12555 SW 128TH AVENUE I
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CITY OF TIGARD
\ OREGON
June 1 , 1995 7
RE: BUILDING PERMIT #
inspect ion (s) have been conducted on t1-is pr•)j ect . However, we
have no record of any subsequent or final i.nspectioas within the
past 180 days .
Please note that permits become v-,,Id if there has net been an
inspection performed for over 180 days . In that case, the b;,ilding
Division may require a new application and fees to continue work.
A notice of non-compliance again:�t the Fioperty may also be
reroz led by the City.
Please advise the Building Division, IN WRI1INr, within 15 days of
this letter, the status of this project . You may request
additional time to compute the project .
Respo^d IN WRITING to : Building Division_, 13125 SW Hall Blvd. ,
Tigard OR 97- 3 . Be sure to .include the following information:
1 . Building Permit # .
Address of property.
3 . Your name .
4 . Your phone number B : OJ a .m. - 4 : 00 p.m.
CL; If you are ready to schedule your nr.xt inspection, pl;?ase call our
24-hour Inspection Recorder at 639-4175 .
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13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 — —
-CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
13125 SW Hall Blvd.Tigard,O egon 97?23.8199 (503)839-4171
R M I T #. . . . _ .,
639-41 ,; i DATE ISSUED: 08/31/94
PARCEL: 2S 104AD-02200
SITE ADDPESS. . . : 12555 SW 128TH AVE:.
SUBDIVISIGN. . . . : BELLWOOD ZON' NG: R-4. 5
BL_OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 49
BUILDING
REISSUE: DWELLING UNITS:0 BASEMEN•T. . . . . . . .. :0 s 1=
CLASS OF WORK. :ADD BEDRMS:O BATHS.-0 GARAGE. . . . . . . . . . ..0 s.f:
TYPE OF USE. . . :SF FLOOR AREAS------- REQUIRED SETBACI/%S-----------_.._
TYPE OF CONST. :5N FT RST. . . . : 119 ,f LEFT. . :0 ft RT.GHT. :0 ft
OCCUPANCY GRP. : R" SECOND. . . :0 S FRONT. :IZI ft hC(1R. . :0 t
STORIES. . . . . . . : 1 F I NBSMENT:0 s f REOU 7 RED-••---__-_-_----
ViE I GHT. . . . . . . . : 0 ft TO -: 1. 1 ) s f SMOKE; EETF C•fORS, :
FLUOR LOAD. . . . :40 psf VALUE. . . . . $ : 3500 PARKING SPACE,-j. . :0
Remarks} : ADDITION OF` 119 SO FT TO HOUSL PATH I
PLUMBING
SI NI'%S. . . . . . . . . . . 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVN'TRS. . :!Zt
LAVATORIEES. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . .0
TUI /SHOWERS. . . . :0 LAUNDRY TRAYS„ . . :IZI CPTCH LAAG I NS. . . . . . . 04
WATER CLOSETS-:0 SEWER LINE (ft ) . :0 GREASE T RAT'S. . . . . . . :0
DISHWASHERS. . . . : 1. WATER LINE (ft ) . :IZI OTHER FIXTURES. . . . „ :UI
GARBAGE: DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASH I NG MACH. . . :I' GI RR I lu D R A I NS. . :0
_...___------------- IrIECHANICAL -____..-_..___..____.______-__.__.._.__._.___.______.. FEES
FUEL TYPES----- ------ UNIT HTRS. . ',0 type amol.rnt by Gate recpt
VENTS . . . . . :0 B P R T $ 44. 50 KS 08/31 /94 -
MAX IAPU :V.! BTU VENT FANS. . :141 BPI_-(; 11 28. 9131 JF. Ilia/25/ 34 94•--c'tjoIIIc
FURN ( 100F( . . .0 HOODS. . . . . . ) B5PC $ 2. .'3 KS 08/31/94 •-
FURN ) =1.01ZIK . . :1.1 WOODSTG )ES. :IZI 14,_1RT' $ 25. 00 KS 08/31/94
FLOOR FURN. . . . :0 CL. Q DRYERS. : 21 P5PC $ 1. 2'5 KS 08/31/94 -
BOtI_/CMP ( .?.HPIOZI OTHER UNITS:0
GAS CUTLETS:41
Owner:
BRAD WE.INILL
12555 SW 12E TH
T UARD OR 97223
Phonq #:
Contractor:
CONTRACTOP 1\401' ON FILE
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Phonp 4:
,i Reg #. . _ __.___._________._____--_--__-.--__-___
$ 101. 91 TOTAL
This permit is is.led subject to the regulations contained in theREQUIRED INSPECT IONS -
w Tigard Municipal Code, State of Ore. Specialty Codes and all other Fvot/fol.Ind Insp P11amb Final
_' dpp.icatle laws. All work will be dont in accordance with approved Post/Beam Strl.lct BI.lilding Final
plans. This permit will expire if work is not started within 180 F'i.1/Undovr f l mor Erasion Control
days of issuance, or if work is susnded fay. more than 180 da s. r X11 'Imb Top Out Crawl Drain
F ,aming Insp
Pe!rmit'l.C' L=1.gn I;P" �, J T.ns1.lT.at > OT1 Insp
�f Gyp Board Insp
1sS1.1eci By : �,V. - : Rain drain Insp _
Imp-"
CITY CSF T I PARD
COMMUNITY DEVELOPMENT DEPARTMENT MASER PERMIT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PERM I'r #. . . . . . . : IIST94033
C,3,j -4 DATE ISSUED: 08/31/94
PARCEL- LIF3104AD02200
fiITE. ADDRESS. . . : 1,2555 SW 128TH AVE
UBDIVISION. . . . : BELLWOOD ZONING: R- 4. 5
iLOCR. . . . . . . . . . LOT. . . . . . . . . . . . . :49
BUILDING
REISSUE: DWELLING UNITS:0 BASEMEN'l.. . . . . . . . :0
_LASS OF WORK. :ADD BEDRMS:0 BATHS:O GARAGE. . . . . . . . . . :0 a f
I'YPE OF USE. . . :SF PLOOR REQUIRED SETBACKS-
!'YPE (.3F CONS- . :5N FIRST— . . '. 119 5f L E F" T. . -0 ft "IGHT. :0 ft
OCCUPANCY CiiP. :R3 SECOND. . . -.0 of FRONT. -0 ft REvIR. 0 ft
'3TORIES. . . . . . I FINBSMENT:O s REQUI
!iE T GHT. . . . . . . . . 0 ft *TOTAL-------------- 1 19 s SMOKE DETECTORS.
1`1_00R LOAD. . . . :40 psf VALUE. . . . 3500 PARK ING SP(ICES. . 0
Remarks : ADDITION OF" 119 SO FT TO HOUSE V'ATIA I
PLUMBING
'31NK5. . . . . . . . . . .. I FLOOR DRAINS. . . . :0 BACI-/,FLOW PREVNTRS. . 'fb
;-AVPT'[)R- II'7S. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . .- . . . . :0
MB/61-411WERG. . . . -0 LAUNDRY TRAYS. . . :0 CATCH BASINS. , . . . . . t111
WATER CLOSETS. . :0 SEWER LINE ('Ft; . :0 GRf7ASE 'YRAVS. . . . . . . :0
DISHWASHERS. . . . . 1 WATER LINE ( Ft ) . :0 OTHER FIXTURES.
,1ARBP6E DISP. . . - 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . :0 SF RAIN DRAINS. . :0
MECHANICAL FEES
UEL by date I.-,ecpt
TYPES- IJ N I I i+r RS. . :0 type amount
V E Nr S . . . . . ..0 BPRT $ 44. 50 KS 08/31 /94
MAX lNPUT:0 BTU VENT
N'T FANS. . :0 13PLC $ L-8. 93 JF 08,/25/94 942560i:
FURN ( 100K . . .-0 HOODS. . . . . . :0 B5PC, $ 2. 23 KS' 1218/31/94
BURN W(JODSTOVES. 10 PPRT $ 25. 00 KS 08/31/94
FLOOR TURN. . . . :0 CLO DRYERS. : 0 P5PC $ 1. 25 KS 08/31/94
BOIL./CMP ( 3HP:0 01-HER UNITStO
GAS OUTLETS0
8RAD WEINEIL
12555 SW 1Z'8TH
TIGARD OR 97223
Phone #'
ContrAatorl
CONTRACTOR NOT ON FILE
CL
cc
Phone
Req
$ 101. 91 TOTAL
This privit is issued subject to the regulat-utis contained in the REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Plumb Final
applicable laws. All work will be done in accordance with approved Post/)deani St rust Building Final
plans. This peroit will expire if work is not started within 180 F_ Uiderfloor E.-usion Control
jays of issuance, or if work is sus(;�d for',.n'ore than,I 1/'�J-1121m/b"Top Out Crawl Drain
P��As,
F'.v�amjnq Inap
Permittee Sign E t 1___/I psu).a4- ion Trtsp
- 1 '�v I Gyp Board Insp
fssupd By : Rain drain Insp
It ! fur' !1'5PFUt !%111
Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 539.4171
Jobsite Address: , Z J J v
IrZSubdivision:
t )(J )C)G1 Lot# Office Use Only
Valuation:
��..� - Planck/Rec #
_
Permit # i)- J
Corner Lot? Y 14,
Flag Lot? Y
Reissue of
iJ�
Map & TL# 5161 ` AIC' 0Z'?&
Cwner: –� ly n _ Approvals Required
Address: �z Planning —
r-- ,
/ 1 -'rv' Engineering a_
Phone: –' / J q _ Z Other _
Contractor: -</-T 427 Z' Items Required
Address: -- Subcontractors
Trws Details
Phone: – Other
Contractor's License #
(attach ropy of current Oregon license)
Contact Name & Phone:
Subcontractors: Architect/Engineer:CL
Plumbing: Address:
re
Mechanical:
(attach copy of current OR Contractees License)
�- Phone
JOB DESCRIPTION:
W - -----
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Applicant Signature & Phone number
Received by: _ _ Date Received:
14 MORDICOMOEVIRESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
,VI/ -023 Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX) �3• �'
Bldg: J
q
Plumb: /• g �
Mech:
Plan Check (PLANCK)'
Bldg: l 3
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) —
Storm Drainage Chg (SDSDC)
Resident,,:) TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C;
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL) ^_
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Water Quantity (JVQUANT) _
> Fire District (F RE)
Erosion Cntrl Permit "=RPRMT)
W Erosion Planck/USA (ERPLAN)
Erosion PlancK/COT (EROSN)
TOTALS: O L q ✓ �3 �� • / `;)
1 ,
CITY OF TIGARD
B!'!LGING DIVISION
RESIDENTIAL PLANS SUBMITTAL
APPLICANT NAME: PLAN CHECK #
ADDRESS: S L f PHONE # `) 7 07
DATE RECEIVED: RECEIVED BY:
CHECKLIST (All items must be in packet before plan will be reviewed)
Y E 5 NO N/A
1 . ] [ ) [ ] 3 FULL SETS OF BUILDING PLANS (No red line revisions
or tape-ons).
5 SITE PLANS (including tax lot and tax map number, easements,
erosion control provisions, floor elevation of garage and main
floor, set backs, drive-way location, north arrow, scale, location
and terminatio-i of rain drains, corner elevations, and contours
if over 15% grade).
3. ( ] [ ] ] BUILDING PLANS SHALL REFLECT TOPOGRAPHY OF LOi
(if house is designed for a flat lot and the lot is not flat, revised
drawings are required. No red lines accepted).
4. K_.J [ ] [ ] REVISION TO PLANS MUST BE FOLLOWED THROUGH
FROM ROOF 'TO FOUNDATION (detailed sections may be
different frorr, the originals as a result of your changes. These
portions of the structure that are affected by the change need to
be reflected on the plans. No red lines will be accepted).
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s 5. FLOOR PLAN(S)
y 6. [ [ ] [ ] FLOOR FRAMING
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s 7. [ J [ ] [ ] TRUSS JOISTS (engineering, details and layouts)
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-� 8. [L J [ J [ ] ROOF FRAMING PLAN (all hips and valley supports indicated
and detailed).
— OVER —
9• ROOF TRUSSES (engineering, details and layouts)
10. COMPLETE CROSS SECTION(S)
11. [ ] [ J [ j ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
ADDITIONS AND REMODELS
12. [ ] [ ] BASEMENT WALL, FOUNDATION AND RETAINING WALL.
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
13. [ ] [ ] [ ] WALL BRACING (structure must meet table R-402.10, revised
alternate method 93-7, or a lateral design shall be provided)
14. [ J [ ] [ ] ALL DERAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. (Attachments must be
clearly legible and fully referenced in the pians).
15. [ ] [ ] [ ] BEAM CALCULATIONS (all beams over 10 h. in length or any
beam that supports a point load).
16 [' ] [ ] [ ] ENERGY CODE PATH IDENTIFIED
DO NOT MAKE CORRECTION IN RED
RED WILL ONLY CAUSE DELAYS
hk 41"W
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F' Permit No:
Address:I ___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 construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. 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 boxes 1 and 2, and either box 3A or 313:
1 . CI I own, reside in, or will reside in the completed structure.
2. 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A.L I My general contractor is _ __ ,
Contractor registration number_ _
I will in-,truct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. B.T1 I will be rr,y own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the C-mstruction 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 gad and understand
the Information Notice to Property Owners about Construction '.esponsibilities nn the
tz tz reverse side of this form.
Jig ure of Permit Applican ' Date �"-_S�
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.417
Inspection:—
Footing Susp. Ceiling Sprink. Rough-in Appr/ dw
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plhg. Top Out Elec. Rough-in FINAL: j
Post/Beam Mech. San. Sewer Gas Line 9.
Plbg. Underfloor Rain Drain Framing
Alarm Wate, Line Insulation �j10fe—y�
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: (.' / �l� Time;a% AM _ PM
Address:
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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,l���Uwrcl�rr
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Inspector: —- _ bate:
ROVED ,DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPE_CPION NOTICE
City of Tigard Building Department
13125 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line kRec-O-Phone): 639-4175 Business Phone: 4171
Inspection•__
Footing Plbg. Under_elab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
t eam Stru San. Sewer: ranting -Bldg.
t Be Hoch. Rain Drain Innulation -Plumb.
; Underfloo Watorr Liine� Gyp. Bd. -Hoch.
Date Request ed:� ---Time: AN _ PH
Address: / �� _✓ /� _ Permit :_ �-7 Q
Bullder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: �. Dates
APPROVED DISAPPROVED APPROVSD DDBJWT TO
—Ca:1 Per Reinap.
CITY (7FTIGriRD - RECE=IPT OF' PAYMENT RFC:FIP'T' NO. 93,-P35M
AJyJnUNT s 0. Oki
NAME WEvINEI..., BRAn CASH Am(Dtjhj a 26. 85
ADDRESS 0 U2555 SW IPAT'' PAYMENT DATE` x oi,, s/9;3
FUNDIVIF..;ION
TIGARD, OR 9',c'.2,i-
PURPOSEW or myMENI' PMOLINT PAID PURPOSE". OF PAYOWNT AMOUNT Ph ID
PLUMBING WERE ........... _..._�.....-.c'9i.00 ST. PUIL_D PER 1. 25
IOTA(.. AMOUNT PAID - - > ?_6. r''.5
C:1 I"�r' t1F T 1 flf lFtU RE CE' l P i C;4 1='W'YMk:N( k2L•.l.:k-.i l'1 NO. :94 ir'`'Ea;
1;11(-.(,K oML11 IN I a 0. 00
NAMES a Wh.IWI,, BRAD I...N3:.41 Nlhl.11.11'J 1
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INSPECTION NOTICE
City of Tigard Building Depart xten
13325 BW Ball Blvd. Tigard, Oregon 9/223•___.----
Inspection Lino (Rec-O-Phone)t 639-4175 Business Phone: 639-4171
Inspections
Footing PlbgUnderrsllabMach. Rough-in Appr/Sdwlk
Fo.nd. /
_CPb .— J
Gas LineFINALt
t'Oet/Beam Struct, San. Sewer Framing g.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor slater Line Gyp. Bd. -Hoch.
Date Requesteds /L� Time: AM __PM
Addresss ��� � jT 7-A Permit
Builder:
TNM FOLLOWING CORRECTIONS ARE REQUIRED:
LLJn.
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Inspector: Date: �Li7L 'T—
APPROVED !_ DISAPPROVED —_ APPROVED fUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Bui.ldinq Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Roc-0-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
F
ount. Plbg. Top Out Gas Line FINAL:
Po�s�'Beam Stru San. Sewer raining -Bldg.
Post/B Mach. Ratn Drain Insulation -Plumb.
I-el Unuerfloo Water Line} Gyp Bd. -Meeh.
Date Requested:_ /Wy / / Time: AM _ PM
AddrenB: .) S /,2 Permit 1: '4'
Build,ir:
T3E FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: - _-- ---,__`_-- Date:�
-iAPPROVSD - DISAPPROVED APPROVED SUR.TECT To ABOVE
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Depwtaent
13125 SN Ball Blvd. Tigard, Orem 97223
Inspection Line (Rec-O-Phone)s 639-4175 Busineed Phone: 639- 17:
Inspection:
Fp6ETnTg� Plbg. Underalab Mach. Rough-in Appr/Sdwlk
gcun Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldq.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbq. Underfloor /Vater Line Gyp. Bd. -Hech.
Date Requestedr / / J I _Time: G AH PH
Address f', I�jTTT(�/ cPermit Is__/�/ - �✓ � 1
Builder:--
THE
uilders _THE FOLLOMING CORR.RCTIONS ARE REQUIRED:
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Inspector: `� Dates_ C
APPROVED DISAPPROVED APPROVED SUBJECT TO REW
Call For Roinsp.
�F Permit No:
'� •\ Address:
: O
issued by:_____ Date:
----FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERIY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, URS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical. and plumbing
permits. 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 boxes 1 and 2, and either box 3A or 36:
1 . [ I own, reside in, or will reside in the completed structure.
2. 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. AJ C I My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Constrcrction Contractors Board.
OR
3. B. --) 1 will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion 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 iasuing this building permi, of the name of
n.
the contractor.
I L
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 We
�- reverse side of this form.
J
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J
Sig rlA-tur-e or Permit�Applicari Da e
CONSTRUCTION CONTRACTORS BOARD
0244,1 8/91
WHITE COPY TO ISSUING AGENCY PEMAIT FILE
PINK COPY TO APPLICANT
CITYOFTIOrARD C"YOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT 011160H PLU11BING PER11IT
13326 SW Hell Blvd. P.O.Elm 23397,Tig",Or"m 97223(603)639-4175 PERNIT -it. . . . . . .
DATE IG5(_JEJ): 01/05/93
SITE ADDRESS. . . : 12555 SW 11281H AVE PARCEL: 2SI04PD--02200
�iUBD I Y 15 1 ON. . . . : BEL LWOOD ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :49
CLASS OF WORK. . :ADD GARBAGE DISPOSALS. hJOBILE H014E SPACES.
TYPE OF USE. . . . SF* WASHING MACH. . . . . . . : DACKFLOW PREYNTRS. .
OCCUPANCY GRI-6. . R3 FLOOR DRAINS. . . . . . . . 'I RAPS. . . .
STORIES. . . . . . . . .. I WATER HEA'TERS. . . . . . . CA'T 01-4 BAS i *
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F I X TU RES------- LAUNDRY TRAYS. . . . . . : EF RAIN DRAINS. . . . .
SINKS. . . . . . . . . . . 1. URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . .
LAYATOR I ES. 01-HER FIXTURES. . . . .
IUB/SHOWERS. SEWER LINE (ft ) . . . .
WATER CLOSETS. WATER LINE (ft ) _ . :
DISHWASHERS. . . . RAIN DRAIN (ft ) . . . . :
Remarks: PLU1y1BINb ALREADY STUBBED 11\1 SETTING FIXTURES ONLY
Uviner: FEES
BROD WEINEL type amount by date recpt
12555 SW 128TH PRIVIT 6 25. 00 JH 01/05/93
5f')C'l 1. 23 JH 01/05/93
TIG,IRD OR 97223
Phone * :
W H L H
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FSI-lone #: $ 26. 25 TOTAL
Reg #. . : 00000
RLUUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the 'I opo�lt 1n5p
Tigard Municipal Lade, State of Ore. Specialty Codes and all other Fin�Al Inspection
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Por,mittee Siynatut-e :
Issued By:
Lall for inspection 639-4175
W