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9830 SW DURHAM ROAD-1 '.Yww.;r .. .. ...�#hWiLYJW�Y��YW'i1Mh11YrMM��;�SuWi .. W'1WHiMKMiMMWWMWYNHWWK ." � . 1¢ I I If F t'�N tuPijan(] MS OC96 �NSF?crlori Noric$ _- City of Tigard Building Departasent 13125 SII Rall niwd. Tigard, Oregon 2223 Inspection Line (Ree-O-Phone): 639-4175 Busi.nens Phone: 6 -41.1 Inspection: --.---- _ —�—------- -- Footing P1%tg. Underslab Mech. Rough--inn A�ppr/Sdwlk Found. Plbg. Top Out Gas Line 06ALt Poet/Beam Struct. San. Sewer Framing -Bldg. ) Poet/Beam Hoch. Rain Drain Insulation Plumb. Plbg. Ursd.,rfloor Nator Lina Gyp. Bd. -Hoch. Date Requeeted^7s— �l LZi'�Q 21 Times XH PN w —/�Q, ^ermit I: �D7i�'3 THE 4 �4VING CORRECTIONS ARE $BQ1i**9ftT----- -Z .414 IOU -- Inspector i^____ Dates L `s APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVF. Cell For Reinsp. i CITY OF TIGARD -� OREGON December 5, 1991 Cindy Merryman 9830 SW Durham Road Tigard, OR 97224 Rea 9030 SW Durham Road Permit #MST 90-0283 Dear Ms . Merryman: The last. inspection conducted on the above project was a gypsum board board inspection on 11/15/90 . The next required inspection will be a final inspection. Please adiise the Building Di-ision of the status of this project as soon as possible so the file may be kept current. Please note that any permit, ,without activity for over 180 days becomes void. If you need additional time to complete ti-le project, please contact this department so that an extension can be discussed. Sincerely, z R.L. Thompson B,tlilding Inspector Notice.A 13125 SW Hall Blvd.P.O.Box 23347,Tlgord,Oiegon 07223 (503)639-4171 ----------- pECPICN NOTICE City of Tigard Buildiaq Department 13125 SA Hall Blvd. Tigard, Oregon 97223 �'0��1��' Inspection bine (liec-O-P;ione)s 639-4175 Bupineas Phones 34-4171 Inspect ion: —,--_._—_-- --.^--- ----- Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Pound. Plbg. Top Out Can Line FINAL: Post/Beam Stxuct. San. sewer Framing -Bldg. post/Beam Mech. Rain Drain insulation -Plumb. Plbq. Underfloor Water Line Oyp. Bd. -Mach. Date Requesteds Z/ z 5 _%6 -AN -PM 7 n Addrens: � 'k � f.l ��i ��Permit 4 e ,�i G'i IF // J_ But lder• 24"�LihLfi.�_- THE FOLLOWING OORREI.TIONS ARE RBQUIRF.D: Inspectors Date: _1&PPR6VED DISAPPROVED APPROVED SUBJECT T) ABOVE Call For Reinap. wr s I INSPEMON NOTICE City of Tigard Building Department P.O. Box 2x397 Tigard, Oregon 97223 Phone: 63f,-4175 Type of Irapection Date Requested A.M./ — --- P.M. Owner– _ Lot #a Builder The following Building Code deficiencies are raquired to '04 co;►erted: _ 1 Presented to _ --- - --- �- APP►oved Inspector _ -� U Disapproved Date — �� 2'. 91-- CALL 1–CALL FOR REINSPECTION C) YES 0 NO INSPECTION NOTICE City of Tigard Building Departrnel�__Z*_ P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 ,p Type of Inspection Date Requested—_,,- Time_�A.M.y- P.M. Address elm 3G ,( �-Z�jCc r, i _ Z1t #k1lJ Owner ---)) - -_ - --------__--- Lot #_-- BuilderThe fnliowing Building Code deficiencies are required to be corrected: Presented to _- - Approved Inspector 1 ❑ Disapproved Date �(✓ L �' 1 V __ CALL FOR REINSPECTICY O YE$ ONO NA1.3TER FE RIII I'T CIIY OF TIFARD �7W Y�CW�TWA RAO PIE R 11111' It WS'I'9 0--028,":3 COMMLINrTY DEVELOPMENT DEPARTMENT 0P.140" PRIM. PER1,111' MEDJ90-(fi283 13126 SW I-W1 Btvd. P.O.Box 23397,T4pA,O"Pgon 979M(603)6394175 DATE' ISSUED,- 09/24/90 SI FE ADDRES':),- 09830 SW DL)1<14(-)Irl RD PARCEL: S U ti 1)1 v 1'.S1.0 f-0 ll:'I::'E R R E E V, ZONINUC Ef L 0 C,K L.0*1*. . . . . . . . .. . . BUII D 1.N(3 .......- N E- L S 1.)E' BASEMENT. 0 f nWFLL.ING UNTI'9: 1 CLASS OF WC:RK. :A D 1) BEDRIIS: 1. BA141S. 1 GARAGE.. 0 Sf TYPE OF' USE:. . . :SF F LOOR ARE'A 5.........--- RE OUIRED SL-".*T'BACKS---------'-'-'-"-'-'- I'YPE (:)1::* 5 H F-I R S I.. . . . .. 1017 L EF T'. 4 0 ft RIGHT . -.F?0 f I CK'i:,L)PAWY GRI'-',. R 3 SE*COND. . . -550 f FJWNT'. 3 7 ft REOR- : 19 ft; ST'ORIES. . . . . . . ..P THIRD. . . . 40 S f RE ()(.I I R E D-- 1--IE:tc,sH,r. . .. . . . . . ..20 ft i,o -1; 151 1;f SMOKE T)E'H--C*TORG. -Y I:r I OOR I A D. . . . ::40 psi f- VOLUE $ 69782 1---'n R K I N G 5 V'n C, Renta-i+.ts-. PF.:-"RMI'T FOR ZERO (,'I..EARANCE I"IREPLACE ADDED 'TO ORIGINAL PERIII'T 9-24-90 .......... S K S FLOOR DRAINS. . . . .0 DOCKFA-OW PREVN,rRs. . o 7 LAVA FORIE'S. . . . . !:2 W A I'E R 1••1E()'1'1: RS. 0 •l-fRor".3. . . . . . 0 TI. D/911OWERS. :2 LAUNDRY 'TRAYS., 0 (,OT(,,H HOG.T.NS. :O WATER ('LE OS "I":1). . :: 1 SEWFA:R LINE ( ft) . -0 (3 R E AS3E TRAI::":,. . 0 DISHWASHERS. 30 WATER LINE (ft) - -0 (J'!'H I-'*R F:'I X'T IJ R ES. GARBAGE DIST'. . - ::0 RAIN DROIN (ft) . W t~ASH I NG MACH. . . -0 SF* RAIN DRAINS. 1 ME.CHAIAIXAL, F'E ES F'U E.I YYPEC3........... UNI 1' 1,41 RS. :0 type 4M0LlYtt by clAte -r e c.,p /GAS/ Vl:'_:*I%I'T'S . , . . ::4 KIR1, 4 343. 00 PIAX 1NP1YT :0 VTU VENT 1:7 ANS. . :0 P P L(I $ 2 2., 95 FURN < 100K » . .-.0 HOOTS S. . . " . . -.0 P 5 1:�,C 4, 1. 1. 1. F'U R 11 > J.0 0 K . . -.0 WOODS1*OVLS. :O MP'R'T* 22. 00 11. -R S. - 0 r,P L C IIJ 0 F L 0 0 R 1;'U R 11. 0 (1 -0 DRYE. P 0 11 L. M P < 3 H P a 0 011-1E.'R UNITS.- I III r5 P C, $ 1. 10 GAS OUTL.EJ'S-.0 P P R*T $ ";2. :';0 W 1.1 e-(. . ...............-----_._------ P 5 P C $ 2. 62 CINDY MERRY11011 F,A Y 11 1 (:,6fa. 82 JIJA 08/24/90 911,30 SW DURHAVI t<1) 11PRI 1; 4. 50 ITIPI I,3 TIGARD OR 97224 $ 0. Phase 0.- PAY11 5. 86 PUR 09/22/90 i! & 1) C'ONS1'RU(*,-T'J01,I 1.2195 SW CONYON RD 04 SU111 I, 1AF',,AVE'R1'0N OR 9700:'.'-j Ptic)rip #- 644 1763 672. E8 101'03.. This permit is issued subject to the regulations coitained in the RE-OUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other r-c)c)t/f(:)t.ivid lyisp FA--replace 11-1sp applicable laws. All work will be done in accordance with approved Pas-t/BeAni St'rL(Ct IIISUIAti011 11-15r) plans. This permit will expi,,e if wor started within 180 Poct/Peani Mechai,, (.3.Yp Eloa-rd Iiisp days of issuance, or if ed for m e. tha 180 d-.1 C-f-.%W1 D-rain Rain d-rairi Iii,sp III/U ii(I F�-v f 1.o c)-r M c?v 11 a vI i.C .x I I e c h A ri i c,A 1. T ii r,p PJ.i.tnib Fivia] Plwab JOP OL(t Fktildinq Final FiLte(i DY tniiriq 1.11-,p E-(,a,-.i(:)ri C(iiitr,a]. 11. fc)r il-ispectic.)ri - 6314-41*75 CITY OF TIGARD MECHANICAL PERMIT Receipt # 13125 SW HALL BLVD. Permi/# _� 77 y -00" P. O. BOX 23397 Description —� TIGARO, OR 97223 Table 3A Mechanical Code _! cry PRICE AMT (503)639-4175 1) Permit Fee �-00 -0- 10.00 N701 2) Supplemental Permit 3.00 Job Addmn / e✓� 1) Furnace to 100,000 BTU 6.00 rA [ Address �0 J�Gc� cL�C f�'T _ incl.ducts&vents TAX W MaPNo. ) Furnace 100,000 BTU + 101 Blosk dflM Subion 2 incl.ducts&vents -_ - 7.50 Nates(a novas of buskow) Floor Furnace i 1 l 9) incl.vent 6.00 MaMrtg Addosa pIWIM 4) Suspended heater,wall heater 600 Owner n '�1 �(� �, :�J� r�` or floor mounted heater rSlatsVent not incl in /Q- k? n �? 5) appliance permit_ 3.00 Name(a roans of bwN>sa) K 6) Repair of heating,rof r ig., 6.00 r- nI�f/r cooling,absorption unit Malling Adaness pfd 7) Boiler or comp to 3 H P 600 Occ-arent I _ absorp.unit to 100,000 BTU City/State -- ZIP 8) Boiler or comp to 3 HP••15 HP 1100 absorp.unit to 500,000 BTU Name g) Boiler or comp 15-30 HP 15.00 absorp.unit nfa-1 million Mailing Address Pfgne 10 Boiler nr comp to 30-50 HP 22.50 absorp.unit 1-1.75 million Contractor City/State rp 11 Boiler or comp to 50 HP 31.50 absorp.unit 1,750,000 BTU State Registration No City Bus Tax No. Air handling unit to 12) 4.�0 10,000 CFM- -- - _ I hereby e,at I have read this a 13 Air handling unit 750 >Y advevvledge application that elle inlOrrrlatirxn given is ) 10,000 CFM + on od.that I am Uv;owrNr or au",onred agent of the owner,ttnat glans sutxnMed are in -- --- oc mf*ance with Stale laws,that I am registered with live Stain[34filders'Board,that the 14) Non portable 450 nixntxtr given is correct.(If exempt bpm State registration please give reason below) evaporate cooler --- - --- --- 15) Vent fan connected 3.00 to a single duct _.. _-- ------ -- 18 Ventilation system not 4.50 included in appliance permit _ - - -- 17 Hood served by 4.50 z(' ) mechanical exhaust signature« 1 naveDomestic type �0 �— Describe worts ❑ addition U alteration ❑ repair I_] 18) incinerator _ _ to be done residential ❑ non-residential ❑ 1 g) Commercial or industrial 30.00 Existing use of type incinerator building or property A _ _ 20) Other i.e.,woodstove.water 4.50 Proposed use of heater,ezolar,clothes dryers, etc. building or property _—_ -- 21) Gas piping one to four outlets 2.00 Type of fuel- oil tl naiural gas ❑ LPG ❑ electric; (A 22) More than 4-per outlet NOTICE SUB-TOTAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- S%SURCHARGE •2 s STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ---- WORK IS COMMENCED. TOTAL 'r" Special Conditions Date issued by _____ -'ITY Or TIGARD rjj:CEIF-T OF PAYMENT RECCUIP-' NO- 00-205C.183. CHE(.;k:. AMOUNT o 5.06 CAE;N J�MOLINT ().(K) I NAME s MERRYMAN, ROCI'JE pAYMENT DATE 9 ".:4 9 C) ADDRESS t qB30 SW DURHAM PD SkjpDjVJ9IC)N 9,93c, OUP'HArl TIGARD, OR 97227' pLJRF,OSE of., rAYM[,'-'NT F'A.Tu OF f-'AyNEN'l- LIZ -M.—ECH—ANICAL PE 4.5f) �-J. ElUILD PFR AMjjUNT PAH) r IN p TION NOTICE City rt Tigard Building Department P.0 Box 23397 Tigard, Oregon 97223 ' Phone: 6394175 Type of Inspection —�� L _ Time —A.M._ P.M�.�r� Date Requested Permit # Address Lot Owner # Builder- The following Building Code deficiencies are required to he corrected - 1 ------- -- J�` "Approved Presented to — — ��_ _— ❑ Disapproved Inspector Dote -- FOR RF;IN5PECTION [] YES ❑ NO V1 A S'l F R P E R ITI 11 CI7'0F716;AwRD WYOF TWARD F11-**1,11I*T It. . . . . . . - NST90-02f-1,3' COMMUNITY DEVELOPMENT DEPARTMENT OREGON PE R11170. : MS'T90-OP83 13125 SW HOJI 13W. P.O.Box 23397,Tigman4,Oregon 972M(6030639-417604/90 DA"TF*. J.EiGWED. VJ8/ (L•:. A 1)L R E!3 1: . 09 6 J W ::;W D U 1�1.4 0 ITI Ft 1) PAl--U -. 2E1114E1A-0'i9W0 r ZONING. R 4. 5 SUBDIVISION--- COPPER (..REL:-'K 1-4 1 0 C,K.. L 01'. . . - - - - , -- - - - - -- .1 ........ ....................... D U I L 1)111 C5 RE I SGUE i DWEr LLING UNITS: 1 -0 -4f CL.A(3S C.)F WORK. cADD E.4 E 1)R I 1'13)-. 1. D A 1*H S 1 6 R A C,1::-, » . . . . . .1 -.0 S f TYPE: 0F' U S E. . . SF FLOOR REQUIRED T'YP'E' OF CONS] . 5 N F I RGI 1.01, + L EF 1". .. -4 0 ft R 1:(37 H'T. ---P(I.) ft 0 1,C U V'O N C Y (3 R P. :R3 5 E,COND. . . 550 si f FR 0 N'T. :37 ft REAR. : 19 ft; S'r 0 R 1'.E S :2 THIRD. 0 f REQU 1'.RED............... H E*I G H'. « . „ . •, » . :i•'0 ft fUT0L. f '311OKE DFJECTORG. -Y FLOOR LOAD. :/411 1)!!i-f V A L.U F 6':.)7(80 V'0 Fi KI N G S PA 0 Renia-rkv;- -I ................. PLUMUING .....................- SINK'). . . . .. . .1 :0 FLOOR DRAINS. .. -, - -0 D()( KFI.-OW l--'RF-.VN'l`RG.. » ::0 I-AWTORIES. 2 WA*TE,.R HEATS R5. . 0 'T'ROPS. . .. . . . . . . . . .0 T U 1:+/13)14 0 W[.--.RG 2 LAUNDRY .0 c wr c 4 ri()GI Iq(3. -.0 W)'TER CLOSETS. . : J �;E.WER LINE (-ft) - --,0 (3REASE "Y'R(WIS.. -0 1)1:$3 1-1 W A S H L R 6. . . . ..0 W A 11-R L 1'.N E (tt) „ :0 O'T 1-4 E R F I X*T 1.)R 1::*43,. - -0 G"ARFIAGE DISP. . . -:0 RAIN DRAIN (ft) . :O WASHING 110CH. . . :0 (:;F R 0 1,H 1)R A 11113. . J. V1 E CHANICAL FEES FUEL. UNIT HTRS. . -.0 type aMOLIVIt by date rrar. v) C., VENTS :4 BPR $ 343. 00 11AX BTU VV,N I' f`A H 3- - -.0 P f�,L $ P22.95 1'URN < 1001", . . :O HOODS. . . . . . .0 p5plc $ 1.7. 15 FURN ==001'. - - "(4 WOODS T(.)V L 5. 4-0 11 P F111, $ 2R. 00 vL..00F, TURN. . . .. :0 CLO DRYERS.: 0 HPLC 11 i. i0 0 1'.L MP < ;.3H1'::0 01+1E.R UNI15:0 115FIC, I; I . J.0 6W-3 OU L E*T E; 0 PPR,T q; 52. 50 P .5 2. 62 ", (,TNDY VIERRYMAN A Y N 6. 8 2 .71...H 08/*24/90 '.')8,30 5W DURHAM FA) T'TGORD OR 97224 M 1) L;0NS'TR(JC'T1.0N 1.2195 5W CONYON RD #4 SUITE (" PEOVE'RTON OR 97005 #.- 644-1-76,3 Reg 0. . . E-2016 ............... This permit is issued subject to the requlatioT,s contained in the REEUI RED INSPEUTIONF3 Tigard Municipal Code, State of Ore. Specialty Codes and all other FOat/f(it.trid Iiisp Fireplace 1,vi s p applicable 1#4s. All work will be done in accordance with approved fJost/Ppani F-.)t-rUCt. TnSLklati.01-1 11-ISP pians. This permit will expire if work is not started within 180 Post/Pearn Merl-iari Gyp Board Ivisp -"o7 than 18@ da ,dFd w, or a days of issuance. or ndpd 7o Crawl Drain F:airi drairi Irisp P L M/Uvi d e-r f 1.o c)v Mechanical. Fiiii-.%]. qii MeCtiAlliCA] InSO Plumb Firial. Plumb 'TOP Out Building Final F-ranviviq Tiisp E-rusi.nii Ts�st,ted By. . ....... Call'I f -r il.vispeetioi) 639---4175 CITY Of- TIGARD RECEIPT OF PAYMENT RECEIPT NO. n90 --204(l)60 CHECK AMOUNT 666.8" NAME 0 MERRYMAN, ROCI,','IE CASH AMOUNT (:) ADDRESS 9F.33(--) SW DURHAM RD 1"AYMENT DATE 06/2`4�90 SUDDIVISION a . TIUARD, CIP 97223, . . . I PURPOSE 017 PAYMENT' AMOUNT PAID PI.ARPOSE OF PAYMENT AMOUNT F,#,ID eu r L—D FI0--f;—E'F� T -."5� .00 PLUMPING P 52.50 MECHANICAL PE 22. 31". BUILD rLR0-7 PLAN CHECK' FE 2218. 45 TOTAL AMOUNT PAID CITY OF TIGA 125 S.W NoM Blvd. PIM C7DIX APPLI ON RD P.O.Boz 23397 PLAN (31BC K COMMUNITY DEVELOPMENT DEPARTMF,4T ! 7 a�or,9n23 --�= _ (503)639-4171 PEWIT IT 5- ji-C� f- D W ISSUED JOA ADDRE`-; 53� 5, - Sihi• TAX MAP/IDT �`Z T/-��/�'iy _�5��•0 Lar: IAND USE: airrER VAIMTION -- - -- - ' ri�+r>z : 11�DY �� t;t; 1✓I A�1 SPFMAL Nt7'I'F'S ADDRESS: -r -E� - -- REISSUE or: ,a_?URern sr -- - _ F1-00D AIN/ PHONE: _- �i 4 - `x4 5''S - — SENSITIVE LAND: (]3KII2ACIUR --- S RB2JIRFD NAME: -�' __ ,� , , ,tiEMINEERIM: AICi2E;S: Z - FIRE DEPT �UlTdF BU11DERS BOARD 1: p/ -�(- 1�'FINS RD3(JIRID _ EXP DATE: p c LIST'/SI • l�f?CIiLFNGINF;Q2 BUS TAX: - NAME: CA1CULAT!lO .S: - .lv%)DRESS: - 11 Z DETA.IIS: - - -- - OTHER: - — �'H4FPfI5: RF1('It3FLS: PI1MB: ty��i) I Mei: PERMIT AOCT DEa�tIMON �1 2 Av D V 10-4 32 00 Build''uig AIRJ[JDfr AI4JL1t TI' PD. BAL. DUE Pezmit Fc��s 10-431 00 Plumbing permit Fees -- 10-4 31 Ol M�ini.cal permit t Fees 10-230 Ol State Building Tex (5%) -`- -- Building , ---- Plumbing , Mech 10-433 00 Plans Chea]�L-- � � Building �;1 , �i "�' —�- -- .?, Plumbing Medi _ 30-202 00 Sewer Cbrnxection 30-444 00 Sewer Inspection - 51-448 00 Street Syst m Dev Charge (SDC) 52--449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg (:R, ) 10-230 06 Fixe TUPAI, G a z ' t L RDC - - �1 APF'LICANI' Received By: _ Date Received: of/3587P.WPF t -- INSpECTION_,��E City o1 719 rd Building Depariment a P.O. Box Ore97 gon Tigard, Oreg Pi gone: 639- 4175 Type of Inspection — Time Date Reque`ted Vermit # Address --— Lot # Owner Builder _. Building Code deficiencies are regr fired to be corrected: ,^__-------'�— I Th( frillowin9 Approved Presented to _ - Disapproved Inspector ----- �f��_--- Date CAUL FCR E SPE ❑ yEs ❑ NO CITY OF TIGA RD► OREGON February 1, 1989 Mr.. John Ruppert Denali Construction PO Box 2396 Lake Oawego, OP 97035 Dear Mr. Ruppert, This letter ie in response to your inquiry of February 1, 1989, as to whether a residence hr.s been connected to the sanitary sewer system. Although the address you gave (9150 SW Durham W1. ) is not on the city address map, your description of the house and arer, is probably the same one we discussed. The property discussed is located at 9830 SW Durham, Washington County Tax Map 2S1--148A, r.ax lot 5900, and was connected to th-. sanitary sewer system April 21, 1981. 1 have attached a copy of the sewer permit and a map of than property location. Please let me know if :his is not the property you are asking about. Sincerely, Brad Roast Building Official j1h enclosure 13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171 -- -- BUILDING DEPAKIMEN"T, TIGAHD PLUMBING PERMIT N9 g holder of a valid plumbing contractors license is hereby authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of Tigard. Such instillations require inspection by the City Inspector who ,.hall be notified not less than four (4) hours; prior to the time the installations are ready for inspection. City of Tigard Business License required for all Cont,-actors and sub-contractors. Job i Owner_ %-✓6. Address y; -a.�- NUMBER OF TOTAL TYPE OF PERMIT _ ITEMS FEE ON EACH AMOUNT i RE 5112 EN T IA Si.t to Family-1 both-each 25.00 j Du Ir.x-Each 1 bath unit _ 21,t+p! �- I Additional bathrooms-each - 10.00 _Mobile Home Space-each - 15,00 INDIVIDUAL FIXTURCS COMMERCTA _ Ito 50 Fixtures In-1 building-each 3.00 _ _ 51 to 100 Fixtures In 1_baildin9_each 50 101 to 200 Fixtures in 1 building -each __ 2_Q0 201 or more Fixtures in 1 b-aildinn-each 1.50 Sewer-each additional 100 ft.� _ 10.00 Water Service to building _ / 5.00 _ _- p •� Other (SPecify):� PERMIT /4 '• For Plumbing Inspection Phone 6394171 4g;State C Plumbing Contractor By TOTAL /_�' 6 v RECEIPT NO. Issued By r ' for INSPECTION TIME: PERMIT NO. : ,;'-3-3,a DATE: --�zzl,t�,_ DATE ISSUED :- I OWNERS NAME : ADDRESS: CONTRACTOR : TEST ' Air El , Watery , Visual El , Laboratory RESULT* Approved Disapproved 0 Pending Lj SKETCH: -Z INSPL'^TOR DATE 50TE: Attach supp(emental test data tietet Qj off SEINER PERMIT Receipt #8316 N. � �2 UUnified Sewerage Agency of Washington County CITY OF _ Tigard DA'TE OWNER: Tualatin Development Co. PHONE : 639-31Ll _ OWNER ' S ADDRESS: 15300 SW 116th Avenue TYPE Or INSTALLATION: ® SIDE SEWER ❑ LANE TAP AND SIDE SEWER ❑ L.INE TAP TYPE .QF OCCUPANCY: ❑ NEk ❑ EXISTING © SINGLE FAMILY ❑ COMMERCIAL EXIST. (PRIOR TO 7- 3 -70 ) ❑ MULT . RES. ❑ INDUSTRIAL FIXTURE UNITS DWELLING UNITS , �. - ADDRESS OF STRUCTURE : Lot 1, Copper Creek Sub-Division, Book 2, Page 43. Permit Conditions: Tlie applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. When calling for Inspection, please refer to the Permit Number. The Application xpires in one hundred twenty (120) days. The amount paid will be forfeited should expiration occur. The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect three feet in all directions from the distance and depth given. If not so located, the installer shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency will instar! 2 lateral at the location specified by the installer. FEES: PERMIT FEE a 25. 00 CONNECTION CHARGE 300. 00 LINE TAP INSTALLATION Penny Liebertz I 11E U [3Y OTHE R TOTAL $ 325. 00 ��� 4/15/81 APPLICANT DAT[ SEWER PERMIT ADDRESS OF STRUCTURE Lot 1, Copper Creek Sub-Division, BUok 52, Page 43. TAX MAP �.�21--/��'1� TAX LOT 7;fMSC_-, c> SYSTEM Fanno Creek _ LOT BLOCK OF dwh 4/15/81 pl _ 4/15/81 APPROVED BY DATE ISSUED BY (IATf 14 V1 D. U. ' S 1 REtOARKS Septic tank to be pumped and Filled per State Cod, � •w �w aw +w d] �v"'�,RA iN�'r�unSioN CQNrRoi, EUMALMN CASEFILE NO.__-_--- - GENERAL CONTR ACTOR NAME&ADDRESS: PERMIT NO.: I s . — APPLICANT NAME AND ADDRESS: EXCAVATION COttTRACTOR — --- NAME&ADDRESS: w�—on-y? OWNER NAMEAND ADDRESS: I — TELEPHONE-NUMBER-. PROPERTY DESCRIPTION: /�PPI.ICANT;,. STREET ADDRESS AND CROSS STREETAJOCA'IED OWNER• / — GENERAL CONTRACTOR: �_��' EXCAVATION CONTRACTOR: - i LEGAL DESCRIPTION: TAX LOT NOq- 24 HR/AFTER HOURS EMERGENCY 1/4 SECTION: — — CONTACT PERSON,TITLE,TELEPHONE: SITE SIZE,ACRES- DISTURBED/WORK AREA,ACRES: LOCATION&ADDRESS WHERE SPOILS SITE RUNOFF DRAINS TO:(CIRCLE OPIE) LEAVING SITE WILL BE TAKEN CATCH-BASIN DITCH PIPE CREEK (NOTE-pERWT5 MAY RE REQUIRED) (,CIRCLE OQ��R.I_!,1 PUBLIC RIGHT OF WAY �gQSiON FDiMCNTA7'IUN C' MMQj, .x] 1.1 MINIMUM ESC REQUIREMENTS MINIMUr"ESC REQUIREMENTSMINIMUM CONSTRUCTION: DURING�..'.)N$'iRUCiION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE :)TABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY FSC PERIMETER RUNOFF CONTROL FACILITIES CLEAN AND REMOVE Al L SIL AND DEBRIS CLEARING AND GRADING RESTRICTIONSCLEAN OPERATION OF PERMAI IT FACILITIES COVER PRACTICES OTHER_-- CONSTRUCTION SEQUENCE OTI IE.R_— -- PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITIi'TECHNICAL GUIDANCE FIANDBOOK -. EROSION CONTROL PLANRSINCLUDING CY PHONE NUMBER, SCII DULEJSTAGING FOR INSTALLATION AND REMOVAL O14AS PLAN CONSTRUCTION F CONTROLMEASURES,AND APPLICABLE STANDARD NOTES. I HAVE READ AND WILL COMPLY I mHE ABOVE ND WILL THCONSTRUCTION MAINTAIN ESC MEASURES AS NECESSARY _IC G 1:1TUR OWNER SIGNATURE so * * 00006A040 USE ONLY • • • • • • • • • • • �. � • • • • • • • . • • • • DATE ACCEPIl:D RECEIPT BY FEE NUMBER RECEIVED __ —