9521 SW LAKESIDE DRIVE 9521 Sins Lakeside Urine —
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CITYOF° TIOAF- i0CF'!:UCC SNI Tll` "'ATE OF
COMMUNrrY DEVELOPMENT DEPARTMENT
G ---
13125 8%V HWI Blvd, P.O.Box 23397,road,0".F223(5W) 3O4175 IT 0. MT9@03Pj0
'-'ITh- ADDREIiS. . . 5W I.AKESIDE DR
SUBDIO
IVISN. . . . s I-AKESIDE PLACE Z 0 bil 14 6 R 4. V)
01-CCK. -01.. . . . . . . . . . v4
1155 OF WORK. kNEW
IYPF- OF
OCCUPANCY GkP. vR3
rICCUPANCY LUAD% 116 4
Uwiioory ....... ........ .... --
40STALUIL HUME.S
PDX 2016
i OKE F31:,':0Vk cit': 97035
Phoro- 14t '-oP)362l0,';666
003"I'Al-GIC HOMES
00 L40X 2016
LAPF... '1ROVUDR, 970315
Ph( iie 144 `50-36203666
R o . #. . : 5'.56,43
Occupancy of the above building is hereby given, arldTtifie%
the compliance with tho Of Oregon Specialty Crodes for the irrout)v
ac(:l;p&,vwy, and use uncle-( wfiich the refrrencec-1 permit wdk;;. iti%tted,
._._...._...._.•_. ._......._._..................
FIRE DEPARTMEN7 DU' DING
.... ......
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I A L
11TT
POST IN CONSPICUOUS PLACA-H.
INSPECTION NOTICL
1 City of Tigard Building Department
Z�Q M P.O. Bnx 23397
n w�vcri2 TG //YSf" �� Tigard, Oragon 97223 /
- - Phone: 639-4175 /�✓�'.r
'Type of Inspection
//
Date Requested___2, / � Time
��,� e A.M.- _—.�L_ P_ , .M.
Address / ^� _�—____._____ Perm't #a,� L_
Owner _ _ Lot # _
Builder _
The following Building Code deficienc;ps are required to be corrected:
7-0
P*000 01 Ut -77
7-1F Di1�ik.,q - i ?ysF
Ir01
Presented to Approved
Inspector
Date
CALL ','OR EINSPECTION
L_1 YE: ❑ NO
sss � +� e. esr awr ew
City of Tigard 'luilding Del'artJoent
13125 SM Hall Blvd. Tigardp Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businesa Phones 639-417?
Footing Plbg. Underslab Mech Rough-in Appr/Sdwlk
Found. Plbg" Top
Out Vias Line F1RAL:
Poet/Beam Struct. Sen. Sewer Framing -Bldg.
ng g'
poet/Beam Mach. Rain Drain
Insulation -Plumb.
plbg. Underfloor Nater Line Gyp. Bd.
-Mach.
I.te Rom,�esteds - -
-- permit
Addresst
Builder, �'� _---
THE FOLLOWING pDRRECTIONS ARE REQItmi
J _
Inspectors_ _ t — Dates _,—..—
APPROVED DIIAPPROVED APPROVED UUBJECT TO ABUVE
Call For Reinsp.
PRO;NSPacT MJ=179
City of Tigard Building Dti;kj-buwW
13125 SW Ball fllvd. Tigard, Oregor 972"j
Inspection Line (Rec-O-Phone)c G31j-4175 Bue`nese Phnnr,: 639-4171
Inspections_- -- ---- ------ - --- ------
Foot Inq PlbU. Undm-slab Mech. RoLlh-in Appr/Sdwlk
Found.. Plbg. Top rXt Gas Line FINAL-.
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Koch. Rain Draiu Insulation -Plumb.
Plbq. Underfloor Nater Line O Bd. --Hach.
r
Date Raquestedi _ ^, Time / AN cN
Address ��� y � _ Permit 1s1L)
Builder:- -
TBE FOLLOWIh: COARECTIONe AR! RSQUIRRDs
Inspectors_•!- Dat"s—r-_39/ —
_�APPROVND DISAPPROVED APPWWND SU&TRCT — ABOVE
—__Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223 "--
Phone: 639-4175
Type of Inspection
Date RequestedY�� r7Z Time A.M. P.M.
Address G ��-� /�/�C� S/� Permit alk g4)"403`�Q
Owner _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
I
Presenter) to Approved
Inspector _ r� Disapproved
Date
CALL FOR R INSPECTION
❑ YE3 ❑ NiU
sess owl
4
City of Tigard lWi.lAi.nq Department,
13125 SN Isn' t Blvd Tigard, Oregon 97223
Inspection Line (Rev-O-.hone): 639-41.75 Runinese Phone, 639-4171
Footing Plbg. Underelab *iCh. ROYQh-itl Apps•/Sdwlk
Pound. Plby. Top Out gab Un'e\ PINAL:
Poet/Beam Struct. San. Seworlrasl,iq -Jill
Post/Ream Hoch. Rain Drain Insulation -Plumb.
Plby. ,ndiil Water Line Oyp. W. �[-Nech.
Date Requestedt / AN __PN
2D =6 3S-0-
nu i Ider:
ll POLLONING CORPF..CTIONS AHF REQUIRED:
G ( Ct 4�f!/U c7 ,
Inspectors _ Daterr �'
APPROVED DISAPPROVED APPROVED SUBJRCT TO ABOVE
---TTT-- Call Por Aeinep.
INSPECTION_MQT199
City of T}.gard Building Department
13125 SR HdaI Rlvd. Tigard, Oregon 97223
Inspection Lino (Rec-o-Pione): 639-4175 Bunineas Phone. 639-4171
Inspections --�--_--_ --- ----
footing Plbq. Dnderslab Herb. Rough-in Pppr/Sdwlk
Found. plbq. Top out Gas Line FINALS
Post/Bwam struct. Sewer ) Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Undortl.00r Water Lin Gyp. Bd. -Hoch.
Dates Requented: --Time: - nAK_1 (PH
Address: -- `�C __ Permit ft
n
Builder:___
'l8E FO1.Ll>MIINI; cORRECTION6 ARE MWIR'3Dt
7
Inspector: ------ --- -- - Dates-
APPROVED DTSAPPROVED APPROVED SUBJECT TO ABOVE
Call Por Reinsp.
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j` �PFCTION�SIO�' ,ICE
City of Tigard Building Department
13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Pf.c. .): 631-4ii:� Business Phone k639-43.71
Inspections
sooting Plbg. Underslab !tech. Hough-in Appr/sdwlk
Pound. Plbq. Top out Gas Lind BINALt
t etru San. Hewer Framing -Bldg.
POs Beats MOON. Ra'n Drain Inaulation -Pluenb.
nd
l�bbg Onderil t—j Wafer Lina Gyp. Bd. -Mach.
Date Raquegttsdt_ ` _l Timei / �AN _PM
Address: %�� , '�'� Permit
Builders_�
THE FOI.LOWINe7 CORRECTIONS REtijUIREDt
Inspector: Date:
�,_ — ----
hP ROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
----Call For Reinsp.
�„NSp;CTI011 NOTIC)r
City of Tigard Building Department
13125 SK Ball Blvd. Tigard' Oregon 97223
Inspection Line (Rec-o-Phone)r 639-4175 Business Phone 639-4171
Innpectl.on:— __ -- -
Plbg.
Underslab Mech. Rough-in Appr/Sdwlk
( plbg. Top Out Cas Line FINAL:
Found.
Poet/Bram Struct. gen. Sewer
Framing -Bldg.
Poet/Beam Mach- Rain Drain
Insulation -Plumb.
-Mach. •�
plhq. Underfloor 2waterr_Lin(e� Gyp. Rd. -Hoch.
r _IL' !
Date Requested:
Permit 1:` -
Address:_
THE FOLIi)WING CORRECTIONS ARE REQUIRED.Inspectors — -- -
�/ DISAPPROVED APPROVED SUBJECT TO ABOVE
n( APPR)VED _
"1T� call For W-110p.
CITYMASTER PERMITOF YIFA RD
COMMUNfTY DEVELOPMENT DEPARTMENT !~'ERMI7 . . , . . . „ M�iT�30-0."381,`
13126 SW FWI Blvd. P.O.Bat 23397,TOW,Oregon 97223(603)8394176
- I9A'rE ISSi. LD:Sa1 —
L� ADDRES PARC:E"L.: `G 1 1 1 CE1- 1 1 200
SUBDIVISION. . . . : LAKESIDE: PLACE ZONING., R-7
-- BUILDING
RE.ISSUE: DWELLING UIV I TS: 1 BASEMENT . . . . . . . . :0 5f
1~'LASS OP WORK. :NE:W BEDRMS:2 BATHS:2 GARACH. . . . . . . . . . :4c^r' sf
Y' 'E (IF USE. . . :t;F- FLOOR AREAS---_._._-__._ .._._.._ RE OUI REI) SE:.TBAC:KS-•- -..._-__.___.__.
TY-'E: OF CON;:3T. '5N FF'IRST. . . . : 1757 G.f LEFT. . .-7 ft RIGHT. :4 ft
CICCUPANCY :113 SECOND. . . :0 f FROM". :20 ft REAP. . ,?E, ft.
ST0RIEG. . . . . . . : 1 THIRD. . . . :0 ;f KEUUIREU______.._._._.__
HEIGHT. „ . . . . . . : 16 ft TOTOL-"- - 1.757 f' SMOKE. DETECTORS. .1Y
FLOOR LOAD. . . . :40 psf VAI...UE. . . . . 6 : P8416 PARKING SPACES. . :O
Remarl<s
F )_UMB I NC- ----- -----------------------------------
E
_-__ __---_---------.______.___...._.._-.,.-_-..._E 11°dKS. . . . . . . , . : 1 FLOOR DRAINS. . . . :0 BACKF LOW VQEVN T F?S. . :0
LAVATORIES. . . . . :2 WATER HEATERS. . . : 1. TRAPS. . . . . . . . . . . . . . :0
TUL1/SHOWE:RS3. . . . :c:' LAUNDRY TRPYS. . . :0 CATCH BASINS. . . . . . . ..0
WATER CLOSE_TS. . :2 SEWER LINE (ft ) . :O GREASE EASE TRAPS. . . . . . . .0
DISHWASHERS:, . . . : 1 WPTE..R L I NE: (ft ) : 100 OTHER F I XTIIRES„ . , . . :in
GA RBAUE D I SP. . . sl RAIN DRAIN (ft ) . :0
WPSH I i,VJ MACH. . . : 1 SF= RAIN DRAINS. I
MECHANICAL _..__._____._ __.._.___-______._-...____ FEES _._.__. .._.___..._..._...._
FUEL TYPES- __.._..___.._...._ _ UNIT HTRS. . :0 tvpe tmot_cnt by date r pcc+t
/GAS/ / / VENTS . . . . . :0 PAYM 6 100. 00 JLH 10/19/90 E060P.14
MAX INPUT:O BTU VENT FANS. . :3 BPR'T 6 400. 00 / ?
F URN ( 100K. . . : I HOODS. . . . . . : 1 BPLC: $ 260. 00
FURN ) =100K . . :0 WOODSTUVES. :0 85r'G I r-10. 00
FLOOR FL1RN. . . . :O CLO DRYERS. : 1 ST DL 6 (100. 00
BOIL_/CMS' ( ;311['.0 OTHER UNITS-0 S SDC 6 37`:;. 0171
GAS OU7LETS: 1 PARK $ -500. 00 I /
Owner : _._._._..__ ______..____.._. ._._._._ ._.__..__.__.._...,.._.. . __ MPR'T 6 ?h. 00
NOSTALGIC: HOMES MPLC 6 9, 00
PO BOX 201.6 M5PC 6 1 . 80 /
PPR'T $ 117. 50
LAKE GROVE (_1K 97035 P:"PC $ `). PS
Phone 0: 5036,_05666 PAYM 6 22e5. 18 JLH 0 :/014/1)1
r.:t_1ni:r•ar_Lar, : -__..___. __._.._ .._._ __._._._..__._ ...._.._..__.--
NOSTPLG I C HOMES
f"'C? BOX ;W01f
LOKE GROVE. OR 970.35
1.8 TOTAL
This peretit is issued subject to the Populations contained in the ---_--- REQUIRED INSPECTICINf1 - -- -
Tioard Mur,iripal Code, State of Ore. Specialty Erodes and all other Foot/fo!.tnd Insp Firep.lac-e! Insp
applicable laws. All work will be dono in accordance with appreved Post/Beam rtro_tct Pas Line, Ins.n
clans. This pewit will expir! if work t started within I Past/Beam Mechan Ins'.tlat i on Insp
days of issuance, or if work is susoWleed Vr sore th im Plm/t.tncislah Insp C-,yp Board Insp
PL1vI/1.1nrJarrloorr Rain drE+.An Tnso
F'prmittep CiiCn�a+ur°e � _ ._ .._ Mechanical Insp Water, Line Insp
Nlt_tmb Top Ot_tr, Appy /Sdtrrlk Insp
I'r,st,ted 13y
Ft-Amina Insp. Mechanical. Final
Cal 1 `z.,r, inspect ion - (1.39-4175
WONUILMaMWANW�WmrWA Wam
SEWER CONNECTION
Ci�OFTIFARD PERMIT'
(CffYOFTWARD 'ERMI,r #. . . . . . . .. 5WR90-04 ,1,7
COMMUNuY DEVELOPMENT DEPT RTMENT ONOON
13125 SW HvJ1 Blvd. 0 0,Box 23397,Toird,L)r*Wi 97? (603)6394175 \1 DATE ISSUED- 08/04/91
L!
i i L H ij LJ rt L Iza b. 1414 6 R 9 W. PARCEL- 2S111CA-1300
SUBDIVISION. . . . : PLOCE ZONING: R-7
B(.00K. . . . . . OT. . . . . . . . . . . . . .
TENANT Nr4ME. . . . .
1-16A NO. . . . . . . . . . t43166 FIXTURE UNITS. . .
CLASS OF' WORK. . . -NLW DWELL T NG UN I TS. . -. I
TYPE OFUSE. . . . . zSF NO. OF BUILDINGS: 1
I N5TALL I YPE BL ISW R TMPERV SURFACE. . . - sf
Remark s i
Ownpi,-. ----------------- FEES --__...._____..____
NOSTALGIC HOMES type amol-Int by date r,ecpt
PO BOX 2016 PRMI $ 1500. 00
INSP $ 35. 00
LAKE GROVE OR 97035 PAYM i 1535. 00 JLH 02/04/91
Phone #1 5036205666
Contractor: ........
CONTRACT'OR NOT ON F-It-E.
Phone #-, 1535. OIZA ral-AL
Pen
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer, Inspection
of the Unified Sewage Agency. The permit enri-es 120 g&', from
the date issued. the total mount paid will be forfeited if the,
Permit expires. The Agency dots not guarantee the accuracy of the
side sewer laterals, If the sewer is not locatqd at the measurement
qivp'.11 the incta?lpr shall orosvect 3 feet in all directions from
purchase
a "t
the distance given. if not so located, Mt ins!all!r soall purchase
a "Tap and Side Sewer" Permit and 0� e c I, M all a lat
! 'ot mif trp
CA13- for inspection 639--4175
PLU"IB I NG PERMIT
C17YOFTIGrARDPERMIT M. . . . . . . : MST90-0380
CITYOF TWARD
COMMUNITY DEVELOPMENT DEPARTMENT o OON71
GATE ISSUEDt 02/04/91
13126 SW kW1 Blvd. P.A.Box 23397,Tiperd,Oregon 97223(603)839.1176
. » . . b At°CC3 I fJ�- �— �PARCECI 28�i�11.300
SUBDIVISION. . . . a i_AKESIDL PLACE ZONINGt R--7
BLOCK. . . . . . . . . . , LOT. . . . . . . . . . . . . 14
Ct.-ASS OF WORK. . aNEW GAnBAGE DISPOSALS. . 11
TYPE OF USE. . . . ,SF WASHING MACH. . . . . . . 11 BACKFLOW PREVNT'RS. . :O
OCCUPANCY GRP. . tR3 FLOUR DRAINS. . . . . . . 10 TRAPS. . . . . . . . . . . . . . .0
STORIES. . . . . . . . ai WATER HEATERS. . . . . . 11 CATCH BASINS. . . . . . . :el
FIX TURFS-----•------------ LAUNDRY 'TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . 11 GREASE TRAPS. . . . . . . ..0
LAVATORIES. . . . . 13 OTHER FIXTURES. . . . . .0
TUB/SHOWERS. . . . : SEWER LINE (ft) . . . . :0
WATER CLOSETS, 12 WATER LINE (ft) . . . . : 100
DISHWASHE:RS. . . . a1 RAIN DRAIN (ft) . . . . :0
Remarks:
OWNER: --- -__.__--_____K__-_______ .___.__ ____.________ ..-___FEES__-_-____-_.______
'067 ALG I C HOMES PAYM $ 100. 00 JLH 10/19/90
PO BOX 2016 BPRT t 397. 00
BPLC $ 258. 05
LAKE GROVE OR 97035 B5PC f 1.9. 135
Phone #v 5036205666 STDC $ 600. 00
SSDC $ 375. 00
Plumbing Contractort.___w____-_.------ PARE; • 250. 00
MPRT 1 39. 00
Nq m e=_ __. MPLC $ 9. 75
Andreas: - _ M5PC $ 1. 95 0 /
City: _ _ _ Stater PPRT s 140. 00
zips- Phonell: P5PC $ 7. 00 ! !
Reg #: _ PAYM ♦ 109 7. 60 JL.H 02/04/91
REUU I RED INSPECTIONS
-- _--This permit is issrted subject to the reg-
ulations contained in the Tigard Municipal Foot/fOLand Insp Rain dr-sin Insp
Code, State of Or . Specialty Codes and all Post/Seas Struct Water Line Insp
other applicable laws. All work will be dune Post/Beam Meehan Appr/Sdwlk Insp
in accordance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of isslianep, or if work is Mechanical Insp Building Final
suspended for more than It-30 days. Plumb Top Out Erosion Control
Framing Insp
L.larr..e Insp
Gas
Caws Line 1.rrsp
/r r Insulation Insp
�--_.. Gyp Board Insp
Authorized Plumbing Contractor Signa -ure
Caul for inspection - 639-4175
Contractor Notes ,
CITY OF T I GARD RECEIPT PT (IF PAYMEN"I' RECEIPT N0. l 91—p 093A 6
j'j h�[1;1'Ai.C;I HOMES CASH
AMOUNT s 3760- 10 j
CASH AMDUN'C a 0" 00
PAYMENT DATE
SUBD I V I 5 17N
9553 �3W LAKESIDE DR
I Ii'
PAYMENT AMI, UN'f F-)A I T.) PURPOE F.. OF PAYMENT AMOUNT PAID �
1'hlC
PE RM 400. 00 PE_UMB I NG PERM 117. 50
HOW I l'Cli.. I='E" 36. 00 ST. BUILD FUER
iI I 1 I II_ A." FE 169. `:0 SEDER USA 15400. 00
I G. f t'l'':F'VCT 35. 00 STRE'E. f SDC 600. 00
,. IlK, 500. 00 STORM DRAIN SDC: 3735. 00
u r Inu II.IN-r PAID > 3760. 18