15525 SW 109TH AVENUE ' r
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15525 SW 109th Ave.
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INSPECTION NOTICE ero,
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested— __��� _ Time ._ _ A.M..— _P.M.
Addrevi _._��r7 Z� t.`('' ' fy _ Permit # 1L
Ltj—
Owner
Lot #_
Builder --X^Y V�.�n:�0 L.,E3"Yl,��
The following Building Code deficiencies ere required to be corrected:
:1>4c� rCl (U'r- S' -122Y -
----- ----- —
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Presented to _ -_-- --- — Approved
Inspector -'
-__.----- -- -� Disapproved
Date
ti ,(
CALL FOR REINSPECTION
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BUILDINC.; 1--lEAKE T
C'TY OF T 167A RD PE"WI: T NO. : 81A.1 )0089
CITYOFTWAM
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COMMUNITY DEVELOPMENT DEPARTMENT !)(.)*Y 1: 1SSUE'l): 'I. :25/89
13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard,Oregon 97223,(503)6394175 PAIM F,M1' , NO 1:4190089
..)(:)R ADDPESS - 11,'532.5 SW 3.09 VIA AVE..'
f6 PSI 'I.01313 1-.'V500 501iii : 4iI)MMI:.J-`1FJI:_I 1.) L.I : 7 05 1:.4 K
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('Xy 5 V ZE MAJAITON : $ 6 '1500 Si;1::. I LA CAN,S
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I..,I NO 161,7- 3241
This permit is issued Subject to the regulations contained in Title 14 ....................... .......................
of the TMC. State of Oregon Specialty Codes zoning regulations Id.Wk 1 1.PE.1.) A:NS PIEG I :I.ON6
and all other applicable codes And ordinances. and it Is hereby T to r.::I;::Am
agreed that the work will be done in accordance with the plans and
specifications and In compliance with all applicable codes and f 1 PJ(;
ordinances The issuance of this permit does not waive restrictive 0 111 ON
covenants Contractor and subcontractors shall have current city I"'t V, 1:::(.1(11;D
business tax permilb This permit will expire and become null and I
void If work is not started within 180 days,or it work is Suspended of
abandoned for a period of '10 days any time after work has
commenced It shall be the resp)nslbility of the permittee to Assure
All required insp9clions are requested and Approved
4ffitfee Signature
C;,
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
'r It � �- � ■r F� � t a
C11Y OF TIGA RD PLAN
CHECK APPLICATION
PLAN CHECK # / " -9 7
COMMUNITY DEVELOPMENT DEPARTMENT PLkMIT +1
13125 S W Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)639-0175 DATE ISSUED
JOB ADDRESS: �S S�ZS� ,S.rt�. AX MAP/LOT
=UB:jtt rrNt� ._ t�IP� LOT: �OS= I._AND USE:
V A LU AT TON: ;5 av _ _�.__.____�.
OWNER SPECIAL NOTES
NAME: � �.—,._. �C��GG�/ REISSUE OF:
ADD RCSS: LAST REISSUE:
a FLOOD PI AIN/
SENSITIVE AND:
APPROVALS REQUIRED
CONTRACTOR PLANNING
NAME: �r9�rCu1 �ks 75'tcG�to__. t_i_ f-�+L ENGINE EFdING: —._—._._...—..._....._...........__
__ —_—`—'_ �_��
ADDREFF IRE DEPT
SS : / =.��_.�•u.) ��._ - -- ._._
OTHER:
- ITEMS RE.4`U1.RE:U
F HONE: —_�+. 3,-•--�.Q�_.__._ _____-._
LIST/SUBCONTRACTORS: _.__—__...._
ARCH/ENGINEER BUS TAX: _.....
NWRI a S Ccr cl
CALCULATIONS:
NAME : �R ._........._.__._.___._.__4�^___...___.__
ADDRESS: TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN.
PHONF :
OTHER:
C;OMMt'N TC5: _.__. '�' t._.5�•�ir�•'���(� Ll!(
PL.RMI 1' it ACCT Ol DESCRIP-F1.0N AMOUN 1 AMOUN I PD, l+nt t u n
�+qqc 1.0-1)32 00 Building Permit Fees
10 4 31 r!0 Plumbing Per•mi.t Fees __.. _. __.. _._.._._...._._.. ......
10 -131 01 Mrcham-al Permit Fees ........_....__ --
10 230 01 State Building lax (5%) ._....__............_ 3,._..._
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plumbing
Mech
10 433 00 F>lanr. Chr..ck Fey '
Bu i Id i rig
Plumbing
Moch
30 202 00 Srwor- Ccmnrtct .i.en
IC) -444 00 :;I,wrr• LnsPectien
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W 449 00 Parks 0,ystrm Dov Chat-go (Pill;)
31 4'�M 00 .';term (trra i n Ago Sy st Llov Chr y (,;.1))C)
10 230 09 11411)
10 %'10 06 Washinyli on County F iry 01 (9')'%x)
10 120 00 Amar t /Wild(JOWe011
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Cll.//� �M . . sem' i tl 4�7..."�j `�►'
CityofTigard Mechanical Per-nit NO. -
t
tion Replace n RC1efutation[] Addition Alteration DATE:
Kew Instaliat >y 5
HEATING /V c
CONTRACTOR� OWNER
ADDRESS-33,L)' L Z-!--Y e cz V JOB ADDRES.I -.2 J 2 /f�,;� e'Y��*at�
PION E.23 a 3 )- 1 APPLICANT -ter
Heat Input Rating(B)"1 per Hour) 1. -a. COV Vent Size y2 � FIuP Size
FUEL OIL C] GAS go ELECT hJ OTHER -
ITE M
THER -ITEM �TNO. — FEE ITuM NO. FEE
For Isniance of Permit SEE BELOW _ _ Each Air Hanaling�.Init or Duct System r0
New-up to & incl. 100,000 BTI-1 — r 6.00 Commercial Hood Svstem T 7.50
New 100,000 BUT's & over 7.50 Other Equipment - Each
Wood)-,irnin Stave 4.50_ _1 Trip Inspection x.50
Wall.Floor- Suspended _ 6.00 Air Condition Corepressor - up to&int 1 H.P. 6.00
Vent System v.,/Fan 4.50 Air Condition Corn rersor-3.1 to_ 15. H.P-irtd. 11,00
"air-Heat Cooling 6.00
CITY BUSINESS LICENSE RF.M'::'Frn BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comments:
_FEES --------
'/- JG STATE Issued Icy_
25,6 PLAN CHECK
TOTAL #
Qinn�hre of Dnnlir...♦
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INSPECTION NOTICE
City of Tigard Build;nq Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address Permit
Type of Inspection
The following Building Code deficiencies are required to be zorremod:
Presented to ...... Inspector
Date
,-ALL FOR RVAGPECTION
❑ Y E S ❑ NO
P. 0. BOX 129 PLUMBINU PLItMl1'
ZEIt6 Ado '1tri-A'0nA3N HiYi'BEfw, 021C,1 91132 holder of a valid plumbing contractors license i., here
6ZI XOSl 4!'L4
'UNI J14i'Li,,auth arlZed to Causa plumbing work as herein noted to ba install,d in accordance with the plumbing code
10l1rHN1321 'fife ` Such installations require inspection by the City Inspector who shall be notified not Tess tt1 to fo
(4) hours prior to the timet the instailatio,,s are ready for ;nspection. City of Tigard Busiaess L icense req
\ for all contractors, and sub-contractors.
/ _ . Addres- l5'a�-7 �z.0 !Or%It �4yE Date.' �l
Qwner ---- --
'NUMBER OF TOTAL PERMIT N
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNTM (Office Use
R[1110EHTIAL --tet--
Ginglif Family—] beth—ecch�^ 25.00 `UCS
Duplex—Each 1 both unit 25.OU _
Addltlonel both ooms—each _ 10.00 -1c
Noblle Home Space—Loch 16.00 _
INDIVIDUAL FIXTURE FEES
1 to 60 Fixtures In 1 b (Wing each 3•00
61 to 100 Flxturas in 1 bulldhN-avch _ _ 2 J0 _
101 to 200 Flxturos h-1 bulldinn each 2,00
201 or mors Fiytures In 1 building—each
MISCELLANEOUS
_Building Sewer-1st 50 It. 1000
&lYmr--each eddltionnl 100 It,
--__ 10.00 a
Water Servke to byit6.De
Prl"iff Weler Systema—Lech 100 It. 10.00 _
01her DI>•x Y _.r. _
PERMIT for Plumbing Irrpvctiort Phone 6,9-0191
StategIg I PlurnblN Contractor By
TOTAL.`��// !,r_' 1 nECEIPT NO. Icwod By
1
BUILDING PERMIT APPLICATION -riGARD DATE._ 529/ _,19 01 3 7 5.)
THE UNDERSIGNED HEREBY APPLIES FOR A PERMI f FOR 1.,E WC.RK HEREIN INDICATED BUILDER PHONE f-,39-3101
OR '{S SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER SHONE
LOT NCj.— 705 .-.—__-
OWNER TuAiatln Det* CO•JOBADDRESS 15525 SI:1 IU9th AvenueSumH;-ir filed 14
----- -- �__".-�
ARCHITECT -- -- --
ENGINEER
BUILDER s$Ilf6
ADDRESS 15300 SW 116th 3Venue DESIGNER TOC
STRUCTURE EX NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR C) RENEWAL ❑ FIRE DAMAGE F1 17EMOLITION
"RESIDENCE ❑ comm_❑_EDUCATIONAL F GOVT =1 RELIGIOUS Ll PATIO Ll CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R s LA14D USEZONER5LP .BLDG.TYPE --§Y-FIRE ZONE_- PLAN CHECK BY -.—AW--h HEAT
Construct single family dwelling W%at,tached g trage. Z Bedroom& 2 Uathm._-
���' _SE_E CORRECTION SWEET NTTtiCHED.
SEWER PERMIT# 23356 - S%0.00OCC.LOAD LOAD FLOOR LOAD 40 HEI3HT 13 NO.STORIES 1 AREA 1790 NO.BEDROOM: 2 VALUE 72,100..
BUILDING DEPARTMENT SET RACKS FRONT REAR 1 LEFT SIDE 1 RIGHT SIDE
r: —
Perm44
lt 3.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE 'GwINO
— REGULATIONS AND ALL APPLICABI E CODES AND ORDINANCES, AND IT IS HEREBY AGP-ED THAT PHE
Plan Check 116• aC) WORK WILL NE DONE IN ACCOR.'%NCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 349.50_ RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER PLUMBING AND HEATING.
State Tax 4j% 9.3 2 _1
Total $35F�•f32 ISDC- ��'-70.Q0
B -- PDCM
By Fl 1 I K lIJO.(?0 A�'UCANTOPA(3ENt
Recelpt No, 8680
Approved duh ADDRESS i F u ua F
DATE INSP. TYPE INSPECTION REMARKS PLU BING DATE
`— — Contractor
Permit No.31<0
Rough-in
—
�� Fixture
Final -- ----
W' TING
Contracto
Permit No.
Gas or Oil
Rough-in
Final
— SEWCR
Final
DRIVEWAY
Final 1;
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Aoproech
BLDG. DEPT.FINA1. TET.PORARY CERTIFICATE OCCLn'kNCY Final
CERTIFICATE OCCUPANCY 9l y�_C/
I
o
Landscaping
Zoning Final
I
I J
N f PLICAI ION C'OF Y ` ��•,•�� OATE_J� - -_—. 18� N9
. 37s
JILQI G PL MIT AP �?� /�
--tE UNDERSIGNED HEREBY APPLIES FOR APERMII FOR THE WORK HEREIN INDICATED OWtBUIRRF'HONr�v�r LL[1_--
DR AS SHCWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIF ICA1 IONS. �� R PHONE _ __-_—
LOT
J �
u` E A D D'.4 ES5
R T��zN DDRE55 I5 ENGINEER
�!�� ��� f� �/�/ 2i ARCHITECT
ERQ"--- —_. - ADDRE5Sj �.1-'iY.. �LlIL--C'!��_ DEF-GNER _���..._.—..
URE - NEW _ ❑REMODEL _ DADJITION OREPAIR lORENEWAL (:]FIRE DAMAGE UOtMOLITIO
/ �IDLNCE -❑COMM [EDUCATIONAL IJGOv'T-L_IIREIiG10US[JPA110 ❑CARPORT GARAGE ❑STORAGEOSLAB ❑FENC
1.JMOVING
❑CONDITIONAt USE 4.1 Df.SIGN REVIEW [:]COUNCIL APPROVED 1_JSIGNS -
CLjPn_NC lANO—USE 2DNEJ5LS/ C2!I!L_BLOG_TYPE
A)_FIRE-ZONE..." PLAN CHECKBV� _ HEATG s�
VALLIG
BUILDING DEPARTMENT SET BACKS FRONT REAR D LEFT SIDE — RIGHT SIDE
t THIS PERMIT IS ISSLIED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20N1
Plan Check �O•�j REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TH,." T
-- ---��' WORK WILL BE DONE IN ACCORDANCE WIT4 THE PLANS AND SPECIFICATIONS AND IN COMPLIANC.. NI
Sub-total 4q. ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIL
----�- ,o N
-- - RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINEI
state Tax_ 9, 3Z2- LICENSE. SEPARATE PERMITS REOUIREJ FOR SEWER, PLUMBING AND HEATING.
Total _- 3•- -' $- / -- ---
_ APPL 1CA1Q1 OR AGENT
Approved _ Receipt No.
---�{ff AUDPE5 PHONE
�5nr- R
_Pnr--s !oo
/ --
J�cv�e.oelAe"T a - 27l� rqg�
X �0-6-�
17 k 40 �$n
3g,s°
.Zo°
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