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Case File��r:+.r..ww�ru..;...w.m�++'rra.+wwww.ww.wrwa.0 4MhVWYi1R��,prm!rWWMM�w�r�n..ww.a.w..c.w,r.r.. r.a1V�wRiy A,tw'Mev.nwry�gw�yMFY9G✓ ".wf1g111 . 111.F11MM1iIMINYM�MAyIf. I l I/ 1 i 1 r i a 6560 SW Alfred Street _ CITY OF TI RD t C'MCIFICATE OF COMMUNITY DEVELOPWENT IDEPARTMENT coanoon ny G".CUPANCY 13126 SW FWl BW. F.C.Fox 23307,Tlpf.W,93n 97W(603)MOOM PE RM IT DATA IGSO's.'I)o 10/2*9/92, 91TE ADDRESS. — s !:'-W ALFRED OT FARCE Ls IS125DA-1.49500 SUBDIVISION. . . . s PA4RI ) TION PLAT 11131-09il ZrJ;41NGs R-4. 5 . . . . . . . . . . . . . . . . . . 1:2 :LASS OF WORK. 11vrE:W or USE. . . :S-1F IPANCY GRP, CRZA oL.-t-UPANCY LOAD ol ,18 TENANT NAME— i Hemorkut Now Sl:"D lj.-ivevay must: he pot eo prior to cocv. Owner3 HAROLD COOPI-R 6540 SW ALFRED rlCARD OR '37r'23 Phone #a 104110t-u COOPER LOOPER MANUFACTURING CO. 6540 SW ALFRED IARD OR 97223-01000 Phone ko 503-R4(, H it, . v P,6 5 4 5 Ocotqpancy of the abt)v+.;) ref(pi-enc-erl bl.liltlillQ it. hffr•et')y r4jyerj, -;Nncl cer L- i f the cooll I karic 0 With the Stake Of Or-orJon S,Pov i a I t y C,01.leA f01-- Lha group, end ting under whicli thp r oft+runcod permit wj%v FIRE DEP(IRIPIF-14T B U I)I 1\1 MST IN rJN.c PICUCIL19 Pl-OCE INSP�(�ON..NO�f[CS �l. e�" city of Tigard Dui3dlnq Dapait-ent 13125 SN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-V-Phone)s 63'i-4175 Business Phone: U39-4171 Inspection: �.� -- — ------- -- — — — -- Faotinq P.lbg. Undecslah Mech. Rough--in Appr/Sdwlk Yound. Plin. Top Out Gas Line Post/Beam struct. San.. sewer Framing Bldg. Poet/Beam Mach. Rain Drain Insulation -Plumb- Plbg. 'Underfloor W ter Line 9Gyp. Bd. I ch. Date Requostrds� �'_ Tom: — A.1dresss -�7,Z/ �__-�5 Permit Is.. Bu l l de.s TIIE FOLLONING CORRECTIONS ARE REQUIRED: t I j Inepectort �. ✓ ------------ Cate: z APPROVED —^ DISAPPIN)VRD APPROVED SUBJECT TO ABOr-E Call For Wnsp. INSk'BCTION NO:ICB ` City of Tig'" BUSlding D"Mrta nt n 13125 SK Ball B1-vd. Tigard, Oregon 97223 Inspection Lina (Rec-O•-Phone) 639,4175 Eiue'_nesa Phone: 639-4171 i .:ne,pection:� _ ��-�--- —.-- --- M rooting Plbg. U-4"lab Mech. Pough-In Appr/Sdwlk ~� Found. Plbg. Top out Cas Line FINALS i Post/Beam Str^ct. S.:n. Sewer Framing -Bldg. Poet/Beam Mech. Rain twain Tueulation -plumb. 1 Plbg. Underfloor Water Line I:yp. Prt. -Mech. Date Regwestads ,// ----Time: _—�—� / —PM Address., ��Cp_1 _ Permit Iluilders q 1 'CHIC FOLLOWING C7RRNCTIONS ARE REQUIRED: 9' ON FIZZ✓ATF PEOFLRL, ' Date' /0_ APPROVED UISAPPROVF.D 1C AP1140"tt, 5UB,IE('r To ABOVE —_Call For Reinap. INSPEC+ION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection L -- 7v r�� --- c 'ZTime_. _ Date Requested A.!VI. P.M. Permit �IZQ— Address Owner - - --- = Lot # - --- Builder ----- The following Building Code deficiencies are required to be corrected: 1 Presented to --------- — --- �-� prnvcd Disarproved Infoectc - Date --. CALI, FOR REINSPECTION ❑ YES ❑ NO J .UNt2jCPjON NOTICE City of Tigard Building Department 13125 SW Ball BMJ.. 2Sgarx1, Oreayon 97723 Inspection LS:.e (Rec-O-Phone)r 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Undorelab Mech. trough-in Appr/Sdwlk Not.nd• Pll.,g. Top Out Gas Line FINAL: Poet-/Beam 3truct. San. Sesmr. Treating -Bldg. Pout/Beam Meeh. Rain Drain Insulation -Plumb. Plbg. Undarfloor Nater Line Gyj'. Bd. -Hoch. Date� Requesttodt�7cZ,Loy`�tj/-�j�_ Time: _ AM ` PN n� L'�TTCY l L �o` pi5 T renes Pe .Ad rniit Os � n 1 Builders 2t- -�p�!Li — TBR FOL1..VING CORRECT_ONS AAE REQUIRE): Dates __`APPROVED -_ DISAPPROVED APPROVED SUBJRCT To ABOVR Call For Reinsp, I INSPECTIONMICF city of Tigard Building DerArtwas'>t- 13125 SM Ball Blvd. Tigard, Oregon 9'1223 Inspection Line (Rec-O-vnone)c 639-4175 Bueinean Phcne: 639-4171 Footing plbg. Urderelab Mach. Rough-In Appr/Sdwlk Found. Plbg. Top Out Gaa LinaFINAL: Poat/Beam Struct. San. Sewer Framing -Bldg. s� poet/Beam Mech. Rain Drain Insulation Plumb. plbg.. Underfloor Water Line Gyp. Rd. -Hoch. Date Request eds._.,7 LL- ez— -;Pimets AM `j G� Address: -•• Permit Builder,- , THE FOLLOWING CORRECTIONS ARE REQUIRFD: -er ' , -a I/ , 07 T /y �. (( ,� �,-t��1�� /,�3�6.G--r tet...,^ %-•S.�-�- "-= /ter 7/ J Y // J C' �i �•- i - G Inspectors '/ _--�_--- Data: !� APPROVED v bI8APPROVE!) APPROVED ,SUBJECT' TO ABOVE V Call For Reinep. NSPEC'T10N NOTICE �"�� "_— City of Tigard Building r.spartoertt 3,3125 811 Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone)t 639-4175 Business Phone.: 639-4171 Footing Plbg• Underelab Mech. Rough-in Appr/Sdwlk Pound• pTTae Line FINAL: �lbq. op Out Post/Beam Struct. Ban. ?9"rFraming -Bldg. Poet/Beam Mech. Rain Dreln Insulation -Plumb. P1bg. UnderfIOOr Water Line Gyp. Bd. -Mach. Date Requested: Timet AM PM Aaareae:-— G o Permit Builder:_ — TOE FOLLOWING CORRECTIONS ARL REQUIRED: +� Data: i ' lnspectort _—APPROVED DISAPPROVED DISAPPROVED APPRovltn SUBJECT TO ABOVE _ ----- Call For ReinaP. INSPECTION NOTICE City of Tigard Building Departmovit 13125 ow Ball Blvd. Tigard, oregnrs 97223 Inspect{.on Line (Rec-o-Phone): 639-4175 Bushes: .:Zone: 639-4171 Inspection: _ Footing Plbg. Underalab Nech. Rough-in Appr/Sdwlk Fovnd. Plbg. Top Out Gas Line FINAL: Post/Ream Struct. San. Smmr Framf_ny -Bldg. Pont./BeAm Mech. Rain Orain Insulation -Plumb. Plbg. underfloor Nater Line Gyp. Ud. -Neck. �( Date Requested: -. � Times -_ / AN ✓ PM nddrees: ��V _� Permitell .'D051 51-14 21-41gx, r�sL/,� Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: T Inspectors-_ -_ - Date:_ 3-3�------_- APQROVED DISAPPROV=D APPROVED SUBJECT TO AE-VX Call For Reinsp. xqmpqwl APPLICATION - STREET IMPROVEMENT/EXCAVATION COPY TO: ORDINANCE NO. 74-14 � (WHITE)-FILE (INSTRUCTIONS ON SEP' (YELLOW)-INSP. \RATE SHEET) j --- a7�p (PINK)-OTHERAGENCY- APPROVED (BLUE)-APPLICANT AOR NOT APPROVED11 CI I Y OF TIGARD, OREGON \ _ APPLICATION NO.: — 28.00 PENDING FE!_, ppiT FEC AMT.: f t CITY HALL RECEIP Nu,, 1Z- z� x.33 7 -- PENDING SECURITY E] PUBLICWORKS DEPART'MENT RY 3 / 10/ ILPENDING AGENCY "OK" E] - - __ DATE—4- Applicationand Progress Record — — — — — — — . — PENDING INFORMATION C� FOR STREET iMPROVFMENT/EXCAVATION AS RE:UUjRFD c MAINTENANCE BOND M PENDING VARIANCE ANNUAL --_ C — EXPIRATIPN DATE / PERMIT N O DATE 'SSUED: BY: — ( 1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL _S� i` r_RY SEWER LATERAL AAfi MAINLINE TAP --- - AS DESCRIBLD HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICAN f _ Cmnby EXcavation P.(), BOX 84R C dllby,,--OR 9701.3266-2792 !1DDRE36- - CONTRACTOR —_- PLANS BY -- City—Standards and 51-Vc fications CIrY .HONE �!^ ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): S cltY HONE •/�X).00 DOLLAR!_— (2) EXCAVATION DATA: - FOR"-ie FFIe —_ B1 .00 28.00 (1.04 X f_— = f STREET _ DEiCRIP;IOV NAME SURFACE CUT PROGRESS a INSPECTION STATUS _ CUT CUT MATERIAL INSTALLCD QUANTITY TYPE LENGTH WIDTH DEPTH ITEM ITEM DATE REMA!?KS/TYPE RY d STREET see dttclC f1 K.j- PENED -- INSPEC- - R 'hoh —_ E _ Q ---- ESTIMATED STREET OPENING DATE: _ U ESTIMATED STREET CLOSING DATE: / T _ �— =- E.D ( ') SECURITY NO. . _ SECURITYAMT.: S: 700.00 STREET -- SURETY CO.: -- CLOSED ce'�T'r'Fn CHECK n -- FINAL. --=_= __ _ CASH ri �pryp� fNSPEC. (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL FEATURES;i EXCAVATION LOCATION AND EXTENT SF-CCIAL PROVISIONS j CONDITIONS: 1• Notify Cita Inspector Carl 1 I ! I N Vieweg #639--41717 24 houre ! before Starting »many work. - ' 1 2. All work shall conform to Cit uP.8 . ,- - - �, - -- 1 St y Spec ficat ons. S•W• AL,FRE'D STREET7!i7.541-.57.1 (Utility Co. - prenotification, etc. ) applies.- '�e - - - - le - - - _ 4. A hard surface patch is required - I I work ares -�-- - , I at t e end of each days work. I (RITE: 6560 S.W. At,E''i< ) 5`Traffic Control is required to be PLovtMOLT1 Apply;-- - - _ -A� ,--for the driveway vewa 5) NOTE THE CI�i3OF TIGARD DOES NOT, HERESY. —SS - --�- - ANT x ��'�$" to RI'3HT-OF•WAY JU GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE ►¢DICTION IS THAT QF--W-Ag'1HIN';TON COUNTY OR THE STATE OF OREGON. THE APPLICANT #GRE^S IO S PER IT THE REQUIRED SECURITIES. TO COMPLY WITH ALL PERTINENT LAWS AND / CONSTRUCT'ON SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AN E"41"LOr�ES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS. Alfr St.. is cequired. APPLICANTS SIGNATURE _..L ^ -- DATE / INSPEGZ'ION NUTICiE L�/.Z�/� City of Tigard Building DepartAumt 13125 SW Ball. B'vd. Tigard, Oregon 977.23 Inspection Line �Rec-O-Phone): 639-4175 Buninens Phones 639-4171 Inspect ion: -_-___---_- Fasting Plbg. Underslah Mech. Rough-in Nppr/Sdwlk Found. Plbg. Top Out Cas Ltne FINAL: Poet/Ream Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. VI im._Pnderflaar % Water Line (;yp. Ud. --Mech. rate Requested:l�� Time: Address: LAS v •emit iss�4.[L_ Huilder: THE FOLLOWING CORRECTIONS ARE REQUIRED: I CWP i i 1 Inspect.or:__� .l�.. --- — - Date��_�� APPROVED DISAPPROVRD APPROVE') SUBJF,CT TO ABOVE Call For Rslnsp. 4 TNSPECTIQH NOTICE City of Tigard Building Department 13125 911 Ball Blvd. Tigard. OLOWn 97223 Inapection Lina (ROC-O-Phone): 639-4175 Business Phone: 639-4171 -- Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Fwtnd. Plbq. Top Out Gas Line FINAL: ast/Ream Atrus_7t,7 San. Sewer Framing -Bldg. Poet/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Vater Line Gyp. Bd. -Hoch. Date RecpientFd: f��Z1 �� Tivet Addreas: 4f' Permit ts1/�GJ/� `J nulider:s THE FOLLOWING QORRECTIONS ARE REQUIRED: 71 Inspectors_„ , _—_.--.- Date:10-11 APPRO D DISAPPROVED — Y_ APPROVED 9usizeT TO ABOVE Call For Reinsp. 1 r INSPkCPION NO'1'IC6 City of Tigard Duilding D-PartO''c` 13125 SN Hall Blvd. Tigan:. oregon 97:.23 Inspection Line (Rec-o-Phone{: 639-417. 9usiness Phone: 63'•4171 Footing P1bg. Underslab Het;. Roug4-- .n `,ppr/Sdwlk �.d P1bg. Top Out Post/Beam Struct. San. Sewe- i aml :q Post/Beam Hoch. Rain Drain Insulation -Pi ,.aw Underfloor Nater Line OYP• ed. -Hoch. i Plby. ^� Date Requested: ZTimm _ -� ') r Addronne /`' i L�� _ Permit Builder: THE POLLONING 'CORRECTIONS ARE REQUIREDt i Datee10 Inspector:--- -- - _��d ----- APPROVED DISAPPROVED __ APPROVED SUBJECT TO AWIVE call For Reinsp. INSPECTzaN �1J7ICfi City rcP Tigard Sulidiuy DepartmentX 13125 SW Ball Blvi. Tigard, Oregon 97223 Inspect—n Line (Roc:-:�--Phone)s 639-4175 Bunineee Phones 639-4171 inspect ion:_ ----.— Footing Plbg. Underslab Hach. Rough-in Appr/Sdwl% Found. Plbg. Top Out Gan Line FINALS Poet/Beam Struct. San, :,ewer Framing -Bldg. Poet/Bram Mech. Rain Dain Insulation -Plumb. I Plbg. Underfloor Water Line Gyp. Bd. -Mach. Date Reguesteds_ G Times AM ---Ph Addreees, f ��J� ..�Permit Builders THE niLLOWING CORRECTIONS ARE REQUIRED: f�� OSv1i✓B 1S�ycv�Y _ ! �aw�LS z Yom.-eon, Inspectors - Dates APPROVED DISAPPROVED APPROVED SUBJSCT TO MMI Call For Minsp. I IMEE ION NOTMC'6 City of Tigard Handing Isepartsssent 13125 SN Hall Blvd. Tigard, Oregon 97223 Inspection Line (Res-O-Phones 639-•4775 Ouainesa Phones 639-4171 Inspections ---- --- Footing Plbg. Underel.ab Mach. Rough-in Appr/8dwlk Found. Plbg. '"op Oat Gas Line FINALS Post/Beam Struct. San. Sewer Framing -Bldg. Pont/Beam Mech. inUral.n�� Insulation -Plumb. Plbq. Underfloor Nater Line Gyp. Bd. -Nosh. Date Requested: •-P - e s _—Times —ii!r—AH PN Address:_ j c t_> �� /yt .� Es> Permit is Bu Ildor:�— -- --_-- ThT FOLLowiNG CORRECTIONS ARE REQUIRSD: Li Inspectors ' `' -- Dates -ZAPPROVED —^ DISAPPROVED — _ APPROVED SUBJECT TO ABN3 Call For Reinsp. I CITYOFTiFARD CFTYOFTMRD MASTER F'F M I l (COMMUNITY DEVELOPMENT DEPARTMEN r semooM 1-1E:RM I T #. . . . . . . : MST9 1—12116 0 13126 SW Hall Blvd. P.O.Bot 23397,Tkgmd,Oregon 47223(FW)639.4176 SITE ADDRESS- - 06560 SW ALFRED ST PARC:EI_.: 1S1F"jDA-- SUBDIVISION. . . . « "ZONING: 111-..00K. . . . . . . . . . .. LOT. . .. . . . . . . . . . . . __.___---.___..___ ._._.-----_.____--__--_-.-- - BUILDING -- - _-_---------- REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 5 CLAS OF WORK. :NEW BEDRMS: 1 PATHS:2 GARAGE'. . . . . . . . . . . 1078 sf TYPE_ OF USE. . . :SF FLOOR AREAS- -_..____.-- REQUIRED aETBACKS - --- - --- TYPE: OF CONST. :5N F I RST. . . . : 1372 s f LEFT, . : 16 ft R I GHT. : 10 ft OCCUPANCY GRP,. :R3 SECOND. . . :0 sf FRONT. : 8 ft REAR. . :53 ft; STCIRIE:G. . . . . . . : 1 'rHIRD. . . . :0 S REOUIRED-___._.__._..___._.___.____ HEIGHT : 18 ft TOTAL----••---•--:0 S SMOKE DETECTORS. :Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 83590 PARKING SPACES. . a0 Remarks : New SFD F'LUM1.3ING GINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0 LAVATORIES. . . . . :2 WATER HE PTER S. . . : 1 TRAG'S. . . . . . . . . . . . . . :0 TUB/SHOWERS. . . . .2 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . .. :0 WATER CLOSETS. . :2 SEWER LINE (ft ) . :O GREASE TRAPFs . . . . . . :0 DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTUR�_5. . . . . ..0 GARBAGE DISE'. . . : l RAIN DRAIN (ft ) . :0 WASH 1 NG MACH. . . : 1 SF RAIN DRAINS. . : 1 ---------____...-_-- MECHANICAL __.___.___.___..___ __-.__.__----_.__._..- - FEES _._ ..-_._._..._. _. .. _ FUEL. TYPES - -- -------- UNIT HTRS. . «0 type aamourt by date I fa c:I_t: VENTS . . . . . :0 TIF $ 1380. 00 JLH 09/ 17/91 - MAX INF'UT :O BTU VENT FANS. . : 3 BF,RT f 3E15. 00 JLH 09/17/91 F-URN ( 100K . . :0 HOODS. . . . . . : 1 BF'LC f 250. 25 JLK 09/1.7/91 FURN i =100K . . :0 WOJDSTOVES. :0 B5F'C f 19. 25 JLH 09/17/911 - FLDOR FURN. . . . :0 CLO DRYERS. : 1 SSDC $ 375. 00 JLH 09/17/91 - BOIL/(,'MP ( 3HP:0 OTHER UNITS: 1 F,ARK $ `_500. 00 JLH 12,9/17/91 - GAS OUTLETS:O MF'RT $ 32. 50 JLH 05/17/91 Owner-: --_____---------_---.-.--..__..-_-.-_--_-__-- MPLC $ 8. 13 JLH 09/17/91 - HAROLD COOPER 11151:'C t 1. 63 JLH 09/17/91 - 6540 SW ALFRED PPRT $ 117. 50 JLH 09/ 17/91 F'5F'C; '6 5. 88 JLH 09/17/91 - TIGARD OR 97223 Phone #: Cont r^actor^: OWNF".R k'hone #: 307"'J. 14 TOTOL This permit is issued subject to the regulations contained in the ------- REOUIPED TNSF'ECTIONS --- - - - Tigard Municipal Code. State of Ore. Specialty Codes and all other Foot/found Insp Insulation Insp applicable laws, All work will be done in accordance with approved F'ost/.Ream Str-uct Gyp Board Insp clan:, This perait will expire if work is not started withir 188 F'ost/Peam Mechan Rain drain Ins,. days of issuance, or if work is suspended for more than 180 S. F'lm/undslab Insp Water Line Insp FILM/Underfloor Appr/Sriwlk Insp Permittee `aignat�_rw� j�� - _-_ Mechanical Insp Mec.tlanical Final Plumb Top Out Vllumb Final fs, ,ued By : � _...._. �_-----___ Frram1nq Insp Buildina Final Call for inspection 639-4175 SEWER caNNr=r_TION CIIYOFTIFARDPERMIT' FERMI-1 C.�TY # COMMUNMY DEVELOPMENT DEPARTMENT 13126 SW wr awd. P'(".BOX 233G7.TOW,Oregon 97223(soot 83p�i 7 DATE I S S U E.D: 09/ E .� 51 TE ADDRESS. . . 06560 SW ALFRED S_. PARC:FI_ : 1 S 125DA— SUBDIVISION. . . . . ZONING: E.LOCK. LO.. TENANT NAME. . . . . : USA NO. . . . . . . . . . : FIXTURE' UN ITS. CLASS OF WORK. . . :NEW DWELLING UNITS. . . 1 TYPE OF USE. . . . . :SF NU. OF PUILDINGS: 1 INSTALL TYPE. . . . :6USWR IMPF_RV SURFACE. . : f` Relnarks: Nev) SF�D Owner: __ _ ---•--_— -------- FEES FEES HAROLD COOPER`^__._....—_—.•---_._._.._.___— tk;pe -amount lay date recpt 6540 SW ALFRED pRMT $ 1900. 00 JLF-1 09!17/91 — INSP 4 55. 00 JLH 09/17/91 — TIBARD OR 97223 Prone #: Contractor: -------------------------.__—.--._ OWNER i lrnne #: s 1935. 00 TOTAL ------- REW.0 I RE.D 1 NSPE=C:T I Of IS ?his Applicant agrees to _omply with all the rules and regulations Sewer, inspection of the 11n>fied Sewage Agency. The permit expires 120 days from _--•-- the date Issued. The total amount paid wil; be forfeited if the _ __ _._____�___ permit expires. The Agency does rot guarantee the accuracy of the ----- side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions fromthe distance given. If not so located, the installer shall purchase ---- a "Tap and Side Sewer" permit and the Agency will install a I!W�l. Permittee 15ignat1_1rL, T s s l-led 13 y : Cull for inspection — 639-4175 i i CITY OF TIGARD — RECEIPT OF PAYMENT RECEIPT' 4I60/+14 � �`1MlhtF; s C;GOP R, 14AROLf'. CASH AMOUNT 0. 00 t,�ql� �;rJ fai_i"RE:U PAYMENT DATE 09/ 17/91 S:lI/DRE:; , o SUF,D:V I S T.ON s TIGARD, OR 97,223 - PURPU.-E OF PAYi4f-:NT AMO_)N C PAI D PURPOSE. OF PAYMENTAMOUNT PO L 1) Ile BU I L.:1I Nl3 1'E:t4M 385- 00 PLUMBING PE=RM � MECHnNIC'AL PE 32. 50 ST. BUILD PER 126. '76 � FLAN CHECK, FE 8. 218 SEWER USA 1900. 00 � SEWER INSPECT 35- 00 RESIDENTIAL TRAFFIC. FEE'S 1280. 00 � PARKS SC;f `.:00. 00 STORM ;RAIN GDC, 375. 00 MAWT�i 'rRAKISIT TIF FEES 100. 00 I. L is I,a 656Qo SW At-FRED ` I TOTAL AMOUNT PAID - _> 4760- 14 4 Permit No: Address: —_..------ ----- - h ' Date: •, : Z Issued — ••' OR OFFICE USE ONL.Y-- STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit. can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 213: own. reside in, or will reside in the completed structure. 2. A. '� My general contractor is - -- Contractor registration number ____-• I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. 1 will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction; Contractors Board and I will immediately notify the office i3Suing this builoing permit of the name of the contractor. I hereby certify that the above Information is correct and that I have read and understand the information Notice to Property Owners about Construction Responsibilities on the reverse side o' this form. —��-' �Ig ture of Permit pylic t Date CONSTRUCTION CONTRACTORS BOARD 0244) V90 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT r, ~' CITY OF TIGARD - R��%P7 UF PAYMENT RECE%Pl NO. 01-217159 | CHECK AMOUNT : 25N. 00 | � AMOUNT � N^ 0� NAME : COOPER, HAROLD CASI; | ADDRESS : 6540 SW Ai FRED PAYMENT DATE x 09/09/91 ' SUBDIVISION : \ TIGAMD/ OR 97223- ' P/JRPQ8 �� E OF P��M�NT mOUNT PAID PURPOSE OF PAYMENT C-10UNT PAID Pt AN CHECK FE me, TO-1-At. AMOLINT PAID >PARCEL #2 MLP 89-1,2- 00 / '