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CITY,-0F TIGARD
OOMMUNfTY DIVBLOPMENT DePARTMENT
1EIIM E1V11 M�II Hhrr,Tiprr,p� s7REtEi•HEiEi (d4ri)X4171 ,i
CERTIFICATE C)E
OCCUPANCY
xxxx PERMIT M. . . . . . . a MST93-0122
639..-4171
DATES ISSUCDe 05/21/93
SITE ADDRESS. . . a 06137 SW MATTHEW PARK ST PARCEL r w S 1 12BC—1 1 Wi11zl
GUBDIVISION. . . . a MA'TTHk:W PARK ZONINIia
L' .UCK.---------------------
.0 T»,ww .�.����� ��
CLASS OF WORK. a NEW
TYPE OF' USE:. . . ASF
OCCUPANCY GRP. s R3 i
OCCUPANCY LOAD a 1 1 H 4 c �
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TENANT NAMEv. . . „
Remarkaa PATH I. TIF, 57ORM PARKS SWC F'EEa _rRAN:IFErRRE:I) FROM DE'MOL..ITION Of
I IOUSE (DUP92.,-0141 ) .
Owners
j TAY MILLER BUILDER INC:
F'. O. BOX 23291
r IGARD OR 97281
Phone #I Ea84754.3
' i,antrac:t or
!AY MILLER
r In BOX 23c91
11GARD OR 97281
Phono #1 684-~7543
Reg #. . 1 30109
aOCCUpant-y of the above referenced building in hpreb
y ylivan, ,and c^ertifiiea
the compliance with the State Of UvO9011 SPecialty Godes for the groatp,
occupancy, and use amder which the refereticed permit was issued.
FIRE; DEPARTMENT
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POST IN CONSPICUOUS PLACE:
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INSPECTION NOTTCE
City of Tigard Buildiay Depart nt
13125 SW Ball Blvd. Tigard, Oregon 972 3
Inspection Line (R6c-0-Phone): 639-4175 Business Phone 39-4171
Inspection: — —"
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. plbg. Top Out Gas Line FINAL$
post/Beam Struct. San. Sewer Framing .-Bldg.
Post/Beam !loch. Rain Drain Insulation Plumb•
Plbg. Underfloor Nater Line Gyp. Bd. -Meah•
Date Requested:
Address: if �� ✓J� r"' t�W Permit tt ��Z'Z'-
Builders ? L f�/2
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors ' Dates
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
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INSPECTION NOTICt! \1 .
Cit? of "figard Building Departownt CCC
13175 t'tW Sall Blvd. Tigard, Oregon 97223
Inspection Line (Res:-O-Phons)s 639-4175 Business Phone: 639-4171
Inspections
FootingPlbgr"Onderslab Hoch. Rough-in Appy/edwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewar Framing -Bldg. G.
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Post/Beam Mach. Rain Drain Insulation -plumb,
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Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requestedt
?J-3
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Address: I:- -..�_(
Permit
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Buildert.
THE FOLLOWING CORRECTICiNS ARS REQUIRED:
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Inspector: 2-1-
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APPROVED bIBAPPROVED APPROVED SUBJRCT TO ABOVE
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Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Dapartnent
L3125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in _ r/BdMlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beare Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Wn:er Llne Gyp. Bd, h.
Date Requested: )/ -3 Time: AN PN
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Builder:
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
7-1 .4
Inspectors c F r"1 J f 'J 1 1 f Date:
APPROVED pISAPPROVED T�' APPROVED SUBJECT TO ABO%1t
Call For Reinsp.
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INSPECTION NITICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 9722
Ins,ection Line (Rec-O-Phone): 639--4175 Business Phone: 639-4171 p
Ine}r
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San, Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Ineuletion -Plumb.
Plbg. Underfloor Water Line Gyp.Bd.) -Mech.
Date Requested: ;L _ ime. 4—AM _PM
Address �4 t� / 'Zrmit #:,/'3
Builder:-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
Inepoctor: _ Date l
PROVED _ DISAPPROVED APPROVED SUBJECT TO ABOVF,
_—_call For Reinep.
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INSPECTION NOTICF. r p
City of Tigard Building Departawut
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
FootingPlbg. Underslab =h. Rough- n Appr./Sdwlk 1
Found. Plbg. Top Out as Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
II Plbg. Underfloor Water Line Gyp. Bd. -Meeh.
Date Requested: Time: AM _PM
Address:
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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;fl`h °�4j � rr•t Ins ctor: nate:
APPROVED DISAPPROVED---J APPROVED SUBJECT TO ABOVE
ht
Call For Reinap.
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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 Business Phone: 639-4171
Inspectionz
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. 'Top Out Gas Line FINALz
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor W t r Li e Gyp. Bd. -Hach.
Date Requested:_ -� �� C Time: AN V—PH
Address: _._�L— f, Permit #:
Builders
THE FOLLOWING CORRECTIONS ARE R8�(12A111T
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Inspect: s Detes_7.l__
APPROVED S)ISAPPROVFD APPROVED SUBJECT TO ABOVE
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ACali For Reinsp. k
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NOHTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415 c'
Permit # 05036767 Pro j&ct # P0029969 33tatuv APPROVED Page 1 of 1.'
Applied : 03/25/93 Is.sue'i 03/25/93 Expires 09/21/93 03/3C/93 07 : 04
RE:SELE;C
Permit Title SFR - ELEC/NEW HOUSE & L . V . OTH 1
Description
Jab Addrisza 8137 SW MATTHEW PARK ST TI
Owner Name INSPECTION - TIGARD Region U
j Applicant Name T & M ELECTRIC
! Phone number 250--1596 Valuation : 0 Approved_"-
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Inspector. Comments - Rejected
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Inspected k,y ___ _,____..._..._ Date ...
Inspection Regijest..-,i
* Cover & SeZ'%'i Ce 4
03/30/9:3 RI DA
03/26/93 PI c�0
03/26/93 LAN KP SERIIICE OK--BIIT DO NOT COVER , I �
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DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON 155
DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPEL;TION REQUESTS (24 hours): 503/640-3561 or 693-4415
Permit, V 050:38'x67 Project '# P00299611 Status APPROVED Page 1 of
Applied 03/5/93 fr'snled 03/215/93 Expires 09/21/9:1 03/26/93 05 : ; ,
RESELEC
Permit Title SI±R - ELEC/NEW HOUSE & L .V . OTH
Description
Job Address 8137 SW MATTHEW PARK ST TI
Owner. Name INSPECTION - T 1 GAR'D Region D
Applicant. Name T & M ELECTRIC".
Phone number 250-• 1596 Valuation - 0 Apprnvp`T'-
ter------
Inspector Comments Rejected ....
S
..................
Inspected by Date
Inspection kequ-y�stcad
* lover & Service
03/6/93 RI CB
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DEPARTMENT OF LAND USE&TRANSPORTATION t_l
LAND DEVELOPMENT SERVICES DIVISION
WASHINGTON 155 NORTH FIRST,HILLSBORO,OR 97124
INSPECTION REQUESTS: 503/640-3561/693-4415
COUNTY dtl
PHONE: 503/648-8761,..
OREGON Page 1 of 1 '�y,
i Gate 03/25/93
'Time 13 : 56
Permit Type Residential Electrical Permit Permit # 05038767
APPROVED Applied 03/25/93 arse
Permit Status
Situs Address 8137 SW MATTHE;W PARK ST 'TI Issued 03/25/93
Permit '.Title SFH - ELE.0/NEW HOUSi: & L.V . Completed
Permit. Descr . To Expire 09/21/9.3
Project. Title SNR ELEC/NEW HOUSE & L.V. Project # P0029969
Project Descr. * EROSION
Parcel Number 2S11,I - Land Use District
valuation 0
Legal Descr,
Owner INSPECTION - TIGARD Construction OTH
Applicant Name T & M ELECTRIC Classification 900
Applicant Addr', : 833 NE; BALDWIN ST Occupancy R3
NILLSBORO, OR 9'7124 Validated by KE
Applicant Phone : 250-1596 Inspector Area
CONTRACTOR : 'T a M ELECTRIC Lic . C 34-148C 648-6556
Fee description Units Fee/Unit Ext fee Data
Square Footage (Enter Sy , Ft . ] 2000 115 . 00
Limited Energy 1 20 , 00 20 . 00
Subtotal Electrical Fees : 0 135 . 00
State Surcharge of 5% 0 6 . 75
l 'Total Electrical Pees : 0 141 . 75
j *** Fees Required *** *** Fees Collected & Credits ***
I' ---------------•--------------- ------------•-------------------------------- i
! Receipt No. Date Payment
03/25/93 141 . 75
TOTAL THIS D.-TE ********* 141 . 75
1 Fees : 141 . 75
Adjustments : o0 Total Credits : . 0
Total Fees : 141 , 75 Total Payments : 141 , 75
Balance Due : . 00
1
NOTICE: This permit becomes null and veld If the work or construction for which It Is Issued In not crimmenced within 160 days. Once construction ties started,
the permtt becomes null and vold If construction Is Interrupted for a period of 160 days. 1 certlty that the Information presented by the applicant and
his agent or agents In support of this permit Is true and correct to the beat of our knowledge. 1 acknowledge that the Building Department's rellance
upon frilse and misleading Information may Invalidate this permit. All provlslone of applicable 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 plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access private property or to use easements. I further 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 atoll verifying complianca with the various codes. Use or occupancy of the building or structure permitted 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 satisfied and
approval Is given by the Building Official. t further acknowledge that a lien may be placed on the till@ of the property upon which the permit Is Issued
specifying that the use or occupancy of the building or struclum Is prov!slonsl and revocable until the satisfaction of all Inspection requirements
APPLICANT'S SIGNATURE
WASHINGTON COUNTY ELECTRICAL (PERMIT
Department of Land Use & Transportation
Electrical Inspection Section APPLICATION
155 North First Avenue,#350-12
' Hillsboro, Oregon 97124
information: (503)640-3470 Fax: (603) 693-4412 NumberDate
j - o lD 7
bate 5-2
PRINTPLEASE
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Please complete all sections, 4. Complete Fee Schedule below w
VnsPlisf. LocatlQ-ntnNumber of Inspactloper psrmM allowed yr
�� naAddress 3 Service included: Items Cost(es.) Sum
Building A. Residential-per unit o 0
City / iL _Suite No.�1�_ $
Tenant Nam toss aq.rt.or loss $e5.00 � '— 4
(if commercial) ,_—` Each onion net thereof
sq.ft 3
or portion thrxsof $15.00
Limited Energy - $20.00 � 1
Tax Lot Nap NO. Each Manufd Home or Modular
Dwelling Service or Feeder 540.00 — 2
Thomas Map Book: Page: Section: _
Directions ��(_ - R ry e�J _ " B. Services or Feeders
��+ / 5 T �'!7�� [ �, InstallaWn,alterations or relocation
L1 200 amps or less W.00 2
Commercial ResidentialM 201 amps to 400 amps $60.00 2
401 amps to 600 ampe $100.00
601 amps to 1000 amps $130.00 ----- 2
fi 2a. Contractor Installation only. Over 1000 amps or volts $300.00 2
o r^ Reconnect only $40.00 --- 2
Electrical Contractor�`{_'_'1_
Address R 3 r\J E" /3 1: ,�, Il, ar^L11I C. Temporary Services or Feeders
Date Job Number Installation,alterntion or relocation
Property Owner .___.� t Y ti-� 1 .(� 200 amps or less __ $40.00 __ 2
p Y 201 amps to 400 amps $55.00 2 1
Contractor's License No. _ � —i ij G _ 401 amps to 600 amps $80.00 2
Contractor's Board Reg. No. J I I`b — Over 600 amps to 1000 volts see W above
Signature of Supl. Elec'n _,kox e- D. Branch Circuits
New,altoration or extension pe,panel
License No. L 1 Phone No. Z f2 )(, a) The fee for branch circuits with
purchase of ssrvke or feeder les.
2b. For owner Installations: Each branch chc-At $2.00 2
b) The fee for branch circuits without
purchess of servks or fssdsr fee.
Print net's Name Phone No. First branch circuit $35.00 2
Each add'nl branch circuit $2.00 2
Address —� E. Miscellaneous (Service or Feeder not included)
City State Zip Each pump or irrigation circle—_ $40.00 — 2
i Each sign or outline lighting $40.00 2
Signal circuit(s)or a limited
The installation is being made on property I own energy panel,alteration
which is not intended for sale, lease or rent. or extension _ s40.00 -- 2
owners Signature ______._.__— __.�__ F. Each additional inspection over the allowable
In any of the above, per inspection
3. Plan Review section (if required) I -- $35 00
5. Fees
A. Enter total of above fees $ /-3 5
5% Surcharge (05 X total fees) $ __
Subtotal $
B. Enter 25% of line A for
For Inspections call Plan Review ii required (Section 3) $
640-3561 or 693-4415 Subtotal $
24-hour recorder, Less Bulk Label Fee $
one working day In advance of need Balance Due $ ;.
This permit becomes null and void If the work authorized by the parmit Is not commenced within ISO days from date of Issuance
of such permIt or If the work authorized Is suspended or abandoned at any time after work Is commenced for a period of 1110 days.
Electrical Permlie are non-refundable and non-transferable. 11/52
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INSPEC'T'ION NOTICE � 1
City of Tigard MAildinq Department
13125 SM Hall Blvd, Tigard, Oregon 97 . 3
Inspection Line (Rec-O-Phone): 639-4175 Business Phon : 639-4171 ti
Inspections
Footing Plbg. Underalab •ch. Rough-in Appr/Sdwlk
Found. Top Out' Gas Line FINAL: Mob
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Post/Beam Struct. San. Sewer Freming� -Bldg.
Yost/Beam Koch. Rain Drain Insulation -2lumb.
Pl.bg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requestedt � � _ _Time: AMP
Address:
THE FOLLOWING CORRECTIONS ARE REQUIRED.
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Inspectors r �'_ Dater,
APPROVED _ DISAPPROVED_ APPROVED SUBJECT TO ABOVE
Call For Reinop.
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INSPECTION NOTICE
City of. Tigard Building Department
13125 Sit Hall Blvd_ Tigard, Oregon 97223 -
Inspection a,ine (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
!P!
Footing Plbq. Dnderalab Mech. Rough-in Appr/Sdwlk
i
Found. �Plbq. Top Out \ Gas Line FINALs
Poet/Beam Struct. San. Sewer Framing --Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
•lbg. Underfloor stater Line Gyp. Bd. -Hoch.
Date Reg:sested:_ Times ��AM PN
Address: 1 /Ar/} f: _1.�
ermit
Builders L T/�/ � •
THE FOLLOWING CORRECTIONS ARF. REQUIRED:
�y �'`...G'TFC Jr�� i..�!tom (�__----- ~� I •
Inepz4L
Date: _�OPPR D APPROVED SUBJECT TO ASOV$
_ Call For Rninap.
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INSPECTION NOTICE
City of Tigard Building ' :partaent
13125 Bit Hall Blvd. Tigard, .regon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underelab Nech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
P Beam Struct) San. Sewer Framing -Bldg.
oatam—Fef—R Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd.
Date Requested: J —�/`3 Time: ktq�PN
Address:
Builders�_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors C— Date:-2���
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__ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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INSPECTION NOTICE
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City of Tigard Building Departsoent
13125 SW Ball Blvd. Tigard, Oregon 9 22
Inspection Line (Rec-0-Phore): 639-4175 Busineeg Phone: 639-41 1
Inspections,��/�c
Footing Plbg. Underelab Mech. Rough-in A r
pp /Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Bnam Struct. 'San. Sewer ) Framing -Bldg.
_ g•
Poet/Beam Mech.
-in Drain Ineuletion
-Plumb.
i
Plbg. UnderfloorWater Line ) Gyp. Bd. -Mech.
Date Requested:, :��_� I
�i /may Times AM PM
r1 ''r �," .,;s r �, Addreees Cl �L_L�Qfi'_� .//1 /i_ "'_1�/ ,—.L
�.a��d
Builders—�� /y�il
�pr�V� aJ �j"i Till FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors
_. Date:
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—APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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Call For Re.i.nsp.
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INSPECTION NOTICE
City of Tigard Building DepartIMMOt a
A3125 SW Ball Blvd. Tigard, Oregon 972
Inspection Line (Rec-O-Phone): 639-4175 Business ;hof 639-4 71
4 ip,.
Inspection:__
,Poo-ting Plbg. Underslab Mech. Rough-in Appr/Sdwlk ifdrye ;'
6und � _ Plbg. Top Out Gas Line FINAL:
Poet/beam Struct. San. Sewer Framing -Bldg. 4�rh�"��
a17+aa,� �3 ,i
Akr ri Poet/Beam Mech. Rain Drain Insulation -Plumb.
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Plbg. Underfloor Water Line Gyp. ed. -Mech. ja
lye�Y Date Requests
dti � PM
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Address. 1 GziL
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Builder:�lw.. — ---- — +';.
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THE FOLLOWING CORRECTIONS ARE RMQUIRED:
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APPROVED DISAPPROVED APPROVED SUBJECT TO ARO
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Call For Reinap.
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CITYOF TIFARD F'L.UMBING PERMIT
MIND PERNIT 1#. . . . . . . : IIS'f93 -slcl
COMMUNITY DEVELOPMENT DEPARTMENT w�ooa
13126 BW HWI Blvd.P.O.Box 23307,TlpaM,Oregon 877 (5W)630.4176 DATE ISSUC D: LA-3/05/93
v
SITE ADDRESS. , : 013.1373 rIAT rHL::W F AFtI'. S'r P'ARCEL: 251. 12BC-1 .1f;cr0
SULADIVISION. . . . : ','Al THEW F'ARK ZUNI NG: {-
DLOCK. . . . . . . . . . . LqT. , . . , . . . . . „ . .
: J. 1 ;.
CLASS OF WORK. . :NEW GARBAGE D I t.aPOSALS. . ; 1
TYF''E OF USE. . . . SF WASHING MACH. . . . . . . : 1 BACKFLOW P'RF'_VNTRS. . -0
OCCUPANCY GRP'. . :R3 F'LggF2 URA I I\IS. . . , . , . :0 'T RAI'=':i. . . . . . . . . . . . . . :0 ,
STORIES. . . . . . . . : I W(=1Tr'F'4 F-Il I"�IFRS. . . . , . : .i.
CATCH HFaSINS. . . . . . . .ct
FIX•TURES---'----__.._.._....._._. LAUNDRY TRAYS. . . . . . :0 5F RAIN DRAINS. . . . .
:i
S I NKS. . . . . . . . . . : 1 GREASE TRAP'S. . . . . . . :0 *,
j
LAVATORIES. . . . . :c OTHER F=IXTURLS. . . . . :0
l : SEWER 1_1NE: (ft ) . . . . :0
TUIa/SHOWF.RB. . . .
i
j WATER CLOSE'T S. . :2 WATER LINT= (ft ) . . . . : i00
DISHWASHERS. . . . : 1 Itra1 DRA:LN (ft ) . . . . :Qc
1.
Remarks : P'AT'H I
I
OWNER:
j JAY MILLER BUILDER INC EIP,RT $ 364. 00 JFi 03/05/93 —
P. O. BOX 23291 HPLC $ 40. 00 JLH 02/x_5/93 93-237142
B5r"C $ 18. 20 J1'l 03/05/93 —
! TIGARD OR 97281 NP'RT s 40. 50 JH 03,/05/9,: - #,
Rhone #I: 6847.`'x43 IyIF'l_C $ 10. 1 JH 0.3/05/93 —
M5FIC $ :'. 03 JH 0:3/05/93 -
P'Iumbiny ("ontr,ac:tor _.._.....__,.__....._._.__...._.__..._. .... PE'RT $ 11 i. 50 JH 03/05/93 _
`.x. Elf~] JH 03/05/93
Adds e.;s: -MN
Ci t Y ..__ _ _ R.,p,-.gp e " .,.___.._____._.....
Z i I”--------- ..—...T'aGARL{J;ItM N...$7-Q84-C0925 ........_ _..
Reg #:�
RE:GIUIRED INSF'F..CTIONS -__.._-........._
This permit is issued subject to the reg--
ulations contained in glee Tigard Municipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Lodes and all F'o t/>3eam Stv-uc_:t Water Line Insp
other applicable laws. All work will be done frost/Peam Mler..han Appy/Sdwlk Insp
in acror-dance with approved plans. This I'lm/undslab InFp Mechanical Final.
permit will expire if worl< i5 nat star^ted P11..N/Underf17ot, P,1. cmb FircaI
within 1130 days of issuance, or-, if work is Mechanical Insp Bc_cildinq Final
suspended for-, more than 180 clays. F-,lumb `['or-.) Out Excision Cont;-rel
F r-am.ing Insp Crawl Drain
/ F i r e p:l a r. e
Gar, Line Insp
/ Insulation Insp
x_ ---- ._. _ _ _. _ (3YP Baarcl Insp
_thor,i.zeci I"Iumbinq Lontrautor S:i ynati_crtr j
Call for inspection - 639 4.17`i
Cantr~actor Notes : 1
i '
xr
C17YOF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT ,,, ;a� IhA T c R F'E R1YI z T
13125 BW lidl Blvd.P.O.B«236107,TlgsM,Oregon O(dW)839-4175 F F:R nl I T ►#, . . . . . . :
N
1171,670,3793 G`
SJ T'E= ADDRESS. . . : 081-37 SW hlf-1'1"THE:•W FIViRK ST F'ARCE::L: r.';3I IPBC--11600
SUBDIVISION. . . . : 1441'rHEW PARK ZONING:
FiL.00K. . . . . . . . . . . LOT. . . . . . . . . . . . . : 11 fi
8(JILDING _._..__._____.__.__........_.___._.__-__..-__ __._.___....____._.___. ■
RE:I SSUE:MSI-92--CA229 DWELLING UN 1 T S: 1 BA',, 0YIE:NT.
CLASS OF WORK. :NEW BEDR1113:3 BA'r-HS:2 GORAGE. . . . . . . . . . ..6,35 s f
l"YF'E. OF USE:. . . :SF FLOUR AREFaS -__.._.___.__._ REQUIRED REwD SETBACKS________--_
TYPE OF GONST. :GN f--'I RST. . . . : 14 '4 s f LEF'T'. . -9 Ft R I GHT. :6 ft �
OCCUr"ANCY GRF'. :R:3 SECOND. . . :0 sfi FROM . :E:0 f't REAR. . :40 ft
STORIES. . . . . . . .. 1 T'H 1 RD. . . . :Ih s f RE-OU I RED-----.--
HEIGHT. . . . . . . . .
.HEIGHT. . . . . . . . . 18 ft -r C1T'AL._.._._...___...: 14 _4 s'f SMOKE DETECTORS. :Y k,
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 76934 PP'IRKING SPACES. . : l
Remar~l<s : PATH I �.
____._-•-.----._ .._.___.__.....___ .__._._ ____._____-_ PL_U11BINCi -____._.._._.•_._.__._.________ _._...__.._.___ _____._.._-_.._._
SINKS. . . . . . . . . . . 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVA'rORIUS. . . . . :+=' WATT-R HEATFR5. . . : :l Tr1AI=S. . . . . . . . .
T•UB/SHOWERS. . . . ..2 LAUNDRY TRAYS. . . .0 CATCH BASINS. . . . . . . :0
WATE R CLOSETS. . -2 SE'WE'R LINE (ft ) . :0 GREASE- TRAPS. . . . . . . :0 1
DISHWASHERS. . . . : l WATER LINE (ft ) . : .L iCIZi O'r'HER FIXTURES. . . . . :0
GARBAGE DISF'. . . : 1 RAIN DRPIN (ft ) . :0
WASHING 01ACH. . . : 1 SF RAIN DRA 1 N'3. . : 1.
------------------- IvIEc:CHF1IVIL faL. _...___._.._..__._...._._..._._.._..._.._...__.._.._ .._.._.._._...__--•--._.__.
FUEL- TYPE'S- ---- _ - .---- UNIT HTRS. . -.0 type amol.rnt I:y (]ate r~ecpt 4'
/GAS/ ! / VENTS . . . . . :0 B1:,RT $ ,3t+4. 00 JH 03/05/93 —
NAX INPUT:0 1?T VENT FONG. $ 40. 00 JI..-1-1 Ifr�' �:.
/ 5/93 9;3--x'3'71.42
F'URN ( 100K . . : :l HOODS. . . . . . » 1 BaF'C: $ J8. 20 JH 0'3/05/93 --
FURN ) 100K . . :0 WOODSTOVES. :0 Iril'RT $ 40. 50 JH 03/05/93 -- 9
FLOOR FURN. . . . ..0 CLO DRVE:RS. : 1 1+1r"'LC: $ 10- 10 JH 03/05/93 •_
POIL.iChIF' ! :3HP-0 OT'IiEWR UNITS: ]. 015GC $ i2- 03 JE1 03/05/93
GAS OUI LETS: 1 F'PR7, $ 117. 50 JH 121.3/05/9,3 -
Owner 5. 88 JH 0.3 05/'):3 -
JAY MILLER BUILDER INC
P. 0. BOX 2.3x191
T I GARD OR 9728J
Phone #: 6847543
JAY MILLE:'R
PO BOX 23491
TIGARD OR 97,2131
Pfrone it, 684--7043
1 Reh #. . : 301.09
598. 24 TOTAL
This permit is issued subject to the regul,tions contained in the -- ----- RE '1!1..JIRE:D 1NSPEC:TIONS --- --
Tigard Municipal Code, State of Ore. Specialty Codes and all other foot/fn Un Cl Insp Fireplace Insp +1
applicable laws. All work will be done in dccor•dance with approved Post/Beam Str~uct Gas Line Insp
plans. This permit will expire if work is not started within 180 frost/Beam Ileclran Insulation Insp t
days of issuance, or if work is suspended for more than :8Q days, F'lmi Lrnds lab Insp Gyp Boar~rJ Insp
Fpr m.ittee F'L.Ih/UnrJerfaoor Rain drain Insp
`�iyn�ii;�..rre : �' � -` _ Mecf)anicat Insp Water L._inF Insp
F'l1.1inE) Top 04.1t fippr/ladryllc Insp
Iss�_rerJ Hy : Frami.rry Insp
He( --,al Final
( all 9`rr
pert ion - 639-417:5
a.
Q4M
CITYOFTIFARD - ,
SEWER CONNEC"(TON
My 1M11D PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT Oslo" PERMIT 4. . . . .. . . : SWR93-0109
13196 8W FYI Bbd.p.0.Baa 0W,T0W,Or*W 07?23(603)d344176
SI-I"E" ADDRE=SS. . . : 08137 SW 1441 THEW PARK 57 V,ARLE_L.: RS112DC-1 i i:,V10
SunD I V I r3 mi. . . . : IIIA FTFIE:W PARI',
ZONING:
BLOCK. . . . . . . . . . : L01.. . . . . . . . . . . . . . 11 '
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : F"IXT'LJRE: L)NIIS. . . :
CLASS OF WORE;. . . :NEW DWELL 1 NG lJN I TS. . : I
TYPE= OE' L)SE. . . . . :SF IVO. OF Bull-DINGS- 1
INSTALL TYPE::. . . . :BIJSWR I I+IPERU :SURF"ACE:. . : : s f
Rem.•ckz - PATH l:
owner __..__._._._.....__.__.._....._____._.. ____._.._____ .___..__.__._._•---•-__..._____.-_ f--EES
.JAY MILLER HUII-DER INC type amol.rnt by date recpt
P. O. BOX 23291 PRIYIT $ C100. 00 JH 03/05/9.3 -
:INf",P $ 35. 00 JH 03/05/93 - s•
TIGARD OR 972'81
Phone ##: 6647543
CON'T'RAClOR MOT' ON FILE:
I='none it : $ E'l ,35. 01a TO'T'AL
Rey it. -
_ ..___.. .._. RI-".UL.1I RED I NSVT LT I ONS) ._.._..__...._._._
ft
This Applicant agrees to comply with all the rules and regulations Sewer, In!5pectian
of the Unified Sewage Agency. The permit expires 190 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 shal. 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.
Lall far- inspection 639--4175
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CITY OF TI 13WSWHs°°"4 PI.NCK/RECT # —75
GA�RD PO Box 23397 PERMIT # _ � -0/Z2,
COMMUNITY USVELOPMENT DEPARTMENT ToprAOrcloo9TM �7 _ __ ____•
I
(303)639 171 DATE ISSUED
i
JOB ADDRESS: 137 SvJ Ma-tll-Y-N4 , . $t .
TAX MAP/LOT ����I ZQG - /l Gvy
1 SUB: —Mau '�0.�k_ LOT: _�1 mo it r-W, LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NAME: -.Jca. J)r)c, REISSUE OF:
ADDRESS: _I'� 2�c ^' LAST REISSUE:
FLOOD PLAIN/
PHONE: -753 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIIRED
NAME: PLANNING:
ADDRESS: _ ENGINEERING:
FIRE DEPT:
PHONE: OTHER:
CONTR. BOARD #: _ EXP DATE: 1, '1,3
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: n ,g ccrz�t LIST/SUBCONTRACTORS:
MECH: _ ( �]_}]� i rrA BUS TAX:
ARCH/ENGINEER
—
CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
; t
PHONE:
PROPOSED BLDG. USE: �:---
;�-
COMMENTS: 1'-t - i.14
F Ali
M
-mac h�P .� c E L� p�,
APPLICANT GNATURG
i.
�,,, Received By: Date Received:
p
4
4,;
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��� � „y. pxH.W 1�In..rM4nMb�eWJb.. - ,. ......... ....._ -..-- ,.•,._
3
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
h1 ` -oI2Z 10-432 00 Buildir.g Permit Fees uv 3Grl ��
10-431 00 Plumbing Permit Fees / 30 //7. )-p
10-431 01 Mechanical Permit Fees 40,JV ,-p
10-230 01 State Building Tax (5%) '.G,1/
Building
Plumbing rbc
Mechanical �3
10-433 00 Plans Check Fee
Building !�U
Plumbing
Mechanical _
10-230 06 Fire —
3-010 30-202 00 Sewer Connection �� v
30•-444 00 Sewer Inspection J?
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
{ 25-448-06 Institutional TIF Fees
25-448.03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) -
24-445--01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL , ZY ��a /1
nm/3587P.WPF
1'
u.
k n K, .-.
,
1
• . .. .. __ . ........• .4..._ .,:. i0W1Y'nsFW.MMf/MMNRMf!)>MMI�Me+.rIMIF ww�..:i
IK
1
CITY i.►F ! IL�Akp hr�UL .[ISI CIF PAYML-M-1 RE:MIPT NO. 193 : 456
lliE4�N NMUlJNT t 263. _k
ivl�M4: t
MILLER. JAY cpsA i AMUUI4 r t 0. Qltzl
l-1r.►IJFtt' Ls�, a F-IAYMEiNl DATE
SLI t31)I V 11-3 I U14 t �
1='1JRPOSSC= OF PAYM1=•N I 1'aIhI.J1.11V f Pot a PURI-"U54; OF P14YMEN f AMOUN C PA I D
IaiJ I LD I Nl3 PF ItM `sh 4. 00 PLUMB I N13 Pk:'r7M 117. 50
MI.CHAN I GAL. PIL 40. 50 f iT. BUILD PLR 26. 11
1='I.4N CHECK r'h 10. 1;3 t3FWER USA 2101. OIA
•f WE.R 1NEwE.CT 35. of,
,
u.,t t' 1 1. MH f fHF--.W PARK
F11?t7 w;W MATTHEW PARR i:•"T
TOTAL AMUUN T r-Ti I D — - 2693. i:?q
t
f_:t'fY IAF 1' II:.4-1`I h,El'F'1F'T i'iF F-'►"tY'NIE NT R CF,I!^'l Niel. o9 3-0,7 714,
I7HC-X'I•t HMIJUNT a 40. 00
ODORAME ISI,1,I._L.0 R, JAY C�:ASH AMULIPIT a Ia. 00
lI')DREE;� a PAYWNT DATE` a IZ► 'i "',;r1:5
"UP D' t
v►i�f l:.1f F` I►r. PAYMENT AMOUNT F OTO t''URPO,—Zf: i.lt Iw'AYI*11:f!'T'
AMOUNT PO f T)Ao
A
1_ .rr 11 h1f1T T jK W f!ARK.
tO1 ":17 6W Mt1TlFtrw PARR
f!:IT'caL AlloUt,11 PAID _ ._y 40. 0Q)