8283 SW LANGTREE STREET-1 Ii
I
I
8283 SW Lanc;tree St _
CERTIFICATE OF'
CITY OFTIGrARD OCCUPANCY
COMMUNITY DEVELOPMENT DF.PA RD) VIE R141 T #. . . . . . . i MST90 -0066
131268W FWl"W. P.O.Box 23397,n9 d,0moon 020
DATE ISSUEDs 03/19/91
`l I TE ADDRES15, 6,203 SW LHNG]'REL I PARCELI
LANGTRFE ESTATES ZONINGo R- 12
. . . . . . . . . .
CLASS OFWORK. uNEW
TYPF OF USE. . . 03F
-')CCLJP-*)N':y ORP. SR3
(IG-UPANCY LOAD iP20 4
TENANT iAW*-:.
Remarks
TITAN PHOPLRTIE'S
PQ BOK 6035
i)LOHA OR 97007
('hurls Oc 6455477
Contractors
11TAN PROPERTIES
00 BOX 11835
OL011A OR "7007
Fllonf, #- f,45647*7
Occupanfy of the mbove t-safei,enced building is hereby giver), and c-'ertifle-
the compliance with, the estate (If Ot,pgon Specialty Co(-jas for this gi,oup,
of-,CIAUJAnCY, and USP under- which the referenced ppr-mit w-45 issued.
!-- !P.E DEPARTMENT BLIIL�D-
POf;T IN CONSPICUOUS Pl-prE
e8 ew n aaa � fJ asr �'
I1S¢pj4'TION NO'�SCF
City of Ttgard Building Department
13125 SM Kali Blvd. Tigard, Oregon 9713
Inspection Line (Rec-O••Phone): 6339-4175 Busine•.s Phones 639-4171
Inspection:------ ---------�IVYLC
Tooting Plbg. Underelab Mech. Rough-in Appr/Sdw.lk
Found. Plbg. Top Out. Gas Line PINALt
Post/Seam Struct. Sen. Sewer. Framing -Ridq.
Post/Ream Mech. Rain gain Insulation -Pli•,nb.
Plhg. Underfloor Nater Line Gyp. Rd. -Meeh.
Date Requested:__ ' `� ~�1 :ime: AM PM Y
Addreee: � 77+ lG� � _ Permit #:
r.
Buildes_�� `C4)
THE FOLLOWING CORRECTIONS ARE F 'QUIPAD:
- ---------------
Inspector: / /% (
APPROVED DISAPPROM APPROVED SUBJECT To ASOVE
Call For Reinep.
jNSPiCTIgr torIcE
City "f Tigard Ruildirg Department
6 13125 !D! Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rer -O-Phone: 639-4'75 Business Phonon 639--4171
1 nspect tor,z
Footin9 Plbg. Underslab Mech. Rough-in Appr/Sdw1k
Found. lby. Top Out Cas Line lINAL�
Post/Beam Struct. St.n. Sewer Framing ,Eldy.
Post/Beam Mech. Rain Drain 1tauIAtion -Plumb'
Ir ',v Underfloor Nater Line Gyp. 3d. _Meeh,
:aquestediC1 ` (�� _/�/. AM __PM
Address:_ 1 Q c
LA`- \� 1�-1q `-- Permit-
Builders
ermitBuilders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inapuctorc Dates
—,:Z�PPROVRD DISAPPROVED — APPROVED SUBJECT TO ABOVE
_Call For Relnsp.
w t� w r� sle
118 ECTION NOTICE ju
`
City or Tigard etull.ding Depertstent"
13]25 SW Hall el.�:. Tigard, Oregon 97223
Insper_ -3n Line (Rec-O-Phone): 639-4175 Busineau Phone: 639-417.1
Inspections— �— -----_--� --- -__--,`-
Footing Plbq. Underelab Meech. Rough-in Appr/Sdwlk
Found. Pl.bg. Top Out Gas Line /INAL&
Post/Beam Struct. San.. ;newer Framing -41dq." 1
Post/Bela Mech. Rain Drain Insulation -Plumb.
Plby. Underrloor water Line Gyp. Bd.
Date Requested& TLgwt _AM PM
►.ldresst Permit #t
Builders
THE FOLLOWING CORRECTIONS Akz REQUIRED:
Inapertnr: ' Dates
L
APPROVED //DISAPPROVED _ APr nVED SUBJECT To ABOVE
—_—Call For Reinap.
City of Tigard Building Departs+nt
13125 Bll,all Blvd. Tigard, Oregon 97223
Inspection Line (RAc Phone): 639-4175 Business Phone: 639-4171
Inspection: _ (
Fasting /ibg. Underalob Mach. Rough-ir. r/� Bdwlk)
Pound. Plbg. Top Out Gas Linw FINAL:
Post/Ream Struct. Ban. Bower Framing -Bldg.
Post/Ream Mech. Rain Drain Insulation -Plumb. C
Plbg. Underfloor Nater Lina Gyp. Bd. -Mach.
Date Reyuesteds / Timet AM�y�// PM
Adureses
Builder:
THE FOLLOWING COI RECTIONS ARE REQUIRED:
i
Ar
C�eel. iz�e4t
b
Inspectors
Li
APPROVSA DISAPPROVRD APPROVED SUBJECT M ABOVF,
_ _Call. For Reinsp.
INSP_�rT�ON o CE
City of Tigard Building Department ✓-
1.3125 8V Rall Blvd. Tigard, Oregon 97223
Inerection Line (Rec-O-Phone)e 639-4175 Bunineee Phone: 6391, 1
Inspectionc— ------- ---------- -------- .,.__ _
Footing Plbg. Underulab He^h. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINALS
Poet/Beam 5truct. San. Sewer. Framing -Bldg.
Poet/Beam Mach. Rain Drain Innulation Plumb.'
Plbg. Underfloor Water Line Gyp. Bd. --Hoch.
"s _
Date Requested: z5 ---.—Times AM /PH
Address: L r �l� PQrmit #:
gm
Builler: 1111e
�
TRW FOLLOWING CORRuL'TIONS ARE REQUIRED.-
j
Inspectors Date 1q .
PROVED DISAPPRO`fED APPROVED SUBJECT TO ABOVE A
Call For Relnep.
w w w w w w w
P
INSPY�,iEkil NOTICE 7
City of Tigard Ewllding Departaent j / �/✓/
13125 BM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: --_-- ---� ---- --
looting Plbg. Underalsh Mach. Rough-in Appr/8dwlk
Round. Plbg. Top Out. Cas line lIKALr
Post/Beam Struct. San. Sewer Praming -Bldg.
Poet/Beam Mach. Ra Ln Drain Insulation -Plumb.
Plbg. Underfloor Water Line Oyp. Dd. -Koch.
Date Requestals_ 1V-< Timet AM PK
Addreser Permit ys
r,
Bu i 1 der r
-HR FOLLOWING CORRECTIONS ARE REQUIREDr
T -
InLpector:_ � _,.--�_— —_--_ Date:.��— 4/
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call Pot Reinep.
m4rxc-P Lq—N-(MLqj
City of Tigard Building D"wrtwent `
13125 Alf B011 Blvd. Tigard, Oregon 9722.1
Inspec aon Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspeatlon:
Footing Pl.bg. Underslab + Mech. Rough-in 11ppr/Sdwlk
Found. Plbg. Top Out Gas Line FIYALt
Post/Beam Struct. San. Sewer Flaming -Bldg.
Post/Beam Meeh. Rain Drain Insulation _plumb.
P.lbg. Underfloor Nater Line Gyp. Bd. �,�--H�o�ch.
Gate Requestedt_�1/ --1Timet dv- AH /-/ PM
Addresat �' t_/t_{t � Permit t tm✓`��(Q!o
Buildett
THR FOLLOWING COMMONS ,MU RBQUIRZDt
inspector.
Date:
APPAOVRD DISAPPROVRD APPROVRD SUB.IECT TO ABOVR
Call For Rainsp.
�IECTION�loT�c>s
City of Tigard Building Departsrin'.
13125 811 Hall Blvd. Tigard, Oregon x7223
Inspection Line (Roc-O-Phoue): 639-4175 Busineee Phonon 639-4171
Footing Pl.bg. nnderslab Mecli. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Pont/Beam st.ruct. San. Se'aer Framing -Bldg.
Post/Noam Mach. Rain Drain (�Ineula'ti on -Plumb.
Plbg. Underfloor water Line — 13yp. Bd. -Neth.
Date Requesteds _z _�(�^ -_.--Tim= AM PN
Add-one s a ►J Permit
F,uilder: _--� ---- -
THE ror.LONING CORRECTIONS ARE REQUIRED:
IF
Inepectors
APPROVED _ DISAPPROVED APPRMMD SUBJECT To ABOVE
Call For Reinep.
}Ks; EO" CF.
City of Tigard Building Departaant
13125 an Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rac-O-Phone): 639-4175 Business Phonalutk'1
Taspecti.ons— - _^--- — -----_r..
Footing Plbg. Undarslab Mach. Rough-in Appr/Sdw1k
Found. P1bq. Top Out Gas Lina FIMALt
Pont/Beam Struct. San. Sewer Framing .-Bldg.
Pant/Beam Mach. Rain Drain 6nsulation -Plumb.
Plbq. Underfloor Water Line Oyp. Bd. -Mach.
Dat-P RequestedtG -` Tuna= AM _K _PM
Permit 2 IC-1L
Ac1�lrapa: � G J,(�'4
RuIIder:
_ ^—
THF, FOLLOWING CORRECTIONS ARE REQUIREDs
Dates, 1 U / P
t4
_�PP}r(,VF11 DTSAPPRnVED APPROVED SUB.TECT TO ABOVE
t 11 !'or Relopp.
Citi or Tigard Building Departaent
131.25 SII Hall Blvd. Tigard, Oregon 97223
I:nspaction Line (Rec-O-Phone): 63Q-41"5 Business Phortes 4171
Inspe flan:_ -------- ----- ----- _'
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Pound.. Plbg. Top Out Gas Line PINALs
Poet/Ream Strutt. San. Sewer /�lraminq -Bldg.
Post/Beam Mech. Rair. Drain Insulation -plumb.
Plbg. Undsrtloor Water Line Gyp. Rd. -Hoch.
!late Requeateas_ �7 � limes __-AN PN
Address:_._ .Permit U
Builder: ___-
T..n FOLLOWING CORRECTIONS ARE REQUIPRO:
Inspectors----�.._` _— __ Dates1
1T APPROVED DISAPPROVED - APPROVED SUBJECT TO ABOVE
Call 'ior Reinep.
0fi2%C_TjPjL NOTIGF
City of Tigard Building Departaent
13125 SM Bahl Blvd. Tigard, Greg,n 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ions __—____ -------
Footing
Footing Plbg. Under.slab Mech. Rouge Appr/Sdwl.k
Found. P1.bg. Tcp Out Oae Line FINALS
Poet/Ream Struct. San. Sever Framing -B g•
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requestedt/r_- Time: PM
Addreens O /7
Ruilder:Ya�
THE FULI.OWINti CORRECTIONS ARE REQUIREDt
Inspector:_---- -_ Date.-
Uv
ate:
OVED DISAPPROVRO APPROVED SUBJECT TO ABOVE
Call For Rei.nsp.
.� s w w as >,w wir •a ar sae
City of Tigard Building Dopnrtsmnit \
13125 SIX Hall Blvd. Tigard, Oregon 97223 \ /
Inspection Line (Rec-O-Phoned 639--4175 Business Phono: 6341-4111
Inspection:_-,_ -----
Footing Plbq. Underslab Mach. Ruurh-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
poet/Beam Struct. San. Sewer ��C1ran:int7 -Bldg.
poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor. Nater Line Gyp. Rd. -Koch.
Date Requestedds Times - AM / /—PM
Address:_ t/ Permit fs�t� Qf�(�l�
67
Builder• ----
THE FOLLOWING rORRECTIONS ARE REQUIREDs
i
Inspectors
ROVEDSAPPR APPROVRD SUBJECT TO ABOVE
Call For Rainop.
INSPNCPIQN NOTI(lg //�j `
City of Tigard Building Departmeet' �Y `
13I25 SII Hall. Blued. Tigard, Oregon 97223 ��7
Inspection Line (Rec-0-Phone)t 639-4175 Business Piton,: 39-4171
Inspection:_
Footiig Plbg. Underml.ab1 Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas tne FINALS
Post/BEam struct. San. Sewer Framing -Bldg.
Poet/Beam Hrch. Rein Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date RequeLs�teds_ L�/ �.� Times AM /J_ PM
Addreee t 02- A,7 'SLTA�N/AL1 �C l Permit i t
Ru i lder t �r L4 —lF ( �
THE FOLLOWING OORRECTIONS ARE REQUII1EDt
Alc
Datet1L_��
tTSAPPROVED APPROVED SUBJECT TO ABOVE
— .all !'or Reinep.
INaPBCTION NO'PICS � '�
city or Tigard Building Depa:t—t �`
13125 aw Ball Blvd. Tigard, oregon 97223 ��
Inspection Line (Rec-o-Phone)t 6Z9-4175 Business Phoff 639-4171
Inspections —---"
Footing Plbg. Underslab Koch. Rouqh-in Appr/Sdwlk
round. Plbg. Top Out Gas Line FINALt
poet/Beam 8truct. San. Sewer _ rraminq l -Bldg.
--ming
Post/p__ Hach. Rain Drain Insulation .-Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Neck.
Date Requestedt �� _.-___Timet ��C_AN �_PH
Addreut � Permit #t d -OC'�f'
Builders a
THE rOLi.OMING ODRRBCTIONB ARB RBQU
Inspector: ��,{c Deter:--_������ 7/ 1
APPROVED V-, DISAPPROVED APPROVED SUBJECT TO ABOVF.
Cell For Reinsp.
ae ■m s. �r aar es mw ew
INaPECTION NOTICE
City of Tigard Building Departaamt
13125 an gall Bled. Tigard, Oregon 97223
Inspection Line (Rea-O-Phone): 639-4175 Business Phones 639-4171
Inapection:
Footing PUM. Un"celab Mach. Rough-in Appr/Sdwlk
Found. ,visp. ftp Out' Gas Line FINALt
Poet/Beam Struct. Ban. Sewer Framing -Bldg.
POst/Bear Hoch. Rain Drain Insulation -ply.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested: �_� - G•��L' Tues --Am ,(
Addreae:__ '< '� Permit
i
Builder:
THE FOLLOWING OORRRCTIONB ARE REQUIRED:
r
i
Date I/
X__-APPROVED DISAPPROVED
--- APPROVED SUBJECT TO ABOVE
--__Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon W1223
Phone: 639-075 l
Type of Inspection
Date Requested_ _1_l1_-A -- ';�f _ Time A.M.__ P.M.
Address - Permit #A�_r�..lPl
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to --- _ -_-- - __ . Approved
Inspector __- _ Disapproved
Date,
CALL FOR REINSPECUON
Cl YES I l NO
INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23397
Tigard, Oregon 97223
Phone. 639-4175
Type of Inspection -C.'"�'"L ' �� LAG►.. , _ L1 CcG�,,CGt� {
Date Requested__—L--"4 7 `�� Tinn-- — A.M. P.M.
Address Permit tom.
Owner --_
Lot` �['J-�v -2
Builder ------
The following Building Code deficiencies are required to be corrected:
Presented to _ _ ------ —--_ Approved
Inspector
- -- I Disapproved
Date
CALL FOR REINSPECTION
FY.8 [� NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection VL�____ --- -
- -
Date Requested 4 —_ Time �- AM P.M.
Address �-u- _ Permit
-_.:ate ------
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to - -------- XApproved
Inspector _ __ ---_-_--_.-- Disapproved
Date -
C LL O REINSPECTION
YEa l-1 NO
mm
ENERPROUR
MASTER PERMIT
CITYOFTIGrARD 11ST90 006c,
WYOFrIMID FIRIM. PL'RMJJ 14. - IIIST900066
COMMUNITY DEVELOPMENT DEPARTMEW 400100H DATF.:: ISSULDA 09/12/90
13126 SW HWI Blvd. P.O.Bm 23307.nolud,OmQ0n 9=(64 6394"1
a,"
111, ADDRESS. . . : 8283 SW LANGTREE ST PARCUL: 2SI12cc H ,Ip
'11!DDIVISION. . . . - LONGTREL ZONING:
H 1.0 C I/. . . . . . . . . . . LOT. . . . . . . . . . . . . S41
S f-3 U E a 22'2 /GA DWELLING L;I11TTSjj3 BASEMENT. . . . . . . . 10 4 s
(A..ASS) OF* WORK. :Nl*.-.-.W BEDRMSc3 B A'T 141.3. I GARAGE. . . . . . . . . . 1000.1.0 S
I Y P 1:;, OF' USE. . . ISF FLOOR REPUIRED SETBACKS
TYPE'_ OF' CONST. :5N F:J R ST. 11. 6 isf LEFT. . :52 ft RIGHT. 103 ft
C)(;CAJPANCY GRP. :R3 SECOND. . . :40 Sf FRONT. v@Y ft REAR. . a87ft
T OR I EG. . . . . . . IP THIRD. . . .. tO 1.3 of REUU I
IIL IG 1A I.. . . . . . . . 120 ft TOTAL--------:51 Sf SMOKE DETECTORS. 92
F I..DOR LOAD. . . . a4@ psf VALUE'. . . . ' $ : 63942 PARK ING SPACES. I
PLUMBING
. . . . . . . . . . ..2 FLOOR DRr4INS. . . . :0 BACKFLOW PREVNTRS. . :
I 0VATORIES. . . . . ..3J. WATER [#EATERS. . . 11, TRAPS. . . . . . . . . . . . . . I
r(JI'VSHOWERS. . . . .. 1.1 LAUNDRI' TRAYS. - - -0 CATCH
W n'TFE.R C L 0 S ETS., . -.0 SLWLR LINE (ft) . :00 GREASE TRAPS.
1)1,5 HWASHERS. . . . 11.0 WAT'F7R L (ft) .
IN.7 0 T H E R F*I XT U R F 0
GORBAGE DISP. :0 RAIN DRAIN (ft) . » 1.0
1J01 HING MACH. . . SF- PAIN DRAINS. . .
FrE.S
UNIT HTRS. . -0 type AMOU11t by date -r,e c,p
VENTS . . . . . :.3 1 PAYM $ 40. 00 JLH 02/1.6/90
140X INVIUT:0100 BTU VENT F'AN'S. . -01 F-'R 11 T 3 25. 0 0
1' 'JRN < 180K a . 10 HOODS. . . . . . »0 PLCK 40. 00
11JRN )=108K aolS WOODSTOVES. % 5FICT 16. F?1-.5
V LOOR FURN. . . . I CLO DRYERS. a STDG $ 600. 014
POIL/CMP ( 3HPI OTHER UNITS.- I. SSDC $ 250. 00
GAS OUTLETSs3 PAI"K It, 250. 00
PRM T $ ;36. 00
T IJON PROPERTIES PLCK $ 9. 00
P() BOX 6835 FjPCT $ 1. 80
MISC $ 1.51, 00
cir.OHA OR 9700*1 5PCT $ 6.63
i 1.1nine14% 6455477 P R MT $ 132. 50
c)ri i,r a e t a,r t ---- .......... 1:'A Y M $ '250. 00 J1 14 06/i-?8/90
T[ j()N PROPERTIES PAYM $ 1392. 18 JLH 09/10/90
1,0 B(.)X C',835
0 1 (AIAA OR 97007
I.,horie #: 64564/1
#. . c 30558
$ 1682. 1.8 TOTAL
This persit to issued subiect to the regulations contained in the REQUIRED INSPE*CTIONS
Tigard Munirinal Code, State of Ore. Specialty Codes and all other Focit/fot.mcl Insp VILM/Ui-ide-rf loo-r
applicable laws. All work will be done in accordance with approved F'OOt/'fOL(vid Insp FILM/Uride-rf laci-r
plans. This persit will expire if work is not started within 188 Past/Beam Insp meet) 'Iiical. 111"r.)
days of issuance, or if work is cusp 160 days. Past/Beam Insp Mechanical Insp(::raw(::raw].1Awl. DrainPlt.tmb 'TOP UUt
,
Permittee Siq11iAtk.Vf1P C-r Awl Dy,ain Plumb TOP OtAt
PIM/Uncislab I n!".p F'-raming Insp
I 1:: ct e d Py: FlIm/t(ndslab Insp FrtAmi rig Insp
[,,A11. for iiispPeticm -- 6;37 417 5
ITY OF TIGARD RECEIPT OF PAYMENT RECEIPT NO. a 90....0466 4
CHECK AMOUNT t 1392. 18
NAME a TITAN PROPERT its CASH AMOUNT a o.00
ADDRESS a PAYMENT DATE a 07/12/90
suall I V I IS I ON
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OV PAYMENT AMOUNT PAID
H6 iTET Nc—, F_CRW 9 t i- o o h 6-- 3-2-5._0 0 PLUMBING PEPM 132.130
IlEf,',HANICAL PE 36.00 51 . BUILD PER 24, 68
F,I..AN CHECK FE 24.CK) S*TREE"T 9DC 600.00
PARKS SDC 250.00
301 L-AN07REF 5T
TOTAL AMOUNT PAID 1 9 16
m
Cinr OF 71GA RD SEWE'R CONNECTIUN
PIE"'RNIT
AD P E.'R 1111 ff. .. . . . . . 5WR90 0074
COMMUNITY DEVELOPMENT DEPARTMENT one" PRIM. PLERMIT 4 , a MST'90 Pi 0 6 6
13126 SW HWI Blvd, P.O.Hm 23307,Tlg&W,OmW 97
I P . /J0
1)n T r' :r s c;u F:,!).. 0 6 8
Eli 813 1.3 W L 0 N(3 1 R L E ST' 1.1 iA k U L L.: (2,'jI 1.i2 L,C 10 0
1-1 DT')J(3 10 N. I ANGTREL ZONING:
L.0 L;K. . . . . . . . .. . e41
. ............. .......
FIXTURE UNI'T'S. . . a
(IF' W0RK,. . . -N1::.W DWELLING UNI'T*S. . : 1
T y F,E. DF' U"i L. .. ., . . i S F NO. OF: BUILDINGS il
1ANIST01 I I*YFIL PL)SWR I:MPF: SURF 0C1-.':. 00 3sf
Rnc in A st I
.......... F-EES
11. 10H 1-:1 R 0 P F.'R T I ES type aniat.11-It by
y qjate -r e c F0
r1
-:10 BOX 683r,,i PRMT $ .1250. 00
INSP $ 35. 00
fel...(: HO OR 97007 PA Y M $ 1285.00 JLF1 OG/28/90
01-101-if-ft ff.- 6455477
(.)1A*IRW:,T0R NUI ON F*TI E
$ 1.285. 00 TUAL
REQUIkED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewe-r .1rispection
of the Unifiel Sewage Agency. The permit expires 120 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 sever laterals. If the sewer is not located at the measurement .............
given, the installer shall 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 t)e Agency will install a lateral. ......
F,(-�-r ni i.t t e e S;i.q t c.,
.......... ..........................
C,A I I fa i)is per-t i ori 639-•41.'75
CITY OF TIFA RDj..(` cm � PLAN CHLCK APPLIC:AT ION
COMMUNITY DEVELOPMENT DEPARTMENT PLAN CHECK N - ) -
13125 S W.Hall Blvd..P.O.Boa 27.197,Tlp wd,01*9m 97227,IM)679.1175 PERMIT N _ !h'f S�t
DATE ISSUED
JOB ADDRESS: '.�� L- 1fJyT`!C E_: l TAX MAP/LO'T -)I -lZ CC IU fl(-,Ll
SUB: L.4N��, frl LOT LAND USL:
_ _ - - -
VALUAtION: 6;
OWNER ,;PLCIAL NOTES
NAME: TREISSUE OF:
ADDRL SS: 4) /�)CJk .: ^�" �'�',�iC ��L1�9 i -- LAST RLISSUE: _ =� --
J
FLOOD PLAIN/
SFNSIIIVL LAND: _
PHONE: 4)2 7
APPROVALS REQUIRED
_CONTRACTOR PLANNING: _
NAME: iS' ENGINEERING: _
ADDRESS: TIRE DEPT
— - _
OTHER: •— -
PHONE: _ ITEMS REQUIRED
BUILDERS BOARD N: _ LXP DATE: 3 - . (� ��_ LIST/SUBCONT^ACTORS:
BUS TAX: _
ARCH/ENGINEER CALCULAI-IONS:
NAME. : _ TRUSS DETAILS:
ADDRESS: OTHER: --
PHONE: -
COMMENTS:
SUBCONTRACTORS: PLUMB: _ Lt/A:iS �tLA9P✓,�/c_ MECH:
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees 1.3z, 51 _ / 3Z,,-V
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) -2
Plumbing _L, G. G3
Mech
10-433 00 Plans Check1 Fee `,� � � � /L(
Building << ku / i
Plumbing _
Mech - �
� 1
,i,of yu (_N 30-202 00 Sewer Connection 1250 / 51
30-444 00 Sewer Inspectior
51-448 00 Street System Dev Charge (SDC) — Z _' G v
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg (SSDC) �,SU
10-230 06 Fire _
TOTAL �.
APPLICANT SIGNATURE r
Received By: Date Received:
cn/3587P/18P !� I
I
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GRADIN
('WNER AL CONlRACI'OR NAME& ADDRESS: CAST:'FILE NO.: _
_ , F PERMIT NO.:
_ I
1)ir
tG l APPLICANT NAME AND ADDRESS:
EXCAVATION CONIRACI'OR -� f Tli[tI'-.�
NAME& ADDRESS:
_13kAf" cakrr„ ti.��il�rIAY�
OWNF.R NAME AND ADDRESS:
TEL FPIIONE NUMBERS: I 1
T• [e N�� G11`17 _ PROPERTY DESCRIPTION:
APPLICAN
OWNER }L 1 S_ r ,_1 '1 STREET ADDRESS AND CROSS STREETA=ATED j
(iIiNERAI.CUNTRACIC)R: —
F XCAVATION CONTRACTOR: 4ir . X4 2 0 -
SI IE/aOB_ —
I.EGnI.DESCRIPTION: �
24 HR/AFTER HOURS EMERGENCY TAX LOT NO.:
CO "AC"T PEtSON�, r �TEILEPHONE: 1/4 SECTION;!
SIFT:SIZE, ACRES:
DIS111RBEU/% JRK AREA,ACRES;
LOCATION 14.ADDRESS WHERE SPOILS
LEAVING SITE WILL.BE TAKEN SIZE RUNOFF GRAINS TO:(CIRCLE ONE)
(NOTE:PI73tMrtSS MAY BE REQUIRED) QA•TCN-BASIN RITC,1 PIPE CREEK
--`T1
ll
- �- (CIRCLE ONE) tRIVATUROPERTY
(PU)3ucala OF WAY
EROSION/SEDI MENTATIM CONTROL- (RSCI MEASURES
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS •
DI(RING CONSTRI1CnON: 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
CONS"IRUCTION SEQUENCE OTHER
OIIIER
PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH"rE HNICAL GUIDANCE HANDBOOK%
EROSION cuNTROL PLAN DRAWING,AS REQUIRED,HAS FLAN CONSTR'W rION NOTES COMPLETE,INCLUDING EMERGENCY
PHONE NUMBER, SCHEDULE/STAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASORES,AND
APPLICABLYi STANDARD NATES.
I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
I TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE.
OWNER S_'h33<ATURE �( APPLIT NATURE
0TICIAL USE ONLY,
R LC E I PT DATF: ACCEPTED
FTE NUMBF.R RECEIVED BY