16769 SW JORDAN WAY-1 ADDRESS:
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C17Y CSF TIGARD
COMR11INITY DEVELOPMENT DEPARTMUNT CERTIFICATE OF '
13125 SW Hall Blvd.Tigard,Oregon 97223.9199 (503)839-4171 OCCUPANCY
XXX)x PERIIII' M. . . . . . . : MST93- 0 3.4 I
63"4171 DATE ISSUED 1 10./29/93
PARCEL: 2S1 16AD--SED62
. r� taUUE21 :lrib. . . : 16769 5W JC1F�nt�h1 WY
j ,jUBU1418I0N. . . . : BEDFORD GLEN ZONING:
BLOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . c6F-1
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jN&PLCTI0N NOTICE
Cita of Tigard Building Departw—t l/ /
13115 811 B 'x
Stall Blvd. Tigard. Oregon 712
Inspections Line (P.ec-O-Phones 639-4175 Business Phonets 639-4171
Inspections — -
Tooting Plbg. Underslab Hoch. Rough-in App!/Adwlk
1
Found. Plbg. Top Out Gas ?.lne 1I1i11l.1
Post/Beam St.ruct. San. sewer Framing
Post/Beam Koch. Rain Draln Insulation
Plbq. Underfloor Nater Line Gyp. Rd.
Dpte Regs•os/tads rL4- ` Times y�AN PM
Addreses-L��lq -7�"�'r.l7A - '/ PwrmU. Is 7y
Builders
TAR FOLLOWIN CORRZCTIONS ARE RRQUIREDs
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Inopectort — Dates/
PPROVLD DISAPPROVRD APPROVED SUBJECT TO ABOVE ;r h"j llds'
Call For Reinsp.
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INSPECTION NOT4 E
City of Tigard Building Departs+ent
13125 SN Ball Bird- Tigard, Oregon 97223
Inspection Line (Rec-4-Phone): 639-4175 Beseinese Phones 639-4171
Inspections
Footing Plbg. Underslab Mech. Aough-Lelsr/Bdwa�
round. Plbg. Top Out las Line r211ALs
Post/Beam Struca. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line Gyp. Bd. -Mach.
- 3 a
Date R•qu•stede I(-4t
_—rime: AM _ PM
Addrwses7(!�� l�grnn a.c Permit f:, �
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Builders 7 �L/fYl 11�7Q _—
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TRE FOLLOWING 0 RRECTI-AS ARE REQUIRED:
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Inspector: Date:
APPROVED --- DISAPPROVED APPROVED SUBJRCT TO hSOV3L
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07 —_Call For Reinep.
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INSPECTION NOTA /� //
Cit? or Tigard Building '/_11
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13115 SO Hall Blvd. Tigard,�373 (_ ,. 4
Inspection Line (Rec-O-Phone)s 639-4175 Business Phones 639-4111
Inspection:
Tooting Plbg. Underelab Mach. Rough-in Appr/Sdwl"..
Pt-und. Plbg. Tap Out Line ' TINALs ;
Post/Beam struct. San. Sewer Framing -Bldg.
Post/Beam Moch. Rain Drain Insulation -Plumb.
Plbq. Underrloor Nater Line /iyp. sd. ) -Mach.
Date Requested
J Tisss AM PN
Address s I{ CL 1..0 y� IJV "�/L JA (� ;1 Permit 1
B, dare.
TNR FOLLOWING OORRECTIONS ARE REQUIRBDs
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Inspecto -/ )1 �� '7
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_APPROVED DISAPPROVED XPPRO"D SUBJECT TO ADOv6
- _ Call For Reinsp.
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' INSPECTION NdIIC:E
Citi of Tigard Building Dapartaent
15125 sw Hall Blvd. Tigard, Oregon 9Y23
Inspec4_ion Line (Rao-O- ais)t 639-4175 Business Phones 639-4171
InepsetlonT
Footing Plbg. Underelab 3sch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Lina FINAL:
Posh./Elam Struct. San. Sewer /I'rPAltig -Bldg. ,
Post/Beam Neth. Rain Drain Insulation -Plumb. w
Plbg. Underfloor Water Line Gyp. Bd. -Nech.
Date Req uesteu r _ ' ? _ Tams s AM PM
Address) )(:-a- Permit #t-[3 b2�51/' •
Builders �1�
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors -- --- Dates
p7„ �a 1 APPROVED DISAPPROVED APkROVED SU9JECT TO ABOVE
Call For Reinep.
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INSpECT�ON NOTICF
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City of Tigard Building Department t
13125 Bmf Ball Blvd. Tigard, Oregon 97223 � f.
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Impaction Line (Rec-O-Phone)n 639-4175 Busin,oss Phone 639-4111
Inspections _
Footing Plbg. Underslab Mach. R-,ugh-in Appr/Sdwlk
Found Plbg. Top out Gas Line FINALt �r
Fur L;II�,am Str_uct. San. Sewer Framing -Bldg.
Post/Beam Mach, Rain Drain �yiBaulation -Plumb.
Plbg. Underfloor Rater Line Gyp. Rd. -Mach.
Data R• ju,ateds 7 ,
TiONt _-Am PM
Address: Permit 2��
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Builders
THE FOLLOWING ODRRECCIONS AAS REQUIREDt P
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Inspectors � Dates
APPROVED G DISAPP APPROVED SUBJECT TO ABOVI
--Call For Reinsp.
I1rPECPIO11 h,—!--L
City of Tig,.•rd Building Department V
13125 811 Ball Blvd. Tigard, Oregon 97.
Inspection Line (Rea-a-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Hoch. Rough-in Ar;-!Q:wlk
Found. -pYbq. 7 :p Out \\ :a■ Lin: FINALS
Q
Rost/Beam Struct. San. lower Framing -Bldg.
Port/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line oyp. Bd. -Hoch.
Date Requestedt. zil
_Times AN PH �
Afdrarr: A111-
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THE FOLLOWING OORRRCT S ARE REQUIRED: } 1
A ON
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Inspectors Date:
_ -APPROVFD DISAPPROVED APPROVED SUBJECT To .j%SOVE
Call For Reinsp.
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INSPRC7IOq�iOTIrs6 0-1 /1
City of Tigard Building dparta,_::.
13125 SN' Nall Blvd. Tigard, Oregon 9723„ %_!
Inspection Line (Rec-S-Phone): 639-417! Businoas khune: 639.4171
Inspection:
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Footing Plbg. Underelab Koch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cam Line FINALS
Oat/Seam itr t San. Sewer Framing -Bldg.
�'ppst/Bean Kwh. Rain Drxin Insulation .-Plumb.
Mg. Ondsrlloor (later Line Gyp. Rd.
nate RequestedN /LC W/ .� Time:
Address:s�' G
BuildersL-J =� ■
TNR FOLLOWING ODRRECTIONS ARE REQUI1l■Ds
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Inspectors Date: ^'
APPROVED DISAPPROVED APPROVED SUBJECT TO A.BOVE
_Call For Rainap.
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LitY Of Tigard L-uildiirq Depart,,Oat
13125 SW Ball Bled. Tigard, r-egon 97223
Inspection Line (Roc-O-Phone)t 639-4175 Business Phone: 639-4171
Inspection: _
Footing Plbg. Undorelab `tech. Rcugh-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg. "
Post/Bear. Mach. Rain Drain Insulation -Plumb.
Plbq. Unuerllnor) Water Lina
Gyp. Bd. -Mach.
`D`aft Aegoaseodt ��._ l �� l'
-7 Time:
AOdrass: 00116 L rmit
Builder: L r% l �� 4 ■
TBE FOLLOWING OORRECTrVW ARE REQUIRED:
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Inspector:
-- _ Date: {I /
APPROVED DISAPPROVED APPROVED SUB.7ECT TO ABOVR is
Call For Reins,. 3;G,
I W_CTIOI NOTICE
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City or Tigard Auildiag Depar-Geent 4v
131?5 Sq Hall 81-id. Tigard, Oregon 97223 t .'+1, ,
Inspection Line (Rec-O-Phone)s 639-4175 Bueinear Phonut 639-4171
Inspectioi: - --- _
Footing Pibq. Underslab Hoch. Rough-in Appr/Sdwlk
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Pound. Pift.-'Toopp Out Gnu Line FINALS
Post/seam Struct. Sower -r-J.ng -Bldg.
Post/Beam Hoch. �45a_n.
~ Insula'`ion -Plumb. i'tds; f ,t
_ x , qmw,
Plbl underfloor Nater Line O Bd. g 'Sli " aasitK `'
G YP• // -Mesh rry ! I AM fiF��
Date Requested! �T Z a ` Timet AM PMy� r � t1 ��
Addreses / Permit 1: ';
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Builder:
TBE FOLLOWING CORRECTIONS ARE RAQOIREDt
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inelactor:
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APPROVID DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
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C 17 Y OF T I G',"ARD
t COMMUNITY DEVELOPMENT DEPARTMENT �
9126 SW Hall Blvd.Tigard,Orogcn 97223.6`190 (603)639-417'1
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ATER CLUS.—TS. . r:w 1 Pli.: F v ,I�;:,WSE: rr ,aa i5. . . . . . . :
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_.ti1 p SIt GE 1:)I SP. . . ; ). RAIN LI M A l#4
., r. i ? ji :'i Ill tl Lt-I C.'!'y date d'v is
Y�'1_J _' 1;ed t. t r1 a F�.
a 349. 00 JH 03/i'6/9 3 �
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unified SAN ITARY•
sewerage
agency
155 N. First Ave.,Suits 270.Hillsboro,Or,97124 SURFACE WATER IJ J
503 648.8621,.
CONNECTION PERMIT
I ISSUE: 0ATC: 0`;;2693 :...'^. .-EXPIRA-rioN DATE 112293- .- PERMIT 104191
,TRUE.' TURF ADDRESS 16769 FROJFCT 1908
TRUCTURE STREET SCd•_,.IOR11.A,N.,14AY. _ ....
.<I In r L 0 62 BLOCK
TYPE. CONNECTION— NEW ._. �: ,,.: OF'_ SEDFORO 0LE.N N0 . 1
TYPE INSTALLATION•' ('lq)'�WLa'.Swk/ERal CON/SLC
TYPE i:)f;Clll`ANCY tl ). l3INLiL[: FAMILY FARCEI.. 281 1.5 All 49600
OTR SEC 4716 MH 18027 e
1WNF R 14E000N HOME,'
T+DRF£'S 9�OU SW 12�1`FI it�rrc> I'1, �� 1 F�EA1'ME".NT� PLANT DURHAM
BEAVERTON qRi9700� n l i
-t .' Y. 1 fq"'iu 16 ili.l.:1
'HONE 5�4-1999 JUR�SD
I
IXTURE EQUIVALENT I1WEI..C.IN0 RF.SIIIE:NTIAL. i
N CTS SERVICE IJNIT8) 0.0 (.WITS 1 SERVICE UNITS i I
CONNECTION FETES SURFACE WATER DC:V["I.OI''MC.N'T FFE'5
WATER QUALITY 180 .00
LESS CREDIT
WATER OL)ANTI TY 100.00
:EE;S CREDIT < 0.00::'
E:ROO'ION CONTROL
INSPECTION 40.00
PLAN C:I•IECK :_'6. 00
SU 13TI')•IAL. 0.00 SUBTOTAL 166. 00
s�
TOTOL 166#00
Al"P1. NAME FETE:R KUY SK Ff10N1
AFFILLIATION VF'
kE"MARKS PROJ#1908-BEDFORD GLEN-101 # 62
*24 I!f)tIR NOTICE. FOR EROSICX CONTROL INSPECTIONS REQUIRED
SIGNATUR . r _._ rr _—_...._�__...._._....�_, ISSLIED BY Ti'ICIMPSONJA
Permit(Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. When calling
for an inspection, plerse refer Lo the Permit Number. The Permit expires one hundred eighty (180) days from the date of
issuanca. The total arjunt paid (permit fee, connection charge, line tap fee and;or other charge) will be forf�Itoj if the
permit expires.
The Agency does .tot gua,antee the occur^ry of the locatlun of side sewer laterals. If the sewer is not located at the
measurement given, the installer shall prospect three feet 1•, all directions from the distance given. if not so located, the
installer shell pur+hale a 'Tap and Side Sewer" Permit at the current charge and the Agency will install a lateral.
6/90 WHITE — USA, BLUE — Accounting, GREEN —Inspection, YELLOW — Curtomer
�3�zsswiiauawd. PLNCK/RF.CT # /► 4 r
CITY Or TIGARD POHox73397 sl' ya,j
COMMUNITI DEVrLO!MLNT DEPART:4E?NT
�,
•rproicgoi�97u3 PERM I1 � � 1%�
39-4171 DATE ISSUED - -
JOB ADDRESS: ��' ` TAX MAP/LOl"
SUB: E LOT: _ LAND USE: —VALUATION:
•
OWNER,__ lo,,,,e
SPECIAL NOTES
NAME: t`�4�_91 5. ��c- • - — — REISSUE OF: —__ --
ADDRESS:
P. �. �� ( 136F —__ LAST REISSUE:
FLOOD PLAIN/
PHONE: ra?-y- Q X 51 _ SENSITIVE LAND;
CONTRACTOR C APPROVALS RE".QUIRED
NAME: — ��1 e. — __ PLANNING:
ADDRESS: _ ENGINEERING:
FIRE DEPT:
PHONE: —_—— — _ -- OTHER: -----
CONTR. POARD #: �S EXP DATE: /Z �
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: � 6�� c -ti — LTST/SUBCONTRACTORS: _
MECH: /11uc"�.�✓ �_� _ BUS '"AX. --
RCH ENGINEER CALCULATIONS:
NAME: l 9Y SE> _ TRUSS DETAILS:
ADDRESS: X11- OTHER: — —
PHONE: /.ss Loa?
PROPOSED BLDG. USE: l_/�e? •,� h l
S
COMMENTS:
AP ICAN SIGNAfUR�
Received B �' 2
By:. _ C. — _-- Date Received. ZJ
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PERMIT ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
ms -o a3 � 10-432 00 Building Permit Fees -
i
_ 10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
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10-230 01 State Building Tax (5%) – S-' 3
Building / 7• yi 1
Plumbing S �
Mechanical _ _O_Dj_
� 1
10-433 00 Plans Check Fee
Building ) fs
Plumbing _
Mechanical _ 0-t-3
10-230 06 Fire --
30-202 00 Sewer Connection _ _
30-444 00 Sewer '.nspection =�--
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
nm/3587P.WPF
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CITY OF T I GARn RECEIPT OF PAYMENT RECEIPT NO. ;93--240494
�
CHECK AMOUNT s 592. 49
NAME s BEACON HOME 5 CASH AMOUNT s 111. 00 1
AGI►RFGS PAYMENT DATE s 05/26/93
SUBDIVISION
(.'"URPOc3Ew- OF PAYMENT AMOUNT PAID PURPOSE" OF PAYMENT G'aM001'41' PAID
E+L.l 1-1.----r-)I NG PF I'tM 349. 00 PLUMBING PERM 117. 1-50
ME'CHAN I CAI. PE 40. 50 ST. BUILD PER 25. 36
PLAN CHECK FE= x'5. .1.3 SEWER INSPECT 35. 00
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I_OT 6;:, BEDFORD GI.J--N
16*769 SW JORDAN WAY
TOTAL AMOUNT PAID 592. 49
I
CITY F)F TI G=UARD RECEIPT OF PAYML:NT R OX I P T NO. a93—P39443
CHECK AMOUNT c 290. 00
NAME: s BEACON 1-101YIE S CASH AMOUNT d 0. 00
ADDREfTEi s ryPAYMENT DATE' : 04/27/93
IPT..1RPOSE OF PAYMENT AMOUNT F'A 117 PUFRPCJl3E: OF P(lYM(-'.NT Al IOUNT PAID
PLAN o-1E.CK F"E 40. 00 PLAN CHECK FE 00
j
LOTS 23 AND 62 REDFORD GLEN
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I� 'FG TNL_ AMOI.IN T F IA I D — _ — > 290. 00
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UN #800 FR1 14:P.4 IL:C.IT.' OF KING CITY FAX N0:503 639-3'171 #800 P14
rnsr 93 — 0A3}4 r
KING CITY
0 16,100 S.W.116th Avenue,King City, regon 97'224 Phone:639.4082
COMMUNITY DEVELOPMENT 0
APPLICATION FOR BUILDING PERMIT
(Instructions on reverse)
DAT$` y -7 -9.3
1. NAME OF AP ICW:
ADDRESS:
AMFM OF PROPOSI®
2, TYPE OF CiMM, IMPFDMEMT OR OONeMUCTION FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - ATTACH TWO COPIES OF PLANS OR DRAWI*1G5 OF
PROPOSED PROJOGT:. amA n � s
i
3. NAME AND ADDRESS OF CONTRA(:
PHONE NO., LICENSE NO. '7 7 VS-Z
4. NEIGHBORS WHO MAY BE AFFECTED BY THIS FROJECT WILL HE NOTIFIED BY THE CITY.
5. APPLICANT UR HER/HIS REPRESENTATIVE MUST SE PRESFsi",' NT THE PLANNING CCMISSION
MEETING NEXT HEM Oto
RIIyRF.SIItTltTIVEB "ME _..-__HmE
(the Ming Citl Planning Cowission 11 consider only those applieatioas received at least fire (5) days
prior to a �eeti
�( SIC;r1ATURS .-
APPLICATICH RE "'VED BY - DATE—
FE
APPLICABLE ! RDC�IVED $ —Z 5y'
PLANNING COMMISSi DECISION: Approv Deni
n.'
CONDITIONS
roved appli tions ar valid for sit months only
Signator Date
10Tt: 0 en lomebuilders Lar regn res that all persons who contract for work an their residence be
registered with the luilders Board which means the contractor is bonded and insored on the job site,
for your protection, be certain your contractor is tegistered by calling City lall the 639-4062,
NOTE: A perndt trust also be obtained fran the City of Tigard Department of
Cammmity Devel opmemt Yes--,X- NO
i CITY OF TICiARD INSPECTION REPORT
The above listed project has been :inspected and A,pproved_perlied
Date _ C,mmts
Suture
' (Su.i.Ed,L.N dnApachm pladAe mutunn. ons (1) copy to KAM CLU)
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