13942 SW FANNO CREEK DRIVE ADDRESS:
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i:`record s micrcrlm�targetslbuilding.doc
CERTIFICATE OF
OCCUPANCY
CITY O F TIGARD V,ER M I T *. . . . . . . # MST93 -9t.110
COMMUNITY DFVELOPMENT DFPARTMENT DATE ISSUFDA 03/16/94
13125$W Hall Blvd.Tigard,Oregon 972223will199 (503)639-41P
PAR.151.1 2:�)IOPDD-0260@
SITC ADDRESS. . . : 1,3142 SW FONNO CREEK DR
SUBDIVISION. . . . : F1 '-EY PARF1, ZONJNBiR- 7
Ekl OCK. . . . . . . . . . t LOT. . . , . . . . . * . . Selo
LLASS OF WORK. :NEW
TYPE OF USE. . . i 6F
OCCUPANCY GRP. tRa
OU,CUPANCY LDA11224 4
TENANT NAME. . . :
Ppmarkso PA7H I
Owners
JAY MILLER SLUR INC
p 0 BOX 23a91
TIGnRD OR 972$l
Phone #1 684-.7543
Cont rata ort
JAY MILLER
PO BOX 23291
T!(3nRD np 97 81
Pha'"a Ot 6134-754x
Reg 30109
Occupancy of the mbovc referenced building is herehy given, and cortifier,
the compliance wil-h the State Oe Oregon Spevialty Codec for the prof.P,
oqncuppm(:Y, and WAP uodor which the referenced permit Wes d.
FIRE DEPARTMENT I) N r7'(--1 E C T 0 R
U L C'I AL.
POST IN CONSPICUOUS PLACS
&Yld4Ti���I� f
CitS of Tigard Building pepartmumt /
13125 SW gall Blvd.
Inspection Lina Tigard, ocr,goq 97123
(Rec-.O-.Phons)t 639-4175 Business Phonal 639-1171
lnspeutione
Footing Plbg. Uncerelab Mach. Rough-in APP r/Sdwlk
Found. Plbg. To out
P Cas Lina lII,AL,
Post/Beam Struct, San. Sewer Framing Pa
q.
Post/Baa°° Mach. Raln Drain Insulation
Pluieb.
Plbg. Undertlt ,r dater Lina Gyp. Ed.
-Mach.
Drta Ra¢,esta; Tisa,
AM
Address,_ t 7 L
Builder, � Deft It
TNR MLLOWIMO OORRRcr:op9 #RR REQUIRED, (!
i
Inspector,
/'�S/
APPROVED �` nIRAPPROVED APPROVED RUBJEr'T r, ABOVL�
Call For Rainap.
INSPECTIyN NOTICE ��►�/
city or Tigard 1k.ilding Departsmnt
13125 sw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O--Phones 639--4175 Business Phone= 639-4171
Inspection=
Footing Plbg. Underalab Hoch. Baugh-in Appr/Bdwllf.'
Found. Plbg. Top Out Gas Lines FINAL=
Poet/Bean 9truct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested
�=f (� _Time: _AM/' PH
Addrese= �� 1Z ¢�N�� `rCtl/ = Permit f:
M
Bu IlAer=�1 l 1 1""1.� Q-- / 2 70--3'-1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
—�-- tMa✓e ae --�1__��---
Inapector=_6��'
APPROVED DISAP-ROVED _- APPROVED SUBJECT To ABOVE
Call For Reinsp.
IN$PEMON NOTICE
City of Tigard Building Departaent
13225 SR Ball Blvd. Tigard, Oremlon 97223
Inspection Line (Re,:-O-phone): 639-4175 Business Phon9: 519--4171
Inspection:-_W
Footing Plbg. Underslab .tech. Rough-in Nppr/gdw--l�
Found. Plbg. Top Out Gas Line FINAL:
Post/Beem Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water LineG t/ Gyp. Bd. -Hech
Date Requestedt �7 - 1 T Timet
Addresa:1 1 , Nrwit #t
Builderx —v1', '?W 70361
THE FOLLOWING CORRECTIONS AAA REQUIREDt
77 /
Al V n
P iii. r / iwr 1.
zl-
'c '7r
Inspectors ��� ✓9;-I e natal
APED
I)ISAP APPROVED SUBJRCT 7'0 ABOVE
2Call For Reinsp,
TNSPSCTION NOmICE
City of Tigard Building Department
13125 ne Ball Blvd. Tigard. Oregon 972
Inspection Line (Rx-O-Phone): 639-4175 Business Pon 639•-4171
Inspect ions_ - — -
looting Plbg. Underelab rAch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Ote Line lINALt
Poet/Bee's Struct. Ran. Sewer frying -Bldg.
Post/Beam Hoch. Rain Drain insulation -Plumb.
Plbg. Underfloor Nater�JLine 1d. t -Hoch.
Date Requesteds_ 2 l 114 Timet _--AM _-T--PH
Address, I-"14r7 +
Builder:
TRE FOLLOWING CORRECTIO"S ARE REQUIRED,
Inspectors ____ — Date:__
).''PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Cal'. for Reinep.
INSPEC'fIQJ} N-tJOR /
(•,.it7 of Tigard Building "%Partasot
13125 aw Ball Blvd. Tigard, or�,o 97223/ /7
Inspection Lina (Roc-o-Phona)s 639-4175 Busin.•ss Phc#1e _44
��-- —
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
round. Plbg. Top Out Oas Line FINALs
Post/Beam strurt. San. weer Framing -Bldg.
post/Beam Hach. Rain Drain Insulation -plumb.
Plbg. Underfloor Nater Una '!{/ oXP• �• '�h'
Date Request.d s_ Z Ito-L� I Times AM PM
Z X61- (C vermit #t
Address s__�
Builders
TBE FOLLOWING CORRICTI7NF ARE REQUIRED:
Inspectors
APPROVED IBAPPROVF'r APPROVED SUBJECT TO ABOVR
Call For Reinsp.
t
INSPRCTION-IOTI0
city or Tigard Building Depaxb Mt J
13rg
125 SW Bal] Blvd, Tigard, Oreoo 97223 e �y�r7//
nspection Linu (kec-O-Phone)r 639-4175 Business Phon ,A 319 1
Inspections_ lVll/JIL
Footing Plbg. Underslab Mach. Rcugh-in Appr/Sdwlk
Found. Plbg. Top out Can Line FINAL,
Past/Beam Struct. San. Seaer Framing -Bldg.
Past/Beam Mach, Aaln Drain
insulation) _Plumb,
Plbp. und*rrioor Nater Line Gyp, 3d, \/-Nech.
Date Requestod��e�,� /
Address, 1 '71 `f�. Uy��/ ('a lC 4 3`M 2 I
rr.i! #r
Builder,_I/� i Uir —751 , 1m_
751 , 1m
TRO FOLLOWING CORRECTIONS AR'S REQUIRED,
- l'� /r 6-✓!+ .off, ('or., /.�•,-�
4
-- - --ter
inspector,— s
Dater-_��,_
_L APPROVED ISAPP
-�— —`_ APPROVEQ StlAJSCT TO AB(riIE
Call For Reinsp.
INSPECTION
City of Tigard Buildbmg Departaont
13125 BA Ball Blvd. Tigard, Oregon 97323
Inspection Fine (Rowe-O-Phoned 639-4175 Business Phon , 9 1
Inspections
Footing Plbq. Underslab �igbl�py h_in Appr/3dvlk
?bund_ Plbq. Top out Lint RINALt
Post/Beam Struct. San. Bawer coming -Bldq.
Post/Beam Mach. Rain Drain Insulation -P1.,tmb,
Plbq. Underfloor Water
�LLLne��// Gyp. ad. -Meeh.
Date Roquestede �,11 �(_ Y,1Mt y PM
Addreas t 1—LLVL (�m eA ` Petit fid-1, �
Builderi ` tt Iv -7 "1('j l
TNR FOLLOWING CORRECTIONS ARE RRQUIPRD:
InryQctoit — Date:_
APPROVED
DISAPPROVED APPROVED SUBJECT To ABOVE
-Call For Reinap.
j�PE�OIt 1107}^E
City of Tigard Building D@q._-hssnt
131L25 NA Ball Blvd. Tlqard, Oregon 97:23
Inspection Lino (Rec-O-Phone)a 639•4175 Business Phonoi 639-4171.
Inspection;
.r
Footing Plbq. Underslab �iNBph. •ough-La A;,vr/Bdwlk
Found. Plbg. Top Out Oat Z FINAL
Post/Bae-. ;truct. San. Bower flaming -'lidg.
Post/Beam Rech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lino J Gyp. Rd. -Hoch.
Date Requelj� ()
steds 7 -.��- _Times AH p�(
Address! l IL 1 «Vl�� 1 Permit sill-2,- UrZ'
Builders - t y\� V � - I v
THL FOLLOWING m_ RRzvT1!N18 ARE REQUIRED,
Inspector: i Dates___,'
DIBA,pPROVSD APPROVED suBjUcT To
Call For Reinsp.
INS j .Norics
city or Tigard Soildleg Departreot
1312S RW Nall Slyd_ Tigard, [zegoo 9'l2
Inspection Line (R*c--O-Phones 639•-4175 Businea• Phonal 639-4171
Inspections
Footing Plbg. Underalab Mesh. Aongh-ie Appr/Sdwlk
Found. Plbg. Top Out Oat/ Lini FINALS
Past/Ream Struct. San. Sewer )basing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plums,
P1b4. Underfloor Nater Ll.1N Gyp. Sd. -Newh.
Pat* Re"eatedt_ z I7
/r � Time: ) AM PN
Addresses ^�j"�'7�L. ��L�V_n f f((1 `\�( Permit ,Jarm 0
Buildors_ — G5
TRF. FOIA/VINO CORRECTIONS ARE RSQQIRiDt
Inopector:
Date:
FROYED - _ DISAPP APPROVED SU&Tncrr To -movit
___Call For Reinsp.
jNBFECTION NOTICE J
Citi of ligand Building Department
13125 .0 Ball Blvd. Tigard, Oregon 9722
Inspection Line (Rvc-O-Phone)i 639-4175 Business PhO 63'i-4171
Inspection
Tooting Plbg. Tlnderslab Hoch. Rough-in Appr/Bdwlk
Found. ibp OIfL� Cas Line FIKALe
Poet/Beam St,ruat. Ran. sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plump,
Plbg. Underfloor Nater Line( gyp, Rd. -Kenh`.I`/
Data Requested..„_. 1 - r:l 7/ 111 _ r, AK
_ I/� ,o� PV1
Addreem s (� / Ll t(.W/Yl l�a�iA151,
HuIIdor1-Al—t ,I 1_Q_0
TNIt FOLLOWING ODRRECTIONS ARE REQUIRRDI
Inspector T ----- bate — —
— D __- DISAPPROVED APPROVRD 8II8JRCT TO ABOVE
Call For Reinap.
I'ISPSCTIOII RO?ICs
City of Tigard Buildinq Department 610
13125 no Rall Blvd. Tigard, Orogon 97221
Inspection Lino (Rer-O-Phons)t 639-4175 Business Phonist' 639-4111
Inspection:_
Tooting Plbg. Undsralab Mach. Rough-in APpr/adwlk
Found. Plbg. Top Out Gas Lino FIMI
�Re m/Batas Btruct. San. Sower Framing -91ft.
yA'a�t�Beam Hmh Rain Drain insolation _Pluo.
C�bq. 0ndoctloor Water Line Gyp. Bd. i� -KeCb.
'•��iL --
Oats RequeStedt Ties: &—: A)4
P!l
Address -Permit t�7�
1luilders � /
THE FOLLOWING CORRECTIONS APE REQUIREDs
Dats:
Inspectors �-�L/__ _
—
171tPAOVED _ DISAPPROVRU APPPMRD SUBJECT To A"rwE
Call For Reinsp.
INSEMICE NOTICE
city of Tiga" rulldlaq Department
13128 w Bali Blvd. Tigard, Oregon 97223
Inspection Lina (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion s
Footing Plbg. Underalab Mach. Rough-in Appr/Bdwlk
Found. Plbg. Top Out Gas Lina Pi NAL:
Poet/seam Struct. � s�w c Framing -Bldg.
Post/Beam Mach. !N�Vr;&TInsulation -Plumb.
Plbg. Underfloor r-" Oyp. Bd. -Meeh.
i
Date Regt:astod:_ ( _Timm AM �_PM
Addreaa:1 j�/�f Z _ y� �� /� L Permit 6
Builder:
THE FOLL0WINO CORRECTIONS ARE REQUIRED:
Inspector: _ Data:_/y
APPROVED DISAPPROVED APPROVED SUBM T TC ABOVE
Call For Reinsp.
arty of fig"A DuLlA mg Department
(.\�
13125 M tall Blvd. Tigard, Oregon 97123
Inspection Line (Aro-O-Phone)* 619-4175 Business Phones 639-4171
Inspections U-- (.1, L"_
Footing Plbg. Underalab Nash. Rough-in Aper/Sdwlk
(Found. �~ Plbg. Top Cut Gas Line PINALt
Post/Beam Struct. San. sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Pliunb.
Plbg. Underfloor Nater Usse gyp. Bd. -Mech.
Date Requested.-I I I 1 '/ Times AM A �' PM
f ! M f:` J Z
Addresss_1�AL1 Z „�y�'(-r C-4JI•` �� Permit L '2
Builder*- �U_.
TBR POLLONING CORRECTIONS ARE REQUIRRDt
k i
F.
,
n C
Inspector*_ \ l� _ Dates -
APPROVED DISAPPROVED _LlAPPROVED SUBJECT To ABOVR �
I
�� �Z Call For Reinsp.
jNBPICTION IMICA
City of Tigard building Dsparlstatst �"•••///
13125 sw ball blvd. Tigard, Oregon 97223
Inspection Lino (Roc-o-Phonw)t 639-4176 Bus+ness Phone: 639-4171
Ialp�atloat � _�
Plbq. Undwralab Mach. Rough-in 11ppr/8dwl k
P1bq, Top Out Gas Line IINALt
,t
Post/Bean Btruct. Ban. sower Praminq -Bldg.
Post/Beam Koch. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Lino gyp. ad. -Meeh.
ff L) 1
Date Aoquestodt_ I J l t —Tibet A __
Addres•t 1 1f� � �� 1n [�-�l� C) ON L� Z Yx - I Permit 1t`h��
Builders 1R_'T 1y -�_1 L
J - 3� g0/6.
TM FOLLOWING COMMONS ARR RBWIRIDt
Inspectors
ww..
APPROVIn DIJAPPROVED I/%PPROVIn SUBJECT To ABOVR
Call For Reinsp.
. CITY OF TIGARD PLUMBING PEERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT' #. . . . . . . : MST93-9610
13126 9W Hail Blvd,Tigard,urpan 97uieelw (60';6394171 DATE I SSUED a 12/28/93
PARCEL: 2S102CC-FPOIO
SITE ADDRESS. . . : 13942 SW FANNO CREEK DR
SUBDIVISION. . . . : FINLEY PARK ZONING: R-7
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :010
-----------------------------------------------------------------------------------------
CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : l
'TYPE. OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . s0!
OCCUPANCY GRP. . -R3 FLOOR DRAINS. . . . . . . ..0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . s2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES- -- - ----- -- LAUNDRY TRAYS. . . . . . $ 1 SF RAIN DRAINS. . . . . s1
SINKS. . . . . . . . . . . I GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :4 OTHER FIXTUREL;. . . . . :0
1 UB/SHOWERS. . . . : SEWER LINE (ft) . . . . :0
WATER CLOSETS. . :3 WATER LINE (ft ) . . . . : 100 h
D I 3HWASHE RS. . . . 91 RAIN DPA I N (ft) . . . . :0
Remarks : PATH I
OWNERa ------------------------------- _—__ -------__-_--FEES----------------
JAY MILLER BLDR INC TIF $ 1520. 00 JF 12/228/93 -
P 0 BOX 23291 BPRT $ 513. 00 JF 12/28/93 —
BPLC f 50. 00 JLH 12/21/93 93-246834
TIGARD OR 97281 H5PC f 25. 65 JF 122/28/93 —
Phone #a 684-7543 SSDC $ 280. 00 JF 12/28/93 —
PARK $ 500. 01b .JF 12/28/93 -
I':Ilumbing Contractors----- ---------- MPRT f 45. 00 JF 12/28/93 —
MPLC f 11. 25 JF 12/28/93 —
Name: _ M5PC $ 2. 25 JF 12/28/93 -
Hddress: +, 'PRT f 155. 00 JF 12/28/93 -
City:` _State : _. P5PC $ 7. 75 ,JF 12/28/93 -
Zips Phone#:-__, BPLC f 15. 00 JF 12/28/93 -
R e g --
------- REQUIRED INSPECTIONS --------
This permit is issued subject to the reg-
ulations contained in the Tigard Municipal Foot/found Insp Water Line Insp
Code, State of Ore. Specialty Codes and all Post/Beam Struct Appy-/Sdwlk Insp
nthier applicable iaws. All work will be done Post/Beau Meehan Mechanical Final
in accordance with approved plans. This PLM/Underfloor- Plumb Final
permit will expire if work is not started Mechanical Insp Building Final
within 180 days of issuance, or if work is Plumb Top Out Erosion Control
suspended for more than 180 days. Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
Insulation Insp
Gyp Board Insp _
>� `-' Rain drain Insp
l= .thorized Plu sing Contractor Signature
Call for inspection 639•-4175
Contractor Notes:
C17Y OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
131251W Hall Blvd.Ttgard,Oregon 97223.9199 (503)639-4171 PERMIT #. . . . . . . : MST9 3-961 V.1
639-•4171 DATE ISSUED: 12/28/93
PARCEL: 2S102CC-FPOIO
';3I TE ADDRESS. . . : 13942 SW FANNO CRI=EK DR
SUBDIVISION. . . . : FINLEY PARK ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . 1010
...-_-_------------_-_-__.__.______..._-- BUILDING -______._______,_._____._-__________--_-__
REISSUE:MST93-9538 DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:3 9ATHSt3 GARAGE. . . . . . . . . . 1410 sf
TYPE OF USE. . . :SF FLOOR AREAS------------ REQUIRED SETBACKS------------
TYPE OF CONST. :5N FIRST. . . . : 1834 sf LEFT. . : 15 ft R I GHT. t 10 ft
OCCUPANCY GRP. :R3 SECOND. . . :864 sf FRONT. :20 ft REAR. . :21 ft
4iTOR I ES. . . . . . . :2 THIRD. . . . :0 sf REQUIRED---------------------
HEIGHT. . . . . . . . P24
EQU1RED---•----------------
HEIGHT. . . . . . . . l24 ft 70TAL------:2698 sf SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . f : 131488 PARKING SPACES. . : 1
Remarks: PATH I
------------------------------------- PLUMBING --------------------------------------
SINKS. . . . . . . . . . : 1
.__-----------------------------------SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :O
LAVATORIES. . . . . :4 WATER HEATERS. . . - 1 TRAPS. . . . . . . . . . . . . . 10
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DIGHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . 10
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAt- -•---------------------------------- FEES -_-__-___-----
FUEL TYPES----- - - -- UNIT HTRS. . :O '. ype amount by date recpt
/GAS/ / / VENTS . . . . . :0 TIF 11 1520. 00 JF 12/28/93 -
MAX INPUTtO BTU VENT FANS. . :4 BPRT f 513. 00 JF 12/28/93 -
FURN ( 100K . . :0 HOODS. . . . . . : 1 SPLC $ 50. 00 JLH 12/21/93 93-246834
FURN ) -1P0K . . -. 1 WOODS'TOVC`S. :0 B5PC $ 25. 65 JF 12/28/93 -
FLOOR FURN. . - . :0 CLO DRYERS. : 1 SSDC t 280. 00 JF 12/28/93
BOIL/CMP ( 3HP:0 OTHER UNITS: 1 PARK $ 500. 00 J1= 12/28/93 -
GAS OUTLETS: 1 MPRT $ 45. 00 JF 12/28/93 -
Owner: -_._______._____.__._____.___.________.--I+IPLC t 11. 25 JF 12/28/93 -
JAY MILLER BLDR INC M5PC $ 2. 25 JF 12/28/93 -
P 0 BOX 23291 PPRT $ 155. 00 JF 12/28/93
P5PC t 7. 75 JF 12/28/93 -
'TIGARD OR 97281 BPLC $ 1.5. 00 JF 12/28/93 -
Phone #: 684-7543
Contractor:
JAY MILLER
1?O BOX 23291
TIGARD OR 97281
Phone #: 684-7543
Reg #. . : 30109 _._.._.___------.-------------._---_.__
f 3124. 90 TOTAL
This ptrtit is issued subject to tht. regulations contained in the --- ---- REQUIRED INSPECTIONS -------
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Gas Line Insp
applicable laws. All work will be done in accordance with approved Post/Beam Strt-tct Insulation Insp
plans. This pertit will expire if work is not started within 180 Post/Beam Meehan Gyp Soard Insp
days of issuance, or if work is suspended for acre than 181 days, PLM/Underfloor Rain drain Insp
Mechanical Insp Water Line Insp
17111-1mh Top OLtt Appr/Sdw11( Insp
Fhaming Insp Mechanical Final
Is=.,_ted Ry - Fir-ep) a_e Tnsp Plumb Final
n. ;
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION
PERMIT
13126 BW Hae Blvd,Tigard,Oregon 97223W99 (603)639-4171 PERMIT #. . . . . . . : SWRT 3-0527
639-4171 DATE ISSUED: 12/28/93
PARCEL: 2S102CC—F'P010
SITE ADDRESS. . . : 13942 SW FANNO CREEK DR
SUBDIVISION. . . . : FINLEY PARK ZONINGt R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :010
------------------•-------------------
TENANT NAME. . . . . :
USA NO. . . . . . . . . . a FIXTURE UNITS. . .
CLASS OF WORK. . . :NEW DWEL-LING UNITS. . rl
TYPE OF USE. . . . . tSF NO. OF BUILDINGStl
INSTALL TYPE. . . . :BUSWR IMPERV SURFACE. . : : sf
Remarks: PATH I
Owner ----------------------------- ----_____ _ _____—_—_—
JAY MILLER GLIA INC type amount by date recpt
P 0 BOX 23291 PRMT $ 2200. 00 JF 12/26/93 —
INSP $ 35. 00 .JF 12/28/93 —
f IGARD OR 17281
Phone #: 664 -7543
Contractor: ---------._—__.----------------
CONTRACTOR NOT ON FILE
Phone #: : 2235. 00 TOTAL
Reg #!. . .
_----- REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rule3 and regulations Sewer Inspection _
of the Unified Studge Agency. The permit expires 160 days from _
the date issued. The total amount paid will be forfeited it the
permit expires. The Agency does not guarantee the accuracy of the
side sewer lattrals. 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 T __
a "Tap and Sidp Sewer' Permit and tilt Agency will install a lateral.
F'e -mittee Signature:_
Issued By -,
Call for inspection - 639-4175
CITY OF TX0ARD RECRIPT OF PAYMENT RFCF'1PT' NO. %93-247005
CHECK AMOUN t r 153004. 90
AME r JAY MILLER BUILMN CASH PMOUN'T r 0. o(a
IDDRESS I PAYMENT DATE. 12/26/93
(3081.)I v 18 1 ON
IRPUBF OF PAYM-N f AMOUNt PAID PURPOI-ift OF PAYMEN V I-AMOIAN I PH 11)
.1.)ILI)1*N—(3 10 Si 3. NN P-1.-.1"J,—MB-T N—1-i- PERM- I bt.). old
f7-(-;HAN1UAl- PF 45— 00 cm]. BUILD PER
ILAN CHECK FE 26. �31-W17.R lisp e~. OL4
,1-*WFR INSPECT :31.5. M0 PARKS BDU 500. 00
')IORM DRAIN SDC 280. 00 HESIDENTIAL THW' F1(',* FEES 1410. 00
"BS IBANS IT TIF FEES 110. 00
3442 SW FANNO CREEK DR. LOT 10, V I N1 F Y P(IRV,
OI AL AMOUNT PAID ", (A 9. 9N
si
Residential Building Permit ARR11cation
City of Tigard
13125 SW Han Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: /39 R s W ranno a 7r. / ° .. CG
9ubdivlslon:�I Ta_Y K Lot# yy Yx'
xp� �'�yy• �"
Valuation:
} 9M k •��
Owner:
Address: SoX ....... ,
Y
iagrd oK e1-7a8)
Phone:
Y
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Contractor: u F
Address:
�
S
mF �Itritf
Phone: .xs::z `
Contractors License # )Y
(attach copy of cunw#Orsyon license)
Subcontractors:
Plumbing:•rdn vktf 5 Const-
Mechanical:
onStMechanical: -Hr-a-+1(l 9
(attach copy of affnwW OR ConbactmV Lbmse)
Architect/Engineer:
Address:
Phone:
COMMENT'S: C-
h��L) CX ,,7,-P(J) 7 5
Applicant Signature & Phone number
Recelved by: Date Received: /a -a - 9 3
Permit N Account Doscrlption Amount Amt. Pd. Bal. Due
M143 Bldg. Permit (BUILD) �3
Plumb. Permit (PLUMB)
Mech. Permit (MECN) -- h /
State Tax (TAX)
Bldg:
Plumb:
Mech: 02
ce
Plan Check 'C; PLANCK)Bldg:
Plumb:Plumb:
Mech: 1_ _
Sewer Conneclion (SWUSA) Y ov
Sewer InspPctlon (SWINSP)
Pains Dev Charge (PKSDC) dcl �5 ✓�J
Storm Drainage Chg (SDSDC) '� �V
Residential 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 (WOUAL)
Water Quantity (WOUANT)
Fire DistrkK (FIRE) _
TOTALS:
w r
L:T 'T Y OF T I C F-1RD - RECEIPT OF PAYMFN1 RECEIPT NO. s 9 ti--R4F+8.3 4
CHECK AMOUN T a 50. 00
4VIME ,SAY MILLER RLDR CASH AMOUNT s 0. 00
WORESS a RAYME-.N T DAT'F p 1 c'/r^_1. /93
!IBC)I V 18 N t
='UFtF 0qC--' OV PAYMENT flMOUN T W411) PORPWA OF PAYMEN'T' f ft II IN f VIA I U
W4 CHECK FE' 18--43R 90. vlo
F_—1 SSUE OF LOT 2.2-51 MC. RN I NU H.1 L.L.
394ic' SW FANNO CR, 1_07' M, F I NI..T-Y PARK
rci?'AL. AMUUNT PAID — — -'- —) 51A. 00