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INSPECTION NOTICE
City of Tige:d Building• Department
P.U. Box 23397
Tigard, Oregon 97223
Phone: 639-4115
y
Type of Inspection
Date Requested_ �� " me A. CP.M�
Address __��.��+ � Permit #
Owner Lot #
Builder
The followin Buil ing Code deficiencies are required to be corrected-
Presented to _ _ Approved
Inspector El Disapproved
Date '-
CALL FOR 9EWSPECTION
❑ YES 0 NO
W W !t W ff_ W � Edi
CITY F BUILDING PERMIT
TI17A ?!-9 PERMIT NO. : BU891.964
CITY OF Tl(ARD
COMMUNITY DEVELOPMENT DEPARTMENT °xr"'" t
TE ISSUED: 3/25183
13125 S.W.Hall Blvd.,P.O.Box 23.197,Tigard,Oregon 97223,(5031 639 4175
1M_-PMT,N0. 891964
JOB ADDRESS: 15369 SW 81ST AVE
TAX MAP/LOT 2S1 12 SUB: ASHFORb OAKS LT:86 BY,:
LAND USE: R4.5
LOT SIZE: VALUATION: $ 95,500 SETBACKS
FRONT: 20 REAR: 5
WORN, CLASS: NEW DWELL..UNI.TS: 1 LEFT: 5 RIGHT: 38
USE TYPE: SINGLE FAMILY NO.BEDROOMS: 3 EXT.WALL CONST:
CONST.TYPE.: VN NO.BATF'S: 3 N: S: E: W:
OCCUP.GRP„ : R3 PROT.OPENINGS:
GCCUP.LOAD N: S: E: W:
TOTAL AREA: 2078
NO.FTORIES: 2 1ST: 1028 ROOF CONST: C FIRE RET?
HE"GHT: 20 2ND: 1050 AREA SEPAR? RATED:
EiASFMENT? 3RD: OCCUP.SEPAR? RATED:
MF7ZANINE? BASEM'T
F',-OOR LOAD: 40 GARAGE: 6:38 FIRE SPRKLR7 ALARM?
FLOW(GPM) DETECT? YES
I EP�'I' TYPE: GAS HUCF'.ACCESS CORR?
PIAN C.'. CK BY: rIt
1".4ARKS
me of 891457
REISSUE OF N0. 880643
LAST REISSUE 891725
FEES:
MILL.ER JAY PERMIT $421.00
N PO BOX 23291 PLAN REVIEW $40.00
E TIGARD OR 97223 FIRE DEPT
R
STATE TAX $?1.05
OTHEF,
r✓ DEVELOPMENT CHARGES:
o MILLER JAY SDC(STORM)
T JAY MILLER BUILDER SDC(STREET) $600.00
R0-0. BOX E3291 PDC(M2 )
$2510.00
TIGARD OR 97223 PRF_PAID ( $40,00)
PHONE (503) 684--7543
RECISTRATi -M NO. 30105 TOTAL: $1,542.05
r
Ths upermit r5 u —
issued subject to the regulations contained In 1 rile 14
--- RECkIFT N0.
-•-----------------
if tt e TMC, Slate of Oregon Specialty Codes,toning regulations REQUIRED INSPECTIONS
all other applicable cedes and ordinances and it is hereby
agippd that the nark will be done In dccordan,e with the pla isand FOOTING SEWER
speciticatlons .and In compliance with all applicable codes and FOUNDATION WALL RAIIN DRAINS
ordinances Tl a issuance of this permit does not waive restrictive POST R BEAM WATER LINE
covenants Cc,itractor and cuhcontractots shall have current city PLB.LINDERSLAB CITY APPRCH/SW
business tax permits This permit will expire and become null and SLAB FINAL
void if work is not started within 180 days,or if work is suspended or PLA.TOPOUT
abandoned tot a period of 180 days any time after work has
commenced It Shall by the responsibility of the permittee to assure FRAMING
ail required inspections are requestp I and approved FIREPLACE
i' GAS LINE
INSULATION
L�Q GYP. BOARD
pp/rtlt ,.IgriAlllr�
L
Is%.'ed By L FOR INSPECTION 639-4175
11 - --
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
t
CUTY OF TIVATOPFIAON
SNO.:: PERMIT
� PERMIT h0. : SE9`31?77
COMMUNITY DEVELOPMENT' DEPAPTIAI:NT
TE ISSUED: 9/25/89
13125S.W.Hall BIvd..P.0.Box 23397.Tigard,Oregon 97223,150118.94175 '11.PMT.NO. 891964
JOB ADDRESS: 15369 SW 81ST AVE USI NUMBER: 39066
TAX MAP/LOT 2S1 12 SUB: ASHFORD OAKS LT:86 BK:
LAND USE: R4.5
L D i SIZE:
SECTION: 12 TWP: 2s RNG: lw
FORK. CLAS ,: NEW
USE TYPE: SINGLE. FAMILY
The applicant agrees to comply with all rules and requlatiO�IS of the Unified
Sewerage Agenev. Ihf= permit expires 1-20 Bays from the date issued. The total
amount paid wall be forfeited if the permit expires. The Agency does not quay--
antee the accr.rracy Of the location of the side sewer laterals. If the sewer is
not located at the mEAsurempnt given, the ins�aller shall prospect 13 feet in
all directions from the distance given. If not so located, the installer shall
purchase a "Tap and Side Sewer" Permit and the Agency will install a lateral.
INSTALL. TYPE: BUILDING SEWER IMcERVIOUS AREA.
FIXTURE UNITS: TENANT IMPROVEMENT:
DWELLING UNITS: 1
NO. OF BLDGS. : 1
I
c)
FEES:
MILLER JAY PERMIT
W :;35.00
E FI0 PDX 23291 CONNECTION CHARGE f1,256!.80
R TIGARD OR 97223 LINE TAP INSTALL.
— - - -_ __ OTHER
c
N MILLER JAY
T JAY MILLER BUILDER
R
p.o. BOX 23291
C TI( ARD OR 97223
T PHONE (50,0 684-7543
R REGISTRATION NO. 30189 TOTALII $19265.110
This permit is Issued subject to the regulations contained In Title 14 RECEIPT NO. /Q `Jf y 74
of the TMC. State of Oregon Specialty Codes, toning regulations ---------------------
Find
_ -_ .___and all other applicable codes and ordinances, and it is hereby REQUIRED INSPECTIONS
agreed that the work will be done In accordance with the plana and ROUGH-IN
specifications and in compliance with all applicable codes .tnd
ordmarmcs The Issuance of this permit dons not waive restrictive
covens^rs. Contractor and subcontractnro shall have current city
business tax pbrmit4 This permit will expire and become null and
void If work is not started within 180 days,or if work is suspended or
abandoned for a period of 180 days any titre after work has
commenced It shall be the responsibility of the permittee 1�assure
all required inspections are requested end approved
xr.,it�fe91y-91ure-
�J-
Issued By r CALL FOR INSPECTION 6.39-4175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
C17Y
F / MECHA'+!ICAL F'Ei+.FIiT
T11 pith, PEPMIT NO. : ME8919 6
CITY OF WARD
CC)MMIJNITY DEVELOPMENT DEPARTMENT MON D TE ISSUED: 9/25/81
13125 S.W.Flail blvd.,P.O.Box 23397.Tigard,Oregon 97223.(503)639-4175 I M.PMT T.NO. 891964
JOB ADDRESS: 15369 SW 81ST AVE
TAX MAP/LOT 2S.1 12 SUB: ASHFORD OAKS L.T:86 BK:
LAND USE: R4.5
LOT SIZE:
ITEM: NO: NO:
WORK CLASS: NEW FURNACE (100K AIR HANDLR (10
USE TYPE: SINGLE FAMILY FURNACE 100K+ 1 AIR HANDLR 10K,
CONST.TYPL. VF1 FLOOR FURNACE EVAP.000LER
OCCUP.GRP. : R3 HEATER VENT FAN 4
VENT VENT.r_'YSTEM
BLR/COMP (3HD HOOD 1
NO.STORIES: 2 BLR/COMP 3-15HP INCINERATOR(DOM
DWELL.UNITS: 1 ALR/COMP 15-30HP INCINERATOR(COM
FUEL TYPE GAS BLR/COME' 30-50HP RI nnro t ;'TTS
MAX.INPUT BLR/COMP 50+HP OTHER 2
FIRE DMPRS? GIGS PAP. NG O!1fLETS 1
HIGH PRESS?
LOW PRESS?
REMARKSt
o FEES-
MILLER JAY I PERMIT
(10.00
F PO BOX 23291 PLAN REVIEW $11.25
R TIGART OR 97223 FIXTURES $35.00
STATE TAX $2,25
OTHER
t,
o
N BELL HEATING INC.
R 15550SE PIAllA AVE:
C CLACKAMAS OR 97015
0 PHONE (503) 243-1184
p _ REGISTRATION NO. 447 TO1.1Ls $58.58
This permit is issued subject to the.regulations contained In TRW 14 RECEIPT NO. �Q j 1/'/G
of the TMC. State of Oregon Specialty Codes zoning regulations
And all other AQP11CAhle codes And Ordinances. And it is hereby REQUIRE" INSPECTIONS
agreed that the work will he done in Accordance with the plans and GftS L I NE
�1leclficatlnns And in compliance with all Applicable codes And POST 8 BEAM
Ainanrp- The Issuance of this permit does not waive restrictive ROUGH-IN
rvenAnts Contractor and subU-ntrActor9 shall have current rlfy
rsiness tax permits This per it will expire and becorre null and FINAL
A if work Is not started within 180 days or 1f work is suspended or
handoned for A period of 180 days any time after work has
commenced It shall he the mponsibility of the permittee to Assure
All requred Inspections OP re1uested And apprn�ed
Permittee SwFunurr,
Issued By `�� J
EftEt FW INSVEET11W 634-41?5
SEPARATE PERMITS REQUIRED FUR WORK OTHER TH4N DESCRISM ABOVE
i
C17Y OF TOGA RD PLUNKING P=RMIT
�k� PERMIT h;u. : NL891974
CITYOf n
COMMUNITY DEVELOPMENT 1EP�.,RTMENT ONIGL�A
\ TE ISSUED: 9/25/89
13125 S.W.Hall 9lvcl P C.Box 23397,Tigard,Oregon 97223.(503)639-4175
---_-__--- _- - IM.PMT.N0. 891964 l
JOB ADDRESS: 15369 3W 81ST AVE
TAX NAP/I_0T 2S1 12 SUB: ASHFORD OAKS L.T:86 BK.-
LAND
K:LAND USF.: R4.5
LOT SIL'::
ITEM: NO: NO:
WORK, CLASS: NEW WATER CLOSET 3 TRAP
USE 'YPE.- SINGLE FAMILY URINAL BKFLOW PRVNTR
CONGT.TYPE: VN LAVORATORY 4 TRAP P"IMER
OCCUP.GRP. : R3 TUB 5HuWER 3 UNEASE TRAF3 I
DISHWASHER 1
GAR14AGE DISPOSQ.. 1
NO.STORIES: 2 WASI41NG MACHINE. 1.
DWELL.UNITS: 1 LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRPIN
SINK, 1 SEWER (FT)
WATER HEATER 1 STORM/RAIN (FF 1
OTHER
REMARKS:
[FEES:
o
w MILLER JAY PERMIT $147,50
N PO BOX 23291
TIGARD OR 97223 FI,:TURES
STATE TAX $7.38
- - OTHER
C
WATTS KEN
N
T KEN WATTS PLUMBING
A Pa BOX 230925
A
C tigard or 97223
T PHONE (503) 684-662G
0
p REGISTRATION NO. 50878 TOTAL: $154.88
This permit is issue;;suble-t to the regulations contained in Titl 14
RECEIPT NO.
of the TMC. Stere of Oregon Specialty Codes, zoning regulations -- __
and all othr, applicable codes and ordinances. and it is hereby FEQU;RED INSPECTIONS
Agreed that the woik will be done In accordance with the plans And PLB.UNDERSLAB
specifications and in compliance with all applicable codes And I POST R BEAM
nrdinances. 1 he issuance of this permit does n•rt waive restrictive WATER LINE
rvennnts Contractor and subcontractors shah have current city PLB.TOPOIJT
�rsrness tax permits This permit will expire and become null and
,Id if work is riot?farted within 180 days,or If work is suspended or RAIN DRAINS
imndoned for n period of 180 days any time after work has FINAL
ornmenced It shall he the responsibility of the permittee to Assure
ii required intipechons are requested and approved
P 1
A
• rmtt mature
Issued ByV rat LF-OR 1NSPEL'TION 639-4175
SFNARATE I tRMIT3 REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
l PLAN CHECK maAyP/P�LI�CA,T
IO-NCIQ TIGArDra-'
PLAN CHECK PERMIT POUAUN(TY OEVELOPMWhT DEPARTMENT
a1asswHds�aP.a@ftZW.TbA0,VnV= 0■ _
,
DATE ISSUED
JOb ADDRESS: 153 ;C S.VL- TAX MAP/LOT -25 /- Z
SUB: _ f It �� •_'• G� 1 LOT: ' LAND USE:OWN �—
•
AME
Nom: SPECIAL NOTES i
N ' REISSUE OF:
ADDRESS T LIST REISSUE: Yof /�z s +
-- __ F1000 PLAIN/
PHONE:
- :ENSITIVE LAND:
LX1UTRACTOR
APPROVALS QU
REIRED
PLANNING:
NOMADDRESS- ,
JAY HILLER BUILDER, 7NC. --7V ENGINEERING:
ADDRESS: PO F�)X 23291 _�_ FIRE DEPT
TIG,-' ?Df OR 97223 OTHER:
PHONE: C)84---)43 ITr.MS BSOUIRED
LI ,T/SUBCONTRACI'ORS:
ARCH/ENGINEER BU', TAX:
NAME:
- CALCULATIONS:
ADDRESS: r TRUSS DETAILS: _
PARKING PLAN.
PHONE:
LANDSCAPE P,-AN:
--
OTHER:
COMMENTS: .f /--f P
��: ERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
.Y1c 10-132 uo Building Permit roes V.2�_
�j 10-431 00 Plumbing Permit Fees `l
10-431 01 Mechanical Permit Fees
10-2.30 01 State Building Tax (5X)
Building -�---
Plumbing
Msch
10-433 00 Plans Check Fee
Building - -=z---
Plumbing
Mech __
L30- 13 00 Sewer Connection (20X) s
30--202 00 Sewer Connection (ROX) - `S
3G-•441 00 Sawer Inspection
51-445 00 Street System Dev Charge (SDC)
52-449 01 Parks I System Dev Charge (PDC)
52-119 02 Parks I1 System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg (SSDQ
10-230 .4 1RFD (95X) -
10-435 00 TRFD (5X)
10-230 06 Washington County Fire 01 (95X) -
10-a35 00 Washington County Fire N1 (5X) -
10-220 00 Amart/Wedgawodd — -
TOTAL. Q �
APPLICANT
�. Renstv..1 Ate• _ .