15500 SW 72ND AVENUE-1 ADDRESS:
15500 SW _7AO A Uk
sq EL.L. e&Q" w., TL.sT, r, PI.Ows
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LIN 1 F I ED SEWERAGE AGFNCY OF WASH 1 t4GTON COUNTY
FI,MgJC UNIT RAT If4GS
�`IlL TOTAL TOTAL
F 1 XTURE VALUE ' I 1,4o NUMOER NUMBER
BAPTISTRY/FONT 4
laATH — TUB/S'FIOIItR 4
— JACUZISVIPL 4
CLISP 1 DOR/oATCR ASP 1
DISHWASHER COM CR A
IXAfESTL
DRINKING FOUNTAIN I
FLAX)R I7RA 1 N — 7 1 NCH 2
— 3 INCH 5
— 4 INC" 6
GARBAGE DISPOSAL
DOM (PO 3/a HF-) 16
— OOFY4 CM 5 HP) 32
— IND (OVER 5 HP) 48
OIL SEP (GAS STA) 6
S`i7WER — GANG 1
— STALL 2 J
S i(K — BAR 2 -
DRADLEY 5
CC AE-:RC 1 AL 3
SERV 1 C:E 3
WASHER, CLOTHES 6
WATER EXT 6
WATER CLOSET b 2`XL "
URINAL 6
I EDU Olt
a
Ct:
- Q URC DL_
(A S A
DATE I-�i4��� _I NSP TOTAL
--
J Um 1 NESS C-Lj L.L �C1 LG/L /17 i P EDU _..
•� ll�C`2 C'C, OOUrITED FRDIA ,
TAX MAP/LOT �J
73-25 RB1
CITYOFTIFAT
RD BUILDING PE••:RBI
WYOFTWARD PERMIT' #. . . . BUr
COMMUN[TY DEVELOPMENT DEPARTMENT OREOOM F-TRIM. PERMIT #. : BUP89 ' 1131
13125 SW Hall B Ivd. P.O.Box 2S;97,Tigairl.Oregon 97279(5f 3 T f.l. ! D ATF:. T:SS U E D: 0 4/2.'/9
SITE ADDRESS— 1 15500500 SW 721111 AVE PARCEL: 2S1 DD- 00200
. ^ ^
£:UI?DIVISION. . - ., :: ;ZONING: I-P
BLOCK. . . . . . . .. . . . LOI.. . . . . . .. . . . . . . :
REISSUE:BUP FLOOR AREAS-_.__..___.._..._ EXTERIOR WALT_ CONSTRUCTION-
CLASS OF WORK. :I4EW FIRST. . . . ..8370 sf NeNR S:NR E: 1HR W:NR
TYPE OF' USE. . . : IND SECOND. . ,. n sf PROTECT OPE:NINGS'?----_.__.___....___
TYPE: OF CONST. .-3N THIRD. . .. .. : sf N: S: E: W:
OCCUPANCY GRP. :B2 •TOTAL-_.__._....._: 8370 sf ROOF' CONST-.A FIRE REIT'?:Y
OCCUPANCY LOAD: BASEMENT. : sf AREA SEP., RATED:
STOR. : 1 IIT. : 18 ft GARAGE. . . : sf OCCU SEP. RATEDa
BSMT'?:N I*IEZZZ ):N RECID REQUIRE-D_......
____..._.___-_____............_....
FLOOR LOAD. . . . : 125 psf LEFT:O ft RGHT :20 ft FIR SF'KL:Y SMOK DET. . :N
DWELLING UNIT'S: FRNT:r_'0 ft REAR:0 ft FIR. ALRM s N HND 1 CI:' ACC'_' Y
BEDRMSc BATHS: IMP SURFACE:18000 PRO CORR:N PARKING:9
VALUE $: rd
Rema•rk.s: Sha-�,p Property Development II •-• 8, 370 Sq.Ft. Buildinq She.11.. Re-•:lsslte:>
permit for revis*d buildinq plans. Sharp II
Owner. --••______.___.._____..._...._..-.._..__._..__.__..__.__.....__._..__. _._.._...__.. .._._.._._.__._._ ..__. FEES
PACTRU ST type amottrit by date •rec-,pt
PRMT $ 4:33.00 MAN
PL_CK $ 1781. 45 MAN /
000030 0000 FIRE `I• .'..7:3.20 MAN
Phone #: 000 000-0000 SPCT $ 21. 65 MAN /
POYM 454. 65 MAN
Cont•ractcar: __ _ _..._...._.._..._._.... _....____._._...._......_.._._.._._.._ F,0yM 4 454. 65 NBW 05/10/89 103791:,
HOWARD GREEN F'RMT $ 175. 00
II I_. G1:F E E.N C:O14STRUC:T1.0N F'L.CK $ 113. 75
1II 5W FIFTH 2960 . . . Additional fees not shown here. . .
PORTLAND OR 97204--0000 -- .w_.•_.._________.._.._._..____.......___._...__._.__ _..__
r'hone #: 503-221-.001:'0 $ 2496. 80 TOTAL
Res r.( #.. . : GRI:�E:.N
.... ___.__.....-_ RE:CTUIRED INST•'E.CTIC1Nfi .-.--....--.......
This persit is issued subject to th? regulations contained in the Foot/Fot.trid lnsp Final Inspec!tion
Tigard Municipal Lode, State of Ore. Specialty Codes and all other Struc Steel Insp
applicable laws. All vork will be lane in accordance with Re i n f Steel I rls p _._•__,.,.__ _ ___ __.__,_.,
approved plans. This persit will expire if work is not started 131 Ab insp
within 100 days of issuance, or if work is suspended for sore Tilt-••up Pnl InsP
than 180 days. Masonry Insp
Framing InsP
CL Roof naiing InsP
' I I n s i.t J.a t:i.a n InsP ...........__.._...............
L , , g '• / ' ` "'L` � J Shear W a I.1 Ins
cr Ferma.ttee+ 5i natt.trF P
>
Firewall InsP
I is s t.t 4e d B y s U y p Board InsP _...__.__.._..._
J ...._.... ............_...._..............._.........-..._.__.._......_..._...._..............___.
n-+
C° Ca.11 for inspection - E.;:3'3._4:175
C)
LL,
I
C11YOF T167ARD
(Can4YOFTWAROD F L.AN ..HEC.K APPLICAI ION
COMMUNITY DEVELOPMENT DEPARTMENT PLAN CHECK #
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)639-4175
PERMIT #
/ /� DATE ISSUED
JOB ADWESS: /.SSd�-.SW ;;n,7 1411c- ��S�fgr � - TAX MAP/LOT
SUB: LO-1 : _ LAND USL: /-/5'
�- VALUAfION: �z6T0UD -- — �^
OWNER SPECIAL NOTES
NAME: lr C6 i7 06=C,/1�C JGrC.t�i ,j _ - REISSUE OF:
ADDRESS: Z 9.S0 -- LAST REISSUE: _ -
- FLOOD PLAIN/
SUNS] 1.1VE LAND:
PHONE:
: -
A_''PROVALS REQUIRED
CONTRACTOR PLANNING:
NAME:: ENGINEERING:
ADDRESS: ► IRE DEPT
- ----p 1 nCR 9 ZZC4 OTHER: _
PHONE:: _ Z?_/- cc 0 _ ITEMS REQUIRED_
BUILDERS 90ARD #: EXP DATE: _ LIST/SUBCONTRACTORS:
BUS TAX: _
ARCH/ENGINEER CALCULATIONS:
NAME.: -,1%IpC��� ir-,,/fQ.�o 1t mlOc/.Ci/�,�_ TRUSS DETAILS: -..=
ADDRESS: _ �Ox 6909 _ OTHER:
�o�-�/gcw(toR
PHONE: 2.2-4 - 9570
COMMENTS: �V
:SUBCONTRACTORS: PLUMB: MECH:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
gC/�'Fjy//3 10--432 00 Building Permit Fees /75:00 -� /75:00
:0-431 00 Plumbing Permit Fees 65,00 _ 6S.00
_ 10-431 01 Mechanical Permit Fees
10-230 01 State 5uildino Tax (5x) _�,? p� /A,�11
Building 8.l
Plumbing 3 ,2-5
Mech ,2—
Mech _
10-433 00 Plan: Ch-:%,.:k Fee _ /30,00
^uilding //3.7-5
PlumLiiq /6 . 2.5
Mech
_ 30-202 00 Sewer Connection _
30-444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC) 720,00
52-449 00 Parks System Dev Charge (PDC) _
31--450 00 Storm Drainage Syst Dev Chrg (SSOC) .oy -- SO0.00
10-230 06 Fire ?V,OU ;;U.00 —
fOTAL (,ZZ,OU /t- / W
REC #
APPLICANT SIGNATURE
Receive,' By: ---� Date Received: 5- / 90
cn/3587F"BP L'
P_O.E3cx:c 23391
CITY OF TIGARD PLUMBING 1-11 SIJ Ha,i Bl"d-
zAgardCR
Applicants must hold Oregon Rehlstration to conduct a plumbing PERMIT 639-4175
business or must be property owner/operator not hiring outside help.
Wm._d D�.ers
�/ T !
_� Plumbing Permit
No. 7 l
Address Des:iptlon
ORS B 14-21.810 OUMI. PRICE AMI-
Job Tax Lot Map.No.
Address FIXTURES !-
Lot Block Subdivision Sink 7.50
Name(or name 01 btjSk*sx, Lavatory 7.50
J
L•c )CX /(" Tub aTutvShowaCrxnb. 7.50
15;xig Address Stwweroryy - 7.50
Owner Clly/ le - up Wale(Ctoset 7.50 _
Dishwasher _ 7•50
Phone Garbage Disposal - _ 7.50
i'JAme
Was"Machine 7.50
_ -
Floor Drain7.50 _
IwitaikV Address Phone Water Heater — - 7.50
Laundry Rocxn Tray 7.50
Occupant City/Stere Urinal _ 7.50
-" ocher Fixtures Specify) 7.50-
Pne 7.50
auToss
7.50
Contractor Ctty/State Dp -- — 7.50
_
MISCELLANEOUS _-
-_ City Baa.Tax No $eget 1st 100' 30•nO _
e
"s. �o --' ,ate Serer ea Addit.100' 15.00
(Resxienfial) Water Service 1st 100' 20.10 ;201(V
1 hereby acknowledge that I have read this application,that the Womatkxn Water Service ea.Addit-2mr 15.00
given is co"M#W 1 am regiAered with C»State Builders Beam,and also Storm&Rain Drain 1 st IW / 30.00
taw a Stale Pkxnbkq Scenes that the numbers gin are correct that AN 15.00
P ig work will be done in a� �ce niarwith��tom#d Ore- Storm b P.-in Drain Addi1.100
gon Revised Statutes Chapton 447 and e93 and apps*ft codes and that WbRe foxes Spwa 25.00
no MHp w*be employed un less Qoeneed under ORS 6A1(C exempt from -
State rogwratlor4 pleass"reason belovr). Back Flow Prevention
HOMEOWNERS-I hereby certify that 1 am the owner 0(0",'proerty pde-
Devkti�An6 f'olFutionDeviau 750
ex�above.art whi h location 1 propoes U make a pkwnbk g Ind Ailatkm for Arty Trap or Waste Not
my own uee onrl Cris property Is not belay conaWe or cled lot ea1e.:easrant. Cocr»c'ted to a Fixture 7 _
r,alch Basin s 7.50
-- kap.U ExieL PlumbirV 4C.00 Per tin.
Specialty Raquernod InApeWonu 401X1 Pamir Hr.
Alter.of Purl p wM-An
c - -- an EA@*V Bldg. 15.00 min.
~ AIJTtfORIILD SIGNATURE -�-- Ode New Bldg.or Build.Ad~ 26.00 min.
_ C�-ain�s_ e fa11i1
Describe wort new 1!) addition[] alteration❑ repalr❑ dieuim _-- 15.00
-� tq be done rtrskientiel marl roekiential
c ExlstkV use of _ SUB-TOTAL
U.; 1
btlflc"Of ProPe.-ty 5% SURCHARGE
prcpqw lAapKrpatty_ails of
b �e_— PLAN REVIEW 25%OF SUB-TOTAL 16 ,
Or ..._ VI_
NOTICE TOTAL
This permit becorrm null and th
vow M wm*or oonstruodon auorUad is not con* t 7 Std
rr+snoad vn/lhln tK1 dayaAr C oerrinrotlon or srontt M slrapended a abandoned for
a period of 100 days d wry ems alter work is conwrwicad
ON.e letuued _ bY ---------
V
CITY OF TIOA RD � PLUMBING PERMIT'
COMMUNFY DEVELOPMENT DEPARTMENT \CaJ11YOF RD r-r:-rz m I T #. . . . . . . . F,L 2
ouEooN
11125SWNWlWvd. P.O.BOX 23197,Tigard.Oregon 97223(603)&V-4175 PR I V1. PERM I T 0. '. EfUr-vmj�-, il 1,31
6 3`y I i I 04JP.2/
ITE ADDRESS. 56
I PIO SW 72ND AVE PARCEL: 2S1 12D--D 200
5 UBDIVTSTON., 01'.4" SHARP II ZONTNG-.
BLOCK, LOT. .. . . . . . . . . . . . :
CLASS OF WDRI/,. . :NEW GARBAGE DISPOSALS- : MOBILE HOME SPACES,, :
TYPE OF' USE. . . . : IND WASHING MACH. . . . . « .. !: DACKFLOW PREVIATRS. . .
OCCUPANCY GRP. . .-B2 FLOOR DROINS. - -- - ;: TRAPS. . . . . . . . . . . . . . :
STORIES. . . . . . . . . 1. WATER HEATERS. . CATCH BASINS. " . . " .- :2
FIX*T'LJRES---,-------------- LAUNDRY TRAYS. . . . . . .. SF RAIN DRAINS. .. . . . :
SINKS. . . . . . . . . . .. URINAL_,(-) GREASE TRAPS. . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. ..
TUB/SHOWERS.. . . . .' SEWER LINE (ft) ..
WATER CLOSETS.. . : WATER LINE: (f t) - --- 1(%0
DISHWASHERS. . .. . :: RAIN DRAIN
Remarks: l.'4t.ti1d:Lriil sheli : Sharp 11« c)1t.trnbiiiq site wci-;+.
....... FE--ES
P A CTR U S I type a n)0 U 11 t by date -ree r)t
I.",R M T k 65. 00
P L C K $ 1.6. 25
00000 0 0 0 0 151-(,IT 13.125
P-1hoiie 0: 000-000-0000 PAYM $ 84. 50 JL.H 04/27/90
Ccint-ractwrt
HOWARD GREEN
H L GREEN CONSTRUCT'101.4
111 SW FIFTH (2960
PIORTLOND OR 9'7204 0000
P,1-i u ii e tf-. 503.._22 1. --0(%l20 84. 50 TOTAL
Req #. . :: 6 Rri-.-E-11 REQUIRED INSPECTIONS
This permit is issued subject to the regulations cuntained in the Water Lime Ii-isp ........
Tigard Municipal Code, State of Ore. Specialty Codes and all other Sta-rin D-raiii Iiisp
I applicabie last. All work will be done in accordance with F*i ii a 1. tri s p e c.,ti a vi
approved plans. This permit will expire if work is cot started ............. ............
within leg days of issuance, o., if work is suspended for more ..............
than 180 day;.
.........................
Permittee SiqM.XtL1-('e.-
Ln f-.-i S Lt e d Lay
irispecticiri 639-41.75
PV'-'RMT*'I- NO , : SEA191,13AKI
CITY OF TIGMRD CITYOFTMRD D U 1:,:,.D 6/;30/t:3<7
COMMUNITY DEVELOPMENT DEPARTMENT °MOONPIRTM . I'-,M*T' .NO . 1391.:1.:3:1.
13125 3W Hall Blvd..P O.Box 23397,Tigard.Oregon 97223.pW)6394175
JOH !aiw NOM07T.T: 31569
TAX MAI:'-/I c),I* 121,A) OBF, 'SHARP 11' KI<
LAND LJSI::*. :
I OT SIZE::
SE('.*TJ:(:)N: Twl:): RN(3:
WOPK CI-ASS : NEW
USE TYI:)I*---: :ENDtJS*T'P]:Al-.
The E11:)I:)JAx:4aI-It tr.) C�c)I11r.)1Y witi.) iii.11 etricl r-ecjt.iJ.aL-tJ.cji-iir. c)f ti-ic-I Ul-Ij.-(!iecl
TI-ie 1:)eir-init exI:)ir-e% 120 (JaLym frc)m ti-10 Clilate iIl;9;Llt0(J . TI-ivi? t(:ttaLi
i?lmtoLlrl t. pr.0.0 wi.11 be -Irmr--P*-.,J.tetI J.-P tl-ie pel'init expil-'em . Thc? A(JeI-)c.!y c1clegi 1-1c)t tjuar,-
iaiitee tl,%te at.::(zmr-iac-y 1:)4-' ti-i(.i 143c.`vLtic3ii cif 1--ii.Cle ilieWel` A.Rte1`91.1111 . 1-(! tI10 W"lWel., J.4;.
I-Int I'lacai.tvicl aLt the giveiri , tl-ie 1:)1,C)ijipec�t 3 Tee1, :i.l*i
ili.11. t1lie cliveii . 14? ritiv, mCi 1J)e :I."IS t'"A.I-el' ffil"all.
wLlr'Cital9ir� ill T*Uf) Rl-ld Sicle 111-11CI triol Agcario.y will -kritstak).J. is
A1146A-
UNXTS : :I:MI::1P0VI;.:MF-..N"T : NO
DWIEI 1-:I:N(*.7 t.JNJ:T5 . I.
NO. OF* 01 DC',S .
F-1 aLf-,T I"Lt S t F-1 E 1:1 M 1T $415. 00
0 (J)NNEX.-T': ON CHAPGAL' $I too .oo
W L.J'W--* TAP INSTALL .
N
E
R OTHET4
HUWARU
C
O1-4 1 GiRE E.N CX]INSTPIXTION
N 1.:1.:1. S FJFJI-I
T
R P,t3 I-,t I i.%ii(i 014 9720A
A PHONE: ( 503) E2P1-----00F0
C
T IAF,.(,ns,rr;IA,r)X)N 140 . Gir*Pein
0
IR I pE(7F;:m1' N(:1.
This permit is issued subject to the regulations cont ned in Title 14 PEQt.)I*Pr--"1)
SFWEP
of the TMC, State of Oregon Specialty Codes,zoning regulations SM_'.W1::
and all other applicable codes and ordinances, and it Is hereby V1.NAL
M agreed that the work will be done in accordance with the plans and
t- specifications and In compliance with all applicable codes and
V) ordinances The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have Current city
business tax permits.This permit will expire and become null and
void If work Is not started wl�h in 180 days.or if work Is suspended or
cc
abandoned for a perlorl. of 180 days any time after work has
LO commenced. It shall be the responsibility of the permittee to 39sure
LLJ
all required Inspections-arequested ind approved.
Permittee Sig tura
(.AL-I.- FOP :I'NSr-Er,'I*R)N 639-1175
Issued By,
SEPARATE PERMIT S REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
C11YOFT1
6cm^`�, PLAN CHECK APPLICATION.
oFrwAan PLAN CHECK H J
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT H cam'//.S/
13125 S.W.No SNd-P.O.Box 23"T.Tigard. DATE ISSUED
JOB ADDRESS: -i AX MAP/LOT
SUB: LOT: .� I LG C r•t- • LAND USE:
VALUATION: 1 SPECIAL NOTES
OWNER { REISSUE OF: `-
NAME: _ LAST REISSUE:
ADORESS. _ FLOOD PLAIN/
--- �_ SENSITIVE LAND:
P110NE: - - APPROVALS REQUIRED
CONTRACTOR PLANNING ENGINEERING:
NAME:
NAME: --- - - -- FIRE DEPT
ADDRESS: _ -- OTHER:
- ITEMS REQUIRED
PHONE' - LIST/SUBCONTRACTORS: —
ARCH/ENGINEER BUS TAX:
NAME: [� ! f - CALCULATIONS:
______ TRUSS DETAILS:
ADDRESS: _
PARKING PLAN:
LANOCCAPE PLAN:
OTHER: - --- -
C:()MMENTS:
�1�
PERMIT N ACCT H DESCRIPTION AMOUNT AMOUNT P0. BAL. DUE
tO-432 00 ^'iilding Permit Fees 4-�3, 0C
10-431 00 Plumbing Permit Fces
-ILL- 10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5X) -
-� =-
Building
Plumbing
Mech L/S
10-433 00 Plans Check Vee � is ---
Building — _
Plumbing _
Mech
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
51-448 00 Street System Dev Charge (;SOC)
52-449 00 Parks System Oev Charge (POC)
J 31-450 00 Storm Drainage Syst Dev Chrg (SSOC)
�~ 10-230 09 TRFO -
G']
10-230 06 Washington County Fire #1 (95X)
10-220 00 Amart/Wedgewood
REC a _�`
APPLICANT SIGNATURE ^ '' )
keceived By: ~� C C/ Date Received: _ S-/0 'cr5�l
cn/3 .87P/l8P
City of Tigard
13125 S.W. Hall Blvd. MECHANICAL PERMIT Receipt+Y
P.O. Box 23397 Perrnil x9/�3
Tigard, OR 97223 Description
639-4175 Table 7A Mechanical Code UTY PRICE AMT
1) Permit Fee -0- -0- 10.00
Name of Development / 2) Supplemental Permit 3.00
Furnace to 100,000 BTU
Address v '7, 1) incl.ducts&vents _ - 6.00
Tax Lot mapFurnace 100,000 BTU +
2) 7.50
inti.ducts&vents
Lot Block Sf�dlvisaton
Name(or name of busirwss) Floor Fumaoe
3) incl.vent 5
Suspended heater,wall heater
Owner Poona 4) or floor rm0unted heater _6.00
city/stare 5 Vent not incl.in
appliance permit 3.00
Flepair of heating,refr ig.,
_6) cooling,absorption unit 6.00
gess Phone 7 Boiler or comp to 3 HF
absorp.unit to 100,000 BTU 6.00
Occupant Cky/Stale ZP 8 B3ilerorcompto3HP-15HP
E bsorp.unit to 500,000 BTL' 11.00
Name --"' -' 0) boiler or comp 15-30 HP
absorp.unit sh-1 million 15.00
MaKkvj Address Phone - Boiler or oomp to 30-50 HP 22.50
10) absorp.unit 1-1.75 million
Contractor City/Stale =� Boiler or comp to 50 HP
11) absorp.unit 1,750,000 BTU 31.50
stale Registration No. city Bus.Tax No. Air handling unit to
12) 10,000CFM 4.5G
I hereby acknowledge out I nave read obis arvf;c sfion Ihal Ma information given k 13) Air handling unit 750
oxrect,that!am Mie owner or auMvor od d of the owner.Ihat 1(),000 CFM 4
ager (clans euibrrvfted are rn A
oarxAanoe with Stab laws,Mos 1 am registered with the$tare Bul dws*Board.that the Non portable
number givtn is correct.(M exempt from Sul^m7stration Please give reason below), 14) evaporate cooler 4.50
Vent fan connected
-.---_.- ----------- - 15) to a single duct
3.00
-- _ -- -- - -- Ventilation system not
16) included in appliance permit 4.50
Hood served by
1�) mechanical exhausts4na4.50
tire 11—or 09"), —_ Dole Domestic type —
Describe work EFJ addition LJ allegation ❑ repair O 18) incinerator 7.50
to be done residential p non-residential Commercial or industrial
Existing use of 19) type incinerate 30.00
building or properly_____ —____ _ Other i.e.,woods(ove,water
Proposed use of 20) heater,solar,clothes dryers,etc. 4,50
building or property
21) Gas piping one to lour outlets 2.00
�
~ Typo of fuel- oil (] natural gas V}' LPG O electric U
c�
22) More than 4-per outlet
Cz �fO pg SUB-TOTAL
W THIS PE T BECOMES NULL AND VOID IF WORK OR CON
J —__
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5% SURCHARGE
DAYS, OR IF CONSTRUCTION On WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTEn
WORK IS COMMENCED. TOTAL t
Special Conditions
HU111-DING
CITY OFTIIFARD PF-PM.*I:*T* NO . R(A:)911.31
CITYOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT DATE. 1SSLJl: 1) 6/;30/0
13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard.Oregon 97223.(503)639411175 11"IUM. 1:)M*T*.NO 09,11.3.1.
%J(:)B ADDPIESS SW 7;.'W.) AVE
'TAX MAG)/L..O'T 2S1 12DD 200 SUB: (3184) SHARP TA L.J : F;K :
I AND 11.1151ii' :
DI, S:rZF: V 100 ,000 SE'TBACKS
+Zro/cog FPONT F�l EA 1:4
W(:)PK ASS : NEW DWELA.. . tJNI*Y*S : L.li:'F*'T*: F :
USE 'TYPE.'. : :l'NDt.J!5TP3:AI NO. W-J)POUMS : 1;:*X*l WAU (:C)NS'Y* :
(:,(')NS'T' . T'YPI:--' : 111N NO. BA*1'1-.IS : N S i :
I W
0C,(:,UP.(33"41:) . : B 2 1:1101' . 0PEN1N(*.,Sj :
LA)AD N S : E W
A P E'A 6630
N(J . STUR'LES : A. 1.S T : 66*30 POOF UINST : A F*11:41i;: PE1*7 YES
HIKJ LHT: I E) t2ND: AREA Sl*.-.:PAR 7 NO IIA11.101:
BASl:-:Ml.-.:N1*? N() *3A D: OCCUP. SEPAIT? N(J NA11::D:
MEZZAN]'Nl:.::'? NO BASE-*.M'I*
F-1-00P LAIAD: 1.25 GAI--IAIGI".: FJPE Sl:*'PKl.-P7 YE5 Al APM7 NU
FLOW((*.-,PM) Dr--:1*l:'-'C 1"? NO
('A CORP? NO
3 VII)CF- .AC YES
1JI-AN Cli-IFEL"K BY JI-IJ
New Bldg REISSUli: OF NO.
I AST Ql::A:SSLJr--:
F'1":I .5
o r, I.,I.,it,t PEPMIT $413:3. 00
W
N PI-.AN PliKVIEW $281 A.15
E --+JJ&:, DEPT 1 E20
R S*I*(-)*Y,I:;: TAX !Gia J. . 6!5
DEVEl.A)PMr--'NT CHAPUES :
C
o GREF:-N HOWARD 51)(11(ST014M)
N H 1- L;REEN CONS114LIC"11*10N S DILI L51,PEF*.A*
T
R 1--1-1- 5W F-14:11-i P= 0
A P v)I-,t 3.ia n(I OR 97PO4 PREPAID < fill!541 . 6,".0
C
T 1:*11-4(]N1;:: (.503) 2'r'.11-0020
0 PI:..c;I:si'r-1A*TA:0N NO . Green TOTAL- : $41.055. (!5
Pr.--L',K'1P'T NO . 16)
This permit Is issued subject to the regulations contained In Title 14
of the TMC. State of Oregon Specialty Codes.zoning regulations PEQUIPED INSPE-121JUNS
and all other applicable codes and ordinances, and It Is hereby FUJI'ING
agreed that the work will be done In accordance with the plans and F*(:)(JNI*)A*Y .1*.(:)N WAI I
specifications and in compliance with all applicable codes and
N ordinances. The issuance of this permit does not waive restrictive Li I...A F.I
covenants Contractor and subcontractors shall have current city PANIF:11-15
business tax permits. This permit will expire and become null and PEI NF.MASONPY
void if v ork is not started within 180 days.or if work is Suspended or F 14 AMT N G
C13 abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assurr, POOF NA:LI-3:N(.',
LL) ail required inspect ons are requested and approved. INSUI-A'T 10N
BOARD
C� 14AIN DRAINS
Signet F*I NAL
P rmi ee 4�11nst
Issued By �LALL 1•:ful
SEPARATF PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
APPLICATION — STREET IMPROVEMENT/EXUAVATION COPY TO:
ORDINANCE NO. 74-14 G� (WHITEFILE
(YELLOWW)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) 1� (PINK)-OTHER AGENCY
(BLUE)•APP!_(CANT
APPROVED [J APPLICATION NO.:
NOT APPROVED ❑ CITY OF TIGARD, OREGON FEC AMT.: f
PENDING FEE. PMT, ❑ C:I1 Y HALL RECEIPT N C70/f.7.4 2;1-X
PENDING SECURITY ❑ PUBL IC WORKS DEPA R TMEN T BY DATE 6. / Zt
PENDING AGENCY "OK" ❑ Application and Progress Record _ _ w _ _ _ — — — _
PENDING INFORMATION ❑ MAINTENAt10E BOND M _
FOR STREET IMPROVEMENT/EXCAVATION As REQUIRED c
ANNUAL O
PENDING VARIANCE I ] EXPIRATION DATE:
PERMIT NO, _ _.,C' DATE ISSUED: _. —1– -- -- • El Y. -
(1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL cLmr.r'�tt. 1•lidewar--4 cirivw.:y alar
~t' `
tea.:;-r-> AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT p''CT' 111 SW FlLrtin Ave. , Shiti<+ t'.!5u, Portland, OF
NAME ADORERS CI --- --PHONE
CONTRACTOR 11. L. Gr 1.11 ;i(d , SLJtA 24601, Por.tlnnd, OF 972014
riAMUADDRFsSS - CITY PHONE
PLANS BY fii!erin ,, Inc R,tr.ct'-,f t, �';,rt_l:�n�, ()k (
NAM[ ADDRESS CITY PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $
iDOLLARS
(2) EXCAVATION DATA: FoR OFFICE USE: ---"" CMIN.
0.04 Xf_1 t = f�._
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
STREET
PENED
IN5PEC-
R TION
E
Q
U _
ESTIMATED STREET OPENING DATE: E__ [ 1 S
ESTIMATED STREET:'LOSINGDAYF. _____ � L_ E
D
(3) SECURITY NO. SECURITY,AMT.: $ STREET
_ CLOSED
SURETY CO.: __ - __ _ / _4
_ FINAL
CERTIFIED CHECK _ CASH 0 SONt)X tNSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS / CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.
1 1 1 I
CURB _"��--
N � �
-CURS , r �. ..� _ J+
�LD
.J
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY. G 'T PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAV JURISDICTION IS THAT OF WASHING COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE RFOUIRe..I SECURITIES, TO COMPLY WITH ALL PERTINENT L AWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND 'To SAVE HARMLESS TME CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE ---L I DATE _ / /
tG�
..............................................,,.....Or,µ �. `� L� ER,oI.
GoNI-4F-GT TG'
I c1q)
184.41 iE_- �. C.' ---- _
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\ 10 % 111A. 86v I qo, ��� 1 I g�, �'i r► \ +•�.+•++•••��, ;
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RIM 195, Z5 co
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Up" PERF. PIPE To
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PRFE'NTER INSIDE MH)
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