13215 SW SHORE DRIVE 13215 SW SHORE DRIVE
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V _x'TE OF SCC � VCY
CIER:a
s CIT OF TIGARDOREGON
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Owner: Michael Johnson Permit No. 5418 '
-� '
Address: RFay on OR 97005
—1.00.0•..—SW Slues P1arPi— , _ _
s , Building address: 13 15 .1;WSrnrP 0r;v � F
s f � Occupancy: g,3 Land Use Zone: R12 Bldg. Type 5N �'3;•
Comments:
E` Certificate is hereby given this 30th day of December , 19 85
_ t that said building may be occupied and that it complies with all ..
requirements of t':e Lundin Code for the City of Tigard, as approved
b the Tigard City Council. g g
xw �..
,Y
Fire Dept. Building Inspector
s.
2ui1ding Official `
r Post C.ertiiicati .;onspicuous Place � 4
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INSPECTION NOTICE
City of Tigard Building Department
l it420 S.W. Main St.
Tigard,Oregon 97229 /
Phone: 619.4171
i
Type of Inspection . LLIz �. ------- - -- ----.--------
Date Requested
Address __I–✓� /S ,S f��� � Permit �—
Owner_.----- Lot #-.-- –--—
Builder __ — --------The following Building Code deficiencies are required to be corrected:
Presented to Approved
L. '1
Inspector {ll1iL"'' — Disapproved
Date _--
CALL FOR REINSPECTION
❑ YES ❑ NO
�t
INSPECTION-NOTICE
City of Tigard Building Department/ J�
12420 S.W. Main St. /
Tigard,Oregon 87223 I +
Phone: 639-41'1 11
Type of Inspection —.— �� '�'
-.
Date Requested _ /�'' "'`�-'� •�� Time_ A.M._ X' P.M. f
Address -- = / —��- — ��--� Permit # �I
Owner_. _ Lot # _
Builder
The following Building Code deficiencies are required to be corrected: --�
AC
Presented to— --_ -�—_— -- �-� Apprr,dd
Inspector _— . � /��0D1sapproved
Date --
CALL FOR REINSPECTION
BYES ❑ NO
W W w w AA[ W 'x1 W
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested_ '= iynl Time_. A.M. Jc- P.M.
Address Permit
Owner_—_ Lot #
Builder.--.--------
The
uilder.--. — -
The i-ollowing Building Code deficiencies are required to be correo9d:
/�1`� L-1a t_r.� �C'����', l� r Erl�cr__._r�✓� T r!\! L.. --
_ rl
,izIV ,,:y� �L✓f' f- .i/cT/ nim �i,,�-r
Presented to ---- ❑ Approved
Inspector ",00061aapproved
Date —
CALL FOR REINSPECTION
,KYEE 0 NO
I
— 1
INSPECTION NOTICE
City of Tigard Budding Department
12420 S.W. Main St.
Tigard,Oregon 97223 !
Phone: 839.417' i
Type v InspectionL11�----
Date Requested__ -7 Time A.M.__ �—P.M.
Address _ �=S %�� �'������ Permit #
Owner — Lot #
Builder __ _ ----------_
The following Building Code deficiencies are required to be corrected: '
v
�G
1
Presented to - _— — — _ Approved
Impactor _�� ❑ Disapproved
Date - ---'
CALL FOR REINSFECTION
❑ YES -r- NO
II IIS 'B
INSPECTION NOTICE {
- _ 1
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171 y
Type of Inspc-ction —____ter�'� 'f �E7
Datt Requested ✓-0' Time A.M.-'`�"9Pi-
Address Permit ;F,
Owner A A A Lot
Builder
The following Pudding Code dficiencies are r quired to be corrected:
All
421
Presentedt #,a Approved
Inspector _— -BfSl iproved
[)ate
CALL .FOR INSPECTION
YES ❑ NO
INSPECTION: NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 6'19.4171
Type of Inspection
Date Requested_ _� Time A.M. P.M.
Adu•ess
-- Permit # _
Lot
Builder
The
_—
The following Building Gode deficiencies are required to be corrected:
Presented to
Approved
Inspector [] Disapproved
D;rrf,
115:
CALL FOR REINSPECTION
❑ YES YJ NO
1
BUILDING PERMIT APPLIC4TION TIGARD DATE _ is t15 5418
THE UNDEF.SiGNED HEREBY APPLIES FOR A PERMIT FC,I THE WORK HEREIN INDICATED BUILDER PHONE _!43-6275_
OR AS SHOWN AND APPROVED IN 1 HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. �—
OWNER i.cilael Johus3or► JOBADD9ESS W A.5 614 chore oriye W&;nterlake I
ti. 97005ARCHITECT
ENGINEER
BUILDER Same ADDRESS 10005 1. Silver Place DESIGNER
STRUCTURE 12 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
X(RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ bLABC, FENCE
OCCUPANCY LAND USE ZONE _ 5-12 BLDG.TYPE 5N FIRE ZONE PLAN CHECK BY 5CR HEAT
_ Con.Btruct single tamily dwelling w/attached gdrast.
Subject t.0 $150.610 1.ea.con Heightils & $3(IU.00 Amart/k,,dgewood Sewer Surcharge.
SEWERPERMITM 11,448 _-_-Garne 32t,
OCC.LOAD FLOOR LOAD HEIGHT Ili _ NO.STORIES 2 AREA_13 10 NO.BEDROOMS VALUE 45 X000.
_BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE A r RIGHT SIDE 6
Permit 260.5u THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, P.ONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEAEBY AGREED THAT THE
Plan Check 1a,J.i WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFicITIONS AND IN COMPHAP'!�'E
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 44.9.83 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITF BUSINFC13
LICENSE.S�PARppTE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 10.4 (. J...
SDC-- $500.OU f
Total 44 ".._
BY CZ
PDC#) 4%15U.jX)j AP0LICANT OR AQERT -�
Approved HCR Fecelpt No. s ADDRESS
�REWN
INSP.. I rPg INSPECTION REMARKS PLUMBING DATE
L 7,
r";t No.
1;ough,in
Pixture
HEATING
j,
301
Permit No.
G
Rough-in
jillial
1.2
SEWER
Final
DRIVEWAY
Vosl
Storm D,aitilge
(Pain Drain)Final
Sidewalk
Curb&Su eat Fin ,
Approach
VJ-DG- DEPT. FINA. TEMPORARY I CERTI lcilii6CC'UPKNCY
CFRTWICATE OCCUPAWY Final
,F LAI.,iscapifig
—e1 on i!j Fioe'
BUILDING PERMIT APPLICATION TIGARD c
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INJICATED 8UILUcR^HONE
OR AS SHOWN AND APPROVED IN THE ACCOtf PANYING PLANS AND SPECIFICATIONS. OWNER PH(?NE .—
cr�iNER // bbF1 S _ 9 `-/ nRcrllrECr
` , ENGINEER
BOILDEA
DESIGNER
ADDRESS I(Y't'�)� ��-<_l
L� %��i 4
STRUCTURE �_'O NL-W ❑ REMOOE'L CJ ADDITION ❑_REF'AIR _Cl RENEW_Al O FIREOnMAGE C1 OE�AOII
RESIDENCE C] C01�+�1 (] EOt;:AT1UNAL C] GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAF PORT ❑ GARAGE G STORAGE C SU1BO FI
SLOG.TYPE _ FIRE ZON'f. PLAN CHECK 8T _HEAT
O�,-CURANCY _LANO USE ZONE
SEWER PERMIT I - -
HEIGHT NO.STOAIES AREA NO.BEOROOM� VA.LUr
OCC.LOAD _FLOOR LOAD --
_ RIGHT SIDE
BUILDING DEPARTMiNT SET BACKS FRONT
REAR LEFT SIDE
porrnft iIT Is 1'SUED SUBJECT TO THE REGULAYSONS CONTAINED IN THE BUILDING CODE Al
rlls PEi1UA
REGULATIONS Aho ALL APPLICABLE CODES AND OROINANCM AND IT IS HEREBY AGREED THAI
�P1aA�.IN WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPUI
WITH ALL APPLICABLE CODES AND ORDINANCE.,.
THE ISSUANCE OF THIS PERMIT DOES NOT V
I su."otal RESTRICTIVE COVENANTS.COPTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSI
LICENSE.SEPARATE PERMITS REOVIREO FOR SEWER.PLUFAgl?IG AND HEATING.
Sta1w Tax
SDC--
Tota) Ap{*u(;ANTOR AGENT
By , Receipt No. ADDRESS —�� — ntor�E
Approved
S 0 C - _--�-----
POC
SEWER CONNECTION S __
.. r
;EWER INSPECTION 8
SEWER SURCHARGE S
r
ter+
96
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1
Bu i I d i ng Perm it No.
Location
Uate
Certification of Registration
With the Builders 6card
1. /P� �. � doing business as (dba) ,
am registered under the provisions
of ORS Chapter MI Oregon Homebuilders Law) .
My Builders Board Registration Number is
MY registration is in full force and effect and expires on
�gnature
BUILDING RECEIPT
NAME: / DATE: _
ACCT. N DESCRIPTION AMOUNT
10-432 Buildi..g Permit -yes
10-431-600 Plumbing Permit. Fees
� I
10-431-601 Mechanical Permit Fees $ �/"""`
10-230--501 State Building TaK $ �G� cel`- p
10--433 Plans Check Fee $
30-443 Sewer Connection (20X)
t !�
30-202 Sewer Connection (80x)
30-444 Sewer Inspection
51--446 Street System Dev. Charge (SDC)
52-449-610 Parks I System Dev. Charge (PDC)
52-449-620 Parks II System Dev. Charye (PDC) rte.
31-450 Storm Drainage System Dev. Chrg (SSDC) s � � �✓
10-230-505 TRFD (95x)
10-478 TRFD (5X)
10-230-50,, Washington County Fire N1 (95X) T�
10-478 Washington County Fira N1 (5X) V, _
' •rT
10--220 Amart/Wedgeweood
TOTAL
e.
' ( I '0 s
(b•/1214P) (/