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1"SpBCTION NOTICE �1
City or Tigard Building Department
13125 S1r Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Bunineas Phone: 639-4171 -
Inspection+_ _ _--_— ---- - —
Footing Plbg. Underslab Nech. Rough-in Appr/adwlk
Pound. Plbg. Top Out Gas Line �PINAL+'
Post/Beam Struct. Ban. Bova. rte` �i Framing
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Post/Beam Hoch. Rain Oran O insulation -Plumb.
Plhg. Underfloor Nater Line Gyp. Bd.
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Date Rogueeted+ c� _� Timet AM PM
Address: � � L(.,L✓� rL'1_�j� �, Permit f+
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Builder: 1Sb.3..is-� r�L'`���— C_LJ�1
THE FOLLOWING CORRLCTIONS ARE REQUIRED: I ,
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Inspectors u Dater`t7`
11PP1OVRD DISAPPROV<D APPROVED SUBJECT To ABOVE
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Call For Reinep.
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INN TION NOTICA
City of Tigard Sanding Dkepartment
13125 BR Hall Blvd. Tigard, Ocegoa 97223 K:
Inspection Line (Rec-o-Phone)e 639-4175 Fusines■ Phones 639-4171
Inspections__ —�� _C
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Footing Plbg. Underslab Mech. Rough-in Appc/sdwlk �
fin'• Plbg. Top Out Gas Line // PIN11Ls�
Fes,_
Post/Bean Struat. San. Bower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb. •
Plbg. Underfloor .Water Line Gyp. Dd. -j"Oh.
Date Requesteds / ' 3
I I _rims: lA�M A� PN
Address s l L`(`1'�
Permit
s
Builders—
THE FOLLOWING OORREcTIONS ARS REQUIRED: ^�
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Inspectors -�1
-------- V _._._. Dates
--APPROVED DISAPPROVED
- 1sPPROVE1) SUBJECT 1'O ABOVE
Call For Reinsp. �
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City or Tigard Building Department
1312S dR Ball Blvd. Tigard, Oregon 97223
Inspection Line j(Rec-O-Phones 639-41751f_Bunineea Phone 639-4171
Inspections T V1 I--AyA �`,,,11,4��['
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Baas Struct, Ban, Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line N/ Gyp. Bd. -Mach. k
Date Requesteds 1 Times AN
Permit 1e,
Builder:-___ —— !- 'y --
THE FOLLONING MRRECTIONB ARE REQUIREDs
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Inspector:_ Dates 1
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"PROVED DISAPPROVED ).PPROVED SUBJECT TO ABOVE '
__Call For Reinep.
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CITYOFTIIFARD
CITY MAD
COMMUNITY DEVELOPMENT DEPARTMENT Coosa" ..
r.:Itidl•r •a. . . . .. .. . hIL,T �.S-rL11. -:g
13126 SW FW Blvd. P.O.BaN 2&7,T4wd.(hips+97223(603)630.4176
-- b,59-41 i 1 UI I l E I S9UED a 5371179.3
SITE ADDRF.SS. . - e 12496 ;SW ESUMME H CRE-67 LR PARCEL e 151.54C,13-01000
5'
SUBDIVISION. . . . i SUPIMER 111LL.9 PARK LONINGs R---4. 5
BLOCK. . . . . . . . . . s L_Uf. . . . . . . . . . . . . eB A
RE T SSUE e DWELLING UNI"f G s 0 BASEMENT. . . . . . . . e 0 s f`
CLASS OF WORK. s ADD BLDRMS s 0 60,1416 12 GARAGE. . . . . . . . . . C 0 9 f •
I'YPE OF USC. . . -SF FLUOR RECOUIRED SE.T'Bf4CKS_..._--..-.__.---._.'--
'T'YPE OF CONST. i5N FIHSI. . . . 1600 ,f LEI-T. . -0 Ft HIGHT. ::j Ft
OCC=UPANCY CRF'. s R3 SEL OND. . . sl?) s f F RUNT. to f t H1-;AH. . e 0 f t
SIORIE.S. . . . . . . a .l •THIRD. . . . :600 %f rtEUI..IIRED_..-.--_......__...__. ._ _...___-- _.._.
HL 1 CSI•i`.. . . . . . . . e12 ft T G TAL--- - --s 0 s i SMOKE:. DET i:CYORS. e Y
FLOOR LOAD. . . . 340 pVALUE. . . . . $ s 2 761110 w EiFtK l h113 SPACES. , 10 f
Reimarl(ss PATH I ADDITIUN OF FAMILY R[.U11 (.41\11) BOTH F+OOPIS 600 SU FT I
S I NK`a. . . . . . . . . . 11 FLOOR UTIA I NS. . . . 1.0 LAVRAtE LOW PREVNTRS. . PO
LAVAJURIEIS. . . . . s2 WA1F:R III_Al L R1;. . . -11.1 . . . . . . . . . . . . . . I0 r
IUS/SHOWERS. . . . eP LAUNDRY I'Ri1rl,. . . eN Gt4jCI4 BASINS. . . . . . . s0
WP'TER CLOSE:TS. . 9a SLWE.R l_I NE ( f t ) . 10 1..ildl:::i 6E 'TRAPS. . . . . . . i 0
DISHWASHERS. . . . s0 Wfa1r_H LINE tft ) . 10, 01141,1+ F=IXTIJHE.S. . . . . ..111 ri
OARBAGI= DISP. . . s0 (RAIN DRAIN (ft ) . s0
WASHING MOCH. . . e 0 SF HA I N DRAINS. . e l
IvIECHANICWL
f•UEL TYPE"S--_.______._.-- UNIT• 141115. . :0 type atmr.f.tnt by date revpt
/GAS/ / / VENT S . . . . . :3 BPRT f t F14. 1210 JF1 03i 1 1/93 -
IrIAX I NPUI s 0 B CU VE::N I- FANS. . a c' LAPI-f:: $ :l 19. 60 "JLH 02/e3/93 93-L13700&
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TURN ( I00 . . :171 HOODS. . . . . . e 0 F:5I-,C * . r-ILA •114 03i 11/93
F-URN )-100K — :0 WOUDSTUVF"S. 1121 MP,RT $ 29. 50 JH 03/11/93 -
FLOOR FURN. . . . -0 CLO DRYERS. e i7 NPL-G' $ 7. 38 .JH 113/11/93 -
L-tOIL/CMI-, ( .3FIV-0 OTFILR UN1'rSs1 M5F'C b 1. 48 JH 0.3/ 11/93 -
GAS 0U•rL.ETS e 0 PPR T $ 67. 50 JH 03/11/93
Owner,e $ 3. 38 JH 103/11/93
WALTER BRUTAN
12495 SW SUMMEMRCREST DR. ¢
T'IGARD OR 972,23 w (!t� 'q3"--23-767F
Ptlone ##s 620-7849
Cont r ac_t or e •_•-1111___.. _.___._,_.__ 1.111__.___._._._.._ oZ�J. (�C' ,�.3 - jVl/
J. I_. Irl. SERVICES0011 PIAL'iON) 0
1C� J SW SUMME-:RCRES1 DR
T I GORD OR 97223
Phone ##e 684-2939
7008r:
f 4GE'. 04 T U rNl_
chis perett is is!ued subject to the regulations contained in the -- --- EZEEMIREU INSPI-J-1TIUNS - - --- -
Tigard Municipal Code, State of (Ire. Svecialty Lodes and all ether Font/fot.tnd Ins3p Gyp Board Ins.p
applir.able laws. All work will he done in accordance with approved Part/Beam Eitrl.tct Rain drain lnsp
Mani, This permit will expire if work is not started within 180 Foot /Beam Meehan trlechanxc:•al F i nal
days of issuance, or if work is suspended r more than 180 days. PLM/Underf laar Plktmb Final
C-1 MerHanl.c-al. lnsp Dl.ti .ldinty Final I rt
1--t,mittee Sign-Ituar F, UL-� - Plr_tmh Tula oUt E=rosion ControlA-6
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Framing Insp Crawl Drain t
i s s m a d N y _._ 1.111_ I r i s 1.t l a t i o n I n s p
i_. to l for Tivprr,tian - 6 .39--•4175 a
15SWHaoe. NCK/RECT
CYIN OF T ARD
PERMIT #
COMMUN11 YDENEILOPMENTDEPARTMENT Tiprd,Orcgon97M
(50])6)9.4171 DATE ISSUED _ I
JOB ADDRESS: �i�T�1S��-'(1 UM'��r`,�l'/E�' �2 TAX MAP/LOT ISL-- ,i" C 6 Gl U 00 f{
SUB: LOT: _ _ LAND USE: __ t
_. _ _
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VALUATION: U
OWNER SPECIAL NOTES
NAME: 4 7- ' ll-01-11 1 _ REISSUE OF:
ADDRESS: ��y`1f Slt' �c�i�rn'='E�'E'''s���' LAST REISSUE:
::�/r,y,Q ,� .3 FLOOD PLAIN/
PHONE: SENSITIVE LAND:
F
%TRACTOfl / APPROVALS REQUIRED
NAME. ��� V/ —V PLANNING:
ADDRESS: /,7s;jS� �S. L� J'u.n M c��,r -S T j�',O ENGINEERING:
r-f 9' X,4 _ FIRE DEPT:
PHONE: (�;� y ,��-�'�Y OTHER: — —
CONTR. BOARD #: �L�G'� EXP DATE: //- �7-
1
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: ��y�u k'�tJS ' LIST/SUBCONTRACTORS: _ —
MECH: �k'�'u� _y _ BUS TAX:
CH ENGINEER CALCULATIONS:
NAME: _ _�- TRUSS DETAILS: _
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: V
COMMENTS: 7
i
APPLICANr SIGNATURE
Received By: Date Received:
a�r�
PERMIT # ACCT N DESCRIPTION AMOUNT AMOUNT :'D. BAL. DUE
`I Q30(Zy 10-432 00 Building Permit Fees ��y,�� �'^'
10-431 00 Plumbing Permit Fees to ,50
10-431 UI Mechanical Permit Fees -V1
10-230 01 State Building Tax (5%) / �'� ;" _ �-0G_
w Building
Plumbing
! Mechanical _ Z, V k"
10-433 00 Plans Check Fee
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
:30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees 1
25-448-06 Institutional TIF Fees
25--448-03 Office TIF Fees
2.5-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage 5, Chrg
(SSDC)
24-445-01 Water Qual , m of)
24-445-02 Water Quanti►- jieu of)
TOTAL 22•v �L`�— 3o 2 t/
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