16700 SW JORDAN WAY �yrM',Ve+roww�W*�M)•• JII•R�FIAIiMM� SpSYI•.'IlM�W+*P
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CITY OF TRVARD
COMMUNITY DEVELOPMENT DEPARTMENT CERTIFICATE: OF
13125 SW Nall Blvd.T•.,ard,Oregon 97223.6199 (503)839-4171 11CC UPANCY
.. PERMIT #. . . . . . . a MST93--029 7
DATE I SSUED t 01/20/94
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PARCEL: 2S 1 16AD-BEn 1'l
SITE ADDRESS. . . o 11:700 Taw JORDAN WY
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SUBDIVISION. . . . t BEDFORD Gt.t_N ZONTNGs
BLOCtt . _..__.II.OT •-- __....�. . . . . . t 19
CLASS OF WORK. t NEW
TYPE OF USE. . . t SF �
OCCUPANCY GRP. 03
OCCUPANCY LOAD j 1 19 4
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Tr ,�A v" NAME. . . t �
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Remarks ; mTH I
Owner t _ . _._. f_.__•__.__..__.� .__._ _. __ _.__
DEACON HOMES INC.
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Phone Mt
Contr,a0:or t __�. _...._._.......__._ _.._.___....._.,.._�_.......__...._•._
BEACON [ACMES
9500 SW 125TH
B AVERTON OR 97005 Ii
Phone *t 524--1999 I
i R a g M. . t 70702 III
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Oc-c:upency of the art•.ruve ref�rprte:ed building i.S hereby given, ).nd certiftes
the c.ump! iarnr.e with the State Of Oregon Specialty Codes for 1-.he groi.tp,
! occupanvy, and s.tse ander which the tWerencecl permit wa% issuod.
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F— RE T)EF'AF?1"MEN l NG ' IN C:T'DR
CIAL F
POST IN CONSPICUOUS PLAGX
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INSPECTION NOTIrE
Citp of Tigard Building Deparlmen
13125 SW Ball Blvd, Tigard, oregop 9
Inspection Line (ReC-O-phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mach. Rough-in nppr/Ddwlk
Pound. Plbg. Top Out oar Line ,
`l TIN11L t��)
Post/seam Struct. San. Bower Framing -Bid
Post/Beam Mach. Rain Drain
Insulation -P1
Plbg. Underfloor Nater Line
gyp. Bd. -Meeh.
t
Date R I '/7 G�y�
equested a—_-
Timet PK
Addareas=-1 =-[( ice. a
Permit t 3 C5 2 _ IN
BuIIdersA(A
TBE FOLLOWING 'CORRECTIONS ARE REQUIREDt
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Inspector:
Dates.
—I_AF1cR0VMD
ates.
ROVED DIt3APPROVEDAPPROVED SUBJECT TO AgpVE
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Call For Reinap.
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INSPECTIOF- NOTICE
City of Tigard Building De.-aztetent
13125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rea 4-Phones 63S 4175 Businoss Phone: 634-4171
Inspections_
looting Plbg. Underelab Mech. :tough-in Appr/Sdwlk
round. Plbg. Top Out Gus Line FINAL:
Post/Ream Struct. San. Sewer Framing -81dy.
Post/Beam Mach. Rain Drain Insulation -P.umb•
Plbg. Underfloor Water Line a�►p_9d•_ -Koch.
nate Requested: (� , �9 TlJINt 2 _AN
Address- l Ca 1�.� 1yr Ja-vt. (J._�L L.T resMic #I —
Builders
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TBE FOLLOWING CORRECTIONS ARE REQUIREDt
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Inspector: — _ Dater
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f APPROVED )ISAPPROVED APPROVED SUBJECT TO ABOVE
.':all For Relnap.
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1NSPE4'TIO�I�I�_CB �
City of Tigard BoUdicg Depertewit
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13125 BM Ball Blvd. Tigard, Oregon 97223
Inspection Lire (Roc-O-Phona)e 639-4:75 Business Phone: 4/71
Inspection:
rooting Plbg. Undersiab Meoh. Rough-iet~ Appr/Sdwlk
Found. Plbg. Top Out gas Line FINAL:
Poet/Beam Struct. San. Sewer �IPCML14 -Bldg.
Post/Beam MI Rain Drain �enlationl -Plumb.
Plbg. Underfloor water Line �t;rp. !d. -Koch. .
Date Requesteedai.? In "C5 TLmo x AK PK
Address t I��r� '3 oyj o-{\ �.� �1 Permit #1 tv
Builderry�ii r.t��1'1 --
THE FOLLOWING ODRRIMMIONS ARE MU'RED:
InspectorrT — — —__� --- -�I
Dates
APPROVED DISAPPROVED APPROVED SUBJSCP TO ABOVE
_Call For Reinap.
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IMMPECTIONNO,TICO ! Ay
Cny
City of Tigard Bulldi
13125 sw Hall Blvd. Tigard, Oregon 9
Inspection Line (Rec-O-Phs2MO)s 639-4175 Busing■ h a: 639-4171 uy {
Inspection:_
I Footing Plbg. OmMsslab �„�Rough-Ln- Appr/Sdwlk Kx�
Found. Plbg. Top Out acs Ll.ns FINALS
j1�3
Post/Beam Struct. San• sewer raw�� -Bldg. n `
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Post/Beam Hoch. Rain Drain Insulation -Plumb. Ll'F
Plbg. Underfloor Hater Line ayp. Bd. -Hech.
Date Requsetex7:Y�.
Addreent !�L/ ��✓ . ( Permit f t [ -ol '�`+i� �y�,rd{J,?�rn 7 � ■
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Builders +, kxlAi
THE FOLLOWNO WR"CTIONs ARE RBQUIRED:
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Inspep natal
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D DI8APPR D APPROVED SUBJECT TO ABOVE
--- , Call For Reinsp.
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INSPECTION_NOTICCZ
City of Tigard Building D.part3 /
13125 SW Ball Blvd. Tigard, CO-eW: 972 '1r
Inspection Line (Rec-O-Phone): 639-4175 Business P nal b39-4171
Inspection:_
Footing Pl urJ' Mech. Rough-in Appr/Sdwlk
Found. Pl ?opn• Line FINAL,
Poit/Beam Struct. Mr..i r ( Framing �I -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. ad. -Mach.
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Data Requesters V Time: AM
Aedress: �Lp 1n� c-�L �Q-V� u)G.� _ Permit 1sq?7
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Builder: bu'_.e� I '� R� J GjZ. f ' 'oil
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TIRE VOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ Date:
APPROVED DISAPPROVED _ PPROVRD SUBJECT TO ABOVE
__ _Call For Reinap.
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jNSPBCTION NOTICE
City of Tigard Building Dem zmnt
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): G39-4175 Busineas Phoq. 39-4171
Inepoction: -
`
Footing Plbg. Underslab Mech. Rough-in ApPr/Sdwlk
Found. /Plb9. Top Oust 1 Gas Une PID7AL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Meuh. Rain Drain Insulation -Plumb.
Plbg. Underfloor // Water Line Gyp. Bd. -Koch.
Date Requeetedt /V /�_/ Tip — PN
Address:�7U )
Builder• f --
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THE POLL04ING CORRECTIONS ARE REQUIRED:
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Inspector _._ Dater
APPROVED _- DISAPPROVED APPROVED SUBJECT TO ABOVE
Call. For Reinsp.
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KING CITY
15300 S.W. 116th Avenue,King City,Oregon 97924 Phone:1139-4082
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
(Instructions an reverse)
DATE._� � I
1. NAME OF APPL I c'ANT: Phone No. 99 _
ADDRESS:�UQ �L� /tet —].1:� �,` � k
17DDRESS OF PROPOSED IMP'RO"JEM N'I'
2. TYPE F CHANGE, IMPROVEMENT OR CONS'T'RUCTION FOR WHICH PERMIT IS REQUESTED. i �
DESCRIBE BRIEFLY – ATTACH TWO COPIES OF PLANS OR DRAWINGS OF
PROPOSED PROJECT:
3. NAME AND ADDRESS OF CONTRT CTOR'1(. �=i'1
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—� _-- PHONE 99 9 LICENSE NO 7 2,1 /
4. NEIGHBORS WHO MAY BE AFFECT"rM BY THIS PROJECT WILL BE NOTIFIED BY THE CITY.
5. APPLIC..ANT OR HER/HIS REPRESENTATIVE MUST 3E PRESENT AT ;'.EE PLANNING COMMISSION
MEETING NEXT HELD ON
REPRESENTATIVES NAME PHONE NO.�__
(The Ring City Planning Commission will co sider only those applications received at least five (5) days
prior to a me g.)
SIGNATURF.
APPLICATION RECEIVED BY -- DATE
APPLICABLE FED RECEIVED a - , TOTAL C
PLANNING COMMISSION DECISION: Approved _ Denied
CONDITIONS f �h ��-11��!!.'1 ti'1 ��� � � n "I,
Iproved applic tions are valid for sir months only
Signature \ '�c� 11 ate ) C f
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ROTE: Orego amebuilders Law requird that all persons who contrect ff r�n thea it residence b^
regis eyed with the Builders Board which means the contractnr is bonded and insured on the site,
For your protection, be certain your contractor is registered by calling ,ity Ball Ph: 639 ,vd2,
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NOTE: A permit must also be obtained ,f ran the City of Tigard Department of
lCa comity Development Yes _ No
CIla OF TIGARD INSPECTION REPORT
The above listed7 ro 'ect has been inspected and
P p Approved _ Denied
Date Camlents
Signature _
MLUd in.g inA � pP_ea.6e- 4zbi m one. M i ) copy to King c ty)
CD 2-8'1
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IN&pF'GTION NOT�CL+_
City of Tigard Building Dspar
13125 Sp Ball Blvd. Tigard, Oregon 973h
Inspection Line (Rec.-O-Phone): 639-4175 Business Pho t 39-4171
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Inspection:____
Footing Plbg. Underslab Hach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Most/seam--ztructt� San. Sewer Framing -Bldg.
et seam Rain Drain Insulation -Plumb.
P1 . Under oor Nater Line Gyp. Bd. -Mach.
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Date kequest.,dt_ f I ` l 3 Times ��1M PM
Address: UP JC ��rnr�Q-1n << 1, Permit #t
Buildert /L(I(°�
THE F�T.IAyAJNG CORRECTIONS ARE REQUIREDt
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Inspector: Datet _
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Reinep.
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Itj$PECTION NOTIM t 1J
Litt of Tigard Building Department /y1f
13125 SO Hall Tiled. Tigard, Oregon 97223
Inspection Lino (Rea-o-Phone): 639-4175 sines Phocta: 1i79 �/
Inupeations_
Footing Plbg. Underalab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
N,st:/Beam Struct. San. Sewer Framing -Bldg.
Past/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line I Gyp. Bd. -Hoch.
Data )tac�vastad: - -�1 -' Time: AN PN
Address: r a-f� L� Permit
Bu lders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspecto�tAPPROVRD
^^- `--- --- Datea —
DISAPPROVED APPROVED SUBJECT To ABOVE
Call For Rainsp.
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t INSPECTION NOTICE ��•-�Z
City of Tigard Building De:partakent
13125 SW Ball. Blvd. Tigaurd, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4:175 Business Phone: 639-4171
Inspections _— —
Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line TINALt
PeAt/Bham Struct. Ban. Sewer' Framing -Bldg.
/ —
:/Sequa Hoch. ;,__Rain Drain Insulati'n -Plumb. i
A -
t Plbg. Underfloor CNater Line Gyp. Bd. -Hoch.
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Date Requesteds L �' --Times AM Z , PM '
JJ coo_,,
Andress s Ito�� ' 10��-'1/� �^.JGI!-.: Permit #i--
Builders i . %Builders
TRE FOLLOWING CORRECTIONR ARE REQUIRED:
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Ingpaato� _..- --- -- Date=
APPWMD DISAPPROVED APPROVED SUBJECT TO ABOVE f re i
Cail For Reinep.
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INSPECTION NOTICE
City of Tigard Ruildiog Departasnt �/ /
13125 SN Ha11 Bird. Tigard, Oregon 9� ! 1
Inspection :.ine (Rec-O-Phonae): 639-4175 Business ne: 639-4171 r
Inspection: ---
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
`Round. / Plbq. Top Out Gas Line FINAL:
Post/Beam Strurt. San. Sewer Framing -Bldg.
Post/Ream Mech. Rain Drain Innulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Rd. -Hoch.
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Date Request
ed
: j j I ! -Time: r AH _. PM
Addreae: Uc�j,eLV- l/,)cl,i Permit V
Builder: �L�►� �-lI
THE FOLLOWING CORPACTIONS ARE REQUIRED:
Inspector: _ Dates
APPROVED DISAPPROVED APPRO'/RD SUBJECT TO A
---Call For Reinap.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.8190 (503)639-4171
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ds pernt 15 lssod suujrt:, to ..'r
led municipal St"tE of Ur?, n°. zity , � 1' -' r. ! I 11 pI.'ace
'plic e 'awc P.. rr':v., Writ dC CQ"r. ll`., ].'tC?
ans. )his F[i itt *1l: '- '' 1
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CITY OF TIGARD O
COMMUN[W DEvELOPMEN7`DEPARTMENT Toprd.Oregon9nPERMIT k 52J M /�i3- - #
(503)639-4171 DATE ISSUED
T'! JOB ADDRESS: 16700 SW Jordan Way TAX MAP/LOT 2S /6,4P IW
SUB: Bedford Glen LOT: _. 19 LAND USE:
VALUATION: _Z1,11-34
OWNER SPECIAL NOTES
i NAME: mon Hanes. Inc. REISSUE OF: M5f -
9500 SW 125th Ave '�■
ADDRESS: _ [AST REISSUE: �.
Beaverton, OR 97005 _ FLOOD PLAIN/
PHONE: 524-1999 SENSITIVE LAND: '
CONTRACTOR APPROVALS RE UQ IRED
NAME: _ _Beacon Hames, Inc. PLANNING:
ADDRESS: 9500 SW 125th Ave. ENGINEERING:
Beaverton, OR 97005 FIRE DEPT:
PHOOE: — 524-1999 _ OTHER:
CONTR. BOARD #: 70782 EXP DATE: 12/93
ITEMS REQUIRED
SUDCONTRACTORS: PLUMB: Canby Plumbing _ LIST/SUBCONTRACTORS:
MECH: Muehe Quality Heating BUS TAX:
ARCH/ENGINEER CALCULATIONS:
NAME: Arm Architect/AIA TRUSS DETAILS:
ADDRESS: 1631 SW Bcones Ferry Rd. 201 OTHER:
Lake Oswego, oR 97035
PHONE: 636-0755
PROPOSED BLCG. USE: Residential
COMMENTS::
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APPLICANT SIGNATURE
Received By: Date Received:
-m^+row5a5H1MMMltvwtrFh`:I,,,,R1yPFl1�,YF�i 1' dlkr'�',�^,'���.Y��,,�.,h.,l,ViN0.2iw+tn,. . „ „ ..... ... -.«..!T►�..+q"""'. .. .. """""n'.r!MAeMUR�I {yg;y' .
';na s
;v PERMIT I+ •ACC.T N DESCRIPTION AMOUNT AMOUNT P0. BAL.-DUE -
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9l-6ay� 10-432 00 Building Permit Fees -3 cq(
10-431 00 Plumbing Permit Fees f,
10-431 01 Mechanical Permit Fees )y
10-230 01 State Building Tax (5%)
Building
Plumbing
Mech.nical •_a2,0_3
i10-433 00 Plans Check Fee _5011 3 -�161 /0 i 3
Building
Plumbing
Mechanical /u., 3
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10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection ?� . 3 'r
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
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25-448-03 Office TIF Fees .
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Oev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
I 24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL 63
nm/3587P.WPF
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CITY (-.)F:' TI[ARD RECEIPT OF P()YMF'NT RECEIPT NO. n93--243c'53
CHF_CR AMOUNT `,"7'7. 49
NAME n BEACON HOMES CASH AilrwNT 0. 00
ADDRESS n PAYMENT DA'L'E: c 08 13/93'
SUBDIVISION
PURPOSE OF PAYMENT AMOUNT PA I D PURPOSE OF PAYMENT (IMOUNT PAID
BUILDING PERM _ 349. 00 PLUMBING PERM 1,1.17. 50
MECHANICAL PE 40. S0 S1. BL.)I 1 D PER 2.5. 3n
PI—AN CHECK FF 1.0. 1 SEWER INSPECT :35. 00
LOT 19 BEDFORD GLEN 1
16 700 SW JORDAN WAY
7 C7TAI._ AMOUNT" f='AID — - -i :=7 7. 49
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$ewerage WATER
N. First Ave.,Suits270,Hillsboro,ro,Or,97124 SURFACE
603 848-88
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1 ' i)lll. S i , �•,ry I''I; .' 1j.l. l LOI;' Ir,
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Y 1'L'IIC 1'lil';1 .i11t1'11:F Irl.
'16700 NF!i1,ll l''1 .i 9
1'1?il1 11.IfiF' 'i (''rRl"1' 1' 'i!d .)I)it0oid WAY
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25300
1.)1,CIII PA1` CY 1.11:r.Y s
f;1'1'1I;f.1' h'79. PIM 1t3t>��t;
1i1111':'F'iif�
9500 41 I TIhV 1111F I T r't ANT
.. . I i)rR 17700.:; . .
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1110 00
WA'F'C:rR 111.1AM 1' is 1*Y 1.00 r 00
CONTROL
PLAN 11,11"A"K 6 00
f �',IIISII1I1 I_ r) , 00 iIIPt11) ICI 16f., 00
f '10 ( 101 166x00
t l'1 Ptriil;. i ,. 11:1R V111, 30 I''III')P1►: �) ' l a
F`1N'F:,c F'i'll 1� I '7�,�7 x11 111 0111.0 GI.F:IJ 2 1 0 1 ire
' 1'11111 0 11 f 11'1 !'ilii I:Pt)'' .11'x1 1;l')rlYj' ( 0 111f;1IL 1:"L[)H11 I:I. 0111 RC.D
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Permit Con .Lions: The applicant agrees to con(ply with all rules and regulations of the Unified Sewerage Agency. When telling
for an inspection, please refer to the Permit Number. The Permit expires one hundred eighty (180) da,rs from the date of
issuance. The total amount paid (per-nit fee, connection charge, line tap fee and/or other charge) will be forfeited 1f the
permit expires. ,
The Agency does not guarantee the accuracy of the locstlon of side sewer laterals. !f the sewer is not located at the
measurement given, the installer shall prospect three feet in all directions from the distance given. If not so located, the
installer shell purchase a "Tap and Side Sewer" Permit at the current charge and the Agency will install a lateral.
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6/90 WHITE - USA, BLUE — Accounting, GREEN —Inspection, YELLOW — Customer T i
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