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i:\records\micro(Im\targe(sV)ui(ding.doc
A
r'LUMBING PERMIT
PERMIT #. . . . . . . . MST93-A 166
CITY OF T IGARD DATE ISSUED: 05/01/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.T1g,-(d,Oregon 97223.6199 (503)639-4171 L 1 S 13 4 A C-0 7 10
UBDIVISION. . . . JEFFREY
' ESTATES
ZONING: R 4. 5 PD
LOCK. . . . . . . . . . .. LOT. . . . . . . , . . . . .004
LAS] Or WORK. . :NEW GAR 'AGE DISPOSALS. . : I
-VPr- OF USE. . . . :SF WASHING MACH* o . . . . . 31 BACKFLOW F-,'REVNTRS. . : I
"CCU1,011INCY GRE'. . t R7 FLOOR DRATNI . . . . . . . .0 . . . . . . . . . . . . . . ..rjf
.:TORICS. . . . . . . ,. WATER HEATERS. . . . . . c I CATCH BASING. . . . . . . :0
LAUNDRY TRAYS. . . . . . ; I SF r,,A I P.i DrA I ris. . . . . : j.
INKS. . . . . . . . . : 1 GREASE TRA"'S. . . . . . . :0
AVATOR I ES. . . . . .4 OTHER FIXTURES. . . . . :0
UL11/13HOWERS. . . . 9 SEWER LINE (ft ) . . . . :0
ATER CL`'SC TS— c3 WAT'r"P L IHE (ft ) . . . . : 112)0
"7HWASHERS,. . . . - I RAIN DRAIN (ft ) . . . . :0
PATH I
'WNE.R.
INNnCLE HOMES TIF $ 17150. 00 S14 03/01/171
7735 SW GLACIER LILY CIR swm $ 180. 00 SW 05/01/95
Swil t 100. 00 sw 05/01/9=
IGARD OR 0- '1,223 7,63. 00 S W 0S/01;'1'=`i
hone #: 'j24--4711 Br'LC $ 365. 93 BON 04/06/95 94-26.7 )'
5 SW 05/01/9w
Contractor..--.- r'AnK $ 500. 00 SW 05/01/')'a
mr,RT $ 45. 00 SW 05/0-1/95
HPLC 11. 15 (7)W 05/01/9
V15
M -,C
ILr 25 SW 05/01/95
i L �",tat e 1-25. 00 SW
—ITi I I I)
i1,7. —p h o rl v#. p5r,.-, f, 11- 25 SW 04'15/m1/95
Ej #I dr ---hown 1-1pre. . . . . . . .
A Jitional rpos not 11 .
REQUIRED INSPECTIONS
�Ii !-, Pel'mit i ': JSSUeJ —1tject to the vog-
lations contained in the Tigard Municipal Footing Insp Insulation Insp
ide, Statu of 01-e. 5pticialty Codv,s antj al ]. roun(jatioi, irisri Gyp Board Insp
applicable law5. All work will be dune Post/Beam Stvuct Rain drain Tn
-A T-ce with-i :Approved plznt . This Post/Seam Mechan Water Line Iii
C01'd - -tl
av,mit w:kll expire if work is riot started Crawl Dr-Ain Water S)ervice I
ithin IVO days of issuatir it-, VJili 1 is Pllll/,-Olds] rAb Inip Appir Sdvyll Ins(:
-ispended for more thjjjn 11.30 PLM/Underfloor Mechanical Fina '
Mechinical Tnsp P I 1.k m b Final
Plumb Top Out 11%tildinp Final
rraming lyisw erosion cantt,i
Fireplace Insp
ct01 f7,i L a t ure,
LLJ 4 175
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Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # is-- a0 S-S
Permit # tFCc ,7,r- u s6
Phone (503) 639 4171 Date Issued d'- -9,r
CITY OF TIGARDFAX (503) 684-7297 Issued by 07o, u S
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development Number of Inspections per permit allowed —
Address Zalz' '`-pa) fz� /–� Service included Items Cost(ea) Sum
City/State/Zip ;Q _�_61 DL 4a. Residential- per unit / 4
�7 1000 sq it or loss / $11000 ///_>,
Name (or name of business) Each additional 500 aq It or
portion thereof - - $2500
Commercial❑ Residential Limited Energy $2500
Each Manurd Home or Modular 2
Dwelling Service or Feeder $66 00
2a. Cooftr-x!.-j► installation only:
v � 4b.Services or Feeders
/� �Cy t Lf�
Installation.00irip alteration or relocation 2
Electrical Contractor
200 amps or lace $6000 2
Address 201 amps to 400 amps $8000 2
401amps to 600 amps $12000 2
City_ 51ate--a4S g— Zip Cyl'>O sot amps to 1000 amps $18000 2
Phone No. Y/-Y,25/2== Over 1000 amps or volts _— $34000 2
-'r--
Contractor's license No. Reconnect only $5000
_�(v d
Contractor's Board Reg. No/ L 4c. Temporary Services or Feeders
Installation.alteration,or rnlocation 2
Signature of Supr. F lec'Fh/ -� �, 200 amps or less $5n oo - Y 2
,-� /�f _r� 201 amps to 400 amps $7500
License No. a Phone No. r��/1 401 amps to 600 amps $10000
Over boo amps to 1000 volts ---
2b. For owner installations: see-b-at ova
4d. Branch Circuits
Print Owner's Name New alteration or extension per panel
Address n)The lee for branch circuits with
City State Z_ip_ purchase of servlse or beder it». 2
branchEach circuit 00
Phone No. h)The leeto branchcircuits without $5
The installation is being made on property I own which is purchase of service or feeder iw.
not intended for sale, lease Or rent First branch circuit $3500
additional branch circuit $5 00
Owner's Signature _ _ 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation circle $4000 2
Each sign or outluie lighting $4000
Signal circuil(s)or a limited energy 7
Please check appropriate item and enter fee in section 5B. panel,alteration or extension $400() _
4 or more residential units in one structure Minor I-abate(10) Sion oo
Service and feeder 225 amps or more —
___System over 600 volts nominal 4f. Each additional Inspection over
Classified area or structure containing special occupancy the allowable in any of the above
F as described in N E C Chapter 5 Per inspection $35 00 —
_ Per hour $5500 _
$55 0o
Submit 2 sets of plans with application where any of the above n Plant —
apply. Not required for temporary construction services.
5. Fees:
NOTICE 5a. Enter of above fees $ (
5%Surcharge(05 X total fees) $
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5b. Enter 25%of line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FON Plan Review If required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $r
COMMENCE[ L_1 Trust Account#
Balance Due $ NqAC�
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IN U PW D 194. P5.
CITY CERTIFICATE_ OF
�F TIG RD OCCUPANCY
COMMUNITY DEVELOPMENT DEPARTMENT PERM I'1 0. . . . . . . : MST9501 k..
13125 SW Hall Bled Tigard,Oregon 97223.8199 (503)839.4171 DATE ISSUED: 11/1G/95
PARc.`EL: 1 S134AC:--.07100
lT•r 1N914 SW 11. 1TN AVE
UBD I V I S I ON. . . . : JEFFREY ESTATES ZONING:R--4 `e PD
. . . . . . . . . . LOT. . . . . . . . . . . . . .IZ104
_;...ASS OF WORK. :NEW
TYPE- OF USE. . . s SF'
OCCUPANCY ORP. :
OCCUPANCY LOAD 12
Remarks : PATH 1
Owner: ----____.._._... ...,.. ___._ .._...........__..._.___.._. -__
PINNACLE HOMES
li-:735 SW GL..ACIErR LILY CIR
TIGARL) OR 97223
hone #: 524-•4711
nntrac.t or:
(.!1-1 o n e #:
Reg t►. . : 10177
This Certificate grants ocCUpiancy of the at�uve referenced building vtr portion
thereof and ronfi.rms that the building has been ingpf?cted \f Or campli'ance with
the State of []reL(on SpecialtyCodes fur the gr^oLtp, n upanc,y and slap Linder
which the rel ren :eci permit was issued.
taUlLDI1VE:i N- P- BUILDING OFFICIAL
P106 T IN CONSPICUOUS PLACE-.
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CITY OF TIGARD EUILfiING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 639-4171
Inspection: _---
Footing Susp. Ceiling f')posink. Rough-in Appr/Sd
Foundation Plbg. Underslab Mech. Rough-in Fire-
place
Post/Beam Struct. Plbg. Top Out Elec. Rough-in
Post/Beam Mech. San. Sewer Gas Lina
Plbg, Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation
Unc erflr. Insul. Shear Wall Gyp. Bd. -Flect.
Date Requested_r 4 �ec1 Time: AM �_PM
Address: 7_�- k 1 �'—
Builder: -i Permi' #: 1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspecto:_ Date:
APPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Neinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing SUsp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslah Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. hough-in FINAL:
Post/Bearn Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing Plumh.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall -Elect.
ate Re uested: //_3 ! `j Time: AM PM
Cdr,�
Builder: l=-, r LT- //,-- Permit #:
THE FOLLOWING CURRECTIONS ARE REQUIRED:
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Inspector: a Date:
APPROVED DISAPPROVED � GVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-C-Phone): 639-4175 Business Phone: 639-4171 1
Inspection:
Footing Susp, Ceiling Sprink. Rough-in ,,Appr/Sdwlk
Foundation Plbg. Underslab ech. Rough Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Pltg. Underfloor Ra.o Drain rami-n~' / Plumb.
Alarm Water Line C nsulatiori' / Mech.
Underflr. Insul. Shear Wall Elect.
c _ �.��..
Date Reque;;ed: Time: AM OPM
Address:
Builder: Permit #:
�1 HE FOLLOWING CORRECTIONS ARE REQUIPED: --�
+47 cc
Inspector: Date:
_APPROVED _DISAPPROVED ,�APPRc.VED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 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 Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Phimb.
Alarm Water line Insulation -Mech.
Underfir. Insul. Shear Wall Gyp. Bd.
Date Requested: �Jr Time AAS PM
Builder: Permit #:e1'_•S ! 2 _ v 1(44)
THE FOLLOWING CORRECTIONS ARE REQUIRED:
z9 1c:
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Inspector: --- ' ` i _ Date:
NPPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE /
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
a
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslabech. Rough i i Fireplace
Post/Beam Struct. Plbg. Top Out�I�I� Elec. Rough-in/1r J FINAL:
Post/Beam Mech. San, Sewer Gas Line $J'L> -Bldg.
Fling. Underfloor Rain Drain <:! g -Plumb.
Alarm Water Line Insulation -Mech.
�\ Underflr. Insul. Shear Wall �J� Gyp. Bd -Elect.
Date Requested: / l( /C4 c,— Time:_XAM PM
�► Address: C2V �4 /V
YBuilder___,��`rIt C��G2ii— Permit #:
v THE FOLLOWING CORRECTIONS ARE REQUIRED:
7^.rQ �.
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Inspector:_ Date: ! ]�
APPROVED ISAPPROVED _APPROVED SUBJECT TO ABOVE
(71J l � �_Call
JCall For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Irfspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Foot;ng Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Understab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time:_—AM PM
Address:
Builder. Permit #: C� ��— 0
THE FOLLOWING CORRECTIONS ARE REQUIRED: 2 e'� 2—
\,til �7-142�
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Inspector: y � Date: 9�' f ^-
,APPROVED ?CpISAPPROOV-ED APPROVED SUBJECT TO ABOVE
�t j`� i�tiall For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in ppr�
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewor Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plurnb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear/Wall/ Gyp. Bd. -Elect.
Date Requested: ( �/�(p1 ys Time; AM PM
Address: I L/ ���( /1/
1
Builder: Permit q: L' 5-
THE
THE FOLLOWING CORRECTIONS ARE REQUIRED:
00
Com'✓�� �tzcc �D ✓ Ai �4
J 'f vCcIf
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Inspector- J1 �i Date:� _� �
_APPROVED __DISAPPROVED AP , BOV
____Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FIf�L C�
Post'Beam Mach. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing -Plumb. j
Alarm Water Line Insulation r
Underflr. Insul. Shear Wall Gyp. Bd. Elect.
Date Requested:�L Time: AM _�PM
Address: 7lL-
Buildeva)-ka Permit #:_2
THE FOLLOWING CORRECTIONS ARE REQUIRED:
-f^,--
Inspector:, ` ^ /' Dater � l�
_APPROVED ,SAPPROVED APPROVED SUBJECT TO ABOVE
��` Call For Reinsp.
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` CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 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 Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear all Gyp. Bd. -Elect.
Date Requested: CTime: AM rM
Address: )
Builder: Permit
t
THE FOLLOWING CORRECTIONS ARE REQUIRED: yr
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Inspector: _ Date:
APP VED DISAPPROVED _APPROVED SUBJECT TO ABOVE
`Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTI,)N NOTICE'f��/
Inspection Line (Rec-O-Phone): 639-4175 /Business Phone: 639-4171
Inspection: M� //U �' - (' r
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 Line -Bldg.
Plbg. Underfloor Rain Drain Framing umb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: � Time: _.AM PM
Address:
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Builder: Permit #: 0
rHE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector. �� Date 7
APPROVED _DISAPPROVED __APPROVED SUBJECT 7TO ABOVE
_—Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-/O-Phone): 639-4175 Business Phone: 639-4171
Inspection:_z—, L,,/-,
Footing Susp. Ceiling Sprink, Rough-in Appr/Sdwlk
Foundation Plbg. Undbrslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech,
Underflr. Insul, Shear Wall gip. Bd. -Elect.
Date Requested: �` Time: AM PM
Address.��_
. 7
Builder: Permit #: _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
25
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Inspector: wr C CZ, - Date: ` �
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APPROVED xQDISAPPROVED APPROVED SUBJECT TO ABOVE
—Call For Reinsp
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 /
t✓
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 Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumh.
Alarm Water Line Insulation -Mech.
Underflr. Insul. ear Wall'�� -. 1 Gyp. Bd. -Elect.
Date Reo,:dsted: C� / 7��/ Time: AM PM
Address:
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Date: 8- 7— `i'_5_
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: _
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. �Pbl . To"' Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Lin Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Data Requested. y Sr/ Time:—.—AM PM
Address:
Builder: Permit #: C 7 5 — C) (0 Ce
THE FOLLOWING CORRECTIONS ARE REQUIRED:
,tet--�r ,'� n-✓L.— L�a'��_
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Inspector: ~ Date:
APPROVED DISAPPR:nVVEE _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing S;isp, 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 aas Lina y- ' -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time: AM PM
Address: ' �!r/ —
Builder: Permit #:ti(',
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: J�J _ Date: 9S—
`APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE 4_l
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: t'Y
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
�ost/Beam Str Plbg. Top Out Elec. Rough-in FINAL:
flost/Beam Medi Sari. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall / Gyp. Bd. -Elect.
Date Requested: / Z Z- Time: AM PM
Address: L �� �� �-
Builder: Permit If
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: i Date:
APPROVED DISAPPROVED PROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE-2-7--
Inspection Line (Rec-O-Phone): 639 4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Pnst/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
f5lbg. Underi % Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Undertlr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:�� 1Cj ,-)— Time: AM PM
Address:__
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date:
1 APPROVED `DISAPPROVED APPROVED SUBJECT TO ABOVE
,J�-' ,Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 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.
an. Se Gas Line -Bldg.
Plbg. Underfloor ) Framing -Plumb.
Alarm Insulation -Mech.
Underflr. Insul. Shear Wall ( Gyp Bd / -Elect.
Date Requested: / I 1 c�5 Time: f � PM
Address:
Builder: Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector _ Date: -�
APPROVED _DISAPPROVFD —APPROVED SUBJ CT TO ABOVE
_Call For Reinsp.
CITY OF 1IGARD UUILDING INSPECTION NOTICE
Inspection Line (Roc-G ' one): 639-4175 Business Phone: 639-4171
Inspection:_
� otinq 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 Line -Bldg.
Plbg. Underfloor Rain Drain Framing I Plumb.
Alarm Water Lino Insulation -Mech.
Underflr. Insul, Shear Wall Gyp. Bd. -Elect.
Date Requested: Time:� � PM
Address: c1-
Builder: Permit #:
THE FOLLOWING CORREC(IONS ARE REQUIRED:
4
�3/ �7/J�-✓T��i.{ 3 '' �d�r-1�� C,.��ls.J.�/Z �c.6�i7r�
`C-» `! (�L✓C J�'r e-;�-;li LI /�tiy n✓i j Z-+�a."i.�ss Y F`�T�'
G]
C)
Inspector: _ _ Date:
APPROVED DISAPPROVED '-WPPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec--O,Phone):
/6639-4175 Business Phone: 639-4171
LInspection: '�
i
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
oundatio Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech
.
Underflr. Insul. Shear Wall Gyp. Bd. � �Elect.
Date Requested. �,� �jS� Time: �� PM
Address: ABuilder: Permit Permit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�% iV SiI7-� •�E J�'�y.'-i 5 /r7 S �f_'w/Li
45 jv��uc� �✓
i
Inspector: Date:
APPROVED DISAPPROVED C__APPROVED SUBJECT TO ABOVE
`Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 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 Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. ec .
Date Requested: Z Time: AM PM
Address:_ / (
Builder:L-4.,f_f Permit #:�� eJ 5 2)S�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: _ _ Date.1 S
/APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
`Call For Reinsp. 0 A �j �j
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Picone): 639-4175 Business Phone: 639-4171
1 �-
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwik
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct, Plbg. Top Out ELej�_'Rough-in FINAL:
Post/Beam Mech, San. Sewer Gas Line -Bldg.
Pibg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: C �� Time: AM PM
Address:
Builder: i ye, /�.+— _Permit N:
THE FOLLOWIXIG CORRECTIONS ARE REQUIRED:
-- �� I( C' �L� v ti
IL
In actor Date:_
/ PPROVED —DISAPPROVED __APPROVED SUBJECT TO ABOVE
_Call For Reinsp. z5cf_4
CITY OF TIGARDmns'rERPEEZMIS PERMITMST95 0156
'COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 05/01/95
13126 SW Hall Blvd.Tigard,Onpon 97223.8199 (503)630-4171
PARCEL ., 1 G 134AC--07100
.SITE ADjRES". . . : 10014 SW 111TH AVE
SUBDIVISION. . . . : JEFFREY ESTATES ZONING: R-4. 5 PD
LOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . .004
BUILDING
REISSUE: DWELLING, UNIT07: 1 BASEMENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:4 BATHS.3 GARAGE. . . . . . . . . . :407 sf
TYPE OF USE. . . :SF FLOOf? AREAS - ._.__ _.__.___ REGUIRED SETBACKS-----
TYPE OF CONST. :5N FIRST. . . . : 1334 sf LEFT. . :5 ft RIGHT. :5 ft
7E�CUpANCY GRP. 03 SECOND. . . :Oe( C- S FROhIT. :'20 ft RU.AR. . : 1 ft
STORIES. . . . . . . :,_ FINBSMENT:O sf
I-iE I GHT. . . . . . . . :C9 ft TOTAL _-_ .. - :2240 b f SMOKE DETECTORS. :`/
FLOOR LOAD. . . . :40 psf VALUE. . . . : $ : 151460 PARKING SPACES. . : i
Rema►^I<s , PATH I
PL.UMBING
INKS. . . . . . . . . . : I FLOOR DRAINS. . . . :0 BACKFLOW PRCVNTRS. . : 1
LAVATORIES. . . . . 14 WATER HE=ATE:RS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
YUIa/SI-I(JWCRG. . . . :4 1._fl:INDRY TRAYS. . . : 1 CATCH BASING. . . . . . . :0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
D I SHWASHERS. . . . : 1 WATER LINE (n ) . : i oo OTHER FIXTURES. . . . . :0
aARElAuE DISP. . . : i RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 G3F RAIN DRAINS. . : 1
MCCHANICAL .___.___._.._____.__..__._..__. ...._......_.._____.___._._, FEES
FUEL TYPE!') -.---.-....__ ____. UNIT HTRS. . :0 types amoi.tnt by date r-ec:pt
/GAS/ / / VE=NTS) . . . . . :0 TIF t 1550. 00 SW 05/01/95 -
"QAX INPUT:O PTU VENT PA ]NS. . :4 swin $ 1���,,0. 00SW os/01/95 —
'"URN ( 10011 . . :0 HOODS. . . . . . : 1 SWM $ 1 [.•0. 00 SW 115/01/95
,—'JrN ) -100K . . : 1 WOODSTOVES. :0 L'PRT t 56,33. 00 SW 0`x/01/93
FLOOR TURN. . . . :0 CLO DRYERS. c 1 BPLC $ 365. 95 DON 04/06/95 94--26;912
BOIL/CMP ( 11P:tis OTHER UNITO: 1 D5PC $ 2(3. 15 IS IV 105/01 /15 -
GAS OUTLETS: 1 PARK $ 500. 001 SW 05/01/95
_.._..._.-_.._.....__....__._____ ...MPRT f 45. 00 aW 05/01/`)3
PINNACLE HOMES MPL..0 $ 11. 2 1 SW 05/01/95 -
1�2.7"'J5 GW GLACIr_R LILY C1R M!SPC: 4, C5 SbJ 4?t5/01; 3',
3BTH $ 22S. 00 SW 05/01/95 ._
TIGARL� OR ')72;.'L3 r15f C $ 11. C'15 SW 05/01/95 -
Pi-1 one #t 5'-_'4-471 1 EROS $ 64. 00 CW 1715/01/11S
-CRP-C :,91. 60.1 SW 05/01/95
"'T",INACLE HOMES ERPC i 20. 80 SW 05/0.11/915,
135 SW ";I_AC I ER LILY CIRCLE
'r 1()ARD OR 97223
i?hgtie #;. 554- 4711
le p # . . . 16177
$ 360!7. 45 TI,TAL
?is permit is issued subject to the regulations contained in the -- - ---- REPUIRED INSPECTIONS - — -
"igard Municjr<-,' "':de, State cf O-e, Specialty Codes and all other Footing Insp Plumb Top Out
applicable laws. All work will be done in a.cordance with approved Fo _tndat ion Insp Fratming IT15p
sI ant. ''his persit will expire if work is not started within 1H0 Post/Pearn atr-uct Fir'epl��ce Insp
.'ays of isstunce, or if hcrk is suspended fol aore tha 1GI days. Post/Ream Mechan Gas Line Insp
Cr-awl Dt-ain Insi_tlation Insp
Pim/undsi�%b Insp Gyp Board Insp
1 PLM/Under-flaor^ Rain di,atin Insp
��i I' ��l,l��(�11 _ . . .,_ ..,.._._.. .. . Mechranical Insp Watev Line Tnc-
-:all for" tnsppc:tion b.39--4175
CITY OF TIGARD SEWER COltiivECTI Otw
�'ERMI'r
COMMUNITY DEVELOPMENT DEPARTMENT PERIMIT #t. . . . . . • = SWR95-0159
13126 SW Hall Blvd.Tigard,Oregon 07223.9109 (503)630-4171 DATE I ESSUED: 05/0071/rj5
PARCEL: 1S134AC-07100
HDDRESS. . . : 10914 SW 11171i AVCS
_X,DIVISION. . . . : JEFFREY ESTATES ZONING; R-4. 5 PO
LGCIi. . . . . . . . . . . LOT. . . . . . . . . . . . . :004
'-C'NANT NAME. . . . . c
SA NO. . . . . . . . . . . FIXTURE UNITS. . .
Lf"+CS or WORK. . . :NEW DWELLING UNITS. . : 1
YPE Of'" USE. . . . . :SF NO. OF DU I LD I NGS: 1
NC 1)ILL TYPE. . . . .13U SWR I MPERV rURFACC. . ; sf
emarks: PATH I
Wrier,: -- ______.____.________..____.—_...____.._______ti_____,_____-- PEES
Ih:NACLE: HOMES type amount by date rF•rr.)t
2735 SSW GLACIER LILY CIR PRMT $ 22'00. 00 SW 05/01/91 -
IN3R $ 35. 00 at•i 015/01/1,
1GARD OR 97223
lone #: 524-4711
antractar: ___---— ------
___ti___—_____—_---
_
INTRACTOR NOT ON FILE
:-lone 2a35. 00 TQTAL__..____,_________
q #. . .
- REQUIRED INSPECTIONS - _._.._.. .
is Applicant agrees to comply with all the rules and regulations Sewer- Inspection
the Unified Sewage Agency, The permit expires 184 days from
.,it date issued, The total amount paid will be fcrfeited if the ��
-ermit expires. The Agency does not guarantee the accuracy of the
Al sewer laterals, if the sewer is not located at the measureser'.
y:ven, the installer shall prospect 3 feet in all directions from
the distance given, if not so located, the installer shall purchase
a "Tao and Bide Sewer" Permit and the Agency wi', install a latir=l,
T-mit tee t3ian,3tv,,e ,
Call far inspection 639-4175
J
���v 5
Residential Building P� ermit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: �`
-� lG Office Use Only
Subdivision:
� � Lot#
Valuation: /5/ �wU Contact Date(`/ IL", f�S Initials
Result k i 1 ,,, •,•.Nye ,1•. 4
Planck/Rec # !q-ls
Now Construction Only: (Square Footage) Permit #�/V Sf9S - U/GG
House: a2-4 o Garage: y v 7 �� Reissue of
Map & TL #. 1613 y AG- U'71 OD
Zone V_ ._5 P O
Corner Lot? Y N Flag Lot? Y N Plat # 549 - 7��— 1 14
Approvals Required
Owner: _. U y1 rr r� t�'~'-� �-, L-
Address: 127 3 C •' L 1 G Fanning Setbacks ��Solar
_ y Engineering
rj 2 2 �_ Other
1 a�v,ly4 - - �
t' Phone: ijy � ) 5 Z `7 - �7 LL
/ Items Required
/�/L7 cJ�tyl4ti Subcontractors
Contractor:
rI " Truss Details
Address: Other
otes
Phone: ( ) AQ JI A I T,
Contractor's License # /2-7 _ �L A AA `M'
(attach copy of current Oregon license)
Contact Name: _
Contact Phone.-
Subcontractors:
hone:Subcontractors: Arch tect/Engineer:
N J 7
C
Plumbing: p/�r f 0057 ! u�k
?- f Jy ' h _5 Address:
mjy 4h'f echanical: ._SVS
C (attach copy of current OR Contractor's License)
CM
W Phone:
__j -
JOB DESCRIPTION: ' ' A
Applicant Sig-at a Applicant Phone number
Received by I u l0 �l�t �` Date Received:'
f1�eQI11WMl,.f Dnp
Permit # Account. Description Amount Amts. Pd. Bal. Due
Bldg. Permit (BUILD) S(o • & ,oo v
Plumb. Permit (PLUMB) Z
Mech. Permit (MECH)
14 )
State Tax (TAX)
Bldg: o2�.lj
Mech:
Pian Check (PLANCK) 3 Z-y 12 7,
Bldg: 3�vS; rll�
Plumb:
Mech: / I•L�� �/
v SwlZ4 i-u Sewer Connection (SWUSA)
Sewer Inspection (SWINSP) _
Parks Dev Charge (PKSDC) Soy
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1) _
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
71-
7-
Water Quality (WQUAL)
Water Quantity (WQUANT) c `' _ /"y
Fire Lire Safety (FLS)
Erosion Cntrl Permit (ERPRMT)
J Erosion Planck/USA (ERPLAN) o`f��• 1
Erosion Planck/COT (EROSN)
_ i-
TOTALS: 5 •c�'� S 0
r
C 1 T'r I)E" "E 1Ftp"C C'T I-,r OF VICiYMf NT RECF"I GST NCI. 195--263912
C.HF-CF, 1 iMnI.INT s 00
NAIh1 s P I14NI1CLF I•IC)hlr's CASH AMGLJNT otA
FADI)RES6 1o:?7 5 CSW GL ALTER 1, TLY C:IR PFAYMEN"E DATE s 04/06/95
TIGAPD, nR t�lll t)FVC.SICFI�! s
PURPOGE OF F't'AYmr'NT AMOUNT VIA ID PURP0131i" OF I-SAYME=.NT ANN INT F'A T D
i
CHECK FE 4--ISR 250. 00
n
J
J
10914 SW 111TH AV1=;-
TO-rpt- FAMCII.INT POI1► - -F 250. 00
4
M
CITY OV TICARD -- RFCFIPT OF PAYMENT RE-CD:IPT NO. s9S-264865
CHL.CK AMOUNT m 567i:-:'. 45
NAME a PINNACA-E vinmi-is CASH AMOUNT 0. 00
ADDRESS 127-a5 15W GLACIER LILY CIRCLE PAYMENT DATE 05/01 /9!55
Tir,4D, OR SUBDIVISION
97&'L';"3—
PURPOSE OF PPYMFNT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
rt BUTLDING PERM MST95--0166 5(13. 00 PLUMBING PERM 2215. vto
MIFCHANICAL PE 45. 041 18T. LSU IL-D PER 41. 65
PL,44N rHECK FE i iF-.7. 20 SEWER USA SWR95-0159 01200. 00
5F.14ER INSPECT 35. 00 PARKS SDG 11500. 00
(AJAL.ITY FAC;lt..ITY Ft-E 180. 0171 RESIDENTIAL, TRAFFIC FEES 1430. 00
cc
.1 MABs 'rRANSIT TIF FEFS 1?0. 00 H80 QUANT ITY FACILITY FEE 100. 00
C.D
EROSION CONTROL. PERMITFEE 64. 00 EROSION CONTROL PLAN CK Po. 130
EROSION CONTROL- r0. so
10914 SW 11111A
TOIAL AMOUNT PU111) 5672. 45
ou
W
65.00' 65.00' -1h.
- ---- N N
S.W. 111TH AVENUE _ _T z I m
196.40'
S 00'36'01 " E
Ln
o
39.50' ►, 55.00' 57.00'
x dz
I
ou
I
CP Ln r LnLnI
n Aavh
Ilk-
� (Cf
' N
.00' 56.66' I
59.86 ti ____ 55 �s_
N 00'22'36" W _ 171.52'
0
Sid
(2.0 5(W Z)6
o S�► 'ly X11.�► N W a (O
y V4
00
771 Ir:21
171.59'