16401 SW 109th Street 1E401 SW 109th ST
INSPECTION NOTICE
City of —'nar.. ' oiding Department
P 0 Box 23397
Tigard. Oregon 97223
f� Phone 639-4175
Type of Inspection 74
Date Requested -30 (IC/ • Time_ x- A.M. P.M.
Address _ ! (� 17Z I /Q r� Permit #► £7l'/'i1/
Owner lot #
/
Builder ]� le /r1��
The following Building Code deficiencies are required to be corrected:
Presented to fl•t"Approved
Inspector Disapproved
Date ()
CALL "OR REINSPECTION
YU Li NO
INSPECTION NOTICE
City of Tigard Building Department
P O Box 23397
Tigard. Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested_ ��� -fl Time _ X A.M. _ P.M.
Address l 1. ''L / `/i Permit * `/17/1
Owner Lot u
Builder --- --
The following Building Code deficien les are required to be c..rrected
77.
Presented toApproved
Inspector ""f� _ �T/ Diapproved
DataCALL FOR REINSPECTION
O YEs I 1 NO
MP.
BUILDINGPERMx T
CITY TIRD //7
PERMIT NO. : E3UH91418
COMMUNITY DEVELOPMENT DEPARTMENT ,....""°"........) DATE I SSUE:D : 7/ 7/09
(3tn S.W.Mas Blvd..P 0 Son 23397.Tigard.Oregon nm.(S03)639-4175PRIM PI1T .NO. B91410
JOB ADDRESS 164()1 5W 109TH ST
TAX MulP/L.OT PS 1 1`.,AA SUB REBECCA PARK LT : 18 BK :
LAND U9E • R4. 3
LOT SIZE : VALUATION : • 91 ,692 SETBACKS
FRONT : 20 REAR: 15
t
WORK CLASS : NEW DWELL .UNITS • 1 LEFT : 13 RIGHT : 8
USE TYPE : SINGLE. FAMILY N(1 . L3E DROUMS : 3 LAT WALL CONST
CONST . 'TYPE: • VN NO. HA THS . 3 N: S : E: W:
OCCUP .GRP . . R3 PROT OPENINGS
OCCUP LOAD N: S E : W
TOTAL AREA 'r.'O.".lti
N(.1. STORIES, H 151 . 1105 ROOF CONST : C FIRE: WE1 7
HEIGHT : 20 2ND 950 AREA SEE>AR7 RATED:
BASEMENT? 3RU . OCCUW. SEPAR7 RATED:
ME1.14,NINL7 BAS;E:M' T
FLOOR LOAD: 40 GARAGE : 400 FIRE: SPRKLR7 ALARM?
FLOW t GPM) DETECT'? YES
1
HEAT TYPE GAS HDI::P ft1:LE51'," CORR7
PLAN (:;HECK HY : r:s.t.
REMARK',
REISSUE. 1.1E NO .
LAST REISSUE
FEES :
O POLIOINS RICHARD I_. PERM ! •40'9 00
W 1.4055 SW 1415 / PLAN REVIEW $P65 : 115
N T I GAR1.) ON FIRE DEPT
E
R STATE. TAX f/P0 45
OTHER
DEI'I L 111'ME.111 CHARGES
C ROBBIN', R.11:13ARL) L. su(:.1STORMI $230 . 00
O
N II I. N HOMES 51)1;C S I NF F 1 1 •600 . 00
R 1405 5%W 141ST PUI;IOP 1 $P 50 . 00
A 1 .IEARL) OP 97224 NREPAlU < •100 00>
C PHONE:. 1503/ 620--•3093
T
p RE.C1SINAl1(:!N NO 16906 TOTAL $1 ,695 . 30
R
AF.:CE::I1'1 No h'IN 7 V
This permit is issued subject to the regulations contained in Tale 14
of the TMC. State of Oregon Specialty Codes toning regulations 'ENU 1 Pl.I) .I.NS PF C I.1 ONS
and all other applicable codes and ordinances and it is hereby 10(.1 T INT. Si WI•It
agreed that the work win be done in accordance with ttie plans and F l n INI)A I I t)hl wilt.1.. PA I N ORA INS
specifications and in compliance with all applicable coder and I,(I,•,1 h I+I:AM WA If.A I INC
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city I'1 1 I.1Nf)E.R!aL..AH CIT Y APPRCH/SW
business tax permits This permit will expire and become null and ',1 AB FINAL_
.oi .if work is not started within tell days or if work is suspended or hl ,t I I1PI)1.)T
abandoned for a period of 11(0 days any time after work has F:RAM)NI
ommenced It shall be the responsibility of the permittee to assure
ill required inspections are i•quested and approved I 1 C)1-.lila AL.F
GA', I 1 NI•
I.-
,/,�tl NILA 1 I ON
�� ir--1
/ _� GYI B TART)
Permittee Signature lll���
eat-- I AI.L FOR 1NSN.CT ION 63ti-4175
Issued By ` .1 — — — — --
I /
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWER PERM1T ✓
CITY OF TI R.D
CITY PERMIT NO5E:H'it1114
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 7/ 1/89
191?S S W Hati Blvd.,P O Bor 23397,T,pord.Onpon 97229.(sC3)a39-4176 PRIM PM'T .NO. 891418
,
..1(:)H ADDRESS 164()1 SW 109TH ST USA NUMBER 037575
TAX MAP/LOT PS1 i AA SUB: REBECCA PARK L1 : 1H BK :
LAND USE: : R4. 5
I.0T SIZE :
SECTION . 1 'i 2 TWP: 's TING : 1w
WORK (::(...AS', N1 W
USE TYPE;: ', I NI;l t I AMTI Y
The applicant I:tcarF..,.,,., cli ': ump1 y with all rul.e!% and re-gulat.ion% of the Unified
Sewerage Agency The permit, expire% 120 day% from the date i't:lsued The total
.ama►.►r►t. 1'i•r d will be ful•fwi. tend if the permit e:'xpire.e The Agency dilea% riot guar.
.lnt.ee the accuracy of the:. 1rcatinn of the % uie %ewer• lateer•al!s . If the %ewer• is
nut located at the mer•►',,, em«.'nit, given , the 1innt.al ;ei' nhall prorspec•t 3 feet in
.r1l direction% from the iii%t..:rnf•t' given Tf nut. %u 1w"ated , tI,e ir►wtaller 'ah►al.1
1►t.rr'c^hra%r•.r rr "Tap anis Side ',ew..:,1•" Permit and the Agency will in%t.a.1l a lateral
INSTALL . TYPE . BUILDING SiI WEll IMPERVIOUS AREA:
FIXTURE. UNITS TENANT NAN1 TMPUOVEhENT :
DWELLING (INT 1 'i I.
NO . OF BL.DGS 1
II•h ',
0 I41)B13:i.N5i P1.L:HAP1J 1 I'1 lfri I I •.35 . 00
W 11855 SW I I i'. T i.1 INN1 (. I .I(IN CHARGE. $1 , 100 . 00
- Ti.GARL) i It I .I NI- TAP INSTALL .
R
l i i til 14
• Ii(Eah<,IN'. 1411;H/1i111 1
N 11 1 14 1411MF''i
T 1 40!) W 111.5T
R
A 1 1GANL) OR 9/2,'d
C PHONE (303) 6PO• 3t3l
T
O REGISTRATION NO . 16911: TOTAL.. *1 . 13n t►0
R
' 141 (:I. IP1 NI) /v L/t/ )t/
This permit is issued subject to the regulations contained in Title 14
of the TMC State of Oregon Specialty Codes toning regulations 1•41 1I141t1 I i I N51 PI ( 1 1(IN'i
and all other applicable codes and ordinances and it is hereb'- 140111 AA I N
agreed that the work will be done in accordance with the plans ai.d
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
abandoned for a period of 180 days any time after work has
commenced It shall he the responsibility of the permittee to assure
all required inspections are requested and approved
7
Permittee .ignature^
.�7/ !
Issued By - ' J. ra1_I.. I OP 1 ti i 1 , i I(LN 6.39.2AiTh
SEPARATE PEPMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
■
MECHANICAL PERM) ; /
CITYOFTIRD / PERMIT NCl . MF :.1'i►1441 v
COMMUNITY DEVELOPMENT DEPARTMENT ""'OM DATE. I ti';UEG // 7/B9
13125 5 W Haa Blvd..P.O.Bon 23397.Tlgnd.Oregon 97223.I' 3)63t,-4175 r R I M . PI 1 NO . B91118
JOB ADDRESS : 16'IO 1. SW 109TH ST — ~
f AX MAP/LOT 251. .1 SAA SUE! .. Pr.bh(.:C:A PAM LT . 1E1 BK
LAND USE : P1 . 3
LOT SIZE :
I IEiM. NO. N(.)
WORK CLASS . NEW FURNACE (100K AIR HANDL..R (10
(1'',F: 'TYPE: . SINGLE l 6MIL'' FURNACE 100K+ 1. AIR HANOL.P 10K
(UST . TYPI: VR FLOOR FURNACE:. E:VAP COOLER
OCCLJP . I..i'P . . R:3 HEATER VENT FAN 'I
VENT VE.N T . SYSTEM
HER/COMP <3HP HOOD)
NO . STORIES P HER/COMP :3-••1SHP INCINF:PATOP(0DM
DWE::I.t. .UNIT'i 1 HER/COMP 15..-30HP INCINEWATOR(COM
FUEL.. TYPE: (,AS BEG/COMP SO—b0HP Rh PAIR UNITS
MAX . I.NPUT bLR/COMP 50+HP OTHER P
FIRE DMPP!:,'/ GAS PIPING OUTLETS
HIGH PRESS'?
I.OW I'RE:.S57
ltl:MAPK S :
- — — FF1. '., --�
O bt(.1FlH.I'NS Ft I LIIAIPI.' 1. I'l.:PM 11 *1.0 . 00
W 1/0155 SW 11151 I'I. AN PF.V1FW $11 25
E T 1 GARD) lift l I X T I Ilt1.S *3,"1 . 00
'itA11. lAX *2. £'5
I.)TI•IL:R
C HF::DJ N RC1NE14T
0
N HE:DIN' 'i HEAT I Nt
H43 NU :':31.s I
A 11:i1..Isl:l'l.ira tar '1/ 1i!;3
• f'HTIN1 (.`.f03) 64S-1139
) REGISTRATION NO 4/211. TOTAL. : $58 30
R
MCC.I PT NO /fir 1/1/ J//
This permit is issued subject to the regulations contained in Title 14 7
of the TMC. State of Oregon Specialty Codes. zoning regulations 141.(JI I I.M.I) .1.N'i1 1 1:T L(1N'-r
and all other applicable codes and ordinances and it is hereby (;A', I I NI
agreed that the work will he done in accordance with the plans and 1'1 1',1 lir IlI AM
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictiveItl.11 II.H 1 N
covenants Contractor and subcontractors shall have current city I I:NAI
business tax permits This permit wilt expire and become null and
void if work is not started within 180 days or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall he the responsibility of the permdlee to assure
all required inspections are requested and approved
Permitter Sig ure
LAI 1:1111 IN'iP1- I I I ON h:39-11 79
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLUMBING VF RMI:
CITY'OF TIGA� PL..lJ
PPERMIT BI . PL891440
VIVO);116A110
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED : %/ 7/89
13125 S W.Mae Blvd.,P.O.Sox 23397.Tipmd,Oregon 97223.(503)639-117. P P I M. IMT .NO . 891418
JOB ADDRESS . 16401. SW 1 09TH 15"T
TAX MAP/LOT r?!] 1 wiAA SUES NEM. 1 .r.A PAP). LT : 1ki kV
LAND I.1SE: : R1.5
L.01 SIZE :
ITEM : Nl) : NI)
WORK CLASS : NEW WATER (:;LOSE:. 1 3 1 RAP
USE TYPE:: : SINGLE: FAM:ILY URINAL.. F.:KI L ow PRVN r14
1:()NST . TYPF VN L..AVORATORY 4 'MAP PRIMER
CUP. GRP P.S TUB !SH()WE.:1.4 3 GREASE TRAPS
DISHWASHER 1
GARBAGE DISPOSAL 1
NI.) STORIES : 2 WASHING MAI.H:LNE 1
OWF.LI... UNITS : 1 1.ALINORI T RAY HL..DG. !SRA]N (1.)XA
11.0)1)14 DRf,'l N
SINK 1 SEWER I F 1')
WATi P HEAT I P .1 STORM/RAIN (FT
l:)1'HF I
Mr1I4K'
i) Gt(.1(iEI.IN!; 1l111.1A141) I 1 I'I 1411 I $ 1 'Ii 'ill
w 1.4H;:)"5 SW 1.11 '.•'
NE 1 ].I; .'.AHD (:)F4 I I 11041.
'i 16lI• 1 AX 4 / Ail
I 1111 I
C I (IW1. I 1; 141:IRf:14t
11
N 1; H I'1 1.IMFt1:Ni.
T 159P SF: 515 f
A li l I ',Irrrrrt i,r' 9
1 I.1II INI ( :50•i) /,40--'.il%0
0 141 I . I , I I(A I I(IN Nil 19907 TOTAL. : •1:54 RH
MCI./ t NO )
This permit is Issued sublect to the regulations contained in 1 air 14
of the TMC. State of Oregon Specialty Codes zoning regulations F4E:.WI I1 I4F.I) I.N!SF'F.:(;Y:1
and all other applicable codes and ordinances. and it is hereby PLP I INI)E:l4' 1.Alt
agreed that the work will be done in accordance with the p'ans and I:,11', 1 it IIF.:AM
specifications and in compliance with all applicable codes and WA 1 F 1; I I NE
ordinances The issuance of this permit does not waive restr ctive
covenants Contractor and subcontractors sh I have current city I'I f. I(.)PI)I I
business tax permits This permit will expire and become null and MAIN DNA(N',
void if work is not started within 180 days or if work is suspended or 1 INN...
abandoned for a period of 180 days any time after work has
cor menced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Signature
Issued By 1 CALL. F (:)R XNSPE:L 1 1ON 639-•-41 15
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR:BED ABOVE
CITY OF TI1RDaPLAN CHECK APPLICATION
n�'m PLAN CHECK a
(:OMMt JNI sY DEVELOPMENT DEPARTMENT ^ / PERMIT N v 3'1 4 "lam
»,nsw •(..61.&P.o.Row MS7.Tigard.Owes,srm.(so1)c311-+1n DATE ISSUED
JOB ADDRESS:
l 4 l_ (,� / s/0 TAX MAP/LOT c Q A
:UB: 7'l-.Cfcc ll r.!
7 f LOT: /a' LANG USE:
VALUATION: t 6/ / , 408 2
OWNER SPECIAL NOTES
NAME: �1 Rpm C r REISSUE OF:
ADDRESS: _ /Ir' S ..'h. /74f LAST REISSUE:
7/ k,¢7 0 a r6 FL000 PLAIN/
SENSITIVE LANG:
PHONE: 6.- e. " 3 d 1 3 A '
APPROVALS REQUIRED
CONTRACTOR / /:/•2__ _L__'.31
// PLANNING:
NAME: L Y /l.' f ls"S ENGINEERING:
ADDRESS: '1,11S f jl A✓ /J/ FIRE DEPT
7/ G'-.,P'" oir OTHER:
PHONE: ITEMS REQUIRED
LIST/SUBCONTRACTORS: -
ARCH/ENGINEER OUS TAX:
NAME: /1-7 As 1. r')z 0 CALCULATIONS: —
ADDRESS: TRUSS DETAILS:
PARKING P1 AN:
LANOSCAPZ PLAN:
PHONE: OTHER: —— -
i
COMMENTS: - _ 1 f .. .4-.....L.4•;t'‘._,. — —---
. 1 :0J[..J[
PERMIT N ACCT N OES :RIPTION AMOUNT AMOUNT PP. BAL. DUE
L 10-432 00 Building Permit Fees 1/)'/ 2f_,f
10-431 00 Plumbing Permit Fees /4-i. :',- . 1. '
10-431 01 Mechanical Permit Fees —.4..:- _ y
10-230 01 State Building Tax (5%) J0 .Cb _.ilii
Building d G, y S
Plumbing 7,.: Y
Mech _
'7710 433 00 Plans Check Fee a � /U / 1110
Building ,.i cel }! ' '
Plumbing
Mech // L.
1 : 30-202 00 Sewer Connection ' _fL1.2_ /4 V
30-444 00 Sewer Inspection ILA: ,LL_
51-448 00 Street System Dev Charge (SOY) ( C e _
S2-449 00 ParMs System Dev Charge (POC) Z , 0 __42-4_,.-
31-450 00 Storm Drainage Syst Dew Chrg (SSOC) _ V 3 (1 —r...--_
10-23
_ -
10-230 09 FRED
10-230 06 Washington County Fire Ni (95X)
10-720 00 Amart/Wedgewood
Harm ,V(1,3_, 65' _•,. - TO(11(011
APP! ICANT SIGNATURE
1
Received fly — Dale Received" __ (,
cn/1`+81P/1 AP
I
I