14005 SW 97TH AVENUE 14005 SW 9-TH AVENNUE
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INSPECTION NOTICE
City of Tigard Building Department A
12420 S.W. Main St.
Tigard,Orpgon 97223
Phone: 639-41'i'1
Type of Inspection
Date Requested Time A.M. P.M.
Address V / 0 -- Permit
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
—
Presented to Appioved
Inspector Disapproved
Date
CALL FOR REINSPECTION
Cl YES F-1 NO
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l INSPECTION NOTICE too
City of Tigard Building Department
12420 S.W. Main St. �.
Tigard,Grego l 97223
P',one. i3g-4171
A
Type of Inspection -----
i
Date liequeste`d�'' f ;T -5 Time A.M._ __P.M. /
Address 1!1657 27� Pei mit #. �OwnerLot— ---- -- ---- Lot #
---------
The following Building Code deficiencies are required to he corrected:
0-Ar-AND L
Presented t _ - Approved
Inspector _-_ �____ __ Disapproved
Oate \
CALL FOR REINSPECTION
YES U NO
BUILDING RECF.PT
NAME --
DATE:
ACCT. M DESCRIPTION AMOUNT
10-432 Building Per-wit Fees
10-431--600 Plumbi• ri Permit Fees s
10-431-601 Mechdlical Permit Fees s
10-230--501 State Building Tax
10-433 Plans Chock Fee s ---
30-443 Sewe Connection (20X)
30-202 Sewrr Connection (80X) S
30-444 Sewer Inspection
51-448 Street System Caw. Charge (SOC)
52--449--610 Parks I `ystQM Dew. Charge (PD`C) t
52-40-420 P .rks II Syitew Dew. Charge 'PDC) f �
31-450 Stora Drainage System Dew. Chrg (SSOC)
10-230-j05 TRFD (95X) s
10-478 TRFD (5X)
10-230--506 Washington County f .ra N1 1,95X) f
10-478 Washington County Fire N1 (5X) s
10-220 Amart/Wedgewood .� f
TOTAL
(19/1214P)
CITE OF TI&I R® N o. T 7
17755 S W ASH _
P.O.BOX 23397
TIGARD. OR 97223 -
Name - - -
- --— ---- ---
Addrtrs -- ---
Lot BI /Map Subdivision/Address
Permit k's Srdg. Plumb Cash Check
Sewer Other Other Rec. By --
� 1(
Acct. No. Description Amount
10.432 Building Permit Fees -
10.431-600 Plumbing Permit Fees --`
10.431.601 Mechanical Permit Fees - --'
10.230.501 State Bldg. Tax
10.433 _ Plans Check Fee
10.435 Other Licenses a Permits -
30.44 — Sewer Connection
30.44, _!_ewer Inspection -
24.446 Street Syst, Dev. Charge --
25.44"10 Parks I S st. Dev. Charge
25.449-620 Parks II Sy 1. Dev. Charge
3' 450 Storm Drainage Syst. Dev, Charge
16.430 Business Tax
10.434 Alarm Permit
10.227 Bail
10.455- — Fines- Traffic/Misd/Parking
10.230• _ CPTA Traffic/Misd/Vic. Asst.
10.458 Indigent Defense -
30.446.401 Sewer Service/USA
30-446-40.7 Sewer Service/City _
31.447 Sturm Drainage
40.475 _Bancroft Prin. Pymt. __ —_
40-471 Bancroft Int. P mt.
10.451 Other Charges for Services
__ TOTAL
0 ACCOUNTING
A�
f PA
BUILDING RECEIPT
NAME: Mw DATE:
ACCT. # oESCRIPTION AMOUNT
10-432 Building Permit Fees
10-431-600 Plumbing Permit Fees
10-431-601 Mechanical Permit Fees
10-230 -5C] Stato Building la,, 14 .0 ,?
10-433 Plans Check Fpe
30-443 Sewer Connection (70%) $
—z A-A-
30-202 Sewer Connection
30--444 Sewer Inspection
51--448 Street System Dev, Charge (SDC) $
52-449-610 Parks I System Dev. Charge (PDC) $
52-449-620 Parks T1 System Dev. Charge (PDC) $
31-450 Storm Drainage System Dov. Chrg (SSDC) $
10-230-505 FRFD (95%)
:0-470 I-RFD (5%)
10-230-506 Washington County Firr. #1 (95%)
10-470 Washington County Fire #1 (5%)
10-220 Aniart/WedgPwood
,?(,4-44L NV, Z eef duua-on, evtt-
- 4A _ �r��,� � �,'I
9/1214P)
l� ■
i BUILDING PERMIT APPLICATION TIGARD CJATE____3-21 is _.___ 5281
THE UNDERSIGNED HEREBY APPLIES FOR A PERMI T FUH FIE WCHK HEREIN INDICATED BUILDER PHONE 620"7416
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONY _7
LOT NO---
OWNER
O.__OWNER Tom Miller JOB ADDRESS 14005 SW 97th AVe.
18270 SW Doone@ Fern Rd ARCHITECT
Y ENGINEER
BUILDER Toa: killer Bldr. ADDRESS Tigard, QF 97124 DESIGNER
STRUCTURE Cd NEW Cl REMODEL ❑ ADDITION L7 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
91 RESIDENCE ❑ CO'AM IJ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY . k-3 LAND USE ZONE B`7 BLDG.TYPE51N FIRE ZONE.___PLAN CHECK BY 111- HEAT...Gas
Coostruct single farily dwelling w/attached Garage (Note: Building to be connecsed
directly to mainline or to 6" line on Property with recorded joint maintenance Agres�ut
with lot 1) 4 Bedroom 3 bathrooms
SEWER PERMIT# 28.364
OCC.LOAD FLOOR LOAD 40 HEIGHT 17.5 NO.STORIES 2 AREA 1686 NO 3EDROOMS 3 VALUE 73000
BUILDING DEPARTMENT SET BACKS FRONT# 20 REAR 15f LEFT SIDE 31 RIGHT SIDE 15
Permit 352.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
4U00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
•
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
392.00 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NO1 WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
14.U8 C,ENSE.�FtA�ATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax I G
908 SDC— $ SUU.OU
Total PDC# Ll $150'VU `APPLLICKINIT O R
By
Receipt No. J�. ?
Approved '�' ADDRE38
HATE INSP. T PE INSPECTION _ REMARKS PLUMING
-- _- DATE
Contracto
Per*lt No:
tr Rough-in
Fixture +�
Final
Ell9T —� HEATING
Contractor
Permit No.
CI Gas or Oil �3K
--
�j 0-- - Rough-in
�.L•1 u� Final
�-ZZ
--- _
SEWER
_ Final
DRIVEWAY
Final -
- - F— -- -- .-- - - -- Storm Drainage -- --
(Rain Drain)Final
_-- --- Sidewalk - ---
-- Curb&Street Final
APP
�BLOG.DEPT FINAL TEMPORARY CERTIFIC T:.OCCUP C reach
CERTIFICATE OCCUPANCv -- / 2 y Final -- _
Landscaping -
i
Toning Final
BUILDING PERMIT TIGAR:) DATE__"&-- 149
THE UNDERSIGN ED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILwR PHONE 6.1v ^7y14-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
ISSy
O'NNEH JOB 11DORES� /�IQt)�' S4.0y7Jx/?.,. LOT NO.
E6/K
ARCHI TECT
_ ENGINEER
BUILDER / ADDRESS DESIGNER _
STRUCTURE V1 NEW ❑ REMODEL ❑ ADDITION_ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE U DEMOLITI
0 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR POHT ❑ GARAGE G STORAGE ❑ SIABU FEN--
OCZijPANC,'Y L'1'-3 LAND USE ZONE BLDG.TYPE _s_.QC._" �_ ..-...PLAN CHECK 3Y HEAT_Cv.4_S-.—_
_ lure rN cT- S/n O/rr 1'��.•,i 1. +�w�//in. w�4�au4� 1 l'a r .c � . �/Lf o r-� �,_;,Jn/n,�.,^�-___
'�� c_'.n^//V6L'.'Y /.'/_� L"'//.'C�' �. 4• -..� /`'/hlA1 C /A!E 4/` !'c) C� .. � .•, r'y/V /'%�-/'
�E!,aa- IL I EA, Sy
SEWER PERMIT N
OCC.LOAD FLOOR LOAD 6 HEIGHT S NG.STORIES AREA 4F6 NO.BEDROOMS .'i V1..t_UE 7-?""'
BUILDING DEPARTMENT-- SET BACKS FRONT .ZO / REAR 1 LEFT SIDE r RIGHT SIDE /j T
Permlil THIS PERMIT IS ISSUED SJBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZON"
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TXAT Tr
�PlanCheck D WORK WILL BE DONE IN ACCORDANCE W1(H THE PLANS AND SPECIFICATIONS AND IN COMPLIAN
GG vv WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT' WAI
Su>tolal 71 . RESTRICTIVE COVENANTS.CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY HUSINc
! LICENSE.SEPARATE PERMITS REQUIRED.-OR SEWER,PLUMBING AND HEATING.
StatA Tax
Total 0
PO-Cl APPLICANT OR AGENT
By
Receipt No. — -----
Approved ADDRESS PHONE
SSDC --- $ -
SOC S oo, oa
SEWER CONNECTIOrJ 5 21,S,
SEWER INSPECTION S 3S, � �
SE',JER SURCHARGE 1 S " �= v( M SgrCJlwrj,(
comments: 14 -Y _ r -
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flu Idiny Vermit No.
Locdo ►
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Certification of R;.-gistrat ion
With the Builders )ard
1, fvM ' 610t INC, , doing business as (dba) ,
_ _ ► __ am registered under the provisions
of ORS hapter 701 Oregon Homebuilders Law) .
Ply Builders Board Registration Number is ��/
Ply registration i in full force and effect and expires on
ignatur