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If this notice appears clearer than the JUL. 03 1998
document, the document is of marginal qualitti'. N ,
11 ROF I LAIED
IMCN MME 0 ORWAM
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i:\records\microfilm\targets\buiIding.doc
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CHY OF TIGARD CERTir-ICATE Cff-
OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #h. . . . . . . : M5T95 -111008
13125 SW Hall Blvd.Tigard,Or6gon 97223*8199 (503)639-4171 DATE ISSUED: 07/06/95
PARCEL 81S104BD---RM0@C,
SITE ADDRLILIIQ. . . a 1,5/t46:: ;>W RU6 V U I
FlueD I V I S I ON. . . . I ROSE MEADOWS
BLOCK. . . . . . . . . . . . . . . . . . . . . . . .1110(`1
CLASS Or- WORK. :NEW
TYVIE OF* USE. . . :9F
OCCUPANCY GRP. ;R3
OCLUPANCY LOAD:227 4
TENANT NAME. . . p
Remarks PATH I
uwtlerl
JAY MILLER
P 0 BOX 23291
TIGARD OR 97a24
Phone #- 684 7543
(.','c)nt ract or s _...._ ..._....__._Y.._.__...
KEN WATTS CCNSTRUCT SEL 100336)
PO Box 230925
TIGARD OR 97e8l
Phone #x 684-4431
Reg ##. . t 44005
Thiqz Certificate certifies that the ahnve rpfev- pnced building or portion
thereof has been inqpected for compliance with the Tigard Building (-.'ode
for the wroup and division of occ-1panc-'y fi:cirl use for which the above
referenced permit was issued, and occupancy ig hereby y-anted.
POST IN CONGPICAJOUG3 F-4-ACE
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 P.. iness Phone: 639-4171
Inspection:
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg, Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing IurfiF
Alarm Water Line Insulation ech.
Underflr. Insul. Shear Wall Gyp. Bd. -E!ect.
Date Requested: Cc'l 1 Time: AM FM
Address:
Builder: F�ermit
THE FOLI OWING CORRECTIONS ARE REQUIRED:
Inspector:
d�"APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
-- OJ-L
ITY OF TIGARD BUILDING INSPECTION NO IC
`J Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-417 1
y
Inspection:
Footing �� Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address:
Builder: _Permit #:
THE FOLLOWING CORRECTIONS ARE REOILORED:
Inspector: Date:,,
_APPROVED DISAPPROVED _ OVED SUBJECT TO ABOVE
C-ill For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Roc-n-Phone): 639.4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab `l ech. Rough-in Fireplace
Pont/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Under`hoor Rain Drain Framing -Plumb.
Alarm Water Line I_ns ulatlo -Mech.
Undertlr. Insul. Shear Wall ` / Gyp. Bd. -Elect.
Date Requested: /!a 7 ( Time:LAM PM
Address: .71' 7 S c�
r p
Builder: _ �' , Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Insppgctor: Date: r/
APPROVED n!gAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
1 I
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 63 -671
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab ec i Rough-in' Fireplace
Post/Beam Struct. Plbg. Top Out Eloc. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drainri amin— -Plumb.
Alarm Water Line InsulaNun -Mach.
Underflr. Insul. Shear Wall G)p. Bd. -Elect.
Date Requested: Time: AM PM
Address: �
Builder: / z/ �� Permi! CXS7— OC<
THE FOLLOWING CORRECTIO ARE REOUIR
k-,5(."/0 r14
Is �ej
en
Lc��7
I srcT
i
uy2"V644. s�� c T
Inspector: Date:
_APPROVED _DISAPPR ED _APPROVED SUBJECT TO ABOVE
_Gall For Reinsp.
r�
CITY OF TIGARD BUILDING IN PECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Ruugh-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rouah-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested: y—/ Time: AM PM
Address: 3—757 s-I
Builder: Permit #:
21=_evo8
THE FOLLOWING CORRECTIONS ARE REQUIRED:
7?_ ..•S_"�—'�, /. mak_- -.--u 1w/we viZ�_`j
Inspector: Date:
L/ApMOVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
MOMMM
CITY OF TIGARD BUILDING INSPECTION NOTICE /
Inspection Line (Rec-O-Phone): C39-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
PostfBeam Struct. Plbg, Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. r;�eaarr/1�(g1L Gyp. Bd. -Elect
Date Requested: J�(� 1�/ Time: (\AM PM
Address: Z 5 2--
Builder:
--Builder:
ermit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
4z4- rL YGc/C9V a S'Tl. az- ea�
lyr4N[, t�'r4uc-� �
Inspector: Dater�—q,,$�
_APPROVED _DISAPPROVED L-*PMOVED SUBJECT TO ABOV7
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underiloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mt-h.
Underilr. Insul. e ear Wall Gyp. Bd. -Elect.
Date Requested: _ 2> �� r Time: AM PM
Address: L `' L'e'—
Build-ar: 4rmit #: gs - yC' �1cs
THE FOLLOWING CORRECTIONS ARE REQUIRED.
cit -1 .� �. ._ Slr el.�>
r
Inspector._ Date:
_APPROVED ,6f§APPROVED _APPROVED SUBJECT TO ABOVE
�- —ll For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE c�y1
Inspection Line (Rec-O-Phone): 639-4175 Business Phon 639-4171
7
Inspection:_-1' �
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation PJB. Underslab Mech. Rough-in Fireplace
Poseam S4r ' Plbg. TopOut Elec. Rough-in FINALeam Mec "'San. Sewer Gas Line -Bldg.
Plbg. Unriar+;oor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underilr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: / / l Time: AM PM
Address: 1.�� 5 Z r �
t�
Builder: Permit tt:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
0 L .
ZAl LAOr�
-Spector: Date 1 d _
_APPROVED DISAPPROVED --APPROVED SUBJECT TO ABOVE
/ 1 4 _Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL,
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect
Date Requested: _ Time: AM __PM
Address: G c
Builder: Permit #: 1 oco b
THE FOLLOWING CORRECTIONS ARE REQUIRED:
b N�� �S •'
Inspector: Date:
_APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
`� _Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Li-le (Rec-O-Phone): 639-4175 Business Phone: 639-4171
i
Inspection: �j..p�..-yn �;,'�}�f� LCA
Footing Susp. C, iong Sprink. Rough-in Appr/Sdwlk
Foundation �Undersl Mech. Rough-in Fireplace
Post/Be4m Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Ibg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underilr. Insul. Shear Wall Gyp. Bd. t.
r �J
Date Requested:_ -3/D A � Time: A PM
Address:--I-3 75
BVilder: Permit #:
TtfE FOLLOWING CORRECTIONS ARE REQUIRED:
r
Inspector: ' ! — Date:
PPROVED _DISAPPROVED _APPROVED SUBJECT TO 4OVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Eloc. Rough-in FINAL:
PostiBeam Mach. �an. Sower,, Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: ��i Time:�M PM
Address:
Builder: Permit #:_ ' _ 0c
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I pectora '
Date:
APPROVED __DISAPPROVED _APPROVED SUBJECT TO ABOVE
_Csll For Rei i�-p.
CITY OF TIGARD BUILDING INSPECTION NOTICE ��
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundatior Plbg. Underslab 1`4-rh. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Oain Drain Framing -Plumb.
Alarm `Water Line- Insu'ation -Mech.
Underfir. Insul. Shaar Wall Gyp. Bd. EI t.
1, n �
Data Requested:/ y Time: AM PM
Address: ,/ S S C1- ;, CE,
Builder: j -] , �. ye Permit k:
THE FOLLOWING CORRECTIONS ARt REQUIRED:
Inspector: r Date:
APPROVED DISAPPROVED APPROVED SUBJECT U ABOVE
—Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O/-Pho..:?): 639-4175 Business Phon"e": ,6/39-4171=
inspection: � l.�C.• lyn4c f 4 Ct J a'o-r�
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
F0–un`dation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Fost/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underfir. Insul. Shear Wall Gyp. Bd. –Elect.
Date Requested:_ �/ % �j Timet PM
Address: -
Builder: .3/j t _Permit #: ff S
THE FOLLOWING CORRECTIONS ARE REQUIRED:
'"Z'P m 1= STT?tet Cv o9 L t–' -s
Inspector: Dale:
—APPROVED —DISAPPROVED 4–APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:
ootm Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
PlUg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain DrRin Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. Elect.
Date Requested: �L Time:✓W AM� PM
Address: 1
Builder: / J —(o La. Permit M: 5yGC
THE FOLLOWING CORRECTIONS ARE R RED:
��i f// T.�:IJ u.�Z�-� —7?���✓/='dIZ C-�..-r j /�i�S c) �tJ ��.�.
Inspector: Date: _/— yam_
_APPROVED _DISAPPROVED cf—OP€ROVED SUBJECT TO ABOVE
_Call For Reinsp.
LUMBIG ERMI"r
CITY OF T I GARD i-P'Lkt1IT'N#. .P. . . . . .. msT95-000
COMMUNITY DEVELOPMENT DEPARTMENT bki'L ISSUED: 02/08/95
13125 SW Hall Blvd.Tigard,Oregon 9722398199 (503)839-4171
l-T'4RLEL-. 25104BLY-RM006
1,6.)IiE�;S. 13'7 52 SW ROSY Cl
i-, V I L)N. . . . : ROSE MEADOWS ZONING: R-7
j t-i.. . . . . . . . . . : LOT. . . . . . . . . . . . . :006
Lil WORK. . :NEW GARBAGE DISPOSALS— : 1
Ui. ubizz. . . . 3 SF' WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTkS. I
Y GRP. . :R 3 FLOUR LIRA INb. . . . .. . . :0 1 HHPIQ. . . . . . . . . . . . . . :113
JN.I . . . . . . . . :a WATER HEATERS. . . . . . : 1 CA'(LH BASINS. . . . . . . :LA
X UkL LAUNDRY TRAYS. . . . . . : 1 5F RAIN DRPINS. : I
. . . . . . . . . . . I GREASE TRAPS. . . . . . . .0
:4 OTHER FIXTUREO. . . . . .0
jB/1SH0WERS. . . . : SEWER LINE (ft ) . . . . :0
WI 11 L,k L,L t-1115 L T S. . :;3 WATER L.INL t ft ) . . . . : i Q10
L).k brlW�4;JHLRS. . . . : 1 kAIN DRAIN (ft ) . . . . sO
-
mAt-j—i : P0 1-H I
.1i r 11ILLLN 11F i,5bO. LAO JF od/08/9j
Li LAJX iz'3291 BPRT $ 545. 50 JF 02/08/95
SPLC $ 50. 00 JLG 12/30/94 94-260101Z
S5Pc $ J'17. 28 JF 02/08/9r5
t,LsA+- /b43 PARK $ 500. 00 JF 02/08/95
MP R 1 $ 4'.:x. 00 JF: 02/08/9tj
IYIPLC $ 11. JF VAL1081'9'L
(y" PC 2. 25 JF 02/08/95
RT '25. 00 JF 0 06/9
P5PC $ j, 1. 25 JF' 12112/08/95
SWM $
1.80. 00 JF 02/08/95
;SWM $ 100. 00 JF 02/08/95
fldditionAi I-OeS not shown 1-lere.
RLUUIHEL) I NSPEL I I LJI'4,)
j, ,.i ;.icer mit is issued suh.ject to the i.,eg--
1..cIot ions contained in the Tigard Municipal Foot/found Insp Pain drain Insp
�;tatp of Ore. Specialty Codes and All Post/Beam Struct Water Line Insp
other applicable laws. All work will be done Post/Bram Mechan Appr/5dwik Insp
A ac--:oi-dance with approved plans. This Plm/undslab Insp Mechanical Final
per mit will expire if work is not started PL.M/Underf loot, Plumb Final
1.6,6) days o F issuance, a r i l' work i � flechanicai Insp Bu i I d i n y F i n a 1
for more than 180 days. Plumb Top Out Erosion Control
Framing Insp Wtr Proofing LAsm
Fireplace Insp Crawl Drain
Gas I-Ine Insp Ftq drain Ssmll
Insulation Insp
Uyp L�avtd Insp
ZP(A Plumbing ontractor Signa, tr,e
Lail for im:pection 639-411b
, .tur- Notes :
.. .........
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT SEWER CONNECTION
13125 SW Hall Blvd.Tigard,Oregon 9727.3.8199 (503)639-4171 PE RM T T
PERMIT #. . . . . ,, . s fawRw:j—oe-o,)
L,31-417i. DOTE ISSUED: 02/08/9;
PARCEL: 2S 1 r114BD—RM006
Fi1TL ADDRESS. . . : 13752. SW ROSY L'1
SUBDIVISION. . . . : ROSE MEADOWS ZONING: R- 7
BL..UI-K. . . . . . . . . . . LUT. . . . . . . . . . . . . :006
I LNANT NAME. . . . . :
ul�H NO. . . . . . . . . . F=IXTURE UNIT'S. . . _
LL ASS O1= WORK. . . :NEW DWELL 1 NG UN ITS. . - 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
.NST(-ILL TYPE. . . . :BUSWR IMPERV SURFACE. .
Remarks : PATH 1
---------------__.__—____..._ FEES ____.... _ .. .. .
JHY MILLER typt �.mol.tnt by date 1-!=r-1,1;
w U NUX 23291 Pk rl , $ 1=,E00. 00 JF 02/08/95
IPl'31 $ 3J. QI0 JF" o`/08/95
1 1 CARD OR 97224
1•11-io n e #- 684-7543
l.ontr-actor-: ----------------------_-------_,._._-
CafJPd' PA(.'"rOR NOT ON FILE
---------------
orrE #: ! GI.a J.J. Q)0 1-OTAL
N,eiq #. .
-------- REQUIRED INSPECTIONS - — ----
1ht3 Applicant agrees to comply with all the rules and regulations ',sewer Inspec=tion
of the Unified Sewage Agency. The permit expires 188 days from
Me date issued. The total amount paid will be forfeited if the _
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" permit and the Age n wliiinstail a
I a, m i t t e e Signati-rr^e : r
r
�/ CaII for inspection 639-4175
CITY OF T I GARD
COMMUNITY DEVELOPMENT DEPARTMENT MAEi'(ER PE RM17
13125 SW Hall Blvd.Tigard,Oregon 97223*6199 (503)639-4171 PE rm I T #. . . . . . . : MST95-111vllvt:
DATE ISSUED: 02/08/95
25104BD-RM006
IL HI)DRESS. . . : 1,31752 SW ROSY LT
i_)Lir_k1)I v 161 ON. . . . : ROSE MEADOWS ZONINGS R-7
il. . .. . . . . . . . : LOT. . . . . . . . . . . . . .006
----------------- BUILDING
RF.IGSUEtM3r94-01R6 DWELLING UNITS: 1 BASEMENI.. . . . . . . . :0 s
L-_PbS OF WORK. NNW DEDRMSs4 BATHS:3 GARAGE. . . . . . . . . . 9481 s f
I YPE IJF* USE. . . 6F FLOOR REQUIRED
lYk'F- OF LONSI . t 5N FIRST. . . . i I I sf LEFT. . :5 ft RIGHT. S5 ft
OC LUPIANCY GRP. :R3 SECOND. . . :887 s FRONT. -LO ft REAR. . :21 f 11
STORIES. . . . . . . :2 PINBSMENT:0 sf
1-1E &GH F. . . . . . :27 ft TC I'AL ,-.108 s f SMOKE DETECTOR5. :Y
FLOOR LOAD. . . . z40 psf VALUE— — $ : 144,129 PARKING riPACES. . : l
Remarks : PATH I
PLUMBING -1----------------
tn I f�l win. . . . . . . . . . . 1. FLOOR DRAINb. . . . ;0 BACKFLOW PRE.VNI HS. . : 1.
'--HVFI I L)H I ES. . . . . :4 WATER HEA7ERS. . . : 1 TRAPS. . o . . . . . . . . . . . :0
1'Ub/5HL)WLRS. . . . :3 LAUNDRY 7RAY5. , . ' I CATCH BASINS. :0
WATER CL08ET"S. . :3 SEWER LINE (ft) . ik) GREASE TRAPS. . . . . . . :0
I Alb
I"-)I IWAGHLRS. : 1 WATER LINE ( ft � - -. 11Z OTHER FIX'rLJRES. . . . . ..0
u44RbPGE DISP. . . : 1 RAIN DRAIN (ft ) . s@
MACH. . . . 1 SF RAIN DRAINS. . : i
MECHANICAL FELS
I ULL TYPES------- UNII HTRS. . :0 tv P rJ amol.trit by date r,ecpt
VENTS . . . . . :0 TIF 1$ 1550. 00 JF 02/08/95
X "N1 A21/08/9"
I NPUT -0 BTU VF f ANS. . :4 BPR 1 $ 50 JF 14 J
100K . . *.0 HOOD:. . . . . . . I BPLC $ 50. 00 JLC; 12/30/94 94-260100
> =100K . . ., I WOWS I UVEE". 00 B5PC $ 7. 2.6 JF 0_:/08/95 --
UUN FURN. . . . 10 CLO DRYERS. : I PARK $ 500. 00 JF 02/08/95
0-11ALI'N UNIfs: 1 MPRI, $ 45. 00 JF 0i2/08/')5
GAS OUTLETb: 1 MPLC $ 11. 25 JF 02/08/95
e _m5PC $ 2. 25 JF & /08/95
iY MILLER PPRT $ 223. 00 JF 02/06/45
(I B(JX 2'3291 r1t15PC $ 11. 25 JF 02/08/95
SWM $ 180. 0124 JF 02/08/95
1 (;PNL UR 97224 SWIM $ IOLA. 00 JF 0;---108/9t5
;iorie #-. 684-7543 EPOS $ 64. 00 JF V'2108195
IT-it I-actor,. $ e0. 80 JF 0�/06/9-1i ---
W(41 '[S CONSTRUCT (SEE 100336) LRPL $ 20. 80 JF 02/08/95 -
BOX 2230925
! ibARD OR 97281
1 1--torit, #: 684 4431
Peg #. . .- 44005
$ 3353. 13 T'OT'AL
This persit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
iigard Municipal Cede, State of Ore. Specialty Zodes arti aii other floot/foimd Insp Fireplaces Insp
applicable laws. All work will be done in accordance with aproved Post/beam 5tmtr-t Gas Line Insp
plans. This pet-sit will expire if work :s not started within 180 post/Beam Mev!ian Ins,_tlat- on Insp)
days of issuance, or if work is suspendf fog move tha' lie 14ys. Insp Gyp board Insp
['11-11"Undo)-fitoot- RAiri drain J.11- J
mtttae �L�4A,J <
ItIsLI.) Watts LiTie I n S-p
Pll.tmt' TOP Oktt 0ppt-/Sdty14: Insp
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Residential Building Permit Application
City of Tigard
13125 SW Hc.,l Blvd.
Tigard, OR 97223
(.503) 639-4171
Jobsite Address: 1 7 7 hyvy K4-Y
►�/� / Office Use Only
Subdivision: l ,e��((C_ � Lot# _ �•,
PtancWRec#_ .--
Valuation:
Perrpit # n S 1< `�s "
AOwner: 1 y �-- Reissue of
Address: r Map & TL #
f
Approvals Required
Phone:
Planning
Contractor: -- Engineering
Address: — z Other--- —
Items Required
Phone:
Contractor's License #
�,r�lU 12 ��� Subcontractors _
(attach copy of current Oregon license) Truss Details
Subcontractors: Other
�*Plumbing:
j-,"iechanicalIK; I f(4 I Ih
(attach copy of current OR Coatracfor's License)
ArchitectfEngineer: Rr 1
Address.
r!j IVjY(4 �17';251
Phone:
COMMENTS:
ka 1'-)
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Applicant Signature & Phone number
Received by: is Date Received:
Permit # Account Description Amount Amt. Pd. Bal. Due
r�5 '_S a:•c� Bldg. Permit (BUILD) o �y U V
Plumb. Permit (PLUMB) o__2 ) Z ' "'' v
Mech. Permit (MECH) yj
State Tax (TAX) ` / 7
Bldg.
Plumb: / _✓
Mech: Z
Plan Check (PLANCK) Z
Bldg: S c�_�✓
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) S v U
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R) / 3 U / .3 v
Mass Transit TIF (TIF-MT) Zs' /2�
fr�s,� n�,, i► USA
Oommer f`TIF (TIF-C)
Fr,u,. r?lc_. ("$A
kKk9rn—aTMF (TIF-1) '
lastitutiortel TIF (TIF-IS)
Office TIF (TIF-0) v
i
Water Ouality (WOUAL)
Water Quantity (WOUANI)
Fire District (FIRE)
TOTALS- +f 13
CITY OF T1CARD -- RECEIPT OF PAYMENT RECEIPT NO. :95-261507
CHECK AMOUNT c 5538. 11-5
NAME s JAY MILLIFIR BLDR CASH AMOUNT 0. 00
ADDRESS s PAYMENT DATE o 02/08/95
SUBDIVISION
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
-6-U-11-DING PERM 545. 50 PL-UMBING PERM 21,2,1�. 00
MECHANICAL. PE 45. 00 SjT. BLIIL.D VER 40. 78
PI-AN CHECK FE 11. 25 SEWER USA 2200. 00
:3EWER INSPECT 35. 00 PARKS SDC 500. 00
RESIDENTIAL TRAFFIC FEES 1430. 00 MASS TRANSIT TIF FEES 120. 00
H2O QUALITY FACILITY FEE 180. 00 H2O QUANTITY FACILITY FEE 100. 1710
EROSION CONTROL PERMITFEE 64. 00 EROSION CONTROL- PLAN CK 20. 60
EROSION CONTROL. 8 80
1375,. SW ROSY CT, LOT 6
roi,At- AMC%12^!T PAID 5 5)38. 13
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