13400 SW 76TH AVENUE s ADDRESS.
r
�n
_J
G]
J
lArecord.iVnicroilm\targets\building.doc
INSPECTION NOTICE
C_..f of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-A-Phone): 639-4175 BuelneBe Phone: 639-4171
Inspection:— LO u) . l 'i IC S - ----
Footing Plbg. Underelab Neah. Rough--in App_/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam :tech. Rain Dral.n Insulation -Plumb.
Plbq. Lnderfloy>r WaterC Line Gyp. Bd. -Mech.
7 I J ' (� Time: 1W _PM
Date Requested: G�
Address• permit t y l I
Builder: �.---
THE FOLLOWING CORRECTIONS Alt* REQUIRED:
inep=42 _ Dates
APPROVED DISAPFROVED Y — APPROVED SUBJECT TO ABOVE
Call For Reinep.
INSPECTION NOTICE ^
City of Tigard Building Departnent. a- 4171`/V
13125 Sp Hall h!vd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phon
Inspection:
Footing Plbg. f.nderslab Mach. Rcujh-in Appr/Sd.rlk
Pound. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. n man Insulation -Plumb.
Plbq. Underfloor Water Line v//LGyp. Bd. -Mech.
Date Requested: r 3_—,q l —Time: AM PM
Address: y � Permit/ #t! 3 5
Builder:
TETE FOLLOWING CORRECTIONS AHF REQUIRED:
gn
�i
V7
H
G7
LL
J
Inspector: V, _ De>re�� �
3
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
T I1 For Reinsp.
r.
INSPECTION NOTICE
City of. Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection•
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINAL:
Poet/Beam Struct. San. Se—r Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Rd. -Mach.
:� - :,3
Date Requested: /_3_- I Time: AM PM
Address: L/ L, / ---� S`PermtiP= C 3
�— --- 4�• -- ------- --`— —
Builder:
—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
01
L
n
ii
Inspector: Dater
APPROVED DISAPPROVED APPROVED BIIBJECT ABOVE
Call For Reinep.
CITY OF TIGARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT
13125 SW Hell Blvd.Tigard,Oregon 97223.8199 '703)839-4171 PERMIT #. . . . . . . : SWR93--051 4
DATE ISSUED: 1'=/1.3/9.
PARCEL: :_'S I O I DC--03601
SITE ADDRESS. . . . 13400 SW 76TH AVE
SUBDIVISION. . . . : ZONING: R-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF' WORK. . . :NEW DWELL I NG UN I TS. . ; 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE., . . . :BUISWR I MPERV SURFACE. . : : s f
Remarks: CONNECT' EXISTING HOUSE TO SEWER. SEPTIC MUST BE PUMPED, FILLED R INGF'C
'TED
Owner: ____---___...___.__.____.___._.___.____.___---._..__.______._.__..-_— FEES
RAYMOND EMS type amor.rnt by date recpt
13400 SW 76TH AVE PRMT $ 02,00. 00 JH 12/13/93 —
INSP $ 35. 00 JH 10/13/93
T I CARD OR 97224-0000
Phone #: 003-639-1258
Contractor:
EMPIRE: PACIFIC CONSTRUCTION
1-10 BOX 65
WEST L I NN OR 97068—•0065 ._--_----_--------------------------
PFi o n e #: 657--•02.60 $ 2235. 00 TOTAL
Reg #. .. : 84786
_._.__.._.._._ 13EQU I RED I NSPFCT I ONS -----This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from Septic Tank Fill
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is not located at the measurement _
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" permit and th^e�Agency will install a lateral.
Per m i t t e e S i.g n a t u r e :
ISSIAed By : - — -
/ Call for inspection — 639-4175
J
i�
� �l� r--
Residential Building Permit Appllcation
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: i 40
Subdivision: Lot # Offlco Use only
Pianck/Rec#
Valuation:
Permit #
l2 a
Owner: Y y _ - Rs;ssue of
Address:
7,� O R Apprgvals Required
Phone: 3 "" S Planning
_ Engineering
�
Contractor: Fxe A c i T'-c Co,s7-,uzT,,-,vZvc.
Other
Address: P0- (9-S
eVPs7_ Items Required
Phone: S 7- Subcontractors
Contractor's License #_ z y 7 g 6 Tniss Details
(attach copy of current Oregon license) Other
Subcontractors:
Plumbing:
Mechanical:
(attach copy of current OR Contractor's Lk;ense)
a Architect/Engineer:
n:
►- Address.-
Phone:
ddress:Phone:
COMMENTS:
;L'I%-7977
Applicant Signatur & hone number
Received by: Date Received: _ —
Permit # Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mcch:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) _
Parks Dev Charge (PKSL C)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) _
Industrial TIF (TIF-1) _
,.- Institutional TIF (TIF-IS)
Office -IF (TIF-0) _
J
c, Water Quality (WOUAL) —
Water Quantity (WQUANT)
Fire District (FIRE)
TOTALS:
I Y (it' T'1.1-;4 10) kt i,I I ' l ['(1 Y14:N I RE!11 1; 1 f I NO
(JI 1-.(111, 11110 114 r
lilt 1"1-4F.: PF. I"R LI (;f.)111,)0 N y (4111-11ANI
-Whkt:
i.')LI I Of v I:fii(ON
PAYMFN'l PUPPIT-A-. 111 r 14.hl I 01101ANI' POIA,
if la 1lt;tl V�vti, Old Sl`-'J-R.R UNIM -J.,
'41 P I
4041 t J4 x. 1 !1
1_/11'2/10/1993 15.: 1L 503-657-0304:^ E MPIRE PACIFIC CONST PAGE 01 !
STATE OF OREGON CONSTRICTION CONTRACTORS BOARD I
REGISTRATION CERTIFICATE
This certifies that the person named hereon
is registered as provided by law as a
GEN CONTR/ALL STIUCTURES Registration
NON--EXEMPT Number: r 84736
CORP^RATTOh
Expires: ( 07/20/94
(
EMPIRE PACIFIC CONSTAUCriON INC
PU i0x o5
( MtST L11N ON 97J)3-0005
ATURE OF REGISTRANT
i--
F-
N
r.
LO
LL1
J