11735 SW 128TH AVENUE-1 f
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11735 SW 128th Ave ' i
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CERTIFICATE OF
C17YOFT167ARD OCCUPANCY
COMMUNITY DEVELOPMENT LFPARTMENT OR100N PERM1�� ",_IT li. . . . . . . c Ihr T r)1 .-00r.5
13125 SW FWI BMd. P.p.Box 23397,Tlpod,OnQon 9)3."r(693)639,4175
-9i
SITF ADDRESS— : 11735 SW 128TH AVE f-'ARCErL.c IS133DD-1:: 000
SUBDIVISION. . . . I VILLAGE AT SUMMER L.AKF PARK 4 Z ON I NGi s R--4. 5
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . . 1187
CLASS OF WORK. :NEW
'TYPE OF USE.. . . I SF
OCCUPANCY GRP. I R;3
1C:CURANCY LOAD:225
FE:NAINIT NAW'. .
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DON MOR I SSETTE BU I LDEPS, INC.
15555 GW SANDY ESD.
tti?01
LAKE QSWF'(3O OR X7035
7"hone lis 620 ..75)38
CION MORISSF"TTE BUII_L?l:F?.S-,, INC.
135 6 Sw SONGY RD.
1_f4KI_ OSWEGO ClR 97035
!hone 11: 620--7538
Cir_r.upenry of the atoove refer^enr.ed building is hereby given, and rrrtifiel:
I.he r_omplianc:a with the State Of Oreyon Specialty Codes for the group,
�r.c:upancy, anti use unds+r whic.,h th* r-Nferenc ed- permit was irm�ar?cE.
FIRE DEPARTM1=NT [k I I 1*1 (N(; I OR
Lill ((...1);ty1G or r f C: Co.
POST 11\1 C1. .6V,i GUOUS PLACE 1
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1
INSPECTION NOTICE � 7 ,
City of Tigard Building oepartAent
1.3115 SW Hal, Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phure: E'9-4171
Inepection:
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdw).k
Found. Plbg. Top Out Can Line FINALt
Post/Beam Strutt. San. Sewer P-aming
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Wn. er Line Gyp. Bd. -Meth.
Date Requested: _1/ Time: A!1 PM
Address•_._1LZs.ra /"6 /!35 '' y Pormit
Huilier: Ic
�/Jj �lhJ��O
THE FOLLOWING CORRECTIONS ARE REQUIRSDI r
7
Inspectors Dates -�/
,APPROVED DIBAPPROVBD APPROVED SUBJECT To ABOVE
Call tar %Sinop.
M W W r IM
NNE
INSPECTION NOTICE
City of Tigard :eildijmg Departmpnt
13125 SW Hall B.rd. Tigard, Oregon 97223 _
Inspection Line (Rec-O--Phone{: 639-4175 Business Phone: 639-4.71
Inspections____
Footing Plbg. Underelab Mech. Hough-in Appr/Sdwlk
Found. Plbg. Top out Cas Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Meeh. Rain Drain Insulattioonn -Plumb.
Plhg. Underfloor Water Line r /\ Gyp. Bd. 1 -Mech.
Date. Requested �Zf 3� 7�-(� _Time: _ A:� PN
Addrene: 1Z r -11 � �'�- Permit 1'0�Ly
Builder:_1 �
THE FOLLOWING CORRECTIONS ARE K?QUIRED:
InepectorrDater �C:� ; 'C41
APPROVED UI:.Af'�'HrrVR.ir 1PPHOVED SUBJECT TO ABOVE
__Cell Por Pelnrrlr.
s
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�/' �/ INSPECT►JN NOTICE
City of Tigard Building Departmr_nt
V 13125 STY Ba11 Blvd- Yigard. Oregon 97223
Inspection Line (Rec-O-Phone). 63)-•4175 Business Phone:
639-4171
Inspection: —
Footing Plby.
Underslab Mech. Rough-in Appr/Sdwlk
Pound.
plbq. Top Out Qaa Lina FINAL:
raminq -Bldg.
post/Beam Struct_. San. Sewer
nsulation -plumb.
Post/Beam Meeh. Rain Drain e
-Meeh.
plbq. Underfloor nn Nater Line
Gyp. Bd.
�L/ - • I Tiros t
Date Requested --
7 Permit #I
Addresst IJ .7
Builder:
T1lL POLLO nwo OOIlN=1(08 Us NWIMDt
inspectorate._ Date++ —
APPROVtD DISAPPROVED APPROVED SUBJECT TO ASOVR
Call rot Reinap.
W
INyP$CTIUN NOTICE
city of ?igard Buil9ioq �Pa�97223
13125 SW Bnll Blued. Si ard, Are9�'
Inspection Line (Rem-O-phone), 639-4175 Business Phone: 639-4171
Inspection:
Foot i.ng P lbg•
Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg• Top Out
Gas Line FINAL:
Framing -Bldg.
Poet/Beam Struck. San. Sewer � ,
Poch./Beam Nech. Rain Drain
Insulation -Plumb.
Bd. -Meth.
Pibg. Underfloor water Line Gyp. B
Time: hM - PN
Date Requested: 7/D_�__--r-�--� 4`?1 i "/ permit t: iv
A.7dress:_
Builder�y��� 2 ��
G
TAE pO-.LOWING CORAEC'TIONS ARE REQUIRED:
i
Date:
Inapectors�
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinnp.
SUN
JtWLWLWMMW
XWXWF V
,�NSPECl�ON NOTICE.
City of Tigard Building Department
13125 SM Rall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buoinese t 6 - 171
Inepectionc
Footing Plbg. Underslab lt. Aough-in�/ Appr/Sdwllc
Found. Plbg. Top Out baa W.t.a FINALt
Poet/Baam Struct. San. Sewer Framing -Bldg.
Pont/Beam Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested:_ Timet AM pM
Address t //2y/O �POartait is t
Bulkier: '0
THE FOLLOWING CO.RRRMIORB ARZ RROUI
Inspect�i—APPROVND
Dates
APPROVRD RUWNCT TO ARM
all For Reinsp.
3
SPE ION NC ICE /
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223 i
Inspection Line (Rec-0-Phone): 639-4175 nusinesa Phone: 639-4171
Inspection: - -- —---
Footing plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. /P1Bbs Out �i Gas Line. FINAL:
Poet/Beam Struc, . San. Sewer Framinq -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
P.bg. Underfloor Mater Dina Gyp- nl. -Mech.
Date Requested:__L�� _Ti.: AAM -- PM
Address
Builders
TBS FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors ^ _
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call per RL: Isp.
INSPEGTIuN NOTICE
City of Tigard Building Department
13125 SR Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —
Footing Plbg. Undor•lab Neth. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lino FINAL:
st/Beam Struc San. Sower Framing -Bldg.
• Beam Mech. Rain Drain Insulation -Plumb.
Pig.—Undorlloor Water Line Gyp. Bd. C� -Nech.
Date Requested: ng_✓4 _ Time: ` PH
Address:��/ _�� __Permit 1:
Sul lder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Tof i f-0 R kc A,c,- "t'[ :::�o u1
t
In•pactor:
i
APPROVED DISAPPROVED APPROVRD SU&IRrT TO AB7VR
—Call Por Reinsp.
INSPECTION N0 ICF.'
City of Tigard Building Department
13125 SW Hall Blvd_ Tigrrd, Oregon 97223
Inspection Line (Rec-O-Phune): 639-4175 Business Phone: 639-4171
Inspection: —
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found, Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. Sana SsnA� Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
_
Plbg. Underfloor C Nater LineGyp. Bd. -Mech.
Date Requested: J Time: AN `_PM
Address'___ Y/ > _ Permit f:
Bullder:��E_-%
THE FOI.I.OWING CURRBCTIONS ARE REQUIRED:
Inspector:_. r_...1--.-_._.-- --......_..-. Dat":_-Air"41 ---
APPROVED DISAPPROVED APPROVED SUIIJECT TO ABOVE
Call For Reinnp.
INSPECTION. NOTICE
City of Tigard Building Department
13125 BW Mall Blvd. Tigard, Oregon 91223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 539-4171
i
Inspection:__-
F'otilm Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. . Flbg. Top Out aas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Pllg. Uoderfloor Water Line Gyp. Bd. -Mach.
� AM PM
Date Requested:
Permit #: -
Addrene: 1L -
Builder:.
THE FOLLOWING CORRECTIONS ARE REQUIRED:
7d:0 10VI SGic//Z
.✓ A G ..c.
nate:
tnepectorl
L�pppy�p DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
----------
a NOF TIGARDMASTER FERMI"F'
Gt1IYOF 1164RD
COMMUNFTV DEVELOPMENT DEPARTMENT oaFT / I='ERMIT #. . . . . . . : Ma'f91 -jzio
13126 3W HW1 Blvd. P.O.Bou 231997,Ttyad,Oregon 972 (603)636.4176
SITE ADDRESS. . . : 11735 SW 12B1+4 AVE FIARCEL: 1S133DD-45000
000
SUBDIVIEiION. . . . : VILLAGE AT SUMMER LAKE F'ARK 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . , LOT. . . . . . . . . . . . . : 187
BUILDING
REISSUE:MST9 l --0083 DWELL.', NG LIN I TS: 1 BASEMEN 1". . . . . . . . :0 s•F
CLASS OF WORK. :NEW BEDRMS:4 BATHS:.3 GARAGE. . . . . . . . . . .610 s
l"YF'E OF USE. . . :SF FLOOR AREAS------------- RE(IUIRED SETBACI-.S-.._--.---__._._
•1 YF'E OF' CONST. :51\1 FIRST . . . : 1289 s f LEFT. . :5 ft RIGHT. :5 ft
OCCUPANCY GRP'. :R3 SECOND. . . : 1224 s F FRONT. :20 ft REAR. . :69 ft
STORIES. ., . . . . . :2 THIRD. . . . :0 sf
HEIGHT. . . . . . . . :c.5 ft TOTAL - _---:.' 13 s SMOKE DETECTORS. :Y
FLOOR l-DAD. . . . :0 psf VAL.UE. . . . . $ : 1 ='6578 PARKING SPACES. . :0
Remark s :
PLUMBING
SINKS. . . . . . . . , . : 1. FLOOR DRAINS. . . . :0 BACKFLOW F'REVNTRS. . :0
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 TRAP'S. . . . . . . . . . . . . . :0
TUE/SHOWERS. . . , :3 LAUNDFRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CLOSEI S. , : 3 SEWER LINE (f! ) . : 100 GREASE TRAP'S. . . . . . . :0
DISHWASHERS. . , . : 1 WATER LINE ( Ft ) . :0 OTHER FIXTURES. . . . . :0
GARBAGE DiSF'. . , : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL - ___..__..__.___._ _..___-.---•-•--__._._.__._ FEES'
FUEL TYPEc;.._____-"_____._ UNIT HTRS. . :0 type amol-int by date r•ecpt
/GAS/ / % VENTS . . . , :0 TIF $ .1350. 00 JLH 08/22/91 -
MAX INPUT :O BTU VENT FANS. . :4 BF'RT 4, 500. 50 JI-1-4 08/22/91 --
FURN ( 100K . . :0 HOODS. . . . . . : 1 HPLC $ 40. 00 JLH 05/09/91 21.3089
FURN ) =100K . . .- I WOUDSTOVES. :0 LaSPC $ t- 0'� JI_H 08/22/`?1 -
FLOOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 375. 00 JLH 08/22/91 -
BOIL/CMP ( .3HP:0 OTHER UNITS: 1 PARK 9, 2310. 00 JLH 08/22/91 -
GAS OUTLETS: 1 MP'RT $ 45. 00 JLH 08/22/91 -
Owner; ___._._._______._.__._______.__._.____._____.__ MPLC $ 11. 25 JLH 08/241/91 -
DON MORISSETTE BUILDERS, INC. M5F'C $ 2. 25 JLH 08/2'2/91 -
1555J SW RANGY RD. PP'RT $ 1517). 00 JLH 08/22/91 -
#L01 P'SF'C $ 7. 50 JLH 08/22/91
LAKE OSWEGO OR 970;33 rAPLC $ 30. 00 JLH 08/22/91
Fw'h on e #- 620-7538
DON MORISSE:TTE BUILDERS, INC.
1.5555 SW RANGY RD.
#201
I.-AKE. OSWEGO OR 97035
Phone #: 620 - 7538
Hey #. . . 35533
$ 2786. 53 TOTAL
This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS --- - --
Tigard Municipal Cooe, State :f Dre. Specialty Codes and all c'' Foot/found Insp Fir-eplace Insp
applicable laws. All work will be done in accordance wt!� i,vd v'ost /Ream Str't-Ict Gas Liffe Insp
plans. This permit will expire if work is not started within 190 F'Ost/BPam Mechan Insulation Insp
days of issuance, or if work is suspended for more than IN days. F'1m/undslab Insp Gyp Soar^d Insp
c PLIrI/Underflout- Rain d�Ain Insp
I'er-mittee Si_ atut-e - "_ C� ({ � Mechanical Insp Water Line Insp
P'11.1mb Top Out Appr^/SciwIk Insp
Isy1..led By : t/.._.__...___--•- -_-._ Framing InspMer.hani.r.'al Final
Call for- inspection - 639-4175
Kill!f f
-01
CITY OF TIGARD RECFlPT OF PAYMENT RECEIPT NO. 19l--216567
CHECK AMOUNT 2746- 53
NAME o MORISSE TTE, DON CASH AMOUNT 0. 00
ADDRL'Scct PnYMENT DATE 08/22/91
SUBDIVISION
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
BUILDING PERM 500. 50 PLUMBING PERM 150, 00
MECHANICAL PE 4!5. 00 ST. BUILD PER 34. 70
Pt-AN CHr.-*,CK FE 41. 25 RES IDENT IAE_ TRAFFIC FEES 1250. 00
MASS TRANSIT 'TIF FEES 100. 00 PARKS SDC 00
STOPM DRAIN SDC 375. 00
11735 SW 128TH AVE
TOTAL AMOUNT PAID 2746. 53
Ipw W W��Iw
CI OF TIFA RD SEWER CONNECTION
CITY OF TWARD PERMI-r
GON
'COMMU14rrY DEVELOPMENT DEPARTMENT OH�77 PERMIT #. . . . . . . .. SWR91-011?�-;
13125 SW Amit 3W. P.O.Box 23197,Tiqwd,OtwjDn. 97223 (SM)63"175
E 17; 121 b 7 2 S 7 11
SITE ADDSESS— i 11735 SW 128TH AVE PIARCEL: IS133DD-1500571
SUSI)I V J S I(IN. . . . : VILLAGE AT C,.jMMER LAKE PARK 4 ZONING: H-6.
BLUCK. . . . . . . . . . : LOT. . . . . . . . . . . . . . 187
TENANT NAME. . . . .
USA NO. . . . FIXTURE UNITS. . . :
CLASS OF WORK. . . .-NEW DWEL!-ING UNITS. . .- I
TYPE OF USE. . . . . ..SF NO. OF BUILDINGS- 1
N3 ,HLL I vF-'F- HLJSWR TMr'FRV SURFACE. . f
HeMat'ks
Owner- ------------------ FEES
DON MORISGETI"E BUILDERc�. INC. t",p e amoont by date
15555 SW BANDY RD. J:IRMT $ 1500. 00 JLH 07/05/91
-
#201 1 N P 4 5. 1110 JI—H 07/05/91
LAKE OSWEGO OR 97035
Phone #: 62'0-7533
C'ontractor:
CUNTRACTOR NOT ON FILE
3535. 00 TOTAL
Rep #. . z
REO,UIRED INSPECTIONS
This Applicant agrtei to comply with all the rules and regulations SewEr Inspection
of the Unified Sewage Agency. The permit expires 129 days from
the d--,te issued. The total amount paid will be farfoited if the
rtreit expires. The Agency does net 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 difer.tions frol
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" permit and the Agency will install a lateral,
1-'er In 1 1. ( e e 1.o I e
y
Lat 1 1 f rjv� i t)S Pect i on 639-4175
IL