10088 SW 72ND AVENUE-1 l
i
INSPECTION NOTICE
City of Tigard Building Department
L9125 SM Ball Blvd. Tigard, Oregon 91223
Inspection Line (Rec-O-Phone): 639-4175 Cusineee Phone: 639-4171
Inspection:____ ----,- - --�--
Footing Plbg. Underelab Hoch. Rough-in Appr./Sdwlk
Fount. Plbg. Top Out Gas Line PINALz
Eoel=/Beam .5truct. � San, gawa,t Framing -Bldg.
Post/Beam Mech. CIWLn Dsaie Insulation -Plumb.
J
Plbg. Underfloor star • ) Gyp. Bd. -14ect_.
Hate Requeate,'.: 2 .-- Times AM PM
Morose:-----�D�, ��r _-. _ Permit #:e"
Bu i Lder -_..-- �QGSc .-�.Wit►�•/------------ - -
L�
THE FOLI"IING CORRRQTIONS ARE REQUIRED:
✓7 �Pl it !%F,li DI6APFMVlD - _ APPROVED SUBJIM TO ABOVE
call For Ra snap.
1
CITYOFTIFARD MASTER 1-aERMIT
OF TW,4RD
COMMUNITY DEVELOPMENT DEPARTMENT Tf OR190h #
13126 SIN VivJ1 Blvd. P.O.Bcm 23397,Tigwd,Oregon MM-1 ,oW)IM4176 -Z
I C4 1
SITE ADDRESS. . . : 10086 -`3W 121\1D AVE PARCEL:
SUPD I V 1.S I ON. . . . : ZONING: R-4. 5
BLOCK. . . . . . . . . . : LOT.
BUILDING ---
E. 113 Is U DWELLING UNTIS.- I BASEMENT. . . . . . . . t581 s f
LLAbLS Lif. WURK. NEW SEDRMS:3 BATHS:3 GARAGE. S+
E O
TYPE.. UISE. . . SF' FL-0011 AREAS—- - REG,!U I RH)' !';E
TYPE OF CONST. :5N FIRST. . . . : 1012' S LEFT. . .-26 ft RIGHT. :22 ft
0GCUPnNCY GRP. : F7_, SE("OND. . . .9�_0 5f i=RONT. :,`?8 ft REAR— :99 ft
Fz,rORIES. . . . . . . ..2 THIRD. . . . :0 S f' REQUIRED------ ---- ---___....__..
HEIGHT. . . . . . . . :27 ft TOTAL - - .-_,...._.:,=54'_- f iMf. VE DETECTOR�3. :Y
FLOUR LOAD. . . . :40 psf VALUE. . . . . It : 126914 PARKING SPACES. . :0
F?e M a?-k 5
PI_UMBING
'INKS. . . . . . . . . . : 1 f_-LOUR DRAINS. . . . :0 1-,;REVNTRS. . .0
LAVATOR IES. . . . . :A WA"('ER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TJB/SIAOWER7. . . . :4 L-AUNDRY TR A Y S. . . ! I CATCH BASIN',3 . . . . . . ..0
WATER CLOSETS. . :3 SEWE:R LINE (ft ) . :0 GREACE7:1 TRAPtj. . . . . . . .�.-0
DISHWASHERS. . . . : I WATEr I-INE !ft ) . : 100 OTHER FIXTURES. . . . . z0
60HBAUL DISP. . . : 1 RAIU Dr-IAIN (ft ) . -0
WASH I N(_j MACH. . . - 1. GF RAIN DRAINS. .
MF:CHANIGAL F'EES
FUEL '1'"7';'E c3--•---.. ----,-_._-.- UNIT H! Rb, '121 ty0p 11t v n t by date )-'e' !.A
'GAc
S/ VENTs @ rI F d 1 50. 0 0 JLH 07/t 1/91
MAX INPLIT -0 STU VENT T, BPRT $ 50 JLH 07/11/91
FURN ( IC60K . . :0 HOODS : 1 DPLc $ 3c-5. 32 JLH 06/13/91 2
URN ) :- 1001-1, WOODF 1 :0 ObPG $ b, '!I- A LH 11.17/ I I/91
L.LJUH F-URN. . . . .*V CLO DRYERS. s I SSDII $ 375. 00 JI-H 07/11/91
3HP.-O C)T HE:P UNITS I P.,A riFI\ $ 100. 011 JL11 107/11 /1)1
GAS OUTLETS: I MPRT 4 8. -00 JLH 07/ 11/91
jN1 i MPI_ 1 2. i"'O JI.-,Li 07,111 /91
IEN AND DONNA DANNER m51 i- 40 JLH 17.17/11/91
—
11E 6' 14 TLJA I ITN 14 1) #71 P PR50 JL+1 07/11/111
P5P(. $ 1 1:5 JL.H 111 I I I I
1,flul. C0 1"l OR 9 7
EVI:-_r1(A?I.FN PACIFIC INC
788*7 _L1W (J)PITOL HWY
POR11-1-AtID OR 97219--0000
Phone 0: 51213--E4n--9999
Trjrf)L
This permit is issued subject to tno regulations containec in the RUJU I RE.D I NbPLI., I I UNS
Tiqart Municipal Code, State o' Dro. ov"Alty Codes and &.11 other Foot /foi:;nd Insp F irppI ace Inr
applicable laws. All work will be dont, . , accordance with approved Po,. t/Bea1m Struct Gas Line Insf,
plans. This pproit will expire if worn is not %,,-ted within 186 Wast/beaim Mechan In q u A at i on it
Jt,.Yq of trs,iarrp, or If work is Suspended for for@ c,.sn 14 days, P.1 M/undt; I ab In sp Gyp Boat-d In
PLM/Undo#t-f i oat, Rail, dr-ain I
cl_.
V�-M L t I tj 11A t 1.11"P Me c:f i or,i r:a I I n s p? I. P?t, Line IT
Plumb Top Out Appt/Gdw1k It
S . a a y FLr'aMi '[j Trap
M e E:h a n i c a I
CACI f'c i n spect i an -- 639-41.75
xw
cj,ry OF TIGARD RECEIPT Cl- PAYMENT RECEIFST' NO. 9 1.--;2 t 52,54
CHECK AMOUNT a 305ri. 89
NAME i I..-F.VERGREEN PACIFIC INC, CASH AMOUNT a 0. 00
ADDRESS PAYMENT DATE 07/11 /191
,UAP I V 15 I(IN
PURPOSE OF PAYMENT nMOUNT PAIU PURPOSE OF PAYMENT AMOUNT PAID
i3u—IL D iw(—, BERM 500. 50 PLUMBSNO PERM 162. 50
MECHANICAL PE 48. 00 ST. PUILD PER 35. 56
PLAN CHeCK F,r:.' 87. 33 RESIDENTIAL TRAFFIC FEES) 121,50. i710
MASS TRANSIT TIF FEF;..cj' 100. 00 PARKS SDC 500. 00
STORM DRAIN SDC 5. 0 G
10088 SW 4ND AVE
TO*T*Ai. AMOIJNT PAID — — — 89
SEWER CONNECTION /
CIT(OFTIFARD CriY0FT1AIma✓
,ERMI'f #PERMIT PERMSWR91-0122
COMMUNITY DEVELOPMENT DEPARTMENT Oreeoon
13126 SW HM!BW. P.O.Boot 23307,Tigard,Oregon 07m(6031630.4176 7-E ISSUED: 06126191
SITE', ADDRESS. . . : 10088 SW 72ND P PARCEL: 1 S 136AB-00302
SUBDIVISION— ZONING: R--4. 5
BL.OLK. . . . . . . . . . e LOl.. . . . . . . . . . . . . :
TE NAN'f NAME. . . . . :
USA 1\10,. . . . . . . . . . .. FIXTURE UNITS. . . :
CLASS OF WOPK. . . :NEW DWELLING JN I T 7. . : 1
TYPE OF USE. . . . . :SF NO. OF' BU I LD I NGS i i
I NSI-ALL TYPE.. . . . :BUSWR T MF'F_RV SURFACE. . :
kemat,ks:
!Jwr)er. __..._.________.______._._...__________.___ ___..__._._._._._-___-.- FEES
SEN P°ID DONNA DANNFR tvpe Gnmol.rnt by elate rer_t
11865 SW TUATITN RLQ #71 PRMT $ 1500. 00 JLH 06/28/91 02
INSP $ 3 . 00 JI.._N 0
TAULPT'IN OR 9i
Phone #1 691-2662
Contravtor:
�t � ✓' �1�`J99 -----_+F__ `_ _____._________
nane 1.b:35. 04d 7(ITAL
....___
Rep #. . v
-------- REQUIRED I 'SPECT I ONS -- -- -
This Aoolicant agrees to comply Kith all the rales and regulations Sewer In3pect.ion
,f t'ne Unified SeNsge Agency. The permit expi-es 120 days from
he date issuNd. tle total amount said will be forfeited if the
erait exoirv. The Agency does not guarantee the accuracv of the
side sewer laterais. If the seller is not located at the measurement
riven, the installer shall prospect 3 feet in all directions from
'he distance given. If not so located, the installer shall purctase
"Tap and Side Sewer" permit and the Agen,y will Inst 11 a lateral.
1
er~mittele Sign-'+t ,.it,ei
Call for insDertion - 639-4175
4
i
Mpg
cuy OF' riGARD - RE(TIPT OF IDOYMENT RECEID",," NO. 9 J-214853
CHECK AMOUNT u 1535. 00
EVERBREEN PAC.'IFJ(,, IN(*.... CASH AMOUNT 0. 00
PDDRF-CJs a 7887 SW CAPITOL HIGHWAY PAYMENT DATE a 06/28,"- 1
PORTLAND, OR stiol) f V I G I ON
PURPOSE OF PAYMENT AMOLIN T V'A I D F-AMPOSE OF' PAYMENT AMOUNT PA 1 D
i�o SEWER INSPECT 35. 00
SEWER PERMIT
#91 1-122
TOTAL. AMOUNT PAID J.535. 00
r I sw Hall[Wd, PLNCK/RECT #
CITY OF T I GAR ro Box z3397 PERMIT # -6! oZ Z
Tigard,Oregon 97223
COMMUNITY DEVELOPMENT DEPARTMENT (503)639-4171 DATE ISSUED _ --
JOB ADDRESS: 7 �- Ry TAX MAP/LOT
SUB: —_ LOT: LAND USE:
VALUATION: ` ,r 2C-252
OWNER SPECIAL NOTES
�_�, REISSUE OF:
NAME:�-�c �. � �.�.s..--
LAST REISSUE: r—
ADDRESS: _i�,,
FLOOD PLAIN/
PHONE: o`� \ SENSITIVE LAND: _— --
CONTRACTOR APPROVALS REQUIRED
NAME: �--y4� ��d ��r ,C,�, � � �
PLANNING:
ADDRESS:
�h - ENGINEERING:
----
C� FIRE DEBT:
PHONE: - C�l `Z OTHER: -
CONTR. BOARD #: �a EXP DATE:
ITEMS REQUIREQ
SUBCONTRACTORS: PLUMB: LIST/SUBCONTRACTORS: -_--
MECH: BUS TAX: _ --
ARCH ENGINEER
CALCULATIONS:
NAME: _ _ _. TRUSS DETAILS:
ADDRESS: __-_.- -_--_ - -- OTHER: _ _-
PHONE:
PROPOSED BLDG. USE: -__ ----_____ --- - --- -
COMMENTS:
APPLICANT SIGN T yyy.+++�^^�������-^^^
Received By: _-- —_--_-_ Date Received: —_--
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. PUE
YK,5LV-(-:fI2, 10-432 00 Building Permit Fees loo—. 5 O
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 cit State Building Tax (5%) 35 �
Building
PI umb i ng 1.3
Mechanical
10-433 00 Plans Check Fee �-5c? 7,D
Building JZ5. 33
Plumbing _
Mechanical _ /
10-230 06 Fire
wg02L 30-202 00 Sewer Connection A5
30-444 00 Sewer Inspection 'S— 2S
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
,i 25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-0) Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charlie (PDC) _. Sc,
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Wdter Quality (Fee in lieu of) _r
24-445-02 Water Quantity (Fee in lieu of)
TOTAL ' cSv Lo
J
nm/3587P.WPF
Cl'fs, OF TIGARB RECEIPT OF PAYMENT RFCE I PT NO. i9l—Pi43P6
CHECK AMOUNT : 150. 00
NAME : EVERGREEN PACIFIC, INC CASH AMOUNT % 0. 00
WllL)FtE- : 7887 SW CAPITOL HWy PAYMENT DATE : 06/13/91
1
.;LJSD I V I S I nN
PORTLAND, OR 9-7,-R.19-
PURPOSE OF PAYMENT AMOUNT r-*'AID PURPOSE OF PAYMENT AMOUNT PAID
----—------
PLAN CHECK FE
PLAN CHECK DEPOSIT' 10066 SW 7r'-'ND AVE
AMOUNT PAID 00