16233 SW 104TH AVENUE .� 16233 SW 104TH AVENUE
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INSPECTION NOTICE
City of Tigard Building Department
P O Box 23497
Tiga, �, Oregon 97223
Ill 639-4175
Type of 'nspection
�/' - ---
Date Requested �� Time ^ A.M.
Address -1 `-� _ �W �'0 y T Permit
Owner - - LotBefilder
_
The following Building Code deficiencies are required to tie corrected:
--- -- ---- - -Z-_7__�
Presented to -- _- _ _ j Opproved
Inspector
--- - - � ] Disapproved
Date
CALL FOR REINSPECTION
❑ YES 11 NO
W WEiI1QX
NO 5ECIL-10269
CITY OF T167A RD
Crri(OFnMW
COMMUNITY DEVELOPMENT DEPARTMENT MINING"
13125 S W.Hall Blvd.,P.O Box 23397.Tigard.Oregon�'273,(503)r39-4175 PAXM . Pm r- N(3 , OC40 169
JOH ADUPI: SW 1.0X4'1 H, AVE USA NLIMJIl'.:i., -1/19,W
1 Ax MAI 1 J I u.I 'I "KH3 MOO FILID !WAW-411`4 (A-04 I. T' . 13 F)K :
I AND
I OT SX,ZE -
SECTION: 1.144 TWIP : 2,-, PNG,' : iliall
WOPK (.A.655 - NIFU
IA5I*'-' 'T*I'PE: GXNGLE FAMILY
111c1 i.l.) ioll, rkilcaia rj+, tile, t.JrItf:hn(:I
5cpWo'l-Rup. Per-mtt expir-es U20 clayis fll'am thr, datte tilaffil.led . 1110 tatw*l
oll"t.111111. piltic! wIll hoo J -11 1,110 pal-in:11, TING Aqrr.-ellc�y di.mill Illit q4,1141—
allteel the ri-F 0-16, 1 ac�a.ttrill a-F the! qlj.clftt !Sewe:r later-M.1m If t'htc lim".W(al- :1.16
lial, :III, 0:iverl ' -itlijit'11111,W1, 1111-1to'1 :1. pl'clli'pebc-*- '3 Tforj�t :1.11
lall dtr-(--icnt:l.orim fi-aril the citstance give.n . 1A.' nut ma :I.ac--aLtwcI , the- 90-vall.
�1t+1 11m III '' Top liIII(JI Prhrl"J. t olicl thr') f^lgiiarl(^y Will :1.I'l in t in:1.'1. M :1.at I.F'l Ir,III I
IN5*1'AI.A.. TYPE: BI-11 I DING SEWIER IMPErMOLIS AAKA:
F"'IX ILIPri. 1INTIS - .1
DWELLING UNI FS : 1,
NO P.M.Dit.11-1 'I.
W 0 1:31..1-.()K M(314136N PF:rlml. I 41.4'ni oU(?
N p41 Box 6835 CONNr-.':G—r10N CHARGE 1N 1. 1.00 . 00
E 1130M rar trill 1.111 177007
PHONF.:' (503) 66)4-6606
ci
0 IAL.1---,AK MORGAN
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T 1 11: 1 o,t4 1, 14opr;sri Iri:s :rt-n:
R pa crux 6835
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T PHONK ('503) 68.1-6606
0 141!:.
R Nt'l 3035VI AI, 41 13.5 o o
V*XX!JP1* NO
This permit Is Issued subject to the regulations contained In Title 14
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby 1AKFAUT PED INSPEC.T' LONS
agreed that the work will be done In accordance with the plans Arid
specifications and In compliance with all applicable codes and
ordinances. The issuance 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 it work Is not started within 180 days,rjr If work Is suspended or
nbpnrj.jned for a period of 18n days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
00
Per Ittee Signature
Issued By
SEPARATE PEIRMITS REWIRED FOR WORK OTHER THAN DESCRIBED ABOVE
�
CITY
RD Mr:c:1iAN:Lc:(I I I1�'f�tM.f T
OF TIVA PEFIMI'T' NO, : MEGeO171
CITY OF TIGARD
ovFooN
COMMUNITY DEVELOPMENT DEPARTMENT 1)(111. ISSUED 2/19/89
13121,S W Hall Blvd.,P.O.Box 23397 Tigard.Oregon 97223,(503)639-4175
r.'141 H • PMT.NO. 060 169
J013 A1:)UFiM-IS : 1 6i? 11W1041TH AVE:
11(%x MAP/1-(:)t' R511 1..1130 7/100 Sit JU: SWA SON G1.,.F:N I 1 13 ["V :
I...AND USE-* :
CVT %'L'ZE:
:1:T'E.M: NO: Nt.�
W(:)r)If :.:I_AcjS NEW FLIP14 ACE 0.00K 1. AIR HANULD (1.0
USE:. TYPE: • SINGLE FAMILY FURNA(:E.: 100K+ AIR HANDL..111! 10K
CON5')T TYPE::! VN r"I...00P 1:41PNAC:E: K.VAN .C:OCJI...EP
OCCUP Gr4p . : AZA HE'ATE'R VENT FAN 1
VENT VI:N'T . SYSTEM
BLP/COMP, <;:HR HOOD 1.
NO S I LM I:E':»!S : e fill.P/(:UMTS I 1.15W I NC:I:NF::r2A'1100(DOM
DWE:I.L . UNI T•r : I BL..R/COMP 19-•,:;'IHP INCINE I' ATOP(COM
Tl:h:i 1•YPE0. (::AS UL..r2/(;OMP :30-..50HI" PEPA'I'N I.JN:1: IS
MAX. INPUT SLA/(:OMT=r 0+1•IP OYHER
I"'11�1 t:)Ml�r)5�'� COS P'rr"ING C)UTI.ET'S I
141C1•4 PPESS,7
I t'Era
O
w HL.LAK MORGAN PEW[T 01010 . 00
N PC) BOX 68,159 r"l.AN PFr.V 71":W $Cd . 6:5
R beavertan of- 97007 6rm5 i I;. IXT'UREa 11124 190
R
PHONE (90:5) 684 -6606 — I S 111'1 1 lox fl 1 7.3
l:)TI-ILP,
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C I':trT C Cyt t'1 E)T 11..
N rYr T'E:M- ).1111:" i
A
C it i.yla.rd lar 97223
O 14-IONF (303) 626 51'7130
R RE:CIr'T'RATION NO :38062 'TOTAL : 11144.85
This permit is issued subject to the regulations contained in Title 14 _,•___•_,_, ,••_,___ _ __..____.._
or the TMC. State of Oregon Specialty Codes,:-oning regulations C
and all other applicable codes and ordinances. and It is hereby I�CWlt111F.L1 1N5rryF..C:I 'I'I1r45;
agreed that the work will be done in accordance with the plans and CAS L INE:
specifications and in compliance with all applicable codes and r!05 ( & DE AM
ordinances The issuance of this permit does not waive restrictive R01AA-I--IN
covenants Contractor and subcontractors shall have current city T.• I.NAI
business tax permits This permit will expire and become null and
void if work is not started within 180 days,or it work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
rl1 required irspec�tions are requested and approved y�
gnature
-Issued By rt Irl Z5'39�T7r --
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
IY
Btj j I DING PE7nM:1:'1*
CITY OF TIGA RDM► PE'PMI'Y' NO SU860169Cllri&Tle-ARDY
COMMUN17Y DEVELOPMENT DEPARTMENT ORMON
13,25 S.W.Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223,(503)639-4175
1'-,14 1:M PM1 NO 1
JOB ADDRESS : 16s'-133 SW 104TH AVE 15 l;fK
iAX MAP/LOT PSI 110E) '11100 SLJV.:; � SWAN�iUN GLEN
I AND USE: R1�2
I I I'I S,7 r. E. V Al..UATI ON 1111 5711227 SF TAM(:,KS
FRONT : 2 0 R-K A Ff
WORK CLASS : NEW DWELL .UNITS : I LEFT : Vii PIGII I' : i:.'.6
tlF*,I:: 1Y NO . DEDPOOMSS : .5 Ex I WAl I CONF)'11
CONST' ,I-YPE : VN NO. BATHS : .3 N: 5 : W .
OCIGUI'l G PP II PPOI OP11:14INC1
11-OAD 40 N W :
VOTAI. API
NO . GTOPTE45 : ii1 1ST: 6!5 i-2 POOF CrINSY : c, i::':rwI rw.'r?
I 4E 1:GAI-11 R N D APLO PATE.KD :
BASEMEN'T7 3PD: 117)(N."Up. SEPAL'? PATED :
ME'.7ZAf-l:Nl�-? 8 MiElfl' 'T
FL OOP 11-OAD 40 GAPAGE. AOO FXPU caPPKLA7 ALAII
1'.Ow IGIPM) 1)U..I I L"1 17 Y15
1-1111 A r I'Yr.,E GAS 11-10I ACQE:5!�i'?
V.-IL AN C.1-let"K Uly : i,:l t
Ar.-':MAPKS :
I NO f.6"1"1
LAST RIISSUE' 1130011,65
PERMIT 1111307 . 00
0 MOFIGAN
N Tlcl IW68-151!s r1l. AN PEVIA.iV 41/10 00
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R k)0 all,V cp I-t a' III at" 97001 6(33!'.') F1 PE. OEP'r
(50,311 684 -6606 SVT Al F I AX 35
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0 81-FAK MORGAN 410!13 0 0
IN
T ITIAN INT.: DU !:;'IME I I 111 00
R PU BOX 611133.5 $230 . 00
A P REP Al 1) < 41 410 Uoi
C
Or)NONE (50.1) 6RA--6606
11110 . 30.510 TUTAII. II11. 1 mp!p
PECEIPT NO .
This permit is issued subject to the regulations contained In Title 14 .-.— q I,---
of the TMC, State of Oregon Specialty Codes,zoning regulations PEQUIRED ".1114SPIECIA13N4.5
and all other applicable codes and ordinances. and It is hereby
agreed that the work will be done in accorcance with the plans and rou'riNc.
specifications and in compliance with all applicable codes and FOUNDAYTON WALL 11AIN URATN'5
ordinances The issuance of this permit does not waive restrictive P()5'r 9 Ur:.Atl 1AJA'Tl'-:n L INK
enverionts Contractor and subcontractors shall have current city P1. 8 UNMi-Atill.-AS (I I T'Y 14P P F('11-1 W
business tax permits. This permit will expire and become null and L AF)
11 1:NAI.
void If work is not started withir 180 days,or If work is suspended or
abandoned for a period of 180 days any time after work has FILS 1'CIP01I
commenced It shall be the responsibility of the permittee to assure F-171AM NG
all required inspections are requested and approved 1;1 FIC'M AM
G,A S I II
I 141!50L-A r I ON
GYP tj 0 A 14 U
Plr
Issuorl By
SEPARATE PERMITS REQUIREC FOR WORK OTHER THAN DESCRIBED ABOVE
ffx�1111[lqlw
CITY®F TIGA RD PLUMBING PEIPIMI'T
I'-"EPMX'r NO : PL.880170
CITYO IFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT 01111FOON DDI E ISSUED . P/1.9/8(:t
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,'-^irgon 97223,(503)6394175 I::,PTM VM'T .NO 660 169
dO8 AD1:)AU55 : 11.6233 SW 3.04TH AVE
'r AX P.S1 1.4100 T-100 Sllr-J' SWANSON OLEN L'r: 13 9K
LAND USE:
SIZE .
I'l"Em NO: NO
W0PK CL.0!oF, : Ni:'.W WAI*EP CI.USF; 1 11'11A P
USE 1*YPE: C-i'INGol-l": FAMILY URINAL BKF LOW P14VN,rr4
C('.)N4*)'(* I YPE: VN L AVOPA'T'"My 15 YNA", C-'111MVP
OCCU11-1 , 1011111:1. SHOWER 12 GREASE 'MAPS
D3:LRl4WASl-lF.'Ir4 T
GAA8Ar,l'-: 0151."'OSAI 1.
NO SIOP11-:5 : WASHM3, MACI-ITNE i
DWELL.. .UNI rS : 1. LAUNEMY 'T'RAY Hl Ei,;. DRAIN 101A
ir*100P
SINK i, 5EWER (F' T')
W(11l1r::111 svinwi/nAIN (Cl
OTHEP
0 Mt*)r4(;Atq r It 1.312 50
W
N BOX 6OZ9,15
E
R cil. 9,7007 1 X,11.117F::5
PHONE 11503) 604-6606 1'A'111-.: 'rAx n1!,
LYI I.JF:.P
C
0 KEN HANr.)(....'I:N
N
T 'I N Pl..l 11,11D)NG
A R IPOPOSW 0*11+1
r" 9,700"',
T PHONE (503) 641-5200
O
R No ic;iotip T01 Al. . IM 139 1.3
T l'is permit is Issued subject to the regulations contained In Title 14 PECE1 P'T' NO
of the TMC. State of Oregon Specialty Codes,zoning regulations
ono all other applicable codes and ordinances, and it is hereby 6dEQ1.111111M, EN51 M'1'IONLj
agreed that the work will be done in accordance with the plans and UIL F.' LINDE1.4F.M.AD
specifications and In compliance with all applicsbe codes and POS I' & 14FAM
ordinances The issuance of this permit does not waive restrictive WA'11--':1*1 1. 't NFI
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will exaIrp anti beccme null and
void If work is not started within 180 days.or if work In suspended or
abandoned for a•period of 180 days any time offer Work has F'I NAL
commenced It shall be the responsibility of the permillee to assure
all required inspections are requested and approved
no V11�'
Issued By ? I
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESChISED ABOVE
L� �
PLAN CHECK AYPLI^ATION
PLAN CHECK #�
PERMIT # _
V DATE ISSUED
JOB, ADDRESS: l(i �� _ �_/ /Oy _ TA): MAP/LOT
SUB: _SG✓�'N5�'IV " /_ .z /, LOT: LAND [ISE: TlZ,-
VALUATION: ' z 7 SETBACES: FRONT: REAR: �`G' LEFT:
_-s RIGHT: _
WORK CLASS: AlcJ HEIGHT: - TOTAL AREA:
USE TYPE: -1�5 _ FLOOR LOAD: .e 1ST:
CONSTR TYPE: 6, Al HEAT TYPE: ! 2ND: SES G
OCCUP GROUP: DWELL/UNITS: 3RD:
OCCUP LOAD: NO BEDROOMS:_ 7 BASEMENT:
NO STORIES: NO BATHS: _ GARAGE: p U
IMP SURFACE:
APPROVALS REQ'D SPECIAL NOTES ITEMS REQUIRED
PLANNING: REISSUE OF: LIST SUBCONTRACTORS:
ENGINEERING: LAST RFISSUE:—_ --
BUS TAX:
FIRE DEPT. : FLOOD PLAIN/ CALCULATIONS: _
OTHER: SEN LND.: TRUSS DETAILS:
PARKING PLAN: —
LANDSCAPE PLAN: _
FLAN CHECK BY: �� � OTHER,. --
COMMENTS:
ACCT DESCRIPTION ,MOUNT
OWNER 10-432 Building Permit Fees
NAME: — 10-431-600 Plumbing Permit Fees / a
ADDRESS:_ 10-431-601 Mechanical Permit Fees s -3 y _Su
— -` 10-230-501 State Building Tax (5%) " '
_ 10-433 Plans Ci.eck Fec a s L ; i/91 & 3
PHONE: 30-443 Sewer Connection (20X)
30-202 Sewer Connection (80x)
CONTRACTOR 30-444 Sewer Inspection t
NAME:_ 51-448 Street System Dev. Charge (SDC) $ dy,p�v
ADDRESS: _ 52-449-61.0 Parks I SyAtem Dev. Charge (PDC) ---
__ 52-449-627 Parks II Svstem Dev. Charge (PDC)
31-450 Storm Drainage Syst Dev Chrg(SSDC)
PHONE: 10-230-50 TRFD (95%)
10-435 TRFD (5X) t -
ARCH/ENGINEER 10-230-506 Washington County Fire #1 (95X)
NAME: _ _- ..1-435 Washington County Fire #1 (5x)
ADDRESS - 10-220 .cart/Wedgewood S
---- TOTAL
PHONE:
PREPAID $ �`
BALANCE DUE
a
APPLICANT SIGNATURE
Re( jived By: Date Received: � '