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CERTIFICATE OF
OCCUPANCY
CI�"OF T I CARD
COMMUNITY DEVELOPMENT DEPARTMENT /95
13125 SO/Hall Blvd.Tigard,Oregon 97223*8199 (603)619-4171 PARCEL; IS134AC-07300
')ITE ADDRIE35. . . 10897 SW 111TH I=Vk 7TONING:R-4. 5 PID
UBDIVISION. . . . JEFFREYOSTATES -
KLOCK. . . . . . . . . . I LOT. . . . . . . . . . . . . :006
LASS OF WORK. :N[�W
YF-'E OFUT.E. . . :n-F
OCCUPANCY GRP. :R:7
1r7CUPANCY LOAD.ice. 4
Pemarks ; PATH I
owner: •-•___.._..- _____.___.____-_____...-__._-.._.__-..._..__..-
'INNACLE HOMES
Q735 BW GLACIER LILY CIRCLE
IiGARD OR 57223
Phone Q 644-4017
Kontractor: -----------------------------
+ ONTRACTIJR NOT ON FILL
-hone 0:
!>qw #1. . :
This Certificate certifies that the above referenced building or portior,
thereof has been inspected for compliance with the Tigard Buildirg Code
for the group and division of occupancy and uFe for which the above
-fere"ced permit was issued, and occupancy is heral-,y granted.
j
BUILI)7NG
INSPECTOR
POST IN CONSPICUOUS PLACE
01-31-1995 11:38RM FROM Pinnacle Homes Inc TO GU47297 P.01
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01-31-1995 ll:RHrl F=POH Pinnac'e Hnr-,e-:> Inc T!.. 604.'297 P.02
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phorle): 3 Business Phone 639-4171
Inspection:
Footing Susp, Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Lii e -Bldg.
Plbg. Underfloor Rain Drain c;Y--Fram g Plumb,
Alarm Water Line (--insulation�i.' -Mech.
Unc erflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: c� I( ( `J �-_ Time: AM PNf"
Address:
Builder: _ _Permit#: T /
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: — Date: :Fz/./y_,
APPROVED DISAPPROVED ---!ti'PROVED SUBJECT TO ABOVE:
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION moriCE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Y-
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwk
Foundation Plbg, Underslab Mech Rough-in ireplace
Post/Beam Strucl. Plbg. Top O,t Elec. Rough-in FINAL: /
Post/Beam Mech. San. Sewer Gas Line (�Rldg.
Plbg. Underfloor Rain Drain Framinc -Plumb. SA 5
Alarm Water Line Insulation
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time: AM PM
C,
Address:_ 1 C (' 7
Builder:_ Permit #:
THE FOLLOWING CORRECTIONS ARE R1=caUIRED:
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Ins actor: `��' _ D_fie: 7 S
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Lin, 'ec-O-Phona): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Roug,rin ;kppr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in C f1�N�?
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain FramingI-^ )
Alarm Water line Insulation
Unoerflr. Insul. Shear Wall Gyp. Bd. -Elect.
/
Date Requested: /� ( �J 5_ Time: AM _PM
Address:- 7
Builder: Permit #: `U J 2—
THE
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: `�_�.� ti _ Date: •)
_APPROVED e6i'SAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
C
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.4171
Inspection:__ —
Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Footing Fire lace
Foundation Plbg. Underslab Mech. Rough-in P
IN �
Post/Beam Struct� Elec. Rough-in
Plbg Top Out l.
Gas Lina
Post/Beam Mech. San. Sewer - 1"u`mb.
Rain Drain Frami�ig
Plbg. UnderfloorMech.
Water Lima Insulatirn
Alarm ll Gyp. Bd. -Elect.
Shear Wall Underflr. Insul. PM
Time: AM
Date Requested:_I?
[iuilder. �� �/ Permit
�y,�
THE FOLLOWING CORRECTIONS ARE REOUIRED:
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Date
Inspector
APPROVEDISAPPROVEO _APPROVED SUBJECT TO ABOVE
all For Reinsp.
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CITY OF TiGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspectic n:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundatioo Plbg. Underslab Mech. Rough-in F'replace
Post/Beam Strutt. Plbg. lop Out Elec. Rough-in
Post/Beam iOech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing ��Pl– V
Alarm Water Line Insulation -Meeh.
Underflr. Insul. Shear Wall Gyp. Bd. -E'ect.
Date Requested: �_ Time: AM PM
Address: C)
Builder: Permit #: Cl
THE FOLLOWING CORRECTIONS ARE REQUIRED:
L
Inspector�J —� Date:
APPROVED __ DISAPPRCVED _APPROVED SUBJECT TO ABOVE
_,Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-0-Phone)�:J639-4175 business Phone: 639-4171
Inspection: / ' L)O+� _
Footing Susp. Cailing Shrink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL.
PosUBeam Mech. San. Sewer Gas Lire -Bldg.
Plbg. Underfloor Rain Drair, Framing -Plumb.
Alarm Water Line Insulatic.i -Mech.
Underflr. Insul. Shear Wall /G Gyp. Bd. `�EI t.
Date Requested:_ / // I ! J _.Tim PM
Address:
Builder._ i�I _Permit p:_ _ 03,s-2
THE FOLLOWING CORRECTIONS ARE REQU"ED:
Inspector: ors Late: i l --9
�IPPROVED _DISAPPROVED _APDRGVED SUBJECT TO AB
�OVE�
Call For Reinsp.
CITY OF TIGARD BUILGING INSPECTION NOTICE
Inspection Line (Hoc-O-Pt )ne): 639-4175 Business Phone: 639-4171
Inspection:_ _
Footing Susp. Ceiling Sprink. Hough-in Appr/Sdwlk
Foundation PI1-3. Underslab Mech. Rough-in Fireplac3
PostlBeam Struct. Plbg. l op Out Elec. Rough-in FINAL:'
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framinr dumb
Alarm Water Line Insulation -Meeh.
Underflr. Insul. Shear Wall/ Gyp. Bd. -Elect.
Date Requested: ( -7/ lime:__AM PM
Address: / �% �f l ��� YA
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: - — Date: Jam" / �-ys
ROVED DISAPPROVED / APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CIT`; OF TIGARD BUILDING INSPECTION NOTICE
Insp ivtion Lime (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspec',c n:
— P
Footing Susp. Ceiling Sprink. Rough-in Appr/5dwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam MEch. San. Sewer Gas Line -Bldg.
Plhg I Inderfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. / y . Bd. -Elect.
Date Requested: �7 { ( � Time: AM -,X— --PM
Address:
Builder: Permit # S4t�—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Date:
APPROVED DISAPPROVED SUBJECT TO ABOVE
Call For Reinsp.
W2?]XMCTION NOTICE.
City of Tigard Building Depart—st
13125 SW Ball Blvd. Tigard. Orr.goe 97223
Inspection Line (Rec-o-Phone): 639-4175 Bjsiness Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in �ppr/Sd
P-)und. Plbg. Top Out Gas Line FINA..:
Past/Heam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: �' �_ Time: AM - PM
Address:_-JQ.�7 LU—t - Permit i:_,
Builder: -- - -- —
THE FOLLOWING CORRECTIONS ARE REQUIRED:
le -— �'� ✓rte o
n2 Whei)
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Inspactnr:�_.
Data:�i—A6
APPROVED DISAPPROVED �PPROVZD SUBJECT TO ABOVE
Call ForRelInsp.
CITY OF TIGARD BUiLDING INSPECTION NOTICE
Inspection Line (Reo-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —
Footing Susp. Ceiling SpJnk. Rough-in Appr/Sdwlk
Foundation F-lbg. Und9rslab Mech. Rough-in Fireplace
Post/Beam Struct. g. To�O-� Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. UnH^rfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Unc+erflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: � q `j� Time:_ AM PM
Address: -7�/� y it �--
Builder: S� l� 7 Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
l9spector_1zL Date:
X
,AF'PROVED DISAPPROVED APPROVED SLIBJE:,T TO ABOVE
_Call For Reinsp.
CITY OF TI(7,ARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Ph-)ne: 639-4171
Inspection: _
Footing Susp. Ceiling Sprink. Hough-in Appr/Sdwlk
e Foundation Plbg. Underslab MRough-r'n–` Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer as Lin -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underfir. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: ��-3 Time: AM PM
Address: (✓ Z //�i _.
j Builder: __SS t 1 :2 ( l Permit #: �–
THE FOLLOWING CORRECTInN' AM HFOUIRED:
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Inspector: /i�1 Date:
4�
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APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
—Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0-Phone)s 639-4175 B:-ainess Phone: 639-4171
Inspection:
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Pound. ,�bg. Top Out Gas Line FrNAL:
� t.r
eam Suc San. Sewer Framing
et Beam Mecl in Drain Insulation -Plumb.
Plbg. Underfloo qWatsr G Gyp Sd. -Mach.
Date Requested: / �7 f L/ ---_, Timet 1111 --PH
Addrons: !CJ "] 7 1' "L ___ Permit 1:
Builder:_
TIIE FOLLOWING CORRSCTIONNSS ARE REQUIREDS
OL
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Inspector: — \ '���'"-- -- Data: 1 /— 1�f
APPROVED
DISAPPROVED APPROVED t'UBJECT To ABOVE
_ Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Depattmient
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. in b�cin.' Insulation -Plumb.
Plbg. Underfloorater Lina Gyp. Rd. -Meeh.
Date Requested:—_ �� l 7 _Time. UAM �pM
Addreas: Permit f: ( - G ;� Z-
Builders �L rj /1 _ I �� - �70 ?6'
TAT.' FOLLOWING CORRECTIONS ARS REQUIRED: l 0
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nepectoM� Dabs
J- APPROVED DISAPPROVED APPROVED SU CT ro ABOVX
_Call For Reinap.
INSPECTION NOTICE
City of Tiga:d Building Departaent
13125 8* Ball Blvd. Tigard. Oregon 97223
Inspection Line (Rec-o-Phona,): 639-4175 Businesr Phone: 639-4171
Inspections ---
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. •--��'^� Plbg. Top Out Gas Line FINAL:
Pia=!Beam St ! San. Sower Framing -Bldg.
P t/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. ed. -Mach.
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Date Raquaoteds / / —Times AM —.—PM
� ( ! Cl
Address s�G' J7 �� Permit is_
Builders
THE FOLLOWING: ODRRECfIONS ARE REQUIRED:
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inspector: _ Dates ('
- - APPROVED
DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rainsp.
INSPECTION NOTICE
City of Tigard Building Departaent
13125 BO Hall Blvd, Tigard, oregon 97223
Inspection Lina (Rec-O--Phone)s 639-4175 Business Phone: 639-4171
Inspection: _
rooting Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
IFound. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
(�lbq Dnderiloor) Water Line Gyp. Bd. -Hoch.
Date Requested: p// / _TIMs CAM c PM
Address: Ifl) 7 7_z/z f�- Permit #s
nul.lder: _
TIM iti)L.LOWING CORRECTIONS ARE REQUIRED:
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Inspect _ __- Date: 1
APPROVED DISAPPROVED ' APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE /
City of Tigard Building Depart
13125 sR Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-.Phone): 639-4175 Business Phone: 639-4171
Inspection: - -- —
ootin C, Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Strict. San. Sewer Framing -Bldg.
Post/Beam Nect,. Rain Drain Insulation -Plumb.
Plbg. Under!.nor Nater Line Gyp. Bd. -Hoch.
-__l1 ` ` .-
Date Requieteds__ Time:/� �, PH
Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_(_ y V V , Date: o� I � - -I
APPROVED / DISAPPROVRD APPROVED SUBJECT TO ABOVE
\ C __Call For Reinep.
INSPECTION NOTICE
city of Tigard Building Departaent
13125 SN Ball Blvd_ Tigard, Oregon 97223
In:.,-�ection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspecttion:` _ _
oo� Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL-
Post/Ream Struct. San. Sewer Framing -Bldg.
Poet/neam Mech. Ra)-n Drain Insulation -Plumb.
Plby. Underfloor Nater Line Gyp. ed. -H h
Q
VAte Requested: _ J Time: AM _PH
AddrFlFles����� Jll �`
Bu .Mt2 Permit fit_
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THF. FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ v� _ - — nate:
APPROM niSAPPROVRn C/APPROVBD SUBJECT TO AIOvE,
-—C&I I For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sit Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: ti � (,- ( C
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. / Plbg. Top Out Cas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Lina Cyp. Bd. -Hoch.
Date Requested`C:, I Time: AM PM
Addrene:!�Q "t 1 t � - Permit
s 2-
Builder:
TKE FOLLOWING CORRECTIONS ARE REQUIRED:
5 Lid �_ : �� AAS Ar
1-� �T. V C-'r_-`-c�1
Inspector:_!
APPROVED DTSAPPROVED APPROVED SUBJECT TO ABOVE
2-.,))e
/e Call For Rainep.
CITY OF TIGARD PLUMBING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MST94-03�j,.,,
13126$W Hall Blvd.Tigard,Oregon 97223*81199 (503)639-4171 DATE ISSUED: 10/05/94
PARCEL: 1SI34AC-0'7300
13rTE ADDRESS. . . : 10897 SW 111TH AVE
`-i'UBDIVISION. . . . : JEFFREY ESTATES ZONING: R--4. 5 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :006
CLASS OF WORK. . :NEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . -SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . : l
OCCUPANCY GRP. . . R3 FLOOR DRAINS. . . . . .. . :0 TRAPS. . . . . . . . . . . . . . .0
srORIES. . . . . . . . :2 WATER HEATERS. . . . — : 1 CATCH BASINS. . . . . . . :0
FIXTURES------------- LAUNDRY TRAYS. . . . . . 10 SF RAIN DRAINS. . . . . : I
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :VI
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . .0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . : 3 WATER LINE (ft ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
itvimarks : PPTH I
UWNER:
PINNACLE HOMES T IF' $ 1550. 00 JF 10/05/94
12*735 SW GLACIER LILY CIRCLE BPRT $ 518. 00 JF 10/05/94
BPLC 11, 50. 00 JF 09/13/94 94-256681.
-rIGARD OR 97223 B5PC $ 25. 90 JF .10/05/94 -
Phone #: 644-4017 SSDC $ 280. 00 JF 10/05/94 -
PARK $ 500. 00 JF 10/05/94
[=llumbing MPRT $ 43. 50 JF 10/05/94
MPLC $ 10. 88 JF 10/05/94
Name : ---646 , le M5PC $ 2. 18 JF 10/05/94
Address : B137S- c,. lnkolp 3BTH $ 225. 00 JF 10/05/94
City : St at e : P15PC $ 11. 25 JF 10/05/911
PhonL-#:-,hs EROS $ 64. 00 JF 10/05/94
Rey Additional fees not shown here.
REQUIRED INSPECTIONS
This permit is issued subject to the reg-
ulations contained in the Tigard Municipal Foot/found Insp Rain drain Insp
Cncip, State of Ore. Specialty Codes and all Post/Beam Struct Water Line Insp
other applicable laws. All work will. be done Post/Beam Mechan Appr/Sdwlk Insp
in accordance with approved plans. 'ihis Plm/undslab Insp Mechanical Final.
permit will expire if work is not started FILM/Underfloor Plumb Final
within 180 day ; of issuance, or if' work i !; Mechanical Insp Building Final
slAspended for more than 180 days. Plumb Top Out Erosion Control.
Framing Insp Crawl Drain
Fireplace Insp ......-
Ga s
.......Gas Line Insp
Insulation Insp
------ Gyp Board Insp
P 1-t I a riz e Plumbingacu
Contrtor Signature
C)1—i 7 e
Call for inspection -- 639-14175
jril:rActor N o t es
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW HaK Blvd.Tigard,Oregon 87223.8199 (503)830.4171 MASTER PERMIT
F='ERMI T #. . . . . . . : I1ST94 -03:�4'
639-4171 DATE: ISSUED: 10/05/94
PARCEL: 1 S 134WC--07300
;SITE ADDRESS. . . . 108')L7 SW 11 11H i-)VE.
SUBDIVISION. . . . : JEFFREY ESTATES ZONING: R-4. 5 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . .. . — :006
_.__________ BUILDING
REISSUE:MST 9 c--02_'68 DWELLING UI\I T TS: 1 BASEMENT. . . . . . . . :0 s f'
CLASS OF WORK. %NEW BEDRMS:3 SATHS:3 GARAGE. . . . . . . . . . :440 sf
rY�'E OF USiE:. . . :SF FLOOR AREAS--_.__._-._.__..._ RE0.UI RED SE.•TBACKS__--__--.--.._.....
TYPE OF CONST. :;-)N FIRS;T. . . . :942 sf LEFT. . :5 ft RIGHT. :5 ft
UCCUF'ANCY GRP,. :R3 SECOND. . . : 1019 r.f FRON'T. :'r'4 ft RC_AR. . :413 ft
STORIES. . . . . . . :2 FINBSMEN'T':O sf RETa(JIRED--- - ----- -
HEIGHT. . . . . . . . :29 ft TOTAL----: I sfi SMOKE DE-rECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . 133957 PARKING SPACES. . : 1
Remarks : PATH I
5INKS;. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. ,. : 1.
LAVA'T'ORIES. . . . . ..4 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . ., . :0
i UB/SHOWERS). . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . .0
WATER CLOSETS. . :.3 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :O
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURES. :0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
W1051-1I NG MACH. . _ : 1 1'F" RAIN DRA 11\1S. . : 1
MECHANICAL _._._.__...__....._____.-----_.-....___......_..__._..._._.._.__ FEES
I"UEL TYf'F_S-_._-.._._.__-_.__ UNIT HTRS. . :O type amount by date recpt
/GAS/ / / VENTS . . . . . :0 TIF- $ 1550. 00 JF 10/05/94 -
MAX INPUT:0 BTU VE:';'T FANS;. . -4 BF'R"T q, 5113. 00 .J 1: 10/05/94 -
FURN ( 100K . . : 1 HOOD-3. . . . . . . 1 BPLC $ 50. 00 JF 09/13/94 94-256681
1-ORN > -10171K . . :ill WOUDSTOVE.:S. .0 B 5 P C $ 25. 90 JF 10/05/94 -
FLOOR TURN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JF 10/05/94
ROIL./CMF' ( 3HP:0 OTHER UNITS: 1 PARI% $ 500. 00 1'1= 10/05/94 -
GAS OUTL.ETS: 1 MPRT $ 43. 50 JF 10/05/94 -
Owner a ----_________._.__..____.____-.____.______.-MF'LC $ 10. 88 JF 10/05/94 PINNACLE HOMES M5F'C $ 2. 18 .JF 10/05/94
12735 SW GLACIER LILY CIRCLE 313TH $ 2'L`13. 00 JF 10/05/94
PJPC: $ 11. 25) JF 1.0/05/94 -
TIGARD OR 97223 EROS $ 64. 00 JF 1171/05/94 -
F'hone #: 644--•4017 FE RPC $ 20. 60 JF 10/05/94 -
f:tint:rar_tnr ----__..__________._.._._ __._.____._ ____-_L.RF='C f �'171. E30 JF 10I05i94
CONTRACTOR NOT ON FILE
CC
mRe #. -_--------_-------__--_-.._--------------_--.
cO $ 332'2. 31 TOTAL
J This permit is issued subject to the regulations contained in the ------- REOUTRED INSPECTIONS --- --- -
Tigard Municipal Code, State of Etre. Specialty Codes and all other Foot/fol_rnd Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Post/Beam St1^uct Gas Line Insp
plans. This permit will expire if work is not started within 180 Post/Beam Mechan InsLrlation Insp
days of issuance, or if work is suspenderj`or vo�re tharY7180,da�s.� Plm/i_rndslab Insp Gyp Bard Insp
4 //i `'t'fe- �F`JLd�e E'L_M Undprflaer p Rain drain 1r.,P
P_
Per'm7.ttPSi nat _� e . ` echanical Ins Water Line Ins
f✓J 1�_lmtr Top Ot_rt Appr/S;ciwlk Insp
Issoed Bye G Fr- . ming Insp Mechanical Final
Call for in'.pection - 639--4175
CITY O F T I GARD 1;FWFR (JNNFC'TA'LIN
COMMUNITY DEVELOPMENT DEPARTMFWr PFRMI I
13125 SW Hall Blvd, figard,Ortoom 97223081" '(503)839.4111 PF-PMI-t it. . . . . . . .. S'WP94-- 03.t,'
6PTF ISSUED: IOY05114
PAPC'EL.-
-1--% ADt)REc3S;- - 111+S97 C.;W Jjjr>•j poF
JFPrPl`'I F-S-tPTFf; P-4. 5 r1t)
. . . . . . LOT. .. . . .. . . . . . . .
wwp,.
. . . . . . . . . . . F:r X-t[JPF7 UN UrS. . .
PSS OP WJPK. NEW 0WE L L I NG I JN 1 1"13. . I
L)F' USE, SV NO. OF S Lf I L D I NCS I
A�il'ALL TYPI`.; , . . .AuSW R
k m, PT F t f
NNAC X�t HOMES Lvp4 �14 Ift 0 un t by dAto
-735 �W G*LACTr-.'R I-Ti.-Y CfRrLlrOm-r s -PP00. 00 YF t0/05 94
39' . 01A J r' 10 12115 1)
`16)011) CA 17c��?3
-10 *. 644-4017
N07 Oh� PAA
;his 4ppl I va"t agrees to 00001y with all the oules ed regul0inne inspocticti
J the Unified &wag# ftrvty. The porrit expirpi 106 days ft,91-
the late tessuod. The tvtol 000t paid will be forfeited if the
jol,vit expires. The RgMy does not averarrtit the of the
'rp -oiler laterals. If the S"#pr is n(A 10"to at the fffasurevefit
giker, the installer shall p"Awt 3 feet ift all di"etiom frot
the distance aivel, If not so Iomtf-A' the iflitalle shall purlr+A10
a 'T40 am side Sew" P'"It acrd the Nwv will install a lateral.
1 "L71AL"O LA
Residential.Buildina Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobilts Address: 7zi bim
:.
Subdivision: om Ilse Only
Lot X �2
Planck/Rec#
Valuation: 5 .3 �J
ff
3
Permit#
Comer Lot? Y N
Reissue of
Flag Lot? Y N
Map & TL#
Owner: L'I Approvals jKe
_qqired
Address: Lj
Planning
z
Engineering
Phone: Other
Contractor: Item
j s Required
Address: S ubconfractr-,rs
U-
Truss Details
Phone: Other
Contractor's License
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors:
,Architect/Engineer:
Plumbing: t' Address:
Mechanical: to
(attach copy of current OR Contractor's License)
Phone:
JOB DESCRIPTIC N: (141
Applicant Signature &'Phone number
hReceived by. Date Rocelved:
NWORMCOMDEVOESAPP
Permit# Account Description Amount Amt Pd. Bal. Due
1-n,Sf�f� O S 2- Bldg. Permit (BUILD) / s
Plumb. Permit (PLUMB) 2 3'1�
Mech. Permit (MECH) Z/,3 , v
State Tax (TAX) 3
Bldg:
Plumb:
Mech: /
Plan Check (PLANCK)
Bldg: So
Plumb:
Mech: /o,
,5bx 4� Sewer Connection (SWUSA) 2a 1 C,v
Sewer Inspection (SWINSP) Y
Parks Dev Charge (PKSDC) -Sc U YC
Storm Drainage Chg (SDSDC) L2 j—V _ :2,�V
Residential TIF (TIF-R) lv3u / 3 u
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS) _
Office TIF (TIF-O) _
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion C:ntrl Permit (ERPRMT)
Erosion PlanckAJSA (ERPLAN) �a w
Erosion Planck/COT (EROSN)
TOTALS: �- S S sv
CI i Y OF- TT0ARD fWATIP't CW" POYMENT Rf:GL.IV,1 N1J. s9,4- -'56bfiI
CHf.;I A AMOUNT a 50 (40
NWAF t P I NNACL+_ f UMf S CWAA AMOLIN'I (a. tlJlra
ADDRESS / P144YMI td 1 D11►1, 04/13/94
SUM)I V 1.'.>I LIN n
f'' MP08F OF' PAYMf-,N'T 11MOUN"7NA C I) PURPOSE OF PAYMI.AJ AMI H►N I 1-'1111)
IM97 Sw ill I ► I
Ilie�U Iaf1�1111J1 PHIU
I I y 01- TMAND RE(+ AP'l (,if II'(4y1t1). hl I Irl 1 .11,' 1 NO.
I 111 I ,K 1111,101 IN T 1i 5 LA 7. .11
110W14 i .tTdl A111-11M a 0. tAo
PRYMI- N] N-0F J0/0,5/94
11)HPUSt. 0'. T:lAYMENT IIM(jl.)Nl PHID PILIRPOHF. (IF PAYMIENU f:lml)l,)I\l I V,f-i k D
1.1U 11_C)Ihl1 I 'l-PM M'3194-0.3h;-! 51A. 00 PlAlm[A 11140 pl-4401 ?P5. ola
MF=1 I I(M I I i il 14 43a '50 C-11. 14111-0 PEli 39. 313
10. 6H 00
Wf.H I W41 1 1 3"J.. 00 PARM., HIA.; `11A1A. 00
cc "JIJIRM DHOM !)))1.; 80. lAIA RVAi I DVN I A HI I H Of I-, I 11:.f'H 14,10. 00
"kHNl,.l I TIV V4 FS j io,o. 00 K lit lti I ON 1 Rl Il PI RM j I I I f 6m. LAO
__j i-RuriLUN PLON L;t,\ 80 1131A
10141)7 SW 1 1 1 1 H, 1 ,11.)1 6 .1 t:.l I HE Y L-.!..;1 0 1 1-.b
y I
I I
1 .8 2'
N 89 34 2 E
�---- - 100.0 *z 25.00
dQ >
A3 f
0
c6 03
T "C" `n I 69535 SF a coo
SF N 89.35'22" E N
1 1 .82 CV
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FEB -- a - 9 5 WED 6 5 9 ENGINEERED CONCEPTS P _ 0 1
ENGINEERED CONCEPTS, INC
5710 S.E. JOHNSON CREEK BLVD.
PORTLAND. OREGON 97206
508 775-6775
603 775 -9108 FAX
F A X T R A N S M I T T A L
DATE. 2/g l f!j Page of
To: kt-ti,
FAX NO. dp&4- - -7z y,
FROM: p.,re-y Su-*-err
RE: 40Q CJ /oB 9 7
REMARKS:
J
U'
!11
_J
0 - 95 WED 9 : 00 ENGINEERED CONCEPTS P . 02
ENGINEERED CONCEPTS, INC,
JOB
9301 S.E. Stanley Ave, SHEET NO_ _ OF_
PORTLAND, OREGON 91222 p
(503) 775-6775 CAI cuI.Alkoov- r-G
FAX (503) 775.9108 cHECKaoev
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