12294 SW LANSDOWNE LANE 12294 `3W L.:nsdowne Ln.
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CEPTIFICATE Or
CirlOFTIOARD Cff YA�O-F�TMND OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT anew PERMIT #. . , . . . . : MGT900PG9
151258W HWI Mid RC Box 23397,TOW,Orft-9? ISMW"75 c4r
r'3sl TU..' ADDRESS. rW L.ANSDOWNE LN 2Slm3cB__0760@
ZONINGo
SLJBD I V 15 1()N. . . . a FYRFSTONE
BLOCK. . . . . . . . . . a LUT. . . . .
CLASS r)F WORIA. sNEW
TYPE OF JJ8F. . . :SF
OCCUPANCY GIRD. TR3
OCCL)PnNCY L.OADsE20 4
TV-.NANT NAME. . .
J. T. ROTH CON9TRUCTI-3N INC
P300 bW 69'rH nVE
IGARD OR 972cS
_l, T. ROTH CON GTRUCTION INC
I p300 514 69TH AVE
TIGARD Ol 9724..3
Phone #1 620 2(,=7
Reg #. . c 31700 sand uprtifies
oc-cupancy of thm above ref v ncpd bla0di.ng iq hereby give',,
'che complianct., with tl z3tAtO Of Oregon Sp.cialty Codes rat-, tho group,
0c.c-.up;jtjc,,yl and ut-r-, und;r which the Perm-it
way i�sueci.
SUIL'. I me I I
FIRE DEPARTMENT p
R/L D I NG At.
POST IN CONSPICUOUS PLACE
ais mw
A I!lFP T.E4►J 49
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City of Tigard Bu clding Departa nt
13125 BW Rall Blvd_ T-gard, Ore.yon 972:23
Inspection Line (Rec--o-Phone)t 639-4175 Busl.ness Phone; 639-417?
Inspection:_ ---
Tooting Plbg. Uneoralab Mech. Rough-in Appr/Sewlk
Fnund. Plbc+. Tor Out One Line !PINALt
B. -m Strutt. San. Sewer. Framing dq.,
Point/Bea-+ Mach. Rain Drain Insu!.ation t G/ -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -loch.
Date 9equeeteds �V -� Times 11N /,—PN
Addresss�/�, ?y -Permit #t
c�
Builders_
THE FOLLOWING OORR=CfIONS ARF REQUIRED:
D
i
Inspectors ra.te: -'-
y APPROVED DISAPPROVED APPROVED SUBJECT TO TROVE
■
11 For Reinsp.
et ew Bis waw ew a!
City of Ti p:d Building Department -F .ter
13125 SIR Be'A Blvd. Tigard, Crognn 97223
Inspection Line (Rec-O Phone): 639--4178 Buslness Phone: 639-4.71
Inspection:. __,__ ---- --------.--_
looting Plbg. Undc+rslab Mach. R, •:gh-in Appr/Sdwlk
lowd. Plbg. Top Out Gas Line FINAL:
Post/beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation
Plbg. Underfloor water L Gyp. Bd. -Koch.
Date Requested: r .-Timet AM __PM
Address:_ .4:2L J�"
.��[_ S :�Ldd.� pirmit
builders--�` �.L�+�-`` -- -- —
THE M; 143WING ()DRRRCYIUNS ARE RSQUIRY_D:
G7 i .ii��k
e _
01
inspector: .�..! _- Date:- —_! /-
PROVED -- `.ISAPPROVRD APPR�IVRD EL'2 TECT To ABOVE
/yam- Call For Roinsp.
A• s! ! asa nM *6^ mkmil .SOI
INSPECTION NOTICE
City of Tigard Building Department
13175 SH Ball Blvd. Ti, rd, Oregon 97223
Inspection Line (Rec-O--Phon : 634-4175 Business Phone: 639-4171
Inspection-,
Footing plbg. 1 4drsla) Merh. Rough-in Apps/sdwik
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Fuming -Bldg.
Post/Bs = Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line-7 Gyp. Bd. -Mek•h.
Date Requr iteds �/' / -�/ _Times -__ AM __,PM
Address- l L` -� �t� Permit
Builders
THE FOLLOWING CORRECTIONS ARE RNQ11JUDs
Inspect s_�� LL -..�'� ----- -- -- nates-Z�
APPRUVED D]SAPPROVF.D APPROVED St1JRCT TO ABOVE
- __Call For Reinap.
�r or ea an aw w ear eR a7- � �
INS'&4`fION ,NC/1'ICE ��/�/ �.•�
City sof Tigard Building Department
13125 TN Hall Blvd. Tigard, Oregon 972x3
Inspection Line (Ree-O-Phone): 639-4175 Business Phones 639-4171
Inspection: -- ---_ ----__ ----
Footing Plbg. Undarelab Hoch. Rough-in Appr/sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Seam strum -Bld. San. Sewer Framing 9•
- umb
Pout/Beam Hech Rain Drain IneulFAtion � P
Plbg. Underfloor `rWater,Line / Gyp. Bd. -Mach.
IJ/ l _ Time: AN
Date Requested: —PM
Address:% %_ / �a�7ts:��"/l-L� Permit t:,_�
Builder: ,A— — -
THE FOLLOWING CORRECTIONS ARE RRQUIREDs
t
Tin pprt nr' _._. Date:
nt I'rtrivF.r r.t:nrr'Nr)V?f APPROVED SUR.TECT TO AAOVE
ff .� Rnr Aninni�.
�K�BCI•ION I70TICF v��c-��
City of Tigard Built ng DMartwOnt
1317.5 S11 Hall Blvd. Tigard, Oregon 9722.3
Insper-tion Lina (Rec-0-Phone): 639-4175 Businne: Phone: 639-417.1
Inspection— .--
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Pl..by. Top Out Gas Line FINALt
-tcuct. San. E.ewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Line ��' Gyp. Bd. -Koch.
Date Requested: - Timet AKn ---PH
01
Address:���
Dui-lder.THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector:- i --- -- Dates-f---
APNtIY ED DISAPPROVED APPROVED SUBJECT '►J ABOVE
Call ftL' Reinep.
I
I4.
TI
�I
�i
IMSPECTION`IOTICE
City or Tigard Building Department
13125 BN Ball BlvO. Tigard, Oregon 97223
Inspection Lire (Rec•••O=Phone): 639=4175 Bunlness Phone: 639-4171 i 1
Inspbctinn: 8
Footing Plby. Underslab Hach. Rough-in Appr/Cdwlk
Found. Plbq. Top out Gas Line FINAL:
Poet/Beam Struct. n. Sewer Framinq -Bldg.
Post/Beam Hach. Rain Drain Insulation -Plumb.
Plbg. lJrderfloor Fater Lina Gyp. Bd. -Herm.
Date Roque oft d: V �/ Time: PM
Addreeq:_ � r n permit 1t C
Builder:
THE FOLLOWING OoRRErtIONS ARE REQUIRF,D:
Inspector: Datet
`J�� �^1
_APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainap.
NEW NEW se e:s es�ew w ser
City of Tigard Bui ding Depaitnont 1
13125 811 Hall Blvd. Tigard, Oregon 97223 f
Inspection Line (Rec-O-Phone): 639-4175 Huninene Phone: 639-41714
i./
Inspection: ---
Footing Plbg. Onderslab ech. Rouen Aper./8dwlk
Found. Plby. Top Out Bas Line PIMA..:
Pont/'Beam Sty °wt. Ban. sewer Framing -Bldg.
Poet/Ream Mewl° Rain Drain Insulation -Plumh,
Plbq. underfloor Water Line ITyp. Bd. y--Hoch.
Date aequestedt Z 7 / _ ---Times r "--AN PH
Address:_ .y ' / �; Z�i Permit 1 s �
Builder-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
SU�t�OTzT" �L�1c DU!7S
Inspector:- _ Date:-1 jz
j
i
APPROVED _— DISAPFRO'VSD -XPvwoVRD BURJECT To ABOVE
__Call For fteinsp.
r
Iw w w w w w w ■s :
city of Tigard Building i"Pftrt-ae'v,t
13125 SW Ball Blvd. figaLd, Oreqon 97223
Inapartion Lina (Pec-O-Phone)' 639--4175 nusii".;s Phone: 639-4171.
Inspection:_----,- ---
Footinq P113g. Underalab �Mech. liocgh-i0� Appr/Sdwlk
Found. Plb . Top Out Gaa Lina FINALE
Post/Beam Stcuct. San. Sawer Fr-.:ng -Bldg.
1
Post/Beam Mech. Rair Drain Innulation -Plumb.
Plbg. Underfloor WAter Lina Gyp. Ud. -Hoch.
Date Requested r--z_. It- Time'
Address'-Lem --/ l�L�� Permit #:
Buil-der'
'.ME FOLT-AIMINR MPRECTIONS ARE REQUIRED'
inspector! _---- Date'
r� APPROVED DISAPPR D J APPROVED SUBJECT TO ABOVE
/ ��1 tf �1`�� Call For Reinep.
WE
I�•SPECTIQN N7PICR
City of T/lard Buildl:tq Department
13125 BW !Tal Blvd. Tigarnl, Oregon 97223 ✓.
Inspection Line (Rec-O-P,one): 639-4175 Business Phone: 6397.4�11 ±'
''
Inspection:__ __ --
Tooting PLog. Underslab Mech. Rough-in Apr-/Sdwlk
Vouni. Pl.bg. Top Out Cas Line FINAL:
Por.,t/Beam Struct. San. Sewer Framing -Bldg.
Pcmt/3eam Me,,h Rain Drain Insulation -Plumb.
Plbg. Underfloor Water LineGyp. Bd. i -Koch.
DZ••, Requested! Timer _,Z-;_AM PN
� D� C . /ias�tt 1
Address: G?t
,� `��,(�� ...
Builder:
_ s
THE FOLLOWING CORRECTIONS ARE MQUIRED:
#/ �� . l,)
!LLIZ--
7� �7C; ?Z /
Ly CE
14
I�epector-� 1 _ Date
�1 C
APPROVED DISAPPROVED SUBJECT TO ABOVE
Call For Rei.nsp.
i
I
I
1
xner.�gIot,.�crr_1..�
city of Tigard suildieg Department o
13125 SW IV:I1 Slvd. Tigard, Oregon 97213 }�
Inspection Gine ,Rec-O-Phone): 639-4175 Business Phoney 629-41-fi; /
Inspection: ---^--_—� ---�-�___—__--
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plby. Top Out Gas Line FINAL:
?oat/Beam Struct. San. Sfrier `� Framl.ny -Bldg.
P. it/Ream Mech. Rain Disin Insulation > -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: � _Times __— hM
Address:_. _� �C-9?.��'L.�Jd?3�.Bacmit V.
THE lOL1.OWING CORRECTIONS ARE REQUIRED:
I
tnapzctor:_ ----- Date:
- -- APPROVED I1ISAFPROVRD APPP.OVED SUBJECT TO A(WVE
call Fo, 1,,einsp.
1N$��C�O�(�1OTICE
City of Tigard Building oeparts mt
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec--O one): 639-4175 Business Phone: 639-4I7I
_ �f
InRpeeti�n:--- — - `1 1 �� -----
Footing PG L'nderslab Mech. Rough-in Appr/Sdwlk
Fov.nd. P1`+q. Top Out Gas Line FI,IAL:
Post/Beam SLruct. San. Sewer ( Framing 1 -.Bldg.
1�
Poet/Beam Mech., Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. .Mech.
Date Requeete:l. —!T �a1M _—PM
Address:_ (/��L-L__ tr?Lc L.•SCLr�d12i.S
it
iSuildeU:
T,H�S/FOLLOWIIiO -ORkRCTIONS ARM REQUIRIP:
.��1= r���� �.(J�f(1�1� _��1�'��L Com.•1
Date: / —
i
_APPROVED ��- DISAPPROVED <-____&p2AovzD sUB.IRCf TO ABOVE
Call For Reinsp.
INSPE(Mlgg BICE
City of Tiyard Building Depart-Awnt
13125 BN Hall Blvd. Tigard, Oregon: 97123
Inspection Lina (Ree-O-Phone)s 639-4175 Bualneos Phones 639-4171
Inspections
Footing Plbg. Underelab Mach. Rough-in Nppr/Sdwlk
Found. Plbq. Top Out Gas Line FINALS
Pont/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plwob.
Plbg. Underfloor Water Line Gyp. Be. -Mach.
Date Requeateds Times :"�_AM _ PM
Address:_ C� ,?Amit f , 6
/
Buiiders _ —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspectors._ _ __----- Date: s
•..�- APPROVRD D23APPRovED APPROVED SUBJECT TO ABOVP, !�
/ Call For Ruinap.
w
IMPNCPIGM NOTICE
City of Tigard Bsild"q DelsartMIsot
13125 Bw Fall Blvd. Tigard. Oregon 97223
Inspection Lfr^_ (Ree-O-Ptgr-' . j9-4175 Business Phones 639-4171
Inspections_ _
Footing Plbq. Underelab Nech. Rough-in Appr/sdwlk
Found. Plbg. Top Out Cas Line rINALs
Post!Neam Etrurt. � > rrnming -Bldg.
Post/Beam Hoch. ain Drain Insulation -Plumb.
Pl.bq. Underfloor �IrJs� l Ovp. Bd. -Hoch.
Date Requneted: _Tina:
Address: ts_
Builder:�y
THE FOLLOWING s ')RRECTIONS ARE REQUIRED: p
Inspectors _ Date:
AFPROVEn DISAPPROVED APPROVED SUBJECT TO ABOVN
Call ror Rainsp.
_C rIT Am$�TLW
CITYOFTIGGARD PLUMPING PERMIT 0111111
COMMUNITY DEVELOPMENT DEPARTMENT 90N R D PERMIT a. . . . « . . : 111131*90 0269
13125 BIN 1141 Blvd. P.O.Box 23397,T;wud,Orr W 97223(6091934.4176 D(-)T'fi: ISSULAL 10/24/90,
SITE ADDRESS_ : 1.'(2294 SW L014SDOWNI: I N FIARCEL: 2S1133CD-07(,00
SUBDIVISION. . . . : 1=YF:F..'ST3NL:. ZONIW?,!
BLOCK. . . . . . . . . . It L0 T'.,
CLASS OF* WORK. . :NEW GARBAGE MOPIA E HOME SPACES.
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . :4 BACKFLOW PREVNTRS. . - 0
OCCUPANCY GRP. . %5N F'1.,OOR DRAINS. -.3 rRAr,s. . . . . . ..
STORIES. . . . . . . . : R WATER HEATERS. . . . . . : 12 CATCH BASINS. :45
I At.JNDRY 'rRAYS. . . . . . ..80 SF* RAIN DR01'1,1S. _ ,_ ::00
91 N I(S. . . . . . . . . . 13 URINALS. . . . . . . . . . . . . :1 C k A 9 E. "T R P F."G)
1.-PVATORTES. . . . . 1 2 OTHF.R FIX'T'URES.. . 5
T11B/SHOWL'RS., e3 SEWER LINE: (ft) . :6
WATER CLOSETS. . A 4 WATER L.TNL (ft) . -. 0 V.
DTSHWAc')HERS. eS RAIN DRAIN (ft) . .. . . :536 Oul 0
Remarks:
OWNERII F'E E S------------
ROTH CONSTRUCTION TNC F,0 11 $ 1.00.00 JLH 08/02/90 203322
:1.8.300 SW 69TH AVE PPR F t 470. 50
DPI...C $ 30 5. 83
T 1:CARD 0 R `3 7': B51-IC 23.53
r-.1hone #0 369--06.39 STDG ri 600.00
,.)SDC 375.00
PARK $ 5P 0.0 P1
• . MPFJ $ 37. 50
........... .... ........ MPL C 9. 38
add res M5PC 1. 68
............ .....
i t ..................._State: PPRT $ 155.00
1.p: -.—Phone f4 P5PC $ 7. 75
PAYM $ -11.:36. 37 JLH 09/2.2/90
R;CPI IIRED INSPECTIONS
fl, .J ,., Permit is issued Subject the req ..
! ot.ions contained in the, Tiqvivrd Municipal F'aot., found Insp Plumb 'Top Out
( ode. State (-.)f Or(-. Specialty Codes And all FOAt/fOLInd Insp Franjil'14 In4jp
,:)tlser applicab".e laws. All work will be done FOC)t/fOL(nd Insp Fireplace Insp
in accordance w-,.th approved plant. This F_00t/fOUnd Insp Gas 1-il-le '111sp
permit will expire if work. is not started Wtr Proofing Eism Insulation Insp
withiv, 180 days of isst.tAnce, or if work is PO%t/Peani Struct Gyp Board Insp
suspended for more k=han 180 days. Feast/Beam Meehan Rain drain Insp
Crawl Drain Water Line Insp
Plm/undslab Insp A p P T/S d W I k Insp
r,LM/Uriderf loar Mechanical F i n a J.
1"tn.4 Droin Bsmlt Plumb FA.nAl
----------- --- Mechanical 1,13p Ad d i t i onvA.)..
Plumbing Contractor Signature
oe cau. for il- spection 639-41.75
Ccm1.(',.ict(.-)r Notes:
................ .........
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection ,
Date Requested Time z P.M.
P.M.
Address JA&4'),C Permit
Ownew Lot
Builder
The following Building Code deficiencies are required to be corrected:
'7--
t1j L) eA
C
Presented toFl- -i,-p,ved
!nspector. Disapproved
Date
CALL FOR REINSPFCTION
F1 YES F—j NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 2.3397
Tigard, Oregon 97223
Phone: 639-4175
ZType of inspection i C
Date Requested �' IQ Tirn'e—6lez L.M. P.M.
°Address _i � l Q��j�iy � _ _ Permit 4'1—
Owner Lot fk
Builder
The following Building Code deficiencies are required to be correctec:
d /1C /AA—i ew
Presented to _ `:} Approved
Inspector
U Disapproved
Date
CALL FOR REINSPECTION
❑ YES ( J NO
INSPECTION NOTICE
V1'i City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested Time A.M.
Address — /�v`P �� �yZ!✓'
ti — u=2dL2 � Permit
Owner _ — Lot #
Builder
The following Building Code deficiencies are required to be corrected:
i
i
I
Presented to _ _
---_ Approved
Inspector g�–-- - �. Disapproved
Det9 ---
CALL FOR REINSPECTION
L 1 Yin ❑ No
CITYOFTIGARD
�' MAS'TE:R F�E:FiMI'T
C YOFTIA4RD PERMIT N. . . . . . . : MST90--0269
COMMUNITY DEVELOPMENT DEPARTMENT owaaaa PRIM. PERMIT N. : MS790••-O269
13125 SW HWI Blvd. P.O.Bac 23397,TOW,O►pa,9 DATE 1SSlJk::D: 09/24/90
�._.�
SIVE ADDRESS. . . : 12294 SW LANNOWNE: LN PARCEL: 2S1A:3C'B--O760L,'1
SUBDIVISI:ON. . . . .. FYRESTON'T' ZONING:
14LOCK. . . . . . . . . . I LOT*. . . . . . . . . . . . . : 1.0
-------------------------------- BUILDING —•_._.__._.....__.._ _. ._....._._._.._...._..._.—._...._.._
REISSUE: DWELLING UNITS:1 BASEME:NT. . » . ,. » .. .. :H s♦f
C:LAS.3 OF WORN.. :NEW DEDRM:"c i BATHS:J UARAGE. . » » . . . . . . :4:' 0 !sf
TYPE OF USE. . . :SF FLOOR AREAS---------- REQUIRED SETBACKS-----------
TYPE OF CONST . :5N F'IFiFF. » . . : 1280 s f LE:Fr. . u l2 ft; RIGHT. : 12 fl-,
OCCUPANCY GRP'. :R;3 SEC CND. . . : 1 r'56 s f FRONT. :21 ft REAFN . :80 f t:
STORIES. . . . . . . :2 THIRD. . . . :0 sf REQUIRE1, ------------------
HEIGHT
.._._.._.._.........._...._..._._._............... .
HE:IGHT'. . . . . . . :20 ft TOT AL•.•--•--•-:2530, s f SMOKE DETE CTORca. :Y
FLOOR LOAD. . . :40 p sf VALUE. . . . . 114612 PARKING SPACES. . :0
Remarks a
----------------- ---------------- PLUMBINt3
SINKS. . . . . . . .. . . n1 FLOOR DRAINS. . . . :0 BAC,KF•LOW PlRE-VN'TRS. . :0
LAVATORIES. . . . . :4 WATER HEATERS. . . :I TRAPS. . . . . . . . . . . . . . :0
rUB/,HOWFRS. . . . ::3 LAUNDRY '`RAYS. . . : ]. CATCH
WATER CLOSET•5. . :3 SEWER LINE (ft) . :O 6REiASE Trh►I�. .. .. . . . . no
DI:SHWASHERS. . . . it WATER LINE (ft) . : 1O0 OTHER F1X rUREE:S. .. . . . 0)
GARBAGE DISI'. . . : 1 RAJN DRAIN (ft) . :0
WASHING MACH— 0.: I. SF RAIN DRAI:NS. . : 1
--------------- MECHANICAL -------------- _......._.._ --.._._ ..__ ..... - FC::E1:i
FUEL TYPES----------- UNIT HTRS. . :0 type <amar.rnt lav nate re p•L
/GAS/ / / VENTS . . . . . :0 PAYM t :1 OO. 00 JL..H 08/02/90 203 322
MAX I NPUT c H PTU VE N T' FANS. . :3 BPR 7' 1; 470. 3
FLIEN ( 100K . . :0 HOODS. . . . . . : 1 BPLC 1+ 305. 83
F URN )=!90K . . : I WOODSTOVE.S. :O B''15P'C 1; (.-?,3. ,"j3 J /
FLOOR F•URN. . . . :0 CLU DF;YERS. a 1 STDC $ 600. 00
rcOTL../C:MP ( 3HP:0 OTHER UNITSvO SSDC $ ,37'x;»00 /
GAS OUTLETS a 1 PARK $ 250. 00
Owner: _ ----.-____._._. _._..._w__....__...__........_.____._-•- Mf-"RT $ 11 7. 50 / !
J . Y . RUTH CONSTRUCTION INC MPLC $ '4. 38
:I.P,300 SW 69TH AVE: 115F'C 1 1. 88
PPRT 15".00
T 1:14ARD OR 97223 I-'SFIC 1; 7. '15
Phone N: 369--2639 PAYM 2136.. 37 JLH 09i22/9O
I . T.Uontractors
ROTH CONSTRUCTION INC
I P.300 SW 69TH AVE
T :L(iORD OR 97223
Phone N: :369-•2639
Reg N. . v 31700
$ 22..46. ;3.7 TOTAL_
This permit is issued subject to the regu6 ons embi;,ed in Pm --••------ REQUIRED INSPFCTIONo -- -
Tigard Municipal Code, State of Ore. Spfc ilty Codes and all ocher Foot/found Insp Mechanical Insp
applicable laws. All work will hr. done in accoreance with ap�roved Wtr P•roofing Bsm Plumb Trap Out
plans. This permit will expire if wcrk is not starter within 188 Post/Beam Struct Feaminq Insp
days of issuance, or if work is suspect for more th 13B days. Post/Beam Mechan Fi•replace Insp
, /l Crawl Drain Ga Line Insp
Permittee Signaturet�{�'s�...� / .'" ....._._ .._.._.._.._......_ F'l.m/undslah In, Insulation Im 1
PLM/Underfloor Gyp Board Insp
issued BY: _.... . _. ._._. F t n g Drain P m' t: R a in d r a i.n l n r:.c.
L U
Uall for inspection -- 639-4175
CITY OF T'��RDS;EWER CONNECTION
r-,C R 11 I'T
10 P-ERMI T SWR90--0320
CCMMU41TY DEVELOPMENT DEPARTMENT 1'.)RIM. F,ER111T it. : 1,151'90 0269
13126 SIN HWI Blvd. P.O.'Amar 23397,T%pard,Orwm IFTM, ?b I)AI*L.*,. ISSUED: 09/24/90
AD' �ESS. FIARCEL: 25103D(.-- FS) 1 ' ,
f:i(jF,qI)IV., ZONINGs
11!'NANT NAME.
IJSP, NO. . . . . . . . . . 4-2 388 FIX",'URE (JNI'TS. . . 9
1:1-0613 GF WORK. . . -.NEW DWELLING LJNITS- 91
Tyr:,E.- (IF USE. . . . . S I:-- NO. OF BUILDINGS21
T N S I'A L.L T,Y 11'.. . 14(j5WR IMI:'ERY SIJRFACE., :Sf
e III a F,k 1r,
FEES
J . T . ROI'H CONS I*RUI'T I('.IN T.NC, type anint.ti-it by date -v e pt:
2,300 W 69'T H AVE P,R VI'T 1500. 00
114SG�l 35.00
HGARD (IR 97223 F-10YM J.535. 00 JL.H 09 22/`30
169 P.639
R0114 CONS I*RUCT I ON INC
1.2300 SW 691*H AVE
T-D.10RD OR 97223
369-2639 1.` 35. 00 'I'MAL
31700 REQUIRED TNSF,ECrIIONS
This Wiplirant agrees to comply with all the rule; and regulations Sewe-r
of the Unified Sewage Agency. The permit expires iig days from
the dale issued. The total amount oaid will be forfeJed if the
permit expires. The Agenoy does not guarantee the accuracy of the
side sev,,r laterals. if the sewer is not located at the measurement ___._.,.__,••-•,__ -------
given, the insti.Aer shall prospect 3 feet in ali directions from _.,,•„__,__._,____.._.....,___,,,,.
the distance PaYen. If not so located, the installer shall Purchase ..................
a "Tap and Side Sewer” Permit and tire Agency will install a lateral.
I-',o-r-ni i t t e e S i. ...............
1x;st.wd Pyx
Call fo-r 1.1v-
t i c)vi 639--41.75
I
"ITY OF TIGAF1 D RECC:TPT OC" PAYMENT RECEIPT NO. :90w•205(.197
CHECK AMOUNT : 3671.317
NAML, r J.T. ROTH CON 3TRucTICIN t AGA AMOUNT : C1.00 +
,�.VDPECO : :12300 SW c•9'CF F'A`iME=NT VATS n C19/v4/17—0
3UPDIVI?:ION x I
TIGARD, OR 9'7'2:•: 121194 183W LANSDOWNE
)E OF PAYMENT APIOUMT PAID PURPOSE OF PAYMENT AMOUNT PAID
Dllll_DIN5 PERM MST'90-026"'i - 470,;C1 F'l-UMHING PERM _..155.00
MECHANICAL PE :X"7'.50 ;:i T. BUILD PER 33.16
!'LAN CHECK FE 215.21 SEWER U; A 1500.00
3E::WE R INSPECT 35.00 STREET SVC 600.00 i
PARv's !3DG 5cl.►70 STORM DRAIN SDC .3^15i.0t► I.
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} 'FO TAL AM(.)UNT PAID - -' 3671.37 f
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CITY OF TIGARD RECEIPT' OP F'AYMENT RECEIPT NO. !9Q -20
c HUI< AMOUNT
NWE ! ', . T. ROTH CONSTRUCTION CASH AMOUNT ! Ct.C►r,,
At DPES', a 1 270() SW 69 TI-1
PrAYN1ENT DATE
SUED I V IS I ON !
T I C?PF,D, OR 972 .-- 1.2294 SW AN'S DOWW:
PI.1P,POSE or PAYMENT AMOUNT PAI'" PUFF'OSE• OF" PAYMENT AMOLjNT Pry I Ci
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AMOI.INT PAIp
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PLAN GkrX APPId ON
�ITY OF' T167AIRD � ��'�s 7 PLAN � ��,� -
rM 639417/ PERKpr ,
OMMUNITY DEVELOPMENT DEPARTMENT DAZE ISSUED _
J�lv� /�D.I�S�Q✓ Gi✓ — I= MAP/Jor -2 1 - 0 L --
.1013 A[.IDRESS. ..�(.L1_l 1 IAMLb'E: --
IDT:
VAI VMCN: 5„�a S 7►rFS
RETS.SQE OF:
L -y IAST I*XS=:
FLOW PUUN/
SEHSrITVE IAM:
ITtfME: .���- 2!3'I APPRdV11IS
1RACPIXt PLANHIM: -
N11t4E: T r /W)vrf 3. 1,2 Z, ENMHEERM:
AICI FSS: FM Wr
gym:
ir�trxtE• �,�-���: � rr�cs �y�
t3[JIIDFFS BOARD if: 3i 7�v OATJ~: ��'1.`lam L �Tf
Bos TM:
t at t fj'3'S�G��LCAICH-MCHS: —
NAME: i7.+�ijly S�wTRUSS DEI'lMS:
J11 17 17 Z-1-i
- . PUM-- ilrs moi: 2
SUBOWIRACTaLSPEF41rr / NXT # 1 ' k4bL JT PD. BAL. DUE
10�-432 00 Buri.
i ,v Permit Fees � O, 5 _ 170 ,s o
._ . 170 -so
�
1' f 10- 131 00 YluNbi.ng Permit Fees ✓, 7.
(
--�--- 10-431 01 Medtianical Permit Fres
- 10-230 01 state Wilding Tax (5%)
Building
Plumbing 7 S
Fiech ► i � .
10-433 00 Plans Check Fee
Building
Plumbing _
Medi _ 'i . L
,y R- v-v do 30-202 00 sewer Ooru>fecti.on n v -�-G U
30-444 00 Sewer Ir'st a tion ---sus
51-448 00 Street a'1►S Dev Chaim (SDC)
52-449 00 Parks Syst cm Dev CtW-'gc' (PDC)
31-450 00 Amm rJrainage- Syst Dev Cirq (.SaC) 7 '-
10-230 06 Fere
rum 2W1 37 /0 ,3�e11I
At'FI,IU�AIr SIGH t RE
nsceived fly: Date naoeived:
of/3587P.WPF
GRADING/EROSION h�1TROL INIAiRMATION
GENERAL CONTRACTOR NAME&ADDRESS: CASEFILE NO.:
PERMIT NO.:
i
J"'!' •a
u7—
),I L; APPLICANT NAME.AND ADDRESS:
EXCAVATION CONTRACTOR
NAME&ADDRESS:
OWNER NAME AND ADDRESS:
TELEPHONE NUMBER$:
APPLICANT ,: r (J J ' PROPERTY DESCRIPTION:
OWNER- STREET ADDRESS AND CROSS ST REETJ OCAT'ED
GENERAL CONTRACTOR:
EXCAVATION CONTRACTOR: — —
SIT 4jGB: J�'-i 6`�
LEGAL DESCkIPTiON:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO:,_ _
CON'J'ACT PER�SQN,TTT'i --,TELEPHONE: 1/4 SECTION_ _
y,.;,�'
SITE SIZE,ACRES:
DISTI T,.ilED/WOR.K AREA.ACRES:
LOCATION&ADDRESS WHERE SPCU S
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAWS TO.(CIRCL•Fi9Nt:�
(NOTE:PERMITS MAY HE REQUIRED) CATCH-BASIN DT, H PIPE tVfEK .,
— (CIRCLE ONE) PRIVATE PROPERTY
PUBLIC R1'Gt"F VVky
EROSION/SEDIMENTITI ` ICoNTROL (ESQ MEASUR,
MINIMUM ESC.REQUIREMENTS MINIMUM ESC REQUIREMENTS
DURING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIMETER RUNOFF CONTROL FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES
CONSTRUCTION SEQUENCr. OTHER
OTHER_ _ --
PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH'TECHMCAL.GUIDANCE HANDBOOK-.
EROSION C`7NTROL PLAN DRAWING.AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE.INCLUDING EMERGENCY
PHONE NUMBER, SCHEDULE/STAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES.AND
APPLIC4BLE STANDARD NOTES.
I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE.
ER SIGNATURE APPLICANT SIGNATURE
• • • • • • • • • • • f • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • J • • • •
OFFICIAL IISE ONLY.
RECEIPT DATE ACCEPTED
FEE NUMBER — RECEIVED_ BY