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Permit C!IYOFIIQARD I • .-4 e______---- CITYCIf WARD MASTER PERMIT COMMUNITY DEVELOPMENT DEPARTMENT \\,..777.9 13125 SW Hal Blvd. P.O. Bcz 23397, Tig J , Oregon 97223 (503) 639 -4175 PERMIT ....... MST -►Il 1 �= Lr • ' 639 -4171 DATE ISSUED: 06/18/92 . SITE ADDRESS.... 12195 SW \1213T AVE PARCEL. 2S103BB- 06510 SUBDIVISION....° ZONING. R -4.5 • BLOCK.......... t LO7'.............. . . -- - - -- BUILDING - REISSUE: DWELLING UNITS:1 BASEMENT— „.... :0 sf CLASS OF WORK. .ADD BEDRMG.O BATHS:0 GARAGE— .......:0 sf TYPE OF USE.... SF FLOOR AREAS REQU I RED SETBACKS . SETBACKS - TYPE OF CONST. 2.5N FIRST.....384 sf LEFT.. .5 ft • RIGHT. :5 ft OCCUPANCY GRP, : R3 SECOND... sf FRONT. :0 ft REAR.. :15 ft STORIES— — — : 1 TH I RD..... 0 sf REQUIRED HEIGHT........ :16 ft TOTAL .0 sf SMOKE DETECTORS.: FLOOR LOAD.....40 psf VALUE..... $s 21044 PARKING SPACES.. a0 Remarks. PATH I ADDITION OF 384 SO FT KITCHEN AND 676 SQ FT DECK -- PLUMBING -_•- - - SINKSS.....'...e.u1 FLOOR DRAINS....s0 BACKFLOW PREVNTRS...O LAVATORIES.....20 WATER HEATERS...o0 TRAPS......... ..... :0 TUB /SHOWERS.....0 LAUNDRY TRAYS... 20 CATCH BASINS....—. :0 WATER CLOSETS..20 SEWER LINE (ft > ..0 GREASE . TRAPS.......s0 DISHWASHERS.....1 WATER LINE (ft> . s0 OTHER FIXTURES..... 20 • ' GARBAGE DI SP...s1 RAIN DRAIN (ft >. 00 WASHING MACH... s 0 SF RAIN DRAINS.. s 0 -- MECHANICAL FEES FUEL TYPES, UNIT HTRS..s.0 type amount by date recpt /GAS/ / / VENTS ......2 BPRT $ 152.50 JLH 06/18/92 - MAX INPUT :0 BTU VENT FANS— c0 BPLC $. :99.13 JLH 06/05/92 228068 ' FURN 4 100K ...O HOODS .1 BSPC $ 7.63 JLH 06/18/92 - ' FURN >=100K .. s0 WOODSTOVES. :0 MPRT $ 25.00 JLH 06/18/92 - FLOOR FURN.... r, 0 CLO DRYERS.. 0 MPLC $ 6.25 JLH 06/18/92 - BOIL /CMP ( 31 -1P :0 OTHER UNITS s O M5PC $ 1.25 JLH 06/18/92 - GAS OUTLETS :0 PPRT $ 25.00 JLH 06/16/92 — Uwn er. -_ -- ° - -- P5PC $ 1.25 JLH 06/18/9E: - PAT AND OUVER KEERINS 12195 SW 121ST AVE . TIGARD OR 97223 • Phone 4 s 639 -2067 • Contractor. -- GROUT CO. v THE 1180 NW 14TH AV ' • -, PORTLAND aR 97209 = - Phone 4$ s 222 -5654 Reg C... 35451 i 318.01 TOTAL This peroit is issued subject to the regulations contained in the -. REQUIRED 'INSPECTIONS Tigard Municipal Code. State of Ore. Specialty Codes and all other Foot /found Insp Gyp Board Insp applicable lass. Ail pork will be done in accordance with approved Post /Beam Struct Water Line Insp plans. This peroit will expire if work is r start' w nin 190 Post /Ream Meehan Mechanical Final days of issuance, or if work is suspend -� ir . -, 4 r :n days PPLM /Underfloaar Plumb Final � , Mechanical: Insp Building Final Per rnittee Signature. \ �. _ Plumb Top Out Erosion Control. Framing Insp • Crawl Drain Issued By. • Insulation Insp Call for inspection - 639 -4175 . i 1. -,y . CITY" ®F TIGARD 13125 sw tiers 7 PLNCK/RECT # .D.397 PERMIT # yn,f yZ --D /ZU COMMUNITY DEVELOPMENT DEPARTMENT Tigard. Oregon 97223 (503) 639 -4171 DATE ISSUED JOB ADDRESS: TAX MAP /LOT .2-5(0 3 —d cc a SUB: LOT: 4 LAND USE: / G f VALUATION: ! 7 OWNER SPECIAL NOTES NAME: REISSUE OF: ADDRESS: LAST REISSUE: FLOOD PLAIN/ PHONE: SENSITIVE LAND: CONTRACTOR APPROVALS REQUIRED NAME: PLANNING: 40.' ADDRESS: ENGINEERING: FIRE DEPT: PHONE: OTHER: 44 VA ' CONTR. BOARD #: EXP DATE: ITEMS REQUIRED SUBCONTRACTORS: PLUMB:, d LIST /SUBCONTRACTORS: MECH: BUS TAX: ARCH /ENGINEER # CALCULATIONS: NAME: TRUSS DETAILS: • ADDRESS: OTHER: PHONE: PROPOSED BLDG. USE: COMMENTS: APPLICANT SIGNATURE Received By: /i` Date Received: ( - S IT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE M3f92 -Of G 10 -432 00 Building Permit Fees /152,50 /52.50. 10 00 `Plumbing' Permit Fees c/ 10 -431 01 Mechanical Permit Fees 2,,dv 10 -230 01 State Building Tax (5%) /D . J 3 (. 2_ 1 Building 2.6 Plumbing J . Mechanical /.z, S 10 - 433 00 Plans Check Fee ("J/oS 0 Building I /. /3 9 � Plumbing Mechanical ("E "L 10 -230 06 Fire 30 -202 00 Sewer Connection 30 -444 00 Sewer Inspection 25- 448 -02 Commercial TIF Fees 25- 448 -04 Industrial TIF Fees 25- 448 -06 Institutional TIF Fees 25- 448 -03 Office TIF Fees 25- 448 -01 Residential Traffic Fees 25- 448 -05 Mass Transit TIF Fees 52 -449 00 Parks System Dev Charge (PDC) 31 -450 00 Storm Drainage Syst Dev Chrg (SSDC) 24- 445 -01 Water Quality (Fee in lieu of) 24- 445 -02 Water Quantity (Fee in lieu of) TOTAL 31g,01 sj q.`ir nm /3587P.WPF / INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171 1( Inspection: - Footing Plbg. Underalab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing -Bldg. Post /Beam Mech. Rain Drain Insulation - Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: /- 2-7 /� .3 n Time: AM PM Address: /2/ 9 5 & /z( 2 4Lii' Permit #: 92. �G/ Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: f I 'l Inspector: A�i� /�" / Date: r — �2 APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call ForReinsp. • INSPECTION NOTICE A f City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171 • Inspect -Ion: ( — Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing -Bldg. Post /Beam Mech. Rain Drain Insulation Plbg. Underfloor Water Line Gyp. Bd. (Mech.� Date Requested: / �� ! Time: AM PM Address: `e/ 10 /,. 572- /J� — Permit #: / 2 Builder: THE FOLLOWIN g z,,z-- RECTIONS ARE REQUIRED: • Inspector- ��∎ _ /� / „/ / ')/-- Date: ( a.. - 25 \ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. 5 /10 /00 Activities for Case #: MST92 -00120 1:11:33 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA007 Application received 6/5/92 JLH PASS BLT 6/12/92 MSTA010 Plan check deposit paid 6/5/92 JLH PASS BLT 6/12/92 MSTA020 Plan check by 6/12/92 RT PASS BLT 6/12/92 MSTA030 Check for prcl. restrict. 6/12/92 6/12/92 RT PASS BLT 6/12/92 MSTA705 Foot/found Insp 6/19/92 GS APP GES 6/19/92 MSTA710 Post/Beam Structural 8/7/92 GS APP GES 8/7/92 MSTA711 Post/Bearn Mechanical 8/7/92 . GS N/C GES 8/7/92 MSTA720 Mechanical Insp 8/7/92 GS APP GES 8/7/92 MSTA•25 Framing Insp 8/7/92 GS DIS GES 8/7/92 MSTA745 Gyp Board lnsp 8/24/92 GS APP GES 8/24/92 MSTA795 Mechanical Final 1/22/93 RT PASS BLT 1/22/93 MSTA797 Plumb Final 1/22/93 MS PASS MRS 1/25/93 MSTA799 Building Final 1/22/93 RT PASS BLT 1/22/93 MSTA092 (F) Issue combination permit 6/18/92 JLH PASS JLH 6/18/92 MSTA735 Gas Line lnsp 8/7/92 GS APP GES 8/7/92 MSTA726 Framing <REINSP> 8/17/92 GS PART GES 8/17/92 MSTA740 Insulation lnsp 8/17/92 GS APP GES 8/17/92 .• MSTA726 Framing <REINSP> 8/24/92 GS DIS GES 8/24/92 MSTA970 Case Finaled 1/22/93 BLT 1/22/93 Page 1 of 1