Case File ---
, 14326S D*
LIR
"J
2
H
T
co
ul
J
I:\recordslmlcrotlm\targets\twilding.doc
APPLICATION - STREET IMPROVEMENT/EXCAVATION �rz `� COPY TO:
(WHITE)•FILE
ORG!NANCE NO. 74 14 '- `� L '- (YELLOW)•INSP.
(PINK)-OTHER AGENCY
(INSTRUCTIONS ON SEPARATE SHEET) (BLUE)-APPLICANT
APPROVED PF "I--- APPLICATION NO.: 415
NOr APPROVED (:I FY OF TIGARU, OREGON I0
❑ FEC AMT.: E ----
PENDINu r- L. PMT. ❑ CIT Y 1-TALL RECEIPT NO.: y'- 7-1'14,16
PENDING SECURITY ❑ PUBI_ICWORKS DEPARTMEN7' 13Y _,i`' DATE_ rl 71_
- -
PENDING AGENCY -OK- (•] Application and Progress Record MAINTENANCE BOND # -
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REOUIREU
ANNUAL
PENDING VARIANCE ❑ EXI=N DATE: 2
PERMIT NO.: DATE: ISSUED .-._�—L!?l___�.�--_ BY.
( 1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL_ 3mcrete Drivaway
Approach_ AS DE'.>CRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
/APPLICANT Rick ICrahn 8811 SW 7lst Place Portland, OR 97223 246-1028
NAME _ ADDRESS CITY
CON'RACTr)?- Kratton const. - -- —
NAME ADDRESS CIT PHONr
PLANS BY _-per City Strndards/3pecification3 -
NAME� ADDR E89 CI—TV--- PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ 250.00
DOLLARS
FOR OFrICE CMIN.
(2) EXCAVATION DATA: 0.04 x s .C'� _ S- 10.00
STREET UESCRIPTiON PROGRESS & INSPECTION STATUS
NAME SURFACE CUT T-CUT CUT MATERIAL INSTALLED —ITEM DATE REMARi•S/TYPE BY
TYPE_ LENGTH WIDTH DEPTH ITEM 6 QUANTITY
STREET
OPENED
lO;i>rd AvIenue -- (See at +ched - TION - - --
0
-- - _ u
ESTIMATED STREET OPENING DATE: E
---1— S
T — ---- -
ESTIMATED STREET CLOSING DATE: .-__- L-_-.L _ E
----- ---- - —__ D _
STREET
(3) SECURITY NO. -_ SECURITY AMT.: $250.00 - . CLOSED
SURETY CO.: - _ �Y�y�yY _— ----- FINAL
FT?9P;"CHECK--x CASH G BOND INSPEC. -
(4),a PLOT PLAN: INDICATE SICAL SPECIAL PROV'SIONS /CONDITIONS
FEA ION LOC %TION AND E T. 1. Notify City Inspector
Carl V eweg # 639-4171
SITE: =4335 Sw 103rd
24 hre. prior to bee nn ng work-
f' 4 1 2. ORS 757.541 - .571 applies
Y pre oc on, etc.)
R CURB —
F. 3. Traffic control shall
Un
* - - --- ----- ---- --- ---- -- --- -- Provided for by the --mtractur.
cc
►�' I ' I �wa+�k. L I�e I I
r
�1
(5) NOTE THE CITY CF- TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCr WORK WHERE
RIGHT-OF-WAV JL211ISDICTION IS THAT OF WASHINGT )Pli COUNTY OR THE STATE OF orEGON
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS AC TIONS.
APPLICANTS SIGNATURE //� C- e, DATE �__
..,C1TY0FTMPARD PL WIB I NG PF RM I T
CITYOFIWA PEmy1TT #. . . . . . . .. 11ST9 1 -0090
IL
COMMUNMY DEVELOPMENT DEPAWMEW oftem
M26 SW HWI Blvd. P.O.Box 23097,TigwJ,("gon 97223(SM)6394175 ;7-7 DPTF ISSUED: 061"11 /91
SITE ADL KESS, . . . 143,;�, SW 103RD AVE PARCEL.- ;:?S111SC-02,100
GULID I V IS 1014. . . . I DOUGLAS [AE IGH'fS ZONING: R-3. 5.
".LOCK. . . . . . . . . . .. . . . . . . . . . . L 0 1 . . . . . . . . . . . . . t10
CLASS OF WORK. NEA GARBAGE DISPOSAL;,. . I
I-YPU--- OF USE. . . GF WASHING MACH. . . . . . . 3 J. BACKFLOW PREVNITRS. . ;0'
OCCUPANCY GRP. ;',3 FLOOR DRAINS. . . . . . . :0 T R AP!:7 . . . . . . . . . ...0
0 I'll I U S. . . . . . . . 2 WOTFER FIFATERES. . . . . . ; I CATCH SASI NS
FIXTURES--....___ _____...___ LAUNDRY TRAYS. . . . . . : 1 '37F RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . .. I GPEASE TRAPS. . . . . . . :21
LAVATOPTES. . . . . 14 11THER FIXTURES. . . . . :0
TULA/SHOWERS. . . . .. SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :3 WnTER LINE (ft) . . . . t 00
DISHWASHERS. RA 1(4 r.)RA NJ (ft)
OWNER: ------------- --FEES-e — ------
i,ELLY TTMMINS I'TF 1,350. 00 JLH 06/11/91 .2
1462�5 1:4W 07TH AVE BPRT 1 465. 50 JLH 06/11/91 P-
SPLC i 315. 58 JLH 05/13/91 21 3280
TIGARD Lm ?7223 85pc 42'8 JLH 06/11/91 0.
Phone #- S cS D C o 375. 00 JLH 06/11/91 2
PARIA f 500. 00 JLH eG/11/91 P—,
P I I'A m 13 111 q C 0 r t v-act 0 r I MPRT $ 45. 00 JLH (cif-+/I 1 /91x'-
N.M. , ri MPLC $ 11. &IS it.-H 06/ 11/91 2
m5pc $ 2. 25 1ILH 1716/11/91 2
Addres 73v.) *T7 -'-f� PPRT s 155. 00 JLH W,/11. /'91 L
ri,rar t.
Cityl _State: Pc5PL $ 7. 75 JL.H . 06/ 1. 1/9 t 2
Z 1.P Ph u n e a
Per.)
.. ..... REQUIRED INSPECTIONS
This per,mi'- is isst-le(j S"t'je(-t to the
ulatiar's contained in the Tige.rd Municipal Foot/found Insp Pain d-ain Iri,�
I
Code, State of Di-e. Specialty Codes And all Post/Ceram Str%uvt Water Line Ihir
other app) icable laws. All Work Will be d0l"V PO'kt/DPam Mer-han Appr/Sldw'," Ttrq'p
in accordance with -:%ppriovPcJ plans. This Plm/undAlab Insp Me0ianic,--Al Final
rerffli.,t will expire if work is not started PLM/Undprfloor Plumb Final
fffhin 1(30 days of issuanre, or if work i-, Mechanical Insp
Building Final
su_.perided f(-.ir more than t80 days. Plumb Top Out Ert- vion Control
Framioq Insp
Fireplace Insp
Gas [- ;re Insp
(2) Insulation Insp
LLJ
Gyp D o a r d Insp
Puthoriz- 47 Plumbing CcfIlractor Siqnatcwe
Call for inspqction S39-4175
Contractor Nntrasa
m
CIIYOFTIFARDrcarAl
MAs,EI2 PERMIT
Ti�4RD ' ( 1:E2 MI'T #1:. . ,. . . . . : !rIS19a--�lk"191Z1COMMUNITY DEVELOPMENT DEPARTMENT owooe: /I
13126 SW Hrl BW_ P.O.Box 23347,Tkaid,Onpcm D72:o ,bQ3)83g-4176 DATE I S5i 1E D: 06/11/91
I TE AI'- . . 1 ,413-_ ` W . 1,1,;RD AVE -- — h: ARCEL: �C 1 1 1laf kl I.1Zii�
SUBDIVISION. . . . : DOUGLAS HEIGH-fS 7QNING: R-3. 5
BL OEK. . . . . . . . .
BUIL.DING -----------------------------------
REISSUE:
____________________.__--_.___.__.Ri: ISSUE: DWEL L I.NG UN I TS: 1 SAf =VIENT. . . . . . . . .0 s f
CLASS OF' WORK., :NEW SErDRMS:3 BATHS:3 PARADE. . . . . . . . . . :804 f
TYPE OF USE. . . :SF 1=1...00R nREf-ir_•__._____._ .._. REQUIRED
TYPE OF' CONST. :5N FIRST. . . . :2315 sf' LEFT— : 1 ft RIGHT. :26 ft
OCCUPANCY GRP. :R3 SECOND. . . :0 sf f E'ONT. :,.';? ft REAr�. . :.38 ft
bl UH 1 F-5. . . . . . . : THIRD. . . . :0 s f REQUIRED--------------------
HE
EQUIRED-...---__.__--______-_-
HE I GH'T••. . . . . . . . :C.J ft TOTAL- s f S1y1OV'E DETEC'1_0RS. :Y
F'L_OOR LOAD. . . . :4P, psf VALUE. . . . . . : X0962 PARK INO SPACES. . -0
Remarks :
PLLRP LAIN(.,
SINKS. . . . . . . . . . : 1. FLOOR DROINS. . . . :0 BArKFLOW ARE'VNTRS. . :0
LPVATORIES. . . . . :4 WATER HE:ATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
IUD/51-IOWEPS. . . . : :3 LAUNDRY TRAYS. . . : 1. CAl'C4a BF1SIllri. . . . . . . :V1
W" I F R CLOSETS. . SEWER LINE (ft ) . :0 GREASE TP.AP0. . . . . . . :0
DISHWASHER.r- . . . : 1 WATER LINE (S't ) . : 100 0TH1_-__R F I XTI.JRI_-
GARBAGE:: DISP. . . : 1 RAIN DRAIN (ft) . :0
W(':"=1•I I NGJ MACH. . . : 1 SF RP I N DRAINS.. ,. : J.
MECHANICAL __»__._.________ _.________-___.__.__w FEES
t=UEL TYPES--------_... UNI T HTR a. . :1d tyrae amount b date rec F
VENTS . . . . . :171 TIP $ 1350. 00 JLH 06/11/91 2
11()X I INIPUT, 421 '+ • to VE.N 1 F HN'i. . :4 I3PH 1 'b 485. ',50 J!_!-1 06,/ 11./91 2
FURN < 100K . . :0 HOODS. . . . . . : 1 BPL(, $ 313. 58 JLH 175/15/91 c^1'2,
FURN ) =11Z11LU: . . : 1 WOODS f 0 VES. :0 P5PC s 1='4. 28 .JLH 4216/ t 1/91 2
Fi_.f_1CJFt
FURN. . . . :171 CLO DRYERS. : 1 SSDC 1 375. 00 JLH 06/11/91 2
BOIL-/r.;Mr' ( 3HP-0 OTHER UNITS: 1 P )RK 00. 00 JL.H 106/11/91 ;.
GAS OUTLETS: 1 MPRT $ 45. 00 JLH 06/11/91 2
0K11pr: -.-.__..._..._....._ . _.__...._.__._._._..__.,_.___.._r_. .._ _..._ .. 111PLC s I I. r-'t, JLH 06/ 11/91 L�
KE-LL" T I MM I Na MSF'C $ 25 JLH 06/1 i/91 2
14625 SW 07TH AVE: [-PRT 1` 5. 0171 J1._.H Q-16/11/91
P5PC i 7. 75 JLH 06/11 /91
T I GARD C 9722-R3
F111one #:
Contr ar- tora
V RAPN ('CONST RUC T'I ON
&8.11 SW 71.ST FAL..
1-'t.:IF?1I_AND OR 97'_-213
1 hcTne #e 721-72: 1
Fiera #. . : 46703
�- -7 1. 61 7 0101-.
This aermi' is isived subiect to the regulations contained in the --- - -- REQUIRE D INSPECTlONS ---
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/fomnd Irntp Fireplace Insp
C3 applicable laps. Ail w-^1, will be done in accordance with approved Post/Beam Struct Oas Line Insp
- ola^s. This ee..,t will a%Aire ,f wprb is net started within lit Post/Ae Am Meehan Insulation Insu
rays if issuince, c- if pork is sus)c far more th- 168 days. Plm/i.rnd ,lata Insp Byp Board Insp
Z !spT
01 N/Underfloor Pain drain Ir1
t(a i.rl T I a t �.t�"� � � t 1��' ht g n i L`r1 l I n s t Water t e r L.:i n e f ri s p
r , � i �.1mb fop Uut Appr/Sdwl k Insp
1 k1ked gay : __... _....._._ rrnminp Tnhu Mec�ha1Ti.c-,, 1
Lal l f'or inspec-tion -- 639-•4175
SEWER CONNECTION
C(TYOF TIG��� C �% ' PIE 71M f
ITYOFYWAIM,
COMMUNrri DEVELOPMENT DEPARTMENT 01129m ERM 1-r #. . . SWR91-00"V)
13125SWHW18tvd. P.O.Bae;23397,T1gmd,Omqon 97 (503)M-A175
91% ADDRESS. . . 14315 SW 103RD AVE PARCEL:
SUBDIVISION. . . . : DOUiGLP43 HEIGHTS ZONING: R-3. 5
BLUCK. . . . . . . . . . LOT.. . . . . . . . . . . . . .. 10
'rENAN*r NAME:. . . . . :
USA NO. . . . . . . . . . . FIX'PIRE UNITS. . .
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF' USE. . . . . NO. OF BUILL"INGS l
i M.-il ALL 'P'V PE, BUSWR IMt-,ERV SURFACE— f
Hqmarlks :
Owner: ------------------ FEES
KRAHN CCjiNi3TRUCTIt3N type_ Amol.int by ciate rec-pt
6R11 SW 71ST PL. PRMT $ 1500. 00 JLH 06/11/91 2
TNSP $ 35. 00 JLH 06/11/91 2
POR'7LAND OR 97223
Phone #: 721--7231
Contractor:
f7ONTRACTOR NOT ON FILE
1575. 00 7`071-iL
Reg REQUIRED INSPECTIONS
This Applicant apreps to cooply with all the rules and regulations Sewer Inspection
of the i)p.ifitd Sewage Agency, The veriit expires 120 days f;-os
the date issued. The total aeoljnt paid will be forfeited if the
persit eyvires. Tre Agency does not guarantee the accuracy if the
side sewer laterals. If the sewer is not located at the leasurevent
given, the installer Fhall prospect 3 feet in all directions fro&
the distance given. If not so located, the installer shall purchase
a "Ten and Side Srwerft Periit and the P cy will irstall a lat ral.
r-lprmittee, al
Call for insvection 639-4175
INSPECTION NOTICE
City of Tigard Buildi"; Department
13125 Sii Ball Blvd. Tigrrd, Oregon 97223
Inspection Line (Rec-O-Phone? 639-4175 Business Phone: 639-4171
Inspection:
Foating P1Gg. d1lrsltb Hach. Rough-in Appr�Sdwlk
Found. Plbg. Top Out Car Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bld;.
Post/Beam mach. Rain Drain Insulation -Plumb.
Plbg. underfloor 4ater�7Line Gyp. Bd. -Hach.
Date Requested: G7� Z Timet _ AM --_PN
Addrees: y�/3 "0�rid Permit
Builder: L
�?�T `v 21r%,.� r2I —
THE POLL.)WING CORRECTIONS ARE RZQU.RELt c
L 1 r ✓ ( 1� L��cc�1 CVYL Ct A
-1
Inspsctorf( !L •�. 1c
-APPROVED DISAP oVED _ i "PRavcn BUBJSCT TO ABOVR
Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Departr_at
13125 = Hall Blvd. Tigard, Oregon 97223
Inspec�-ion Line (Rec-O-Phone): 639-4175 Bueineee Phones 639-4171
Inspection:
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FIN...:
Poet/Beam Struct. San. Sewer araming -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.j
�L
Plbg. Underfloor Water Line Cyp. Bd. -Mech.
Date requeeted:__11L
Address:__ �r Permit
Builder. �G"t � r r1/ 2,43
THE FOLLOWING CORRECTIONS ARE REQUIRED:
to
J
G7
11.1
J
rnapact or: Data:I
�( APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVR
��'\\\ _ Call Por Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13325 bW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
(Footing , Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas I1ne )PINALt
Poet/Beam Struct. San. Hewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Itiulation -Plumb.
iPlbg. Underfloor Water Line Gyp. Bd. -Mach.
Date ,gequestedt �/:! Tlme. WX
� W _ PM
j
Address: �D� r Permit #t % / '009t
Dulldert-_-_`_'
TBE FOLI.OWIMO CORRECTIONS AAM REQUIREDt
ImpactorsDate: - / -! /
v APPROVtO DIBAPPROVND APPROVED BUB"CT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Depa►:vent
13125 Sit Hall Clvd. Tigard, Orc 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections. - -
Footing Plbg. Underslab Mech. Rough-in Appr/Sdu,lk
Found. Plbg. Top Out Gas Line FINALS
Poet/Hnam Struct. San. Sewer Franj -Bldg.
Post/Beam Mech. Rain Drain C Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. B3. � -Mecv.
Date Re uesteds h`�. � Time: _AN _PM
Address:� j �� rf Permit
THE FOLLChRNG CORRECTIONS ARE REQUIRED'
Inopecto s ,__ _ Dates
APPROVED PIF`^^:tOVEO APPROVED btIBJECT TO ABOVE
Call For Reinsp.
INSPECTION h0TICE
City of Tigard Building Depa_:atent
13125 M Nall Blvd. Tigard, Oregon S 223
Ine:pection Line (Rec-O-•Phono)s 639-4175 Business Phone: 639-4171
Inspection: !.
Footing Pibg. Underalab �uhrugh- Appr/Sdwl.k
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beast Struct. Sari Sower Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date R, {ueated//s��_ , / Timor >+!i Plti
Address: �7 Permit o:.�L -
Builder:
THE FOLLOWING CORRECTIONS ARS RF,QUIRED:
CC>/b/AC
g
Cil
CD
IBJ
Inspectors
APPROVED ISAPPR D _` APPRrMHD SURJRCT TO ABJVF.
all For Reinsp.
/ SNSPECTION NOTICE
��� City of Ti.Tard Build/ng Departat
en
NNP 13125 SW Hall. Blvd. Tigard, Oregon 9722:3 C�
nepection Line (Rec-O-Phonel: 639-4175 Business Phone: 639-4171
Inspection: A ____-
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Foune. Plbg. Top Out Gas Line :INAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Boam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. > -Mech.
Date Requested:_ - _/Time: _AN PM
Addresa t / 7 ��� �L/ r� �. Permit f:
J,.
Builder a
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspecto Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
INSPECTION NOTICE
City of Tigard Buiiding Department
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phona): 639-4175 Businsss Phon 639-4171
Inspection:--
Footing Plbg. Underslab ��Nech. Rough-in Appr/odwlk
Po Plbg. Top Out /Gas Line FINAL:
Post/Beam Struct. San. Sewer / !rasing -Bldg.
st/Beam Rain Uraln Insulation -Pli:mb.
bg. UnderflWitr.t Line Gyp. Bd. -Hoch.
---
DatR Requested: Time: AMS y PH
Addrene: %!�' ���:� � r PC,rmit 1:
Builder-
THE FOLLOWING MRRECCIONS AAS REQUIRED:
t&8�7_
Inspect: nate:. C' /
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Cell For Reinsp.
INSPECTION NOTICE
City of 11gard Building Department
13125 Sp Hall Blvd. Tigard, Oregon 91223
InevA+ction Line (Rec-o-Phone): 639-4175 Biteinees Phone: 6�9-4171
Inspection:
Footing Plbg. Underslab Mach. Rourth-in ApprjSdwl;:
Found. Plbg. Top Out Gae Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Rech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Wdter Line Gyp. Bd. -Mach.
Date RequentedttTimes �AN PM
Addre®e: . 3��-� /Q�5 f d Permit i:eFl— 4 'a_
Builder• � .1, 2 7�/ _ �1 z"J--
THS FOLLOWING C^RRECTIONS ARE REQUIRED:
tr
J
m
LLJ
J
InspWtore ` L L Dater_ �(e
"PROM a"vrsAPPRO#ID _4 APPROVED SUBJECT To ABOVE
all For Reinep.
ire►
INSPECTION NOTICE
City of Tigard Building Department
13125 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Flag.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Watec Lina/ Gyp. Bd. -Mech.
Date Requested:_ - �( `Time: _ AM _PM
✓C� _ Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
LIZ
71
cr
H
C)
Il!
Inspector:_ �. Dat"..
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
/� ___Call For Poinap.
INSPECTION NOTICE ��2✓
City of Tigard Building Departiaant
13125 811 Ball Blvd. Tigard, Oregon 97223
Inrpection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection:
Pooting PILg. Underalab Mech. Rcugh-in Appr/Sdwlk
Found. Plbg. Top Ort Gas Line FINALS
Poot/Beam St-uct. an. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drai�� Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested%_ z7 - Time: AN (Z_PM
Address: �C/ _ Permit 1s
Builder: L1
THE F0IJOWING CORRECTIONS ARE REQUIRED:
i
v'7
G'?
Inspectorf
`APPROVED DISAPPROVEn APPROVED SUBJECT r0 ADM
-----tall For Reinap.
INSPECTION NOTICE C
City of Tigard Building Department /
13125 SN Hall lvd. Tigard, Oregon 97223
Inspection Lina (Rec-O-p n ) 39- 75 Business Phones 639-4171
Inspection: +-
Footing - Plbg. Underelab Mach. Rough-in Appr/Fdwlk
Found. Plbg. Top Out Gas Line FINAL.
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requeateds 22[Q c7'7% �� Time: _ AH I _PN
Addregs:_ .�,r Y� Permit #:`?/ �0Y/)
Builder: _G%� L�
TNZ FOLLOWING CORRECTIONS ARE RBQUIRl:D:
2
l/1
H
J _
C3
r.
LO
w
J
Inspectors Datn:
,—APPROVED DISAPPROVRD APPROVRD SUBJECT TO
Call For Reinsp.
ciTy Or TIGARD RECEIPT OF PAYMENT RECEIPT NO. s 91-c'14c_'04
HECK OMOUN'r, 4706. 61
NAME a KRAHN, RICHARD K. CASH AMOUNT 0. 00
ADDpess a DBnt KNAHN CONSTRUCTION PAYMENT DATE a 06/11/91
8811 SW 719T PLACE SUBDIVISION
TIGARD, OR 97c23-- 14335 SW 103RD AVE.
PURPOSE OF PAYMEN'r 0MOUNT PAID PURPOql=- OF PAYMENI' AMOUNT PAID
N6'TLDING PERM Nl-.3,T91-0090 485. 50 PLUMBING PERM 155. 00
MECHANICAL PE 45. 00 ST. BUILD PER 34. 2a
f-,I-PN CHECK FE 16. 83 SEWER USA SWI191-0099 150121. 00
E;EWkR INsrrCT 35. 17
,10 RE;SIDENT IAl. TRAFFIC FEES 1250. 00
MASS TRONSIT I IF FEE.3 100.00 PARKS SDC; 500. oli)
SI ORM DRAIN SDC 375. 00
TOTAL AMOUNT PAID 4706. 6)
CITY CIF=. 1 I GARr -- RECEIPT OF VIAYME..NT RECE I PT NO. :9 1—;!,1;3280-
C HECK AM(IONT s 1,012). 00
NAMKF R KAHN CONS T RI.IC 1'I CIN CASH nMOUNT 0. 00
ADDRESS a AH11 SW 719T FAL PAYMENT DATE:. s 05/15/9t
SUBDIVISION
1-I CARD, OR 97;-''2 3—
PURPOSE:, OF PAYMENT AMOUNT PA I D PURPOSE OF PAYMENT PMOUN11* PAID
N I PI-AN CHECK FE 5--29R IOLA. 00
J
G]
�1
.J
143335) 9IW 103RD AVE
TUIPL_ AMnI,.INT PAID — — - �> 1✓ @. 0�1
I
ti
uiu zs sw E�� Blvd. PLK;�/RECT #
CITY OF TIGARD PO BOK 23397 PERMIT a �1 ��1�/-OO y,
Tigard,(kegon 971L1 �
COMMUNITY DF—YELOPMENT DEPARTMENT (rd,Orcgon9503)639-4 t PATE ISSUED
1
TAX MAP/LOT
//elf '3/�U
JOB ADDRESS: IL I3 _z5 �� " -�. ����.
SUB: --'( .
LOT: LAND USE: —
VALUATION:
SPECIAL NOTES
OWNER
NAME: -/�G//L//�j ��f c __ REISSUE OF: —
ADDRESS: ,L`7`�2 S .Sw 7 LAST REISSUE:
FLOOD PLAIN/
PHONE: �3 '" �� �- / _ SENSITIVE LAND:
CONT APPROVAU RE-UEIREO
NAME:
f//�1WtAA-� PLANNING:
—
ADDRESS: / `,��) f-'L: ENGINEERING:
FIRE DEPT: — --
L/ 1 OTHER:
PHONE: /.,
CONTR. BOARD II:
EXP DATE:
ITEMS REQU I RED
SUBCONTRACTORS: PLUMB: ��'�� / t'�GI/L1 '�iy� - LIST/SUBCONTRACTORS: _
MECH: 91 �/U'/ f� 70teC BUS TAX:
RCN ENGI�NEER. CALCULATIONS:
NAME: _ )ems �,� --- TRUSS DETAILS:
ADDRCSS: �/�. / - � OTHER: _--
Pf{ONE:
PRif:'OSFD BLDG. USE:
" COt'iMLNTS: -- -- - ____---
PPIICANT SIGNATURF
Received fly: - `._- --_- Date Received:
PERMIT # ACCT h DESCRIPTION AMOUNT AMOUNT PD. BAL. D1JE
10-43?_ 00 Building Permit Fees
_ 10-431 00 Plumbing Permit Fees -
_ 10-431 01 Mechanical Permit Fees
10-230 01 State 301ding Tax (5%) fir,• 2.� - .ry'�f�
Building
Plumbing
MechanicalC/o
10-433 00 Plans Check fee �r
Building
Plumbing —
Mechanical _
A-230 06 Fire �-
3C-202 00 Sewer Connection —
?5/
30-444 00 Sewer Inspection
2.5-448-02. Commercial Y1 IF Fees - ---------
25-448-04 Industrial TIF Fees - - —
25-448-06 Institutional TIF Fees -- ----- -
25-448-03 Ot j*q(�e TIF Fees — —�
25-448-01 Residential Traffic Fees —
Ico GY1 �arr�
25-448-05 Mass Transit TIF Fees / — —
52-449 00 Parks System Oev Charge (PDC)
31-450 00 St:erm Drainage Syst Dev Chrg
t:
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
?_4-445-0?. Water Quantity (Fee in lieu of)
TOTALSa(c, /u� _ U /
r
nm/3YIIV.WPI
I
Building Permit No.
COUNTYWIDE
TRAFFIC IMPACT FEE Planning File No.
PAYMENT OPTION FORM
Tax Map&Lot No.
Date
Project Name
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I
request the following (Choose whichever option or options are applicable):
Cash or Check
(] Credit Voucher
Bancroft or Installment Payments
and/or
(� The Ordinance allows for deferral of payment of the TIF until issuarce of the occupancy permit if the
I—J TIF is greater than$.5,100.00. If the TIF meets this requirement, I also request this option. I under
stand the TIF must be paid prior to issuance of an occupancy permit. I also understand that the TIF
will be recalculated based on the prevailing rates at tifte of payment. Please be advised that TIF rates
may increase up to six percent cacti July 1s1t. This rate increase is not subject to appeal.
i
OWNER-APPLICANT OWNER/APPLICANT
f ,
CC: Huil&ig Permit File
Pa;ment Option Notebook 10ml 11t(V