13668 SW MICHELLE COURT' i a�'d��/���!'�^fIVA� y •1� • .�/ 4' i. � I1./'�,5 w •, �1.,��� .- I � ��� 't
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CITY OF TIGARD BUILDING NSP CO 'r
EL i N NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp, "OH99 Sprink. Rough-in Appr/Sdwlk t4 y
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Foundation Plbg Underclat Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg. I .
{� is
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. ,*
Date Requested: Time: AMS] PM
Address:
Builder: �[p. 5 �- Cc16Permit #:4:LC1 1 ��5 C)
THE FOLEINhi 1.0ARECTIONS ARE REQUIRED:
+ �
Inspector._ Date:'?.//�
APPROVED DISAPPROVED -`-APPROVED SUBJECT TO ABOVE {I
_Call For R ainsp.
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CITY OF Tl%v^RD
I COMMUNITY DEVELOPMENT DEPARTMENT
13125 3W Hall Blvd.Tigard,Orspon 97223+8199 (503)632-4171 s=LUMS T NG PERMIT
1-,:-R;..'T #. . . . . . FLM"):5 ..0 10"
y t,a� dF1.71 DATE: ISSUED. 05/19/95 �
ITE. ADORC'S . . . : i:vt-3 JW mrm!ELL.E CT
'3USDIVI5?:ON. . . . . 1-41LL73HIRf
"L0C,I . . . . . . . . . . . LOT. . . . . . . . . . . . . :0!5 1
,LASS Or ta:)Rl;, . tA1..T rr rZI AGC DIS '( ^AI_ . . : MOBILE" 1-410mr, '.'1"nCE�'. s
TYP' ' OF USE. . . . :OF WASHIN_� MACH. . . . . . . : BAC K^LdW 6''RE�'NTRS< ,
�E"CI F'ANC`f C PP— :11N3 FLOOR CRAll'J7d. . . . . . . . TRAP^. . « . . . . . « . . . . .
TORIC . . . . . . . :2 WATER HEATERS. . , . . . ; CATCH T"' INS. . . . . . . s l
X rUNES3 .. _.._..�_..., ..,_..._ . . LAUNDRY TrA`+ ;. . . . . . .
1 hJi��S. . . , . . . . . . . UR I NAL..^. . . . . . . . . . . . . GREASt TRAPS. . . . . . . p
r4ATONTrO. . . . . : fTTI°fCR f IXTUF2C��. . . . .
} TUB/S iOWCRS. . . L.INC !ft) . . . .
WC)TCF C:L OWTS. . ; WATCP t_a I'iC ( f"t
i DTSHWA ihfE125. . . . i RAIN DRAIN (ft) .
r-1( T.Tn s t;j�1 J.1 rl is 1•(E 10 s4 d C V
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MARIt rMIT' ; t;ypp r.:rnn��,rrf by dot r Y-roc
13660 SW MICHELLE C:T PRM ' i! t311 00 S 05/19/95 ,
Vii. S 1.1 0i/1 r) '3`
T7;3ARD OR ')7;1,'4 4
i'h(�nG� bks �;r)�...e3•TiJ
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OWNER 5
t t7 ort e� #; 1• 1 75 TOTi)L.
00.0 0 $
r?l-PU I RED I N9 PEC T 10;4!:-
,
This
permit is issued S11ject to the eg latitns car�tained in the Cia(c k,f 3.0�v
Ei.gardlluricinal Code, State cf Lire. Specialty Codas and all other ! .irt:�:s Ir�s;AcDrw'ti orr _,-
appikWe ;ar;s. all work will to done in atcor-dance with
a;;:prsred plans. ?hit permit will empire if work is net st®,tad ___. .... .... .. .. .._.._. ___.�..,...._,_....,.
thin IN days of isauarco, nr if w37^i; is sJpended fn more _.... ...__.
,n !R days.
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7`777771
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City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Hail Blvd. Permit #PIE
Tigard, OR 97223 -`
(503) 639-4171
MINIMUM $25.00 PFRMIT FEE + ST. SURCHARGE
•
Now Single Family Residences Onty
Job1AYN
0 1 OATH HOUSE$140.00 0 2 BATH HOUSE$195.00
Address 0 3 BATH HOUSE$225.00
Fee includes all plumbing fixtures in the dwelling and the }Int 100 feet
c-r f <a �� of water service, sanitary sewer and storm sewer. Soe fees below.
FIXTURES _ QTY PRICE AMT
L1"`C < / Sink 9.00
UN"Ad*— (/ !a Lavatory W 9.00
Owner4 Tub or Tub/Shower Comb. —9 op
Shower Only 9.00 I
Water Closet 9,00
Nwr.,.,. w r Dishwasher — 914
Occupant — Garbage Disposal 9.00
Washing Machine i 9.00
Floor Drain 900
Water Heater 9.00 —'
Laundry Room Tray 9.00
Urinal 9.00
Other Fxtures (Specify) s 9.00
Contractor
_ 9.00
Sewer 1st 100 30.00
C*v Ta N' Sewer-ea. AddiL 100' _ 25,00
t
_ Water Service 1st 100' 30.00-
I hereby acknowledge that I have read this application, that the Water Service on. Addit. 200' 25.00
information given is con-act, that I am the owner or authorized agent of _
the owner, that plana submitted aro in compliance with State laws, that Storm &Rain Drain 1st 100 30.00
1 am registered witti the Construction Contractor's Board, that the Storm &Rain Drain AddiL 100' 25.00
number given is correct (if exempt from State registration, please _
give reason below.) Mobile Home Space 25.00
/ Back Flow Prevention
Device or P ntl-Pollution Device —� J
Any Trap or Waste Not
Connected to a Fixture 9,00
Describe work new u! addition 0 alteration repair v Catw Basin 900
to be done residential non-residential Q Insp. of Exist. Plumbing 40.00/hr rj
Specially Requested Inspections 40.0(Vhr -----1
Existing of
buildor
building or property Rain Drain, single family dwelling 30.00
Residential backflow prevention
devices 15.00 i
Proposed use of
building or proper,
'(Except residential backflow-----4
prevention devices)
NOTICE *Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SUR,:HAROE 7`,
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED. PLAN RF-VIEW 25% OF SUBTOTAL
Special Conditions TOTAL I �-) 7"7
_ Y_ f
-_ — — Deflt Iutled 5' by�Il/ 0 t t--
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Permit #: AM 0 10
Address:
\ ' ]slued by:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not register-?d with the Construction Contractors Boatd to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
t need not submit this statement. This statement will be filet! ,vith the permit.
i Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
i
1. 'I own, reside in, or will reside in the completed structure.
2. 1 understand that 1 must register as a construction contractor if the structure is sold or offered tu:Cale
before or upon completion.
j 3A. My general contractor is —
l—J (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
el 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
j Hanle of the contractor.
f� I hereby certify that the above information is correct and that I have read and do understand the information
l Notice to Prope ty Owners about Construction Responsibilities on the reverse side of this form.
,'�,4igttature of permit app icano (Date)
(White copy to issuing agency permitfile,
pink copy to applicant)
t �
� _
nformation Notice to (Property Own4i zs
About *construction Responsibilities
Nota: This Information Not,,,, to Properly Owners about Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acting as your own contractor to construct a new home or make a substantial improvem,nt loan existing structure, �w
you can prevent many problems by being aware of the following responsibilities and areas of concern.
.x'
EMPLOYER RESPONSIBiLiTIES:
If you hire persons not registered with the Construction Contractors Hoard to tic labor in constructing or assisting in the
construction or improvement of a residential structure,you will,in most instances,be.ruled to be an employer and the people
you hire will he.employees, As the employer,you must comply with the following:
Oregon's witld,;.!; :ag tax law: As an employer,YOU must withhold income taxes from employee wages at the time employees
are past. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
inf 3rmation,rall the Oregon Dept. of Revenue at 945-8091.
I
Uuaemployment insurance tax: As an employer,yon are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information,call the Oregon F''mployment Division at th-.Department of Human Resources
0
at 379 3524,
a
Workers'compensation insurance: As an employer,you arc: subject to the Oregon Workers'Compensation Law,and must
obtain workers'compensation insurance for your employees. If you fail to obtain workers'compensation insurance,you may
be subiect to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information,
call the.Workers'Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S.internal P.evenue Ser vice: As an employer,you roust withhold federal income tax from employees'wages. You will be
Y g ,�.
liable for the tax payment even if you didn't actually withhold the tax. For mare information,call the internal Revenue Service
at 1-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN: �
Cotte compliance: As the permit holder for this project.%on.a are responsible for resolving any failure to meet code requirements
that may be brought to your:attention through inspections,
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools,paint oveaspray,water damage from pipe punctures,fire,or work that must be
re-done..
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure yaau have the expertise to act as your own general contractor,to a,trrdinate the work of rough-in and finish
trades,and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board(PO Box 14140,Salem,OR 97309-5052,
5(113/378-4621). The Board is located at 700.Summer tit. NE Suite 3110, in Salem.
prop-own.pm4
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CITY OF' TTGARU — REC;EIPT OF F-,AYMf-"WT RECFIKIT NO. a95 -_iR4, ;6116 � ....
CHECK AMOUNT : ]S. 7'S
;111ME a SMITH, MARK 1.1. C AS>H PMOUNT o 0. 00 I :
ia[)DREGS e 1366A 'SW MICHELLE CT. PAYMENT RATE' a 00/19/95
TTWIRD, OR SUE►U.IVIS7ON
97i�24•—
OURPOSE LD PAYMENT (404OUNT PAID PURPf"ISF OF' PAYMENT AMOUNT PAI 1) ��. ,:
f ll.UMAING PF'.RM PLM9!�,•-0100 I 1!;. 00 PT. PLIII ;) P Q 0. 7115
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417'41-41- AMOUNT ISA I f1 5. '75
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CITY OF TI GARD
CERTIFICATE OF
COMMUNITY DEVELOPMENT DEPARTMENTOCCUPANCY
13126 SW Hallk3rvd.Tigard,Onpon 97223•e129 (�03)it1�.41 "ERMIT #. . . . . . . s MS'T9-'+ _017.1 871 DATE Y cAIFD 0 09/22/9,4
PARCEL- 2S 104C•A--05101? �
';I TC ADDRESS— : 13668 SW M i.CHELLE 1;T
SUBDIVISION. . . . c 111L.L.SHIRE ZONINUsR--7 1:11)
BLOCK. . . . . . . . . . r LOT. . . . . . . . . . . . . :051
CLA S OF WORK—NEW
TYPE OF USE. . . s 5F-
OCCUPANCY GRP. s R3
OCCUPANCY t_CJFfD a 4,'1 4
's'E;NANT' NAME. . .
Remarksl PATH I
Owner. _..._..__._ .•...........
MARK `3M I TH
36 n"ia SW LAURELWOOD RD
HIL..I._i3BORO OR 97123
Phnne th 464-5641
Cutis;ract or; _....._...__..__.. .. ._._ _.... . . . ........ .___.__
MALC.OM MORLNO
12":7`0 SW MORENO DR
GAS TON OR
PhorIP #J 985-7439
Rey #_ . . 28'5t
Orr-upaancy i)f thw above referr enr: ed building is hereby given, and r..ertifles
th7l compliance with the State Of Oregon F!)pea_ialty Code-, for the tgroupl,
or_c�I.ipanvy, and use a.tnciel- which the referenced permit as issued.
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POST IN C(]Nf..,P T f';UOUt, pI._lal'IL
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INSPECTION NOTICE
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1 , City of Tigard Bnildi.ng Departsaent
1.Mry`t 3 y`, { 13125 aw Hall Blvd. Tigard, Oregon 97223
w� 46ia( Innpecti.on Line (Rec-O-Phone): 639-1175 Huei.neee Phones 639-4171
Inspection:--- -- - —
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out: Gas Line �INALsT
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Post/seam struct. San. Sewer Praminq Bldq.
at/Beam Mec Rain Drain Insulation -Plumb.
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Plbg. Underflnor Water Line Gyp. Bd. -Meah.
Date Requesteds �1+ Z� G� Times ... AN 4-' PM
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Address 2; M G�^�A Permit #s
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Auildor:
THE PotiA ZING OORRECTIONS ARE REQUIREDs
V'j C-N< 4"�
Inspectors Dat ,
APPROVED DIBAPPROVEO APPRovRU SUBJECT TO ABOVE
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Call For Reins).
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INSPECTION NOTICE
• City of Tigard Building DeparUsent
13115 SN Ball Blvd- Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Buniness Phone: 639-4171 ~
Inspection a --
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Pllx3. Top Out Gas Line FINALS
post/Beam Strur-t. San. Scorer Framing
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water/Line Gyp. Rd. -M�,`
Date Requested: / /I<� Time: C�cf AM G (y PH
Address:-, G _ ���.1 � �� Permit !: / / o� / Q
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Builder,_ (,Jis � L
T1iE FOLLOWING COLA SCTIONS ARS REQUIRED:
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Inspectors Date:-- -.,-----
__ApPROVID DISAPPROVED APPRO4ED SUBJECT TO ABOVE
' —� - Call For Reinsp.
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IIRS PECTIp-R NOTIC& i
Citi of Tigard Building Department
13125 SW Bal-1 Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
inspection:
4 Footing Plbg. Underslab Mach. Rougt-in Appr/sdwlk
Lound.
Plbq. Top Out Gas Lina Com'
Post/Beam Struct. San. Sewer Framing ld
CO-t/ Mach. Rain Drain Insulation
-Plumb.
Plbg. Underfloor Mattern Line OYp• Ed.
Timet AM PM
Date Requested:
X,1.
4y..Y F - L.h Permit r:.L_.y==_ ---
Address:
Builder: Z {
FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: — Date:
APPROVED �SAPPROVRD APPROVED SUBJECL TO ABOVE
n � V Call For Reinap.
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1 INSPECTION NOTICE
City of Tigard Building Department
13125 Sit E1a11 Blvd. Tigard, Oregon 97223
Inapa,.tion Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171 A
Inapectiont
Footing Plbg. Underalab Mach.. .:.,ugh-in Appr./Sdwlk
wm
Found. w
Plbg. Top Out Gas Line PINAL:
Poet/Beam Struct. San. SewernyFt
Praminq -Bldg.
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1 Mai M
Pcat/Beam Mach. Rein Drain Insulation -Plumb. aG"`r Ixe)�x�yt� ry
Plbg. Underfloor Water Line # yAE�7ri
Gyp. Bd. -Hoch. svIr,-Y' 11
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Data R•qu•ated•
-- ---Time: AH PN
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Addreaa
t_ — Permit 1: `r C)�
Buildar: '+ rM•r
t TBE FOLLOWING CORRECTIONS ARE R4QUIRED: ^� 1 pvP �rj
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Inepectors �j
Data: / 7
/APPROVED _.�DIB)1PPR0VRD APPROVED SUBJECT TO ABOVE ;
1/ --**"G11 For Reinap.
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city of Tigard Building Department
13125 SR Ball Blvd. Tigard, Orego 97223
ese Phone: 639-4171
Inspection Line (Rec-O-Phone): 639-4175 p
Inspection: — -
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
post/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. ed.
-Mach.
Time: !AM
Date Requeateds PM
,
Permit t:
Address:----- — " ,
THE FOLLf1WING CORRECTIONS ARB REQUIRED: (-
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(/���J •. -may !e _ ��
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A W r t fl�d
ttF� s tY yt 4`t
Inspectors__ ���! I/ �� — �. Dater
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—APPROVED _ 1. hISAPPROVED _ APPROVED SUBJRCT TO ABOVE
- ----Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department 1 y
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i Jill
Inspection:_----_ ._--_-_-� -- -
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
s Found. Plug. Top Out Gas Lino
Or, 'I
Poet/Ream Struct. San. Sewer Framing -Bldg. 4'
Poet/Beam Mech. Rain Drain Insulation
Plbg. Underfloor Water Line Gyp. Bd. -!tech.
Date Requesteds_ T Timet AN PH
Addresss� P®rmit #hIS pV
Builders
THE FOLLOWING OORRECTIONS ARE RRQUIREDs
Inspectors4J l Dates
APPROVED -_ DISAPPROVED _- APPROVED SUBJECT TO ABOVE
_-___Call For Rainsp.
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INSPECTION NOTICE V
City of Tigard Building Dep&rtaient
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspeetii Line (Ree-0-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mach Rough-in Appr/Sdwlk
Found. Flbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Bea,m Mech. Rain Drain Insulation -Plumb.
i
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: (� ��` CLQ Time: _ l AMa (�PM u
Permit I:�"► o G 14
Ruilders
a d;
THE FOLLOWING CORRECTIONS ARE REQUIRED: • v tiv L,(-
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Inspector: Date.. 1 -1
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.APPROVED DISAPPROVED %v ArPROVED SUBJECT TO ABOVE
r� Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223 7
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
F" "d. Plbg. Top Out. Gas Line FINAL-
Post/Beam Struct. San. Sewer Framing -.Bldg,
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Lino Gyp. Bd. -Mach.
Date Req"
.a
—Z� Time: A►,_ 1 1'k ;,Requested:
_7_ /r PM
Address: I '? D ) "�� ll Permit f:
Builders
THE FO ING CORRECTIONS ARE REQUIRED:
,— - -----GAY--_ .i�►s t�?'� -
1w
Inspector.
Dete:�
__--APPROVED — LL DISAPPROVED )t "IVRn SURJECT TO ABOVE
Call For Rei
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INBPE,'TION NOTICE
City of Tigard Building Department
1.3125 Sw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Post/Beam Struct. an�Sew�er Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Ply,
Plbg. Underfloor (.Treter Lin Gyp. Bd. -Nosh.
Date Requested: 7,�L
L
Time: _ AM _—PH
Addreee: /�t'� , st _ ,Permit 1~ �C
1=I�L.LLI
-C'� C s
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors_ Dater
APPROVED
_�- DISAPPROVED APPROVED R[78.7R(`T TO ABOVE
For Reinsp.
i
�__—_ '
I INSPECTIfrN LTIC'
city of Tigard 6k.ildi.ng Department
13125 SN Ball Blvd. Tigard, Oregon 47223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
InepectIon:
�
i
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. l\en. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb. ;
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
1 G; q
Date Requested: / _Tl:se: AM PN
Address= / 1�'C (_1/ � ` ��°'L� Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
Inspectort� = Date:,
1►PPROVl0 OTBAPPROVRD APPROVED SUBJECT To ABOVE
Call For Reinsp.
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INSRECTION NOTICE
City of Tigard Building Depart
13125 Sw Loill Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)c 639-4175 Business Phone: 639-4171
Inspections
► em
Footing Plbg. Underslab Much. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg. w
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line GYP. Ed� -Rech.
Date Requestedr :2— Z 3 C, Times _ 'AN PM
Address:,Ti�� ` L I 1 C_ a-1 I- _ P l mit, t �� C
Builders t)ALLL. �c I �
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Dates1--,
A:t'ROVED DISAPPROVE' APPROVED SUBJECT To ABOVa
_ Call For Reinsp.
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INSPECTION NOTA �(' l L-f�
City or Tigard Building Departsent
L3125 Bw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 63 4175 Business Phone: 639-41.71
Inspection: _ Q/Z ✓CL t_,
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Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
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Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
;d
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underrloor Water Line Gyp. Bd. -Mach.
Date Requested/c—_may—_/1/_ //- (')e, ,+ 1 Time
tT —AM u RM
Address: CO �, d / l7� C/Z_r .!Permit
t L�_ Qc�'ia
Permit 0:
Builder: R)Q•'Z
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspecto _ nate: F'!0AfL
......APPROVED _ DIS"PROVHD �" APpRpnr) SUBJECT TO ABOVE
Call
For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buainens Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation ���� -Plumb.
X //
Plbg. Underfloor. Water Line Gyp. 13d.- � -Mech. CC�
Date Requested: �j / / Time: _ AM �tm
S Addreees � CC J �i7/ `/,G �L t�L /Per1hit?1/���
Builder:_ ) -)CZ-.t
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ _�- __._-----
APPROVED —A_ CISAPPROVED APPROVRD SUBJECT Tp ABOVP.
Cell For Reinap.
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" PS ECTION NOTICE `C n
City of Tigard Building Departaant
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 629-4175 Busines-, Phones 639-4171
Inspections
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested:
11 —Times / AM PM
Addrsse: Permit !:('t
Builders
THE FOLLOWING OORRECTIONS ARE REQUIRED:
v 1 P_tikj
Inspector:_ _ �r �: `—�. _ Datse /
APPROVED DISAPPROVEDAPPROVED SUBJECT 1U ABOVE
` call For Reiner.
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INSPECTION NOTICE
City of Tigard Building Depart—t
13125 SM Ball Blvd. Tigard, Oregon 97223
inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections __ ---•
Footing :11x g. Underslab Hoch. Rough-inAppr/Sdwlk
Found. Plbg. Top Out Can Line ,-FINALS
Post/Beam Struct. San. Sewer Framing f/ .-Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. h.
l
Date Aem:astad: �_/ � Time: AM PN
Address: �� /�(�/ �„_� ermii �s� �- �i�'�•
Builder: J ) 1�? t A,
THE FOLLOWING CORRECTIONS ARE ASQtlIRED:
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Inspector•— �� 1,1 't �-` Date: ,� � C
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_APPROVED DISAPPROVED ��PPROVED SUBJECT TO ABOVE
Call For Reinap. t
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INSPECTION NOTICE 'J w
City of Tigard Building Department
13125 S11 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Busineao Phones 639-4171
Inepectlon: �
�
Footing Plbg. Underslab CMech. Rough-in '� Appr/Sdwlk
Found. Plbg. Top Out Lins��/ FINAL,
Poet/Beam Struct. San. Sewer Framing -Bldg.
oet/Been h Rain Drain Insulation -Plsmb.
.__.
Plbq. Underfloor Water Line / Gyp. Bd. -Hoch.
Date Requested,// / � � - /,�'4V / / Times AN
q PM
Address, /3 to / /I c e/K_ Ui- T Permit t t
Builders--��y�• QZ K. �J�/
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THE FOLLOWING OORRECTIONS ARE REQUIRED:
r> v4 �� Cc✓ Gc,c_
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Inspectors ��-'"_'1 Dates_ 4
APPROVRD IBAPPROVED — APPROVED SUBJECT I" ASOVE
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INSPECTION NOTICE
City or Tigard Building Department /J
13125 811 Ball Bled. Tiga-d, Oregon 97223 v
Inspection Line (Rec-O-Phone): 639-4175 Businea■\P'hone: 639-4171
Inspection:-_-.
Footing PLbg. Underslab `Mach. Rough_Jh Appr/Sdwlk
Found. Plbq. Top Out Gas Line / FINAL:
Post/Beam Struct. San. Sewer 1ro1 i"'r' -Bldg.
Post/Beam Mach. Rain Drain nsulati -Plumb.
Plbg. Underfloor Nater Line Gyp. Nd. -Rech.
Date Requested: (� o /(.� TiIDsi `,��( AM _ PH
Address i .� tK 3 �1 Cep. `rt Permit 1 t i` `t- Q
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Builder:
THE FOLLOWING (MRRECTIONS ARE REQUIRRDi
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Inspector: V�" �A— �._ ----- Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
L'Call For Relnep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 sm Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businems Phone: 639-4171
Inspect ion:_N��_-- -- ------
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line -,ll FINAL-
post/Beam 5truct. San. Sewer 1, �1�nsulatln
�r -Bldg.
Poet_/Beam Mech. Rain Drain -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date RequeatedsTime: -PH
1 ,
Address: P.
Builder: / /� / /� / /�__L�_�.� ;V
Tint FOLLOWING CORRSCTIONS ARE REQUIRED:
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Inspector:
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Relnnp.
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INSPECTION NOTTICS
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city of Tigard Bul"W Dspart
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131,25 Bsl Mall Bivd. T:q- star Ostegoo 97223 FVrt
Inspection Line (Rec-O-Phone): 639-•/5 Business Thune: 639-4171
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Inspection:_ —
Plbg. Underelab Mech. Rough-in A pprdwlk
Footing
Found. PLbg' Top Out
Gas Line FINAL: .e
Framing -Bldg.
Post/Beam Btruct. Ban. Sewer
Post/Beam Mech. Rain Drain
Insulation -Plumb.
Plbg. Underfloor Hater Line Gyp. Bd.
-Neth.
Times AM _PN
Date Requested: <<1
Addreea: r
TBE FOLLOWING OIRBECTIONB AAL,, REQUIRED'
i
Date: ----_-_
Inspector:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
�NS,PECTION NOTICE �
City of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inopection Line (Rec-O-Phone: 639-4175 Bueinese Phones 639-4171
Footing Plbg. Underalab kMech. Rough-in a APDLISdwlk
s
{r Found. Plbg. Top Out Gac Lina FINALt si
Ili u a
Post/Beam Struct. Ban. Sewer -Bldg.
�` 7 a Poet/Beam
Mech. Rain Drain Insulation -Plumb.
P1bg. Underfloor Nater Line Gyp. Bd. ,� -Koch.
Date Requeated: T� f AM PK
� .
� AddreHa: /
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Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ _--- -- Data:_
-----"APPROVED DISAPPROVED — APPROVED SUR.IErf TO ABOVE
a -__L /11 For Reinsp.
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INSPECTION NOTICE
city of Tigard Building Depart—t
17125 f, Bell Blvd. T.lgard, Oregon 97223
Inspection Lime (Rec-O-Phone): 639-4175 Business Phone: 639-4171 _
Plbg. Underslab Footing
CMach. Rough-in /+ Appr/Sdwlk
i
Found. Plbg. Top Out Gas Line FLNAL:
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Poet/Beam Struct. San. Sewer /Framing-----
C' -Bldg.
;., Insulation -Plumb.
a Post/Beam Mach. Rain Drain
3+"! j Plbg. Underfloor Water Lina GYP• ad. -Mach.
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h Date Requested!_,_,_ n L> f TLme: _ AN PM ,.
/`Q Ct Permit It
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Addrees:_
fiaiar a;S
Builder:��
1u+}�Iti�
q'+ fiYN=' THE FOLLOWING CORRECTIONS ARE REQUIRED=
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APPROVED DISAPPROVED APPROVED SUB.TF.C_'T TO ABOVF.
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INSPECTION NOTICE
City of Tigard Building Departwont
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion:__._ - ---- ------ -._� — --
Pootinq Plbg. Unde-relab Meeh. Rough-in `-ipr/Sdwlk
Pound. Plbg. Top Out Gas Lino PINAL:
Poet/Beam Struct. San. Sewer Framing Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line / Gyp. Bd. -Mech.
Date Requestedt �j(e - �'7 C-- C/ _Times AN PM
Address: ermit 1:t #:
P
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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J - e'
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inspector: nater
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-_APPROVED V DISAPPROVED APPR)VED SUBJECT TO ABOVE
Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SU Ball Blvd_ Tigard, Oregon 97223
kykt1 tory Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
t�jvt a Inspoct ion -----
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looting Plbg. UnderslahMech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer FCaming -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Oyp. Bd. -Mech.
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Date Requested: T1mes— � -/� � AM PM ,•', l
Address: ��
I.C/)f'' /rt / Permir_ fi:
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THE FOLLOWING CORRECTIONS ARE REQUIRED! ? 4rpxsR� .
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APPROVED _� DISAPPROVRD --� APPROVED SUBJECT To ABOVE
_L Call For Roinsp.
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City of Tigard Building P.epartmient
13125 ON Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Tooting Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. ( plbq. Top Out 1 Gas Line FINAL:
111
Post/Beam Struct. San. Sewer Framing -Bldo.
i
Post/Beam Hoch. Rain Drain Insulation -Plumb.
I
Plbg. Underfloor Water Line Gyp, Bd. -Hoch.
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Date Requestes / C C/
/ c� Timet AM PH
Address:
i
Address: -/ (� Cl n J / / //� /'�� Me P1,rmlt /0 t ��I C)��
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Builder:_
THE FOLLOWING coRRECTION3 ARE REQUIRED:
- -_
Inspector:% _`1 f--- ---- - ..._—___— Date:
Y
APPROVED - DISAPPROVED - APPROVED SUBJECT TO ABOVE
- Call For Reinap.
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INSPECTION NOTICE (U
City Of Tigard Building Departsent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line Ree-O-Phone: 639-4175 )Business Phone: 639-4171
Inspectloa: C _—S�f C_ ILI-L� -- --- --
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
r
Round. Plbq. Top Out Gas Line FINAL:
net./Bens 3truct. San. Sewer Framing -Bidg.
j r
oet/Beam Mec� Rain Drain Insulation -Plumb.
Plbq. Unf jrtloor/ water Line
Gyp. Bd. -Hoch. I
Date Requested: Tinea //elAM _pM
Address:
Builder:.--j
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I t Z�
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6N
Inspector:
Date:
a __^APPROVED ---- DISAPPROVED APPROVED Sjk,jZrT To ABOVE
C) Call For Reinnp.
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NI SPECTION NOTICE
City of Tigard Building Department
13125 SM Bnll Blvd. Tigard, Oregon 97223
Innpection Gine (Rec-O-Phone): 639-4175 Business Phcne: 639-4171 w
Inspection•-_ -.___
Footing Plbg. Underelab Mech. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct.le'� San. Sewer Framing --Bldg.
Poet/Beam Hach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line gyp. Rd. -Mech.
f Date Requesteds� CL 1)& / �7 Time: AM PH
tY1.5F
Permit #: - �U
Builders
THE FOLLOWING ODRRECTIONS ARE REQUIRED:
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Inspector, - `y Dater Z1 - Z6
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__APPROVED _- DISAPPROV)D APPROVED SUBJECT TO ABOVE
Par Reinep.
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INSPECTION NOTICT
City of Tigard Building Department
13125 SO Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspection: _�_ ���+ --� �►
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
w
Post/Beam Struct, San. Sewer Framing -Bldg.
Post/Beam Hoch. Rein Drain Insulation -Plumb.
Plbg. Underfloor/ Water Line Gyp. Bd. -Mech.
Date Requested: CyIJ —Ti/mer✓{ � AM ��PH
Address: 4' �L Che n Pe nE: it 1
Builder:
THE FOLLOWING CORRECTIONS ART REQUIRED:
Inspector:�./7�E Date.--- _../
J� APPROVED — DISAPPROVED _ APPROVED St16.lErT TO nnUVP.
For Reinsp.
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INSPECTION NOTICE r_ -/ ✓+
city of Tigard Building Department
13125 OR Ball Blvd. Tigard, Oregon 97223
Inspection Line (ROC-O-Phone)t 639-4175 Business Phone: 639-4171
r
Inspection:
ootl.nq Plbg. Underslab Mach. Rough-in Appr/Sdwlk
�v
Found.
Plbg. Top Out. Cao Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. - (Mel�to-.,
Date Requestedt_ 7 /� `7n Time:
_ _� A!1 PM
Address �
: K Permit #G&Is�_
Builder: _ 77 0,57
THE FOLL40WING CORRECTIONS ARE RRQUIRED:
AJC / A Ab__Tr r ti
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rte^----�------� `-�� -��-�r---�-
Inspector: v/ _ Dater
____._APPROVED DISAPPROVED APPROVRD SUBJECT TO ABOVE
_ Call. For Reinap.
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CITY OF TIGARD F'ERMDI I•N#. .. . . .1.F: MST'94--0098
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COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 03/23/94
-1 13125 SW Hall Blvd.Tigard,Onpon 97223.8199 (503)639.4171
PARCEL: 2S104CA--05100
SITE ADDRESS. . . : 13668 SW MICHELLE C T
SUBDIVISION. . . . : HILLSHIRE ZONING: R--7 PD
BLOCK. . . . . . . . . . . LO1.. . . . . . . . . . . . . :051 :.
CLASS OF' WORK. . :NEW GARBAGE DISPOSALS. . 1
r 1"YPE OF USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVN7R�;. . :0 r
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES;. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES______.___._____-- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS . . . . : 1
51NKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :3 OTHER FIX1'URES. . . . . :0
FUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER LI_.OSETS. . :c' WAl`E:R LINE ( ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : F1A1_'H 1
/ 1 C t.Yr / 4�!C •c C
OWNER: __ ___._._.___.__-___----•--_.___-- --.--..__.____.___-_.___._.FEF•5-_______.________
MIRK SMITH TIF $ 1X'0. 00 JG 0:3/2::.3/9-4 -
RD BF'RT $ 468. 00 JG 03/23/94 -
36552 SW LAURELWOOD
BPLC $ 304. 20 JLH 03/01/94 94--249510
HILLSBORO OR 97123 EA511C $ r . 40 JG 03/23!94 -
Phone #: 464-5691 SSDC $ 280. 00 JG 03/23/94 -
PARK $ 500. 00 JG 03/2•'3/94 -
Plumbing Contractor ____._.__._--__-__ MPRT $ 42. 00 JG 03/23/94 --
� MPLC $ 10. 50 JG 03/23/94 -
Nerme: _V1 �� 1.1 M;151"'C $ .,. 10 JG 03/2'3/94
/C'-
Add _, -/``+-Y�a -Sr_ 5-Ial^ (A,.��_ _ _ _ _ PPRT $ 140. 00 JG 0.3/2,3/94 -
CitY�_ IIsi,^lZ _State : �e t•� P5r-,C $ 7. 00 JG 0:x/23/94 -
Zip: j123 Phone#:.�
Reg #:
-------- REPU I RED INSPECTIONS
This permit is issued subject to the reg
ulations contained in the Tigard Municipal Foot/foclnd Ipso Rain drain Insp
Lode, 'Mate of Ore. Specialty (.:odes and all Post/Beim S;tr.lr_t Water, Line Insp
other applicable laws. All work will be done Post/Beam Mechan Appy,/Sdwlk Insp
in accordance with approved plans. this Plm/Undslab Insp Mechanical Final
permit will expire if work is not started VILM/Underfloor Plumb Final
within tA0 days of i. ssl_lance, or if work is Mef-han ical Insp Building Final
suspended for more than 180 days. Pli..lmb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
�_�
Insulation Insp
_._l 4 G Y p Board Insp ........
hor^i zed Plumbing Contractor Signature
Call far• inspection - 639 -1075
I;ontr,actor, Note=_
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C17Y OF TIGARD
v
MASTER PERM17
'COMMUNITY DEVELOPMENT DEPARTMENT FERMI:T #. . . . . . . : MST94--0098
13126 8W Hall Blvd.Tigard,Oregon 97223.8103(j6a)OW-g171 DATE ISSUED: 03/23/94
PARCEL: 2S 104C A-..•05100
SITE ADDRESS. . . : 13668 SW MICHELLE CT r1 •
SUBDIVISION. . . . : HILLSHIRE ZONING: R-7 PD
BL.00K. . . . . . . . . . . LOT. . . . . . . . . . . . . :051 r
____--•-•---------._._____._____.____.__.__-_- BUILDING
REISSUE: DWELL I NG UN I T S: 1 BASEMENT. . . . . . . . : 130 s rlELf � .r { 40
CLASS OF' WORK. :NEW BEDRMS:3 BA"fHS:�_ GARAGE. . . . . . . S f_.____
TYPE OF USE. . . :SF= 1=1_OOR AREAS-------__. �. � i • • • c 70E1
UTRED akTBACK�
TYPE OF CONST. :5N FIRST. . . . :2050 s f LEF T. . :7 ft RIGHT. : 10 ft
OCCUPANCY GRP. : R3 SEC:OND. . . :0 s f FRONT. :23 ft REAR. . ::36 ft
STORIES. . . . . . . :� THIRD. . . . :0 �f REQJ
IRED---------------------
HEIGHT. . . . . . . .
___-_- _-_--_____.._.HEIGHT. . . . . . . .
:21 ft TOTAL-_. .._._..._._.:2.050 ,f SMOKE DETECTORS. :Y r'
FLOOR LOAD. . . . :40 ps f VALUE. . . . . $ : 113024 PARK I NG SPACES. . : 1
fiemarks : PIATH 1
r
5 1 N K S. . . . . . . . . . : 1 FI-0013 DRAINS. . . . :0 BACKFLLTW F,REVNTRS. . :0
LAVATORIES. . . . . :3 WATER HEATERS. . . : 1 T'F2f1Pra. . . . . . . . . . . . . :0
TUB/aHOWE"R a. . . . :3 LAUNDRY 'TRAYS. . . : 1. CATCH BASINS. . . . . . . :111 4r ,,' ,.,•
WATER CLOSETS. . :2 SEWER LINE". (ft ) . :0 GREASE. TRAPS. . . . . . . :0
DISHWASHERS. . ,. . . 1 WATER LINE (ft ) . : 10QI OTHER FIX1-URES. . . . . :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASHING MACH. . . : i SF RA I N DRA 1 NS. . : 1
___..........__._.__.-____ MECHANICAL - -- -.___...._._.___.__.____.-___ --- FEES
FUEL_ TYPES-- - - ----- UNIT HTRS. . :1Z1 type amol_cnt by date r,ec t
/GAS/ / / VENTS . . . . . :0 TIF $ 1520. 00 JG 03/23/94 -
MAX INPUT:O DTIJ VENT FANS. . :3 HRRT $ 46 B. 00 JG 03/23/94 -
FURN ( 100K . . :0 HOODS. . . . . . : 1 FPLC $ 304. 20 JLH IZ13/01/94 94--249510
FURN ) =100K . . : i WOODS TOVES. :0 135PC $ '3. 40 JG 03/23/94 -
FLOOR F•URN. . . . :0 CLU DRYERS. 1 SSDC $ a80-OO JG 03/23/94 -
BOIL./CMN ( 3I-II-':I/1 (J) HL:R UNITS- ] 1-44IRIA $ 500- 00 JG 03/23/94 -
GAS OUTLETS: 1 MPRT $ 42. 00 JG 03/23/94
Owner-: ___.________.____.__..______.._______.__----.__ ..IhFrl_C $ 10. 50 JG 03/23/94 -
MARK SMITH M5PC $ 2. 10 JG 013/23/94 -
36552 SW LALIRELWOOD RD PF'RT" $ 1.40. 00 JG 03/23/94. -
f-'5PC $ 1. 00 JG 03/23/94
H I l_LSBORO OR 97123
Phone #: 464--5691
Contractor-:
MALCOM MORENO
12530 SW MORENO DP
GASTON OR
Rhone #: 985-7439
Rey #. . : 2851
$ 32'97. 20 TOTAL_
This permit is issued sub iect to the regulations contained in the -------- REOUIRED INSPECTIONS -- - --•--
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot /for.lnd Insp Fireplace Insp
applicable laws. All wore will be done in accordance with approved Rost/seam St r-Lict Gas Line Insp
clans. This permit will egiire if work is not started within 188 Rost/seam Meehan Insr_Ilat ion Insp
days of issuance, or if work is suspended for ore #han 1days. F'lm/�_mdslab Insp Gyp Roar d Insp
PLMiUnderfIoar Rain drain Ins
Ic1miF;tee Siynat�.n'e : '
�,7,
tG ... Mechanic�ai Insp Water Line Insp
F`l�(mb Top Or_It Appr^/5dwlk Insp
,, 'irked By V) aminy Insp Mechanical Final
Call for inspection - 639-4175
i
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CITY OF T I GARB SEWER CONNECTION I
4='ERMI
'COMMUNITY DEVELOPMENT DEPARTMENT FERMI f #. . . . . . . : SWR94-01.01
�l
13125 8W Hall Blvd.Tigard,Oregon 97223.811103(808YAOW4171 DATE ISSUED: 0:;/23/94
PARCEL: 5104CA--05100
511E ADDRESS. . . : 13668 SW MICHELLE CT �
SUBDIVISION. — ii HILLSHIRE ZONING: R-7 F'D
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :051
TENANT NAME. . . . . : f'
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : ;
(:;LASS OF WORK. . . :NEW DWELLING UNITS. . : 1 `
f yp,E OF USE.. . . . . :SF NO. OF BU.I LD I NGS: 1
INSTALL TYFIE. . . . :BUSWR IMF'E=RV SURFACE. . : : S
Remarks : FIATH I
Owner: ---- - -- ---_.______._._________.__________._._______.___--••- - FEES -_--_-.---------
MARK SMITH type amount by date recpt } r
36552 SW LAURELWOOD RD F'RMT• $ 2200. 00 JU 03/23/94
INSF' f 35. 00 JIB 03/23/94 -
HILLSBORO OR 97123
Phone #: 464-5691
Contractors
CONTRACTOR NOT ON FILE
1"'hone it: x.2,33. 00 "fJTAL i.
Reg #. . .
REQUIRED INSFIECTIONE;
This Applicant agrees to comply with all the rules and regulations Sewer inspectiun
of the Unified Sewage Agency. The permit expires 188 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency dues nut 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 ��
- i
the distance given. If not so located, the installer shall purchase _ A,
a "Tap and Side Sewer" Permit and the Ac wi11 install lateral.
l'e r m i t t:e e Signature: r, • .,✓ _-._.____ ___ __--_
I s s I-red B v »
Call 'For inspection - 639-4175
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t 'I
City of Tigard
Residential Building Permit Application
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 6394171
I
Jobsite Address: /� t l✓l, d.Cr'.
■
Subdivision
Lot f Office Use only
l/�, Oy1Cl' Plar,a�pec# ,. ,
Valuation: �
Permit #
Owner: A/'A! Reissue of
Address:
Phone:
�a Planning
���- ,� < / ( ;.'ct u I .
Engineering _ _ _
Contractor: //�//1 �Dsy1 /c' r -10 Other _ _ _
Address:
Items Required
Phone: _--- .r ,� Subcontractors
Contractor's Lice) se# 2Y,51
Truss Details
(attach copy of current Oregon license)
Other
Subcontractors: MOM
�( f ./4
Plu /1 f �l Ver -
Mechanbal: c ;f i Y
(attach copy of rrent OR Contractor's License) I Z
� 7
Architect/Engineer:
Address:
i
Phone:
I
. i
COMMENTS: f
ApplicaN Signature & Phone , tuber
Received by: Date Received: " _ }
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Permit # Account Description Amount Amt. Pd. Bal. Due
0 �JSJ�JC- GU 7i Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) /"/o 41 U
Mech. Permit (MECH)
State Tax (TAX)
' Bldg: s ��
Plumb:
Mech: U
2- —s G Gel.,70
Plan Check (PLANCK)
Bldg: >C%
Plumb.
Mech:
15 WIP—q41- 0/0 Sewer Connection (SWUSA)
Sewer Inspection (SWIN SP)
3 i
Parks Dev Charge (PKSDC) JU / U
Storm Drainage Chg (SDSDC) Zi / _
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL) _
Water Quantity (WQUANT)
Fire District (FIRE)
–
TOTALS: S .2d `7��--- J2 Y2-
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[::I 1 Y Of" T I C3ARD Rki CL IPI T OF PAYMFN'1' F2F'C:F.T FST NO. v94,—P50435
CHECK AMUIIN'r a '"ri~'Ap.cas -
IAMF: a SMITH, llf)Rl, C A13W AMOUNT b 01.VW
)1)DRESC3 b PAYMF:.N T DATE a 03/P3/94 ;.
SUHDIVtSTC)N a
'UW-`0SF,. CW NAYPO'.NI AMOUNT PAID PURG'OSE% OF C'AYrIFF:NT f 11011NT P A 1 D
__.. .......,_._.. __............ _ ___..._ _..__...........__.....................
I4111I.-DING PERM 460.00 I-'I._IJMBINt:3 1414.00 �.
'lUAIVIANICAL 6IF' 40. 001 Fit . B U I E..1) F'I:::R
!'l ON C'HF".CK. F E. h:4. '/[9 8F.W R IDSA ra G)k). 1914
1NE3PEA,'1 :iii« VIP) PARKS FiI}C; "?if%)Ni tJC9
i . !RM DRAIN SDC,: 11:113y. ON reErUDF.MTTAL INAF-i":T:C F"F,:T:S 14101. 019
IHSS TRANFif T TIF r"F:T13 1.!01. GIG)
1 i•ritl SW MIC.:F3 El I.F. CT
11:11 A1.. fIMC1l1W'T' P011) } 5P82. !try
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FtF..CE I P'T (IF- F.'Ta'YMr,N i FO-CJ: � It IT NO. :94- 9'0 0
CJ IF-I. , PMO L)N T a ?bifrt, 00
IQR 0 13M f.TFT, hIAFiN' I.;AS H HMI'IUNT a 0. 00
�DT)1)FtF'R8 a POYMEN1 DAA 01194
'-'3tJr%1)I V 113 ION a
IMPOSE+' OF PAYMF.I\I 1 AMnl_IN T FSA 10 PURPOSE OF PAYMF.N I AMI)I IN f TSA 11) f
riN CHFUK F.F. P50. 00
f
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.:f,68 SW MICHELLE CT �
i i i I r at. AMC)OW PAID P50. 044
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