Bd. -Mach.
Date Requested:
/ --.---Time: — AM — PM
Address: /%7�� / Permit #i9 f
20-Builder:_
THE FOLLOWING CORRECTIONS ARE REQUIRSD:
J
Inspectors #I" J Date:_
APPROVED DISAPPROVED APPROVED SUBJRCr TO ABOVE
Call For Reinap.
INSPECTION_NOTICE:
City of Tigard Building Depa_rtmont
13125 SW Ball Blvd. Tigard, Oregon 9722.3
Inspection Line (Rec-O-Phone): 634-4175 BusineBB Phone. !,39-4141
Inapection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. Sen. Sewer Framing -Bldg.
Po Bt/Beam Mach. Rain Drain Insulation -Plumb.
P1bg. Underfloor Water Line Gyp. Bd. -Hoch.
Dato RequesteLd,s X)_ / I 7L/ / Time: AN PM
Address: L>� r'�` [-'_/.1Ey/Perm I t 1
Builders ,
THE FOLLOWING CORRECTIONS ARE RE('iUIRED:
Inspector
_` Dates
�71PPROVED DISAPPROVED APPROVRD SUB-IRCT TO ABOVE
Call For Reinsp.
RECEIVED PLANNING
MAY 2 3 1991
_ BARCLAY HOME DESIGNS]_
14835 S.E. 82nd Drive, Suite 200•Clackamas, Oregon 97015.503-656-1988
a,0
Rso., c-h'Ee\e-f M ST-9 o - X 347-
0&37
60137T 'E u eMp_ s-uzo 2 P L;4ju \Awn- -rQF- PCU 1 LP"Za SPcc--1 o w
+KL c 1;1�1LL s w�ro►2 K r� mo fu • , (14t S k)GTF-
f o
INSPECTION NOTICE
City of Tigard Building Depart1slent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businens Phone: 639-4171
Inspection:_ —__ _-- ----- --
Footing Plbq. Uww :.1 . --h.h. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Moch. Rain Drain Ineulatlon -Plumb.
Plbg. Underfloor Water Lino/ Gyp. Bd. -Hoch.
Date Requested: t-0'- Times AM) PH
Adaree : _ /_ '4 /CJ'�—�
e (�/_�i�. Permit
THF. FOLLOWING c�RRECTIONS ARE FAMIRM
�
Inspectors Dates
�__
APPROVED DIIAPP110VND _— APPROM Bosom TO Asm
call For "insp.
INSPECTION NOTICE
City of Tigard ia:ildiug DepartAoent
13125 810 Ball Blvd. Tig&.rd, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection•._ __
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Freminq -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: E
Tim : AM PM
Address: _ ;L5 '� Permit S:`�/L' -dl��
Builder }
THE FOLLOWING CORRECTIONS ARE REQUI�R�EDi
iz K �.u Oti-yt�gpeti,.
so, /
7 ti-c y&A
Ae
Inspectors .µ+ Data:
APPROVED ~DISAPPRO D APPROVED SUBJECT To ABOVE —
_All,/Call For Reinsp.
T INSPECTION NOTICE
City of Tigard Huilding Department
13125 SK Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection: ------------
rooting Plbg. Underelab Mach. Hough-in Appc'/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
poet/Beam Struct. San. Sewer Framing -Bldq.
poet/Beam Mach. Rain Drain Insulaticn -plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: _ -Time: AM PM
Permit :�L� - O 307
Address: ..
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: �4/ Date:
APPROVED DISAPPR:')VED APPROVED SUBJECT TO ABOVE
Call For Rainap.
XNSPECTION NOY".ICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buei.neps Phone: 639-4171
I nepect ion:__ ---- --
Footing Plbg. Underella-b— Hoch. Rough-in Appr/Sdwlk
T Out Cas Line FINAL:
Found. Plbg. op
Post/Ream Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Ineulatl_on -Piumh.
Plhg. Underfloor Water Line Gyp. BrI. -Mech.
Date Requveteds L� C -4-/ _Timet AM ___—PM
Address: '� � _ Permit it
Builder. — -
` i
TIIE FOLLOWINO OORRBCTIONS ARE REQUIRED:
Inspector:. _ Date$ ' /►
APPROVED DisAPPROVED APPROVED 9UBJECr TO ABOVE
Call For Reinsp.
INSPECTION N91ICE
City of Tiqard Building Department
13125 SSS Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-P ne): 639-4175 Business Phone: 639-4171
Inspection•
Footing Plb UndEr■ ab Mech. Rough-in Appr/Sdwlk/
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water. Line Gyp. Rd. -Koch. /
�/ A _ X_ _PM
Date RRquested:-_���� �-_--- Time: M/
Permit
Address: �� —_ -
Builder: /� �% --
TBHES FOLLOWING CORRECTIONS ARE REQUIRED:
l '- ' �7�0�lrilc a
I
Odd- _---
r_
Inspectors _._--_-. Date l
APPROVtO DISAPPRMIW e`—XFPRovr:D SDBJSCT TO ADM
Call For Rainap.
ssr w w a ew eo Im
INSPECTION NOTICE
City of Tigard Building Dapartaent
13125 SW Ball Blvd. Tigard, Oregon 97723 `
Inspection Line (Rec--O-Phone): 639-4175 Business Phone: 639-4171
Inspection: -
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. PILg. Top Out Gas Line FINAL:
Foet/Beam Strutt. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: �' Time: AM PN
Address:�1-! %`^�/�1 �c� F� Prllolt
Builder:, �'�v�•�'
THE FOLLOWING CORRECTIONS AVE REWIRED:
S,QF�n tzT' r I��aT Dvc r<' �✓ YG`=s
f7CO�l�U�- L SU t'T'OIZ-1 cJ U LQ. _R-L4.LO
J
r,
---
Inspector:
i
APPROVED DISAPPROVED APPROVED SURJF.rT To ADOVF
Call F-r Reinsp.
'NSPFCTION NOTICE
City or rigard Building Dsparttnent /
13225 S'M Ball Blvd. Tigard, Oregon 97223
npee one:
Inspection Line (Ret-0 Huai Ph39-4171
-Phone): 614 ,- am
Inspection:__ —
Rooting
Plbq. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Strutt. San. Sewer Framing -Bld g•
Post/Beam Mach. Rain Drain
Insulation -Plumb.
Und re llootc Nater Line Gyp. Bd, -Mach.
� Time: ----AM � PM
Data Requested: — --
Address:- 1� y� � 7 _ Permit
THE FOLLOWING CORREC'T'IONS ARE REQUIRED:
_ I
ItupaCLOrt _ _.,_____ Datet
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rsinap.
INSPE=(gr! NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businesa Phone: 639-4171
Inspection•_ _—_—
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL: ky
Poet/Beam Struct. San. Sewer ���/,(,cF�ir_a{rming -Bldg. f
Post/Beam Mer_h. -Rain Drain ""�7"" Insulation -rlumb. f
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested._
,. y r� l Tlmes AM PM
AddreNe: Z � 6 �+=_
Builder.:_- r�.
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
}
C'
Inspector: / Date:
APPROVED DISAPPROVED APPROVED EVEJECT TO ADM
__—Call for Rainap.
t
MEMORANDUM
CITY OF TIGARD
To: Wayne Lowry, Finance
From: Brad Roast, Building Official -�c
Date: 2-28-91
Subject: PDC Refund, 14441 SW 125th Ave, Permit # MST90-0342
Please issue a check for $250.00 to Mrs. Alice Perrine (4625 Firwood Rd, Lake
Oswego, Or 97035), as a refund of a portion of her PDC fee.
Mrs. Perrina was not informed as to the increase in the PDC fee on January 1,
1991, thus she was not afforded the opportunity to pay the lower fee prior to the
increase. Mrs. Perrine had made several inquiries about her permit fees and any
possible increases, and was not properly informed.
I have discussed this matter with Pat and he concurs with the refund.
Mrs. Perrine paid for her permits on February 15, 1991, receipt # 91-209811.
Please forward the check to me, so I may send it with a cover letter.
Thanks
� - �
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-Q .�-�� ..auk � �� -�
,Zig-��' O1�6'f-��,,�.v .��r-r-� � .�Lr.�.c.G� G.�.�
���
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_-ate- orl ..- dXZ i.)
our U,se- oWktbla t� st: i r, �,( � a,rL �1n�s rn o n ul
1S s}tlI in f1� Jain
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a K-*'- zz) 6i- .�
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Cr
(.4c-7315
INSPECTION NOTICE
City of. Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:__, —_—
Footing Plbg. Underelab Ncch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL: I
c
Post/Beam :,truct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Req:teeted:_ -: � -/ �l /Time: AM
Addreee t�Ljy1_ 4;:2
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r
f
Inspectors. 'Ie'
Dater
APPAOIRD DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinsp.
4
r
I
INSPE_ TION NOTICE
City of Tigard Building Departammt
13125 SW Ball Blvd. Tigard, Os-tsgon 97223
Inspection Line (Rec-O-Phonh): 639-4175 Business Phone: 639-4171-
Inspections
Footing Plbg. Un�lerslab Mech. Rough-.in nppr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Beam struck. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbr,. Underfloor Water 7Line Gyp. ed. -Mech. y/
Date Requesteds_E —c7/ —�7 _Time: ___AM JQPM
,(
Addresn: / G/ '7 �J � Permit f: rL�
Builders �1�i�li'K/1L� i
THE FOLLOWING cORRECfIONS ARE REQUIREOt
'T ��tillyLi.� �i.✓� OAF/'
'y 2J) PF'ey'w `— Ay s;'1%✓6:
!'r Z�` �L'i4 a �l.'GT' it•/�.�c la�.a �'" 7�/�S /rc/S✓7ar ri�u�t - i
I
i
f
i
iinepwtost - Datee
nr*Novso D:u►rMov�o `--�r�ee�r-D evs ncT To AMM
call for MteM.
PLUMBING PERMIT
C17YOFTIGARD CITYOFTWARD PERMIT #. . . . . . . a MST90-0342
COMMUNITY DEVELOPMENT DEPARTMENT OREGON
13125 SW Holl Blvd. P.O.Box 23397,Tigard,Oregon 97223 (503)839-4176 _/ I DA'T'E ISSUED: 02/15/91
SITE ADDRESS. . . : 14441 SW I,-5TH AVE PARCELa 2S109AA-•00900
SUBDIVISION. . . . : IONINGa R-1
BLOCK. . . . . . . . . . . LOT. . . . . , . . . . . . . .
CLASS OF WORK. . eNEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . aO
OCCUPANCY GRP. . aR3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES------------------- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . 31
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . a0
LAVATORIES. . . . . :6 OTHER FIXTURES. . . . . :N
TUB/SHOWERS. . . . a SEWER LINE (ft ) . . . . :0
WATER C:LOSETS. . :4 WATER LINE (ft ) . . . . : 100
DISHWASHERS. . . . al. RAIN DRAIN (ft) . . . . :0
Rvma+rksa on septic system
OWNERa ________________.____.._._.________ ____._.____.._____.__....._FEES____..__.__
'TIM AND ALICE PERRINE PAYM $ 100. 00 JLH 10/19/90 206036
4685 FIRWOOD RD BPRT $ 770. 50 1 1
BPLC $ 500. 83
I-AKE OSWEGO OR 97035 B5PC f 38. 53
Phone #: 620-7315 STDC $ 600. 00
L;SDC f 375. 00 / r'
Plumbing umbing Contractor: PARK 500. 00
MPRT 43. 50
Name : ras _ __ HPLC i 10. 88
Odd ressa G7 ,�. �! �s_�. r-_______ M5PC t 2. 18 1 /
F i t y a ,`�p.� /6 S t at e:;%i+9- PP R T * 185. 00
Z i p: ;�'►Ic`S Phone#a G,t?�7 P5PC $ 9. 25
Reg #:'_ -//�/G _ _ _---_.� PAYM $ 2938. 67 JLH 02/13/91
__-_- REQUIRED INSPECTIONS ---- -
This permit is r.snmed subject to the r-eg.
111ations contained in the Tigard Municipal Foot/found Insp Gas Line Insp
lode, State of Ore. Specialty Codes and all Wtr Proofing Ssm Insulation Insp
other, applicable .laws. All work will be done Post/Beam Struct Gyp Board Insp
in accordance with approved plans. This Post/Beam Mechan Rain drain Insp
permit will expire if work is not started Crawl Drain Water Line Insp
within 160 days of issuance, or if work is film/rindsl.ab Insp Appr/Sdwlk Insp
suspended for more than 180 days. PLM/Underfloor Mechanical Final
Ftng Drain Bsm' t Plumb Final
Mechanical Insp Building Final
Plumb Top Out Erosion Control
�- Framing Insp Wtr Proofing Bsm
Fireplace Insp Additional. . . . . .
fauth razed �Klumbinq Cantractor Signature
Call for inspection 639-4175
Contractor Not es a
1 - I
Ct ®FTIFARD �r
IY
MASTER PERMIT
MYOFTWAX), PERMIT *1.. . . . . . . . MST90-17134e
COMMUNITY DEVELOPMENT DEPARTMENT OREGON
13125 SW Hall Blvd. P.O.Box 23397,Tigard,Oregon 97223(6031839-1175 ISSUED: 02/15/91
_v, 1'�._ I J... I 1:'iL_ V-ARCEL -
JBDIVISION. . . . : ZONING- R-4. 5
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . .
----------------------------------- BUILDING
RE I SSUE: DWELLING URI ITS: J BASEMENT. . . . . . . . :0
CLASS OF WORK. .-NEW BEDRMS:4 BATHS:4 GARAGE. . . . . . . . . . :990 sf
TYPE OF USE. . . :GF FLOOR REDU I RED S1-'_TBACK3--- --
TYPE OF CONST. :5N FIRST. . . . :2412 sf L.E F-T. . 9 9 ft RIGHT. :99 ft
OCCUIZIANCY GRP. -.R3 SECOND. . . :2301 sf FRONT. 62 ft REAR. . :55 ft
STORIES. . . . . . . :: THIRD. . . . .-0 sf REQUIRED---_.-_._._____________
HE:IGHT
EUUIRED-------
HE16HT. . . . . . . . :20 ft TOTAL._ --- - - 4713 sf SMORE DETECTORS. : Y'
FLOOR LOAD. . . . : 40 psf VALUE. . . . . 2346 18 PARKING SPACES. . :0
140marps ; on septic system
PLUMBING
I NK:J. . . . . . . . . . . I FLOOR DRAINS. . . . :0 BACKFLOW PPEVNTRS. . :0
__AVATORTES. . . . . .6 WATER HEATERS. . . : I TRAPS. . . . . . . . . . . . . . :0
UB/SHOWERS. . . . :, LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0
WATER CLUSETS. . :4 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :0
OISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES.
''iARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . -O
.MASHING MACH. . . : 1 SF-" PfIN'\1 DRAIN'-' 11
MECHANICAL EELS
FUEL TYPES----- - UNIT KTRS. 17) t y P) amount by date r e f- pt
/GAS/ VENTS . . . . . :0 PAYM $ 100- 00 JLH 10/19/90 206036
MAX INPUT.-O BTU k ENT FANS. . -'—: BPRT $ 770. 50
FURN < 100K . . :0 HOODS. . . . . . el B V'L C $ 500. 83
FURN ) =100K . . . I WOODSTOVES. -0 B5PC $ 313„ :5 3
r-"LOOR FURN. . . . a@ CLO DRYERS. : I STDC $ 600. 00
Ml-' 3 H P.'0 OTHEP 1.,NITS-41 SEDC $ 3'71'. 00
GAS OUT LETS: 1 PARK $ w -le
jwn er* -, . -- -- - _.. .. MPRT $ 43. 50
FIM AND ALICE PERRINE MPLC $ 1121. 88
e"'.5 FIRWOOD PP M 5 P L' $ 12. 18
PP R 7 11 185. 00
J-411\E. USWEGO ON 970,35 $ E). P5
'hone $-",'A Y M $ L935- 67 JLH 01 / 15/91
ont ract or.:
)14NER/CONTRACTOR
'hone #'
3035. !77 TOTAL.
This ptrait is issued subject to the regulations contained in the REQUIRED INSPECTIONS
--
Tigard Municipal Code, State of Orc Specialty Codes and all othv Foot/found Insp Mechanical Insr,
,?Pulicable laws. All work will be dcrit in accordance with MoDroved r F'rr'oafing B s m Plumb Top Out
olans. This persit will expire if work is not started within 181 Post/Beam Struct Framing Insp
rays of issuance, or if work is susntlidpe fo- sort thv 180 days. Post/Beam Me&'All Fireplace Insp
Cr-Awl Drawn Gas L-inr IllsP
P I M/11 T-1 d S I A b 111 s r Ins ,tlaific'n
PLM/Unde"floor Gyp Board Insp
Ftnq Drain Bsm' t Rain rit-AIT)
ir} ; : ectinn - 639 4175
1E
098
CITY OF TIGARD RECEIPT OF' PAYMU-N'T RECEIPT NO. a91--c'". 11
CHECK AMOUNT (�935. 67
NOME PERRINFA, ALICT cA"-)-1 AMOUNT 0. 00
ADDRESS 4625 FIRWOOD RD PAYMENT DATE 0''/1`,5/91
Stj6DIVISION
LAKE 01-33WEGO, OR (.,)7035- 14441 SW 125TH AVE
PURE'-10SE Or. PAYMENT AMC)LINT PA 11) PURPOSE OF PAYMENT AMOUNT P111D
IWILDING PERM MST90-0342 770. 50 PLUMBING ':IERM IS i. 00
i,4 .Ci ION I CAL PE 43. 50 sr, ^:!'f'-D PER 4'3. '36
PLAN CHF-CA FE 41I. -Ill 91 I.Fr--T SY)C 600. 00
.PARKS SDC 500. 011 STORM DRAIN SDC 375. 00
FOTAL. AMOUNT PAIP i'.935. 6;,
JEW X
t' Permit No:
Pr Address:
O
Issued by: _ - _- Date:
FOR OFFICE USE ONLY__--
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2.B:
1. Z= I own, reside in, or will reside in the completed structure.
2. A. C—) My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B. -71 I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change 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.
Slgne, t
ure of Permit Applicant D o eZ
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
i
f
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction
Responsibilities was developed by the Construction Contractors Board in
accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature.
If you are acting as your own contractor to construct a new home 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 persons riot registered with the Construction Contractors Board to do labor in constructing
or assisting in the construction or improvement of a residential structure, you will, it,, most instances,
be ruled to be an "employer" and the people you hire will be "employees". As the employer, you must
comply with the following:
Oregon's Withholding Tax Law: As an t.;rnployer, you must withhold income taxes from employee wages
ai tie time empToyees are paid. You will be liable for the tar payments even if you don't actually withhold
the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390.
Unem loyment Insurance Tax- As an employer, you are required to pay a tax for unemployment insurance
purposes on tt ie wages Drell employees. For more information, call the Oregon Employment Division DHR
a t 378.3224.
Workers' Compensation Insurance. As an employer, ,you are subject to the Oregon Workers' Cornpensa-
fforT7niv-,and must obtain woers' compensation insurance for your employees. If you fail to obtain workers'
compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of
your employees is injured on the job. For more information, call the Workers' Compensation Division DIF
at 373-7434.
U.S. Internal Revenue Servlce: As an employer, you must withhold federal income tax from employees
wages. You will be liable o the tax payment even If you didn't actually withhold the tax. For more informa.
tion, call the Internal Revenue Service at 221.3960.
OTHFR RESPONSIBILITIES AND AREAS OF CONCERN:
Code Compliance As the permit holder tot this project, you are responsible for resolving any failure
to meet code requirements that may be brought to your attention through inspections.
Liabi� and Propert Dame a Insurance: Contact your insurance agent to see if you have adequate
Insurance coveragefor ace encs an c-omissions such as falling tools, paint overspray, 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 your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate
the work of rough-in and finish trades, and to notify building officials at the appropriate times so
they can perform the required inspections.
YOU have additional questions, write to Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310.0151
Phone 503.378.4621
0244J 10124/89
II
(,'11"Y OF" TlOoFll) RECEIPT OF PAYMENT RECEIPT NO. .9f,"p—2060 e)
CHEM' AMOUNT 100.(1)(1)
NAME a PERRINE. CW13H AMOUNT Q.()4:)
ADDRESS a 4625 FIRWOOD RD rAYMENT DATE a 10/19/91)
SUBDI V I S I ON
LAKE OSWEGO, OR 9707,5--- 14441 SW 1:25TH A V F.-'
l' UPPOSE OF PAYMENT (.,)Moullj,r PAID I-"L.Jf4,'POSE OF PAYMENT AMOUNT PAID
PLAN CHECK. FE 1�>--46P 1 C.) (TC)
TOTAL AMOUNT PAID I oc).00
WASHINGTON COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES co 3(-)l
�
155 N. First Avenue REFER
Hillsboro, Oregon 9717.4
Telephone: 648-8722 SUBJECT
LOCATION ,Y.. -i - IL/ v V
HEALTH DEPARTMENT MEMORANDUM
The subject noted above has been reviewed and the following decision is recorded:
No Yes
( ) N).. . .. .Health Department requirments haoe been met in full..
No Yes
).. .. ..Additional requirements as follows must be met before Health Department
/ approval can be given.
Comments
4 1
La
4/86-rev. WCDPH SS84e / Public Health Sanitarian
------------------------------------------------- -----------------------------------------------
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l,ocatlnn, depth, & aRan6�ent all Aartx
of the Individual septic tank system (Includlnr
distrlbullon box & subsurface Itnes) will
conform to details shown on this plot plan.
Any devil."on from "an es here shown mull hl 1L�� �a-^ILJ
be APProve4 by the County Health Department ►V I , 1
la wrltlne In advance of Installation. Fellure fIVEr�CF
on thepart of the bullder or owner to
comwith these requirements voids eneYt
obllplyptlon for Health Dspartmant
,he
flolehed""'M.
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