14550 SW 130TH AVENUE-1 -.nti� ptnresuai .. ,. -`y:wNMNiMMUM1gIV1yNN.w.•si�:�
14550 SW 130TH AVENUE
CITYOF TIFARD A,;�
C11YOFTWIMM PLUMB I N6 r'FRIO I T
COMMUNITY DEVELOPMENT DEPARTMENT mon ;-1EF;MI,[ #. . . , . ., . : M1•491-0 :59
"--49ft SW Hrl OW P.O.Bac 2330'7,TOM,Omgm 07223(603)W"176
UPIE ISSUED;
S I T E: ADDRESS. ! 4950 SW 130'T'H ''AVE F=t-1RCEiL y :' _S I Q01 017 WDF 1 >
SUBDIVISION. . , . : WOODFORD ESTATES ZONING: 0-79L(7CK. . . . . . . . . . L(7 T. . . . . . . . . . . . . a 13
C:.I..AS!i I.7F WORK. . :IVEW -GARBAGE WllIEiPI:►'.-ILFa. . A____�,_......_.....__.____.__....,_,_____...._�_......_._.._..
TYKE: OF-' USE. . . . a SF WASHING hIACH. . . . . . . : 1 BhCKF L OW PREVN1 RS. . :0
OCCUPANCY GRP. . 03 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . :0
STORIES. .. . . . . . . :; WATE'F' HEATE.RS. . . . . . .. i CATCH BASINS. . . . . . . :0
F I XTURE_S-----._-•. _-•--- .--- L.Al.il'JARY TRAYS. .. . . . . . 1. 5F RPM : DRAINS. . . d . i 1
"..INKS. . . . . . . . . . ; 1 (. RE.OSF` .. RA{'S. . . . . . . 9k
LM(47ORTES. . . . . eU OTHER FIXTURES
TUB/5HOWERC:. . . . : SEWER L SNE (ft ) . . . . t 0
WATER CLOSETS. . :.3 WA'T'-R LINE (ft) . . , . : 100
DIE,MWf•1SHL-'.Rc. ¢ i rtC1Il l n0141 N* ( Ft ) . . . , e0
Remark s
OWNER.,
J- 7. ROTH CONSTRUCTION INC TIF $ 1580. 00 JLH 0;'?/ 14/30
12300 SW 69TH AVE. 1~PRT $ .470. 50 JLH 02/'14/92 -
F3PLC.. $ 305. 83 JLH 14-x/2.3/91 221 11A3
TIl�faRD OR 97�?23 B!1jPC $ 5 3 .J1-H 142'114/5 c: -
Phone Or 639-P637 SSI)c $ 00 JLH 02,'14/92 _
PARK $ 500. 00 JLH 02/14/92
P11.amhiny I;rlr;tralctor: -_ _------ ._- - PIPLC $ lar. 13 JLH 02/14/92
MSPC $ 03 JLH 02/14/9e
Name.AC.�- �._ r L --S:�__ _. PPRT $ 161 . 5121 YL.H 02/14/9P
tadd:•e s : t�7Y�!3 S PSPC $ 8. 13 Jl_F'1 02/14/92
City : f QX. )i p State: _
%% -r ___�• 14-IRT $ 40. ti0 JL'i 02/14/92
z i P,-. �..._7`` z:shone#e_�9.7`�
Reg
r
'This ppvmit is i%suec) gubjer_f, to t' a rea. RF-Qu1 RFU i NESF►�C.:`f I C)N;",
I ulati.ons Cantm' ined in the Tigard Mk.1nic.ipmi Foot/found 7rrsp 13Aink�cirAin Insp
Cnde, State of 1_,:^p 3pecialty Caries anri all Flat/undslab Ir1sp Waiter Lino Insp
other- applicable ?awr. All work will be done Pl_M/ljr,clerfl oor, Apj-)r^/Sd1A'J k 1 r1 Asp
in acc:ordancr. with ,approved plans. This Mec:han'.czal. 111,;p Appr/8d1 lk ltisp
permit will expire if wnrk i :% not started Plumb lop Out A- r'/Sda►lk insp
wiviiti Is@ days of iIgIIAnCa, ,)r if work is PI'1m1J 1'"p l.lc.lt MechanicaI Final
suspended for- more than 1811, clays. Frgm ►r►rj Insp Plumb Fir1,a1
Framiry (REINSP) F)lumb Final
Fireplace Insp Budding Final
089 Line Insp
Insulation Innp
._..._ _ Gyp Lauard Insp r __
1
or PI bing Contractor Sitlr►attllre
Ca 1 for insper,tion 639`-•4175
l:'ontr �C:tar^ Nnter. :
.................. ..........
TA CERTIFICATE OF
CITYOFTIFARD cffyl6lmlD , OCCUPANCY
Ce)MMUNFTY DEVELOPMENT DEPAMMIT oftew PE R141 T #. . . . . . . i MST91-021,59
'WS SW HWI Slod P.O.Box 23W.Ti PW,ONW 97�,,t"*"P rwor ic
!iITE ADDRESS. . . : 14550 SW J3WTH AVE PARCEL.
. . . RD E5TATES Z014ING: R-7
7 wc)uDro
BLOCK. . . . . . . . . . t LOT. . . . . . . . . . . . . t13
CLASS OF WORK. :NEW
TYPE OF LISF.— a 9
OCCUPHNCY CARP. sR3
OCCUPANCY LOAD z220 4
TENW,11' NAME.
Neroarliss
Owners
J. T. ROTH CONS T-RUCT 10114 INC;
1i2300 SW 69TIA AVE
T*IGARD OR 97223
Phone #- 639-2637
LOTltrmctort - ------------------
J. T. ROTH CONSTRUCTIW4 INC
12300 SW 69TH AVE
rlu()RD OR 97:1?3
Pt-jonp .4o b.39-2639
Rej #- - o 3174'0
Uvrmponcy of the above referenced bmildinp is hereby ijiveli. and certifies
the compliancv with the `hate W Oretion Specialty Lodi !s fo,.-, the W'OuPs
o�-,cupancy, and use tAnder which the referenced permit was jr-sucod.
FIRE MPAR110ENT t. 11NG ~�7 CR
WILD, jot
POST IN CONSPICUOUS PLACE
r
�NBPRCTSQNNOTICI
City of Tigard Building pepartanat
13125 SN Ball Blvd. Tigard, CM*Wim 97223
Inspection Line (Rec-O-Phons)i 639-4175 Suuiness Phones -4171
Inspection: '
Footing Plbg. Underelab Mach. Rough-in Appr/Sd '.
Fo ,,kd. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. MIA Oraia Insulaticn -Plumb.
Plbg. Underfloor �Yator Line Gyp. Bd. - h-
G7Cate Regaesteds Time° AM PN
Address: ����- `/ �- Permit
Builders —
TM FOLLOMI CORRECTIONS ARE REQUIRED:
1
ey
i
Inspectors _ _ natal
APPROVED DISAPPROWD APPROVED SUBJECT WABOV8
Call For Reinsp.
NI sPSCfION YoTICR
City of Tigard Building Department
13125 811 Ball Sled. Tigard. Oregon 97223 �
Inspection Line (Rec-O-Ph no): 639-4175 Business phones 639-4171
Inspection:��:
Footing Plbg� nderelab Mech. Rough-gin Aprc/Sdwlk
Found. Plbg. Top out Can Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain InSLlation
-Plumb.
Plbg. Underfloor Watery Line Gyp. Ed. -Hoch.
Date Requester: / // -� Timet
AM pN
Address: ���L �Q Permit
Builders_
TRE FOLLOWING CORRECTIONS ARE REQUIREDt
p
Inspectc r: Dates
_`APPR7�A
DISH ?ROVED APPROVED SUBJECT Tp J►gpyE
Call For Reinap.
INS ECTI____�N NO�PI�E
City of Tigard Building97223
13125 B11 Hall Blvd. Tigard. ��°
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171—
Inspection: Appr/Sdwlk
plbj, Underslab p►ech. Rough-in
Footing pINALt
Plbg• TOP Out Bas Line
pounA• -Bldg.
San• sewer
Framing _
Post/Pearn Struct• Rain Drain plumb.
Post/Beam Hoch.
Plbq. Underfloor N1►ter Linepyp. Bd. _hech.AM J—PM
--Times —
Date Requested: ��
U ��.� Permit #tC
Address:_
Builders_
THE FOLLOW
CORRXCTIONS ARE REQUIREDs
�-
-----------
__—
—
Inspectart -�-- _--_ -------
'� APPROVED
DISAPPROVED --__. APPROVED SUBJECT To ABOVE
J� Call for Reinsp•
INBPSCTION NOTICE V W 1
City of Tigard Building Departewnt
13125 ON Ball Blvd. 7i'Tard, Oregon 97223
In§..setion Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Tap Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Watery Line Gyp. Rd. -Meeh.
Oats, Requested:-5- ✓ !�- Time PN
Address: �7�� .7y Permit Is
Builders ! _
THE FO CORRECTIOMS ARE REQUIRED:
i u �F i
2 4
�3 Ic kiS r 3z_ .
Inspectors Date: 5
APPROVED -a Ot PPROVRD APPROVED SUBJECT To ABOVF.
___Call For Reinsp.
s
INSPECTION NOTICE
City of -.Tigard BaildLng Dspartatmt
13125 Be Hall Blvd. TWE". Oregon 97221
Inspection Live (Roc-o-Phone)t 639-4175 Business Phonet 639-4171
Inspectiont �—
Footing Plbg. Undermlab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Toy Out Gas Line FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam ?loch. Rain Drain Insulation -Plumb.
Pl.bg. Underfloor lister :.ins �yp. Bd. \l -Hoch.
Dote Requested t -�) - 6 Tinto t
// _�� PH
Address
• l �C/ �j�) _ Permit
� 7
Builders_ -—
TRS FOLLOHI$C'CORRECTIOHS ARE REQUIR902
GEJ- '
L L..
L
Inspect 1— 041`
r,
APPWM DISAPPROVRn APPROVED SUMMIT TO ABOVR
Call Po: �:tinep.
]NSPRcrIQM NOTICE
city of Tigard Building Departaent
13125 ON Ball Blvd. Tigard, Oregon 97223
Inspection Line (ROC-O-Phone)s 639-4175 Business Phones 639-4171
Inspection:
Footing Plbg. Underslab Much. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Dre.in Insulation,/ -Plumb.
i
Plbg. Underfloor Water Line Gyp. Bd. -Much.
Date Requested: if, G ix. Time: � AM 7 oPH
Address:/�Y %a1/ .� Permit
Builder:
TNM FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inspectors _ _ Dates _
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall B`rd. Tigard, Oregrm 97223
Inepoction Line (Rec--O-P ns): 639-4175 Business Fhone: 639-4171
Inspection:
Footing P1 Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Ed. -Meeh.
Date Requested: Times AM PM
Address: �J ��/ _ Permit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
r
Inspectors /L-
Dates 50 2�-
~ APPROVED DI3APPROVED APPROVED SUBJECT TO ABOVE
Call For Rsinsp.
INBPECTION NOTICE
City of Tigard Building Department
13125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-A175 Business Phone: 639-4171
Inspection: --
looting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. P.bg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer `lremin9 ) -Bldg.
i
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. ad. -Mach.
Date Requestede IJP ---;)/ Time: AM ' PN
Address: �:�%� Permit is
Builders
THC FOLLOWI CORRECTIONS ARE RQQUIREDs
I
Tnepectors 7/o^ __ _ Dates
i A!1►NDptD DTSAPPn IVSD APPROVED SMWM TO ADM
Call For Reinep.
INSPtCTION NOTICE
Cl.-y of Tigard Building Department
13125 ON Ball Blvd. Tigard, Oregon 97213
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _
Footing Plbg. Underslab (Mach. Rough-in Appr/Sdwlk
Found. Plb.' Top Out an L no FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain on -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requested: `7 Time: _AM PM
Address: V Permit
Builder:
TNR FOT.I.ON CORRECTIONS ARE REQUIREDs
OF
�,.
r / v L► �
T
d.L7tu-
�c. .�
��
OF
a t L .:df�y�y��a.�'� A L w-V- !•.�Y r��. .� r�,
In
t
ort
Date;
APPROVED DISAPPROVED �v APPROVED SUBJECT TD ADM
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Departaent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone)s 639-4175 Business Phone: 639-4171
Inspection:_ —"
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. lbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lin_e/ Gyp. Bd. -Hoch.
Date Requested: ��_�?'_?� _T � AM PM
Address: :'T �: -Tr�� _ L� Permit
Builder: _
TNS FOLLOWING OORRBCfIONS ARE REQUIRED:
i
Inspector:- 'of Date:_
APPROVED _ DISAPPROVED APPROVED SUBJECT TO ABOVE
Call Fol- Reinsp.
INSPECTION NOTICE
City of Tigard Buildl,j Departssent
13125 OR Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Tooting Plbq. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. n. Sewer ` Framing -Bldg.
Post/Beam Mach. in Drai_ n Insulation -Plumb.
Plbq. Underfl ('Nater Lina Gyp. Bd. -Mach. �
Data Requested:—_c,.,) - Time: AM
Address: .� r._,rte__ --- Permit
�
Builders .F Lr���? _�"t�'�1G-� � � (� � -� �LO 7Lw
THE FOLLOWING CORRECTIONS xRE REQUIRED:
1
Inspector//� ------ Date: ` 7�
APPROVED DUJAPPROVED APPROVED OVE ED SUBJECT ID AB
Y- __Call For Reinap.
320MION NOTICE "
city Of Tigard `_ 11A, Deperfasnt
13125 w Hall Blvd. Tigard, Oregon 97223
Inspection Lin. (Rec-O-Phon.)s 639-4175 Su.in..s Phones 639-4171
Inspections --
Footing Plbg. Underslab Mach. Ratgh-in Appr/Sdwlk
Pound. Plbg. Top Out Oas Lin. FINALs
Post/Beam Structs. Ran. Sewer framing -Bldg.
Post/sham M.ch. in Drain/- Insulation -Plumb.
Plbg. Underfloor tt. Line , Gyp. Bd. -Meoh.
Date^ Requs st.d t_ d 2 ��- Time: — AM
Adfr..ss S�Ji Permit 1
Builder• I
TBE FOLLMINO CORRECTIO' ARE REQUIREDs I
J
Inspector s � Dates � 7
___APPROVED DISAPPROVED APPROVED SUBJECT TO APO"
Call For Rainsp.
..._..... ....-C; —... Y up.- ..,,hp,.......•_y_T.vy..._1n...Y!+r.-l.iWyY^n�lY- ;.
INSPECTION NOTICE
City of Tigard Building Department
13125 Of Ball Blvd. Tigard, oragou 97223
inspcotion Line �Rec-O-Phoneys 639-4175 Buainese Phones 639-4171 i
Inspections ---
looting Plbg. Underalab Mach. Rouqh-in Appr/Sdwlk
nd. Plbg. Top Ou` Can Line FINAL•
Po JBeI Struct. San. Bower Framing -Bldcf.
Post/Beam ?tach. Rain Drain Insulation -Plumt,.
PlTr4. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requesteds 1:2 G� �" Tis�'� PH
A.dreast L V 3, _ Permit #s��'�
Builders
THE FOLLOWING CORRECTIONS ARE RBQUIRRDt
04
t
Inspecto Dates.__ �G
f
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinap.
r
INBPECTIGN NOTICE
city of Tigard Noi1/.aaq nMpartMMVt /
13225 W Ball Blvd. Tigard, Oregon 97223
Inspection Lina (Roc-O-Phone): 63_-4175,�Business Phone: 639-4171
Inspections_ , /Oa"z Ol^ /VlaON
Plbg. Undar• Hach. Rough-in Appr/Sdwlk
Pound. Plbg. Top out Gas Lina FINAL:
Post/Beam Struct. San. Sewer lraml-g -Bldg.
Post/Slam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Date Requested: -z—
Tims: AK _X—PK
Ad'iress: 3 J Permit
C\ 3Builders L Q�
THE POLLONI CORRECTIONS ARE REQUIRED:
Inspector:
_ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
`Call For Reinsp.
t
1
a
F
CITYOFTIFARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
13125 BWFWIBlvd p.O.Ba23",.TOW,o►wo„orr231so31e3wt75 PERMIT #. . . . . . . : MS791-0z,::,'a
639-417.1 DATE ISSUED: 02/14/92
SITE ADDRESS. . . : 14-50 SW 1301"14 AVE
SUBDIVISION. , , , ; WOUDFURD ESTATES PARCEL: 2S 109AD-WDF'1.
ZONING: R-7
BLOCK. . . . . . .
_.___________________.---•-______.___-- BUILDING
----- _-----------------------
RE I,SUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 _--_
CLASS OF WORK. :NEW BEDRMS:4 BA"fH5:3 GARAGE. . . . . . . . sf
TYPE OF USE. . . :SF FLOOR AREAS----------._- . . :760 s f
REQUIRED SE-fPACKa------.-.._--_
I YPE OF CON5T. :5N FIRST. . . . : 1094 sf LEFT. . :5 ft RIGHT. :5 ft
OCCUPANCY GRP. :R3 SECOND. . . . 109j2 s f FRONT. :20 ft REAR. . .-30 ft
STORIES. . . . . . . :2 THIRD. . . . :0 s f RE CgU I RED-------•----
HEIGHT. . . . . . . ---------
� '0 ft TOTAL-------;2186 a f SMOKE_. DETECTORS. :Y
F'L_.00R LOAD. . . . :40 psf VALUE. . . . . 4 : 114236 PARKING SPACES. . :0
Remarks :
------"--------- PLUMBING
SINKS. . . . . . . . . . : 1 FLOOR DRAING. . . . :0
L_(aVATOFtIES. . . . . :5 BACKFLOW F'REVNTRS. . :0
WATER HEATERS. . . : 1. TRAPS. . . . . . . . . . . . . . :0
TUB/GHOWERG. . . . :3 LAUNDRY E' TRAYS. . . - 1 CATCH BAS I'JS. . . . . . . :0
WAT'E'R CLOSETS. . SEWER LINE (ft ) . :0 GREASE TRAP S. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE: (ft ) . : too OTHER FIXTURES. . . . . ..0
GARBAGE: DISE'. . . r 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : ). SF RAIN DRAINS. . : 1
__-_____-_-._---- MECHANICAL
TYPES---- FEES
FUEL TY
GAS/ / / UNIT�H1"RS. . :0 type `amu _1r,t by date recpt
VENTS :0 TIF $ 180. 00 JLH 02/14/92 -
MAX INPLIT:O BTU VENT ANG. . :4 SPRT s 470. 50 JLH 02.1'14/92 -
FLjRN ( 100K . . a0 HOODS. . . . . . : 1 SPLC s ."sOS. Fla JLH iF ',r
..'i /91 cc^cD110.:,
F=UPN ) =100K WOODST•OVES. :0 B5PC _-
FLOOR FURN. . . . :0 2". _,.:, JLH 0F:/14/9` --
CLO DRYERS. : 1 SSDC s ;_80. 00 JLH 02/14192 -
L30IL_/CMF' < 3I4p:0 OTHER UNITS:O PARK $ 500. 00 JLH 0`/14/'3 t' -
GAS OUTLET5: 1 MPLC f
MSPC 10, 13 JLH 02/14/92^ -
C.1wner: -_______._---
J. T. ROTH CONSTRUCTION INC 2. 03., JLH 0.:'!14/92: -
i 2'304'1 SW 69W AVE PPR
t 162. 50 JLH OE/14/921 -
PSPC $ 8. 13 JLH 02/14/92 -
I-IGARD OR 9722,.'3 Mt'RT t 40. 50 JLH 02/14/92 -
"hune #: 639-261-57
I. 1 ROrH CONSTRUCTION INC
1 =300 SW 69TH AVE
1-IGARD OR 97223 1
,hone #: 639-2637
r?eg #. . 31700 -------------------------------------
This pertit is issued sibject to the regulations canteined in the --------$ 3183. 15 TOTAL
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/foLinndOInspD INSPECTIONInsp---
applicable laws. All work will of done in accoroance with approved F'ost/Ream Strurt Gas Line Insp
Plans. This permit wiil expire if wonfol- inspec-tion
18Q1 Post/Beam Meehan Insulation Ir-,sp
days of issuance, or if work is s� ays. PIM/Undslab Inso Gyp Board Insp
Permittee Signatf.111 _ 'LM/Under,flp01' Ra T1 drain Ins
ei-hanical Insp Wat?r Line Insp
Plumb Top Out Appr/�dwl k Insp
I s s l_1 e d Bye _..__ F'ramin ina g P Mer•I-ranir-al sinalction - 639-4175
—� SEWER CONNECTION
CITYOFTIOArRD
FF_RMIT
PERMIT #,
' CONIMMY DEVELOW-NT D�d TN�IIID 541R9c-OQ� ,
311268W►WlBMd p.o.Box 23M,Ttprd,Oregon Mac-
600 76 DATE ISSUED: 02/14/92
SITE. ADDRESS. . . : 14550 c,W 130T'H AVE
SUBDIVISION. . . , : WOODFORD ESTATES PARCEL: `S109AD-lJDF13
131-OCK. . . . . . . . . ZONING: R-7
. . LUT. . . . . . . . . . . . . . 13
_------------------------
I'ENAN7 NAME. . . . . . _________________._____._________.___.._ _._._
USA NO, . . . . . . . . . : FIXTURE UNITS. . . :
CLASS OF WORN.. . , :NEW
TYPE OF USE. . . . . :SF DWELLING UNIT:;. . : 1
INSTALL rr'1-�E. , . , :PUSWR N0. OF PU I LD I NG5: 1
I MPERV SURFACE. . : : s f
Remarks:
Owner-: -._____----__ _
-- --_-- --___ ____--- ---- FEES
J. T. P.OTI-I CONSTRUCTION INC type amol-int by date _ �
12300 SW 69TH AVE recpt
PRMT $ 1900, 00 JL.H 02/14/92 -
TIGARD OR 97223 INSP $ 35. 00 JL.H 0,:'/14/92 -
Phone #: 639-2637
Contractor:
CONTRACTOR NOT ON FILE
Req #. . : t 1935. 00 TOTAL --
This Applicant agrees to comply with all the rules and regulations E~ _ REQUIRED INSPECTIONS --------
of the Unified Sewage Agency. The permit expires 188 days from
ewer Inspection
the date issued. The total amount paid will be forfeited if the ---
permit expires. The Agency does not guarantee tho accuracy of the
side sewer Iaterals. If the sewer is not locat!-d at the measurement ----
given, the installer shall prospect 3 feet in all directions from �- --`
the distance given. If not so located, the installer shaX purchase ---
a "'iep and Side Sewer" Permit and the A e -Fill 'n 1 d iateral.
I--etmittee 5iilnat: , r -- ------
r.s s i_i r-1 6
Call for inspection - 639-4179 --
r
CITY 17V T I CARO — RECE.I P'T OF >'A`r'MEN7 RECE I PT NO. 02--2P3546
CHECK AMOUNT 4868. 15
NA14E s JT ROTH CONSTRUCTION CASH AMOUNT a 0. 00 4
ADVRE6S t PAYMENT DATE n 02/14/922) `
y M;, SUBDIVISION �
i
C'
PURPOSE OF PAYMENT AMOUNT PA I D PURPOSE OF PAYMENT AMOUNT PAID I
BR.1 I l.1D I NA PERM_ 4 70. W, PLUMBING PERM
162. 50
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SEWER INSPECT 35. 00 RESIDENTIAL TRAFFIC F EES 1 P-80. Nidi �r
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CITY 4F TIGARD ffall PLNCK/RECT #
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CO,MMUNITI'DEVELOPMENT DEPARTMENT TBard,Oregon 97W PERMIT #
(503)6394171 DATE ISSUED
JOB ADDRESS: ,���Ci p •j .,.
SUB: TAX MAP/LOT -46/O 9 i9cl�• 4f,
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VALUATION: '1v��i1' %
OWNER
SPECIAL NOTE`S
NAME: �.'�%" /I�;:r� �.L 3�`' �,�/r.
REISSUE OF:
ADDRESS: J2. ,'fi .;1,/�i1 � LAST REISSUE _ -
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CONT= APPROVALS REQUIRED
NAME: f r .f Jam' PLANNING: ���
ADDRESS: _1.: t't,`,f -� ENGINEERING:
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PHONE: `'-i � i OTHER:
CONTR. BOARD #: EXP EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: �� ,�/���'��;
LIST/SUBCONTRACTORS:
MECH: .,,�7, —�,`. ''2�%'� � BUS TAX:
ARCMENGINEFR CALCULATIONS:
NAME:
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ADDRESS: a% OTHER:
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PHONE:
PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGfVATUR _
Received By: u Date Received:
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INA
TY OF
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NAME. s L T_ ROTHCONSTFtourTUR CHECK AMOUNT a t�'S�1. 00
14DDRFSS s 1 r'31dQ9 Gi. W. 69TH AVF 1fa' CASH AMOUNT
PAYMENT DACE
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PURPOSE (IF' PAYMENT AMOUNT PAID p
PLAN CHECK FE
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14350 SW 132ND AVENUE:
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T'0Tnt AMOUNT PAID 2,50. 00
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