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BLWA)161('.�, PlESMIT,
PERMIT NO. : BU81131176
6,Aw" rW� CITY-011;&A FWD
COMMUN!iTY DEVELOPMENT DEP/,RTMENT oet of DAIE ISSUED: a/ 8/88
13125SW Hall 1310.P.O.Box 21391,7:gard.Oregon 97223.(503)639AI75 PR I M. PMT.NO. 881176
.JOB ADDRESS : 1,(4933 SW 915T AVM
TAX MAP/LOT 2511ADIZ11300 STUD : MALLARD I A K F-_5 19 BK :
L.AND USE : WAI. SPD
LOT VALMATION: 111 86,!542 SETBACKS
F:'RONT: 20 Pk_-.AR : 6
WORK CLASS : MEW OWFLA... . UNITS : 1. L.EF'T': 10 A 1:GHT : 39
USE TYPE:: SINGI E* F:'AMIL.Y NO. BEDROOMS : F-*.Xl* .WALL CONST:
CONST . TYPE : VN NO. BATHS : 3 N: 5 : F W
OCCUP .(.-,PP. : P3 PROT .OPE'.WLNGS :
OCCUP. I OAD N S E W
I'L)TAl APE'.A . 19'._,6
NO . STORIES : e isT: :1.0:5'e1 ROOF CONST : C, F'IPE RET7
HF'.IGHT : i 2ND: R72 AREA SF PAN? PA*Y'F.:D:
13ASEMrz_'.NT7 3140 : OCCUP. SH PART RATED :
ME2ZANINF:7 BASF'_'M' T
Fl-OUR I OAD: 40 CARA('E: Q*79 F:: .:RF:: GPRKLP? ALARM'?
1%**l Ow(CIPM) OF-1ECTI? YES
HI-KAT Y'YPF.:: (:,A5 110C.P.ACCESS"? COPE17
P1 AN C'HECK UY : L)c,r
REMARKS :
REISSUE-: OF NO .
I AST' Ar-'111"SUF
Fr_r.;-*!:i
0 CA Ml:::P(:)N BRAD PEMMIT $39011 . 00
W
N 1.965 SW P.."9PE) C*F PLAN Pli-VIE:16t) III P.5 6 . 1.0
E 9!0;30 F*1,41F. nE::PT
R
I.i-I ATE TAX *19 . 70
C THrr:1-4
C 0F.*,V1.L.OPMFNT CHARGES:
o CAMIE'RON BRAD SIX.(STORM) $230 .00
N CAMKRON COW.0-POC'11''LON CO SOC(STPF::E:T) $600 . 00
T
R 1963 SW i.? 3RD C'T' PDC 1#2 41250 . 00
A q1,C.j Ili t I R In or 97030 PREPAID < $100 . 00>
C
T PHONE (303) 6664014'.
0 14F.S.;ISIRAT ION NO . 4555; '11 OTAL : $1. ,A69 .80
R
RECEIPT NO .
This permit is Issued subject to the regulations onlalned lit Titht I I ............
of the TMC. State of Oregon Sped ilty C deEi, zoning rF g,.0sti_ s
.)EQUIAIED INSPECTIONS
and all other applicable coJes an J ord,nar(es, rend I' Ivhireby
agreed that the work will be done in accordance wito t;ip 0an I P I'll F1.110TINC F..W E P
specifications and in compliance with all .applicable c,;ies nJ P"OUNDAI'TON WALL RAIN DRAINS
ordinances The issuance of this permit dons not waive reser ,we P0511 & DVAM WATER LINE.-
covenants Contractor and subcontractors!hall have rurran', :-ty P1,13 . LINDEP17PLAB CTT'Y APPACH/SW
business tax permits This permit will 6.4pire ind becosi -j null and SLAB FINAL.
void if work is not started within 180days.orit work issi,Fpendpirfor
abandoned for a period of 180 days any time :!;',ttr work has PI P . MPOUT
commenced It shall be the responsibility of the,mr,nittee to assure I 1':'RAM I NG
all required inspections art-requested and app oved F:A:141F.PL.ACE
GAS 11 INE
INSULATTON
&LoA Nvvg�w, Gyp . BOARD
Permittee Siqnptute
Issued By __5 -113AI..1 F-GR iNSPEPH-1113N-639
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWER PERMIT
CI'NOFTIGrARD _PM rr NO. : sEse1I86
C"YOFnGARD
� RD
MOON
C0041MUNITY DEVELOPMENT DEPARTMENT MDATE ISSUED 6/ 6/00
13125 SAV Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223.(503)6394175 1:)R-
LM. PMT .NC) . UF-31-1't6
JOB ADDRESS : 1,'q933 �JW 91ST AVE USA NUMBER: 3,592-7
MAP/LOT PS11AD11300 MALLARD 1-.AKI:.'!:)
I AND USE: PAI 5PD
LOT GTZR :
!-5EC.7*1014: I.A. 'TWIG: O. I:-*,1N(.', : W
1141014K CLA5S : NEW
USE TYI-"E: S'l:N(.-sLE 1=AM1L.Y
ThVA atlar]A.r-.�Rl I'll, to With ili.11. 17'1-11cnfli, 13+ th4o Uriifikacl
15611WOWK(7e., Ageanc--y (301"In1t roxlair,*rta 1.@() cjayin from tlicl T I I(it t a t RJ.
nincit.int J-Wmi-4ecl .
tl)0Y P61--mit The clowifi niit Qt.1ni"...
flLrite)e t1*10. at'C1.11-facy of ti-le 1.ac�OiLion a-F the %:Ictc--� :I.s . I F ti-iwj! I'
licit It iic�Nwc.�r� 1.%
lo(zhitiod Ott the givCir) , t1*16 J,Oita tml.Tcor- tuhat].1 3 -Ferwt,
fir-min tli*ft If not 9;() J.c)04Lte(J
Sc-4-14611" Pel'Init Aq (.,y W:
.It . n 00 t U0.J. in. 1.lit t Ole 1-Ot.l.
TWiTALL . TYPE BUIL-DING IMPERVIOUe-i API�_:A:
17;IXTUPE UNITS
I*)WF.A-L.TN(; UNITS T'[.!NANT IMPROVEME*NT NO
NO. OF BLDGS . 1.
F C,E 51
0 CAMEK PON BRAD PERMIT
W 1.965 SW 23RD cTCONNVc,rTON CHAPGF
N
E Lir 970"rM I INE TAP INSiTALL .
R I -- OT
C CA MEPON BRAD
0
N CAMk;.:P0N COW"aT RUCT I ON C(7
T
R '1-965 SOW 23RD CT
I., gir,imml,iatm (if., 9,70:30
TC PH(:)Nr--*.
0 Pr:-:(;15Y'AA*T*TON NO.
P TOTAL:
RECEIPT NO.
This permit is issued subject to the regulations contained In Title 14
of the TMC, State of Oregon Specialty Codes. zoning regulations RV41.11PEU INBPECTIONS
and all other applicable codes and ordinances, and It is hereby RULIGII—X14
a(.--eed that the work will be done In accordance with the plans and
.pecifications aid In compliance with all applicable cones and
ordinances. The issue ice of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have Current city
business tax permits This permit will expire and become null and
void if work Is not started within ISO days,or it work is suspended or
abandoned frir a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to fissure
all required inspections are requested and approved
Permittee Signature
INSPECTION 639---4175
Issued By: ALI FOP
SEPARATE PERMITS 9. ►_QUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
P1...UMF_4IN(; Pr7i_RMTT
JW F-Ent"'111"' NO . : Pl...881.1'77
CRY OF �'�� mori nTARD DATE `:SSUED: C-3/ 13/SO
COMMUNITY DEVELOPMENT DEPARTMENT U'RTM PMT.NO. Be 11*76
13125 S.W Hall Blvd.P 0 Box 23397,Tigard.Oregoi,97223,(503)639-4175
,JOB ADUWESS- . 14475-3 SW 91ST �VE
TAX MAP/LOT 251.IAD:1.4300 SUB: MALLAPE) I A K ES I.1 9 BK .
LAND USE : PAJ. 3PI)
LOT t-'bIZF-.: :
ITEM: NO : NO
WORK CLASS- NEW WATER CLOSET 3 TPAV*'
USE TYPE: SINGLE FAMILY URINAL PKFI OW 1::,PVNTP
CONST .*TYPE - VN LAVORATOPY (4 t)PIKF-:.W
OCCUP . IMAP. : P3 TUS SHOWEW rrlAps
DISHWASHE'141 1.
GARBAGE DISPOSAL
NO . STORIES : 2 WASI-IING, MAM-11INE
DWEI L -UNITS : I LAUNDRY TRAY ( DIA
1**I...O()P DRAIN
SINK I SEWER (FT')
WATER HEATS P I STOPM/11RAIN (FT 1.00
OTHEP
I7EMAQK!5 :
rrrsiw
C.AMI-i'PON BRAD PERMIT ilill.47 . ,10
wo J-965 SW 133RD CT
N go-ii*v-sihiain or 970ji0 FIXTURES
E
R STATE TAX $7 .38
OTHER
C
0
N
T
R
A
C
T
0 TOTAL : 1$154.Ge
R
REMIP1 NO.
This permit IS Issued subject to thoi iegulation3 contained In Title 14 pEQIII RE:D IONS
of lh� TMC. State of Oregon Specialty Codes, zoning regulations
and all other applicable codes and ordinances, snJ it is hereby PLB . UNDEPSI AS
igreed that the work will be done in accordance with the plans and POST A SEAM
specifications and in compliance with all applicable co-les and WATIF-A LINE
ordinances The issuance of this permit does not waive restrictive PIAS TOPOUT
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and PAIN DRAINS
void if work is not started within 180 days,or if work is suspended or F I NAL
abandoned for a period of 180 days any time after Work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
&a- cmrsup,-,
Permittee Signature
C_
.OLL F(IP INSPErtT(')N 6*.39417n
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED t.BOVE
WN
XMI&I
CITY OF T���RD PLAN CHICK APPI [Cj)IJON
CHECK
C'CVAMUN-'TY DEVELOPMENTCITYOF TIFARD) PLAN DEPARTMENT PERMI-1 # #
13125 SW HM Hfvd. P.J.Box 21397,Tigard,Orogon 9722.3(503)639-4175 -
DATE TSStJV,D
jun ADDRESS: �IA9t (' �0._q
1-AX MAP/1,01-
'�UB: -i/220v�'�9
LOT:
VAL.UATION: LAND USE:OW NER a0400-C—.--
NAME: SPECIAL NOTES
ADDRFSS: ......7 --- REISSUE OF:
LAST REISSUE
FLOOD PLAIN/
PHONE: SENSITIVE LAND:
CONTRACr TOR APPROVA-L-SkE
-RUIRED
NAME: PLANNING:
ADDRESS: 23 c E-NGINEERTNaT
FIRE DEPT
01 HER:
PHONE:
RE D
ARCH/ENGINEER LIST/SUBCONTRACTORS:
NAME: BUS TAX:
ADDRESS: CALCULATIONS:
TRUSS DETAILS,
11AkKING F' AN:
-
PHONE:
LANDSCAPE PLAN- -----
OTHER:
COMMENTS:
PERMIT # ACCT # DESCRIPTION
10AMOUNT AMOUNT PD. BAL. DUE
-432 00 Building Permit Fees 3
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
Building — a -f,l
Plumbing
Mach
10-433 00 Plans Check Fee
Building
Plumbing
Mech -4
30-443 00 Sewer, Connection (20%)
30-202 00 Sewer Connection (80%)
30-444 00 Sewer Inspection
51--448 00 Street System Dov Charge (SDC)
52-449 01 Parks I System Dev Charge (PUC)
52-449 02 Parks 1.1 System Dov Charge (PDC)
31-450 00 Storm Drainage cyst Dev Ch:-g (qsDC)
10-230 09 TRFD (95%)
10-451 00 TRFD (5%)
10-230 06 Washington County Fire #1 (95%)
10-451 00 Washington County Fire #1 (5%)
10-220 00 Amar-L/Wedgewood
TOTAL
rn REC #
APPLICANT SIGNATURE
Received By:
0 ?n Date Received:
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