10525 SW 71ST AVENUE i
r
0
10525 SW 71ST AVENUE __
CIIYOFTIFARD BUILDING PE'RIIIT
(CrIYOF W-ARD PERITI'T #. . . . . . . - Eil.11-190 0 2 13
COMMUNITY DEVELOPMENT DEPARTMENT it. DUF-190-0213
13 ,
125 SW Hall P O.Box 23397,Tigard,Oregmi 97223(5p
10525 .":W 71S) AV F"A RC E L I S 1.3 6 PC---0 01*5 00
SUBDIVISION. NETZGE*n ()CR[-:.' 1*1-'iACTS ZONYNG- R--- ,. 5
P OCK. LOO.. . . . . . . .. . . . . . ..2
............
RE: ISSUE. F*LOOR ARF-.*AE)--------------- E*-"X'T E R 10 R W A L L C 0 14 S tj c r I o H
CA-AGE) OF WORK. F,IF,ST".. f N- S: E W
(.)F' USES. . . SF ISECOND. S f f-*'R OJ'E CT 0 PE III I N G S
I y C",ON',-i I . 5 N I'H IR D f N S-. E W
(')Cr,.(jr-',()I%ICy GNP. :R13 TOTAL..-•----- --N El si f ROOF' CL)Ns,r-.
OC(.'Uf:' ,4N('..Y L-001): 14 q 9 E-111 E N7'. f ARCA S EP. RATED
C)*T 0 F:. - :L 11*1 f t GARAGE:. . . OCCU SEP. RATED.
i;Z,:)ITT'? I'll ZZ'", R E'Q 1) (E.;1::.'T El 0 C 14,S— U I R E D
F'L.(:10 R L 0 A D. . . . :-40 V)!s f LETT ft RGH1 /f t I"IS F"K L. (SMOK DET. .
DWULI IN(.3 L)III IT HT ft RF-AR., ft F'I R JZ11- HNDICP ACC-
DRVI(3: 001 HS IMP 13)L)RF7()CE*
r"'R0 C kR: PARKINC .-
3
V 0 L IJ 1-,'. ?50
e ni a
0wrv.r.. 1: L F.S
R DE R'T' K 1:NG pe amount b date -r e e I:)t
:1.0525 SW 7113'1 AVE T $ :.51. 00
P1 CK $ 9 '7 115
11GARD ()R '5PCT $ 0 7 15)
R.
�)L) C
11 ti ci ri e 0 503 244-94�'3 PAY 11 $ 25. 50 JUA 07/25/90
W N E F. N'T R 0 CTO R
fl c)I I e 25. 50 TOTAL
OWNER
....... REOUIRED INSPECTIONS
This permit is issued sub)ect to the regulations contained in the Foot/f0t.trid 11115P
Tigard Municipal Code, Stats ol Ore. Specialty Codes and ill other Post"'PeAm 11-1sp
1pplicable laws. All work, will bp done in accnrdance with F'•r A ni.i ri q I ri F.i
approved plans. This permit will expire if work is not started
within 160 days of issuance, or if work is suspended for more
than 18C days.
.......... ......
.. ............
1-:Iernitf.tee
..........
1 d 11
CA11 fo'(' 1 "ISPec.-tiol-i x,39••-41%5
�F Permit No: --------___- _-
Address: ---
t- i : o}
Issued by: __ -_-_ Date:
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPON;IBILITIES
Note: Oregon Law, ORS 701.0;55(4), requires residential building permit applicants
who are not registe ed with the Construction Contractors Board to sign the
following statemer', before the building permit can be issued. Licensed Architect
and Engineer appli„ants, exempt from registration under ORS 701.010(7), need
not submit this statemeni. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:
1. F=1� + own, .eside in, or will reside in the completed structure.
2 A. C� My general contractor is
Contractor registration number
I will ;nstruct my general contractor that all subcontractors who work on
the structure must be registered 1 1h the Construction Contractors Board.
OR �•�
B. 1 will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. if I r ange my mind and do hire a General
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor,
hereby certify that the above information is correct and that I have read and understand
the Information Notice to Property Owners abol.t Construction Responsibilities on the
reverse side of this form.
4-
_§I0nafu_i:e__o_V_Pe0nIt A00licant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 10124189
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
r,
ITY ("IF "TIGARC P.-ECEIFT OP F'AYMEPAr RECEIPT NO,,
VIAME ROPER'T CHEC'k AMOUNT ; 2 6 75
ADDRESS 3 1 Q!j'25 BW '71 CASH AtIOUNI t 0. "W-
ST PAYMENT DW F
SUP111 I v I s 1 ON
TIGARDOR. Y 72
P'URPOSE OF PAYME'NT AMOUNT FlAtt.) PURPOSE OF PAYMENT .')MOIYNIT PAID
ST. BUILD FIER 75
�:)MIJUNT FAID
� � Z
n
ui
r 40 J ¢
w.
All
w
f
ZO Q cY
X I N J � D
� � 5 � L Q
c � p p w
LL
CL
Mer fJy r1 Q Q cj
00,
y a
r
V4
1
,e
4 a
l
o
WE U�w
XMFXW [K
�"p.1 N' 94 ry L-A..ov s
S 2 S —t 1 11,✓
Ti c�,r..�..r� c�+• 4' 1 Z z 3
L/ x L( Thi "�►Y� 7"S I ti
�"AY�.,ra �.✓�W � C�4l
'ri
r
30 20 6 0
100
. ._L
-- 4, N N►
01
i llZ..� IC 1 NG
500 ���
clow
CO
4 6 ,1''
w
401
400 ,a
l
0 178 51
STREET
....I dam..w. .+r�NM.w•+. ..,._w...... _ .,w^^...��.�.......+.+f ...._�.....« �... _....�. ..�r•..� \` .
Q . r 3
4 oV
� � s
I- w > W WIFT- � �J
Ir ,3125 SW Hail B J PLAN CI I.E X APPLIC
ATION
�n
CITY ®F° TIGA� �/
P.0
Box 23307 PLAN Q�������f' -ZL(Z.6
` Tigard Orogon 71 3 PFImT 0 lid.V/ f U o.Z 13
COMMUNITY DEVELOPMENT DEPARTMENT(
(W)639-4171
DATE ISSUII?
' JOB ADDRESS: l O � 2 ..,1 -1 ( � - I(L" WYE TAX MAP./LM
SUB: Uti LAND USE: —
VAILUMON:
OWNER SPECIAL NOTES
NAME: Y� (� ��l ` v� (r REISSUE OF:�
ADDRESS: _ Z C- LAST REISSUE: - -
T ''L -L - FLDOD PLAIN/
_ SENS=E LAM:
APPROVALS RWUIRED
C10" RAC"M1 MMWING: -
NAME: -i C. - FMINEERING: - -
IMORFiS: FIRE DEPT -
-- (7L'IiFR: ----
PHONE: _-` -_-_ - ITFI"LSL RBQUIRFD
BUILDUI S 1DAM ,¢: IDM DATE: I=/SUBC10N RAC7l0RS: --
BLZ TAX:
ARCH ENGINEER C1 WUT-(MONS: - - -
NAME: TRMS DETATIS:
ADDRESS: _---- - OTHER: ---
F'IiONF: (--- -
us
cof4mlx. S:
SUBOON RACPOR.S: PLlM: MDQi:
PEIMT ,P A= 0 DESCCRIPTIOtd AMOUNT ANrJ.Nr PD. BAL. DUE
/;-N1'y ► 10-432 00 Building PeXMit Fees
10-431 00 Plumbing Permit Fees
1.0-431 Ol Mechanical Permit Fees
�- 10-230 01 State Building Max (5%) •76- _ _ ^ _ __: Z_
Building _ 7S__
Plumbing _ - --
Mech
10-433 00 Plans Check Fee - 7 _
Building __— F, —
Plumbing _—_—
Mec h
3(�--202 00 Sewer Ocxuiection
30-444 00 Sewer Irrqec Ucn
51-448 00 Street System Dev C!.atge (SDC)
52-449 JO Par) . System Dev C] (PDC)
31-45(' 00 Storm Dralrk'mge Syst Dev C1trg (SSDC)
10-230 06 Fire
WITAL ------ w�✓. Sh
— RDC _------
APPtIC AMr f7C1^!A` JRP
IbPneiv Rl BY: Date Remivedi
of/35871'.WPI'