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CITY OF TIGARD CERTIFICATE OF
OCCuF='AIyCY
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MS T94--0266
13125 SW Hai;Blvd.Tigard,Oregon 97223.8199 (503)639.4171 DATE ISSUED: fZ3/29/9"a"
PARCEL: �nI1413B•-16400
SITE ADDRESS. . . : 1E• 58 'SW 1'2'---RD AVE
SUBDIVISION. . . . : RIVERVIEW ES"FATES 7.ONING:R--7 F11)
`IUXK. . . . . . . . . . s LOT. . . . . . . . . . . . . 110
-ASS OF WORK. :NEW
YPU Or USE. . . t SF
)CC UPANCY GRP. :R3
ICCUPANCY LOAD:230 4
I::_NANT NAME. . . s
em:�rkt�: PATH 1
ITN SHADOW E:NTERDRISE 1140:
7245 SE" HANNEh:aN CT
l_ADSTONE OR 97027
'hune #I: 656--0096
MIN. :3HAUOW ENTERPRISES), INC
17245 SE HANNE'MAi`J CT.
t3LADSTGA OR ')7027
'hone #t 630-•0096
key #. . : 4,13428
Occupancy of the above ref?r. . ed building is herebv giver), and Certifies
rite rampliance with the State Of Or^egr.n Gpecialt,, Codes for the group,
occupanr.y, and use t.tnder which the referenced ,er-mit was issued.
BIJILDi Cl �F' CTCiR I:rUII.1) 0 FFICIAI..
POST IN C ONSP I CUOLJI� PLACE
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: ,6 4171
Inspection:— I
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line _Id
Plbg. Underiloor Rain Drain Framing -Plumb.
Alarm Water Line Insilation -Mech.
Undeiflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:._ z /� J l I _Time: AM PM
Address: Z&3 -2e�--
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
.NN
`�-
Un
Ln
InfArPROVED
tor: Date:DISAPPROVED APPROVED SUBJECT TO ABOVE
—Call For Reinsp.
CITY OF TIGARD BUILDIN.G INSPECTION NOTICE
I tion Line (Rec-O Phone): 639-4175 Business Phone: 4171
Inspection:_
Looting Susp. Ceiling Sprink. Hough-in wlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Dain Framing c�'lutnb>
Alarm Water Line Insulation _ ec t,S
Underflr Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �' �� f% Time: AM PM
Address:
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
0 m5c le- z-CV6
J
Inspector: Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
LAlff—For Reinsp.
s
INSPECTION NOTICE
City of Ticl4rd Building Departwont
13125 SA Hall Blvd. Tigard, Oregon 97223
Inspection tine (Rec-O-Phone): 639-4175 Busineas Phone:: 639-4171
Inspections
Footing Plbq. Qnderelab Hoch. Rough.-in Appr/Ldwlk
Found. Plhq. Top out Gas Line FINAL:
Po9t/0'am Struct. an. QlMerl Framing -Bldg.
Post/Beam Nech. Rain Drain ) Insulation -Plumb.
Plbg. underfloor,,�j►/ WaterLine Gyp. Bd. -Hoch. Y
Date RequesteJ R C/ Times AN '` PH
Addrnsi
Builders fA I1 L` ` ^
THE FOLLOWING CORRECTIONS ARE REQUIRED-
TT
�r� JadpQ04710,4 IAI.
2'
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Inspecto - Date:
_APPROVED DISAPPROVED APPROVED SUBJRCT TO ABOVE
_Call For Relnap.
IN:a' Ec"ION NOTICE
city of Tigard Uuilding Department
11125 SN Ball Blvd_ Tigard, Oregon 97223
InspepCion WAS ee�(R�^-0-Phone): 639-4175 B:ksineon Phone: 639-4171
Inspection: (/`//� �✓ _JG � / �_ _------
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line PINAI.:
F et-/Beam StSan. Sewer Fr+uoing -Bldg.
Post/Be Rain Drain Insulation -Plumb.
(Plbg. Undurfloor star Line Gyp. Bu. -Mech.
\\
Dare Requestedt �r Times AM PM
Addreea: Permit #I
Builder:
TNF voiLcmrNG cORR:cTION3 ARF. RFQUIRFD:
Ln
1-1
cc
W
W
J
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Inspector: ------- -- Date:
71PPROVED -__ DISAPPROVED APPROVED SUB.I1:r-T TO ABOVF
-Call For Retnep.
INSPECTION NOTICE �y
City of. Tigard Dvlldlnq Department (-1•-/
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Bu®inese Phone: 639-4171
Inspection:
Footing Plbg. Underslat, Hoch. Rough-in App,/Sdwlk
��ound. Plbg. Top Out Gas Line FINAL:
Poet/Beam St.ruct. San. Sewei Framing -81"g.
Poet/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hech.
Date Requested: 7 - 4 9 —TSmes
Address: 1 lD �. t y1^ ` Pf.vit i
Builder: C)ll. /\ �GLi.L f \Cl(XC�� l0"T�1- ► 31 J
THE FOLLOWING OORRSCTION9 An REQUIRED: '
Lj
Inspector: _ ^_ Date:,_ LZI
PPROVED DISAPPROVED APPROVED RUBJFCT TO ABOVE
_Call For Reinsp.
wwsw .
LN__SP4f_MIOtL NOTICE `
city or Tigard Building Department
13125 OW Ball Blvd. Tigard, Oregon 97223
inspection Line (Rec-O-Phone): 639-4175 Buai.nens Phone: 639-4171
Inspection: _
r( ee:. tiaq Plbg. Underslab Meech. Rough-in Appr/Sdwl.k
Found. Plbg. Top Out Gas Line FINAL-
Pont/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hach. Pain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Reque/a/t-ed: �- 7 ^ _ _Time: AH _PH
Address:r/ Cf7�� V Permit f:
Builder: _
THIS FOLLOWING COPRECTIONS ARE REQUIRED:
Inspect7"__7lPPROVED
Date:
DISAPPROVED —--`APPROVED SUBJECT TO AROVE
,Call For Reinap.
INSPECTION NOTICE
City of Tigard Bui!-ding Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rer,-O-Phone): 639-4175 Business Phone: 6 4y�
Inspection• ------- -- -- ---
noting Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Pound. Plbq. Top Out Gas Lina FINAL:
Poet/Beam Struct. San. Sewer Framing --Bldg.
Poet/Boam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lina QQ Gyp. Bd. -Meeh.
D&te Requeot/ed:l_- v �`� 1 -1 Tiim�ei _— l AM _-PH
Address:—L� 1 �� p � Permlt �1s��"1____�_�_�
Builder:—_ AS_G�1 4 1
THE FOLLOWING CORRECTIONS AAF-4UPQVTVMT--- --_`_
i
Inspector: Data:
`_—APPROVED DISAPPROVED APPROVED sulLyRrT TO ABOVE
__Call For Reinsp.
INSgEC1CION NOTICE
City of Tigard Building Department
13125 SA Hall Blvd. Tigard, Oregon 97223 -^'�-
Inspec.-tion Line (RAc--O-Phone): 639-4175 Business Phone: 639-4171
---
Footing Plbg. Underslsb Mech. Rough-in Aprr/Sdwlk
Found. PtVg- Top Out Gas Line FINAL:
L
Poit/Beam Struct. San. Sewn Framing --Bldg.
poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water LineGyp. 9d. -Mach.
-ate Requested: Le j IIZ/1 __Time- PN
Address:& ;2��:%`3 //0.1 Permlt
Builder: 6 - 7�U ) _ _ ---- —
THE FOLLOWING CORRECTI ARE REQUIRED:
D:
, i
Inspector: - Date:_��G�� "
AppROVED DISAPPROVED APPROVED SUBJECT TO AROW1
Call For Reinsp.
INSPECTION NOTICE
City of Tig+ird Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Buninese Phone: 9- 71
Inspection•
Footing Plbg. Underslab Mech. Rough-i.- Appr/Sdwlk
Found. Plbg. Top Out Gas Lin" FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfl.�or Water Line � � -Mech.
Date Requested: 6, 2 _ Time: _ AM / PM
Address: 1�` /C' .� /2 Permit 1: `0 _
Builder:
THE FOLLOWING CORRF.CTTONS ARE REQUIRED:
Gin/zpG c� � �• �r�_ -__ �.c-"2 /tet
Inspector: _ 14-
Datet
�
"PROVID DISAPPROVED '� APPROVCD SURJRCT TO A004N
____Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 ^N Hall Blvd. Tigard, Oregon 97223
Inspectinn Line (Rec-O-Phone)s 639-4175 Business Phone: 63 4171
Inspection:
Footing P11.g. Underslab Mech. Rough-in Appr/Sdwlk
FoLnd. Plbcj. Top Out Cas Line FINAL:
Poet/B�am Struct. :an. Sewer Framing -Pldg.
Post/Ream Mech. Rain Drain -Plumb.
Plbg. Underfloor Wr.ter/�Line c�Gyp. Bd. -Koch.
Data Requested: p lG-) /� / / Times (/AM ( PK
Address: ] !1 /�� %l P'Mit is
Builder!
TIFF FOLLOWING CORRECTIONS ARE REQUIRED:
fl:
F--
Cil
W
J
Inspectors Date: l
` APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
call For Rsinsp.
_INSPECTION NOTICE
City of Tigard Building DePartment
2-1125 SN Hail Blvd. Tigard, Oregon 972' 3
Ir+npection Line (Rec-O-Phone): 639-9175 Business Phone: 639-4171
Inspection: — ---
h-in Rou h
M-
Underslab c . ipr/Sd•wlk
Footing Plbg• g �
Found.
Plbg. Top Out Gas Linn FINAL:
Poet/Beam Struct. San• ewer
Framing -Bldg.
Poet/Beam Mech. Rain Drain
Insulation -Q'l�•
Plbq. Underfloor hater Linn GYP• ad.
-Mach.
1jn 7 Lme: AM PM
Dets Ftequeated:
Permit I:
THE FOLIAMING CORRECTIONS ARE REQUIRED: .7
LOY-� -af-e
---- nater S "��
Inspertor: �..._—
APPPOVP.D DISAPPROVED APPROVED SUBJECT To A
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Depart-Dont
13125 SW Ball Blvd. Tigard, Oregon 97273
Inspection Line (Rec-O-Phone)s 639-4175 Business Phon 6 71
Inepection•__� — '—
Footing Plbg, Underelab Hech. Rough-in Appr/Sdwlk
'ound. Plbg. 'cp Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -.Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Ba. 1 �-/Rech.
Date Requesteds_CC 10 -2 4NN/,` AM
Address:
1p Z J l.' Permit #1
—
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED-
Inspector- ' _ Dater
,"PRO IED DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Departuent
13125 BO Ball Bled. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 9-4171
Inspectior:
Foc,ting Plbg. Underslab / Hoch. Rough--� Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINAL:
Ir'
Past/Beam Struct. San. Sewer �Framin -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line / Gyp. Rd. -Hoch.
Date Requested: U r /(' Time: _AM _ PH
Address:�il� ,�S ze) • � Permit is
Builder: (S
THE FOLr.OWING CORRECTIONS ARE REQUIRED:
N -_�_--
J
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CD
Ill
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Inspectors --.--- Date:
*PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
,_—Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 63 - 1
Inspection:_ _
Footing Plbg. Underslab Rou -in ='Appr/Sdwlk
Pound. . Top Outer,- "j as Line FINAL:
Poet/Beam Struct. San. Sewer ✓ ��/� -Bldg.
Post/neam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line / Gyp. Rd. -Hoch.
Dntn Requested- f(J�LI[ �y Time: AM _PM
4 / c
Addrens:� l .y _ ( U Permit
nulLder:_ � l" _21/_ 62-2 -7
TIM FOLLOWING CORRECTIONS ARE REQUIRED?
/lr��•� y � r�,�'lcr�' �/�cTr� C'ri �
4A.10/CK C`b•r���/F-i F' - -- -
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Inspector: nate• �1/
VED DISAPPROVED APPROVED 9UB.IECT TO ABOVE
-Call For Reinap.
-CITY OF TIGARD PERMITNG PERMIT 4#. . . . . . ..
MST94--0266
DATE ISSUED: 07/2i/94
COPAMUNITY DEVELOPMENT DEPARTMENT
1312E SW Hall Blvd.Tigard,Oregon 97223.8199 (503)639-4171 PARCEL. 2S 1 14D13- 16400
'3I TE ADDRESS. . . : 16258 SW 103RD AVE
SUBDIVISION. . . . : RIVERVIE:W ESTATES ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOI.. . . . .. . . . . . . . . .. 10
CLASS OF WORK. . :NI:--W GARBAGE DISPOSALS. . : 1
1-YPE OF USE. . . . :SF WASHING MACH. . . . . . . : l BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. . -. R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :2 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIXTURES--------- LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0
FUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :3 WATER LINE (ft ) . . . . : 100
D 1 F_4HWASHE RS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Qpmarks : P'ATI1 I
OWNER: _____..-_----..-.------_._._..____.._.._.._._._.._. _..._._..__.-- ---------.-•--FEES-_._______._____.__
I117`11 SHADOW ENTERPRISE INC TIF $ 1520. 00 JG 07/2:1/94 -
1.7245 SE HANNEMAN CT BPRT $ 458. 00 JG 07/21/94 -
HPLC $ 2::97. 70 JG 07/21/94 -
GLODSTONE OR 9.7027 B5PC $ 22. 90 JG 07/21/94 -
Phone #: 656--0096 SSDC $ 280. 00 JG 07/21/94 -
PARK $ 500. 00 JG 07/21/94
Plumbing Contractor :- ---- - ---_---__ _ IhIPRT $ 45. 00 JG 07/21/94
MPLC $ 11. 2`5 JG 07/21/94 -
Name : 'C� L' 1�1 `(1C� 1y15F'C $ c . '5 JG 07/21/94 -
Address: �. --��� PPRT $ 155. 00 JG 07/21/94 -
City : CJ- S i —State : 0^� P5PC $ 7. 75 JG 07/21/911
Zara: S Phone#: ,��< 7_-7yZ� EROS $ 64. 00 JG 07/21/94 -
Rey #: Additional fees not shown here. . . . . . . . .
REQUIRED INSPECTIONS
fii :s permit is issued subject to the reg--
ulations contained 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. All work will be done Post /beam Mechan Appr/Sdwlk Insp
i.n accordance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of issuancp, or if work is Merhanical Insp BlAilding Final
a_ suspended for more than 180 days. Plumb Top Out Erosion Control
rr Framing Insp Crawl Drain
inn Fireplace Insp _
Gas Line Insp
~ / / Insulation Insp
x , L � �. �� , � _ -- Gyp Board Insp
Flu .h rized Plumbing Contr for Signature
LL Call for inspection _. 639-4175
J
Contractor Notes
-CITY OF TIGARDMASTER PERMIT
F'ERIn . IhST94 -0c'G6
COMMUNITY DEVELOPMENT DE
pRT,MNT DATE ISSUED: 07/21/94
13125 5W Hell Blvd.Tigard,Oregon 97223.8199 (503)639-4171
F'ARCF'I_: 2S 1 14BB-16400
_:)ITE: ADDN S'.:�. . . : 16258 SW 103RD AVE
SUBDIVISION. . . . : RIVE_RVIEW ESTATES ZONING: R-7 F'D
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 10
-- BUILDING
REISSUE:: DWEL_L.ING UNITS: 1 BASEMENT. . . . . . . . :0 s f
CLASS OF WURK. :NEW BEDRMS:4 BATHS.3 GARAGE. . . . . . . . . . ..500 sf
TYPE OF USE. . . -SF FLOOR ARF_•'AS-----____._..._.._. REQUIRED SE:TBACKS--------•--
TYPE OF CON13)T. :5N FIRST. . . . : 1110 S LEFT. . :22 ft RIGHT. : 12 ft
OCCUPANCY GI?F'. : R3 SECOND. . . : 1080 S FRONT'. :1=0 ft REAR. . :22 ft
5TLIRI ES. . . . . . . :2' THIRD. . . . :0 s f REUU I RED-•-
1 tE I GHT. . . . . . .. . :30 ft TOTAL----•--•-- :2190 < f SIdOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 ps f VALUE. . . . . 109740 F'ARK I NG SPACES. . : 1
Flemar-i<s : F'AT'F-1 I
__--_---____---_------.-------_------ PILUMHING
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW P'REVNTR5. . : 1
LAVATORIES. . . . :4 WATER HEATLRS. . . : 1 TRAP'S. . . . . . . . . . . . . . :0
T.UB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . 0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAP'S. . . . . . . :0
DISHWASHERS. . . . : 1 WATER LINE= (ft ) . : 100 OTHEFR FIXTURES. . . . . :0
GARBAUE: DIST'. . . : 1 RAIN DRAIN (ft ) . :0
WPSH I NG MACH. . . : 1 SF RAIN DRO I NS. . : 1
MECHANICAL -._____.._____._____.._-___.______..._.___..____ FEES
F=ULL UNIT FIT R5. . :0 type alno!tnt by date r,eupt
/bAS/ / / VENTS . . . . . :0 TIF $ 1520. 00 JG 07/21/94 -
MAX INPL1T:0 BTU VENT FANG. . :4 BPRT $ 458. 00 JG 07/21/914 -
F'-URN ( 100K . . :0 HOODS. . . . . . : 1 BPLC 297. 70 JG 07/21/94 -
F=URN ) -11BOK . . : I. WOOD('31'OVL_S. :0 BSPC $ 2 :. 90 JG 07/21/94
r=LOOR TURN. . . ., :0 CLO DRYERS. : 1 S SDP:, $ 280. t'10 JG 07/21/94
ROIL/CMF' ( 3HF':0 OTHER UNI.TS: 1 PARK E 500. 00 JG 07/21/94
GAS OUTLETS: 1 MPRT $ 45. 00 JG 07/21/94 -
L]wner; .___._.h1PL(I $ 11. 5 JG 07/21/94 -
MTN SHADOW EhITERF'RISE INC Ih15F'C $ 2. 25 JG 07/21/94
J7.'-'.'45 SE FIANNEMAN CT F'F'RT $ 155. 00 JG 07/21/94 -
17115F'C $ 7. 75 JG 07/21/94
GLADS'TONC OR 97027 EROS $ 64. 011, JG 07/21/94
Phone #: 656-0096 ERF'C $ 20. 80 JG 07/21 /94 -
Contractor: ---..._._..___.---------------------------- $ x:0. 80 JG 07/21/94 -
h1TN. SHADOW E NTERF'R I SES, INC
17;7-,45 SE HANNEMAN C1.
' L.ADS SONE: OR 97027
horre #: 65b•-•0196
Ileq #. . 45428 __-_--.__._____--._-_-._._.-__-_.---------._-_-_-__
$ 3405. 45 TOTAL
o� permit is issued subject to the regulations contained in the ------ - REQUIRED INSPECTIONS ------ -
,23rd Municipal Code, State of Ore. Speclelty Codes and all other Foot/fot-tnd Insp Fireplace Insp
LL) ipp:tcable lawti. All work will be done in accordance with appp ed Post/Beam Struct Gas Line Insp
plans. This permit will expire if work is not starte withi ;8 post/Beam Mechan Inst.tlatxon Insp
days of issuance, or if work issuspended f a 1 a PIm/t_tndslab Insp Gyp Board Insp
PL_M/Under,flour Rain drain Insp
F'er-mittee Signat!ts 1 _ ++r-chanicaI Insp Water Line Insp
ice" R11_tmb Top Ot.tt Appy^/(_=)dwlk Insp
s s t_t e d LAY : v �.--�.---..__.......___-._ ..._._._. Ft-am i n g I n s p Meehan i ca 1. F i n a l
Call for inspection - 639--4175
FSEWER CONNECTION
PERMIT
CITY OF TIGARD PERMIT #. . . . . . . . SWR94-02'53
COMMUNITY DEVELOPMENT DWARTINNT DATE ISSUED: 07/21/94
13125 SW Hall Blvd,Tigard,Oregon 9722398199 (503)639.4171
PARCEL: 25114BB--16400
SITE ADDRES,13. 162158 SW 103RD AVE
SUBDIVISION. . . . : RIVERVIEW ESTATES ZONING: R-7 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 10
TENANT NAME. . . . . :
USA NO. . . . . . . . . . : FIXTURE UNITS. . . :
CLASS OF WORK. . . :NEW DWELLING UNITS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :LAUSWR IMV.ERV SURFACE. . ; S f
Remarks : PATH I
Owner— FEES ----------------
MTN SHADOW ENTERPRISE INC type amount by date t-ecpt
17c-,43 SE HANNEMAN CT PRMT $ 2200. 00 JG 07/21 /94 —
INSP $ 35. 00 J G 07/`1.'94 —
GI...()DSTONE
GI...()DSTONE OR 97027
[:11-,(jne #: 656-0096
CONTRACTOR NOT ON FILE
liiune #: $ 2235. 00 TOTAL
I
REQUIRED INSPECTIONS
This Applicant anrees to comply with all the rules and regulations Sewer-, Inspection
the n ified S The permit j,t!rj,,.J1* days from
he ateissued.' paid wil e o eitedif the
permit expires, The Agency does not guarantee the accuracy of the
,,idp sewer laterals. If the sewer is not located at the measurement
the installer shall prospect ' feet ,n all directions from
t'�e distance given. If not so located, the installer hall
'a
P "Tap and Side Sewer" Permit and the'gency 11 e 1.
Permittee S i g nat 1.tr-q
Issued By:
a
rL, Ca 11 r inspection 639-4175
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LL!
I Gi-IND I21 (A, 1 PT GIF 1'11 Y Mi ld 1 121-I.1:.J 1' I TAl?. r.�;� i ,•►�y4,
I:I Il,1 1: t l"11 A I.4 I "',,'"1111, 45
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Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd. LoyJ` �)
Tigard, OR 97223
(503) 639-4171
Jobsite Address:
t �
1 , �> /�� /� Office Use Only
Subdivision: , �. ,rc� "� Lot #—-r- (
Valuation: _�Q ? ` -1V U, '~ Plandc'Rec #—
++hh
Permit #
Owner:
7--- Reissue of
Address: V-2LAZAVC11c �^
MapBTL # 5 '
Phone:
r (' Approvals Required
_ ��' J `�' ��`
Planning
Contractor: _ l,�(,1 C "� _ Engineering
Address: — Other
Phone:
Items Required
%,ontractor s License # r. �7 ( � Sub- p] VI
(attach copy of current Oregon license) Truss Det.iils
Contact name & phone: ," cZ
Other
Subcontractors:
Plumbing:
Mechanical J,
it 11
(attach copy of current OR Contractor's License)
Archltect/Englneer:
(�
J Address:
CD `
w _
Phone: A 7, i._
JOB DESCRIPTI C
Apoltant Signa t e & ho e'number
deceived by: Date Received:
Permit # Account Description Amount / Amt. Pd. Bal. Due
Bldg. Permit (BUILD) U
Plumb. Permit (PLUMB) S 7 > >^
Mech. Permit (MECH) _ 4 �� J
State Tax (TAX) ��,�✓ —
Bldg: ,2-7 . 90
Plumb: ? >� Y
Mech: �22>
Plan Check (PLANCK)
Bldg: 7
Plumb:
Mech: //• 3
Sewer Connection (SWUSA) All" 2 Z aO
Sewer Inspection (SWINSP) 3 S' 3 )'
Parks Dev Charge (PKSDC) Utz _ 15,11)
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R) i 0 "
Mass Transit TIF (TIF-MT) v '/ I
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS) _
Oft ice TIF (TIF-0) _
Water Duality (WQUAL; _
Water Quantity (WOUANT)
Fire District (FIRE) —
Erosion Cntrl Permit (ERPRMT)
Erosion Planck/USA (ERPtAN)
Erosion PlancMOT (EROSN) q ,
y
TOTALS: �5 ' U -i i Z S `i p• �'
l
CITY OF TIGARD
BUILDING DIVISION
RESIDENTIAL PLANS SUBMITTAL.
APPLICANT NAME:` C� f �, .� � f� PLA CHECK # _
ADDRESS: ELI `� ` /'t"rril2r'�1?, , i � <<�F6NE #
DATE RECEIVED: _ �\' _ RECEIVED BY:
CHECKLIST (All items must be in packet before plan will be reviewed)
YES NO t I/A
j [ J 3 FULL SETS OF BUILDING PLANS (No red line revisions
or tape-ons).
2. [� ]! [ ) [ ] S SITE PLANS (includingtax Iot and tax map number,e.-Isemen ts,
erosion control provisions, floor elevation of garage and main
floor, set backs, drive-way location, north arrow, scale, location
and termination of rain drains, corner elevations, and contours
if over 15% grade).
3. J [ 1 [ 1 BUILDING PIANS SHALL REFLECT TOPOGRAPHY OF LOT
(if house is designed for a flat lot and the lot is not flat, revised
drawings are required. No red lines accepted).
4. (. ] [ ] [ ] REVISION 1.0 PLANS MUST BE FOLLOWED THROUGH
FROM ROOF TO FOUNDATION (dotailed sections may be
different from the originals as a result of your changes. These
portions of the structure that are affected by the change need to
be reflected on the plans. No red lines will be accepted).
5, FLOOR PLAN(S)
6, (l,] ( ] [ ] FLOOR FRAMING
7, TRUSS JOISTS (engineering, details and layouts)
g, [ ] [ ] [ J ROOF FRAMING PLAN (all hips and valley supports indicated
rook and detailed).
/v '&-G' ` . ROOF TRUSSES (engineering, details and Iayouts)
A/ply 10. COMPLETE CROSS SECTION(S)
lvv _I 11. [ [ 1 ( ] ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR
ADDITIONS AND REMODELS
12. [ ] ( J [ ] BASEMENT WALL, FOUNDATION AND RETAINING WALL
SECTIONS (will need engineering if walls are 8 ft. high or
higher)
13. [ [ ] [ ] WALL BRACING (structure must meet table R402.10, revised
alternate method 93-7, or a lateral design shall be provided)
�l el 14. [vY [ ] [ J ALL DETAILS REQUIRED BY NO. 13 ABOVE SHALL BE
INCORPORATED INTO THE PLANS. (Attachments must be
clearly legible and fully referenced in the plans).
15. [l�J�[ ] [ ] BEAM CALCULATIONS (all beards over 10 ft. in length or any
beam that supports a point load).
' 16. [/� [ ] [ ] ENERGY CODE PATH IDENTIFIED G
tt-t
DO NOT MAKE CORRECTION IN RED
RED WILL ONLY CAUSE DELAYS
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