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1
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Uregon 47223
Inisectiun ..i (Rec-O-PPhhlonne)t 639-4175 Business Phones 639-4171
Lsepections Ci4K e 4 , le
rooting Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Fous.d. Plbg. Top Out Cas Line FINALS
.,'Beam Struct. Ban. Smatr Framing -Bldg.
^ust/Beam Meeh. Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Line Gyp. Bd. -Neth.
rate Requested: - _ Timm AM �PH
Address, / Z Permit /
„r
Builders_
THE FOLLoWTNU CORRICTIWS ARE REQUIRED:
i
.r
Inspector.: / Yf�' — Dates—"
C.. trPROM, _ DISAPPROVED APPROVED SUn.7ICT TO AhOVE '
Call For Reinep.
CITYOFTIGAr -RDRD BUILDING PERMTTfes'
COMMUNITY DEVELOPMENT DEPARTMENT rErMIT #. . . . . . . II BUP'91---0179
13125 SW HWI P kfd. P.O.Box--,3387,TqWd,Oregon 97223(6W1639.4175
SW TAMERA
PARCEL: ICJ133DC-14LAOO
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK ZONING, R-12
BLOCK. . . . . . . . . . : L01.. . . . . . . . . . . . . :S
REISSUE: FLOOR EXTERIOR WALL CONSTRUCTION -
CLASS, OF WORK. :NEW FIRST. . . . ., Sf N: CS: E.- W.-
TYPE OF USE. . . :SF SECOND. . . ., s PROTECT OPEN INGS?---------------
TYPE OF CONST. .*SN THIRD. . . . sf N.* E: W:
OCCUPANCY (-)RP. :k'3 TOTAL__-_ 0 sf ROOF CONST: FIRE RET' :
OCCUPANCY LOAD: BASEMENT. - Sf AREA SEP. RATED.
GTOR. . IAT. _-, ft GARAGE-_". . . : !3 1' OCCU SEP. RATED:
BSMT?: MEZZ'): REDD SETBACKS----
FLOOR LOAD. . . . -412) Ps-F LEFT. ft RGHT: ft FIR SP'KL: t3MOK DE T.
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM: 11NDICP ACC:
lit=DRMG; BATHS: IMP SURFACE: PRO CORR: PARKING:
UALUE. $ : J'c-40
Rem&v-ks : 5 7,0 _;q ft deck
Owner-: FEES
DOUG POLING type amol-tnt by date t-eept
13227 SW TAMER; LN PRMT $ 36- 50 JLF1 07/25/91 215743
TIGARD OR 9*7223 PLCK $ 25. 03 JLH 07/ :'5/ )1 215743
Phone #: 226-5409 SPCT $ 1. 93 JLH 07e
/ 3/91 215743
Cont r-actoi
OWNER
Phone ---------------
Req 65. 46 TOTAL
-------- REGUIRED INSPECTIONS -------
This pereit is issued subjPLt to the regulations contained in the Foot/foi-Inci Insp,
Tigard Municipal Code, State of Ore. Specialty Codes and all other Framing I n s p
applicable laws. All work will be done in accordance with Final Inspertiol;
approved plans. This pervit sill expire if wvk is not started
within 180 days of issuance, or If work is suspv0d for sore
than 160 days.
Per-mittee
Issi-ted By
CMI for insPvrt ion 639-4175
CITY
n1�IT13123 SW hall[Nd. PLNCK/kECT #OF .IGARD 1`0 Box 23397 PERMIT it u Q
COMMUNITY IJ[VELc)1'MENT UI?I'AR'1'MI?N'I' Tigard,Oregon 9722. ---
(503)63"171 DATE ISSUED
JOB ADDRESS: Z3 227 .S. w 7,-4,M6$A Lxj. _ TAX MAP/LOT ?
SUB: Uj l�c�l �•>�SrrM1 M.,l�,/� LOT: LAND USE:
VALUATION:
OWNER C � SPECIAL NOTES
NAME: �L vL�4 H?LING- _ REISSUE OF: _
ADDRESS: LAST REISSUE:
FLOOD PLAIN/
PHONE: _ v��'G ` S 6/25)!E
G j 1.//�l SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIREQ
TAME: PLANNING: _C/
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: e OTHER: _0 7
CONTR. BOARD ; : EXP DATE:
ITEMS REQUIRED
SUBCONTkACIORS: PLUMB: ------- LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH ENGINEER CALCULATIONS: _
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE: , Y'��ti!���
COMMENTS:
APPLICANT SIGNATURE
i
Received By: — Date Received:
i
PERMII N ACCT # DESCRIPTION
AMOUNT AMOUNT PD. BAL. DUE
hNpq/_`12y 10-432 00 Building Permit Fees
_ 10-431 00 Plumbing Permit Fees -- -
10-431 O1 Mechanical Permit Fees _ — -
10-230 01 State Building Tax (5%)
Building Z.
Plumbing _
Mechanical
10-433 00 P' Aeck Fee —
B01ding u 3
Plumbing
Mechanical —
10-230 06 Fire
30-202. 00 Sewer Conrection -- -
30-444 00 Sewer Inspection - - -
25-449-02 Commercial TIF Fees ---23-448-04 Industrial 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 ----- —5?-449 00 00 Parks System Dev Charge (PDC) -
31-450 00 Storm Drainage Syst: Dei, Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of) _ —
24-445-02 Water Quantity (Fee in lieu of) -- - —
TOTAL -- =-�-�_ --�—
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