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10925 SW 108TH AVENUE pm 10925 SW .108TH COURT _ 1 'A^ 1 W Q S J T W U 3 N m O '-1 CITY OF" TIGARD BLDG. DEPT. 12420 S.W. MAIN STREET l TIGARD, OREGON 97223 PHONE 639.4171 CONTRACTOR: Pursuant to Section(s) of the Uniform Building Code, the following item(s) require correcting: r-- _— o — C G� Permit NO. Inspector CALL FOR REINSPECTION C.: ty of 11066 a 14�ectitIrf1lt"at vern11[ �r-�-7 Rel:ace �1 nelocat.on LJ :.cid�t,On � !.Aeration � � 2%Stott •�Z- New Ihs:aGa!ion TOfAL ?ACTOR C1%,NER oW A 15►.1'1 Ose-0. bt2t�. C^>:T. )� IVORY, ADDRESS W. " ' Ap7^nEc� 1- B t.,A-c - �S� A�TLICAr�7 '�, = PHC1Nc -- - Meat Input Rating 03TU Per Hour)—_— Vent Srze Flue Size _ FUEL. OIL ❑ GAS 53" ELECT Cl OTHER ITEM NO. FEE ITEM NO. FE 0D Air Condit on Corn_-ressor 15 to 30 HP . For Issuance o1 Peri-nit �� - .` New-Un3e' 100.000 FTU 4.00 Air Handling IU,000 CFM _ J_ 3•L i? New• t00.ODD BTU & over Air Handling Over 10,000 CFM 1 5•L 4.00 Evaporative Cooler _3 i Floor Fu,nace — �4.00 Range Vent Fan 2.( Floo: Suspended -� — 3.1 .� Install Vents Only 2.00 Vent System _ • _ Reps Neat &Cook^9 I 4.00 Hood Commercial 3 1 _epa , ----- 4.00 Con n�rcial Duct System 1 10.(10•L k _Air Condition Compressor Under 3 FSP Y j 50 — '-- fr • Condition Compressor : to 15 HP g INSPECTOR'S COMMENTS -- CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR Sl1B CONTRACTORS DATE ISSUED b'. TE APPROVED BY-__— RECEIPT NO.._._ 1. 774 Signature of Appl' ant I _ ~-7 JOHN [. P.EItIRhEDi Ft�i!?P.�NS, J"t BUILDING DEPARTMENT, TIGARD NO. f. PLUMBING PERMIT i holder of a valid plui ibing contractors license is hereby authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four (4) hours prior to the time the installations are ready for inspection. City Of Tigard Business License required for all contractors and sub-contractors. 1 ,4, Address /6 ,�- � j ZGP _ Date—�9_r -. NUMBER OF TO" _ PERMIT NO.'S TYPE OF PERMIT ITEMS FEE ON EACH AM JNT (Office Uw Only) Single Farnhy-1 bath-each 25.00 Du lex-Eich 1 bath uni, 25.00 _ Additional bathrooms--each 10.00 Mobile Hnme S i!Sa-eochM 15.00 _ INDIVIDUAL FIXTURE FEES _ 1 to 50 Fixtures in 1 bulldin -each _- 3.00 51 to 100 Fixtures in 1 building-each 2.50 101 to 200 Fixtures In 1 building-each 2.00 _ _— _201 or more Fixtures In 1 building-each 1.50 MISCELLANEOUS Building Sower-1st 50 ft. 10.00 Sewer-each additional 100 ft. 10.00 _w , Water Service to building 6.00 c _ Private Water SX1temf--each 100 ft. 10.00 Other (Specify): _ PERMII R :5 6 0 For Plumbing Inspection Phone 6394191 % stategoly Plumbing Contractor ;�y TOTAL _j,, 116 RECEIPT NO. Issued By �% t(, i I • •agrpy7•�t+^.ut•:: ,...-� ..: >�Y�MAfI,I"�W017r°el�il�nu�'"ar;^I"'+mFrMu+w,l,�"','P4r•'43Pu+,d rn,,yr5,�;..„pGM>fi1•,r;;,W.ifJ'+9��w7 >. �,:.��",.,...�.�;..r�.......... CITfoo BUILDING PERMIT APPLICATION ofrIGwRD Sxi•'aL43 THE UNDERSIGNED HEREBY APPI.IES FOR APERM1T FOR THE WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING; PLANS AND SPECIFICATIONS. OWNERPHON` LOT NO. OWNERRrrow."Ised Uyye JOB ADDRESS10925 JW 106th HOME ADDRESS _ ARCHITECT ENGINEER BUILDER LtIPIIQ ADDRESS 1 '785 5W 1.16th DESIGNER STRUCTURE ❑AIEW ❑IgFMfJDEL ❑ADDITION ❑-�REPAIR ❑RENEWAL �QFIRE DAMAGS ❑DEMOLITION [DMEESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GAR.AGE [--]STORAGE❑SLAB ❑FENCF BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS OCCUPANCY I :_LAND USE ZONE. " ' —BLDG. TYPE ��`I FIRE ZONE_ PLAN CHECK BY ” t' HEAT ��Aft I.onstruct single fe Ily cf>.aping W/ut�t�rh*U ur,l IF4. — lsmadx'uotr. — :; flstfleJ�. SEE rnRkECTION :;hLf'T ATTALHE .40 HEIGHT dam&IS1RI AREA ----_�L4�EQfl44MS_ VALUE BUILDING DF ARTMENT SET BACKS FRCNt 5 REAR 49 LEF T SIDE ��' RIGHT SIDE it Permit w,19 t,.0o THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check (37,50 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Subtotal 2192. Dfj ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS State fax .i T,{)(a LICENSIE• SEPARAJ,� lf6REOUIREL, FOR SEWER, PLUMBING AND HEATING. Total 01120.30 P!I' 1 ti,10 I,00 By P1 2 3 APPLICANT OR ACIF 'JT Approved ���� Receipt No - ,. ... ,.-.wr¢•rww..,r+.r.+... .. . u,. .. ......aYlr.. .,..se.�rr.,.r.w,+. _......r.r:w..�..+wn..... LIl1NF -___....�_____.. DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE __ L _ -- - --- Contra,for - --- / Permit''o. r- Rough-in Fixture Final HEATING Contractor �D Permit No. �t�() �qZ -�'�� • S r ti Gas or Oil Rough-in - Final .�__.._ ----- --- SEWER --- Final DRIVEWAY Final Stotvn Drainage (Rain Drain)Flnal Sideval k Curb&Street Final Approach BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OC�C--IPANCY Final CERTIHCATE OCCUPANCY !? 1 �A ,-'J - d Landscaping Zoning Final I BUILDING PF.:RMIT APPLICATION of TICITY ,ARD DATE ____ _ 6��C�y)-�Q��/� THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HER FIN INDICATED BUII_D6R pHONE,L1.L,y:.SLL.�� OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PL S AND SPECIF ICAT IONS. OW ---- NCR PHONE LOT NO Arrowhead Dev. 10925 SW to rAve. �,o�,EAUDREss Black Bu11 Park `_R r JOA pDUR658 -'- ARHITEG ENGINEER Same 15785 SW 116th Ave es,��45. John Adams C,UpE�— NEW C�REM_O�E� _C�AOUITIbN CDpEfAIR LjRENEWAL_ COFIRECAMA04_ []DEMOUTIOr `� �IpENCE COMM EDI GATION.AI C�GOV'T 0p!1 ICIpUS L.JHHPATIO CAR PbRT��C ARAOE D Sry_�TORGE LJSIA �FENCE nn APPROVED SIGNS I�aONp��yI,,,JMOVING _ OCONDITIONAI USE C]bEtICNF1fV1EW MrOtJNCI, �S 'CUPANCY. FR ELAND USE ZONE _.BI DG TYPE — FIRE -ONE_l PLAN CHECK - Hem- - -�.� ------�-----� ---- 06 c�S�G..1.SZ9Q,_____..F.LS?.p.f� _..Z++<._.__._!CLQ.3l�.�'•I�..,''t.--.2.--A�1E�8�..I�.N9.�b�.C?8IIDm6..,.�....YALU�s3,-'S"SO- __ BUILDING DEPARTMENT E _ _9+ � E _RIGHT SIDI ET BACKS FRONT 25 REAR 4 LEFT SIDE 1 •0 �_�----ter_—� Permit` THIS PERMIT IS ISSUED SUBJECT To THE REGULATIONS CONTAINED IN THE BUILDINO CODE, ZONIN( Plan Check RFGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREf:D THAT TH, WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONR AND IN COMPLIANCE WITI Sub-total �,q ,Z L ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THI/ PERMIT DOES NOT WAIVI RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES State 78x �O LICENSE, SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total3 y BY D� ^ Avoi 1CAN1 0Q AGENT App�ovod Receipt No _-- �__ A1�D-p€-Sy- ARROWHEAD DEV CQ, INC, —15785 S. W. 116th TIGARD, OREGON 972.23 S'DG PH. 639-0243 P D C Sawa*. Goo SEWER PERMIT N! 13911 Uf nfied Sewerage Agency of Washington County CITY OF Tigard DATE --- '- i OWNER: Allen W. DreW PHONE : OWNER'S ADDRESS: TYPE OF INSTALLATION: XXXAWILDING SEWER []BUILDING SEWER AND SIDE SEWER TYPE OF OCCUPANCY: 9NE':: XEX SINGLE FAMILY ❑ COMMERCIAL ❑EXIST . (PRIOR TO 7-1-70 ) ❑ MULT. RES. [] INDUSTRIAL FIXTURE UNITS DWELLING UNITS 1 PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND REGULATIONS OF THE UNITFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT' PAID WILL BE FORFEITED SHOULD EXPIRATION OCCUR. FEES: PERMIT FEE $_ 25. CONNECTION CHARGE 600. SIDE SEWER INSTALLATION ISSUED BY 2 /I OTHER TOTAL 625. APPLICANT D TE NOTICE: LaO—DAYS OF ABOVE GATE. SEWER SERVICE ��TT CHARGE WILL BEGIN FOR THIS SEWER PERMIT V? PERMIT. ADDRESS OF STRUCTURE 10975 SLI 108th Ave. r TAX MAP _ TAX LOT 5 YSTLM fr�nnu L01 11 BLOCK OF ku) 42-!L , " 0 -al-D APPROVED BY ATE ISSUED BY DATE REMARKS bldg-J1891 i� I CITY OF TIGARD ORDINANCE #77-71 PARK SYSTEM L'EVELOPMENT CHARGE DATE : .2//S //a"/ ESTIMATED SALES PRICE APPLICANT NAME f �h TELEPHONE # C�N .(�� JOB ADDRESS C' BLDG. PERMIT AMOUNT OF FEE FOR P. D. C. DESCRIPTION OF IMPROVEMENT_ EXEMPTIONS - PER ORDINANCE #77-71 FEE RATES: A. Single family dwelling unit under $40,000.-------------$ 75.00 B. Single family dwelling unit over $40,000.-------------�_.__� C. Mobile Home Court Space New Development) ------$ 50. 00 D. Multi-Family dwellings--per unit-----------------------$ 50. 00 CONSTRUCTION IS LOCATED ON 5.E. ��7—N.W. SIDE OF S.W. PACIFIC HIGHWAY . N.W . is Park District #I. S.E . is Park District #II . CITY OF TIGARD ORDINANCE #77-26 STREET JYSTEM DEVELOPMENT CHARGE DATE: ESTIMATED SALES PRICE �' S 70 APPLICANT NAME c' Com__,.. �� s C^4. TELEPHONE JOB ADDRESS : .z BLDG. PERMIT �� / AMOUNT OF FEE FOR S. 0. C. DESCRIPTION OF IMPROVEMENT- EXEMPTIONS -PER ORDTF,"IJCE 7/-77-26 FEE RATES: A. Single family dwellinc unit under $60,000.--------- 5300.00 B. Sirgly futmi.ly dwellinj i!nit over '560,000.--------- $400.00 C. Mobile Homu Court Space (New Development)---------- $150.00 D. Multi-Family Cwellings--per unit------------------- $240.00 E. Commercial, Industrial & Institutional(Park. Space) $ 50.00 each F. Single family unit under x;40,000. ----------------- $250.00 C _jJ11_DiNG PERMIT APPLICATION c0F T1GA,,RD DATE � -�____. ,92�'. Na + 1tgD[ HSiGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUIL-DERPHONrreWS1'4' 'y - ` I AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWrNLV.-H I LOT NO 1 �� ARCHITECT JOB ADDRESS S��e�• HOME ADDRESS Wo. A / i�� ENGINEER ADDRESS 1QQr1 _ —DESIGNER ,,RE �'�EW OREMODEL_ OADDITION -OHEPAIR —_CIRENEWAL ❑FIRE DAMAGE ODEMOLITION X rNCE [.jCC,MM OEDUCATION_AL _0G_0_V'T ORELIGIOUSOPATIO OCARPORT OGARAGE ❑STORAGE❑SLAB [:]FENCE 71POND 0MOV_ING _ OCONDITIONAL USE YO ESIGN REVIEW -OCOUNCIL APPROVED OSIGNS IANQUSE 20NE.'�_—•--.B—L—DG TYP _FIRE ZONE _PLAN CHECK BY_._- HEAT4C1—eC- _ (z- L H_E1_GH7� ..___.NQ.JTDBIES._ _._�RF�/ N_S?.@�12NS29MS VALU g�'?0 :c- ;JAU-_- — FIQQFlJ.4H�_k� - -BUILDING DEPARTMENT SET HACKS -FRONT v-igEAR �� _ LEFT SIDE RIGHT SIDEt-ImIt Lt 0-0 -- — TH!S PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check __ -'/� ,,-,� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE �-r--Y WORK WILL FE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND INCOMPLIANCE WITH S Ib total All APPLICABLE CODES AND ORDINANCES. THE I,SUANCE OF THIS PERMIT DOES NOT WAIVE ��--L- REJIHICTIVF COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS ate Tax rr�� LICENSE SEPARATE PE RMITS REQUIRED FOR SEWER, PLUMBING A� HEATING. T M a I Fly _ i Pl i N -0-4 G N iapproved Receipt No. I'PHON Z. �^ 1� � DU--.tet 1 If IL