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CITY OF TIGARD CERTIFICATE OF
COMMUNITY DEVELOPMENT DEPARTMENT OCCUPANCY
1312E SW He"..Blvd.Tigard,Oregon 97223.8199 (503)839-4171 PERMIT #. . . . . . . : MGT94._.'1 3/#6
DATE ISSUED: 0,::/02/95
PARCEL.: aS114AD--03100
SITE ODDRE.SS. . . : 16640aW 89TH PL ZONINGaf2-1.'
SUBDI'viSION. . . . : WAVERLY ESTATES
BLOCK. . . . . . . x 1-0 F.. . . . . . . . . . . . . :03 @
-ASS OF WORK. :NEW
rPE: OF USE. SF=
aCCUPANCY GRE'. x R3
OCCUPPNCY LOAD a`25 4
TENANI NAME. . . :
emarks a PATH I
IF7L.VIN WAYMIREr JR
U L•'GX 231164
TIGARD OR (,74131
PhOT►e #s 639-674;
Contractors -- -
0E,Lu T N 'WAYM RE
�.(O PDX 231164
164
T i OPARD OR 97281
'hone #: %. ''S-•6742
?5. 76
!c+_upar►cy of the above referenced twilding is hereby divan, cricJ certifies
oe c_oiepl .iance with the State Of ore+gon Specialty Codes fur the yro�.►p,
,cr_uf-)ancy. and 1t5t+ under- wl ich the refer"enr.ed pel-91XN�
was %S"ecl.
E{ J DING �I �F�E'CT0R EA.1IP`ICIAt_.
_ POST IN CONSPICUOUS PLACE=
G�
Lo
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J
CITY OF TIGAR9 ovrLOi;:.: :"SPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 635 4171
Inspection: rfkA:�_,,,_1
Footing Susp. Ceiling Sprink Rough-in ApP d Ik~
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
P,bg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulati-)n -Mech.
Underflr. InSL'I. Shear Wall/
Gyp. Bd. -Elect.
Date Requested: -� +C� j� Time: AM PM
Address: _/ �!_i c' '� c, [� � !L
Builder: Permit #: `l C'_��k�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I'i ����•�t�t-= ��?�'7 -Ste' /
r�
H
uc�
w
J
Inspector: � ia_ Date:
,APPROVED _DISAPPROVED __�(,APPROVED SUBJEC i TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Insp--ction-Line (Aec-O-Phone): 639-4175 3usiness : 639-4171
1
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Be3m Struct. Plbg. Top Out Elec. Rough-in Or-
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing
Alarm Wc.: Line Insulation ech,
Underflr. insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: (• /�Jl; Time: AM PM
Address: /( (^
Builder: Permit 1#:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
rt
H
tD
_J
Inspector: Data: 2/Z/ �:�
1,,PP5_0VED __DISAPPROVED `APPROVED SUBJECT T(� ABOVE
`Call For Rernsp.
UTY OF TIGARD PLUMBING PERM11'
COMMUNITY Dt',IELOPMENT DEPARTMENT PE R lyl 1 T #. . . . . . . . -0346
13125 SW Hall Blvd.11gard,Oregon 97223s8199 (503)639-4171 DATE ISSUED: 09/14/94
PARCEL: 2_S114A0--WElZl30
ci)ITE ADDRESS. . . : 16649 SW 891'!1 PL
SUBDIVISION. . . . . WOVERLY ESTATES ONING: R-12
BLOCK. . . . . . . . . . . L01.. . . . . . . . . - -030
CLASS OF WORK. . :NE-W GARBAGE D I SPOSA LS. . : 1
TYPE OF USE. . . . :SF WASHING MP'-;H. . . . . . . : 1 BACKFLOW PREVNTRS, I
OCCUPANCY GRP. . :R3 FI-OUR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . .. :0
STOfIIES. . . . . . . . .2 WATER HEATERS. . . . . . . I CATCH BASINS. . . . . . . :0
FIXTURES------- LAUNDRY TRAYS. . . . . . .0 SF RAIN DRAINS. . . . . . 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LnVATORIES. . . . . .4 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
W(I'VER. CLOSETS. . :33 WATER L INC ( f t ) - - - - ' 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft) . . . . :0
P,:,marks : PATH I
UWNER: --------------------FEES-----
MELVYN WPYIIIRF.'- JR r.I f-, $ 1550. 00 1AG 09/1.4;X3 4
r' 0 B 0 X _31164 B PR T $ 525. 50 KS 09/14,'94
BPLC $ 50. 00 JF: 0')/08/94 94--256t.'46
) IGARD OR 97261 B5PC $ 26. 28 KS 09/14/7'4 -
Phone #: 639-674L SSDC $ c'80. 00 KS 09/14/94 -
PARK $ ti0lb. 01,? [IS 09/14/94 -
[='1
Plumbint t
/Y _on r"ac (.)3
/V MPRT $ a3. 50 KS 09/ 14/94 -
MPLL $ 1'k., 88 KS 09/t4/94 -
N a in e . Uln_� 111--4TI 145PL 2. 18 KS 01)/ 14/94 -
J_7*;qC LLtA_=
Address - 3BTH $ 225. Q10 KS 09/14/94 -
C i t yate : V15P('-' $ 11. 25 KS 09/I Ai./C)Zf
Zip: _r'h o n e# EROS $ 64. 00 KS 09/ 14 /94
Rey Additional fees n o t shn,.4n here. . . . . . . .
REUUIRED IN�PECTIONS
This permit is issued subject to the reg.-
ulations unntp-- ned in the Tigard MUnicipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty CodeS and all. Post /Beam Struct Water Line Insp
other Applicable laws. nil work will, be done Fiat/Beam Ilechan Appr/Sdw1k Insp
it, acroi-r-ianup with Approved plant.,. 't!-tis Plm/undslah '[n!--p Mechanical [-final
permit will expire -'.f work is not started FILM.'Underfloor PIUMb Final
within 1.60 days of issuance, or if work is Mechanical lnsp Building Final
Lr. suspended fol" more than 180 days. Plumb Top rout Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
&
InSLllati0l. Insp
X_
Gyp Boowd Insp
11
Authorx.zed F."lombing onvaut or Signature
Call for inspection -- 639-4175
Conractor Notes :
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503,1 639-4171 PERMIT #,. . . . . . . : M5T94--034(_,,
639-4171 DATE ISSUED: 09/14/94
Pf--4RCEL: 2S1i4AkA--WE030
'--'11- A D D R E 5's). 16649 SW 89T1.1 1::1 L
SUBDIVISION....: WAVERLY ESTATE'S ZnNING: R- 12
131-OCK. . . . . . . . . . LOT. . . . . . . .. . . . . . :0::,0
BUILDING
I1IEISSUE:MST94-0333 DWELLING UNITS: 1. BASEMENT. . . . . . . . :0:0 Sf
CLASS OF WORK. :NEW BEDPHIS:4 BATHS:3 GARAGE. . . . . . . . . . :440 S f
FYPE OF USE. . . -GF FLJOR AREAS- - REGIUIRED SET L I ACE/.0
] YPE OF" CONST. :5N FIRST. . . . :968 5f LEFT. . - 121 ft R I GH"*. : 18 f t
OCCUPANCY GRP. : R3 SFCOND. . . : 10:'9 15 f FRONT. :'210 ft REAR. . .30 -f t
STORIES. . . . . . . :2 FINBSMENI :O S f REDU T
1AEIGHT. . . . . . . . :ii25 11-t TOTAL--------: 1997 s SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 136,285 PARKING SPACES. . : 1
Remarks : PATH I
PLUMBING
S I NV
1.1. Is. . . . . . . . . . : 1 FL.LOR DRAINS. . . . :0 BACKFLOW PREVNTRS. I
LAVATORIES. . . . . :4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :21
TUn/SHOWERS. . . . : LAUNDRY TR()YS. . . :0 CATCH BASINS. . . . . . . LO
WATER CLOSETS. . :3• SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . : 1 WATE N LINE ( Ft ) . : 100 OTHER FIXTURES. . . . . :O
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :O
WASH I NO MACH. . . " I SF-' RAIN URA INS. . : 1
MECHANICAL FEES -----------
UEL UNIT HTRS. . :0 t /pe amount by date t-ecpt
/GAS VENTS . . . . . :0 TIF $ 1550. 00 KS 09/14/94
MAX INPUT-0 BTIJ V FN'T FANG. . :/i BPRT $ 525. 511171 KS 09/14/94
FURN ( 100K . . : I HOODc.. . . . . . : 1 BPLC $ 50. 00 JF 09/08/94 94256546
FURN > =100K . . :0 WOODSTOVES. -0 B5P(" $ 26. 28 KS 09/1.4/94
FLOOR FURN. . . .0 CLO DRYERS. : 1 SSDC $ ::80. 00 K5 09/14/94
BOIL/CMF ( 3HP:0 OTHLI'R UNITS: I PARK $ 500. 00 KS 09/14/94
GAS OUTLETS: 1 MPRT $ 43. 50 KS 09/14/94
OWTIet-: $ 10. 88 KS e9/14/9,4
MELVIN WAYMIRE JR M5PC 1; 2. 18 KS 09/14/94
D () PDX 231164 3BTH $ 225. 00 KS 09/14/94
F-15PC $ 11. 2:' KS 09/14/94
TIGARO OR 97281 EROS $ 64. 00 KS 09/14/94
Phore #: 639--674,':_:' ERPC $ 20. 80 KS 11219/14/94
$ 20. 80 K'i 09/14/94
MELVIN WAYMIRE
PO BOX 231164
TIGARD OR 97281
r-11rine #: 639-6742
ccReg #_ .- 33976 -------------------------------------------
C-0 ♦ 3330. 19 TOTAL
1.0 This permit is issued subject to the regulations contained in the REOUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. SptL:ialty Codes and all other Foot/found Insp Fireplace Insp
oplirsblc laws. All work will be done in accc!,dance with approved Post /Ream Stt'uct GAS Line Insp
plans. This pirmit will expire if work is not syrtpd within 180 Post/Beam Meehan InSUlatiOn Insp
days Of iSSUMC, or if work is suspended fo more thAr 190 Nays. Plm/undslab Insp Gyp Board Insp
I
PLM/Underfloor Rain drain 1.n s p
: 'ey'lnittee `m;igylatut'eg Mechanical Insp Water- Line Insp
Plumb Top Out Appy/,Sdwlk Insp
Framing Insp Mechanical Final.
Call for insp RR ion 639--4 175
.w
INSPECTIUIP NOTICE
City of Tigard Building Department
23125 SW Hall Blvd. Tigard, Oregon 9723
Inspection Line (Rec-o-Phone): 639-41'15 Business Phon :
Inspection:
Footing Plbg. Unleral.ab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINALS
Poet/Ream Struct. San. Sewer Framing -Bldg.,
Post/Beam Mach. Rai). Drain Insulation -Plumb.
Plbq. Underfloor Hater Line y-- Bd.,> M,ech.
d _A
ate Requested: Times / ` AM PM
a '
Address: , ��_ QLA� Permit �s9���3��
Builders
THE FCLLOHING CORRECTIONS ARS i.EQUIRED:
Inspectort,
APPROVED DISAPPROVED APPROVED SUB-)RCT TO ABoVE'r `
--Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Depart:eteet.
13125 SM Ball Blvd_ "igard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639•-4171
Inspection:_
Footing Plbg. Underelab ech. R gh•A^n n Appr/Sdwlk
Found. Plbq. T- ,) Outas Lin FINAL-
Post/Beam Struct. San. Sewer Cf ramin ✓ -bldg.
Poet/Beam Mach. Rain Drain Insuletio.. a -Plumb.
Plbg. Underfloor water Line Gyp. Bo. -Mach.
Date Requested:_ Times --AM __PN
/- nC
Address: (� �'1 Permit /:� —� �
_ j
Builder:
THE POLLOWING CORRRCTIONS \RE REQUIRED:
Inn{rpt.:r Date:
` A":`ROVED ____ DI3t.PPROVRD -- APPROVED SURJSC`i TO ABOVE
__Call Por Reinsp.
�NSPECTInN NOTICE
City of Tigard Building Department
13125 SW UP11 Bivd. Tigard, Oregon 97223
Inspe!•tion Line (Rec-O-Phone): 639-•4175 Business Phone 631- 71
Inspection:___
Footing Plbg. Underslab �w
n Appr/Sd
Found. Ping. Top Out
Poet/�Aam Struct. San. Sewer -Eldq.
Poet/Beate• Kirh. Rain Drain Insulation -Plumb.
PLbg. Un6erf'lonr Water Line Gyp. Bd. -Mach.
Date Requestedt It \ ,_Time:
Add Permit
Permit �: / T_�_L--,1
nuilder•
THE POLLOWINt: CORRFCTIO143 AI.E REQUIRED:
.1e'L< r
a
��• s Ax
�.4
W
J
Inn pector:� Date. MIA/
��APPROVRD _ DISAPPROVED APPRGVRD SUBJECT TO ABOVR
—Call For Reinsp.
INSPECTIUN NOTICE
c1ty or Tigard Building Depart—nt 1
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0-Phone): 639-4175 Business Ph. ue: 639--L71
Inspection: — ----- ---
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. q-: oP Out Gas Line FINAL:
Post/Beam Struct. Sen. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insu)acion -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: /O/�j I _Tima' AN 7 —P)'
Addreas: L _ !1 - Permit 1:�T -�✓ (L
Builder: --
---
TBE !O / ING COR:3CTIONS ARE REQUIREDs
Inspector: __ Dates L- O I
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION N(MCE Lj city of Tigard Buildiog Dspartsaent
1.)125 BSA Hall Blvd. 'Pigard, Oregon 97223
Inal.a�tion Line (Rec-47-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
P et/Bam Stru �San. Sewer framing -Bldg.
:0.
am % Rain Drain Insulation -Plumb.
Plbg. Underfloor f Water Line Gyp. Bd. -Mech.
Date Requested: ZL�-7 Time: M ,PM
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
-.��-
c 5k- A--, .
Inepectnrs _ Dates
APPROVEDDISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Aainep.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sr. Ball Blvd_ Tigard, Oregon 97223 /
rnapertion Line (Rec-O-Phone): 639-4175 Bauiness Phone&31 3�
Inspection.-__-_-------
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL;
Poet/P am Struct. San. Sewer Framing -PIdg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor atiiD-t1ne y/ Gyp. Bd. -Meeh.
Data Requested: / Time: G AM PH
Address: Z(I�L i N "�'�-c- Permit 0 t ! 7L y.3'T
THE FOLLOWING CORRECTIONS ARE REQUIRE7:
CL
1
J
CJ
C.7
41
Inspector: — Dater C
PROVED DISAPPROVED APPROVED SUB.IErT TO ABOVE
_ Call For Relnsp.
INSPECTION NOTICE
City of Tigard Building Departaseat
1 p 3125 SHall B).vd_ Tigard, Orogon 97223 �
Inspection Line (Ree-O-Phone): 639-4175 Bueineos Ph.06'3 =4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
B aru^~ San. Sewer Framing -Bldg.
oet/Beam Mss!(. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Laine Q Gyp. Bd. -Meeh.
Date Requooted: //ZV Time: y AN ___PM
Address: //�--477_7�� /�/� { Permit
r.
Bu i 1 de : !. !2 ' 1`ITHE FOLLOWING CORRECTIONS ARE REQUIRED:
I napec-t.or-:
tJY1rROVED DISAPPROVED _T APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW hall Blvd. Tigard, Oregon 97223
lnnpection Line (Ree-O-Phone): 639-4175 Business Phone: 639-4171
Inspec:tion:--------- ---
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. '..'op Out Gas Line FINAL:
Poet/Beam Struct. /San. &awer Framing -Bldg.
Poet/seam Mech. Rain Drain Insulation --Plumb.
Plbg. Underfloor Nater Lina J Gyp. 3d. -Hoch.
Data Requestedt (7// /G 2 S- /T Time: x AM PM
Address:1u 'f, - Permit 1:
/&R.
Builder: {o (1 . ✓ 2—
THR FOLLOWING CORRECTIONS ARE REQUIREDt
i1
Inspector: Datet
APPROVED DISAPPROVED APPROVED MWL !O ADM
Call For Reinsp.
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•
Doting • Plbg. Underslab Mach. Rough-in Appr/Sdwlk
�o.nd ) / Plbg. Top Olt Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requas/ted//s �) �!^�j� `/ (� /��� __._:rimes AM s PH
Addrens: /(! �C" 7 %� C/ h V•L's'�-Permit #s
'-j �J
Builder:L L1
J U--
TRE FOLLOWING OORRECTIONS ARE REQUIRED:
11
J
J
Innlwctors \`� - �--- Dater / /_�1C
APPROVED D;SAPPROVED L"APPROVED SUBJECT To ABOVE
Call For Reinnp.
1.
L;I I Y CII I RFC f 11 - 1 (it I I%--I'll 114 1 r-''I I .I. I P f NI). 94- k,tit, .1
?V1
1 it A K Alyll-A INT `151.5. t 11)
MIA.VIN 111. 00
J141)I V X fi I ON
I rMF.h11 AMOUN t' RHI D PURP09F- Ell-* Pf-MILINIT I-IMIKINI PMD
...............
`k"t. 50 PI 1IMBINCS PFJ4M P25. 016
I IANJ III I 'l 43. 50 BUILD VIVA 39. 11
+N CHI 1 220111. 00
R IN, ;P1 I 1 35. 01A Pt- WS, SIA, 500. 111111
4,50. 041
LD (,0N PU HM J I 1 F 1 64. 00
ILL)
I I)N (-'.(JNI RRL Pl.,44N CK
A 49 SW 89 IF H PI I W t-
I"AMC)l IN U P0 I D
GIlY OF 11GARD Rf.-f1lPt OF PAYMENI REGF,".IPl NO. a 914 6
CHECK AMOUNT a 50. 00
NAME WAYMIRE, MEL.VIN CASH AMOUNT a 0. 00
ADDRESS s PO JAOX 231164 PAYMEN1 1'.)AIE 09/00/94
SUBD I V IST ON
TIGARD, ORFBON 4-7281—
VIURPOSF-, OF PAYMENT AMOUNT PAID PURPOSF. OF PAYMI-'.N-1 AMOUNT PAIL)
(414 CHECK Fr-.. 9-19R 50. LAO
649 SW 89TH PL
t-), ;VER(.Y ESTATES LUT 30
IiAt- AMOUNT PAID 00
CITY OF T I GARD SEWER CONNECTION
COMMUNITY DEVELOPMENT DEPARTMENT P ER 111 T
13125 SW Hall Blvd.Tigard,Oregon 9772398199 (503)639-4171 PERMIT #. . . . . . . : SWR94-0309
639-4171 DnTE ISSUED: 09/14/94
PARCEL: 2SI14A0.-WE030
S11"E ADDRESS. . . : 16649 SW 89TH PIL
SUBDIVISION. . . . : WAVERLY ESTATES ZONING: R-12
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . 1030
-----------------------------
TENANT NAME.. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . .
CLASS OF WORK. . . :NEW DWEI-LING UI\IITS. . : l
TYPE OF USL. . . . . :SF NO. OF BUILDINGS: 1
INSTALL. TYPE. . . . :BUSWR IMPERV SURFACE— : S f
Rpinarks: PATH I
ovinet- '. FEES
MEL.-VIN WAYMIRE JR type amol-trit by date r-ecpt
P 0 BOX '--`31164 PRMT $ 2200. 00 JG 09/14/94 -
I NSP $ 35. 00 JG 09/14/94 -
T I GnRD
TIGnRD OR 9726t
Phone #: 639-674 '
Corltr-actot—
f-FINTRACTUR NOT ON F- ILE
$ 2235. 00 TOTAL
Reg
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and reguic.tions Sewer- Inspection
of the 11nified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be fovfeited 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 shalt prospect 3 feet in all directions from
thp distance niven. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Pncy wi 1 i stall a lateral.
I--,e v-m i t.t e e S)i g n a t ,.t i e
T 1-t e(I B
Call for- inspection 639-4175
C;
-4
Residential Building Permit Application 1 %
City of Tigard
93125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4979
Jobsite Address: 16649 S.W. 8g;"h p1 a,c-P
Subdivision: Waverly FFEatPs Lot# 30
Office Use Only
B Planck/Rec # / " r �'
Valuation. L?_6 ,
Permit#
Corner Lot? Y CN
Flag Lot? Y
/„1 Reissue of '7
�''J 1
Map & TL# `` I y '»-k%� �✓ U
Owner: Melvin G. Waymire, Jr. Approvals Required
Address: P.O. Box 231164 Planning
_ Tigard, OR 97261 Engineering
Phone: 639-6742 Other
Contractor: Melvin G. Waymire, Jr. _ Itrms Required
Address: same - Subcontractors
Truss Details
Phone: - _639-6742 Other
Contractor's License # 35976
(attach copy of current Oregon license)
Contact Name & Phone: _ Mel Waymire
Subcontractors: Arch ltect/Englneer: Alan Mascord, Designer
F- V // Plumbing: Harmony P_ lumhina Address: _1-4()6 N.W. 18th Ave.
'
/Mechanical: cPnoral F'ornare _ Portland, OR 97209
(attach copy of current OR Contractor's License)
Phone: 225-9161
.J
JOB DESCRIPTI N: ('ansf .rurt. Si nq1 p-fami l y resi deuce - Path A
App ica Signature 81 hone number
Received by: Date Received:
N IWORMCOMMARrSAPP
Permit# Account Description Amount Amt. Pd. Bal. Due
/1J
;14 6 Bldg, Permit (BUILD) S.I S; .S U
Plumb. Permit (PLUMB) �1 . )d
Mech. Permit (MECH) Ali,I-V
State Tax (TAX)
Bldg: --4' .2K T
Plumb:
Mech:
Plan Check (PLA CK) ��� Srif' J 0. /y ,�Y✓
Bldg: .SCS
Plumb: /
Mech: /0"a
J
•�wIQ J� ,p3o/ Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) j 3 T
Parks Dev Charge (PKSDC) S �' _ You /
Storm Drainage Chg (SDSDC) bs _ - 0 1
Residential TIF (TIF-R) / (/ 50 �
Mass Transit TIF (TIF-MT) 12-y _ !J t, ✓
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
o Office TIF (TIF-0)
cr
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CITY OF TIG,ARD
WAVERLY ESTATES
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