14605 SW 130TH AVENUE-1 i
{
14605 SW 130TH AYMUE f�/
1
CITYOFTIFARD . 4
RD CERTIFICATE OF'
COMMUNITY' DEVELOPMENT DEPARTAAENT �nm OCCUPANCY
131258WHOBW P.O.Sm 23M.TOW.OmWn 9M(503x~75 PERMIT #P. . . . . . . : MST91--01`37
-,l
DATF: IgRUE'DP 05/1.3142
3 I TE ADDRES,. . . a 1460"i 3W 1:30TH AVE F'f•1RCEL s 2S 10 lAD•-WDF+3
SUNUIVISION. . . . s Wfl0DFC;'U Ei'fATES 'ZONING: R--7
BL.00K. . . . . . . . . . a LOT. . . . . . . . . . . . . o23
CLASS OF WORK. :NEW
TYPE OF LI E. . . :,F
OCCUPANCY GRP. :R3
OC(_(JPANCY LOAD s 225 4
1 ENANT NAME. . . a
'tem�trks
J. 7. ROTH CONSTRUCTIrm INC
t.r:3OO SW 69TH AVE
TiC3ARD OR 9722:3
Phone #I: 639-2637
Cont rar_•t or a
J. T. ROTH COV9TRUCTION INC
12:300 SW 69TH AVE
T I(:3ARD OR 976,23
Phone #s 639- 2637
Reg #. . : 31*700
Ucc:up*nry of kite above referenced building is hereby given, and certifies
the compliance wi+ h the State Of Orpgon Sper_ial.ty Codei, for the Group,
occupAncy, and use Lmdpr which the referenced permit was issued.
---FIRE DEPARTMENT I I_.V l NG T NSprwpT m
BUILDING .,FICI - �__.. ...
POST IN CONSPICUOUS PLACE
,�$PSCTION NOTICE j
(1 City of Tigard Building Departamt
13125 BN Ball Bled. Tigard, Oregon 97223
Lnepection Line (Rec-o-Phone): 6:3-4175 Business Phones 639-4171
+oaction:
Footing Plbg. Undorsiab Her..h. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL.
Post/Beam Struct. San. Sower Framing /" Bldg.
� r
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lino �j Gyp. Bd. -Mach.
Date Requested s /� 3^ / Z' Times � AM PH
Addreses � LOG' S -36 Permit
Builder:_, _
Y
THE FOLLOWI RRECTIONS ARE REQUIRED!
l'Jz .r+-t try .�i2its�9,[Fi�*1e�J d-�• dleif�s its
il V If OF
3 �
Inspectors__ Date:
APPRO'MD DISAPPROVED / APPROVED SUBJECT TO ABM
Call For Reinep.
ft BPSCTI01[ BICE
city of rigasd Building Depart—nt
13125 X11 gall Blvd. Tigard, Oregon 97223
Inspection Line tRec-O-"hone►: 639-4175 Business Phone: 639-4171
Inspection:
footing Plbq. Underslab Hoch. Rough-in Appr/Sd, )'4
four . Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing =-Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. ad.
Date Requested:_—/__!&� Times %K PH
Address: %°7'� Permit
Builder:_
THE FOLLOW2 RRECTIONS ARE REQUIRED:
I
Inspector: /, f —— —
APPROVED �__ DI9AP�i^'!gin APPROVED SUBJECT TO ABOVE
� I
call For Minsp.
IKSPECTIOM NOTICE _(�f
G city of Tigard DuL).ding Department
I � / 13125 SM Hall 81 Tigard, Oregon 97223
✓A_1 Inspection Line (Rec-O-Phone 639-x}175 Business Phone: 639-4171
Inspection:
Footing Plbg. Un slab Mech. Rovigh-ir Appr/S/Sdwlk
Found. Plbg. Top out Gas LineALey' /
Frost/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor ZWater Line Gyp. Bd. -Mach.
Date Requesteds �J (� Times AM PM
Addrese: It-14 (/ �3y Permit 2
Builder: ___ _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I
1 r
Inspector: � �� Dates � 7-`' La
""PROVED 018"4-
RPPROVLD SUUJECT TO ABOVE
Call For Reinap.
INSPECTION NO2ICE v
City of Tigard suildf Dapartaant
13125 ON Hall Blvd. Tigard, oregoa 97223
Inspection Line (Roc-o-Phons): 639-4175 Business Phone: 639-4171
Inspection: r
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bids.
Post/I.eam Mach. Rain Drain Insulation Plumb. >
Plbg. Underfloor Nater Lina Gyp. Bd. -Mach.
Date Requested: __—Timet
Address: /7 4/Q� /,3// Permit !:
Builder: —THE FOLLONI RRECTIOMS ARE REQUIRED:
Inspector:_ Date: _
APPROVED DISAPPROVED APPROVED SUBJECT IV ABOVE
Call For Reinsp.
/ INSPECTION NOTICE /
iL City of Tigard Building Department
s l• 13125 ON Ball Blvd. Tigard, Oregon 97223
epection Line (Rec-O-Phone): 639-4175 Bu:1ness Phone: 639-4171
Inspections__
Tooting Plbg. Underslab Hoch Rough-in Appr/Sdwlk
Found. Plbg. lop Out Cam Line TINALs
Post/Bead Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Rain Drain Invulation -Plumb.
Plbg. Underfloor Nater Liinem, / oyp. ed. -Hoch.
Date Requesteds / %csG/ Time: f'M
/ Q
Address: i yI�C�J �. YJ Permit sem{.....
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED
�e YL"4 ✓ C 14 c 4-1�
i
Inspector: Dates
APPPOVED DISAPPRO PROVED SUBJECT Tn ABOVE
Call Tor Reinsp.
MU-1-CIT1-0—NNOTICE t
City of Tigard Building DepartMent
13125 811 Ball Blvd. Tigard. Oregon 97223
inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspect tont_ ---�—"�" f
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwik
Found. Plbg. Top Out Gan Lino FINALt
Post/Beam Struct. Srn. Sewer Framing -Bldg.
Pest/Beam Mach. Rain Drain insulatian -Plumb.
Plbg. Underfloor Water Line Gyp. Bd, -Koch.
Date
Date Requoetuds ,, --- PM
Address: y Permit ft '
i
r
Builders '—
o `
TAE FOLLOWING CORRRCTIOkiS ARS REQUlRR0t
1
av/'
( ti
Inspectors Dates
AFp pAM UISAPPROVI APPROVED SMINCT TO Rom
&�,NCal1 For hel. :p
SNSPECTIOB If'E -(�� u
Citi. of tigard 8111142LIM19 pevt JJ7
13125 8W Ball Blvd. Tigard,
m 97223
Inspection 1-114 (Rec-O-phone): 639-4175 Business Phonvt 639-4171
Inspections
Footing Plbg. Underslab
Mach. Rough-in Appr/Sdwlk
Found.
Plbg. Top out Gas Line
FINAL:
PostA(Va: Stru't. San. Sewer
Framing -Bldg.
Poet/Beam Nech. Rain Drain
Insulation _ply
Plbg. Underfloor =Water Lina G
Date R equestede -Neth.
_ Tit PM
AddreassL1"
Permit •:
Builders
THZ FOLLOWING t70R"CPIONS ARE REQUIRED:
----------------
Inspector:
- _ Date:
---APPROV3D DISAPPROVED
APPROVED SUBJECT TO ABOVN
Call For Reinsp.
i
IN;PEcrcap Bo�cs.
city of Tigard Building Department
13125 Sti Ball Blvd. Tigard, dreg n► 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phonet 639-4171
Inspections
rooting Plbg. Underblab leech. Rough-in Appr./Sdwlk
round. Plbg. Top Out Gas Line FIHALt
Poet/Beam Strutt. San. Sewer Framing -Bldg.
Post/Beam Hach. Rain Drain Inaulat ion -Plumb.
Plbq. Underfloor (later Line (Gyp. Bd� -Hoch.
Time: �� AH ..PM
Data Requesteds _
1,q Permit rt, ( I
Builders ,
TU rOI.1A1fIHG CDRRECTI0l18 ARE REQVIREDt
i
h
(
Date: 3 hy 9
APPROVED DISAP�IIOVED APPROVRD SUBJECT TO ABOVIr
II/Call For Reinsp.
1
'c
�ras!(TiON NOTICE
City of SigavA ltnii9acd 9 223
13125 811 8+11 Blvd. Tigard.
inspection Line (Rec-O-Phone)+ 639-4175 Business Phone+ 639-4171
inspections
Yootinq Plbg. Underelab
Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out
pas Line FINAL,
Pr.�9 -Bldg.
Poet/Beam 8truct. San. Sewer ' \�
Insulation
Post/Beam mach- Rain Drain -Plumb'�! f
Plbg. Underfloor Mater Line
Gyp. Bd. -Koch.
�� Time: _—_—__PM
Date Requeetedc
Address, ---
� 1 i
Builder+ r
THE FOLLOW CORRECTIONS ARE REQUIRED:
✓' —
------------
--------------
Dats, -
Inspectors_—
APPROVRD DISAPPROVED PPROVED 6UBJEt"P TO ABDVZ
�' A
Call For Reinsp.
INSPECTION NOTICE
Bite Of Tigard building Department
13125 BW ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing PlI..- Underslab Mach. Rough-in Appr/Sdwlk
round. /_ Plbti t ) Can Line FINALS
Poet/Beam Stru/ct. Ban. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater LLinnoo Gyp. Rd. -Meeh.
Date Requested. Y Time: _X—AM p PM
Ad3rese:- .� Permit i s
Builder:__Jqc� G 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
d
Inspector:_ //`/
� ---- Data:
APPROVED nISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
�r
INSPECTION NOTICE
City of Tigard Building Departsast
13125 ON Ball Blvd. Tigard, Orsgan 97223
Inspection Line (Rec-O-Phone)s 639.4175 Business Phones 639-4171
Inspectiun: ' �Q�G6 -� /eG75*
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. �r lrlbg Top Out ) Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Draln Insulation -Plumb.
Plbg. Underfloor Water Line
�/ Gyp. Bd. -Hoch.
Date Requested,_ ~/C) - / 2 —Time: AM P!l
Address, � _ Permit is
Builder,
THE FOLLOWING OORRECTIONS ARE REQUIRED:
r tTXU
f r�g
Inepwetorc Lf Dates _j (✓-
APPROVED — '� DISAPPROVrO APPROVED SUBJECT TO ABWE
--�"1 Call For Reinep.
i
IN5MCrI2N NOTICE
Citp of Tigard Wilding Departmeec_
13145 BA Hall Blvd. Tigard, Oregon 97223
:nspection Line (Roc-O-Phone): 639-4175 Business Phones 639-4171
Inspection,
Footing Plbg. Underelabh. R!ugh- Appr/Sdwlk
- - ,
Found. Plbg. Top out arLLno FINAL.
Post/Beam struot. San. Beller ` framing -dld
9•
Post/Beam Hoch. Rain Drain Insulation -Plumb,
Plbg. Underfloor Nater Line Gyp. ed. -Mach.
Date Requested,--- ^ - �7 �� Times
// ^ AM PM
AddresssP
_r/�7lDQ� L
/'��) .rmit
Builders
TBE FOLLOMING CGRRECTIONS AAE REQUIRED,
4
I
I
Inspeotor,� ']/ -• Date,
APPROVED DISAPPROVED APPROVED SURJECC TO ABOVE
Call For Reinsp.
I
I
i
INBPlCTInrr rn..I�,
1312C
Oo! l Blv loildiny Daps
"taPeation Line 8a11 Blb' =ward
(Rec-O-Ph 'e): 639- wagon 97223
4175 Businean Phone: 639-4171
Inspection: � _
Tooting '
Plbq Dnderslab Neck. Rough-in
Found. / llppr/Sdwlk
P16q. Top Out 4aa Line
POILC/beam :tract. FINAL:
Ban. Sa.:nr
Post/Be Framing -Bldg.
am Neth.
Rain Drain
Plbg. Underfloor
Nater Line Insulation -Plumb.
Data Requested: GYP. Bd. -Koch.
Address a
__,PM
Builser: '�-- Permit 1:
u �
THR FOLI.OMINO OORR=C,ICNB
_ ARE REQUIRED:
i
--
I
r
r
- APPROVED Data'
D IBI►ppRoysD
APPROVED SUBJECT TO ABOVE
_Call For Reinap.
I
INSPECTION NOTLU
City of Ti9-'d Building Depattrrnt
13125 = Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-o-phone)s 639-4.175 Business Phones 639-4171
Ina,sections
Footer Plbg. Underslab Mach. Rough-in Appr/Sdwlk
end. Plbg. Top out Gas Line lINALP
st/Brsr Btruct. San. Fewer Framing B1
_ - dg.
Rain Drain Insulation -Plumb.
PXbg. Underfloor Nater Line Gyp. Rd. -Neth.
Date Requested:
/ Timse `����
//,, PM
Addreess Permit �e
Builder:
TR9 FOLLOWING CORRECTIONS ARE RBQUIRRD,
i
.t
I
p
Ynspert tors
oates�
APPROVED DISAPPROVED APPROVTD SUBJ9CT TO ABOVE
Cell For Reinsp.
...... ...........;.....,.,..,.»....................,...,..,...,..,..mrwvr..n.u.nr..:aw:n,.w+.....,.......w..nw.r.u.orwi,.•,,.u+rwa�Yevn�tirr.o..n_.......... _....._............_.._..._............,.+...«.........._...
I
City of T19Md Baildiea Departiment }
13125 811 Ball Blvd. Tirard, 6.vagon 97223 i
Inspection Lina (Rec-o-Phone): 639•-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underslab Mach. Rough-in Appr/S' 'k
Found. Plbg. Top Ojt Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain , Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mach.
Data Requested: Times AM
Address ; Permit ti-_q1-61177
G -
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED.
i
Inspectors_ _ Dates
i APPROVED DISAPPROVED APPROVED SUBJECT CO ABOVE
_Call For Reinap.
INSP MICN NOTICE
City of Tigard Building Departs—t
13126 OR R 21 Blvd. Tigard, Oregon 97223
Inspection Lin. (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspections
rooting Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Lino FINALS
Post/Beam Struct. an. Sewer , Framing -Bldg.
Post/Beam M.ch. nn Drain Insulation -Plumb.
Plbq. Und.!rfloo Natme' Water LiGyp. Bd. -Mech.
Date Request/eds / `7 r� Times AM PM
Address: / -L " Q ` D `C-'�C/.�PeruLt #/s /Z21 7
THE FOLLOMING CORUCTIONS ARE REQUIREDs
i
Inspector: ." - Dater
V APPROVED DISAPPRMRD APPROVED SUBJECT TO ABOVR
Call For Reinsp.
INSPECTION NOTICE
Cit? of T19aed Building Department
13125 Bw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rae-O-Phone): 639-4175 Business Phonal 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
��nd Plbg. Top Out gas Line FINAL:
Post/----Bean struct. San. sewer Framing -Bldg.
Post/Bean Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line gyp. Bd. _Me�ehh/.7 �
Date Requested:_ -- ` 6 - Time �lof PM
Address: 1`Tz"0, �
1,�6) permit #t -[/Vl
--
Builder:
TBR FOLL01'Un CORRECTIONS ARs REQUIRED:
i
i
Inspector: _ �L� Z,-
Cate:
APPROVED DISAPPROVRD __ APPROVED SUBJECT TO ABOVE
Call For Reinsp.
I
Injmroc MTICE
city of Tigard suilding Departiowt
13125 M Ball Blvd. Tigard, oregoa 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: ---
Foo it�ng Plbg. Underslab Koch. Rough-in Appr/Sdwlk
round. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain insulation -Plumb.
Plbq. Underfloor Water Line oyp. ed. -Koch.
Date Requested:_�7,3 Time
Address: ��lv�� /� Permit 1:
Builders
THE FOLLOWING CTIONS ARE REQUIRED:
7 CA_iLn, Lt/44-L e�,�
1
Inspector: ' l Date:
APPROVED DISAPPROVED —Z APPROVED SUBJECT TO Asm
Call For Reinsp.
aw(* TIFARDIDMASTER PEPMIT
COMMUNITY DEVELOPMENT DEPARTMENT one" r-,l-_RM I T *1. . . . . . . : MST91-019 7
13126 BW HWI Blvd P.O.Ba 23307,Tiprid,Oregon 97?23(600)8304176
SI'T'E ADDRESS. . . : 14605 SW 130TH AVE PARCEL.: 2S109AD--WDFc:::
SUBDIVISION. . . . : WOODFORD ESTATES ZONING: R-7
SLOCK. . . . . . . . . . . 1_.01.. . . . . . . . . . . . . :23
-------------------------- PUIL.DING --_-_---.____---_-_---_-_------__-___----
REIc5SUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :465 sf
TYPE OF USE.. . . :SF FLOOR APEAS-_.._._---._.. REOU I RF_D 5ETBACKS---------- -
TYPE
------__ .TYPE OF CONST. :5N FIRST. . . . : 1323 sf LEFT. . :5 ft RIGHT. :8 ft
OCCUPANCY CRP. :R3 SECCIND. . . : 1. 120 sf FRONT. :20 ft REAR. . n30 ft
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRE.L)--------------_____.____
HEIGHT. . . . . . . . ..25 ft TOTAL-.------.24 +3 s f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 ps f VAL.UE. . . . . f : 120748 PARKING SPACES. . :0
Remarks :-------------------------------------- PLUMBING
SINKS. . . . . . . . . . .. 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTR5. . :0
L-HVNTORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . .0
TUB/zHOWERS. . . . : 3 LPUNDRY TRAYS. . . :0 CATCH BPSINS. . . . . . . .0
WATER CLOSETS. . s3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . , . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE D I SP. . . : 1 RAIN DRAIN (f't) . :0
WAST-(I NG MACH. . . : 1 SF RAIN DRAINS. . : 1
-- ME:CHANICAL ---------------- __.__._________.__.__ FEES
FUEL TYFES-- ___.__._._.__ UNIT l-ITRS. . :O type amount by rate reept.
/GAS/ ! / VENTS . . . . . 10 TIF f :380. 00 JLH 01 /31/92 -
MAX INPUT:O STU VENT FANS. . s5 SPR.T $ 485. 50 JLH -
1=URN ( 100K . . :0 HOODS. . . . . . el BPLC $ 315. 56 JLH 12/23/91 221098
I URN ) =100K . . : I WOODSTOVES. :0 B z—,C; $ '4. c_H JLH 01,131/92 --
FLUOR !=URN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JLH 01/31/92 -
BOIL/CMP ( 3HP:0 OTHER UNITS:O PARK 1, 3100. 00 JLH 01/31/92 -
GAS OUTLETS: 1 MPRT $ 4-x. 50 .JLH 01/31/92 -
.:ner': - -_.__________._____.___.___._. ______-_ MPLC $ 10. 88 JLH 01/31/92 -
. I . ROTH CONSTRUCTION INC M5PC 4 2. 18 JLH 01/31/92 -
1 ,::300 SW 69TH AVE PPRT s 147. 50 JL_H 01/31/92 -
P5PC $ 7. 38 JLH 01 /31/92 -
J CARD OR 97223
fione ##s 639-2637
(.orntractor: --__.__________________________
r . T. ROTH CONSTRUCTION INC
1C.300 SW 69TH AVF
TGARD OR 97223
,rine ##: 639-2637
g . . 31'700 -------------------------------------
$ 3196. 80 TOTAL
This permit is issued subject to the regulations contained ,n the ------- REOUIRED INSPECTIONS ------
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp FireUlace Insp
applicable laws. All work will be done in accordance with approved Post/Beam Struc�t Gas Line Insp
plans. This permit will expire if work is not started within. 168 Post/Beam Meehan ins�_ siat ion Insp
days of issuance. or if work is sus7/Z
f a e ar 188 da S. Plm/undslab Insp Gyp Board Insp
�7_ _ PL_M/Under-floor Rain drain Insp
i`ermittee Signat'Are: / _ Mechanir_�al Insp Water Line Insp
F111_mb Top Out Appr/Sdw1k Insp
Isst.ted Bv: _...__.__._. _-.... __. Framinq Insp Neehranical Fivial
f-all for inspection - 634-4175
SEWER CONNECTION
CITYOFTIGARD ® PERMIT
CYOFTNOPERMIT #. . . . . . . :
SWR92-0013
COMMUNITY DEVELOPMENT DEPARTMENT omiNon
•11266WFW EINd. P.0.Bar2NV,T%W,0npon 97g@A176 DATE ISSUED: 01/31 /92
--iI3I_ ADDRESS. . . : 14605 SW 130TH AVE PARCEL: 2SI09AD—WDF23
SUBDIVISION. . . . : WOODFORD ESTATES ZONING: R- 7
FLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :23
F'ENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . .
i.L ASS OF WORK. . . :NEW DWELLING UNITS. . : 1
! YPE OF USE. . . . . :SF NO. OF RUILDINGS: 1
T NSTALL TYPE. . . . :BUSWF2 I MPERV SURFACE. . : : 5f
emarks :
Owner: -__ --- ------_ _------------------- ------------------ FEES --------______
J. T. ROTH CONSTRUCTION INC type amol-int by date recpt
12300 SW 69TH AVE PRMT $ 1900. 00 JLH 01/31/92 -
INSP $ .35. 00 JLH 01/31/92 -
TIGARD OR 97223
Phone #: 639-•8637
Contractor:
J. T. ROTH CONSTRUCTION INC
12300 SW 69TH AVE
TIGARD OR 97223 ---_.---------------._-_--_--_-_--_-_.
Phone #: 639-2637 t 1.935. 00 TOTAL
Reg #. . : 31700
-------- REQUIRED INSPECTIGINS -------
this Applicant agrees to comply with all tee rales and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 188 days from
tie date issued. The total amount paid will be forfeited if the
oermtt mxplres. 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 thtAgSwirill insta a lateral.
r m i t t e F
Si ci n gat .t,-
_red By
(:all for inspection 639-4175
♦a+r:�w.:..w.,«a......,,...w.....,ami.....�.,...........�...+.....,,ue,...w,.w.....v.......,n...w.uy .. _ _____.,..,..w.«.....,....«........dam.....-.,_.. ..._.,_........_.
I
CITY OF T I GARD RECr:'.I RT OF PAYMENT RECEIPT NO. a 92-22217 1 A
CHECK AMOUNT c 4881. 80
NAME a .IT ROTH CONSTRUCTION CASH AMOUNT a 0. 00
i)DE►REa�3E3 it
PAYMENT DATE a 01 /31/92
SUBDIVISION r
1
I
` PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
BUILDING PERM 485. 50 PLUMBING PERM 147. 5. 0
MECHANICAL PE 43. '50 ST. BUILD PER 33. 84
PLAN CHECK rE '76. 46 SEWER USA 1900. 00
I
SEWER INSPECT 35. 011 RESIDENTIAL TRAFFIC FEES 1es(4. 00
PARKS 'SDC: 500, tAta STORM DRAIN SW3 280. Wo
MASS TRANSIT TIF FEES 100. 00
14605 SW 130TH AVE
I
T01 AL AMC)UN'i PA I D _. ._ _ ...) 4881. eel
I
.k:;.waaotii..Xtaw.rf:a.Cat+7'w._.u,....w..on:phwuy;<,we,,,w,r„dr
Cl TY'` OF
PAYMENT REf1E^.,
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NAME' if}•F' i. ...
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ADDRESS ,�. ��..,_..
• T. ROTH CONSTRUCTION CHECK AMOUNT �
t iP301? SW 69TH 4Vr.NUE CASH (AMOUNT 250. 00
0., NY!
PAYMENT rmi-r- x 121:3 9
TIC�ARD} Oft7 ... SUBDIVISION
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PUR""USE OF-' PAYMENT
ttMC1l.1NT PAID PURPOSE OF PAYMENT
AMO
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14600 f3W
11 rAt. AMOUNT Pn i Ia
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