12885 SW FALCON RISE DRIVE .w.u.r, ,.w...w...y.1.�....ar+wr.r.... �••`vw1:.w+r�a�wmwrs..ww,u,.uri,r.:....r�;..,,v«....�....,..�.wn�..�,W�....w�L�'+�+�'aiku+�%WW9«itii4k18ewr��
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--- 'P,faa MTH UWTPA Ms SeeZ1 --
CERTIFICATE OF
CiTY OF TIGA R D OCCUPANCY
CllnrlYOF RD
COMMUNrrY DEVELOPMENT DEPARTMENT onooll PERNIT #. . . . . . . ii MST90 fkbt,
13126 SW 14WI Blvd. P.O.Ban 23397.Tigard,Oregon GZ20 W"N)W"l 76
NAT+ f9SHFPs lA4,'H)091
GI TE ADDRESS. . . 1,2885 SW FALCON R I Sr. DR PARCEL IS133JD-11
SURD I V 13l ON. . . . I VILLAGE AT SUMMER Li'l.'KE PARl, Z nN I NG: R--4. 5
BL07K. . . . . . . . . . o LOT. . . . . . . . . . . . . 1192
CLnSG OF WORK. iNEW
TYPE OF USE. . . c SP
01"CUPANCY GRP. cR3
OCCIA'-'ANCY LOAD 12-?O 4
TF1,4ANT NAME. . .
RemArks :
Owner,
DON M13RISSETTE BLDRS, INC.
P 0 BOX 19524
PORTLAND OR 97219
Phone #; -.503-620-7538
Contractors
DON MORISSETTE BUILDERS, INC.
15555 SW BAN(,':-Y rD.
#201
LAKE OSWEGO OR 970-35
Phone #1 620--'753r
mi— i 351533
L)ccupmncy of the above referenced building is hereby given, and certifies
the compliance with the St&4 * Of Oregon Spp,:.-ialty Codes for the grog-0,
occupancy, and use under, wh., -h the referencpd permit was Issued.
............
TUMDINS INSPECIOR
W
POST IN CONSPICUOUS PLACE
=NSPEC'PION NOTICE `�
City of Tigard Building Department:
l� 13125 MW Hall Blvd. Tigard, Oregon 9722.1
Inspection Line (Rec-O-Phone): 639--4175 Busineno Phone: 639-4171��
Inst-ect ion:
Fa ting
Plbg. 11nderslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gam Line FINAL;
Poet/Beam Struct. San. Sewer Framing _Bldg,
Post/Beano Hach. Rain Draln Inaulat'.on
Plbg. Underfloor Water Line Gyp. Bd. h
Date Requested:_ Times PM
Addresst , Persit #t
Builders
I
THE FOLLOWING C+,ARYCTIONS ARE REQUIRED:
i
i
.-'--- Date:
"-P.PPROVED _ DISAPPROVI{D APPROVED SUBJECT TO ABOVE
Call. For Reinsp.
��'1S.rLNoxxcl� i �
City- of Tigard Building Departnant
13125 SR Ball Blvd. Tigard, Oregon 97223
Enspection Line (Rec-O-Pho Ojr fi39-4175 Business Phone: 639-4171
Inspection:",_`
F.aoting Plbg. /:derslab Mach. Rough-in / Appr/Sdwlk'
Pound. Plbq. Top Out Gas Line FIBALs
Post/Beam Struct. San. Sewer Framing -Bldg.
POOL/ ,Sam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Roquested:� �/ - Time:
hddrson: t►c>�t� ..� it f:
Builder,4,' '�-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: ^( , _— bates_ —__
�/hPPROVED 9I6APP1AIM APPSOVRU susim TO ARM
0411 !er PAL"p.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ions
A--_ --
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Inaulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date RequAsr_ed: j Timet +��,f AM PM
^ G/
Adrlress: �d�.-! �ti �etIDit #: �fb l /.3G(C�
_.
Bu!l der:_ ...
THE FOLI.OWTNG COR .CTIONS ARE R]!QUIRFD:
ZL
' / r
Inspector:
�APPRMv DISAPPROVED _ APPROVED SUBJECT Tia ABOVE
___Call Far Reinap.
INSFECT�ON [G�
City c.[ Tigard Building Oepartaent
13125 BM Ba1I Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phones 639-4175 Business Phone: 639-4171
Inspection: --
Footing Plbg. Underelab Mech. R,^uqh-ln `-Appr/Sdwlk
Pound. Plhg, Top Out Gas Line FIHAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Moch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requested ` Times A/M� PH
Address: 1y.c{ -recmit
Buildetr �1
THS FOLLOiirNo coRRBCTIONR ARE RBQUIRms
4 �� -1
1 ^7 _
!f C 111iS t I F
" .r<St l �V llC - 4
Date:
____,APPROVED PROVED APPROVED St1nJ6cr TO ABOVE
11 For Reinep.
�ISPfiCTION�O�' FCB
City of Tigard Building Dwpart—t
13125 SN Hall Bled. Tigard, Oregon 97223 X
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 635-4171 '\
Inap&zt',.on:_. — --- —____._ ---------
Footirg Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gr t., Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nrter Line (� J Oyp. Bd. -Mech.
Datp Recp:ested: w —` / Time AM PM
Address.- it i s
Bull or.: l^
TME FOI.I.ONING CORRECTIONS ARB RIEQUIRED:
0,"Z- SJ al -rD AL n :57/ e- CIO agoDT
Inspector:_ 1 __- ^„ Date:_,_ C
_____APPROVED DTSPLOPROVRD PROVRD SIIIIJRCT TO ABOVR
Call For Reinep.
iNSPEcrigg
City of Tigard Iwi..lding Depac�
13125 SW Ball Ulvei. Tigard, Oregon 47223
Inopectic Line (Rec-0-Phone): 639-4175 Busineas Phone: 639-417
Footing Plbg. Undernlab Mach. Rouc(h-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Bean Struct. San. Sewer sialr -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Oyp. Bd. -Meeh.
-"zf Times AM " PH
Date Fequestedt . � J 1
J")� rmit 11
Address: --� - p
Builder:__ .✓�i'7 7 . M__ QO _6,7 3 �7�?
THE FOLLOWING (30RRECTIONS ARE REQUIRED:
�7G/}G. � �GC�Un11 i /—�Jia'ti1.7Cc �l Aj
J
CEJ A rn,L,
Inspc•;a rt --- Date: :,7 ZJ
APPROVED DISAPPROVED APPROVED SU&TELT TO ABOVE
Call For Re'.nep.
INSPEg'1'ION NOTICE
City of Tigard Building Department,
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec--o-Phone): 639-4175 Susineas Phane: 639-41.71
Inspections
Footing Plbg. Underslab Hach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Raln Drain Insulation -Plumb.
Plbg. underfloor WnterylLine Gyp. Bd. -Hoch.
17
Date P.equested: '„`" 'L' C TLms —AIA _ PH
Address:- 5 l� 1� .� Permit 1:z)
THE FOLLOWING CORRECTIONS ARK R6QUIREDs
-zoo
NOWWw-/ v
M
Inspectors T '^ Dote t 8 ! --
APPROVED DISAPPROVED APPROVED SUBJECT 'ra ABCV6
Call Ror Reinep.
,i wt, ■w +�[ +a�+Mr +�
INSPECTION NOT M
City of Tigard Building Department
3.31.25 SW Ball Blvd. Tigard, crayon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
,spections
��i-- ---
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwtk
Found. Plbg. Top Chi �/_egjss Lin a FINALi
Post/Ream Struct. San. Sewer Framing -Bldg.
Poet/Ream Mech. Rain Drain Tnsulation -Plumb.
Plbg. Underfloo, Nater Line Gyp. Bd. --Hoch.
Date Requeateds, _Titres —AM PH
5
Address, r►vit �s
Bulldor,
THE FOI.WWING CORRECTIONS ARE REQUIRED,
Insprcto --- Dates L-Z 8
- APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
IN E1,1'IOIL�IOTICE
Cis-_p of Tigard Building 7epartaent
13125 :.11 Bell Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 634-4175 Business Phone: 639-4171
n a pact i on:._ ----
Footing Plbq. pnderglah Mech. Rough-in Appr/Sdwlk
Found. Gas Line FINK!.:
Poet/Beam Strutt. San. Bower Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -r'umb.
Plbg. Underfloor. Water Line Gyp. Sd. -Meth.
rate Regp3eateds f,/ Time: ___AH
�P/1
Addreae:�����-
THE FOLLOWING CORRECTIONS ARE RRQUIRED:
Tnepector:- ! ���---- -- - Date:_.=_____—:-1�� •
1
APPROtED DISAPPROVED APPRCri?F.D SUBJCCT TO ABOVE
:ell For Reingp.
IKBP CTION NOTIq
City of Tigard Building ?epartswrt s�
13125 SW Hall Blvd. Tigard, Oregon 7223 1
Inspection Tine (Rec-O-P'.one)s 639-4175 Buetneee Phone: 639-4171
Inspections_J_,
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwl.k
Found. Plbg. Top Out Gas Line FINAL:
at/Beam S-trucrN San. Sewer Framing --Bldg.
(Poet/Beam M!j Rain Drain Insulation -Plumb.
Pl.bg. Underfloor Water Line Gyp. Bd. -•Mach.
Date Requested: — / r _ _Time?' , AN PH
i
Addrena: � - ��e�mit 0:
Builders.�����_._...�,, --- -- - — --- — — _
THS FOLLOWING CORREt"I-ONS ARE REQUIRED:
Inspectors--, _-� —. _ Date:v/J��- --
C,- RPPr.JVED DISAPPROVED APP,IOVED SUBJECT TO ABOVE
Call For Reinsp.
i
jNSPLCTI0I1 1,�� /�
City of Tigard Ip:ilding ing Department
13125 RIS Ball. Blvd. ?igard, Oregon 97127
Inspection Line (POC-0-Phone): 639-4275 Busing+ Phone: 639-4171
I nspac-tion:
Footing Plbg. Underelab Hoch. Hough-in Appr/Sdwlk
Found. Plug. Top out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain insulation
-Plumb.
Lbq UndUnderflooc Nater Line Cyr-. Rd.
-Mech.
Data Requested: � Am PH
,� - e —Time: X
Builders ---- 1
THE FOLLDWINC 0'1RRECTIONS ARE REQUIRED;
F
-
Inspector: J
_ Dater
�APPROMI) DTSA[PROVRp
--. APPROVED BUB.IECT 1'O ABOVE
_,7411 For Reinsp.
INSPECTION NOTICE
Ctty of Tigard building Department 10*17
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Roc-0-Phone): 639-4175 Busineee Phone: 639-4171
Inspection-_ _�---�— -- —
9
Footing Plbg. Underalab MAch. Rough--in Appr/Sdwlk
Fc,,:d. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet./Bean Mech. Ra n Dr.ain� Insuletlon -Plumb.
Plhg Underfloor Wetar Lin G y Bd. -Neth.
i
Date Requeated: ~!�_ / Time: /V:!AM PM
I
Addreb,-: 5 -Y\ '_ Permit 1:..0 3
Builder: ,
_ 9
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors Datae �
APPROVED DISAPPROVED APPROVED SONJECT TO ABOVE
Call For Reinep.
I SPECTION NOTICE 1 ��
City of Tigard Building Department
13125 RW Ball Blvd. Tlgard, Oregon 97223
Inspection Lin.s (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_.Y
/ootirg Plbg. Und,ariolab Mech. Rough-in Appr/Sdwlk
(I d• Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulatior --Plumb.
Plbg. Underfloor Water Line Gyp. Bd. 1--Hoch.
Date Requeeted: % � �� � Time:/L" —AN PN
Address:_— 25 tiY 'ZLLn�i.t I:.Llc__Y-]���_
-r
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
4.,, `tea ,.rr --AEA.4 ,v _
(FD `ac�+� IU�.�-�7> ==T�L',illG
Milo,veL T/14 i L
Inspectors
"PROVED DISAPPROVED AppROVRD SUBJECT TO ABOVE
Call For Reinep.
PIASTER I"IF':+VI1T
CITYOF TIGrARD CM ;qltD I 0-R III I T #1 11 T)1'.)0•-•0 13 8 6
COMMUNITY DEVELOPMENT DEPARTMENT ORROON
13126 SW HrJI Blvd. P.O.Box M. 97,TIgAird,Oregon 97223(503183D X176
ISSULD: 12117190
0 D 1)R E S S 1.c281..35 5 W F0 L.C,0 H R.T.SE JR
VISION. VILLAGE P SUMPIFERLAKE #5 ZONING:
1.1 t:)(:1:. ., .. ,. . , ,. „ . . ,. L OT. . . . . . . 1'312
. ...... FiUILDING
ItiE.I S�-)U DWF--I LING U1,111S.- J. P E III F 1.4 7 0 -f
OF WORK. I N L W E4 E.1)R III S.13 B AT Fl S- 3 6 A F11 A G EL. . . . .. . . . . :`..`i(:,0 of
0"E., 017 USE. . . - 3F F'LOOR 0RE()G------
OFF' (11NST. .511 FIRSI ., 1275 ri-f L L"FT. 6 -ft RIGHT. ". 15 ft
0 Cl C',U PO 14 C,Y 6 R f :R3 SECOND. -.960 Sf 1=RONT. -20 ft REAR--.34 1•'•t:
SIT
f*-L-
SIT 0 RI E S. . . . . . . .2 THIRD. . :0 Sf R E[4 U I R E 1)-
:20 I't T 0144 L................. ... 2 2 35 15 N 0V E- D Ur E C 1,0 R 13. Y
I!-,L.0 0 R L 0 A D.. :40 r)sf VAI U1.. . . . . 1; 11.2891 PA R I<1'.N(3 S PA C E S 0
Re-nia-rPs.
-
........................ PLUP1111FIG ..........-
S IN K 43. . . . . .. . 1. ,. : .I.1 .1. FL 0 0 R DI T 11 S. ::0 1?()C K F L 0 W I."R F-V I+J*1:0;,, 0
L 0 V(11 L)RI E S. 3 WPTER HUITERS.. . 1. I RPPS, 0
UD/SHOWERS. P. LAUNDRY I RAYS)- - ::0 A T C 1-4 D P 91 INI::i. . - . 0
W 0 TE R C,L 0 S EJ S., 3 SEWER LINE (ft) .. :0G R E 0 9 E TR A PS. . . . . . .. ..0
1) I .-,I`IW0SHE.R9). . . . ^ t WOTE'R LINE:.' (ft) ,- '.1.0 0 OT H E:R f�,I x*r t I R i::.F; w
G(1R P()6 E !)I S."',. . . II RAIN DR0114 (-ft;) . -.0
Iff)CH. .1 SF' RAIN DRMNS. - I
M1XFI0NIC,0L
FU F'.L TY PE:S 1.)H I T H T R S. . -0 tyl:)e 'A n)C)u)I t lav date?
MS/ VENTS . . . . . .0 PAYM $ 40.. 00 JI...H
1'1(-'fX INPUT:0 DTU VUHT 1:'(.)N(:) 3 DFIRT It 4 6,-';.IS 0
JRH ( 100K . . I0 HOD
OS. . . . . . I B PIL I, $ 302. 58
I UPH )=1110K 1. W 0 0 D"I'T 0 V E S. -0 B 5 1."C11 $ 03. 28
0 0 R, F U R 1q. 0 CLO DRYERS.: I STDC. $ 600. 00
PH I I ICIVIV` < 3HI,;:O OTIAL"R UNITS-0 SM, $ 375. 00
6 A S' 0 LYT L.ET S) j. PARK f- 250.. 00
ITIPIRT q*1 3 7.,
00H NORISSEITE BLDERS, IN(,. 1`11:11-C, $ 9. 38
1' 0 BOX 1-9524 M 1,5 P C, $ 1. 88
PPR T $ 132. 50
. -M-11,0ND C)R E 3
' 'i #.- 503-620--7538 TIF' :1:35(4,, 00
I c.,t C)-F,I 1:1 0 Y N 1i ..3"71.4. E2 5 1 1.r 1171`:)0
111ORISS)ETTE PLDERI.3, lINI(-
0 BOX 1952`1
I Urk I I AND UR 97219
503-C-,20-7538
..................
$ 3 554 2.5 TO T P L.
This permit is issued subject to the regulations contained in the ....... REQUIRED INSPUJIONS .......... -
T juay-d Municipal Code. State of Ore. Specialty Codes acid all other Fo(.)t/ft)t1rict InsI:) Ga-, Lirie Inst)
iDDlicable laws. All work will be done in accordance with approved V,0 S t/14 f*,-a M 13 t-r tt(-t I-)S;t.t 1.a-t I'l 111 S I..)
t,iars. This permit will expire if cork is not started wi^n 189 P%..,st/Pe,.%ni Ile0ari Gyp Fioa-f (l Ivisp
,lays of issuance, or if worl, is sus d d fo more han/88)days. P L M/U ri t.1 e-r f-*I c)o-r Ra j.i) (I-r a:j.ii Insp
Mer,J1810 raj. 111VsF) W,-,A1-,V-r' L.i))0 11-1 Fi r)
F"Itinfl- T(:)p Ot.tt nV)pr/S(iw1k. I ii!;r)
r,-..%ni i.n q J ii s p III e c hA ri i t-a I Fi ii a I
i -rPP1AC.,e 11-1sp Fllt.tnib Fi.riA].
F,39-4171
SLWE11 CONNECTION
PERMIT
C11YOFTWARD CRY -- TWOM .-,ERM.*('T #. . . . . . . .. SWR90-04-2
r74�mmm
COMMUN67Y DEVELOPMENT DEPARTMENT 0*100 IATE 11131;UE.,l): 12/1.7/90
13125 SW HMI 66-d P.O.Box 23397.TOW.Oropm 97223(603)6394176
1�e'nf-ccym RISE VK PHLEL: 1b1JJ1)x)-VS'192
AJ1.4DIVISION. . . . : VILLAGE @ SUMMERLAKE #5 ZONDA(i:
0LOCK. . . . . . . . . . LD*T*. . . . . . . . . . . . g192
...... .......... ......
FENAIAT NAME.. . . . .
USA NO. . . . . . . . . . ..43.13 2 FIXTUkE UNITS. . . :
CLASS OF WORK. NE..'W DWELLING UNIIS. . -.- I.
I*YPE OF USE. . . . . :SF
ISF NO. OF BUILDINGS: 1
Y*NSTALL TYPE. ,F1LJSWR TAVERV SURFACE.
�.'va ma-v k s c
F*LES
00N MORISSETTE' BLDERS, TNC. type a n)c)Lt ri t by date -r e c.,r.)
0 BOX 195e4 VIRMT 1.500. 00
IN S P 1 ;:i5. 00
0 Wr L A N D 0R 97c_'1.9 1--'A Y M I 1 '.535. 00 1:1-1. 12/17/90
1�1-1Cvle 03 503-620-7538
Cc)r)t-ractor:
CONTRACTOR N0'r ON FILE
..................
'111m-le #1 $ .1.5 3'x.0 0 TO 1*F41
REQUIRED I N S P E 1, 14 G
This Applicant agrees to comply with all tt, rules and regulations Hewer Iri!:ipertia-vi
if the Unified Sewage Agency. the permit ex,, res 126 days from
the date issued. The total amount paid will be forfeited if the ...........
nermit expires. The Agenry dots not guarantee the accuracy of the .......
side sewer laterals. If the sewer A not located at the measurpoent
given. the installer shall prospect 3 feet in all directions froe
the distance given. If not so located, the installer shall P*Kbase
A "Tap and Side Sewer" permit and the AjencA,yv 'lI install a late 1.
............. ........
"IerriviAtee, Siqiiatt.vre:
11"SUP(i Dy-
...........
Call fo-V irlsipecIti-m-i 639--41.75
W-KNOULIN
. • MST90--0386
PLUMPING PERMIT
CITYOFTIFARD PERM11 to. . . . . . .
My
r� TWA -
COMMUNITY DEVELOPMENT DEPARTMENT OFORNOON
RD
13126 SW Hell Blvd. P.O.Box 23397,T194M,Oregon 97223(SM)6304175 121.1 -7190
u 1.4 1)1 v I,1,01.1. . . . x VILLAGE o sumplu..
MAIICK. . . . . . . . . . .. RLAKF* 05 ZONING:
...........
('J.-ASS OF WORK. . -NE1,1 GARNAGE D f SPOSAI
TYPE OF USE_ . :Sr. WAS14INGMAIm. . . . . . . ..
OCCUPANCY GRP— 'R3 1:7'LOOF? .0 PACKFLOW PREVNTRs. . ,0
C,
.37'ORTES. . . . . . . . WAI*ER VIEAIE''RS MAPS. . . . . . . . . . . . . . .0
FIXWRES LAUNDRY )RAYS. 0 CAMH BAST14S. . . . . . . ;@
STNKS. . . . . . . _ 11 (-)F RAIN )RAINS. . . . . al
LAVA'VORIES. . . . . . .3
"EGREASE TRAVIS. . . . . . . ..
1*1JFf/SHOWERS N F1 X rURE 5. . . . . 0
SEWER LINE
WAT-ER OSE TS. . WArFR LINE
%
DISHWASHERS. . . . RAIN DRAIN" (ft) . . . . ..0
Reftla.1 k
EX S
1)(')H MORISSET'rE IRL-DERS, INC.
F"OX 19524 PA Y M s 40. 00
P PR T ti 465. 50
AND OR 97219
B5PC 23. 28
503620-7538
S,rDc 9c 600. 00
$
PARK 250.00
Name c 11PR 7' 50
Addrea MPLC 9. 38
Ci ty MF)Pc lF 1. 88
Zips —Ph a e 0 PP R 7* $ 132. 50
Reg We--'*'-***- P 5 V,cl, $
...... ( , 63
A d d i t i c)n a I fe" 1_10i- shown hpl,p. . .
"t"s permit is issUed S"hJ(-DCt to the reg
REPUIRED INSPECTIONS
L1.1ations contained in the 'Tigard 11tillic .
Code .1'e qpal FU0t/fC)L1J'JCJ
' State of 0 Codes and all. L) Water Livie T11sr)
Othc!T APPlicable laws. r.' StrLtCt
in All work will be dons- APPv,,`)dwlk 11.1sp
accordance with approved p,a III$. This mec.,hav) MPc.,hanicA1*
Will expire if work is "lot startF�,d MechanicAl Iny' Plumb Final
PL PLM/Und er f 1 oo
within lao (jays of SP FlUildilly Final
or if w()-pp jr-
Rtspevided for mo'r'e (dumb 'rot) 01.,t
180 days. F'('OsiOn Control
F n)i.119 t)
ri-rvPlace Insp
Gas Line Insp
V Dation Insp
x
k-fP Poard Iri%p
Authorized Plumbing Drat RAi)j dr-ail, P
gnatUlle
Call.Contraetor NoteCall. for 111spectiol-, 639,_.4.t,?S
l'
.....w..sra.d�,a. ...:rt:wa•....Ui...an....,r.r.•...i•,.......r.... . •.
nr...wn.w....v.....,........w.w..rm i.aiw-.r.w...u...r..w................•.•..v+.•a+aYMbrN.IM'.MiiM.rW11.�WiMINbN
I
1
1
I'fY OF T I CARD — RECEIPT OF PAYMENT RECF:I PT NO. 1 90....207 721
1.".HE:Ck;: AMOUNT c 4199.25
i MOR I St. TTI~, DON HOMES INC CASH AMOUNT c 0.00
�i1:1iJRE-aI'i
15555 55 'SW MANGY RDAD P'AYME'NT .DATE e 12/ 17/90
SLI I TE: 201 SIJBD I Y I S I ON n
LAKE OSWEOO, OR 97('135" 1.2885 7W FALCON RISE
I F'(JRf 0f3E- OF PAYMENT AMOLIN'T PA I D PURPOSES UP PAYMENT AMOUNT PAID
f+IJ
it. I NO C'Iwf�M� M�i1"`�'�'J-•07 0i, 465.50 r-l._UMR I Nle PERM
132.50
MECHAN I CAL. PE �;.50 ST. BUILD PER 31 . 77
IPl._o-;N ClAE CI::' Ff_' 271 . 96 SEWER LISA FWC 90,—C)442 1500.60
3EI+JE:R INSPECT -"5. 0 ► MASS TRANSIT Y I F" FEES 100. CH.)
REBTVENTIAL TkAWl" IC: FEE_E; 1250. 00 3TORN DRAIN 3D
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III
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"OTAL. AMOUNT" PAID 4199. ,?"
I
PLAN CHECK APPLICATI/OON,
CITY OF TI6rA RD �fD PLAN CHECK N _ Z/ 2
MUNITY OK=VEI.OPMENT DEPARTMENT
PERMIT t(
w.wxa�eo•s�a�� ,J GATE ISSUED
TAX MAP/LOT
,708 ADDRESS: �- CA r, LAND USE:
ALUATION: SPECIAL NOTES
OWNER R6
21 SS REISSUE OF: _
NAME: 0 , (AST REISSUE: _ —
c -
ADDRESS: f-� �-�,��t- FLOOD PLAIN/
SENSITIVE LAND: _ --
PHONE: APPROVALS REQUIRED
PLANNING:
�JO� AR ENGINEERING:
NAME: FIRE DEPT
ADDRESS: , �— _ OWER: -
-_
------- _ ITEt1S REQUIRED
PRONE: - LIST/SUBCONTRACTORS:
BUS TAX:
ARWENGINEER �.� CALCULATIONS:
NAME; Tri 1_ C ! TRUSS DETAILS:
ADDRESS: PARKING PLAN:
LANDSCAPE PLAN.
OTHER: w -
Co(liENTS:
DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
PERMIT N ACCT N _ - r
1C-432 00 Building Permit fees j) Sn
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit fees
10-JZ30 01 State Building Tax (51)
Building 13
Plumbing Gv'aV
Mech LsZ� r= -7/. 4i
10-433 00 Plans Check Fee
building G-�, S�
Plumbing
Sewer Connection $vb
30-202 00 5
_ 30-444 00 Sewer Inspection
51-448 (10 Street ^ystem Oev Charge (SOC)T i �F `-.5--
52-449 00 Parks System Dcv Charge (POC) - -
31-450 OU Storm Drainage Syst Dcv Cllrg ("SDC)
LO-230 09 TRFO —�
10 230 OG Washington County Fire -
10-220 00 Amart1wedgewood
RUC N
APPLIcnNI SI%NnTURf
i D;a t.- Received: �l_ to `�6•
i13125 Sw Ilan Blvd. PLNCK/RECT # /l�CITY OT TIGARD 1O Box 23397
COMMUNITY DEVELOPMENT DEPARTMENT 'Iigard,O'egon97W PERMIT # ,(��t 9U d 3f��+_
(503)639-41» DATE ISSUED
JOB ADDRESS: 17S=a ,E G,' �z/� �h s ;IDS ' TAX MAP/LOT /s 3.3,90 VS L 14 Z
SUB: LOT: /��_ LAND USE: _
VALUATION: �t 110,
OWNER SPECIAL NOTES
NAME: �
. �,(1 REISSUE OF:
-�o� `9loviss� f r ,i�
ADDRESS: 1y5J✓E 5�� ����sy � t�. ol Y�� LAST REISSUE: _.
/1al� y7& 5.5 FLOOD PLAIN/
PHONE: 5"'3y SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: _ n� _ PLANNING:
ADDRESS: _ ENGINEERING:
FIRE DEPT:
PHONE: _^� OTHER:
CONTR. BOARD #: EXP DATE: _
IIEMS REQUIRED
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS:
MECH: qtr, __ BUS TAX: _
ARCH ENGINEER CALCULATIONS: _
NAME: 'T�� _ TRUSS DETAILS:
ADDRESS: OTHER:
PHONE: l-5 '4'
PROPOSED BLDG. USE:
COMMENTS: -- --
APPLICANT SIGNATURE
Received By: Date Received: _
GRADIN •IEW)NI N CON I k)1, SIN#. lc %)/A—L�.. .
GENERAL CONTRACTOR NAME& ADDRESS: CASEFILE NO.:
VIA
PERMIT NO.:
APPLICANT NAME AND ADDRESS:
EXCAVATION CONTRACTOR r
NAME& ADDRESS:
L - A '-
1
f3�� � ��2 t�-� OVA R NAME AND ADORES
3_____- _J r Iir,�
7TIEPHONE NUMBERS: T I I)ti)Q`P 4-7
APPLICA.NTy�.1 M L�f'1`= C Tim '� PROPERTY DESCRIPTION:
OWNER; \ M L-)I.
l STREET ADDRESS AND CROS ATED
STREE 17WC
GENFRALCONTRACPOR:�,rrl MC ' 1`s e` TTT Nit IQI-t4ZL, •�v�) � � 4
EXCAVATION CONTRACTOR:k' '
�iLl
SITEpOB:
24 HR/AFTER HOURS EMERGELEGAL DESCRIPTION:
TAX LOT NO.:
CONTACT PERSON,TITLE,TELEPHONE: 1/4 SECTION:
SITE SIZE,ACKtb-. L
LOCATION& ADDRESS WHERE SPOILS DISTURBED/WORK,,,,EA.ACRES:
LEAVING SITE WILL BE TAKEN SITE.RUNOFF DRAWS TO: (CIRCLE ONE)
(NOTE:PERMITS MAYBE REQUMFD) CA?1CIT=�$rN DITCH PIPE CREEK
-- (CIRCLE ONE) tMATE PROPERTY
UBLlt RIGHT OF WtiY
EROSION/SEDIMENTATION CO���SCI AStI�
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENT
bURiNG CONSTRUCTION: SFOLLOW.UJG CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIME;ER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS
COVER PRACTICES CLEAN AND REMOVE ALL SRT AND DEBRIS
TI
CONSTRUCTION SEQUENCE ENSURE OPERATION OF PERMANT FACU_rrjES
OTHER
1HER
PLAN FOR EROSION ro NTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH'ITC1MCAL GUIDANCE HANDBOOK'
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCIiON NOTES COMPLETE,IN LUDIN ��GENCY
PHONE NUMBER SCHEDULE/STAGING POR INSTAU,ATION AND REMOVAL OF EROSION CONTROL MEAS(1R M RGE
APPLICABLE STANDARD NOTTSAND
-
I HAVE READ AND WILL COMPLY WITH THE ABOVE ANT)WILL CONSTRUCT AND MAWrAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON THr CONSTR l)CTTON SITE.
OWNER SIGNATURE .__ --4LI
• • • • o • s • • • • • • • • o • • • • • • • o • 000 • • • • oo • o • • • os• �• ofo� olo • •� E
OFFICIAL USE ONLY. oo • • • • • • • • • •
RECEIFrT DATE
FEE NUMBER----_--- RECEIVED ACCEPTED
B
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16666 S.W. Bangy Roa,, Suite 201
Lke Oswego,Oregon 97086 I
Phone:(509) V0-7688
FAX:(609)620-7486
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