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CITY OF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
131258W Hall Blvd.,llpord,OR 97223 (503)6*4171 PERMIT M. . . . . . . s PLM97-0078
DATE ISSUED: 03/17/97
PARCELS 2S104DC-08300
SITE ADDRESS. . . : 13195 SW MORNINGSTAR DR
SUBDIVISION. . . . a MORNINGSTAR ZONINGS R-4. 5 PD
w BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . 1020
CLASS—OF—WORK. . :NEW GARBAGE DISPOSALS. s 0 MUBILE HOME SPACES. a 0
TYPE OF USE. . . . %9F WASHING MACH. . . . . . S 0 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . 1 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . : 0
FIXTURES-------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . : 0 URINALS. . . . . . . . . . 5 0 GREASE TRAPS. . . . . . . s 0
LAVATORIES. . . . . : 0 OTHER FIXTURES. . . . s 0
TUB/SHOWERS. . . . s 0 SEWER LINE (ft) . . . a 0
WATER CLOSETS. . : 0 WATER LINE (ft) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN ( Ft) . . . 1 0
Remarks: instl i backflow prevention device
Owner: ---------------------------------- ----------------- FEES — ----------
TIM/GILDA GRAVES type amount by date recpt
13195 SW MORNINGSTAR DR PKMT f 25.00 TAT 03/17/97 97-291790
5PCT $ 1. 25 TAT 03/17/97 97-291790
TIGARD OR 97223
Phone Its
Contratctoro --------------------------------
GREEN !SEASONS TURF & TREES INC
PO BOX 538
WEST L.INN OR 97068 -------------------- —'`-------'—"----
Phone R: 503-631-7346 $ 26. 25 TOTAL
R e g It. . : 000056
------- REQUIRED INSPECTIONS --------
This perait is issued subject to the reialations contained in the Water Line Insp
Tigard Nunicipal Code, State of Ore. Specialty Codes and all other
applicable lawn. All Mark will be done in accordance with
approved plans, This peroit will expire if work is not started
within IN days of issuance, or if work is suspended for sere
than 18e days.
d
Permittee S i g n t li t e:
m Issued By:
C7
Call for inspection — 639-4175
City of Tigard PbnddRec. M .
13125 SW Hall-Blvd. Perma 0
Tigard, OR 97223
(503) 639-4171
MINIMUM$25.00 PERMIT FEE+ST. SURCHARGE
w..r Zw-SnoN Pap X Ileeldam Onhr
�... . \ 0 I HATH HOIME 9140.00 . 0 2 BATH HOUSE 9119.00
Job r J�+J r . 0 2 BATH HOLM IM-00
. Pae now" so Pita 6h Idiom in 9r 0 end 9w*m 100%a
Ca 1 d wow aaMa. a WWW wow end elonr wow. on tree below.
.r..t ....r�....i FI9CTURl9 CITY PRICE AMT
9.00
N.",w,.. Lavatory 6,00
Qwner Tub or Tub/Shower Comb_ 9.00
s simmer Only 9.00
VWIn Closet I 9.00
�... .,...w.r� Ow wsstw 9.00
tiarbage Dleptreat 9.00
Occupant •w•e+� MladrYre 9.00
flow Drem 9.00
ww. ♦ VAW Heft 9.00
L&W y Roan Trey _ 9.00
1.10101 6.00
r'nYeen OYw Fkemes (SP@dIV) 9.00
Qkdftm•+ 9.00
Contractor
On ', L o 9.00
aw,«., s 9.00
I www la Iw 20.00
*AM NOW 0w w 4r r r."�. -M. AddlL 100 25.00
water service let 100' 20.00
I hereby admovAedge That I hew reed Mk gWksoon, Mat the 1111fiIsr wrrb.w.AddI 20C 26.00
lnlb nefkxr OWen M Correct MN I an MN owner or euMorlcad pant of Storm s Ran Oren let 100' 34.00
9»OWTW, Mat piano SON, lbd are in conglenn wM Slob laws.Mat
I an ra910a with the Construction Contrarlora Board. Met tin %mm A Ran Q7n Ad& IW 26.00
nrsnber given Y correct (M exempt Aon Blatta registration. Please
gtw resew below) Mob6t Flom.Speoe 26.00
Pleverft
.. Davlao or Ard-PoUAlon Device 9.00
•1wft"to~0 ago Any Trip or W WN Not
Conraaled In a Fbdun 9.00
work fww 0 attsration 0 wpeh 0 Cafth basin 9.00
to be dam reetdentla1 �} r�on-�afdw�liM Q nap. of Exbt Phimift I0.00ft
syph pled 40.00fhr
ExIs" use of I Ran Drain, sit" Arrrdy Oms*q 34.00
1. building or property
C
idemiN backltow praverMlon
devioa 16.00
0 Propoeed use of ••
buodbq or property `�retpt reelfSrrrW
s , 3r.Ntrrriorr d`"Iaey)
u
NOTICE 't♦Aln ri mr Fee X6.00 IUBTOTAL
2S to
PERMf S BECOME VOID IF WORK OR CONSTRUCTION _
AUTHORIZED IS NOT COMMENCED WITHIN 160 DAYS.OR IF 9!i 9URCHARt73
CONSTRUCTION OR YMK 1S SUSPENDED OR ABANDONED --
-FOR A PERIOD OF 160 DAYS AT ANY TME AFTER WORK 18
PLAN.AN REVIEW 2671 OF SUBTOTAL
TOTAL 2 25r
Speclo Condbons
Dab barred` M
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4176 Business Line: 639-4111 — —'
SUP
Date Requested �? s d AM---%,Z.—PM — BLD
Location Q s Suite MEC
Contact Person Ph PLM 97-0007?
Contractor 6►"M Stat S Ph (A3—ys�o 7 SWR
BUILDING_ Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation fJ FPS
Fig Drain �C•C Ai SON
Crawl Drain Inspection Notos:
Slab SIT _
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler 4227
-
Fire Alarm
Susp'd Ceiling —
Root
Misc: ---- -
Final ,
PASS PART FAIL
LUMB
Post&Beam —
Under Slab
Top Out
Water Services
Sanitary Sewer
R Drains
6W PART FAIL
CHANICAL
Post&Ream --
Rough In
Gas Line --- --
Smoke Dampers
Final —�
PASS PART FAIL
ELECTRICAt — -
0. Service
R Rough In
lti UG/Slab
N Low Voltage
Fire Alarm
Final
_m PASS PART FAIL —
(7 SITE
Backfill/Grading
Sanitary Sewer
Storm Drain <einspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ Please call for reinspection RE: [ ]Unable to inspect-no access
Fire Supply Line ---
A7A
Approach/sidewalk InspectorExt ,I-L�
Other G} '
Final
PASS PART FAIL 00 NOT REMOVE this Inspection record from that Job site.
f,
CERTIFICATE OF
CITY OF TIGARD PERMIT #. . . . . .. 3 MST94-0406
COMMUNITY DEVELOPMENT DEPAMMENT DATE ISSUEDt 02/06/96
13125 NWHO O 21Vd.Tigard,orpon er22209155 (50)U"174
PARCELt 28104DC-06300
SITL. ADDRESS. . . 1 13195 SW MORNINGSTAR DR
SUBDI VISION. . . . t 14ORN`iNGSTAR ZPNINGt R-4. '5 PD
BLOLK. . . . . . . . . . s LOT. . . . . . . . . . . . . t O20
CLA86 nF WORK. sNEW
TYPE 'JSF. . . t SF
OCCUP e GRP. e'34-
OCCUVIANCY LOAD t 1
Rymarkgt PATH I
JACK VISKOV
6249 SW CANYON CT
PORTLAND OR 97221 -.0000
Phone M1 297-4783
Cont Tact or a
HOMES BY JACK VISKOV INC
6249 SW CANYON CT
PORTLAND OR 97221 r
Phone Mt 297-4733
Reg ii. . t 050610
This Certificate grant% orcupancy of the Above referenced building or portion
the)-pof and confirms that the bui `.ding has been inspected for compliance with
the citrate of Oregon rper•ialty Codes for the group, occ ncy, and use under
which the referenced permit was issued.
[iIJII.. DTN(JW- 5 OR BUILDING OFFICIAL
POST IN CONSPICUOUS PLACF
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DEPAI TtMENT OF LAND USE 5 TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
166 NORTH FIRST,HILLSBORO,OR 97124
46
COVN"1t->rV 9 INSPECTION REQUESTS: 503/640.3561/693-4415
OREGON XXXXXXXXX--> 640--34'10 F
Page 1 of 1
Date 03/24/95
Time 13 : 08
ciermit 'Type Residential Electrical Permit Permit # 05065160
Permit Status APPROVED Applied 03/16/95
Situs Address 13195 bW MOItN1NGSTAR DR Ti Issued 03/24/95
Permit 'Title SF'R - NEW HOUSE Completed
Permit Uescr. To Expire 09/20/95
Project Title SFIA NEW HOUSE Project # P0048368
Project Uescr. ,r EROSION
Parcel Number I 251'1'1 - Land Use District
Valuation 0
Legal Descr.
Owner INSPECTION -- '1'1.GARD Construction OTH
Applicant Name I F'AI'TH ELECTRIC Classification 900
Applicant Addi . : P. O. BOX 20416 Occupancy
KEI'LER, OR 9'730'1 Validated by PH
Applicant Phone : 393-3428 Inspector Area
Fee description Units Fee/Unit Ext fee Data
----------------------------------------------------------------------------
Square Footage [Enter Sq. Ft . ] 2500 185 . 00
Subtotal Electrical Fees : 185 . 00
State Surcharge of 5% 9. 25
Total Electrical Fees : 194 . 25
*** Fees Required *** *** Fees Collected & Credits ***
Method Check # Receipt No. Date Payment
CK 1992 03/24/95 194 . 25
TO'A'AL THIS DATE ** ** *** 194 . 25
Fees : 194 . 25
Aoj'Astments : . 00 Total Credits : . 00
Total Fees : 194 . 2`, 'Total Payments : 194 . 25
Balance Due : . 00
a
a
NOTICE: This permit becomes null and void If the work or construction for which It Is Issued Is not commenced within 1110 days. Once construction has shrtsd,
W the permit becomes null and void If construction Is Interrupted fora period of 1110 days. 1 c*t^that the Information presented by the applicant and
J his agent or agents In support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance
upon false and mlaIsading Information may Invalidate this permit All provisions of appilcable laws and ordinances governing the construction and use
of this building or structure will be compiled with whether or not specified on the plans or noted on the plane correction shesta. I acknowledge that
the granting of a permit does not grant authority to access prtvate property or to use easements. I fuller acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at various times during the process of construction and the building
Inspection steff verifying compliance with the various codes. Use or occupancy of the building or structure permiftod prior to approval by the
Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all Inspection requirements are satiafled and
approval Is given by the Building Official. I further acknowledge that a IIsn may be placed on the title of the property upnn which the permit Is Issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all inspection requirements.
W Department
of COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Electrical Inspection Cectl APPLICATION
155 North First
ntt A Ar.venge,#350-123505A-12
Hillsboro, Oregon 97124
Information: (503)840-3470 Fax: (503) 893-4412
PermitPLEA�;E PRINT
Number `�' — Date �
✓1(
Please complete all sections, 1 through 5.
4. Complete Fee Schedule below
1. Location of Installation �L Number of Inspectlmn pw psrmn allowed
Address) "3 9-S S-(ti 0) - if��SkU' !Ali Service Included: Items Cost(es.) Sum
Building A. Residential-per unit
City�I G — Suite No..--
Tenant Name 1000 W•n.or lees � $110.00 l IO 4
Each additional 500 sq.ft ^�
(it commerclon _ or portion thereof _moi— $25.00 S
��q� umlted Energy $25.00 —. 1
Map No. � Tax Lot Ql __. Each Manufd Home or Modular
Thomas Map Book: Page: Section: _— Dwelling service or Feeder -- $88.00 .— 2
Directions_ _`_—__ B. Services or Feeders
Installation,alterations or relocation
200 amps or lose -- $80.00 _ 2
Commercial ❑ Residential 201 amps to 400 amps $110.00 2
401 amps to 800 amps $120.00 2
nI : sol amps°a toso enols $340.00 2
0.00 — 2
2a. Contractor Inst llatlo o
Over 1000 amps or volts $34
Electrical ��ntractor Reconnect only --. $50.00 _ 2
Address C-Pkp, 1161P
Date .lob Number _ C. Temporary services or Feeders
Property Owner _V Ls k 0v Installation,alteration or relocation
Contractor's License No. _ =1• � amps or lose $50.00 2
Contractor's Board Reg. No. r, 201 amps to 400 amps —_ $75.00 2
401 amps to 800 amps _ $100.00 2
Signature of Supr. Elec'n Over 600 amps to 1000 volts see W above
.r '
Licei.se No. _— Ph� �
o. -3 D. Branch Circuits
New,alteration or extension per panel
2b. For owner Installations: a) The fee for branch circuits with
purchase of service or feeder fee.
lint Owner s Name Phone No. Each branch circuit $5.00 2
b) The fee for branch circuits without
Address i purchase of service or feeder nae.
First branch circuit $35.00 _ 2
i --- tom-
Each add'nl branch circuit $5.00 2
E. Miscellaneous (Servke or Feeder not included,)
The installation is being made on property I own Each pumper Irrigation circle—_ $40.00 2
which is not intended.or sale, lease or rent. Each sign or outline lighting $40.00 z
Signal circult(s)or a limited
Owner's Signature energy panel,alteration
or extension —M $40.00 _ 2
= F. Each additional Inspection over the allowable
In any of the above
3. Plan Review section (if required) Per inspection $35.00
Please check appropriate hem and enter fee In section 5B. Per hour $55.00
In Plant $55.00
3 4 or more residential units in one structure
^Service and feeder, 800 amps or more 5. Fees
!System over 600 volts nominal o a
A. Enter total of above fees $ -1
�__Classified area or structure containing special 5% Surcharge (.OS X .Mal fetes) $
occupancy as described in N.E.C. Chapter 5 Subtotal $
Submit 2 sets of plans with application where any of the B. Enter 25% of line A for
Review if required (Section 3) $
above apply. Not required for temporary construction Subtotal Plan PlanR $
services. $ ----
Less Bulk Label Fes
Balance Due $ 70TT'
For Inspections call This wmN bwow►u null mW v*a N Ow vowk d by en psm*is rm oewm Aad
640-3561 or 693-4415 w%M les d"a hen&%at lamenm etwoh Mr"er NIM work wtherkM M
24-hour recorder, one working day In advance of need E'er awl" .ire .,mfts waft " dr°r'°.'b°d"°�''"
4194
S -may 5 s l
DEPARTMENT OF LAND USE i TRANSPORTATION
WASHINGTON r" LAND DEVELOPMENT SERVICES DIVISION OWO-12
I
66 NORTH FIRST, HILLSBORO,OR 07124
COUNTY, PHONE: NW640-3470
� N OREGON INSPECTION REQUESTS (24 hours): 603,/640-3641 or 603.4415
Permit II : 05065160 Project q . P0048368 Status PENDING Page t :aE 1
Applied - 03/16/95 Issued Expires 03/22/95 09 31
RESELEC
Permit Title SFR -- NEW HOUSE OTH
Description Begun - 03/16/91;
Job Address 13195 SW MORNINGSTAR DR TI
Owner Name INSPECTION -- TIGARD Region
Applicant Name FAITH ELECTRIC
Phone number 393-3428 Valuation: 0 Approved_,/
Inspector Comments : Rejected
7_ A IVR-RESULTS
fi=F-STERR(IR ,
Plumbing
Mechanical
Electrical
gtructrual
General _ ,�Q _
Inspected by -. ry�i^� � Date : 2 ��--
Inspection Roquosted
- ' .a I 0)A B AP DN Ivit
03/23/95 R1 i,�,
DEPARTMENT OF LAND USE i TRANSPORTATION
• WASHINGTON LAND DEVELOPMENT SERVICES DIVISION
166 NORTH FIRST,HILLSBORO,OR 97124
COUNTY, INSPECTION REQUESTS: 600/640.1661/693-4415
OREGON
Permit 0 05065160 ProjNct w : P0048368 Status APPROVED Page 1 of 1
Applied 03/16/95 Issued 03/24/95 Expires 09/20/95 03/28/95 05 02
RESELEC
Perinit Tj tl,- SFR NEW HOUSE OTH
Description Begun : 03/16/9'3-
.lob Address 1319�, 5W MORNING T1. TI.
Oweer Name IKl t.";'r I( - 'IGARD Region D
Applicant Name FAITH ELECTRIC
Ph ne number 393 - 3428 Valuation : 0 Approval._..__
Inspel �ctor C ,rnm,:ents . Re,jected__� _
�a�7t,./ vf-' 132
VR-RESULTS
Na ._-.. _W)a cum L-I_ _._�_ . _ �_Y._ `1-
REQUEST ERROR !
ecl - �.
Plumbing
Mechanical
Structrual
al
r 1, 0110E *6�ontlRl> m:liI w1d vo111 Mtm vrat,7rcoo strue"mi/or which K Is Issued Is not commenced wllhin 4,44-04
the permit becomes null and void K corttruction Is Interrupted for a period of 180 days. I ce"that the Infonrratlon presented by tine appgcant and
I 1-1 s p e C t.]*;w0*wppoftlh suamitt of this permit Is true and correct to the best of our knowledge. 1 acknowledge that the Building DepaMrsrifs reliance
�tlpOrt th rani.m leading Information may Invalidate this permit. All provisions of applicable laws and oMinences governing doconahuctim and ries
,;; of��this building or stffithiq will be compiled with whWwr or not specMed on til plans or noted on the plans correction sheets. i acknowledge that
Cover t16gIirItlIV6fs4Wmltdosf grant authority to access p""OrapsrtyPw to use easements. I turther acknowledgk6lt the uee21#6rccupsncl tel T
03/2 J"- m or In depends upon my I pnctlons at veriow times during the process of construction and the!wilding
ng compliance with the vsriou4 c 0ss eceupsney of llw buildli g or efnncture permitted prior to approval by the
Building Department Is solely at the risk of the applicAnt and such use or occupancy Is revocable until an Inspection requirements are satIsfled and
approval Is given by the Building Official. 1 further acknowledge that a lien may be placed on the We of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or stnrctuure Is provlekmal and revocebls until the satisfaction of all Inspseflon requirements.
APPUCAllrf 910MAIURI
, CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 sw Mea Blvd.Tigard,Oregon 97M0811w (603)639-4171 PERMIT
PERMIT
PERMIT Ike . . . . . . a M9T94-0426
639-4171 DATE ISSUEDe 1.2/12/94
PARCEL: 2S104DC-08300
SITE ADDRESS. . . : 1:3195 SW MORN I NGSTAR DR
SUBDIVISION. . . . : MORNINGSTAR ZONINGe R-4. 5 PD
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . a020
BUILDING - __.-______-_-_________-_-_-_.___-.___
HE 1 I:,SUE.: DWELLING UNITS: i BASEMENT. . . . . . . . a204 s f
CLASS OF WORK. :NEW BEDRMS:4 BATHSs3 GARAGE. . . . . . . . . . :734 of
TYPE. OF UrE. . . tSF FLOOR AREAS---------- REQUIRED SETBACKS------•-----
TYPE OF CONST. :5N F I RST. . . . :2061 s f LEFT. . : 15 ft RIGHT. s 24 ft
OCCUPANCY GRP. aR3 SECOND. . . s1364 sf FRONT. 120 ft REAR. . a20 ft
STORIES. . . . . . . : 1 F I NBSMENT s 0 s f
HEIGHT. . . . . . . . ..29 ft T07'AL-------:3425 s f SMOKE DETECTORS. e Y
FLOOR LOPU. . . . :40 psf VALUE. . . . . !i : 236626 PARKING 6PACES. . : 1
Remarks: PATH I
----------------------------------- PLUMBING -------------------------------------
SINKS. . . . . . . . . . :
-------•-----------_-_-_-__--_______._SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW P,REVNTRS. . t 1
LAVNrORIE:S. . . . . s4 WATER HEATERS. . . al TRAPS. . . . . . . . . . . . . . 10
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . 11 CATCH BASINS. . . . . . . 10
WN I E_H CLOSETS. . :3 SEWER LINE (ft ) . e 0 GREASE TRAPS. . . . . . . 10
DISHWASHER . . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . t0
WnSH I NG MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL - --- -- -_________._______________.- FEES --- -------____
FUEL TYPES---__.___.___-.. UNIT HTRS. . -0 type amount by date recpt
/GAS/ / / VENTS . . . . :0 TIF $ 1550. 00 JG 12/12/94
MAX INPUT:O BTU VENT' FANS— :5 BPRT $ '775. 50 JG 12/12/94
FU HN ( 100K . . :0 HOODS. . . . . . : 1 BPLC • 504. 08 KAR 11/10/94 94-•25Z;-19
FURN ) =100K . . .- I WOODSTOVES. :0 BSPC f 33. 78 JG 12/12/94 -
FLOOR FURN. . . . :0 CLU DRYERS. t 1 SSDC t 280. 00 JG 12/12/94 --
BOIL./CMP ( 3HP:O OTHER UNITS: 1 PARK t 500. 00 JG 12/12/94 -
GAS OUTLETSsi MPRT is 48. 00 JG 12/12/94 -
Owner: ---------.-._--_--__.-_--.._--__--__----MPLC $ 12. 00 JG 1/12/94 -
JAL:K V I SKOV M5PC $ 2. 40 JG 12/12/94 -
6241) SW CANYON CT 38TH f 225. 00 JG 12/12/94 -
P5PC f 11. 25 JG 12/12/94 -
PORTL.AND OR 9722:1 .0000 EROS f 88. 00 JG 12/12/94
Phone #: 297-4783 ERPC f 28. 60 JG 12/12/94 -
Contractor: ----______._______________---..__.__ERPC f 28. 60 JG 12/12/94 -
HOMES BY JACK VISKOV INC
6249 SW CANYON CT
PURTLAND OR 97221
Phone #: 297-4783
Reg #. . : 050SIO
$ 4092. 21 TOTAL
This perait is issued subject to the regulations contained in the ------- REQUIRED INSPECTIONS -------
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Seam Struct Gas Line Insp
plans. This perait will expire if work is not started within 188 Post/Beau Meehan Insulation Insp
days of issuance, or if work is suspended for anre than 181 days. Plm/undslab Insp Gyp Board Insp
PLM/Underfloor Rain drain Insp
Permi.ttpe 5ignaturFj: � Mechanical Insp Wate, ,..,ne Insp
Plumb Top Out Appr/Sdwlk Insp
1. SsI_ted 13y : Framing Insp Mechanical Final
Call for inspection - 639-4175
,CATYOF TIGARD
COMMUNITY DEVELOPMENT DEPARTMC'NT
13125$w H&N sad.Tq,ro,(-N"w 97223N1r! (502)6394171 SEWER CONNECTION
PERMIT
PERMIT #. . . . . . . s SWR94-0a l6
639-4171 DP.TE iSSUEDs 12/12/94
PARCELS 2S104DC-08300
SITE ADDRESS. . . . 1319 J SW MORN I NGSTAR DR �
SU81)JVI SION. . . . a MORNINGSTAR ZONINGs R-4. 5 PD
BLOCK. . . . . . . . . . . L01 . . . . . . . . . . . . . ..0c^0
----.________________--_-____.-_._____-------_-_----_--_--___--______--------____--._
TENANT NAME. . . . . e
USA NO. . . . . . . . . . a FIXTURE UNITS. . . s
CLASS OF WORE'.. . . a NEW DWELL-I NG UN I TS. . s 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGSs1 i
INSTALL TYPCC. . . . aBUSWR IMPERV SURFACE. . : asf
Reimarks a PATH I
Ownev-: ----------------------------------------------- FEES
JACK VISKOV type amount by date recpt
6249 SW CANYON CT PRMT $ 2200. 00 JG 12/12/94 —
INSP $ 35. 00 JCS 12/12/94 —
PORTLAND OR 97221-0000
Phone #: 297-4763
Cont ract or s
LONTuAC:TOR NO-1 ON FILE:
--------------------------------------
Phone #: f 2235. 00 TOTAL
Reg #. . .-
-------
. . . -------- REQUIRED INCIPECTIONS -------
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires IN days from _
the date issued. The total amount paid will be forfeited if the
permit expires, 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 the Agency will install a lateral,
P e r_m i t t e e
Issued By :
all for inspection - 639-4175
i
Residential Building Per snit Ap iicatioII '
Clty of Tigard
. 13125 SW Hall Blvd.
Tigard, OR 97223
(503) 63li1-4171
Jobsite Address: y�— t1�
-
Subdivl:lon:.��k,��lG Lot 0 j' ' . ofta II On
Valuation: �,,��(t.:__� PlanckiRec
Cotner Lot? N Permit
Role." of
Flog Lot? Y �N }
Map&'1 LJ
Owner: Iorn c +r�_gL-;� 0siKo�)
Address: 1 S- _ktL��� Plann
zz i ..
I-ngineering
�p
Phone: Other
Contractor: /40 r1 le--s 46(� u�_tc ( lav it L. .- It RaauinM
Address 62WI Sw �5uk, itractc+rs
rugs Ustaile
Phone: - Other ..w....`._....,.._,._.._, - .
Contractor's License #t nn6lD RI Q 3 '
(attach copy of current Oregon license) � t pu
Contact Name & phone:
Subcontractors: Archtte npinser• �-. K _L. 1.
Plumbing: C) ►' _A _ Address: ,y
m Mechanical: T�1�[)�J�� ar4 t
(attach copy of current OR Contractor's License)
JOB DESCRIPTION:
Applicant Sig tura & Phone number
Received by: L&i, L) Date Received:
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