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INSPECTIO61 NOTICE
City of Tigard Building Department
'r fir' P.O. Box 23397
Tigard, Oregon 97223
� b, ne: 639-4175
i
Type of Inspection _ � --
Dale Requested Time A.M. P.M.
Address Permit
Owner _ `_ Lot
BuilderThe following Building Code deficiencies are required to be corrected:
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PS
Presented to _—t 1 Approved-
Inspector 9proved
Date _r-T
CALL FOR REIN PFCTION
0 YES l-J NO
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APPLICATION, STREET th1PROVEMENT/EXCAVATION COPY TO:
LE
ORDINANCE NO. 74-14 ( •
(YYELLOELLO W)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) r;JPI(BLVUE)APPL CANTNCV
APPROVED Is APPLICATION NO.:
NOT APPROVED ❑ CITY OF TIGARD, OREGON FEE AMT.: S.
PENDING FEE.PMT. ❑ CITY fit.M. RECEIPTNO.: QGI/C1z r 7 7
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BYE = DATE- L-1 -i f
PENDING AGENCY "OK" ❑ Application and Progress Record
MAINTENANCE. BONLL_�k
PENDING INFORMATION ❑ FOR STREET IMPRUVEMENT/EXCAVATION AS REQUIRED h --
ANNUAL O one
ar
PENDING VARIANCE ElEXPIRATION DATE: Y
PERMIT NO.: DATE ISSUED: l_I .�_ ,�.__. BY:
!'HO Sal Jry C 8@LrV�G`09$
(1) AAPQPLUIChATIA Npcon IS HEREBY MADE TO EXCAVATE FOR AND INSTALL
—_ AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT _ Fernwnod DeV•!Inc. . -P7 Box 231207 Tigard, OR 97223 6.39-8115
NAME AODREI-S CITY - PHONE
CONTRACTOR.-_._�� at this time _ _- —
NAME DORESS CITY PI/eINE
Tech. Engr. �
.. Corp. (& Applicants 8835 SW Canyon Ln, Portland 97225 297®3721
PLANS BY-_—_--- —_-- _ - �- _--
NAME ADDRESS CITY PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): f
DOLLACIS
(Z) EXCAVATION DATA: FOR OPPICE VSE O t 77.0.04 X s__ � = s �¢�•'�
STRE.FT DESCRIPTION PROGRESS & INSPECTION STATUS
SURFACE CUT CUT CUT MATERIAL INSTALLED
NAME_ _ TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY ITEM DATE REMARKSJTYPE BY
STREET
, QPF,Nr,D -_ - --
Bonita Rd (see at ched lan) INSPE
R
TION
Q
U
ESTIMATED STREET OPENING DATE:-- / _ S
ESTIMATED STREET CLOSING DATE: / E -
---� _ DSTREET
_
(3) SECURITY NO._ SECURITY AMT: E_ v`�wL�•c�+�J +CLOSED
SURETY CO.: FINAL —
__ CERTIFIC.0 CHECK D \OND INSPEC.
(4) PLOT PLAN: INDICATE SITE PFRIINENT PHYSICAL SPECIAL PROVISIONS /CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT. 1. See attached plan for speci�il
�Z'.-r iSt�J/�•/ construction provisions and
1 (see attaches pl 1 I con(jitiions applicable hereto.
1
1 1 details) I 1 _
t ions of lil P 68-09a
t d_);,licable nereto.
FQJITA W).
1 1 I i 1
1
(5) NOTE THE CITY OF TIGARD DOES NOT. HEREBY. GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT L A,f.S AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE - DATE I �__
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CITY OF T'67A RD PEPM1f* NO. : MF 890103
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COMMUNITY DEVELOPMENT DEPARTMENT T01,00" DATE. :1 SSLJI;;:U : 1./P./I/89
13125SW Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223.(503)639-4175
1.,:,1M,T* .NO . 0900.52
It)13 ADDIA;Afi : 8133 5W 1:03N.UrA PD
! ()X 251. 12FM SLAV L.*Y BK .
I i)ND LISE : P 7
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WORK MASS : NEW FURNACE <100K 1. AIP VIANIA-W <10
USE 'Y*Yl:*'F:: : S]:NGIAr'.: FAKILY 1-UPINIA(:E 10OK4- A114 HANDI 1-1 1.0K
CONS1 . TYPE - VN FLA)UP 1j!'LJWN0 (:,E: E.VAI-,) . COULEA
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HL.P/COMP
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I*(WA 1 A S E41 W/(::OMPA '30.....50HP PEPAM
MAX 1:IN Pt.)T,
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NO . TJ 1,AL. 66
I'*X,F:..*I:;)'7* NO. (0 23c)I
This permit is issued subject to the regulations contained In Title 14 ,.,.,,„„,_,•,_...........••................
of the TMC. State of Oregon Specialty Codes. zoning regulations
and all other applicable codes and ordinances. and It Is hereby
agreed that the work will be done in accordance with the plans and GAS IAMF
specifications and in compliance with all applicable codes and PMVI & SEAM
ordinances The issuance of this permit does not waive restrictive 1:1111:11UGH-I N
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 be the responsibility of the permittee to assure
all required inspections are requested and approved
Permitter ittirici
Issued By --- __2 F(MR
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
A PLAAMWEN(2, PEK10i 1'. 1
CITY OF TI67A RD arAw F"ERMI'T NO . : PLA390102
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COMMUNITY DEVELOPMENT DEPARTMENT offem
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. .. StjI.JF.7U: J./R-el/8 9
13125 S.W.Hall Blvd.P 0 Box 23397,Tigard,Oregon 97223,(503)6394175
PP3:M . I;*'Mr .N0 . (390031P.
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013.3 5W WINIT'A PD
I1^lX MAP/1-01 is :11128S
LAND I.KiE : 1417
NO :
WC)PK 01 ASS : NE.V W A T 1:-;*P 0 05E:1
015E 'T*Yl:'F'.: : 1;11:N(*.-,I. F:: P"AM11 I.JAJ:NAI FL
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OCCIAP . C:IPP : P3 RIB 51-10WEP c1. UPEFASE '1*P(4l::1Cl`
OTSHWASIAEP I.
CAPIROiGA: OTGPOSAL, J.
NO . %1*0121:11.:5 : 1. W65HTN(:" 1v16(:.'IA1'.N1;.:'. J.
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F] DPAIN
ST.NK 1. S E W L.".II t I
WATE34 HEWTEA4 I t-VTOPM N 11: 1,
W 0 14:1.1..1. T 6M rrnwr 1 $1.17 . 50
N 81-10 '.SIJ Mr-U."LEA
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!;i VATS $5 .60
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R NO 35261:11
NO.
This permit is issued subject to the regulations contained in Title 14 .............
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances. and It is hereby PEW-11:11EU :I'N'3PEC'TJ0NS
agreed that the work will be done in accordance with the plans and PI—H 'UNDEPSLAB
specifications and In compliance with all applicable codes and c"ll-A-M
ordinances The issuance of this permit does not waive restrictive WA Y'I::P' T'NE:
covenants Contractor and subcontractors shall have current city 11'L.11 . N)POU'r
business tax permits This permit will expire and become null and
void If work Is not started within 180 days.or if work is suspended or PA1.19 DPAT.NS
abandoned for a period of 180 days any time after work has F:'*I:NAL
commenced. It shall be the responsibility of the permittee to assure
all required inspections are rpquested and approved
•
errnittee Signature
Issued By IRMA- —J
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
W--
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CI11Y OF T 1 GA RD 111.)r I UlNG PI-.:RM1-T
PEMM17' NO,
CffYOFTMRD
COMMUNITY DEVELOPMENT DEPARTMENT 1./2 lei 09
13 125 S W Hall Blvd.,P.O.Box 23397.Tigard,Oregon 97223,(503)639-4175
PW I M- PKT.NO. 890052
ADDWEA i$ : 81-53 !aW 80NIVA RD
TAX M6P/LO'I* .251. SUB : L.T HK :
I AND USE P1
S 1:71: : VALLIA11"ON 41 6P 900 5
F-WON'r: 20 I'IP-:AIQ :
WORK CL.AW:i : NIEW E)WF':l-L. . LIN I T S 1. 1 7 111 GFI T
1151. TYPE' : NO. HEI)POOMS : 3 EXT -WALL (*,ONG'1' :
(','0NSVT* VYPE:: VN NO. BA11-IS : N: S : W
III III fJM . : R".5 P1401, (:)PE,.NJ'N(.,5 :
IGIL.till 1. 061) N: S : W:
'11,01 AI 1268
N0 . S'r0A1I;::C5 : 1. J.15 1268 ('ONS'T : (11 FTPE. PEl"?
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2ND: APEKA SIEEPAP? PA'T E,D:
PASEMI:rN I"?
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ri-ow I'.)E1'TI*r.(:*`T`? YE-5
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01` 8:115 SW BONT'I'A F41) MI-P OF' NO . 881W-21
Inc I AST, Pki.iSsur 1390051.
0 WILLTAM
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51'A I I--' I AX $1.6 . 10
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N 11111850 . 00
T VA:'34NWOOD [)E.V I N(',' $600 . 00
R8110 514 MA1:1--Ell"Y41': !i I' Ipp
A $250 . 00
C i ri w r) Op 971k!�.�iA I-*'A 0 < 11110 . n()>
T I I II NIF (503) 215--m-11.
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R Il:4A'T*V.)N NO .19 f'.!*7 6 /023 01
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This permit Is issued subject to'he regulations contaIr.ed in Title 1.1 NE:111F.IP'T No.
•
of the TMC, State of Oregon Specialty Codes,zoning regulations
.............
and all other applicable codes and ordinances. and It Is hr,reby
agreed that the work will be dcine in accordance with the plar.q and 1-*113011 NG
specilications and in compliance with all applicable codes .nd FOUNIN)7'10N WAI—L. PAIN UPAING
ordinances. The issuance of this permit does not waive restrictive 1-101:1 1 & bllAM WAILP
covenants 1;ontrsctor and subcontractors shall have current city P L.8 .IJ N D 11F.:W5 L A R
business tax permits This permit will expire and become null and
void 11 work Is not started within 180 days.or if work is suspended or 511 ACS FT NOL
abandoned for a perloc' of 180 days any time after work has IN R 'TOPOUT,
commenced It shall be the responsibility of the permittee to assure IfflMVNC;
all required inspections are requestel and approved
1 A I.,E,
OAS LIM.-.'
"5t-JI---A'r1:ON
Permittee Siqnature
Issued By: RAI
SEPARATE PERMIT'S REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
F_ SLIA1111P PEP1111
CITY OF TIGA RD My W40 l::+JZM1'T NO , : SEK(39010,41
COMMUNITY DEVELOPMENT DEPARTMENT DA11-i.: 15SUED : I feAl I a?
13125 S.W HAH Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)6394175 PnIm. rwr .NO . 890032
JOB ADI)PI.-GS : 8133 SW BONI Y'A 1:11) USA NUMBEP: C37165
TAX MAF-1/1 O'1' 251. 3.280
LAND USE : P7
I_0*T SIZE'.:
5FXfInN: is 1UP : Pill PW.', - 1.w
WOW< CLASS : NEW
USE TY1."IE : SINGLE FAMILY
app)3A.Cal-It ingirreavi to Qumpl.y W3.01 a1l. r1v..)gi.43.akt.i.i:irisi ri�;' thea t.40.41:1ecl
Sewor-age A51ei,ey . The pellnit expil-em IfE*0 dayll; lIrum thly# clate. :11.16wllvd . 'The tat'ni.].
Ilk IF%C)t.1 I I rt, pa 1.0 W J1.:1.T 1:)w f 1;1 r'r ird i t 0 d :1.-P t h1w 1a)G r In].1, 0X 11 J.I'esi . 'The A( d 1:1 ell) rI C) cI 1.1 ni I
wiitev thli,? at_,euraey a-F the I'arnatitill I:)-(? the "li(In Inewter. TateraIiii If the mewer., 1.11;
riat. lar-,ait.wd at the ineauairemprit, giveii , then %hall. 3
a 3.'t di I-,(�s:^IA.(:)rt III f I-,ci m t h e, d.i.w t a nv�ni 9 1 v e n 1:4' 11 a t in a 1.a c:a t a d , the i.nstia*I.J.er
F)urc.,hittwe In. "'lar) arld 5itiu Sewer" rlerni:l I, atici thili? AQq-I1r.,y wil.]. :LrIllitia,11 a
INS'T'ALL . 'TYPE: BUIL-01W, SEWEP Impt-JIVIOUS AP A :
F*IX'tLJAF UNITS : Tr-_'NANT TMPP0t,,L'MEN'T' :
DWEI L.ING UNITS : 1.
NC). OF nL.DGS 3.
FEC:S :
0 GODWIN WILLIAM PEPMI*T 00
W
N (31-1.0 SW MAPLELFAF ST CONNEC'T'ION GHA PGE-_ 41:1. , 1.00 . 00
E 'T.TGAPD OR I. INE 'TAP INS'TALL .
R
O'THE R
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0 CC.)DWTN WIL.I_1AM
N
T FE.PNWOOO DEV . INC
R 81.10 SW MAIPLAKLEAF 51'
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C T I CARD OR 101223
T PHONE, (".10:.3)
0
PEGISI'PATTON NO . 419276 'TOTAL..: $1. 135 . 00
PECr;.'IP'T NO .
This permit is issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes,zoning regulations PEQUIPEED INSPECTIONS
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and ncwwJ i—j,N
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
hUsiness 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 be the responsibility of the permittee to assure
all required inspections are requested and approved
1��l t t�,eS 19 nLure_A
Issued By: I r.pp
441 ip
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE