16423 SW 109TH PLACE 16423 S► 109th PL.
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INSPECTION NOTICI
G� City of Tigard Building Dev,artment
J
C P.O. Box on 97 Tigard, Oregon 9223
A /� " ' Phone: 639-x'175
Type of Inspection
Date Requested //_ •��_ r!�_� rime _A.M.K P.M.
Address ��� _ Permit # '19'_—S
Owner Lot # , _
Builder
�-
The following BuZing Code deficiencies are required to be corrected:
Presented to _— __.__ Approved
Inspector — �_ �. D pproved
Date — --- —-- CALL FOR REINSPECTION
L] YES 0 NO
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon v7223
Phone: 639-4175
Type of Inspection
Date Requested—// Time A4
- M.
Address Permit
Owner Lot
Builder
The following Building Ccde deficiencies are mquired to be )rrected:
---—------
U
Presorted tooprove
Inspector
� Ctvpprovvd
Date
--
CAUL YOR RZINSPECT10,V
17 YES E] NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone 639-4170
Type of Inspection
Date Requested v Time<-�-yy. M. P.M.
Ac dress ----^�- � � --�' Permit * 7
Owner Lot #
Builr,er
The following Building Code deficiencies are required to be corrected.
Presented to _ —��A iproved
Inspector [ Dimpproved
Date
CALL FOR REINSPECTION
ED YEe NO
INSPECTION NOTICE
City of Tigard Building Departmer,
P.O. Box 23397
Tigard, Oregon 97223
Phc..a: 639-4175
Type of Inspection
Date Requested /Z rf-CA .--P.M.
Address Permit 0
Owner--
Builder I 4�t�
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector %!y��- LJ Disapproved
Date
CALL POR REINSPECTION
F-1 YES Cl NO
i
TY OF TIGA RDIN PLUMBING PERMIT
A-01101 {` RMIT NO. : PL892339 ✓�'
CRY OF 116ARD
one
COMMUNITY DEVELOPMENT DEPARTMENT TE ISSUED: 11/ 9/89
13125 S.W.Hall Blvd.,P.O.Rox 23397,Tigard,Oregon 97223,(503)6394175
JOB ADDRESS: 16423 SW 109TH PL
TAX MAP/LOT 2S1 15PA SUB: REBECCA PARK LT-19 PK-
I-AND USE: R4.5
LOT SIZE:
ITEM: NO: NOt
WORK. CLASS: NEW WATER CLOSET 3 TRAP
USE TYPE: SINGLE FAMILY URINAL BKFLOW PRVNTR
CONST.TYPE: VN LAVORATORY 4 TRAP PRIMER
OCCUP.GRP. : R3 TUB SHOWER 3 GREASE TRAPS
DISHWASHER 1
GARBAGE DISPOSAL. 1
NO.STORIES: 2 WASHING MACHINE 1
DWELL.UMITS: 1 LAUNDRY TRAY BLDG.DRAIN (DIA
FLOOR DRAIN
SINK 1 SEWER (FT)
WATER HEATER 1 STORM/P!',IN (FT 1
OTHER
REMARKS:
FEES:
GOT IER SAMIII PERMIT 1147.50
N 9541 SW INEZ ST.
R tigard or FIXTURES
STATE. TAX 17.38
OTHER
C
0
N
T PACIF.0 PLUMBING
A 1235 N HOLLY
C CANBY OR 97013
T
O -
p REGISTRAT'ON NO. 34498 101AL. 1154.88
This permit is issued sub{ect io the regulations container!in Title 14 RECEIPT NO.
of the TMC. State of Oregon Specialty Codes zoning regulations ------____.
and all other applicable codes and orr!;nar,,,a, and ;i is hereby REQUIRED INSPECTIONS
agreed that the work will be done in accordance ivit'r the plfins and PLP.UNDERS...AB
specifications and in compliance with all applicable codes and POST A BEAM
ordinances The Issuance of this permit does not *sive resbictive WATER LINE
covenants Contractor and subcontractor3 shall have Curren: city
business tax permits This permit will expire and become null and PLB.TOPOUT
void If work Is not started within 180 days,or if wort fa suspended RAIN DRAINS
abandoned for a pericd of 180 days any time after work ;ms FINAL.
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Signature/
Issued By "'1r TOR I NbVIEL I I I 09-417zi -
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOF
TBUILDING PERMIT
PERMIT NO. : BU892193
cmtTt�sfto !�
COMMUNITY DEVELOPMENT DEPAR7AENT 01100" TE ISSUED: 11/ 3/89
13121,S W Hail Blvd.,P.O Bos 23397.Tigard,Oregon 97223.(503)63f Al 75 I M.PMT.M;. 892193
JUD ADDRESS: 16423 SW 10'71'H PL
TAX MAP/LOT 2S1 15AA SUB: REBECCA PARK LT:19 BK:
LAND USE: R4.5
LOT SIZE: VALUATIJN: $ 87.078 SETBACKS
FRONT: 1='2 REAR: 5
WORK CLASS: NEW DWELL.UNITS: 1. LEFT: 6 RIGHT: 3j
USE TYPE: SINGLE FAMILY NO.BEDROOMS: 4 EXT.WALL CONST:
CONST.TYPE: VN NO.BATHS: 3 N: S: E: W:
OCI.UP.GRP, : R3 PROT.OPENINGS:
OCCUP.LOAD N: S: E: W:
TOTAL AREA: 1889
NO.STORIES: 2 1ST: 1807 ROOF CONST: C FIRE RZT?
HEIGHT: 20 2NDs 882 AREA SEPAR? RATED:
BASEMENT? 3RD: OCCUP.3EPAR? RATED:
MEZZANINE? BASEM'T
FLOOR LOAD: 40 GARAGE: 43P., FIRE SPP' ,-R? ALARM'?
FLOW(OPM) DETECT? YES
HEAT 1'YPEs GAS HDCP.ACCcSS?_ CORR?
PLAN CHECK BY: Tlt
REMARKS:
REISSUE OF NO.
LAST REISSUE
O FEES:
COTTER SAMIiI PERMIT $397.08
N 9541 SW 1NEZ ST. PLAN REVIEW (258.05
E tigard or FIRE DEPT
STATE TAX $19.85
OTHER
DEVELOPMENT CHARGES:
N GOITER SAMIII SDC(STORM) i250.00
T COTTER CONSTRUCTION SDC(STREET) $600.00
A 9541 SW INEZ ST. PDC(M2 ) $250.00
C tigard or 97224 PREPAID ( $100.00)
T PHONE (503) 639-4869
RI REGISTRATION NO. 34025 TOTAL : $1.674.90
This permit is issued suble-t to the regulations contained in Title NO.te 14
of the TMC. State of Oregon Sperialty Codes, zoning regulations REQUIRED INSPECTIONS"__-------
and all other applicable codes and ordinances, and It Is hereby
agrend that the work will be done in accordance with the plans acid FOOTING SEWER
specifications and in compliance with all applicable codes and FOUNDATION WALL. RAIN DRAINS
ordinances The issuance of this permit does not waive restrictive WATER LINE
BEAM POST R
covenants Contractor and subcontractors shall have current city PLS.UA BEAM
CITY APPRCH/SW
business tax f7rrr.iis This permit will expire and become null and
void+f work i, -;,i started within 180 days,or if work is suspended or SLAB FINAL
abandoned fir a period o 180 days any time after work has PLB.TOPOUT
commenced It shall be the n sponsibility of the permittee to assure FRAMING
all required inspections are r quested and approved
FIREPLACE
GAS LINE
INSULATIVN
ti 0'4P. BOARD
":VSig'n,ore
Issued By
0 75
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWER PERMIT
CITY
OF TIFA
R PERMIT NO. : 3E892341
CITY of T16 ND
COMMUNITY DEVELOPMENT DEPARTMENT 01100N D TE ISSUED: il/ 3/89
13125 S.W.Hall Blvd.P O.Box 23397.Tigarcl.Oregon 97223.(503)6394175 I M.PMT.NG. 892193
J01? ADDRESS: 16423 SW 109TH PL USA NUMBER: 39110
TAX MAP/LO1 2S1 15AA SLB: REBECCA PARK LT:19 BK:
LAND USE: R4.5
LOT SIZE:
SECTION: 15 TWP: 2s RNG: lw
WORK CLASS: NEW
USE TYPE: SINGLE FAMILY
The applicant agree!, to comply with all rules and regulations of the Unified
Sewerage Agency. The permit expires 120 days from the date issued. The total
amount paid will be forfeited if the permit expires. The Aqency does not quar-
antee the accuracy of the location of the side sewer laterals. If the sewer is
not located at the measurement given, the installer shall prospect 3 feet in
all directit�ns from the distance given. If not so located. the installer shall
purchase a "Tap and Side Sewer" Permit and the Agency will install : lateral.
INSTALL. TYPE: BUILDING SEWER IMPERVIOUS AREP:
FIXTURE UNITS: TENANT IMPROlvEMENT:
DWELLING UNITS: 1
NO. OF BLDGS. : 1
FEES: I
0 DOTTER SAMIII PERMIT $35.00
W
N 9541 :iW INEZ ST. CONNECTION CHARGE $1.250.00
E o;;drd or LINE TAP INSTALL.
R
OTHER
C
0 GOTTER SAMIII
N GOTTER CONSTRUC7iON
R 9541 SW INEZ ST.
A
tigard or 97224
T PHONE (503) 639-4869
IR1 REGISTRATION NO. 34025 TOTALS $1,285.00
5 1111s permit is issued s,.�blerl!o the regulations contained In TIN- RECEIPT NO. �6 914-j-,14 _..__..._._._..__.._________
of the TMC. State of Oregol Sner-ally Codes, zoning regulations REQUIRED INSPECTIONS
and all other applicable codes wd ordinances. and It Is hereby
agreed that the work will be done In accordance with the plans and ROUGH-IN
specifications and In compliance with all applicable codes and
ordinances The Issuance of this permit does not walve restrictive
covenants Contractor and subc3ntractor5 shall nave current city
business tax permits This permit will expire ano become null and
void it work is not started within 18C days,or If work is suspended ur
abandoned for i period of 180 dhvs any time after work has
commenced It at all be the responsibility of the per!,uttee to assure
all required inspections are requested end approved
Ct' - L �
Perm a Signatur
Issued By �" LiAl l EOR_INSR unN K1O-.1M _,_�__.-_
Jt/
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY
OF
TIFA
MECHANICAL PERMIT
RD PEkM:T NO. : ME8'y�340
(�WYO_FT�WAARDCOMMUNITY DEVELOPMENT DEPARTMENT °�`° TE ISSUED: 11/ 3/89
13125 S.Nr Hall Blvd.,P.O.Bcx 23397.Tigard.Oregon 97223.15031639-4175 jM.PMT.N0. 892193
JOB ADDRESS: 16423 SW 109TH PL.
TAX M'tG/LUT 2S1 15AA SUB: REBECCA PARK LT:19 bK:
LAUD USE: R4.5
L.OT SIZE:
ITEM: NO: NO:
WORK CLASS: NEW FURNACE (100K 1 AIR HANDLR (lu
USE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDLR i0K
rCONST.?YPE: VN FLOOR FURNACE EVAP.cool.LP
OCCUF'.Gk.'. : R3 HEATER VENT FAN 3
VENT VENT.SYST'EM
BLR/COMP (3HP HG'ID 1
NO.STORIES: 2 BLR/COMP 3-15HP INCINERATOR(DOM
DWELL.UNITS: 1 BLR/COMP 15-30HP INCINERATOR(COM
FUEL TYRE uAS BLR/COMP 30-50HP REPAIR UNITS
MAX. INPUT PLR/COMP 50+HF' OTHER 2
FIRE DMPRS? GAS PIPING OUTLETS 1
HIGH PRESS?
LOW RRESS? J
REMARKS:
FEES:
W GOTIEF SAM III PERMIT $19.AO
N 9541 oW INLZ NT. PLAN REVIEW $11 , 13
2ipard or FIXTURES $30.50
STATE TAX $2.03
OTHER
t;
SANCHEZ ALAN
N
T TRI-COUNTY TEMP CONTROL
R 10505SE 55TH
A
C m11Wauklie Or 97222
1
q REGISTRATION NO. 52540 TOTALS $52.66
�C15�y1--
TF11a permit is Issued subject to the regulations contained in Title 14 ----------
RECEIPT N0.
of the TMC, State of Oregon Specialty Codes. zoning regulations RED INSPECTIONS REQUI
and all other applicable codes and ordinances, and it Is hereby QUILIME
agreed that the work will be done In accordance with the plans and GAS
specifications and In compliance with all applicable codes and POST A BEAM
ordinances The Iraunnce of this permit does not waive restrictive ROUGH-IN
,-ovenants Contractor and subcontractors shall have current city FINAL
business tax permits This permit will expire and become null and
veld 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 ehall be the responsibility of the perm ttee to assure
all required inspections are requested and approved
r
It a Slgneh
Issued By CAI I FOR- NSFECIION 639- :175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOF TI GARD
COMMUNITY DEVELOPMENT DEPARTMENT u� °M° � PLAN CHCCK APPLICATION
13125 S.W.Hall Blvd..P.O.Box 23397, 'j� PLAN CHECK #
r+gsne,o�egor,sM23,(503)6394175 PERMIT # y
D,ATt ISSUED
JOB ADDRESS: .3 S L4-2 �UrJ � �% . TAX MAP/LOT
SUB: ft IQ t cLA- 04,?r? K LOT: �C4 LAND USC:
- - -
VALUAfION:
OWNER SPECIAL NOTES
NAME: ✓A ►y) &qM--!:Q C 6^1,1j 7—, REISSUE OF:
ADDRESS: 9 S y I S,v✓:t „/ r- Z S LAST REISSUE:
pIR 9 FLOOD PLAIN/ - -
SENSIIlVE LAND:
PHONE:
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: ENGINEERING: -
ADDRESS: �� t IRE DEPT - -
_ _ OTHER:
PHONE.: ITEMS REQUIRED
BUILDERS BOARD #: EXP DATE: / -iy -9[ — LIST/SUBCONTRACTORS: _
- TAX:
HRCH/ENGINEER BUS
CALCUI_A I.T.ONS
NAME: C--,o rT F k' G ow-5"f --- -
TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
COMMENTS:
SUBCONTRACTORS: PLUMB: Phk c I F l ('cam n,r°,,n/e-. MECH: --jam`(,O L wT Y _:j
PERMIT # ACCT # DESCE:IPTION -yCt
AMOUNT AMOUNT PD. BAL. 6'11E
10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees -
10-431 01 Mechanical Permit Fees _ - -
10-230 01 State Building Tax (5x) -
Building
Plumbing
Mech
10-433 00 Plans Check Fee �7
Building
Plumbing
Mech _
30-202 00 Sewer Connection
30-444 00 Sp--,ver Inspection - --
51-448 00 itreet System Dev Charge (SDC) --
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg (SSDC)
If)---230 06 Fire -
TOT
�� REC N �
�.��_ EC M _..
APPLICANT SIGNATURE
Received By: Date Received:
cn/3587P/I8P,'