12127 SW LINCOLN AVENUE-1 srra
12127 Sb: Lincoln Ave,
4.
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1
T
CITYOFTIGARD PLAN CHECK -"PPLICATION
COMM
(C my .J, PLAN CHECK #
UNITY DEVELOPMENT DEPARTMENT
13125 SW HW 13W- P.O.Han 21397, �\ ORLOVN PERMIT # —
Tq.,d.o�. +U77 21(507 8W-4175 � DATE TSSUFD
JOB ADDRESS: //Yll 6610 ST- 776Jr",/)TAX MAP/LOT Z'S 1- 17 4 Q - ';'sem.
SUB: LOT: Z. LAND USE.
VALUATION: _.VALU - - -
OWNER �7�' S_PECIAL NOTES
NAME: O V G _ REISSUE OF:
ADDRESS: I" ��u</ '7 ST LAST REISSUE: _
yq 27�- L7 -'P %Z t FLOOD PLAIN/
-
SENSITIVE LAND:
c� "7 ------- --
APPROVALS REQUIRED_
CONTRACTOR PLANNING:
NAME: �`� /�( Vf0 U ll p PV, ( /uC. ENGINE ERING:
ADDRESS: FIRE DEPT
OTHER: —A--� --
PHONE: 7 ITEMS REQUIRED
ARCH/ENGINEER
I_ICT/SUBCONTRACTORS:
�
NAME: BUS TAX:
_ TCC �N'✓f� Dt�tJitc.J - -
CALCULATIONS:
ADDRESS; TRUSS DETAILS:
PARKING PLAN: _
PHONE:
LANDSCAPE PLAID:
2�`�-. �'7/ OTHER: ----—�i..
—------
COMMENTS:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
?,.r .C(o 10-432 00 Building Permit. Fees e� -YQ i'o C'010-431 00 Plumbing Permit Fees -� /� ._5'a
1.0-•431 01 Mechanical Permit Feas moo. s0 So
10 230 01 State Building l,// 0
ax %)
/
Building 5—Plumbing S 8 k
Mech d.OY
10--•433 00 Plans Check Fee 'S-0, /3 � � eI/3
Building
Plumbing
Mech _ _ /G. 3
fj —q 30-202 00 Sewer Connection —�
30-444 00 Sewer Inspection -35 3S"
51-449 OO Street System Dev Charme (SDC)
52-449 01 Parks t Gy stem Dev Charge (PDC) �,Sc Zsu
52-449 02 Parks II System Dev Charge (PDC) _-
31-450 00 Storm Drainag? Syst Dev Chrg (SSDC) .2 S p _So
10-230 09 TRFD
10-230 06 Washington County Fire #1 (95X)
10-220 00 Amart/Wedgewood
7F-1 W C�it 17
cc, c C TOTAL_ ,1•.. r.
REG # �Qo 7—
APPLICANTT SIGNATUP -
Received By: _4 Date Received:
ht/3587P/18P -
INSPECTION NOTICE
City of Tigard Building Department C
P.O. Box 23397
Tigard, Oregon 97?23
Phone: 639-4175
Ty-2- of Inspection GG
Date Requested S 0 C Time _ A.M. C P.M.
Address /,�/,.l 7 L C J C' LQ- 4-» Permit
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrvrted:
9CraWO0
---
C4 V_
Presented to ET
_ - -- __-- �I APprow,d
Inspector
—_ .--- - _----- � Di!3-pproved
_ — - --
Date `' '" 'j _
CALL FOR REINSPEC*ON
0 YES NO
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IN5PECTlO_N NOTICE
City of Tigard Building Department �r
P.Q. Box 23397
Tigard, Oregon 97223
Ptione. 639-4175
Typq of Inspection
[�_L- Time f_ A.M.— PA
Date Requested __._ n
�,1/ Permit #
Address i_ /4
Lot # —
Owner__ -
BuilderThe following Building Code deficiencies are required to be corrected:
Approved
Presentee) to —
Itiispector / _.__�
_ [+16 sapproved
Date -----
CALL POR EINSPECTION
Y18 ❑ NO
W W W
INSPECTION NOTICE
City of Tigard Building Department (✓�
P.O. Box 23397
Tigard, Oregon 97223
�( S Phone: 639-4175
Type of Inspection ' \` C L\U`1-
c? --
Date Requested— � - `1 `(J�7 Time __.___—_ A.M._V P.M.
Address L-21_:2 -7 _ 04C i. -C Ple-4 ►—J Permit #. � 2-
Owner . Lot #_
Builder .�_ 1C�Q�JC—'.� L3 / ' ---
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector ❑ Disapproved
Date
CALL FOI AINSPECTION
D YES 0 NO
car I� >•i car fad sir 1W fW
INSPECTION NOTICE
City of Tigard Bui:ding Department r,
P.O Box 23397
Tigard. Oregon 97223
Phone. 639-4176
P,
Tfpe of Inipection yy- '- - ---
Date Requested ' �- Time A.M. _P.M.
Address ,� �� i s � �L)7 C L -YPermit * Z '
Owner Lo+t
Builderi.!.
The fallowing Building Code deficienc are recared to be corrected:
iv
�*�j�c�--_�/'►cLw- --_----
UA 73?
14 41
Presented to ❑ Approved
Inspector _ Disapproved
Date ey --
CALL FOR REINSPECTION
❑ YES ❑ NO
i
INSPECTION NOTICE �ry-
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 C.
Phone: 639-4175/�
Type of Inspection �.T,��� '�� ".�
Date Requested z , �,� J Time-.A.M.---'V P.M.
Address Permit #
Ls
Owner Lot # '1 0qN
�1
Builder ( / i✓ f' /�� ,Z --The following Building Code deficiencies are required to be corrected:
Presented toy Approved
Inspector
Dlapproved
Date
CALL FOR REINSPECTION
❑ YES El NO
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 21797
Tigard. Oregon 97223
Phone: 8/394175
Type of Inspection _ --�"--"� �-"----
Date Requestedr—
_ Time" A.M. P.M.
//� _� Permit # -
AddressY�!...
' Lot
Owner__ -_.._� q / —
Buildek
The following Building Code deficiencies are required to be corrected:
-- I
Presented to- _ --- — t Approved
Disapproved
Inspector
DateCALL FOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE 01•.---
City of Tigard Building Department �}
P.O. Box 23397
Tigard, Oregon 97223
Phone:� 639-4,,175n 1� A
Type of Inspection � CU A YIC�'
Date Requested— /�,1— ITime_ __. A.M. P.M.
Address � ��� 7_ L _ Permit #_ ,
Owner Lot
Builder,2 -ttV*')�r
The following Building Code deficiencies are required to be corrected:
4�
_�
Presented to_J ❑ ZpaprpProvod
ed
Inspector ��d c -- _ _
Date
CALL P) EINSPECTION
YDS C7 NO
APPLI- ATION -- STREET IMPROVEMENT/EXCAVATIONF� COPY TO:
C�
LE
ORDINANCE NO. /4-14 ( •
(YELLO� ELLOW)-INSP
(INSTRUCTIONS ON S[PARATL SHEET) Q I ~—`❑ (PINK)-OTHER AGENCY
(BLUE)-APPLICANT
01011it
APPROVED APPLICATION NO.: . +z
NOT APPROVED f� CITY OF TIGARD, OREGON FEE AMT. S y �Z•`ter
PENDING FEE. PMT. ❑ CITY HALT, RECEIP;Tl*.: .y�-1
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY DATE�'
PENDING AGENCY ''OK" ❑ Applic.Ition and Progress Record
FOR STREET IMPROVEMENT/EXCAVATION MAIN SER QUIRFUBONyD�
PENDING INFORMATION ❑ �^"
A NN UA I. ❑
PENDING VARIANCE (J EXPIRAT[,ONDATE:
PERMIT NO.: - �_^ c�"��-'� DATE ISSUED: _1` _ 1�_� ��.-L".- BY,
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL +ti Allri/9,k
AS DESCRIBED HEREIN, IN FULL ACCUPI")ANCr: WITH CITY REQUIREMENTS.
APPLICANT' LL1._v 'I ' oiHl-tt rt4� J" 1�:1 1 rk. L115-Ye 71
NAM! ADDRES; CITU PHONE
CONTRACTOR
NA ADDRESS CITY A FHhNE
PLANS BY_ .AL�/ __
NAME ADDRESS i �� CI*Y HONE
ESTIM.ATF.D IMPROVEMENT TOTAL VALUATION ( COST): $
DOLLARS
FOR OFFICE USE: C'
(2) EXCAVATION DATA:
0.04 X s
STREET DESCRIPTION _ PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM d QUANTITY
STREET --,
—_ _ P N --
1NSPEC-
R TION
__— E
_ Q
ESTIMATED STREET OPENING UATE:_ J / / 4._S. ES
ESTIMATED STREET CLOSING DATE: /_ 1'� / r �_ E
�„_�' STREET
(3) SECURITY NO. --,_ SECURITYAMT,: �y�. _ CLOSED
SURETY CO.: _ `FINAL
CHecK CASH ❑ OoND INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL_ SPECIAL PROVISIONS J CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. \ / .4 ,
top #j. ILI foe
1 1
A// / 77
CURB �'(� ZAdjOl�� — — — — .. _. _.� _ _ ' a c'�+t- y �sde 4e
>
_ 1
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(5) NOTE THE CITY Or TIGARD DOES NOT, HERESY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE, OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CIT)' AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE , ���I-ilk. _� DATE_ / /
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard. Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested l� rr II,, Time. A.M. X P.M.
Address �r%� �, �l' lL�l� - Permit # `'
Owner_ / / 1 Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
izle��1<411 C-V-4-z
i
Presented to proved
Inspector / ❑ bitepproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
CITY O " T167A RD 4
CITYOFT14911111110 PEPMIT N(.) . ; 19tA381926
COMMUNITY DEVELOPMENT DEPARTMENT 0210001
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223.(503)639-4175 C�n D611i. 15SUED: 10/ 11 /88
JOB AODPF:SS : 12127 SW LINCOLN AVE-
TAX MAP/I OT PSI. 2AD SUB" L I F?K
I.-AND 1.151 .-
LOT SIZE: : VAI UATI ON; 581*710 SU FLAACKS
F'IQONT : 3 FJ Pl-".AW 1.
WORK CI ASS : NE:W DWEI-I... . UNITS : I I...EF'T: 23 PIGHT : El 0
1.15E 'T'YPE: : Csl:NGL.F: I:"AMXI..Y NO. BEDWOOM5 : 2 Ex*r .WALI... C'.ONS'T :
CXIINST . IYPI:_7 : VN NO. 14AI H!:i N: 5 : E: W
(XICUP OWFI . R3 PROT . UPLNINGS :
OCCUP . I UAD N F: W
TOTAI... APE:A : 1.268
N0. STO11- 1ES 1 1.'a T : I c*i 6 8 POUF' CONST : G F-I PE: PEET?
: 18 F2 N 1'.): AREA SE::PAR7 P ATE*D:
RA%EMF:NT7 3PD: OCX.AJF*- . SIL:PAP? PATE:D :
MI;_ZZAN I NF' 13ASI--.m' 'I
ITI 00P 1 Ool): (.;A1: 0Ga1: el 15 FJPE SPRKLIT? ALAPM?
F,LOW(C.PM) mn.-I-Eiz.-T"7
I*11,-,.FA I I I W177
I:*1_.0N CI-4ECK BY . I••.I t,
PF.MAIIKS :
PFISSUE: OF' NO . OH 1.521.
WLISSUL813 r.'!3.
0
NW GODWIN WI I...I_1:AM PERMIT'
111,3 10 . 00
E (31.'1.1 SW MAPLAO EA IF 51 PLAN Rk-EVIEW $40 00
F' YA.CARD E--IPr-_, DIEEPT
5TATE-'. TAX $15 . .5 0
C OTHE-N-1
0 Dir-EVE:1-OPMEEN'T C1rlAP(*.1I:..S .
N (30DWIN W11 L.1.AM SDC( STO WM)
T $250 . 00
F:*F:14NW000 OF.V I NG i D C,( S T A F.:F:T 11 $600 . 00
A 13ti.0 !.iW 'T,
P1:>(::(#t ) $250 . 00
T PPEKPAID < 11140 . 00>
0 1::'HONII:: 1150'311 RA5 9 6/1.
�iujl!._TPATION NO '192 L6 '113TAL: $3. 14P5 . 50
This permit is issued subject to the regulations contained in Title 14 PECA-E-IPT NO.
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it Is hereby PF-((j.jIPIt:A) INSPECTIONS
agreed that the work will be done In accordance with the plans and
specifications and in compliance with all applicable codes and SE WEP
ordinances The issuance of this permit does not waive restrictive WAI.A_ PAIN 1111-11AINS
covenants Contractor and subcontractors shall have current city P05 I & PLAM WAIE:P I_INF:
business tax permits. This permit will expire and become null and PI.-4 . UNDF:PSLAB
(TTY APPRCH/SW
void if work is not started within 180 days.or it work is suspended or
abandoned for a period of 180 days any time after work has SLAB abandoned NAI
commenced. It shall be the responsibility of the parmittee to assure PL8. T'OPOLIT
all required InsIliections are requested and approved F-PA M INC,
FT
GAS LINE::
IN51.)LATION
Permittee Signatijif GYP BOARD
Issued By
CAI 1 1: (71P .1 N5 r)uur I'nN ei'.vq._,ell.
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
MA'AIAN11 GAL. PKAMI: f
11H.1-M.l. I' NO . : MEBWMAI
CITY OF ����
RD CITYOFWARD
C.
COMMUNITY DEVELOPMENT DEPARTMENT off DA I I::' '1A, 1.0/11/68
13125 1 W Hall Blvd.,P.O.Box 23391,Tigard,Oregon 97223.(503)6394175 1::,1:4.1 M P M T NO (301926
1.21.27 SW L-INCOLN ()Vl-:
R51 PAB L.1 :R BK :
I VEM N(1 NO
Will!l< CL.A$S : NEW 1-1.)ANACAK 0.00K r. A144 HANDI-P <:I,.O
T'Yl.:-F- . 15INGLE F:'AM1L.Y VIMINACE 1.00K+ AIP 1-11ANDI-13 10K
N':) I I Y PE VN FLOUR 1::*(JRNA(:,E V:VAP (.,C)()Lr:::P
HIEATE:14 Vk:.NT F:*AN
VENI VE*N*I' , SYSI EM
BL.P/(:.'OMI:) <31-IP HOOD
!Y10PIEL) . 1. 3-45HP ]:NC:I:NF.*.WA*TC)F4(DL)M
1.)WFIA 1.1NJ: 1 ':; : I U11-0/l(U)MP 1.5-30HP I NG I NE.PATOP i COM
GAS UL.P/CoMP 30-50HP RE.PAJA4 LIN1150
MPUI Pl(:,(:)Ml:l 504-HP OTHEP
014PPS GAS l:*I:l.P:11N('., OUTI—ETS 1.
it i.cir rimmber
I.I D W CN W11 L.I AM PE PM1 It *10 , 00
W
N '31 1,0 11M MAl:4-E1..EAF,- ST PI-AN FIE"VIEM
E f I ON lF-:,1X1UAE S Ill 50
R Ito 'C (T.:: TAX
5 $2 . 03
(31 HI_.P
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PECE.J P Y' NO . /0/0 7
T hi� [1--rfnit IS ISSLJPd subject to the reguistions contained in'title 14
r
iif Itit, TMC State of Oregon Specialty Codes, zoning regulations J:N PE:-,-T -1(:)N.j
;-,n(i all other applicable codes and ordinances, and it is hereby GAS LJNE
a(jrpP(j inat the work will be done In accordance with the plans and
,.porlflcailons and in compliance with all applicable codes and VIOS V & FAFAM
—iiriance.% The issuance of this permit does not waive restrictive POLKA-11—.1 N
(,vvns,its Contractor and subcontractors shall have current city F INAL.
t,us!nF ss x permits This permit will expire and become null and
mi if work is riot started within 180 days,or if work is suspenL ad or
itmi,doriell for Ft period of 180 days any time after work has
,mi-ni-tirr,d It shall be the responsibility of the permittee to assure
ingpections are requested and approved
Prn„liter' Signature --
N«twd Ry T N Ll 1'!5-
SEPARATE
5-SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SE.WEH PF.541,11 T
CITY OF TIFA 'r,e1t, I'1 :Gti1:C'T' N(:) . : 451A30r.20/42
RD CITYOFTIFARID
COMMUNITY DEVELOPMENT DEPARTMENT 011100. :1.0/ 1 1 9(:)
13125 S W.Hall Blvd.,P O.B,)x 23397.Tigard.Oregon 97223.(503)639-4175
PMT . NO . 6113:1.926
J0FJ i-*iDDNF.5S 15W LAAGOLN o- VL-.: 1,11 Jr1iF+ I . 036471
1AX MAP,/1-0.I RW. tPAR SUB I I' - 2 SK :
LAND USE:
I-OT SIZE:
�A".C"TTUN: 2 MI"' . Om RNG, : 1.w
140AK CLASS : N(:-".W
I. TYPE; SIMLA:.: FAMIA.Y
The ml:)I:)JA(-.:41I1t 1,C) C.;c)mpl y wi 0-1 MA.:1. i-t.i 3.e% at ri cI r-e(jm'I.iati c)rim c)-I' tti". uiii-11A.VacI
Graweratg(a, 1.20 (1111.41s 111i'lain Lhf.,r cIRLtio ifolfil.le,(J . rural 10 t,13 t.01.1
allinal.111t I:)iltid WJAJ f.)e Tc)i-47e:I. I,ecI J -P the ;1r.-1r•tnit n:�xl:)iiesi . c1cie.p.; ricit yclarr
in.1-1 t,V 0 t1-1a Ac!C,t.t r ncy of t h orik I ci c!ot t i a i-i c)41 t.h t..-.) lo j.cl IF0. is*41 W o?r- :1.is to I,i it Ito I-F the lat.oweer i%
lint 11:1cloted alt t'llive giverl , LI'le :1 rinitacl Ier, usliao.J. I;ir,cj#np*ftC:t, a -Fev.-it iii
m.1.1 dti-cat.:!tAonio fr-mrli the givell . If f-l(air, in(:) the irlstall.er Hil-VIVAJ.
lit "I"lip allicl Sicle Liewror" Per,lnit akiicl tl*ioi Agil,.-!nr-,y at Ilitteral.
rym 81.)11 DING S-E-WEP I M V'EP V I OU S APE A
1:' 1�Tl J PE I IN I T 5 'Ir ENA"NT TMIPHOVEMENJ
OWE.L.I.-ING, UNITS I
NO. BI-E)GS . 1.
0 WIL.L.I.Am P E P M IT 111133 . 00
W
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E TICARD C)P 1 INE'. I'AP TWO(alL. .
R
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This permit Is issued subject to the regulations contained in Title 14 ».•»•»..
of the TMC, State of Oregon Specialty Codes.zoning regulations w.-Q1 I.NliplECTIONS
and all other applicaole codes and ordinances. and it is hereby ROUL.1-1—IN
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work Is not started within'180 days•or if work Is suspended or
abant;nned for a period of 180 days any time after work has
comm-inced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved.
Permittee Signature
Issued By: ..... L�4�1"' - 6
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OFT167ARD
CITY01IFTI6AND PEI:4M:I:'T' NO PLA3820,40
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223,(503)6394175 ISCA)ED '1 1. 1. (30
FIT M. PM I .IND F191772F)
JOR ADDAE-IbS : 1.21.2*7 SW I-AWOLN AVE.
FAX MAP/LOT 'PS-0. PAB SUD 1, L)K
I_ANI:) USE: :
1..01 nIZE
IT'E'M N('.) . NO
WOPK CLASS . NE:W WA'I*r-.*'1:4 CI-E)SET P 'T WAP
UE IYPEK : SINGL.E I-:*r)Mll Y 01111NAL 1:)I<r-:*l 0W I::'PVN'TW
CUN5'1' . '1'YPF.: VN I AV0PA1'UWY 4'.? IPAP 1.441MER
(:)CGUP. GPI'-`. : P13 si+.'W:.-.P 2 GPEASE *TPAPS
51-11WASHEP
(.'>.APRAGE- DISPOSAI
NO . 51'OPTIES : 1. WASI-CEW.,, M(-I(*,1-4*.I:NE'. I
DWELL .UNITS : 1. 1 A(.1NE)PY '1*14AY BI DG . Dl--4A'.I:N (DIA
FILDOW DPATN
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WA'T'r-.W 1--IF::A*T*F.::f4
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N 111111. 7 150
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S"I'All: 'T'AX
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This permit is issued subloct to the regulations contained In Title 14 NO . tv(/
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and
specification? ind In compliance with all applicable codes and P1 B .UNDE".P51 AB
ordinances The issuance of this permit does not waive restrictive 17,
h:AM
covenants Contractor and subcontractors shall have current city WA'TEP LINE
business tax permits. This permit will expire and become null and PL.0 . 1,01-10U1,
void if work is not started within 180 days,or If work Is suspended or PAIN DPAINS
abandoned fora period of 180 days any time after work has
commencet It shall be the responsibility of the permittee to assure FINAL
all required 7nspections are requested and approved
Permittee Signature
Issued By
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SEPARATE PERMITS REOUIPED FOR WORK OTHER THAN DESCRIBED ABOVE