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INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested�U— L Time A.M. _.P.M.
Address 13-32 Permit #------.-__--•-
Owner —--- ---- Lot #
Builder —_ -- ----
The following Building Code deficiencies ere required to be corrected:
TAW
ItAk
-- - _ -
Prf,sented to �Appruved
Inspector [_j Disappicived
Datef� ��7 „-f—
CALL FOR REINSPECTION
0 YES 0 NO
INSPECTION NOTICE
City of Tiga,d Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone:/6399)-4175
Typo of Inspection
Date Reywaster! __.. Time X_ A.M.----P.M.
Address - -- xJ .(_) �� Permit1--
9wner _ Lot
Builder .— �. -----.
The following Building Code deficiencies are required to be corrected:
Presented to �_ TI}-A-P�Proveu
Inspector (_� Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
or NW��=�
CITYr OF TIGTA RD PEPIM111' NO.
CIT(OFTWARD DATE ISSUED: 7 V3 89
oxeooM
COMMUNITY DEVELOPMENT DEPARTMENT PRTM. PIMIT .NO . I391.35H
13125 S.W.Poll Blvd.,P.O.Box 23397.Tigard,Oregon 97223,(503)639-4175
Al'..-DREIIS . 15.32.5 SW I<V.-..N*Y'(:)N DVI
TAX MAV-1/1-011, 2SI :I PCD SUU : ASHF()PI) (")AI<':i L.'T : Ir.16 1:.:1<
I OND IJSI:L* ;
1 (31, SIZE' .. V A I UATTON : A 66 ,d196 SEETRACKS
FTION T : 20 fit-:AP : 6.1
WORK ASS : NEW DWEA-I... .UNITS : 1. LEF'T : 5 PIXA.-IT : "")9
LISE STNIt.A..11".: F'AMIL-y NO . BEDROOM) : 3 EXT . WALL. CONST .
CON:,, 1' . -'Y,-I::: : VN NO . PAI'l-45 : 3 N: S : E : W
OCIOUP .(*..'RP. : P3 Pf"(31' .OPENINGS :
(XICUP . I OAD N E: W
TOTAL.. )REA: 3.1930
NO. STORIES : IS'' : 10141 MN".'i V : ('.1 V-1PE RET7
HE:1(',4I--I*1* : F20 2ND: 49:1.6 AAE'k) riE.PAR"I PATED;
BASEME'.:N'T-? 31411): OCCUP . SEEPAPI? RAn-*.D:
MF.-'.:7.Z(*IN]'Nl::.'? BASE.11 I T
PA 11014 1 OAD: '(10 GARAGE; 173 F*IPE. SPIPIKI-14? ALAPM7
l`rL.OW((3PM) DETECT7 YK'i
FILA T• TYPE GAS I-II)CI" .ALICESS7 ('10PIPAI7
1:4 EE,M A A K S
(IF NO. EE11-102
LAST Ar-USSUE- 891.202
M 3'.L L-E:A .JAY 1113::141. 00
0 P . r) . BOX t"3291. pLAN REVI.EW $,10 . 00
W
N T]'(.-)A 1:113 DEVI.T.
E ISTATE I AX $1.9 .70
OTHER
DEVELOPMIE.NT CHARGES
C MT I I...E".1.1 .JAY Six,,( s'ranm) $d50 '00
0 %.JAY M11 L.V.14 D(.11l I)F34 SDC I ST'REE'T') $600 . 00
N41(. :90 .00
T 1:) . n . a(I X "13 r.?9 1. P D It 1
R T 1:[3A 1:4 L) 9 t"1t I x P 1.11.:'.P A 11) < $410 . 007
A
C PH(INE 11,503) 604--75413 TOTAL $i ,".11.:3.70
T NO . 30109
0
R PECEIPT NO.
..............................................
This permit is issued subject to the regulations contained In Title 14ITIc;(;jl►I17F:I') INSPECT IONS
of the TMC. State of Oregon Specialty Codes,zoning regulations F'O(J 1*:I'N(.; SE.:WE:14
and all other applicable codes and ordinances, and it Is hereby
agreed that the work will be done In accordance with the plans and F'OLINDATION WALI PAIN ORA INS
specifications and in compliance with all applicable codes and & 0E.Am WAIEP L.INE'
ordinances The issuance of this permit does riot waive restrictive 1:1.14 .UNDEPSLAS ll'.1111'y APIP'll- CH/Sw
covenants Contractor and subcontractors shall have current city SI AU F'T NAI-
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 'TOPOLIT
Fibardoned for a period of 180 days any time after work has I WAMM:,
commenced.It shalt be the responsibility of the permittee to assure F3'.A E.P I AC rn,
all required insnections are requested and approved GAS LINE
INSUI A TA:(IN
("YVI . H(JAPI)
Permit Ignatu�
Issued By F.AL.L. F'011 INSPECTION 639-4- 115
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
S)Ewp.:P PE WMI'T
NO. 1.-.4-:891366
C11Yr Cad' TI67A RD
(C:ITY 0"TWX
.,.�rlD
09100N DA'T'E. 3:51SUED; 7/ 5/89
COMML114ITY DEVELOPMENT DEPARTMENT l:)P1M. l%"M*T'.N0. 891358
11125 S.W.Hal Blvd..P.O.Box 23397.Tigard.Oregon 97223,1503)6394175
1-5325 'SW KEN'FON D14 1.150 NI,JM13L:-'-R: 37'""73
P-51. :L2(:,B 5U13 : ASHF'014) (:)At<!:*) L.T : 1.26 8K :
I-AND USE :
1...01' S;I ZE:
12 TWFI: Pill 14ING : 1W
WORK CLAMS : NEW
USE". l'Yl:)I:;: : 5T.NGI E FAMILY
tl:) 01:11nc)14 Wl.th 1111:1. I"LlIevi alrid ci-P tl'%*: Uril.-FJ.ecl
liewfipr�agf.i Agc#n:�y . exp:1.r-ei9 U.20 clayli; 41r43ln th*-7, (ULtc-, 1.%1114.4ed . 'Thie totatl
aLincit.tol, paid 4:1.11 hivo Tcir-4?e?j.trm(:1 if the 1*iife Ag4wriczy i'lot cil.latl
4:1.11trAe th(--.4 (:).p the Ic1clat:1.01-1 (J-P the ii;iclim %awar- lattioratl.% . 1411 thcA mewer, I.,:;
1-1cit 11:1(.14.tivld P.I.I. the vlive?rl ' r)i,(:)%pjmct 3 Tee7t. iri
-11'r-clill thvdilatvkrw'(a g:Lverl . T-p I'l(it #44:1 tl.l(..A
at. "'Taq:) iarlcl 5J.0*1 5c"W"I.." Pior,triit iitxici thiv+ Agc)ricy w:01 irimutl:l. iR.
.1.Ms I 17 P E 1131.1 1 H r,17 1.
1::'*EX'T'LJPr-' UNITS : 11.NAN'T' 'EMPPOUHMEN1 i
DWIZU 1W., UNITS : I
NO . (:)I:" H1 DG'Si 1.
111KES
M1 I LIEN ..JAY P F.,R111 T 111135 . 00
0
W 13 . U BOX 231-29:11. U)NNEECTIMN CHARGE $1 , 100 . 00
N I T G,A 1*,l D Op I INFI: TAP INSTALL-
E
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011-11IFE."
C JAY
0 .JAY wri i F,::ri ritjv-or--:A
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T BOX c!3291.
R TIGAPD
A
C PI.-IONF: (r-503) 613A 7"5 A.3
T NO , '301.09 TUTAL: Ill 1. 1.Z
0
NO L
.....................................................
This permit is issued Subject to the regulations contained in Title 14 REQUTREA.) TN5PF:Cl':F(:)Nt�
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It is hereby 14M.K.91-4.-7:N
agreed that the work will be done in accordance with the plans and
specifications and Ir compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business lax 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 a'Iet work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and appruved
Permittee nature
(".N.A.. FOP INSPECI-TON 639-417".1i
Issued By
SEPARATE PERMITS PEQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
MFICHAWICAI
PI:FNO . : MIE.691 ,56`5
CITY OF TiG�4 RD �ny OF'TWARD DATE:' Vic-ill[JED
C'
OREGON
COMMUNITY DEVELOPMENT DEPARTMENT PPXM. PM*T' .NO .
13125 S.W.Hall Blvd..P.O.Brix 23397,Tigard.Oregon 91223,(503)6394175
-TON DIA
.Fj5 : 153ER5 15W KEN L AK S :1,P6 F.-.!1<
TAX MAP/L., 251. J-2CIEl
I.-AND Wir-::
LAXT !ii 1ME: NO : NO:
:1. A344 FIANDLA <10
WOWK GLAIiiS : NEW t;:AJr.4NA(:.'E'. <100K
USE.: TYPIE-E . 45ING1 E. f"AM11-Y 1:1.1111NA(".E 3.00K+ A1.141 1--IANI*.)I-.14 10K
TYPE::: VN F'UPNA('.1E E:VAI' A. 00I.-F.il
OCCUP .GAP . P,-5 IALZATEP V1'-':N'T' F*AN 13
Vi:N*T
VEN'T . ".iY5*TF-'M
:.
1:311..,1•'1/(COMP <3HP I-K)OD :1.
KZ). 15TOWIES : Z? INCiNFRA11:31MOM
OWEN L . UNITI-ii : I HLA/COMP 1-5-301.41P 1NC1N1-*:AA'TOA((*',OM
ITUEL. 'FYPE. C.-P(A S Fim-P/COW) 30-1,
PEEPAlP UNI*TS
MAX . I:NPUT BLIPI/Cl(7MP 1150+114) OHEll
FIPE IMPIP157 GASi PIPIN(3 OUTLEI'S
HAAAA PRI115
I-Ow P1:41:15s'?
RLMARK!i :
MILL EA JAY PEAMI'T' $10 .00
W0 $10 . 13
p . PLAN PEWIEW $30 .50
N 'T'.11DAM) (71:4 F,3:X 11.11RES
E V"TATL I'AX $
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T R 41,5 NW R.'33-51'
h:11.1.:1.fit b m r 0 (3 97 1.2,3
A
PHONE: (503) 6418-4159 'T'OTAL :
T REGISITIATION NO . 417P11.
0
R I 'T' NO.
This permit is issued subject to the regulations contained in title 14 PEKIRLYIPEA) 1Nsr)E:C1J0N5 ('S&Q F-
of the TIVIC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances. and it Is hereby I I N E
agreed that the work will be done In accordance with the plans and & BEAM
specifications and in compliance with all applicable codes And ROLIGH.—I N
ordinances The issuance of this permit does not waive restrictive FJ NAL.
covenants Contractor and subcnntractors 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
fermi Signature
I.N'3PF::(.-TTON
Issued By
SEPARATE PERMITS REQUIPED FOR WORK OTHER THAN DESCRIBED ABOVE
-alivAWK
LJMB:I'.N(.; PEAM11
PEPWIL'T NO. : PIL-1139.13611
C11YOFTIGARD
CITY01FTWARD 1C.,50ED: 7/ ::i/019
041FOON
COMMUNITY DEVELOPMENT DEPARTNIENT 1::,I":l:M . PMT .N(:) . 893.315- 8
13125 S.W.Had Blvd..P.O.Box 23397.Tlgerd.,)rvgon97223,(503)639-4175
001`3 AD011:411: 1.531,25 Sw KEN*1'(:)N 1:)I:,'
TAX MAPILATT 125:1. 12(:33 5L)18: -F OAK IFRK :
I AND U1.3"EE :
I*T'EF ri NO : NO:
W(:)Rt< GLA!EOS : NE:W WATER Cl 'TIPAP
SINGI E FAM:11-1 Y UP1NAL B01-061 l::,PVN'T'l:l
CONST .TYPE' , ')N LAVOPATORY ZI 144AP PPTIMILA:4
SHOWEW a (1l14EASE
D',:SHIJASHE'A J.
G"PARDACAE D15POSAL 1.
NO . STOWIES : P. WASHING MACMINE:
DWELL.UNITS : 1. LAUNI)PY TRAY 1 B1 DG . DRAIN ( 1)1a,
Fj 00P I)PAIN
!SINK 1. SEWER (F**T')
WATE-11 1-11FA111:14 J. S'TOPM/PAIN (FT
110111 1 F14 I A Y PEPM]. $147 ."50
0
IN P . 43 , ROX
N I*T.(*..APr.) (')P FIX11MIMIii,
E STATE TAX
R 5
OTHEP
C WA1'T".1 I<EK N
0 KEN WA 1 ':, 1:)LA.JMH1N(.*;
N
T ICI
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A
C VMIINE. (503) 684 6626
T NO. 50111:117113
0
A PECEIP'T' NO
This permit is issued subject to the regulations contained In Title 14 HEQUJRI=D 1:N5iPr-.:J"*Y"((:)NS
of the TMC. State of Oregon Specialty Codes,zoning regulations F11 B .UNDLASLAB
and all other applicable codes and ordinances. and t Is hereby
agreed that the work will be done In accordance witri the plans and POST. & HE AM
specifications and In compliance with all applicable ccdes and WAI'I;-'P I I NE
ordinances The issuance of this permit does not waiverostrictive PLAR . TOPOU-T
covenants Contractor and subcontractors shall have current city t4A3*N DPATW.)
business lax permits This permit will expire and become null and
void it work Is not started within 180 days.or if work is suspended or P-INAL.
abandoned for a perijd of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all requited inspections are requested and approved
PermittilitI15,01gristure :ol-1 IN51PIEUTTON 639-4175
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
Id
i
CITYOFTIGrARDPLAN CHECK APPLICATION
CnYOFtleAem PLAN CHECK M _
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT N
13125S.W."MBlvd,P.O.Box 23397,T19ard,OmVon97223.(503)639-4175 DATE ISSUED
JOB ADDRESS. % .? 5 411 L d - ' _ -- i AX MAP/LOT S - Q_ Cl/_3_!_---
SUB: ' / G''l�t%s_.. amLOT: /.—L LAND ISL:
—�!; r,/S-t<• —__.._�_
OWNER VALUATION: SPECIAL NOTES
NAME: I' , REISSUE OF: ly 7 Z
ADDRESS: LAST REISSUE: l .�
FLOOD PLAIN/
_ SENSITIVE LAND: _ --_--
PHONE: /,,k S � .—
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: ENGINEERING:
ADDRESS: V FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
NAME: CALCULATIONS:
ADDRESS: TRUSS DETAILS: —
PARKING PLAN: _
LANDSCAPE PLAN:
PHONE: w OTHER: _
COMMENTS:
PERMIT N ACCT N DESCRIPTION PMOUNT AMOUNT PD. DAL. DUE
10-432 00 Building Permit Fees ' y'. _ ��_ _ s: 6( _
10-431 00 Plurbing Permit Fees _L�_L?` ,�y��5!'
10-431 01 Mechanical Permit Fees _�.� •�
10-230 01 State Building Tax (5%)
Building (• ? ��
Plumbing ____
Mech _ "),c 3
10-433 00 Plans .heck fee SO.13 _A) % „z
Building —
Plumbing
Mech --
��l N*41 30-202 00 Sewer Connection
30-444 00 Sewer Inspection
51--440 00 Street System Dev Charge (SIIC)
52-449 00 Packs System Dev Charge (PD(:) �Sci _ .2 4'-
31-450 00 Storm Drainage Syst Dev Chrg (SSUC)
10-230 09 TRFD
10-230 05 Washington County Fire N1 (91.)X)
10-220 00 Amar•t/Wedgewood -
TO'l At
RTC N
APPLICANT SIGNATURE
Received By: __-- ___��_ _�� DAto Received: