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<.- APPROVED FOR CONSTRUCTION
CITY OF TIGARD
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6807 SW OAK STREET
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City of Tigard nuild:ing QePRrtsont
13125 R11 Rall R1•d. Tig,", Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 6J9-4171
Inspections- _
Undermlal, 4fech. Pau h-in Appr/Bdwlk
rooting
plbg. g _
Found.
Plbq. Top Out Cee Line
post/Beam Strutt. San. Serer
Framing -Bldg.
Past./Beam mech. Rain Drain
Insulation -Plumb.
Plbg. Underfloor water Li • Gyp. Bd.
-Mtar:h-
L) 2 _Time s AM
:-_---
S
Date Requested! �
��---
- P�.rmi(f1
Addresss n
nuIIder:,___
TRE pOLLOwING OORRECTIONB ME RE UXRMs
S
Date:
inspector:--_-,,-'inspector:--_-,,-'.' --- __
A APPROVED _ DISAPPROVED APPROVLI, SUBJECT TO ABOVE
Call Far Reinsp.
I �
! C11YOFTIFARDBUILDING F,ERIhIT
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CI'<1fOFi11�ARD r,E M11 #. . . . . . . : E1UP"-)1 -0321'
COMMUNITY DEVELOPMENT DEPARTMENT «naioN
13125 SW FMII Blvd. P.O.Baa 23397,Tfpud,Orpon 07223(603)a W4s76 1 ---�_ DATE ISSUED: 12/3121/91
i
`SITE AD RE'SS. . . : V6807 SW UAK ST F'ARCE.:I_.: 1,5136AA-01900
SUBDIVISION. . . . : FUR VAL.LF Y ZONING: R--4. 5
BLOCK. . . . . . . . . . . 1_01`. . . . . . . . . . . . . :3
PE.I5SUE: FLOOR AREAS- --_--__._..._._
EXTEP.IOR WALL CONSTRUCTION-
.LASS OF WORK. :ALT FIRST. . . . : sf N: S: E. W:
!-YF'E: OF USE. . . ,SF SECONl;i. . . : sf PRnTECT
1 YF'E OF CONST'. :5N THIRD. . . . s s f N: S: E: W:
OCCUPANCY ORt'. :R;3 TOTAI---.----: 0 -f ROOF (:ONc;l FIRE REIT'
UL CUF'ANCY LOAD: BASEMENT. : sf AREA SEF'. RATED:
5TOR. : HT. : ft G(--4RArE. . . - sf' OCCU SEF'. RATED:
BSMT?: ME*ZZ?: REGI) SETBACKS----------
FLOOR LOAD. . . . : p=f LEFT: t t RGHT: ft FIR SF'KL: SMOK DET. . :
DWELLING UNIT'S: FRNT: ft REAR: ft FIR ALRM: HNDICF' ACC.-
BEDRMS: BATHS: IMF' SURFACE: F'R0 CURB: l'ARK I NG:
VALUE. $ : 2000
Remarks : enclosi.nq car^ port
i_lwner: - _._.---._________._._________._____..__._ ____..___ FEES -_--_._.__--__-..
CHRISTOPHER BRACKNEY type amount by date ► ec-pt
6807 SW OAK ST F'RM1 f, :;PW JLH 12/30/91 -
PLCK $ 21. 13 JLH 12/10/91 22052
T IGARD OR 97223 `,PCT $ 1. 63 JLH IP/30/91 •-
-'hone #: 244--2063
' ontr--Actor: __-_______.__ -__________.____--
f'!WIVER
I.'one # : $ J5. 26WTOTAL
-_--�- ____._____.
RE:QU.IRED INSPECTIONS -------
1is permit is issued subject to the regulations contained in the Ft-amint insp
ligaro Municipal Code, State of Ore. Specialty Codes and all other Gyp Soc,r^d Insp
3ealicable laws, All work will be done in accordance with Final Inspection ��--"--__.__._�_
approved clans. This permit will expire if work is not started
within 18Q days of issuance, or if Werk is suspended for more
than 110 days.
;- e r m i t t e e S i ca n a t i.1 r e : n
f
/ Ca 11 rot- inspection - 639-4175
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dF
Permit No:
•; � s-. '�� Address _ - -- ----_
IQ Date:
Issued by:--- - -- --
' FOR OFFICE USE ONLY -
,STATEMENT:
INFORMATION NOTICE TO PROPERTY UWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:
1 "] I own, reside in, or will reside i the completed strkicture.
My general contractor is -- __ -
Contractor registration number -_ -- -- --
wll
II elstructuretmustt beregistered w th the subcontractors
tConstruction Contractors Board.
OR
B. moi_{ I will be my own general coni actor.
If I hire subcontractors, i will hire only subcontractors registered with the
Construction Contractor, Board. If i change my mind and do hire a general
contractor, I will contract with a contractor who is registeredwith the
immdite
ha
issuing this building permit of
ncrt e name olf the cortractorotifY } office
I hereby ceationthat
Notice to Property Owners about Ccorrect ont that
tionhave
Responsibilities understand
on the
the Information
reverse side of this form.
� mac.-
Signature o Permit Applicant / Cate
CONSTRUCTION CONTRACTORS BOARD
0244J 1/90
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
T�
- '
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| �lTY OF TlGOMD - RECEAY � �E
%�T �F � � �T CEIpT NO. » - 34 '1 �
| C\0ECK AmO�V»T : ~ '
CABH AMOLNT : 0. 00
\ NAME x BRACKNEY, CHR I8TOPAER j:,,AyMFNT DATL
� AD0��S8 x 680-,' 8W OAK ST �UBDlVISIOm :
�
| TXt;j)RO, OR 972L3-
/
/ �JRP��� OF PAYMENT
AMOUNl �'A�D
PURPOSE OF P��YM[NT AM[NJNT PAiD
---- ----- ----'--------- 1
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� -'------~-----------' -- �- � BUILD� 87. � �L �
^UD PER . '
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TUTAA- AMnUNI PAIL) - - - -> 34. t3 �
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N PMIT t; ACCT r DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees ,124-J ?
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check Feey1/1 —_-_—
Building
Plumbing
Mechanical
y 10-230 Ob Fire
i
30-202 00 Sewer Connection _—__—
'
30-444 00 Sewer Inspection
{ 25-448--J2 Commercial TIF Fees
25-443-04 Industrial TIF Fees
I
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 (Fe(, in lieli of)
24 -445-02 Water Quantity (Fee in lieu of)
TOTAL
nm/3587P.WPF
. T( r�( 13125 Sw Hau rind. PL /NCK RECT #OF
CIARDTY TIG
V Box 23397
('01NUMUNI Y I)I:-Vl,,' 'ttl:Nr f)►a'Al2IT1f,N'r Tipraprcgon97�?S PERMIT H G -' �y -p 2 Z
(503)639.4171 DATE ISSUED
JOB ADDRESS: _[�` 0 7 S w mai.�� _ TAX MAP/LOT /S 1 Xi 414 - 0l f V 0
SUB: __ - LOT: LAND USE: _
VALUATION:
OWNER SPECIAL NOTES_
NAME: �hi i s'�`aP/e .�.;,/,,,�-y �- REISSUE OF:
ADDRESS: ,>sU ,� >,�„ na/_ — LAST REISSUE:
77-7 -13 FLOOD PLAIN/ ----__----------_-___.
PHONE: ��``� `�'` Z�'�3 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: Sli♦� _ PLANNING:
ADDRESS: ENGINEERING:
-- FIRE DEPT: _
PHONE: OTHER'
CONTR. BOARD #: _ _ _ EXP DATE:
ITEMS_REQUIRED
5 CONTRACTQRS: PLUMB: LIST/SUBCONTRACTORS:
MECH: __- - _ BUS TAX: _
ARLHJENGINEER CALCULATIONS: _
NAME: _ _ TRUSS DETAILS: W
ADDRESS: _ _ -- — _ OTHER: � .—
PHONE:
PROPOSED BLDG. USE: je I ,
COMMENTS: �
A0PL16N1 SIGNATURE
Received By: __ /� � Date Received:
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CITY OF TICarRD RI:C..I IP " OF PAYMENT REC:E'IPY NO. t91 F';i'0 1-,C,
t HE.0 R AMOUNT lb we �
t ihl!: s BRACKNEY, CHR LYTOPHCR CASH PMO UNT i, S I i ilit
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A'Cr1�lF�s>:i s 6807 SW C1AK C='A'�MI_N DOTE.' f
SUBDI V ISION �
TI(WARD, OR
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PL Pf,C)GF OF PAYME._N'1 AMOUNT PAFI1 PURPOSE:': CIF" V-AYMLNf OMOLI14T C=IA?i'►
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FCl-I'AL AMOUNT PAID
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