11832 SW 126TH PLACE ADDRESS:
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CITY GF TIGARD CERT IE"ICATE O
OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PERM T #. . . . . . . . MST9:3--`1
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)63P-4171 DATE' ISSUE=D: 03/30/94
PAE2CE':.L: 1 S 133DD--1 18017+
S T TE ADDRLn(, . . . 11332' SW 1 r_'&TH PL
SUBDIVISION. . . . VILLAGE: AT SUMMER LAKE PARK 4 Z ON.T.NC:R•- 4. D
I:1L.OCR. . . . . . . . . . . I.OT. . . . . . . . . . . . . : 155
CLASS OF WORK. :NEW
TYPE OF USE. . . :SF
OC.CLJPANCY GRP. :Ra
OCCUPANCY LOAD:22 7 4
TE".NfIN'T' NAME. . .
RFinarks : t''N'I'H I
Uwnert - _ _..._._.._._..... _._._ __.......__.._..._._.._.___.._... _....._._._._.
MORISSGTTE" HOME':-i
15555 OW BANGY RD
surTc:; ffz-!oI
LAKE_ OSWEGO ON 97035
Phone 0: 620-7436
contractor:
DON MORTISSETTE" BUILDERS, INC.
5000 SW MEADOWS RD
GUITL 141
LAKE_ M-3WE GO OR 970.35
Pharle 0: 620-7538
Rerg #. . : 3 533
Occupancy of the above rr-ferenved building is hereby given, and certifies
the compliance with the :hate Of Oropon Spec.,iialty Codes for the group,
occ1_slrarlr:y, and use under- which the referenced permit was issued.
F I RF DE IRTME'NT AUt. i
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POST 1N CONSPICUOUS PLACE
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JNSPECTIAN NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)s 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing f ldg.
Post/Beam Hoch. Rain Draln Insulation -plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Hoch_
Ante Requested: �tJ— V Times __AH PM
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Address: ZZ O ^ nZ �`JLi� Peron �t
Builder: 0
THE FOLLMl.". CORRECTIONS ARE REQUIREDt
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Inspeotort
APPF40M DISAPPROVED APPROVED RUR.TECT TO ABOVE
VC--CIQ Call For Reinsp.
INSPECTION NOTICE G
city of Tigard BuIlding Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec--O-Phoneys 639-4175 Business Phones 639-4111
Inspections
Footing Plbg. Unserslab Mech. Rough-in Appr/Adwlk
Found. Plbg. Top Out Cas LineNJ�►
Post/Beam Struct. San. Sewer Framing -Bldg
Poet/Beam Mech. Rain Drain Insulation -P1
Plbg. Underfloor Nater Line Gyp. Bd. -spy►.
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Date Requeateds � � __Times 11M yC P!I
Addreass u-2 Z ( ' �1 Permit is
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Builder:
THE FOLLOWING CORRECTIONS ARLS REQUIRRDe
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Inspector Dates ✓ �/
_X,"PRONSD DISAPPROVED APPPOVRD SUBJECT TO Arx"
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 BA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businesn Phones 639-4171
Inspections
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation .-Plumb.
Plbg. Underfloor water Line Gyp. Bd. �xe—ch
Data Reqoesteds_ � —AH PM
Addreees g�1�1C �e L
Builder: 2- 741- 6—.12-6% c
TBR FOLLOWING CORRECTIONS ARE REQUIRED: p�f
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Inspector$ Dates S`
A►l110Vl1> _�bIBAPPROVED APPROVED SUBJECT TO ABOVE
��`(� Call For Reinep.
INSPECTION 40TICE /l(
city of Tigard But? Ing Department c/
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-C-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in ��Ampr lk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water
�Lz17� Line / Gyp. Bd. -Mech.
.,- 2, Times Requeeteds
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AddrePermit 1: Pl1
Builder: V)hY(/J
TNM FOLLOWING CORRECTIONS ARE REQUIRED:
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APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
city or Tigard Building I.epartsent /
13125 SK Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection•
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San, Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain IneulatLon�/ -Plumb.
Pl.bg. Underfloor Water Line lf� Gyp. !42 -Mach.
Date Requested: _ �- 7 �/ 7 Timet AM PM
Addresst � i�l �Z(�t� Permit #t�3_
Builders ? �,
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TNF. FOLLOWING CORRECTIONS ARE REQUIRED:
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✓APPROVED DISAPPROVED APPROVED SUMIECT TO ABOV9
Zt � ,—Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 fisc Hal Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bunineee Phone: 639-4171
Inspection.___
Footing Plbg. Underrlab Koch. Rough-in Appr/Sdwlk
i` Found. P1bg. Top Out 088 Line '/ FINAL:
lost/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line Ovp. Bd. -Mech.
Date Request(els ��- Z 2- TLMI q nM PM
Addreeee I l� ?I _ PermLt s
Builder: ...\ i l C l l-1 ti \f� L( Y�`�(c7 ( Cn S
TB! FOLLOWING CORRECTIONS ARE REQUIRM 47-11 wk-1
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Inspectors �L/ " oat/s
APPROVED 0I8"PROVED -APPROVED SUWMCT TO ABM
call For Minop.
INSPECTION NOTICE \,V
City of Tigard Building Department
13125 SN Ball Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Meoh. Rough-in X Appr/Sdwlk
Found. Plh.j. Top Out Gas Line ]/�� FINAL:
Post/Beam Struct. San. Sewer Framing Uri
(y 1 -bldg.
Poet/Beam Mech. Rain 'train Insulations -Plumb.
Plbg. Underfloor Walter Line Oyp. sd. -Mech.
Date Requested: L ! I L( Times __L_AK ____PM
Addrees t ) 1 1 Permit #t
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Buildert 41Y i��Jf.�./Vc_
/THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector, Date: -�. - l q
APPROVAO _DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tlyard. BuildL.g Department
13125 SO Hall Bled. Tigard, Oregon 97223
Inspection Line (Roc-O--Phone)s 639-4175 Bueineas Phone: 639-4171
Inspection:
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Poet/Beam struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Rech.
Date Requested:_ - \ - -0t4 Time: AM `_PH
) y^= C - k 1
Address: � ` � � 1 �.�W Permit #I ` ��"1AA
Builder:_ ^
TAE FOLLOWING CORRECTIONS ARE REQUIRED: 1 2 `'\
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Inspectors Date:
APPROM ` v DISAPPROVED APVROVED BUBJNCf TO ABOVR
/�� 'call For Relnsp.
,INSPECTION NOTICE
City of Tigard Biilding Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busineas Phones 639-4171
Inspections
Footing Plug. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lino FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requeeteds54� _ ` Timet AH PH
Addraes: 1 ` r�� G\0 Pei'ti►it #,q3
Builder:_
THE FOLLOWING CORRECTIONS ARE REQUIREDs �9
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Inspectors -- Dates
APPTAMM L42SAPPPOVID APPROVED SUBJECT 7A ABOVE
Cal.l For Bsinep.
NSPECTION NOTIeg
City of Tigard Building Department
13125 89 Hall Blvd. Tigard, Oregon 97223
Inspsetion Line (Ree--O-Phone)s 639-4175 Business Phone: 639-4171
Inspection: 1 --L"
Footing Plbg. Underalab <qh-in Appr/Sdwlk
Pound. Plbg. Top Out Can Line kFINAL:
Post/Boum Struct. San. Sewer framing �" -Bldg.
Post/Beam Hoch. Rain Drain naulatiOn /X -Plumb.
Plbg. Underfloor Nater Line /y1 Gyp. Rd. -Hoch.
Date Requested: Tubas ANrA
�y�' ��?M
Address' Ilk 32,
Builder:_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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APPROVED DISAPPROVED V APPROVED SUBJECT To ABOVE
call For Reinsp.
tNSPEC'CION NOTICE
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City of Tigard Building Departaennt
13125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwl.k
Found. Plbq. Top Out Gsa Line FINALE
Past/Beam Struct. San. Sewer Framing �' -Bldg.
Poet/Beam Mer:h. Rein Drain Insulation -Plumb.
Pl.bg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requestceds_ 2 C� Y Timet pK
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hddroses-0 X11- � �Peermit +t "13-9ySS7
Builders l __ �
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THZ FOLLOWING CORRECTIONS ARE RlQUIREDt �4 \ J
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APPSOM k,168APPROVED APPROVED SUBJECT TO AB0V3
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N ION NOTICE
City of Tigard Building Department
13125 SR Ball Blvd. Tigard, or-Von 97223
Inspection Line (Rec-O-Phone): 639-4175 Husiness Phones 639-4171
Inspection:
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Meeh. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line G� Gyp. Bd. -Hoch.
Data Requestedt__ "� ` r tt ` Times _AM --PH
Address \ 9 1 2 �d _ Permit fs_ ` Z
Builder:
TTS 10LLOMIlNS OORRECTIOBB ARE REQOIREDs
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Inspectors _ Date:----------
_APPROVED _L.,27SAPPROVRD APPROVED SUB"c.•T TO ABOVE
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INSPECTION NOTICE
City of Tigard Building Department
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspectiont�
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Frami.nq -Bldg.
POHt/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Hoch.
Date Requestedt ��^� Time: _ AN PH
Address:` �� + G�`Q Permit +: 1
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: y �L �J`��" _ Dates_ L y
APPROVID ___\,!.,ffDISAPPROVED APPROVED SUBJECT To ABOVE
1✓ Call For Reinsp.
INSPECTION NOTICE
city of Tigard Building Departasant
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phono)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Bram Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Neth.
Date Requested: '7 7 _ i 6 _Time: _ AM PN
Addrese, 1 \ } \ L Ld = P \ Permit 1: Q3 — c-4�7
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date: l �4
APPROVED _ITISAPPROVED APPROVED 9111LTRCT TO ABOVE
_ Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SII Ball Blvd. Tigard, Oregon 97223
Inspection Ltne (Rac-O--Phone)c 639-4175 Business Phone: 639-4171
Inspection:
Fx:ting Pibg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out ) Gas Lina FINALS
Poet./Boom Struct. San. Sewer Framing -Bldg.
Past/Beam Hech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Rd. -Hoch.
Date Requestted:`� /7._jn` 7 Time: _r_AM /Q PM
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Address: V�7C 11-lQi~ _:P1 Permit f: ?'3
Builders_
TRE FOLLOWING CORRECTIONS ARE RUMIREDs
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Inspectors _ bate:_Z_
APPPA)M DISAPPROVED APPROVRD SUR.IECT To rBOVR
Call For Relnep.
INSPECTION NOTICE
City of Tigard Building Department
135.25 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Itlspectiont
Tooting Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
/Found. Plbg. Top Out Jas Line FINALt
CPost/se 11Ct. San. Sewer Framing -Bldg.
Post/deals Mech. Rain brain Insulation -Plumb.
Plbg. Underfloor r Water Line Gyp. Bd. -Hoch.
Data Requelstedt_ /` /✓_� `( � Times _AM
Address: 1�7iz7?- �ZLP( �1• Permit it
Builder:
TIM FOMOVING CORRECTIONS ARR REQUIRED:
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Inspector! 3�i ---- --------- Data, //�✓Q�/
APPROVED DISAPPROVED APPROVED BUB"CT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department s
13125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line ;Rec-O-Phone)tt 639-417(5 ,Business Phone: 639-4171
Inspection: LL\Y/ • �L�J` JC_ 4S. `
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Roam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Meeh.
nate Requefste4dt t -�3 � Time: pM
Addreset _11 (��L- Permit /#i
Builders�
THF. FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors
11?PRDV7s0 DISAPPROVED APPROVED AUBJECT TO ABOVE
Call For Reinsp.
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. Underslab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gan Line FINAL:
Post/Seam Struct. San. Sews Framing -Bldg.
Pow/Seam Hoch. Ra nl Dram Insulation -Plumb.
Plbq. Underfloor Nater LLUAL..t Gyp. ad. -Hoch.
D+stA Raywe`.edt Time: AM PH
-Permit r:.
Builder:
THF: FOLLOWING CORRECTIONS ARE REQUIRRD:
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Ins or -- — -- Data:-_�, 2-7
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APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department /
13125 SW Ball Blvd. Tigard, Oregon 9722.3
Inspection Line (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspection: _
Fuotin�� Plbg. Underelab Necks. Rough-in Appr/Sdwlk
POurtd,� Plbg. Top Out Gas Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Pont/Beam Hoch. Rain Drain Insulation -Plumb.
Plhg. Underfloor Water Line Gyp. Bd. -Nech.
Deter Requested: -/u�- �c.�t' Time: ______AM _�PM
!lddr.ees: /� Permit ��- / f, L� Z
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Iflepeoiols ---- � _ - _---" _ Dates��
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
' Call For Reinsp,
CITY OF T PERMITS#ER. . .. . :PERMIT
MST93--9487
COMMUNITY DEVELOPMENT DEPAMMONT DATE ISSUED: 11/16/93
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)830-4171
PARCEL: 1S133DD-11800
SITE ADDRESS. . . : 11832 SW 1 L'6 TH PL
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARI' 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . L01.. . . . . . . . . . . . . : 155
._--_----_-_----------------------- BUILDING
REISSUE:
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:4 BATHS:3 GARAGE. . . . . . . . . . :880 sf
TYPE OF USE. . . :SF FLOOR AREAS------ --- REQUIRED SETBACKS------------
TYPE OF CONST. :5N FIRST. . . . : 1200 sf LEFT. . -5 ft RIGHT. :c ft
OCCUPANCY GRF-'. :R3 SECOND. . . .- 1500 sf FRONT. :20 ft REAR. . :36 ft
STORIES. . . . . . . : THIRD. . . . :0 sf REQUIRED----------------------
HE
EQUIRED----•---•----------------
HEIGH'T. . . . . . . . :'=7 ft TOTAL-------:2'700 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . 4 : 140040 PARKING SPACES. . : 1
Remarks : PATH I
----------------------------------- PLUMBING ----------__-•---------------••---------.-
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUU/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOGETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISE'. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL -------------------------------------- FEES --_--.._.--__-----
FUE:L TYPES---•-------- UNIT HTRS. . :0 type amol-int by date recpt
/GAS/ / / VENTS . . . . . :0 TIF ! 1520. 00 JH 11/16/93 -
MAX INPUT:O BTU VENT FANS. . :4 BPRT ! 535. 50 JH 11/16/93 -
FURN ( 100K . . :0 HOODS. . . . . . : 1 BPLC ! 348. 08 JLH 08/25/93 93-243579
FURN ) =100K . . : 1 WOODSTOVGS. :O B5PC $ 26. 78 JH 11 / 16/93 -
FLOOR TURN. . . . :0 CLO DRYERS. : 1 SSDC 4; 280. 00 JH 11/16/93 -
BOIL/CMP ( 31AP:0 OTHER 1_INITS: 1 PARK $ `50. 00 JH 11/:6/93 -
GAS OUTLETS: 1 MPRT $ 45. 00 JH 11 /1c /93 -
Owner-: ---- ----- -------__.__.______.__._____-•HPLC $ 11. 23 JH 11/16/93
-
MORISSETTE HOMES N:.PC $ 2. 25 JH 11/16/93 -
15555 SW RANGY RD PPkT $ 14.0. 00 JH 11/16/93 -
SUITE #201 P5PC $ 7. 00 JH 11/16/93 -
LAKE OSWEGO OR 97035
Phone #: 62'0•-7538
Contractors __---______-___-•-.---._._.____._____
DON MORISSE.TTE BUILDERS, INC.
15555 SW RANGY RD.
#201
LAKE OSWEGO OR 97035
n; Phone #: 620 -7538
cc Reg #. . . :S5533 ----------------------------------------
3165. 86
.....------,._._-.__-----.-.._._---- _.--,--.-_-•--_3165. 86 TOTAL
This pertit is issued subject to the regulations contained in the - -- --- REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/fnUnd Insp Fireplace Insp
applicable laws. All work xill be done in accordance with approved Post/Beam Strutt Gas Line Insp
plans. This pereit will expire if work is not started within 180 Rost/Beam Mechan Insl.ilat ion Insp
days of issuance, or if work is suspend d for tore �han 180 day1j. Plm/Undslab Insp Gyp Board Insp
/ F1_
' M/Under-floor Rain drain Insp
�"'ermittee `5ignatrirel cru-'a ` �1��+� o-� _ Mechanical Insp Water Line Insp
L Plumb Top OUt Appr/Sdwlk Insp
, _1ed By : _,_ _ Framing Insp Mechanical Final
Call for inspection - 639--4175
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CITY CSF TIGARD SEWER CONNECTION
PERMIT
F�ERMIT #. : SWR93-0416
•COMMUNITY DEVELOPMENT DfsBSIkWME NT DATE ISSUED: 11/16/93
13125 SW Hall Blvd.Tigard,Oregon 97223.9149 (1503)639-4171
PARCEL: 1S131-!IDD-11800
SITE ADDRESS. . . : 11832 SW 126TH Pt_
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK. 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 155
TENANT NAME. . . . . :
AICA NO. . . . . . . . . . . FIXTURE UNITS. . . .
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF ESU I LD I NGS: 1
INSTALL TYPE. . . . :PUSWR IMPF_RV SURFACE. . : : sf
Remarks : PATH I
Owner: ------------------------------------------------------ FEES
MORISSETTE HOMES type amoi-int by date recpt
155..5.5 SW TANGY RU PRMT $ 2200. 00 JH 11/16/93
-
SUITE #201 INSP $ 35. 00 JH 11/16/93 -
LAKE OSWEGO OR 97035
PIione #: 620-7538
Contractor:
CONTRACTOR NOT ON FILE
---------------------------------------
Pti on e #: t 2235. 00 TOTAL
[Reg #. . .
------- REOU I RED INSPECTIONS
--- ---
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit e;(pires 188 days from _
the date issued. The total amount paid 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 prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agen y will ins 811 a lat ral.
permittee Si natur
By:
Call for inspection - 639-4175
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LJJY W- TIE ARD LW PlAYMENT PH.3-11-11 NO. j
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WIMC. MIAHISS17JTE, DON HMIM)N I vi. o0
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PURPOSE OF PAYMFNT OPIOUN T PA.0) PlARPOSE OF PAYW-.NJ' (AMI)ON I PFA I U
--DING PF 53'-1. 5Z F-l"AAMBINO PERM 14x1.1. 00
MEVIANICAL. PF 45. 00 ST. EAU I L.D PER I.. (413
PLAN (..'HF(',K FE 109. 33 SFWFR I-MA 00
',FWFR lNSPF.CT 3"51. 001 PARKS SDC� i'..50. 00
, irlRM DRAIN 18110, PAO. fala Rr-.S1DPNTtAL 'TRAFFIC.' I di 10., 17.1 VA
M},- : ; TRANSIT 77F FFFS, 110. 00
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11031-, !-.-M 126141 r'l
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Residential Building Permit Awa ication
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: //T 3 2-- 2 6<12t"
,l�,//- 01f1c#tlse Only
Subdivision: �Z. G' /4/<,e Lot aft �t
1��6 4 U — Planct;/Rec#
Valuation: _
Permit#
Owner: e fte A Reissue of
Address: ISS-5 S cv /3�0,,� y j�� � Lu/
� Apprapvals Required
:t
Phone: "e-
ring
Contractor:
Address:
items RNuIred
�..
Phone:
Contractor's License #
(attach copy of current Oregon license)
Subcontractors:
Plumbing:
Mechanical: ii,,(/
(attach copy of current OR Contractors License)
Architect/Engineer:
Address:
IL
Phone:
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w COMMENTS:
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Applicant Signature & Phone number
Received by: Date Received: _
Permit # Account Description Amount Amt. Pd. Bal. Due
,fj15 Bldg. Permit (BUILD) ,-v
Plumb. Permit (PLUMB) / / Y
Mech. Permit (MECH)
State Tax (TAX) u3
Bldg: j
Plumb:
Mech: Z )
Plan Check (PLANQK) .SS .3j
Bldg:
Humb:
Mech: 7_ 3
Sewer Connection (SWUSA) ?,'�`
Sewer Inspection (SWINSP) �3
Parks Dev Charge (PKSDC) U _ ,2 5-r.) _
Storm Drainage Chg (SDSDC) r S- V /
Residential TIF (TIF-R) /q/ L) / /U
Mass Transit TIF (TIF-MT) Li
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS) _
Office TIF (TIF-O)
Water Quality (WOUAL) _
Water Quantity (WQUANT)
Fire District (FIRE)
TOTALS: i , ,�� r .S�SC1� G..
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