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16412 SW 109TH PLACE U o u L(Uto U vol j r T: 16412 SW 109TH PLACE • ll� . r 1 ,v a INSPECTION NOTICE City of Tigard Building Department P.O. 3ox 23397 Tigard, C regon 97223 Phone: 639-41775�5 Type f Inspeolion '`_, ---'L CSC>/�C •��LU` n-t Requested �-� `f0 Time_ A.M. P.M. Address _ fU Owner - -- — --- Lo. # — Builder --- The following Building Code deficiencies are required to be corrected: Presented to Approved Inspector .--------- I Disapproved Date —e7: ,17 __— C,,iLL FOR REINSPECTION its ❑ No tll� -F-_ Permit No: Address: - --- -- t Issued by:.-. Date: = -- - -FOR OFFICE USE ONLY- - _._-_--_-- STATEMENT: INF'ORMA'TION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION _IESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the follc wing statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 28: 1. !1 -] I own, reside in, or will reside in the completed structure. 2. A. = My general contractor is Contractor registration number I �vill Instruct my general contractor that all subcontractors who work on tf.e structure must be registered with the Construction Contractors Hoard. OR B. �_ I will be my own general contractor. If I hire subcontractors. I will hire onlsubcontractors registered with the Construction Cuntractors P,oard. If I cNrge my mind and do hire aeneral contractor, i will contract with a contractor who is registered with the Construction Contractors Board and 1 will immediately notify the office issuing thin building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Inturmation N Aice to Property Owners about Construction Responsibilities on the reverse side of this form. Signature< Permit Applicot Date CnNSTRUCTION CONTRACTORS BOARD 02,AJ 1/90 WHITE COPY TO ISSUIN(., AGENCY PERMIT 7-ILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE. This Information Notice to Property Owners About Construction ResPties was Ped Y eConstruction acco dancelwith ORS 01 055(5), passedby the 1989 Oregon Board in Legislature. If you are acting as your own contractor to const.uct a new hon1^ or make a substantial improvement to an existing structure, you car prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a reesiderWel structure, you will, in most instances, be ruled to be an "employer" and the people you hire w;II be "employees". As the employer, you must comply with the $ollowing: Ore -un's Withholding Tax Law: las an employer, you r, ist withhold income taxes from employee wages a' the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more Information, call the C.egon Department of Ravenue at 378-3390. Unemployment Insuiance Tax: As an employer, you are required to pay a tax for L-nemployment insurance purposes on the wages oli employees. For more information, call the Oregon Employment Division DHR at 5783224. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensa- tion Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be. subject to penalties and will be liable for all claim costs if one of your employees is injured o,7 the job. For more information, call the Workers' Compensation Division DIF at 37:--7434. U.S. Internal Revenue Service: As an employer, you must withhold federal Income tax from employees' %,.ages. ou will he liaele for thF tax payment even if you didn't actually withhold the tax. For more informa tion, call the Internal Revenue Service at 221.3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Compliance As the permit holder for this project, you are responsible for resolving any failure to meet code requlrements that may be brought to your attention through inspections, Liaolitland Property Damage Insurance: Contact your insurance agent to ;ee if you have adequate insurance coverageor�iccldenfs eriaomisslons such as falling tools, paint overspray, water damage from pipe punc:turPq, fire, or work that must be re-done Time to Pupervise Emolc,yees: Make sure you have �,ijffi.:ent time to supervise yuui employees. t�x�;► Ise: Make sure you have the expertise t,) act as your .wn genei.a contactor, to coordinate the work of rough-in and finish trades, and to Notify building officials at the appropriate times so they can perform the rey6!,—cd inspactloos. If you have additional questions, write to: Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310.0151 Phone 503.374-4621 0244J 10,;:4199 CITYOF TINA C rnrY COXFRD COMMUNITY DEVELOPMENT DEPARTM04T 0920014 P E R PI I 1 -0 J.13126 SIN HWI Blvd. P.O.Box 33397.Tigwd,Oregon 972x1(503)6,1^4175 01: T R III]'' 14. — - - .. :: ILly"M 'T' tt.. Z r t.i, TVY- 6,3'-.14 17 1. 09/24/9 PJ 316-1412 EM 109TH PIL ' 1'T E ()D 1)R E. Z(.11-4 1 Iq G- :;UBD1:v19T0N. . . 1. . Y.41..00K. , - — - - -'. LOT.. . . . . . . . . . . . :24 .......................­­...-.-'---'---............................... GLASS OF WORK. . -.ADD GARBOGE DISPOSMI-S. - [-JOITIE SPAGES. T*Y 1. W(-)SHING II(PIGH. . , -I F 0 F IJ 16 S r' (:IF,C;L)1.1(-)N I',Y GRP'.. . R3 FLOOR DRAING- . . . . . 'TRAPS. .. . . . . . . . . . . . . . :ii'T 0 R 3'.ES;. W0,144"R HE0 ,11'.RG). 1::'.T.X*T IJ R E S......................... LAUNDRY TROYS. . . . . . .. SF R(-Illq DRA'[NG. NK!"'. UR I NAL G R F(I S E 'I R PI P 13. . . L.PVP '(')RI'ES. O'TH U R F1 X-T U R E S. . ;IAoWEF:S. SEWER L.INL: (ft;) - W�TE L'L 0 6 F1,S WAI*ER LINL T).i ",111,10SHERG. . . . .. RAIN 1)R 3'.N (i't) I I:e 11)iA v t:4- (.Tw vi e-r _............_.»_._._ F E.E.Si RANI)OI L NT.N(3111YO type A III C)Lk 11 t -r e c,r-.t GW 10 9'T I I P L Pnyll 15. ?5 J:.1.4 09/22/90 P R N'T 1.5. 00 'T3'(])()RD OR 97024 5 P(11 1' 0. 15 11 C))'I c--? t#a 6c'4-F.19` 9 .. . ... ...... ...-- 0WNF:'J;:/(,'ONJ'RAC',TOR $ 15. 75 TOTAL Reg OWNER REOUIRED I N S I--'E C,'1`1 0 N- This permit is issued subject tc: the regulations contained in the JVISP ».-_.•---••• Tigard Mvicipal Code, State of Ore. Specialty Codes and all other Ins'le(-,tiol-I ......... applicable laws. All work will be done in accordance with ---.............................. approved plans. This permit will expire if vori, is not started ....... ...... ......... ... within 189 days of issuance, Or if work is suspended for more than Iff dayF„ ................. .......... Pernil.ttev ------ .............. -............. T51 r,k I e cl F3 y ..»..»»......._...»..............__......__._ ............ L;all fa-r inspec"Lia" 6,J9--41'75 i i I CITY (IF T'IC)Allr) — R1:.1-C-11''T Of! PAYMENT RECEIPT ILIO. :90——2()5090 CHECk: AMOUNT 15.75 f N,-;ME : NINUMIYA, RANDALL C:A.i11 AMO(INI n C►,�.►�.; l ADDRESS 1641.2 SW .109TH F'I_ PAYMENT DATE t 09/24/90 0 SURD I VI,IL7N n T IGARD,OR 97 211 I ►_„1F1=LIE OF F'AY71E:N1” ��MULtNT I'F;11) f'tIF,["'USE CIF- PAYMENT AMOUNT PAID F''l_LIMEr1NG F'F1tM F'L.M90-_r;117C► 1�.r:►r:► <,.'� . FH..Ii!..1J r'C"Ft r-r•"%� 1 i l 1,,,VIDTAL AMOUNT V'AIC> 1' CITY OF TIGARD PLUM 131 NG PERMIT 13125 SW WALL BLVD. P. O. BOX 23397 Aj4AicanK must mold Oregon Registration to Co4rdJUCI a plumbing; TIGAI'.D, OR 97223 Iwtitxst,w must be proper'yowner/operator not hiringoulside help. N ofDevelopme (503,1639-4175 --- � /y --� --` Plumbing Permit No. _ J7 puycriptian ORS 814-21-010 OUAN. PRICE MAT. Job Tax Lot Map.No. Arlrirnma __ FIXTURES 1,04 Ukxtk Sutdiviakxt - - S,.., 7.SU caw or name sates lavatory 7.50 /7 Tub or TubNyjwe.r 04W). 7.50 Mailing Address Slower Only 7.50 (?canerClty/Stale J Tip - -- Water closet 7.50 Dishwasher. 7.50 r Phone Garbage Disposal - -- -7.50 --- Name Wash 1 Macfune ,X7.50 Flnor lxa m 7.50 to '—Address Frhor e - W.:+r Heatr 7.50 _ Occupant _.—. Laundry Room Tray - 7.50 p city/State -- Urinal 7.50 NaMe Mane, Ott w- Futures(Specify) 7.50 1 r /� DSe ase 'f� 7.50_ r 7.50 C,om riK.1or CI W/Stato Zip 7.50 MISCELLANEOUS_ City Stm Tax No Sir 1 sl 100• 30.00 State Board No. tate s. o. Semw-ea.Addit.100' 15.00 M( dential) Water Service 1 St 100' 20.00 - 1 hereby aclvowledge tat hI have reed Owl a VWAtkx%that the intonnalion Water Service ea Addit.MDr 15.00 given is correct dut 1 am mosiered` M the State Bu4dses Board.and also Storm 6 Rain Drain 1 st 100• 3e 00 - he"a State Pkxnbh0 license OW tho numbers grmn are correct titat ati -- pkxnbirq work will be done in tuxxx der roe with app:icabld provisions CA Ore- Storm 6 P.-in Drain Addd.100' 15.00 gon Revised Statutes ciutptera 447 and 633 arvi applicable codes mrd ttvt Mobile Horne Space 25.00 no help wl"be employed wools kw sed-LimUo ORS Wo1(It eKempt from - State regisLratlon,please give reason below). Back Flow Prevention HOMEOWNERS-I tweby oerwy dw a am the owner of the property oo Device or Anti-Pollution Device 750 scribed at; e.at whktr location 1 propose to make a slumbin0 inetaYmtlon for Arty Tran or Waa%Not rtty own use and 044 property b not bekq crrabvc+ed for$ale.tease of rent C wwwofed to a Hxu" 7.50 Caklt[task+ 7.50 kW.of U--xW.PkxftbhV 40.00 Per He ---- _ •4. i alty Regseeted inspections 40.00 Per Hr. _ Itain Drain, Single Pam. Dw1q. 15'00 AUTNORIZEn SIC NATURE Dme ---- DemcTibe wrxk new❑ aditus Q altwetxw--LJ m)-alt(_ tp be dorm- residential n_ rton-tr•rlde loaf ]- Exts"uve0 MINIMUM PERMIT FEE 25.00 btNdklprxproperty------ _ .._._ SUB-TOTAL l�p?� of 5% SURCHARGE lh2r+0 or WDSettY -- ---- —-- J 2 51 Pt.AN RI V I EW- Ura pamM tmon»a ntAl and void 0 rrorlt a ooneen.eion autforttad Is not coo TOTAL 416im d wklrkt 1 tf0 Jaya er ft orxsdnx�k rn rr oak M suapanfad a abarxi.a+ef for a partod to Ian do"at ony tin"~'rnw•,'•r rxxrrnanoecl Data IAsued _,-_ by ----- INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested Time A.M. X P.M. Address Permit Owner Lot The following Building Code deficiencies are required to be correct*1: J Presented to 44.Approved Inspector Disapproved Date (ALL FOR REINSPECTION FI N Es I-A NO ItUALWWWAWAKMARWKWAW EFW CERTIFICATE OF' CITYOFTIFARD OC�UPANCY CITYOFTWARD PERMIT M. . . . . . . i BUPS92506 COMMUNITY DEVELOPMENT DFVAp "' PRIM. PERMIT M. s 892506 13125 SW HallBlvd. P.O.Boz29.'!97,TiVsrd,Oregon97 (503► �i 5 DATE ISSUED: 0!6/29/90 SIVE ADDRESS. . . s 16412 SW 109TH PL PARCEL c 2S115AA-06100 SUBDIVISION. . . . s ZONINGS BLOCK. . . . . . . . . . I LOT. . . . . . . . . . . . . or4 CLASS OF WORK. cNE:W TYPE OF USE. . . c5F OCCUPANCY GRP. sR:1 OCCUPANCY LOAD n TENANT NAME. . . F'emarF+.s a JUDY RUDISHAUSER 47,35 SW TROY PORTLAND OR 00000- 0000 Phone IFI 000-000 -0000 Contractors ---.__-,..-___--_._-..___----...__.-_ JUDY RUDISHAUSER ACCENT CUSTOM HOMES 4 735 SW TROY DORTLAND OR 97219-0000 '-�,onP Ms 583--244-35:19 Rep p- - s 61564 Occupaocy of the r.bovv referenced bulldinp is hereby pi -en, and certifies the compliance with the ':Mate Of Oregon Specialty Codes for the group, oc,cupancy,o and use under which the -referenced permit was issued. FIRE. DEF'ARTMCNT 13-1_ aNC3 IN8F' k BUILDING, FFICIA POST IN CONSPICUOUS PLACE I I INSPECTION NOTICE City of Tigard Building Department P.O. Dox 23397 Tigard, Oregon 97223 Pnone: 639-4175 Type of Insrection Date requested -, - �D 1—'Time )e– A.M. ��P.,, L Permit Owner — _ Lot Builder ` lip— – 'The following Building Code deficiencies are required to he corrected: ----r - - . ^ Presented to _. Approved Inspector [� Disapproved Date -- CALL FOR R RL.WSPFCTION INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type if Inspection _Lye' 0e2 - Date Requested / Time X A.M. P.M. Address -._ _-/�o -e'/�- �LJ 1 '�`'' Permit # Sd Owner Lot # Builder The following Building Code deficiencies are required to be corrected: di-224 Presented to -. / Approved Inspector .� - -- - -- - --� �_ � Disapproved Date at CALL FOR REINSPECTION C 7 YES 1-1 ,10 INSPECTION NOTICE City of Tigard Building Department p.0. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 639-4175 Type of Inspe-.,'^:r — Date Requested :Iv ' op Time A.M. P.M. Address �G �z / 0 9 / -T_ Permit Owner __- _ Lot # Bu'Ider Tne followinq Building Code deficiencies are required to be corrccted: Presented to _ Approved Inspector /� w.,. ❑ Disapproved Data CALL FOR REINSPECTION O YES C] NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, OregoM-97-22.3 Phone: 6394175 Type of Inspection � --- Date Request9d Time_ A.M. P.M. Address/� � 1 Permit # -�S Owner _ Lot Builder��^�� --���•- `� The following Building Code deficiencies are required to be corrected: -- - I Presented to Approved In:pector ____---__._.__-- -------_— Disapproved Date _ ------ —__-- ----.__-- CALL, FOR REINSPECTION Cl YES ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 ' Phone: 639-4175 1 Type of Inspection \ \ Date Requested _ _ . Time //nn ��'A.M. P.M. . Address . l- �� �� '- Permit # v Owner Lot # Builder The following Building Code deficiencies are required to be corrected: �` :'�(Nl d�lc= W ATS!L- �"ic.li�„ 'F o ►'2.v-•-�� - -PV-j oCL - -V r4 Ot= ISL K-vETz.L A L. a� I.Ni—14.L L k'0 c._. -1;-40 i Nxr--IS �l Presented •uApproved Inspector [] Disepprovet' Date �•��y� _ CALL FOR REINSPECTION ❑ YFv ❑ NO i A I . l � I CITY OF T I GARD — RECEIPT OF PAYMENT REC NOt 0010'7C109 NAME: ACCENT CUSTOM HOMF';CASH AMOUNT .00 CHECK: AMOUNT 7,20:1.88 : ADDRESS: 4775 SW TROY PAYMENT DATEs 01-2-2-90i PORTLAND, OR 97214 BLOCK" NOrADDR: I z641y 5W 109TH PL PURPOSE OF PAYMENT AMOUNT 1"AID PURPOSE OF PAYMENT AMOLffVT PAID BUILDING PERMIT FcBY`506)--� —�—_-415.00 PLUMHING�P PMIT j592510>__ MECHANICAL PERM (8925tl) 45.00 STATE BUILD PI.PNIT 'TAX (iii TO, L FLAN CHECM: FEE 1a1-00 SEWER USA t OK512 1.250.00 SEWER INSPECION 75.00 STREET SOC SCICT.00 F'ARti5 SYSTEM f.EVELOPMENT CH 250-UO STORM DKAIN 1) '750.00 PFF•lIT W LL. EF. MAILED T'0 CONTRACTOR F'cat I NSF'1-C t IOj,jF C,Al.,L TOTAL AMOUNT PAT[) BUILDING PERMIT CITYOFTIFARD ..::. . .. �. . r. . CITYOFTWARD f 1...R11I T 0. . . . . . . .. BUP8 92506 COMMUNITY DEVELOPMENT DEPARTMENT MIGOa FRIM. PERMIT ##. : 892506 13125 SW Hall Blvd. P.O.Box 23397,Tigard,Orepor .1223(s",► -4VI i � `, � DATE ISSUED: 01/22/7,',0 SITE ADDRESS. . . : 16412 SW 1091H PL. PARCEL: 2S] 15AA--08700 SUBDIVISION. . . . .. ZONING: r REISSUE:BUP FLOOR EXTERIOR WALL CONSTRUCTION-- CL(4SS OF WORK. .-NEW F iRST. . . . : 13.35 s f N: S: E W TYPE OF USE. . . :SF' SECOND. . . : 910 s f PROTECT TYPE OF CONST. :SN THIRD.. . . . ". sf N: S: E: W: OCCUPANCY GRP. :R3 1C)1'AL-.___.-...___. ti-f ROOF CONST:C FIRE RET?: OCCUPANCY LOAD: BASEMENT. : sf AREA SEP. RATED: STOR. : 2 HT. : 20 ft GARAGE.. . , a 420 sf OCCU SEF. RATED: BSM1'?: MT-.::LZ?: RECD SETBACKS-------------- FLOOR ETBACKS»---._---..----FLOOR LOAD. . . . : 40 psf LEFT:27 ft RGHT : '7 ft FIR SPKLs SMOK DET. . :Y DWELLING UNITS: 1. FRNT:20 ft REAR".22 ft FIR AI-RM: HNDICP AC(::: HEDRMS: 3 BATHS: 3 IMF, SURFACE: FIRO CORRs PARKING: VALUE. $: 3:3630 Remarks: Ow r1 e r: _ __....._. __....._.._._.._._.._._.._. ._._._ _._.... ..._...._.__.___._.. _.._._.__._._._._.__._..__._...__ FEES JUDY RUDISH(dl.lGER type amount by date rc4r_pt 47;35 SW TROY 1-IRM'T' $ 415. 00 MAN PLCK $ 269. 75 MAN 1='ORTLAND OR 00000 0000 " PCT $ 20. '75 MAN Phurle N: 000-•000-••0000 F'AYM $ 110. 00 [ION SSDC $ 250. 00 MAN Cantractar s ..----..__._.__._-_..._._._......._..... _.._..._._.._........._._.._......__ STD[, $ 600.00 MAN JUDY RUDISHAUSER PDCF $ 250. 00 MAN ACCENT CUSTOM HOMES 1-'AYM $ 1705.50 JLH 04/20/90 47:35 SW TROY PORTLAND OR 9'7219---00Cd0 _..... Phare N: 50:3-244•-35,49 E 1805. 50 TOTAL Req ##. . : 61564 - — RE0UIRE1) INSPECTIONS ___.._....._.... . This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other ...... -__._..___.._._.._..__..._ __.__.....__....__...._. ___...____._...._ applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within IBB days of Issuance, or if work is suspended for sore than 190 days. Vlermi.ttee Si.grlature+: Issued B y s Call fur inspection 639-4175 PLUMBING [' EMIT CITY®FTIGrARD CITYOFTWA71PERMIT P1 11892510 COMMUNITY DEVELOPMENT DEPARTMENT ORIGM PRIM. PERMIT #. .- 892506 13126 SW Hadl SNd. P.O.Box 23397,TOM,OrW 91?,q DATE ISSUED: 01/2E/90 SITE ADDRESS. . . : 16412 SW 109TH PIL PARCEL: 2S115AA--06700 SUBDIVISION. . . . : Z0111116: BLOCK. . . . . . . . . . i LOT. . . . . . . . . . . . . :24 CLASS OF' WORK. . :NEW GARBAGE DISPOSALS. . ." I NUBILE HOME SPACES. : TYPE OF USE'., . . .. ::;:;J:: WASHING MACH. . . . . . . : I BACKFLOW PREVNT*RS. . r OCCUPANCY GRP. - -R 3 F'LOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . : STORIES. . . . . . . . .. 2 WATER HEATERS. . . . . . . I CATCH BASINS. . . . . . . . FIXTURE S LAUNDRY TRAYS. . . . . .. . I SF' RAIN DRAINS. . . .. . . SINKS. . . . . . . .. „ . I URINALS. . . . . . . . .. . . . . GREASE TRAFIS. . . . . . .. . LAVATORIES. . .. .. .. 4 OTHER FIXTURES.....: TUB/SHOWERS— SEWER LINE WATER CLOSETS.. .. .-, 3 WATER LINE DISHWASHERS....: I RAIN DRAIN kenia-rks: Ownert. FEES JUDY RUDISHAUSER type amount by date re C,pt, 4*135 SW TROY PRMT $ 147. 50 MAN SPOT $ 7. 38 MAN r-',ORTLAND OR 00000-.0000 1---,A Y M $ 154. 88 J I H 04/PO/90 Phone #c 000-000-0000 Cciiit-ra(ctcir: ROBERT FOWER 1592 SF*.* 51ST HILLSBORO OR 97123 Phone It: 503 640 5770 $ 154.88 'TOTAL Reg 19907 REQUIRE-D INSPECT IONS This permit is issued subject to the regulations contained in the ......... --.—...... ...... Tigard Municipal Code, State of Ore. Specialty Codes and all other ....... applicable lams. All work will be done in accordance with .......... approved plans. this permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ........------- Pe-f,nii.ttee ............ ........................ ...................... Call ft:)-r ivisppetinri 639-4175 MECHANICAL C11YOFTIFARD 4� PERMIT CA�'iL COMMUNiTY DEVELOPMENT DEPARTMENT CnYOFTWARD� PERMIT t . . . . . . . .. MEC892513. 0""Mm 13126 SW HWI Blvd. P.O.BM 23397,Tigad,Or"m 97 03L83G.ai76 PRIM. PERMIT 8 92506 DATE ISSUED: 01/22/90 SITE ADDRESS. . . : 16,41 '2 SW 1.09T[i 1.',l PARCEL: 2S1.15AA-- SUBDIVISION. . . . BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :24 ZONING: CLASS OF WORK. . :NEW FLOOR FURN. . . . 1:--.VAP COOLERS: 'TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . 9 4 OCCUPANCY GRP. . :R3 VENTS W/O APPI....- VENT SYSTEMS: sToRIES. . . . . . . . .. 2 BOILERS/CL'MPREGSORS HOODS. . . . . . . : I 1::'U E L TYPE'S---- ..___..._.______ 0--3 HP. . DOMES. INCIN: .-GAS 3-15 HP. . . . : COMML. INCINP MAX INPUT BTU 1.5-30 HP— . - REPAIR ONITS: FIRE: DAMPLRS?. 30 50 HP. . . • : WOODSTOVES— i GAS PRESC'- 504- HP. . .. . . CLO DRYERS. . : NO. OF UNC C41R HANDLING L)NI ['S OTHER UNITS. : p- TURN ( 100K BTU., <= 10000 Cfn): GAS OUTLETS. : I 1::'URN )=:100K BTU: 1 > 10000 efilir "e" CM-Ity"ACtOT I'M111be-r Uwvie-r: FEES JUDY RUDISHnUSER type anIOU11t by d-ate rerpt 4735 SW TROY PRMT $ 10- 00 MAN PORTLAND OR 00000-00P)o PICK $ 11. 25 MAN 5PCI $ 2. 25 MAN Ptic)rle 0.- 000 000-0000 PRMT 1 35. 00 MAN C01-It-raeto.r.- PAYM 4 :i8.. 50 JL-H 04/20/19(4 SKY HEATING & AIR CONDITION 16625 SE SUNRIDGE LN r"LWA(LJKIE OR 97267 Phc)rie it: 50,32359083 $ 58. 50 TOTAL Reg #. . c 50244 This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with .......... approve d plans. This permit will expire if work is not startod within 188 days of issuance, or if work is suspended for sort! than 180 days. ....... .............. ISSUed By: Call fc)-v j-vispectic)ii 639-4175 ® SEWER CONNEC'T'ION CITYOFTIFAD7Cff Y , _ PERMIT . �: OF11SAID F�ERM1 T 0. . . . . . . . SWR8 92512 COMMUNITY DEVELOPMENT DEPARTMENT + PREM. PURMIT a. . 892506 13126 SW Hall Blvd. P.O.Baa 23397,Tigard,Oregon 97223 A�Wj 8r4)76 DATE: ISSUED: 01/22/90 SITE. ADDRESS. . . : 16412 SW :-0911.1 P1. PARCEL: 2S115AA--06/00 SUI+DIVISICIN. . . . : ZONING: BLOCK. . . .. . . . . . . = TENANT NAME. . . . . : USA NO. . . . . . . . . . ..3': 178 FIXTURE UNITS. . . : CLASS OF WORK. . . :NEW DWELLING UNITS. . : TYPE OF USE. . . . . ;SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . aBUSWR IMPERV SURFACE. . .- :5t Remarkts c i-ieecl c-,crrlt•f,ac.,tc)•r rit.tmber F'E:E::; __.._.__. _...._ ..._.. JUDY RUDISHAUSER type amcit.tni lay d •recpl 47;3* SW TROY PRMT $ 35. 00 MAN P,F*0MT $ 1.25P. 00 MAN PCRTL.AND OR 00000.._0000 PAYI". $ 1285. 00 JLH 04/20%90 Phone Hit 000 000-•0000 JUDY RUDISHAUSER ACCENT CUSTOM HOME-i.13) 4'735 SW TROY PORTLAND OR 97P19-0000 V'hnne N» 50;3•-.244--35;:39 $ 1.285. 00 TOTAL Reg it. . : 61.564 _...._.___.._..._ REQUIRED INSPECT IONS -This Applicant agrees to comply with all the rules and regulations of the Unified Sewage agency. The permit expires 128 days from ........... ___..._..._. _... the date issued. The Intal amount paid will be forfeited if the _......................... .._........ peimit expires. The Aqency does Tint guarantee the accuracy of the ..... side sewer laterals. If the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions from the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer" permit and the Agency will install a lateral. _ ,.-. ._...._ _•_.._•_ _...__..__._..._.........._._..__ PP-rnlittee Si.mrtatt.t-(,e: 1!all(i'd 11y: Call fa-r ir1spec.,11.ic:)r1 G39__417": CITYOFTIIFARD CrrraFTRD PLAN CHECK APPLICATION *atoCOMMUNITY DEVELOPMENT DEPARTMENT PLAN CI4ECK p //- 02 9� 13125 S.W.KWI Blvd_P.O.Box 23397.Tigrd,Omgon 97223,j5W)69.4173 PERMIT p L DATE ISSUED JOB ADDRESS: � ��j� � TAX MAP/LOT a ,s /-1 S* �4� SUB: ���.Pi'(,,"TA -'-f"/A , LOT: LAND USE: -- VALUAI'ION: /•3030 _ OWNER SPECIAL NOTES_ NAME: _ REI.SUE OF : _ ADDRESS: LAST REISSUE_ 6ti FLOOD PLAIN/ SENSITIVE LAND: _ PHONE: APPROVALS REQUIRED CONTRACTOR PLANNING: _ NAME: 'r7JT .✓l SpM,A,9 ENGINEERING: _ I ADDRESS: TLL1)'-r EL __ I `� l�lif (`,�__I.'__ FIRE DEPT -----�-T-7 3 r., �( L. �, / >✓' _� OTHER: TlU C T UM_ c 1 `-7 PHONE: `�jZI- 7," •),-1 ITEMS REQUIRED BUILDERS BOARD N: EXP DATE: j - ) LIST/SUBCONTRACTORS:r� BUS TAX: ARCH/ENGINEER CALCUI_ATIONS:� NAME. he - I! TRUSS DETAILS: _ ADDRESS: 111 1 5l.. �; '_ �'i OTHER: -LAC k A/l,L4s PHONE: COMM17NTS: UBCONTRAC70kS: PLUMB: 4 IS MECH: Y d L kA I l 1�1 1 '5().' PERMIT N ACCT p DESCRIPTION AMOUNT AMOUNT PD. BAT_. DUE 10-432 00 Building Permit Fees !y/� 10-431 00 Plumbing Permit Fees �. ,�U __ 10 131 01 Mechanical Permit Fees L ',au 10-230 01 StatL, Building Tax (5X) Building Plumbing Mech __ r ✓ 10-433 00 Plans Check Fee Building Plumbing Mech 30-202 00 Sewer Connection 30--444 00 Sewer Inspection 1 !� 51-448 00 Street System Dev Charge (SDC) 52-449 00 Parks System Dev Charge (PDC) 1 u _ u 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) .- 7 4' 10-230 06 F i ro TOTAL =(717. __ /I,)L) REC N -.�y/,/,f j APPLICANT SIGNATURI APPLICANT By: _ Date Received: Z/ 1- cn/3587P/18P —"