12270 SW 128TH AVENUE M
12.270 SW 128TH AVENUE
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May 2'0 . 1986 CITY �lIFARD
OREGON
25 Veers of SeMoe
Ridgecrecit Hom..s 1961-1986
9397 NW Fox Hollow Ct.
Portland OR 97229
atrr: Joyce Stoll
De. r W. Stoll:
Thank yc,•, for returning the certificate of occupancy which I had typed incorrectly.
Enclesed please find the corrected one, and I apologize for any inconvenience this
may )lave caused you. Please note I have dated the corrected certificate as per tae
original final inspection date.
Ver} truly yours
.L
ulie D. Ouellette
Bi►ilding Permits Clerk
i
13125 SW Hall Blvd.,P.O.Box 23307 Tigard,Oregon 97223 (503)639-4171 ----
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INSPECTION NOTICE
City of Tigard Building Departinent
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
- I
Type of Inspection —
Uate Requested � _�+Time___ A.M. P.M. {
Address 1�Z�Q_� �2 got — Permit
Owner-------- Lot 't
Builder
The following Building Code cteficienciet are required to be corrected:
{ Presented to �� Approved
I` i
Inspector Disapproved
Date
CALL F R REINSPECTION
I [ VES 0 NO ,
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested 'r Timey A.M. P.M.��
Address / Z Z 7 U �!
- — � Permit #
Owner _ Lot #__
Builder
The following Buildiniy"Code deficiencies ara required to be corrected:
Prwo ted to __
❑ Approved
Inweator Disapproved
Date
CALL TOR REINSPECTION
fJ
YES 0 NO
BUILDING PERMIT APPLICATION TIGARD DATE_ April 17 19-s4 _ 4804
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 6211-l�}
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT N0._�5T
O�:�NER -- �,ir:kEG[c8t ilWP;�+ JOB 1�L1u j� �ti► ��}cllwec3dj-1
p. 9722�iARCHITECT
ENGINEER
BUILDER ADDRESS 10240 SW "limbus Suite L I IDESIGNER
STRUCTURE Gtl NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL [_l FIRE DAMAGE ❑ DEMOLITION
Q RESIDENCE ❑ COMM ❑ EDUCATIONAL Cl GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT El GARAGE ❑ STORAGE_❑ SLAB❑ FENCE
OCCUPANCY 1i-3 LAND USE ZONE -9=§a3L BLDG.TYPE _ StV�.FIRE ZONE_._PLAN CHECK BY _ l3Ctt HEAT�(baa
Coustruct single family dwelling wjattached
Subject to Lerun Heights $11W.JU :;gwar 5Ulcil3ri.e _
_ 2 Rathrouri 3 Hedr"m
SEWER PERMIT 0 26517 _�- - ':a.rapr 462 --
OCC.LOAD FLOOR LOAD 40 HEIGHT 14 NO,STORIES--2 AREA 11:17 NO.BEDROOMS 3 VALUE 5b.UU(.1.
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE 111 RIGHT SIDE
Permit 30 1.tH) THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 195.65 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCE:— THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 490.65 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CUNIRACTORS TO HAVE CURRENT CIrY 9USINESS
State tax 112.04LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATOIG.
SDC-- 4400.Uu
Total Stilci.b`.� _
PDCO ' I(ju.LK) APPLI-- CANTORAGENT
BY CH
_ Receipt No. _�. -----------_-.....p -----`T --
Approved F-CR AbDRE88 PHONE
DATE INSP. TYPE INSPECTION — REMARKS PLUMBING — DATE
_ Contractor /� R �
r — Permit No.t3'I67 ?.�lv �,22`$�
Fiough-in
Fixture• ---
�G„!L ' Final
HEATING
Contractor
-- _ Permit No.
/0•�' � -=�- - _� Gas or Oil
Flough-in
----- --- - - --- ------ ---- Final
- - - — — SEWER
- � - -- Final
------_ — _--------- � DRIVEWAY r:
— _-- -�__ ------_� Final
Storm Orainagr
--- li IFtain Main)Final
Sidewalk
Cu•b&Street Final
— BLDG.DEPT.FINAL TEtv'POP.ARY criir KATE OCCUPANCY Final
CERTIFICATE OCCUPANCY ----
C" rl
,Gr1 Lendscnoing
- ` Zonin•. rinal
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CITY OF TIGARD—12420 S.W.MAIN--•TIGARD,OREGON 97223
RECEIPT
DAT 2 _. AMOUNT: S��
LLARS
of
NAME: CASH:
ADDRESS: HE
�— M.O.:
# OF
FOR: ACCT. N PERMITS SURCHAROE AMOUNT
SEWER BILLINGS 40-364
BUSINESS LICENSE 05-331
PLUMBING PERMIT 05-332 —� $
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333 A _ '• �..,� -2-51, 04'
SEWER CONNECTION 40-363 ___ �• jL'
SEWER INSPECTION 40-365G�,
SYSTEM DEV.CHARGE 25-366
PARK DEV.CHARGE #1 30-361 C'D, .--Q_
PARK DEV.CHARGE #2 30-:,68
ZONING ADJUSTMENTS 05-362
Aorl—, —
TOTALS s3� SRECEIVED BY:
PERMIT NUMBERS ASSIGNED:
Number Amount ltumbw Amount Numbw Amount
S `1i0 S
S!,yrs oZG 4�( S
RECOPY " 17 8 8 3
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,ter �t ...::�a..^x �� � �.,
�l�
BuiIdinq Permit No.
Location �3 ?0 tz-dtb
Uat ee
Certification of Registration
With the Builders Board
doing business as (dba) ,
am registered under the provisions
of ORS C . pter 701 Oregon Homebui lders Law) .
My Builders Board Registration Number is
My registration is in full force and effect and expires on
Signature
iFEW un"I
INE UINL`�ItFi1GNE0 HiHLBY AP?LI LS I OH Aft-fWI I I-UH ItIL "Wk)" itI,HL 114 1-101I "NI I
GR AS SHOWhI AND APPROVED IN THE ACCOMPANYING PLANS ANU SPECIFICATIONS. Ov/NER%I OrIE V�T
/ Lor
.7'.VrJEN •nl�.f .O`ft�(,V l013 ADDRESS-,/ L7
__- 111J" y St��L9�L,LL „ 1 CZ17— AnCtIfTECT
3 ENGINEER
AODEW,.( U'Z.�L �� �v•�su�A1. OESIc Y£R
f7
iTRUCTURE � '151NEW ❑Rk4U10EL `_IADOITION `- ORcPAIR— ❑R-NE':IIA,L + QFIREDAMAGE ❑DE:•IQLIT
�j RESILE"ICi [iCOftM ❑EOVCATIONAL ❑GUV'T ❑RELIGICU=CJ?ATIn ❑GAR PORT ❑GARAGE t_l STOilAGE❑SLAB ❑FEI
C('.CL:PAr;_Y1i-a—LAND USE ZONE....--��oLOG. TYPE 5N � PLAN CHECK BYNEAT
CONSTRUCLSINQLLF Mil Y DWELLING W/A'LEAGI1F.1_) G ItA(;E.
BA"H„KOU 1 BEDROOM
SEWER PERMIT it �� 5"/� _ Garage _
� __I- IG
-LQD AU FI EHT / �aj ) : AREA,, NO.BEDf100A1�
SOJILCING DEPAR rMENT — SETBACKS FRONT _ REAR LEFT SIDE MIGHT SIDE
'^_:r-lt
THIS PERMIT IS ISSUED SUajECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZOP.
I ion --!itcR REGULATIONS AND ALL APPLICA9LE CODES AND ORDINANCES, AND IT IS HEREBY ,AGREED THAT
r--- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN C43MPLIANGE V
$a i total �, ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT wI
�-- RCSTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSIP
!7:at.- Tax I LICENSE. SEPARATE PERMITS REQUIRED FCR SEWER. PLUMBING AND HEATING.
i - SDC
Tura► I PDC _
r ---
_--� APPLICANT OR AGF_NT
Appro:l-d I Receipt Nu
T'ln FlFSS � SUN►_ -��
SDC - S
FDC - 8 #
SEWER CONNECTION $
SEWER INSPECTION S
SEWER SURCHARGE 8
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