12980 SW 132ND AVENUE v'.
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INSPECTION A2TICE v
City of Tigard Railding Departssent
13125 810 Hall Blvd- Tigard, Oregon 97223
Inspection Lime (P.ec-O-Phone): 639-4175 Busineas Phone: 639-4171
Inspection: — -— _i� >,1 - / / Fit >
Footing Plbg. Undetelab Mech. hough-in Appr/Sdwlh
Found, Plbg. Top out Gau Line FINAL:
Poet/Beam, struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation. ,"-P—lamb 1 I
Plbg. Underfloor Water Line Gy-,. 9d. -Mech.
Date Requeateds_ !D' L/-L� _ -- ,T = PM
Permit 0:
�7
udresa:
1 �7
Builder: _
h
THE FOLI.k oGNG CORRECTIONS JkRZ REQUIRED:
Inr•Y._ore Data:
APPROVED r— DISAPPROVED APPROVED SURJECT Tn Adow
Call For Reinip.
Cirf OF TIFARD
lamp,
COMMUNITY DEVELOPMENT DEPARTMENT
13126 BW HWI 01vu, P.O.13m 23997,T19W,Oregon 91 (5091839.4176
PERMIT
DfoTE ISSUED: 06/03/91
Sf I E ADDRESS. 12:)80 IsW 132ND (.)v PARCEL.: j-S104AC-jzjjAc.!1
SUBDIVI',ION. . . . : ZONING. R-4. °,3
CLASS OF WORK,. . :AL.T GORBAGE MOBILE HOME SPACEr,.
TYPE OF USE. . . . :SF WASHING MACH. BACKFLOW PREVNTRS. .
OCCUPONC G p P. p-'- PLOOR DRATNS.
UK I E S. . . . . . . . .. WATER HEATERS. CATCH BASINS. . . . . . .
F- ix, LAUNDRY POTN DF4)INS. .
SINKS. . . . . . . . . . : URINALS,. . . . . . . . . . . GREASE TRp4r-s. . . . . . .
LPv(-vropIEs. . . . . : OT14ER 'I-" ' . . .
TUB/SHOWERS. . . . : SEWER LINE (ft ) - -- i0o
WATER CLOGE-TS. . WATER LINE ( Vt ) , . . ., .
DISHWASHERS. . . . RAIN DRAIN (ft ) . . . . :
Remar-ks : TURN AROUND PLUMIAIN -, FOR !'AL.W ';EWi 1,
f-EEF
MARLIN CLAY70N 4; ,pe im(7--trit L,y (I a t tn t
lk?980 SW 132ND ()VE PRMT $ 30. 00 JLH 06/03/91
TIG'ARD OR 97223 CT t l.. 0 JI.-H 06/03/
r1harle 0.-
LontrActors
C.111PO'L.E5 SRELI ON
SKELTON PLUMBING
PO BOX 6566
qLUHA OR 97007-0000
Ptl O'l P 0.' t710,j-H44 $
F-'P,rj #. . : 4E,496
;nis persit is issued subJtct to the regulations contained in the
^rr—ouRFOUTREL INSPECTIONS
t Ills()
Tigard Municipal Code, State Of Ore. Specialty Codes and all other �'i
an,olicabit laws. All wvO will be dere In accordance with
aproved Wins. This pervit will exove if work is net started
wtthin lU days of issuance, or if work is susoerded for more
tma" 186
Issueti Bv :
CITY OF TIGARD RECEIP'( OF V.,AYMENT RECElf)-i" NO.. :91-213860
(",HE'CK AMOUNT - 63. 66
NAME 3 'SKELTON PLUMBING CASH AMOUNT fA, 00
ADDRESS : PO BOX 6566 f"AYMENT DATE ; 06/03/91
ALOHA, OR 97007- SUDD I V f S I ON 2
PURPOSE CIF VIPYMENT AMOUNT PA I D PURPOSE jr PAYMEN r AMOUN T PA 11)
39.1. 01.1 ST. BL11LD PER 1.
BUSINESS TAX 32. 06
IPLUMBING PERMIT 12980 SW 138ND AVE:
BUSINESS TAX
TOTAL AMOUN', PAID - - 63. 56
� 1■► +llA e�' SIT III!' Ills' s �
CITY OF TIGARD
13125 SW HALL BLVD.
�'LUM (3(N(; 1'itZMIT P. O. BOX 23397
Applicants must mold Oiegon Registration to conduct a plurnlNng TIGARD, OR :7223
twsiness or must be property owner/operator not hiring outside help. 0 639-4175
Nanw d ilevek�prrrenl � r/ � ' l
Plumbing Permit No.
Doscnpbw
OILS 814.21-610 OUAN. PRICE MAT.
Job Tax Lot Map.tat
Address
FIXTURES
1171 Block oubdrvtskxr __-_
Sink J-So
.nine rOr name of busirtess) Lavatory __---- _ - --750
l ub or Tub/Showcr m
Cob --- --7.50
T sib r�3ress
Shower Only 7.50
Owner Water Closet- 7.50 -
Dishwasher 7.50
Garbage Disposal 7.50
- Name Washing Machine 7.50
Waco Drain 7.50
iia fi uig 7k7dress 1 ,/ --' Wattx heater 7.50
Occupant -"�( - - Laundry Room Tray 7.50
P City/Stag Zip
I lrinal 7.50
lame Phone Other Fwtires(Specify) 7.50
1 � IdAi3 .s �i �� ,� - _ _- 7.50Phone
--
7.50
Contractor city/State-- -- 23P - - 7.50 -
MISCELLANEOUS _
City Cares.Telt No. .
Server 1 s1 100' _ V 50.00
tete�xrteers s. Soryer4a.Addit 100' 15.00
nta `wvs Boardr !;la
(flesdon6al) Water Service 1st 100' 20.00
1 homl7y"i nwladge that I have read this applicatbn,ttW Lha inkxmation Water serrrioe ea.Addit.200r 15.00
gr.v n i.rxxr eat,that 1 am roosiered with tivn State Duikim's Board.nd also SWm 6 Rain Drain t st 100' 30.00
have a Stale Pkrtt*vj fir nY that the r"T%bews riven are 00med.MW all --
plumbe•9 work will be bx,e in aoxxdance with r.,iplicable provisions o1 Chs. Strum i P-in Drain AdcM.100' - 15.00 _
gon Ravised Stahlles Ctutprers 44 7 and 69:;and applicable Codes and that Mobile Horne Space 25.00
no help will be ernpbyed unless Ik m&l under ORS 603.(H exwrO born
State registration.please 9"reason Wow). Back FlowPreventiorn
I I0mv-.0% 1ERS-1 hereby o•rtify dud 1 am the owner of the property de- Dsvioe as Anli-Pollution Device 7.50
ecribed above,of wWh location I propose b make a ptunt*V inalailatlon kir Any Trap or Weele Not
my own use and thio property Ia not beln9 oon sbuded for safe,tease or rent Connected loe FatNxe 7S0
Catch Basin 7.50
A.--- --- kup.d F_tdrit.Pkmt V--- 1 40.00 Per 1•Ir.
Specially Requeelitid Inspoctions M 00 Per H•.
Ahw.of P4,attb4q wtltrin
an Frdeft;9 Bldg. 15.00 marc,
AUD4MtZFD SK3NATUn1 Dade Kew Bldg.or Build.Addtdm 25.00 mot.
a fossil
Describe work newE] addition[] alteration Q repak p dwells _ 15.00
IQ be donne residential(1 non-residential
Edstktp use of _
brltidltlg(x prg)wrly $25.00 uainimum SUB--TOTAL
PropOeed t,ae of
5% SURCHARGE
t7trM�r►gcxlfwa.erty.- .. _ _-__ - 25% PLAN REVIEW
----
Tate po4"*bewwnae r%A and void*wrxk or on natuotlun audxwuod Is not co,'i TOTAL
mena-W wlthlrn 190 days os If rmuoucS an or wont Is olApended or aberd"A kx
A r wfix1 to 190 days of any dnw afsw work Is come rens
1I0`47CtAL r)OND(T10+43
Date ►lsuud ---- by .-- -
� M
all
t
invoice
Griff'S Septic Service, Inc.
"We Do The Job Right The First Time"
Name_ __--- _ _ — --- Date_.
Address-- -
Initial On Acct.
State Zip Code
Price Amount
Installation of New System
Repairs of Existing Systems
Pumping
I
Cleaning Lines
Starter Chemical
One Chemical Treatment
Total:
Approval
i
By:
Cu9tomer sit, 13952 S. Carus Rd,
Oregon City, OR 97045
222-3474 or 632-6138
-NO JOB IS TOO TOUGII
INSPECTION NOTICF
City of Tigard building Department
13125 SW Hall Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business rhones 639-4171
Inspection:
rooting Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer l Framing -Bldg.
f g.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor. Nater Line Gyp. Bd. -Hoch.
Date Requested:_ :`� ���/ LJ — STinses u{ �
Addresses�jL/
Buildersr
MR FOLLOWING CORRECTIONS ARE REQUIRED: -
l
Is
Inspectorr
_. Date:
APPROVED _ 013APPROVED _0"�APPROVF.D S'JBJECT TO ABOVE
Cal! For Reinsp.
3EWER CONNECTION
C17YOFTIGARD PFRMT7
CWOF RD PERMIT SWR91-0097
01110m
COMMUNITY DEVELOPMENT DEPARTMENT 4
13126 8W HWI Blvd. P.O.Box 23397,TOW,Or"m 97223(603)4"4176 C—_7 DATE ISSUED: 05/17/91
�;.[TE t'?T)DRESS. . . 12'480 SW 132ND AVE. PARCEL: 2SI04AC 00900
,::i U121,I)I V I';I OIN.1. . . i Z Q N I IA C
EkLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . .
'I ENANT NAME. . . . . .
USA 1\10. . . . . . . . . . :43649 FIXTURE UNITS. . . .
CLASS OF WOPI-K. . . -AL T DWELL-I NG UN I T,5— . . 1.
I'YPE OF USE. . . . . :SF' NO. OF' BUILDINGS:
INSTALL I YPE. .BUSWR IMPERV SU,(FACE.
Remarks:
Owner: FEES
MARLIN CL-AYTO14 type amal-,Ylt t)v drt t e r,ecpt
12-180 SW i32ND AV(-. PRMT $ 300. 00 JLH 05/,1'//91
TNSP � 35. 00 JLH 05/17/9t
TIGARD OR 972,:3
C;hone #-.
C'ontractot-:
OWNER
00 01 Ni_
Rey
REDUIRED INSPECTIONS
This Applicant agrm to ccroly with all th# rules and regulations Sewer, Inspection
of the Uvifiod Sewage Agency. The persit expires 120 days fro#
the date issued. The total avoUnt paid will be forfeited if the
pervit excires, The Agency goes not guarantee the accuracy of the
side sewer laterals. If the sewe, is not located at the vessurekert
given, the instiller shall arospe,!t 3 feet in all directiens, fro*
the distance given. If not so locatcu, the instai4er snail purctase,
"Tip and Side Sewer' Pirsit and the Aqepcv will inst 11
lateral.
I.(fa
Uall for insr-ection 639-4175
CITY OF TIOARD RECEIPT OF PAYMENT RECEIPT NO. s91-213,'.369
C14ECK AMOUNT a 33'5j. 00
NAME s Cl,..AYrON, MARI—IN CASH AMOUNT 0. 00
ADDRESS o PAYMENT DAIE
SUBDIVISION
PIJRPCSE OF PAYMENT AMOUNT PAID PURPOSE Of--* PAYMENT AMOUNT PAID
SEWER USA GWR91 -0097 300. 00 SEWFR INSPECT
I 8981b 314 1;3R'ND AVE
TOTAL.. AMOUNT P41D
BENCHVIEW ESTATES JOINT V�INTURE
8875 S. W. Beaverton-Hillsdale Hwy.
Portland, OR 97225
(503) 297-4881
November 13, 1967
Unified Sewerage Agency
150 N. First
Hillsboro, OR 97124
Attn: Terry Chamberlain
Re: Sanitary Sewer Cost Participation
Gentlemen:
Marlin L. and Betty L. Clayton, 12980 S. W. 132nd
Av^_nue, Tigard, OR, owners of Tax Lot 809 , Tax
Map 2514A
is participating in the cost of installation of the
sanitary sewer main in S. W. 132nd Avenue, a part of
the off-site improvements of Benchview Estate; sub-
division. It is understood Mr. and Mrs. Clayton
will he assessed a connection fee when he connects to
the main, but will not be required to pay any other
fees, charges or assessments. The connection fee is
currently approximately $960.00.
Benchview Estates Joint Venture
b y: Gl/J L- ,taw
Louis J. Faso
LJF:cal
_ '...�<.ti �^n fry I��+e.2 t7 f �it u .✓ •r..�K' f�v,.S� �. •; <
'r..+5 w tit 4..A.$ iO r..A i t ;d&Ar it .3 •W'*
Ile
125 SW 11311
CITY QF TIGARD 13110 Box 23397 � PERMIT #
('OMMUNTlY DEVELOPMENT DEPARTMENT
Tigard,Oregon 97223 PERMIT #
(503)6394171 DATE ISSUED ---
JOB ADDRESS: -'�? :�1r�� �s.r� =� ���,._ TAX MAP/LOT _-- --
SUB: _—___ LOT: _ LAND USE:
VALUATION: — —
OWNER SPECIAL NOTES
NAME: _�.: < ��'o�i REISSUE OF: _—
ADORESS: _ LAST REISSUE:
FLOOD PLAIN/
PHONE: _ SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: _ _ PLANNING:
ADDRESS: — _ ENGINEERING:
FIRE DEPT:
PHONE: __ OTHER: -
1.ONTR. BOARD #: _ EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PI.JM3: ________ _ �— LIST/SUBCONTRACTORS:
MECH: _ BUS TAX: -----
ARC/ NGINEER CALCULATIONS: ,.
NAME: _ TRUSS DETAILS:
ADDRESS: _ ___ OTHER:
PHONE:
PROPOSED BLDG. USE: —-
COMMENTS:
APPI ICANT SIGNATURE
Received By: _ Date Received: _ __
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
10-431 06 Plumbing Permit fees
10-431 01 Mechanical Permit Fees _
10-230 01 State Building Tax (5%) _
Building
Plumbing
Mechanical
10-433 63 Plans Check Fee
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewe► Inspection
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-n3 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mas: Transit TIF Fees —
52-449 00 Perks System Dev Charge (PDC)
3I-450 00 Storm Drainagc Syst Dev Chrg
(SS[)C)
24-445-01 Water Quality (Fee in lieu of) _
24-445-02 Water Quantity (Feu ;i of)
10TA1_
nm/3581P.WPF
PERMIT # P.�,CT # DESCRIPTION AMC"NT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
10-431 00 Plumbing Perm,L Fees
10-431 01 Mechanical Permit Fees _
10-230 01 State Building Tax (5%)
Building
Plumbing _
Mechanical
10-433 00 Plans Check Fee _
Building
Plumbing
Mechanical
10-230 06 Fire -
30-202 00 Sewer Cunnection _
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees _
25-448-03 Office TIF Fees _
25-448-01 Residential Traffic Fces _
25-448-05 Mass Transit TIF Fees
52-449 00 Parks Systr-i Dev Charge (PUC)
31-450 00 Storm Drainage Syst Dev Clorg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water quantity (Fee in lieu of)
TOTAL
nm/3587P.WPF
i