10855 SW 74TH AVENUE i
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INSPECTION NJTICE
City of Tigard Build-ag Departaent
131.25 SK Ball Blvd. Tigard, otegon 97223
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Insp,sction:__---
Footing
Inapaction Line (Rec-O-Phone): 639-4176 Business Phon pl �1.d.r.lab
Mech. R gh-in Appr/Sdwlk
Found. Plba. Top Out Gee Line FINAL.-
post/Beam
INAL:poet/Beam Struct. San. Sewer / framing: -Bldg.
Post/Beam Mech. Rein Drain Insulation -plumb.
Plbg. Underfloor Water Line G Gyp. Bd. -Meth.
Date Requested:_r,Z.��L z Timet
Address:—�. . �� L �•-�` Cmit�*�,���
Builder:—
THE FOLLOWING CORRECTIONS ARE R3'1U1RED:
1 neipector
XPPROVRD DISAPPROVED APPROVED SUBJECT TO ABOVE
Cull For Reinep.
INSPECTION NOTICE
City of Tigard Building Departaent
13125 RV Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O•-Plione): 639-4175 Business Phone: 639-4171
Inspection:
rept;pq > Plbg. Uuderelab Hech. Rough-in Appr/Sdwlk
aannd. Plbg. Top Out Gas Line FINALs
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Roquenteds�.
Address:_._ 1 C) O F�-57
Builder' --
TNF. FOLLOWING (,Y1RRP"TIONS ARE REQUIRED:
Inspectors tJ�� —-- - -- —— Data:
APPROV=D DISAPPROVRD APPROVRD SUBJRCP Tn ABOVE
call For Aoinep.
Y
C17YOFTIGARD �tAm13LJIL.DING PERMIT
�CITY _
tOMMUNIRY DEVELOPMENT DEPARTMENT oasoori { ER*Mt-I #. . . . . . . . EAUI-92 X101
13125 5W Hall Blvd.P.O.3ox 23397,Tipud,Oregon 97723 150318394176
L1,L9--14171 ---� DATE ISSUED: 01 /17/9E
SITE ADDRESS— :. . 10855 SW 71 TH AVE PARCF~I._: 1S1.S6DR--01&00
SUBDIVISION. . . . : ZONING: R-4. tj
SLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
REISSUE: FLOOR AREAS,----------- EXTERIOR WALL CONSTRUCTION
CLASS OF' WORK.- :NEW FIRST. . . . :0000 .f N.- S. E. W:
TYPE OF USE. . . :ACS :SECOND. . . : s f FIR01"ECT OF,EN I NGS?----------
TYPE E; CON ST. :5N THIRD. . . . . sf N: S: E: W:
OCCUPANCY GRP. -M1 TOTAL--. _ --: 0 s f ROOF CONST- FIRE RE —`
UL GUF'4NCY LOAD: BASEMENT. . s f AREA SEP. RATED:
STOR. : 1 HT. : 13 ft GARAGE. . . : 1440 s f OCCU SEF', RA-ED:
9SMT? : MEZZ?: READ SFTPACF;S __.__..____. REUUIRED-------_____ .__._____. .
FLCOR LOAD— . - LF_.FT:5 ft RGHT:26 ft FIR SPKI_: SMOK DET. . :
DWELLING UN1Ta:O FRNT : ft REAR: 16 ft FIR ALRM: HNDICP ACC:
EEDRMS:O BATHS:0 IMP SURFACE: PRO CORR: PARK I N[3
VALUr_. f: 10000
Rema►^ks : pole barn
Ownev: FEES ---------___
__
DON _
DORRELL type amoi.int by date recpt
10855 SW 74TH AVE !~RMT f 60. 50 ,JLH 01/17/92, -
PLCK t 52'. 33 JLH 01/13/92 =1874
TIGARD OR SACT t 4. 03 JLH 01/17/9~_ -
Phone #- 642-OPrP
Contractor: -_.-...--•-----_.__.. _._.___.________ ..___.•.
OWNER
TOTAL
Phone #: f 136. 86136. 86 �_ _________..__
------- REQUIRED INSPECTIONS
This pewit 1s issued subject to the regulations rontained in the Foot/f•oLlrid Insp
Tigard Municipal Code, State of Ore, Specialty Codes and all other Fr-aminy Insp
applicable laws. All work will be done In accordance with Rain drain Insp
approved plans. This persit will @spire if Mork is not started F i nal Inspection
within 198 days of issuance, or if work is suspended for sore
than l98 days.
P •m i.t t ee S i rjnat ur,e :
iss .lecl
By: -
Call for- inspeCtian - 639-4175
$F Permit No:
��. "' •, Address: _-- ---____--
�� Z Issued b _- --- E .te: �-
1858 �.__..__.._FOR OFFICE USE ONLY ---_--
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
whe are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill iii the applicable blanks, and initial box 1 and either box 2.6 or 2B:
1.if41 own, reside in, or will reside in the completed structure.
2. A. C__i My general contractor is
Contractor registratiol number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B.je I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. It I change 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 ccr,trac+or.
I hereby certify that the above information is correct and that I have read and understand
the Information Notice to Property Owners About Construction Responsibilities on the
reverse side this form.
gnature of ermit AFpl cant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 1/90
WHITE COPY 10 ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
r,
c-Ti'll 01,: 11DART? RECEIPT OF FlOYMENT RE:(.',FJP,T NO,, 9-
rl.'HEMK AMOUNT r 1.44. 53
NAME a DORRELL, DONAL CASH AMOUNT 0. oel
PAYME14T DATE 01 J 1'7 42'
SUBT) W If-"5 TON
;:'Ijr,POSE 0- PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AM13UNT PIP 11)
BUILDING PERM 80. 50 ST. BUILD W:R 4. 03
1 ru3'5'oS SW 74TH
II
TOTAL AM(WINT PAID 84. :=+3
13�sswau PLNCK/RECT # q Z 7 11{crry OF T IGARD «x7 397 PERMIT # ���� _ l2.
COhi�1IJN11'Y 1)I;Vlzl,01'MI'NT 1)EI°ARTNIE r Tigard,Oregon 97223
(503)639-4171 DATE ISSUED
JOB ADDRESS: �G��7� r`7�/7y %' e0 TAX MAP/LOT `
SUB: ,�- LOT: LAND USE:
VALUATION: 41eZ
OWNER _ SPECIAL NOTES
NAME: 1� 11i� > _ REISSUE OF: _
ADDRESS: � � JIB/ ��/ ii ox- LAST REISSUE:
?r FLOOD PLAIN/
PHONE: ) O i ' �� 2� SENSITIVE LAND:
hr&
CONTRACTOR _ APPROVALS REQUIRED
NAME /_�j� �'�=f �— _ PLANNING: W—� —�
ADDRESS: � � � � ENGI14EERING: _
FIPE DEPT:
PHONE: OTHER: &0
CONTR. BOARD #: EXP DATE:
ITEMS RL
QUI
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS: _
MECH: BUS TAX:
AARCH/ENGINEER CALCULATIONS: _
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
ICANT SIGNATURE
Received By: _ _ Date Received:
i
41f 01,70 RIEW
PERMIT # ACCT # DLSCRIPTION AMOUNT AMOUNT PD. BAL. .DUE
Y -volt 10-432 00 Building Permit Fees
— _ 10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10- 230 01 State Building Tax (5%) 2/—�
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee `Szf S —'
Building
PI umbi ng
Mechanical
10-2.30 06 Fire
30-202 00 Sewer Connection
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 Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) ---- — — ---
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL O 7'S 3
nm/3587P.WPF
MILMMALPE
CITY OF t IGARD RECEIPT OF PAYMENT pE7 .E I P r NO. c92-2218'74
C'iEr,',K (VIOUNT s 52. 33
NAME s DORRELL , DONAL 114. CASH AMOUNT 0. 00
ADDRESS v 20850 SW JOHNSON PAYMENT DATE s 01/13/9;2
ALOHA, OR r L SUSD I 11.3 1 ON
PURPOSE OF PAYMENT AMOUNT PA 11) PLJRFJ' t- OF PAYMENT AMC')()N r Po i n
P L A N C H E'%",K F=E. ;';3
COVAL AMOUNT PAID 52. 33