10921 SW GENEVA STREET a r r+ +r,r'w� .�.y�+:�,I��Ir,.a�Rfwy�{�p�,�•pM, � - �IiA«!i•a•�.,�.�1•+Ily�l�grywmr.,1 �•remu�r�w�w• •�w.1y; +•.swfw•«w v
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INSF3rr'iON pm'�C�g
City of Tigard Atild1*9 Dgpat-usettt
13125 BR Hall Blvd. Tigard, Orem 97223
Inspection Line (Rec-,O-Pho�ri)t 639-4175 Buniness Phones 639-+,171
Toatiu9 Plbg. 9nunrelab Mech. Rough-in 9,,Appr/Sdw1k
round. Plbg. Top Out Gas Lina TINALt N
Poet%Beam Struct. San. boweri
Fr.aming -Bldg. » �
Post/Beaty Mach. Rain Drain Insulation -ply,
Plbg. Undorfloor Nater Line Gyp. Bd. -Mer•• _
u.
Dette Requested: S a--=—e� - Timat __Ak _app
Address: / C
Permit t t_ej_
Bu ilder,!_ f/G
THE TOLWWINU CORRECTIONS ARE P.EQUIREnt b
` F
F
In.tPoctort L.
�`-► __ Dating S
APPROVED �0I54PPROVXB 11P12
QOVEG t1USJE.:_ tr CAM
� / Call For Reivap.
J
CITE' OF TI A.RD
COMMUNirl DEVELOPPIENT OEPARTMEtAT
13125 sw Hal!Biv 1,Tigard,Crayon 972..' -8199 '50b)639-4171 f.,E Rr 1.1 1 GATE t J17
6 3r,-.4 17.1
14C 00t'RESI-3. 10'421 SW GENEVA G F PAPUT,I.,-.
l"1j81'1I V I S I UN. t IPP T' 5 LAND I NU 0 IN I NU`i;
BLOCK. . . . . . . . . . 1_C71'. . . . . . . . . . . . 0(* 1
GLASS I-A- WiRV.. aNl---W 40
rypE or* UbL. . . t GF
QC C'UPANCY 1--JRP. i:R3
0CCj,jt-"ANGY 4
rF.NV4,JT NAM(
PAT14 I
R1-7Iijnu-.-0)14NG'E VP.V
1672' !3W 14f1A-()lvlE'rfT
1-114N OR 97068
Phone O !157- 8000
j Ir
RENA16 ;ONCE- Cif. Vrl0F,MENl*
i67a .=)w r,-*m..t-s on
WriF.21 LINN OR 970Cb
557-8000
Req 0. 49955
Jcr.�uponry (if U.:e obove refvreime-d t)v'tlrling is hc-roby pivf-on, and vel-L i f o.
iflie c'umplialice with the Stmtv Of (W-OW)" 43Pec"It" f-C)rJ&u f t.1-1 f.& ,fir rai.tfry
li P'Z�1 Ir y and u s p I.,old ev- t-oh i ch t I I P r o f"re lic 0 d pe r IN i t w-.4'A isf,Lied,
F J R '�C IWVIUCTOR
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IN i.T.111413PIGUOU'S 01.-At'-T.
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�t�'iPECTION PiOTI i_E i ! •
Wl .'v of Tigard Buildiry Oepsrbeent
L3125 JW Hall Blvd. Tigard, Oregon 97223
Inspection :Ane 639-417'i Business Phone: 639-41.71
Inspection _--
F wtirg Pl.bg. Unde.alaL M,lch. Rough-in Appr/Sdwlk
lounU• Plbg. Top Out ;as Line pXN11L!
Post_/ltemn Struct, San. Sewer FramingB1QQ.
Pont/I,am Mech. Rain Drain Insulation _ply,
Pll+g. Underfloor dater Line Gyp. Bd. -Koch. �
Date Ra+d.ietedi 13 / / '?` Timet _ AN PM
I `ddr use:�V Tc�/�- v �js��//��i /� Permit 6)U
THlt RILLONING OURRECTIONB ARE RS(IUIRED:
C.
Inspectors
APPROVED --� DISAPPROVED T--- APPROVED RUBJECT TO ABOVR
Call For Reinsp.
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INDFr.=0t1 NOTICE
Cit? or Tigard Building M"part:asnt �
13125 SW Hall Sled. Tigard, Oc+sgon 9723
Inspection Line (Rec-O-Phone)r 639-4175 Business Phone: 9 1�1
y i
Inspectfonc� � a�_ _ i
tooting Plbq. Underalab Meeh. Rough-in Appr/Sdwlk
Pound. ' Gas Li:a 1►INAL:
Post/Beam Struct. Dan. Dower Framing •Blc+;.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor i at Gyp. ad. -Moch. Owl
Date Reques/gods Timer AN PH
Address: l/) r�iZ(/,4 / Permit It
Builder:
THE FOLL4MING CORREC"'IONS ARE RsQUIRED:
41
i
Inspector: Date:
--APPROVED DISAPPR0VXD PLPPROVED SUILINCT TO hOMIR
--Call For Relnep.
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43
i
INSPECTION NOTICE
city of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-417;
Inspect'.ont--
Footing Plbg. Underel.ab Mech. Rough-in •
Found. Plbg. Top Out Cas Line FINAL:
Poet/Beam St[u,:t. Sen. Sewer Framing -Bldg.
Post/Beam Mecn. Rain Drain. Insulation -Plumb.
Plbg. Underfloor Viter Line Gyp. ad. -Meeh.
Date Requestedt �! � _ _ Timet AM T'—' PM
Add-ens: 1012 l 14) -�`: r„i Permitptt 93—no3b
Builder: f7EN4)Sjllt/CL4< /µx•' }L.d.. ' / v.a+A
`t
fi MV FOLLOWING CORRECTIONS APR REQUIRED:
A DJC/7 1 cN A4 _ LEA /A/ '
— L i��E Fa>Z >�. TO 7,09 C_ e t= ip c
4
i
Inspectorl Date:__
APPROVED DISAPPROVED KPPROWED SUBJECT TD '�BOVB
_Call For Reinep.
k ,:
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd- Tigard, Oregon 97723
Inspe,Lkon Line (Rec-O-Phone): 639-4j75 Business Phone: 639-4171
Inspection:-__
FcatIng Plbq. Undorslab Mech. Rough-in Appr/,Sdwlk
�I
Found. Pl.bg. Tap Out Cas Line FINAL:
Post/Bean Struct. San. Sewer Framinq -Bldg.
s'
Post/Beam Mech. Rain Drain /Insulatl_on -Plumb.
Plbg. Underfloor Water Line d -Hech.
Dates Requented• �� G' Time: _--AM PH o
Address:_ --- Permit #s
Builders
THE FOLLOWING CORRECTIONS ARE REQUIMM:
i{
Inspectors s��J �--� Dates 3�/S=✓ -K
APPROVED DISAPPROVED APPROVED SUBJECT 'r0 ABOVE
Call For Reinsp.
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INSPECTION NOTICE t A
City of Tigard Building Department k
13125 SW Ball Blvd. Tigarc', Oregon 97223
Inspection Line jRuc-O-Phone: 639-4175 BusineAe Phone: 639-4171
.P
Inspections—_--.
Footing Plbg. Undaralab Moch. Rough-in Appr/Sdwlk
Found. 11bg. Top Out Gae LLne FINAL:
PGgt/Beam Struct. San. Sewer Framing -Bldg.
3
Poet/Ream Hoch. Rain Drain Insulation --Plumb.
Plbg. Underfloor Water Linc, dyp.� Bim; -Hoch.
Date Requested: Tines AM PM
Addrean: U 1 L ' v (.�-�SIJ tA... W Permit is 9 3- G`Cy
Builder:.— _ _'
THE FOLLOWING CORRF.CTIUN.^ ARE REQUIRED:
k
A
Inspector: ✓ ti/'
_-- Date:
APPROVED DISAPPROVED APPROVED SUB3;:CT TO ABOVE
_ WCall For Reinsp.
INSPECT_ON NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Lino Roc-3-Phone): 639-4175 Huei.neos Phone: 639-4171
Inspection: ------ �v_�
Footing PLbg. Underslab �ch. Rough-ip P.ppr/Sdwlk
i -
Fnund. Plbg. Top Out SCkfe Li�j FINAL:
Pont/Beam Struct. San. Sewer _ rami -bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mer-h.
Date Requeeted: _ Time: �AM _PM
Address: Permit
-
Builder:—
THE
uilder:_TRE FOLLOWING CORRECTIONS ARE REQUIRED:
�r
A. -��• "171 '
Inspector:— /,,L17 Y ---- Date:,
APPROVED DISAPPROVED 4/APPROVED SUBJECT TO 1B0VE
Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department Y
13125 SW Bell Blvd. Tigard, Oregon 97223 •
Inspection Line (Rec-O-Phone): 639-4175 Businesa Phone: 639-4171
'A
I :epect:or_:
3-Footing Plby. Underelab Mach. Rough-in Appr/Sdwlk
Found. P1bg. Top Out) sae Line FINAL:
Poet/Beam 3truct. San. Sewer Framing -Bldg. -
Post/Seam Nech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hach.
3 Data Requesteds Tlma:
Address; �� ---- Permit
Builder:
THE FOLLOWING CORRECTIONS ARE RBQUIRBDs
Af
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M1
Inspectors// �� 19-3
i--- Dater
`APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
__Call For Reinep.
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INSPECT ON NOTICE
1111 City of Tigard Building Department
! 13125 SW Ball Blv-,:. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busineus Phone: 639-4171
Inspection;_ —_
Foots-ng Plbg. Undersl w Mech. Rough-in Appr/Sdwlk
i Found. Plbg. Top Out Gas Lire FINAL:
lj Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Moch. Rain D Insulation -Plumb.
Plbg. Underfloor WaterLineGyp. Bd. -Mech. ,`
Date RequenLede,-� �--,!� -� Timer AM -PN i
^�� ell-
6
r
Address:- Gi'ti�_�` Permit �r ����L
Builder:
1 THE FOLLOWING 001tRSCTIONS ARE REQUIRED:
i
Inspector: - ^_ Datet_, J
—_APPROVED -� DISAP ROVEUAPPROVISD SURJFCT TO ABOVE
Call For Ref.nsp.
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INSPECTION 7M ICE +
City of Tigard Building Department
13125 SM Hall Blvd. Tigard, CIregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspecttion
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas kine FINAL:
j1bg.
/Beam Struct San. Sewer Fra:Cil:a -Bldg.
ech.- Rain Drain Insulation -Plumb.
Undertloo Water Line Gyp. id. -Mach.
squestgd: / aC / � -_Time s AM�'cym
AddLRae:�(.) t
•k
Builder:
° THE FOLLOWING OORRECTIONS ARE REQUIRED:
77 1
1:
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Inspector. --- ----_� P,-tel.
�. APPROVEb DISAPPR7JED APPROVED SUBJECT TO ABOVE
—Call For Reinap.
to � ....
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4 - - +ti1IIMiiIIYIYiY11■iIM 7 'rhiSn'or.+. 7N'YI1S-;C.
' [11Y OF ' 1(-4)RD - kF:i F I Pl" UF PH1"MLN I RL-CE: PT NU. 293--c.'36003
CHECK I iMr1UN T' t 504 7. 04 C
0 !4AML t RENATSGANLE DEVw l_I.,IF' W-1-Ir CA�A-1 AMOUNT' ¢ OL 110 ►
o-it;!iRE1,-t, t 167? 6W WILL.AMET'Tr:.. FALL,, DR' PPYMkN'I DHTL 0:11,27, ;.3
WEST L.1NN, ('JR 13USUTVl`3TUM t
9 70613_.
PLIPPIM E. OF F"AY ME::NI AMf.UN T PA i i) OF PAYMLN1 NrAOUN1 t�t?10
_._. _.._.....-._...W_.___..._....__.. _....._._....._,_....._...._.
...................._:.-_.-_.____-_...._....
..___
BUIL ll7NI_� WF RM M B T 9 02+.:c0 418.. 00 PLUMBING PERM 14'/. 50
MECHANICAL Or. 4,2:. '60 bT, BUTI_r7 PER :3171. 41:;
PLAN CHf-C:F, F'F- r:. ill SE W L R USf1 2100. 00
''r::WC:r2 TNSr='F_I' T :35.00 P"APP''SOC 1500- 11.11A
! t ORM PkA T N SDr "7W. 00 kF I DE"NI IAL T ROF'F I C,, F•EF S 1:550. 00
i1
MASS TRANSIT TIF FII-13 1 ]1�. rnV►
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TOTAL (-)MOUNT wit D _ > `;047 04
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t1Ty0FT1FA1-4.001EA11\16 PERMI1
PERMI1 #. .. .. .. .. ..
. . . . . . . .. MST0,3-0030
' 1W
CFTYVF4OM
(;OMMUNrTY DEVELOPMENT DEPARTMENT RD " 0
13126 SW Hall Blvd. P.O.Orm 23307 Tigaml,Aragon 07223(5W)639-4176 D A I E ISSUI)i 1. 125193
SI-1E 14I)DRESS. T-10921 ciL.NE'�A -'��—T _7 A
PARCELt ISI ,�-ji
mss, FjUBDIVISION. HART 1•--) t%4)INU
ZONINGs
BLOCK. . . . . . . . . . . LOT. . . . . . .. . . • , . ..
CLASS OF WORK— .NEW GARBAGE DISPOSALS— : 1
t�tI YPE Or- USE. WASHfNG MACH. . . . . . . x BACKFLOW PkE VJq I Rb. . S lb
O' CCUPANCY (,.jRP, ,. R3 FLOOR DRAINS. . . . . . . 90 TRAPS. . . 0
STORIES. . . . . . . . !2 WATER HEATERS. . . . — ill CATCH BA��N, S, ., 'RO
F I X TU PIE 5...----..._-------------- LAUNDRY TRAYS. . . . . . io SF RAIN DRAINS. . . . . : 1
5114KS. . . . . . . . . . . I GREASE TRAPS. . . . . . . x Ila
LPVATOR I ES. 0 CHER f-' i vrimr!,.s.
THS/6'HOWERS. SEWER LINE (ft ) . . . . .0
WPTER CLOSETS. . -.3 WATER LINE ( ft ) . . . . : LOO
DISHWASHFRS. . . . ti RAIN DRAIN (ff ) — . x0
Remarks : POTH 17
OWNER:
RENAISSANCE DEV TIF $ L460. 2111 JV4 01/25/93 -
16*72 SW WILLAMETTE I -LS DR BPR,r $ 4 i a. 00 JH 01/25/93 -
HPLC $ P71. 70 JLH 01/12/93 93-235
5
WEST LINN OR 97068
85pu $ 20. 90 JH 01/25/93 -
Phone #i 55-T-8000b 1)C $ 280. W'J JH Ol/L5/93 -
Pl�jmbing Cantractov, PARK $ 500- 041 JH 01/P5/93 -
MPRT ; 43. 50 JH 01/.'5/93 -
MPLC i ILA. 88 JH 01/25/93 -
------- ly,5F-,C 1. 2. 113 JH . 01./25/9:3 -
Addr t t,!! I-A P'E'RT $ 147, 50 j H 01/25/9.3
ki
City: State: P5PG s 1. 38 JH 01/25/9,3
Z i P t r,,�i e 4
Reg
RNOUIRED INSPECTIONS
This permit is issued subject to the req-
UlatiOng contained in the Tigard MUT13C.�iP&I Foot/found Insp Rain drain Inap
C'dde, State of Ore. Specialty C.0des and all Pogt/Beam Strurt Water Lino Insp
other applicable laws. All work will hp done Post/B&Avi Merhan Appr/Bdwlk Insp
in accordence with approved plal-is. this PIm/f.tridslab Insp Mechanical Final
peraft will expire If work is riot StArtP11 PLII/Und erf 1 not, Plumb Final
within ISO days of i9suance, or if woois lleah.avilcal Insp
s,tAspended for more tho.n ISO dayr- Buildknq Final
Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplaup Insp
Gas Line Insp
Insulation Insp
Gyp Board Itisp
Authorized Plumbing Crintract, Signature
Call for inspoction 639- 4175
Contractor Notest
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CITYOFTIGARD MASTER FERMI I _ '
Ory TMRO PERMIT #. . . . . . . . MSTC 3 0030
COMMUNITY DEVELOPMENT DEPARTMENT 0110"
13126 SWHrlBNS'P.O.Baer233177,Tigard,OrPW97ri'_ 03)6"16 I.1hITG ISISUED: VI1125/93
SITE ADDRESS. . . : 10921 SW GENEVA ST PARCEL. 1 S 134AC--81-021
i SUBDIVISION. . . . : HART' S LANDING ZONING: � •
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .1-'I
BUILDING -_. . ._.
RE I SSUE: DWELLING UNITS: 1 BA5E:MENT. .. . . . . . . :111 s f -
CLASS OF. WORK. :NEW BEDRMS:3 BAT HS:3 GARAGE. . . . . , . . . . :440 s f
TYPE OF USE. . :SF FLOOR AREAS----------- REQUIRED
TYPE OF CONST'. :51\1 FIRST. :9135 sf LEFT-27 ft RIGHT. : 0 ft j
OCCUPANCY GRP. :R3 SECOND. .949 sf FRONT. -20 ft RF_AR. . :25 ft
STORIES. . . . . . . :2 TH I RD. . . . :17.1 s f REAfl-I I RED•- -
HE::I GH].. . . . . . . . :29 ft TOTAL-------: 1884 S f SMOKE DETECT ORS. :Y
I FLOOR LOAD. . . . :40 psf VALUE. . . . . " : 94',x;84 PARKING �31D'F-iCES. . : I
Remar;<s : PATH I
i'LUMBING
`INK . . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0 d
i LAVOTORIES. . . . . :4 WATER HEATERS. . : 1 TRAPS. . . . . . . . . . . . , . :0
FUB/SHOWERS. . . . :;3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . , :0 i
I WATER CLOSETS. . :3 SEWER LINE (ft ) . :QI GREASE TRAPS. . . . . . . 70 e i
DISHWASHERS. . . . : 1 WATER LINE (fL• ) . : 100 OTHER FIXTURES. . . . . :0
! GARBAGE. DISE='. . . : 1 RPIN DRAIN (ft ) . :QI r
i WA1,733F•1 I NG MACH. . . : 1 SF RAIN DRAINS. . : 1 i
--- MECHANICAL - --___.____ .__.______ _. --__--_-----_.__. FEES
FUEL TYPES--..._____._._.._. UNIT HTRS. . :0 type aM0'A nt by date recpt
/GAS/ / / VENTS . . . . . :0 11F $ 14E 21. 00 JH 01/25/93
MAX INPUT :0 E11"U VENTFANS. . :4 13PR1- $ 418. 00 JI-4 01/25/93 -
TURN ( 100K . . - I HOODS. . . . . . . I E3PE_.0 $ 2'71. 70 JLH 01/::2/93 93-235515
1=1.1F21V ) =100[/,
. . :0 WOODST'OVES. :0 B5PC $ 20. 90 JH 01/25/93 -
FLOOR FURN. . . . :0 CLE] DRYERS. : 1 SSDC 11, 280. 00 JH 01/25/93 -
BOIL/ChIP ( 3HP:0 OTHER UNIT'S: I PARK 1. 5111111. 00 JH 01/25/93 -
GAS OUTLETS.- .1 h'IPRT 43. 50 JH 01 /25/93 -
1 Owner-: ----_.___.___.______.___._._.__.__..___......_.___..-IvIPLC 1, 10. 88 JH 01/25/93 -
{ RENAISSANCE DEV M5PL 11 2. 18 JH 01 /23/93 -
1672 SW WILLAMETTE FALLS DR PPR1 $ 147. 50 JH 01/25/93
j
1:15PC $ 7. 38 .JH V'1i25/93 -
WEST E_INN OR 97068
1-'hone #: 557-8000_._.»_.___.____'-____.._....__._._.__-._.._ i
Contractor: -
RE140ISSANCE DEVELOPMENT �
1672 SW WILLAMETTE: FAILS DR
WEST I_INN OR 97069
N
Phone #: 557-800111
Reg #. . : 49955
$ 3162. 04 TOTAL
This permit is issued subject to the regulations contained in the --- ---- REQUIRED INSPECTIONS
Tigard Municipal Code, State of fire. Specialty Codes and all other Foot/found Insp Fir-ep) ace Insp
applicable laws. All Mork will be done in accordance with pproved Post/beam Stre-lct Gas Line Insp
a
plans. This permit will expire if work is not started i in le Post/Beam Mechan Inst.11ation Insp
days of issuance, or if work is suspended f more th ,1 days. F'lm/e_indslab Ivisp Gyp Board Insp
PI_hl/Under-floor Rain drain Insp
Flernlittee Signate_tr e : '/ _ -?'�.---��Fpcharlical I1esp Water Line Insp
P.te_lmb Top Out Appr,/SdwIk Insp
Isse_tel:) By : Fr,aminq Insp Me ch anir_•a1 Final
Call fore inspection 639--4175
Orf, ° t
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CITRD' TI�� SEWER CONNECTION FrERhI T
T
' C�11f'OF11 �r11RD "I-
COMMUNITY DEVELOPMENT DEPARTMENT om!e�oa �� R1+1I r #. . RM I SWR9;3 �zu2� n
.3126 5W HWI BNd. P. O.Ba 23327,Tigard,Oregon 97223(609)6394175
SITE ADDRESS. . . : 10921 SW GENEVA ST PARCEL. I.S1 34iaC WI_. r.::S. • •
SUBDIVISION. . . . : HART' S LANDING ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :: 1
I ENANT NAME. . . . . : i
USA NO. . . . . . . . . . . FIXTURE UNITS. . . .
CL ASS OF WORK. — IVI=I^1 DWELL I NG UN I TS. . : I
TYPE OF USE:. . . „ . :SF 1J0. OF NU I LD I NGS: 1 •
INSTALL TYPE. . . . :BUSWR IhIPERV SURFACE. . : : Sf
Remarks: F"ATH I
Owner. ------- -_____.____._____.__________________.._______..____
FLES
RENAISSANCE DEV type amo+_,nt by date rErcl)i:
1672 SW WILLAMLETTE: FALLS DR RRMT $ c1o0. i7jo JM 01/25/93 -
INSFr $ 35. 00 .TF1 V_11/C'_5/93
WEST' LINN OR 97068
GI r or e #: 557-6000
Contractor:
CONTRACTOR I..""T ON F='ILE
F'honu i#: $__L,135. 00 TOTAL_------__._..__.__.._.._.__. ,
Rey #1. . .
REUUIRLD INSpECI IUIVS
This Applicant agrees to comply with all the rules and regulations :.fewer Inspection
of the Unified Sewage Agency. The permit expires 180 days fr..
the date issued. the total amount paid will be forfeited if the _
permit expires. Trio Agency dues not g1rarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, th, installer shall prospect 3 feet in all din ctions from
the distance givei,. If not so located, the installer hall purchase
a "Cap and Side Sewer" permit and the Aolvy wil stal/l�a llateral.
P e r on i i; L e e i I n t r-c r e :
I S 5 1-1 u, Ny - _._.___.___..--
Call fore inspection - 639-4175
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CITY. OF TI GARh 13123 SW ltau uwa. PLNCK/RECT # 1 --,�
COMMhNITY D VEI,OPM I,"NT Di:PARTMENT Tigard,Oregon 972:' PERMIT #
(501)679-4171 DATE ISSUED
JOB ADDRESS: f L� 7�'1; y�L- TAX MAP/LOT -2 /
SUB: LOT: •_! LAND USE: —
S�y
VALUATION: l��f. — _-
OWNER SPECIAL NOTES
NAME: REISSUE OF: —
ADDRESS: Z 'Z2Jj✓-7 Z '��S ��(/ — LAST REISSUE:
02C —_-- FLOOD PLAIN/
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PHONE: ` � �0�� S(:NSITIVE LAND:
CONTRACTOR. , ,rqAPPROVALS REOUIREO SU r59Z-0w3
NAME: j_� s � PLANNING: O k'-- CanJa►E,vt
ADDRESS: ENGINEERING:
_ FIRE DEPT: _
PHONE: — �STOTHER: T/
�ONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: �- / LIST/SUBCONTRACTORS: _
MECH: �( C�OL'd�l fy BUS TAX: — -- — i
KOLENGINEER CALCULATIONS:
NAME: _ �)� _ TRUSS DETAILS:
ADDRESS: � �C�,' —_ /� OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
PPL I C. NT S I GNAT9RF --
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Received By: �_ — Date Received: —
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PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
? cuo3d 10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees r 1172
10-431 01 Mechanical Permit FeesZ
10-230 01 State Building Tax (5%) 3
Builfjing , �0 `
Plumbing ,Y
Mechanical
1 �
10-433 00 Plans Check Fee 2.-5Y 3r rs'y
Building c?'7l. `I�
Plumbing -
rlechanical Jo ,
10-230 06 Fire
30-202 00 Sewer Connection -you
30-444 00 Sewer Inspection 3� �"i
25-448-02 Commercial TIF Fees
125-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees 3 y
25.-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) *-y
2.4-445-01 Water Quality (Fee in lieu of) —
24-445-02 Water Quantity (Fee in lieu of)
TOTAL 52F/ v� ���Ll/ Ks.d Y47, 0,�
nm/3587P.WPF
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7!il�rECTION NOTICE _
City of Tigard Buildinig Department ^
y 13125 SII Ball Blvd. Tigard, Vtr n 972
v,-
epee:tion Line (Ree-O-Phone): 639--41,75 F.uninese Phone: 639-4171
Inspection:_
Footing Plbg. Underslab Mach. Rough-in Appr/sdwlk
Found. Plbg. Top ,jut Gee Line FINAL: r
1+{ Pont/Beam Struct. San. Sewer Fremf.ng -Bl(.g.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line GYP• Bd. -Meeh.
Data RaqueetedsTime:
--ter--- - �
Address:�L � -�'G' _� L Permit #:
Hui
ldar:
1 THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inapector.:
Date:
JPL_
PROVED DISAPPROVEb APPROVED SUBJECT TO ABOVE
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