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PLUMPERMIT
CITY OF T I GARD PERMIBTING#. . . . . . . : MST941930811
3
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 03/09/1947
13125 SW Hall B,vd.'Tigard,Oregon 97221-8199 (503)839-4171
PARCEL: 15134AC--JE009
SITE ADDRESS. 10967 SW I I 1*1 H AVE
SUBDIVISION. . . . : JEVFREY ESTATES ZONING: R-4. 5 PL)
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :009
CLASS OF WORE;. . :NEW GARBAGE DISPOSALS. . : 1
.I*YPE OF' USE. . . . :SF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . :0.
OCCUPANCY (3RP. . : R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FI X LAIJ14DRY T'RAY''.. . . . . . :12.1 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LnVA70RIES. . . . . :3 OTHER FIXTURES. . . . . :0
lUL-1/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :2 WATER LINE (ft ) . . . . - I.00
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : PATH I
OWNER: -.__-.___------FEES---_---.-_---___
1-7 OUR D CONSTRUCTION T 1 F $ 1520. 00 JH 03/09/94
P 0 BOX 1577 BPRT $ 391- 00 JH 03/09/94
LAPLC $ 254. 15 JLH 02/17/94 94-
BEAVERTON OR 97075 B5PC $ 19. 55 JH 03/09/94 ---
F-Jhone #: 641-0935 SSDC $ 280. 00 JH 03/09/94
PARK $ 500. 00 JH 03/09/914
Plumbing Contractor: 11 r)R T $ 43. 50 JH 0,3/09/94
MPLC 10. 88 JH 03/09/96.
Na m e . N5PU, 18 JH 03/09/94
Rddress P P RT 13e. 50 JH 03/09/94
(_1.t y ._A__11x Pv -!Q. State : Ife-vep,L) P5PC 6. 63 JH 03/09/94
Zip: q - .1
REQUIRED INSPECTIONS
This permit is issued subject to the reg
ulations contained in the Tigard Municipal F70ot/fOLtnd Insp Rain drain Insp
Code, State of Ore. Specialty Codes and all, Post/Beam Struct Water Line Insp
other applicable laws. All wank will be done Post/Beam Meehan Appt-/Sdwlk Insp
i. n accordance with approved plans. This Pllm/undslab Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor Plumb Final
1,)ithin 180 (Jays of issuance, or, if work is Mechanical Insp Building Final
"'Uspended for more than 180 days. Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp
Gas Line Insp
Insulation Insp
Gyp Board Insp
Authorized Plumbing Contractor Signature
Call fe— inspection 639-4173
(,ontrArtor Njtes :___
-- —�– '- � CERTIFICATE OF
OCICCITY OF T PERMIT #. . . k�ANC:YMST94--'32180
COMMUNITY DEVELOPMENT DEPARTMENT GATE" I"GUED: 08/05/94
13125 SW Nall Blvd.Tigam',Oregon 97223.8199 (503)839.4171
PARCEL: 1 S 1-4Al:;---07600
I'TE ADURE SS, . . s 109a'7 OW 111TH AVI-
SUBDIVISION. . . . s JEFFREY i.STATES ZONINGaR--4. `; PV
BLOCK— ., . . . . . . LOT'. . . . . . . . . . . . . 2009
CLASS OF WORI-i. :NEW
TYPE OF USE. . . :SAF
OCCUPANCY 014P. 01.'
OCCUPANCY LOAD: l 1 e 4
TENANT NAME. . . :
Rr.marks : PATH I
Owne-rs __..-..._. __ ..,..... _......_... _._... _. ...._.. ..... -- _._....,_.......
FOUR D CONS'rRUCTION
P 0 DOX 1577
BEAVERTON OR 971 '75
phone #: 641, ..-093
Contralct ars _... _.. _._..........._...._.. .. ___. . .. ....__....-. . _......__.._._.....
FOUR U CONSTRUCTION
PO BOX 1577
BE AVERTON OR 97075
Phone #s 64r. -11933
Re #. . s 71 037
OCCLIpanc;y of the above refer-enced buylding is hereby given. Arid cerfiffies
the compliance with the State Of Dv--egun Specialty Codes for the group,
or-cupancy, And u6e under which the referenced permit was is%ued.
D I NC. �NSPErTOR
BUILDING FFIGIAL
POST IN CONSPICUOUS PLACE:
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INSPECTION NOTICE
City of Tigard Building Departrent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-44175 Business Phone: 639-4171
Inspection: i � _ 1 W6r-
Footing Plbg. Underslab Mech. Rough-in Appr/Sdw1k
Pound. P1bq. T)p Out Cas Line IPINA�LI )
Post/Beam Struct. Sar.. Surer Framing Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb
Plby. Underfloor Water Line
Gyp. Bd. Nech.
Date Requesteds -Z� -1 r Timet 11M//.�./ PK
Address: I � �p� Imo( ' tro` ''r� � Permit l:
Builder;
TAE ROLLOWING CnRRECTIONS ARE PEQUIRED:
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Inspectors_� i Dates
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ZAPPROVED �^ DISAPPROVED p� APPROVED SUBJECT TO ABOVE
Q ` j Call For Peinap.
INSPECTION NOTICE v
City of Tigard Building Department
13125 SW Hall Blvd.. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Bunineee Phone: 639-4171
Inspection:_____ __..__�_�.__—
Footing Plbg. Underslab Nech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. San. Serer Framing -$ld
Poet/Beam Nech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line G $dA'CG
� / (o Co f� .•JIiDDD
Date Requested: 3 _� `7 Timm 11M ,1� _PN
Address: I 1D9 6� 111 �� Permi7
Builder: U1 - v) co1 5 f
TNM FOLLOWING CORRECTIONS ARE REQUIRED:
y t,-A v e- 3 9 ----
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Inspector. , Or..teI
APPROVED DISAPPRQVED _ APPROVED SUBJErT TO ABOVR
( '/all For Relnsp.
INSPECTION NOTICE
City of Tigard Building Department
33125 SW Ball Blvd. Tigard, Oregon 47223
Inepocti.on Line (Rec-O-Phone): 639-4375 Business Phone: 639-4171
Ine ---
Footing Plbg. Underslab Poch. Rough-in /Appr/Sdwlk
Found. Plbg. Top Out Can Ltne
Post/Beam Struct. San. Sower Framing -B1QQ.
Pont/Beam Mech. Rain Drain Inealation -P1 ib
Plbq. Underlloot Water Line G••p. Bd. -Meoh.
Date Requestedt Timet `Q�__ AM
Address:J--0a^� 1.0 �� -- it #1
Builder: 1/GL.1 I I �SY 417 t tL J
THE FOLLOWING OORRECTIONS ARE REQUIRED:
'I- Z!!L 24'
Inspector:
APPROVED DISAPPROVED APPROVED SUSJUCT TU P'BOVE
Call For kainsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Businens Phone: 639-4171
fnapect
Footing Plbg. Underslab Nech. Rough-in Appr/Sdwlk \)
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct, San. Sewer Framing -Bldg.
Pont/Ream Hoch. Rain Drain Insulation -Plumb.
Pibq. Underfloor Water Line Gyp. Bd. -Hoch.
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Date Rnqueeteds, // 7 Time: AN f� PlH
Address: CO / _1 / Permit
Builder:
TNI: FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: `7Zd ttj '
APPROVEb - DISAPPROVED 1►P ROVED SUBJECT TO ABOVE
_Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspectio, Line (Rec-O-Phone): 639-4175 Businens Phone: 639-4171
Inspection:_�__�__��
Footing Plbg. Underelab Mech. Rough-in Appr/8dwlk
Found. Plbg. Top Out Gas Line FINAT-
Post/Beam Striv t. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line ( Oyp. Bd. -moch.
Date Requesteddt D CO- 1�� TimesAM PK
Address: 1096 7 n ��� �` Permit #t 9/'CY—.�f9� '
Build-§r:
THE FOL.T,OWINO OORRECTIONS ARE MiQUIRED:
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Inspector:_ �i Date:
_APPROVED ✓ DISAPPROVED APPROVED SUR.TFrC TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building department
1.3125 SW Ball Blvd. Tigard, Oregon 97223
Inspect .on Lire (Rec-O-Phone): 639-4175 Ruaine_Hu Phone: 639-4171
Inspections__.___._,__— ——�—
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Found. Plb,,. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer gaming S�'�^ -Bldg.
Post;Rnam Mech. Rain Drain Insu]-tion -Plumb.
Plbq. Underfloor Water Line C� Gyp. Bd. -Mech.
Date Requested:
7 I ! TTL/�Lmot AM PM
Address: A / �� / `Z/ 1 Peim�Lt�t 1 �V
Builder: [ _._ Z
TIM FOLLOWING CORRECTIONS ARF REQUIRED:
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Inspector _ _i Dater
APPROVED DISAPPROVED V'/APPROVF.D SUBJErT TO ABOVR
_--Call For Rainsp.
INSPECTION NOTICE
City of Tigard Building Departm mt
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:•
Footing Plbg. Undersl.ab "Koch. Rough-in Appr/Sdwlk
Found. Plbg. Tog Out Gas Line FINAL:
Poet/Seam Struct. San. Sewer <Framing J �� -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Koch.
Date Requested: �`J - / 7 _
f�/ Time: �_AM _PH
Address: C)C 6 �� Permit #t
Builder: Ik 7d L) - 7 L/ _
THE FOLLOWING CORRECTIONS ARE REQUTRE1D:
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k'6 \'k r Q V111 11-1 A t t-1A • .,e�
inrpeatort
APPROVED _� DISAPPROVED APPROVED SUBJIRCP TO ABOVE
V�L� ��call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SN Bt,ll Blvd_ Tigard. Oregon 97223
Inspection Line (Rec-.O
.O-�Phone): 639-)4175 Business Phone: 639-4171 /
Inspection:—
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
Fund. Plbg. Top Out Gas Line FINAL-
Post/Beam Struct. San. Sewor Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -P)_umb.
Plbg. Underfloor Water
•�'Line
p Gyp. Bd. -Nech.
Date Requested: p n/ Tiimet AM --k—PM
Addrann: I1�7 /iP �� / ( Permit
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Builder (! cJ �.(�7 5�. rtV �`�`7,5
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: � —�� nate: �.. l —
APPROVED DISAPPPOVRD APPROVED SUBJECT TO ABOVE(
lJ - -Call For Reinep.
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INSPECJ.'ION NOTICE \ "/
City of Tigard Building Department �•�
.13125 SN Ball Blvd. Tigard, Oregon 97223
Inspection Line (Re/c/-O-Phone): , 19639-4175 Business Phone: 639-4171
Inspection: _��/�f?��4 tc/a
Footing Plug. Underslab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas tine FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Poet/Bean Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hech.
Date Requeatadllt_C,1_ �! / 7-1/ Times
_Time: Y—_AH (y/'PH
Address:_1 V / 6f fh / ` Permit /: ' /V Q V
Builder: SCJ a) ),5 _
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: " - Date: /
APPROVID _ V DISAPPROVED APPROVED SUBJRCT TO ABOVE
Call For Reinep.
pNSPECTION NOTICE
City of Tigard Building Department
13125 Sw Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Businpas Phone: 639--4171
Inspection•
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Pl�T-p Gas Line FINAL-
Pont/seam Struct. San. Sawer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Innulaticn -Plumb.
Plbg. Underfloor Water Line/ Gyp. Bd. -Hoch.
Data Requested: /(� 7[� Times X—AM PH
Address: 109 �V e - / Permit Ot 1 -7 �
Buil.dor:_ !LC/'/7.�
THE FOLLOWING CORRECTIONS ARE REQUIRED?
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Inspector: Date:
APPRDVR'D � DISAPPROVED APPROVED SUBJECT TO ABOVE
00- Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection L.',.np (Rec-O-Phone): 619-4375 Business Phone: 639-4,7)
Inspection:`
Footing Plbg. Underelab Hoch. Rough-in Appr/8dalk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam struct. San. Sewer Framing -slog.
Post/Beam Mech. Ratn Drain Insulation -Plumb.
Plbg. Underfloor <c`Nater Line Gyp. Bd. -Meeh.
Date Requeste
d: C> 9 e/ Timms ��AN _ PN
Permit
Builder:._ ( e P/u mh 2,
THE FOLLOWING OORRECTTONS ARM REQDIRED:
Inspector: / "— Dstet
_APPROVED =or
_— APPROVED SUBJECT TO ABOVR
Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 M Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phones 639-4171
Inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Pound. Plbq. Top Out Gas Line FINAL:
st/Beam Btruot. San. Sewer Framing -Bldg.
st/Beam Mach ' Rain Drain Insulation -Plumb.
Plbq. Underfloor Nater Linv Gyp. Bd. -Hoch.
Date Requested:_ �~ `/ L/ Times _)L_AH PH
�. �� .,T_
Pertom,! �v
Addreeset)'71"% �� mit f:- l/
Builder:
TBE FOLL0WZNG CORRECTIONS ARE REQUIRED:
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UspBotors_ Dates I
APPROVED DISAPPROVED L APPROVED SUBJECT TO ABOVE
Call For Ralnsp.
INSPF'CTION NOTICE
City of Tigard Building Department -'
13125 BA Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-0-Phones 639-4175 Business Phones 639-4171
Inspections
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out gas Line FINALt
Poet/Beam Struct. '/an. 8eaerr rraming -Bldg.
Post/Beam Mach. -.Rein Dea<� Insulation -Plumb.
Plbq. Underfloor ta! LiM gyp. Rd. I e, -IMch.
Date noques-todt / � Z (� �i Timet Rlt __PM
Address. t 11 l p-1 t IPermit #sq "��J-1j 0"Q/ly
Builders buI
THE FOLLOWING CORRECTION$ ARS REQUIRED:
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Inspectors Dates L
----
AFFNOVED DISAPPROVED APPROVED [SUBJECT TO ABOVE
Call For Reinsp.
INSPECTI►N vrvsT IS
City of Tigard Building Department
13125 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phons)s 639-4175 Business Phones 639-4171
Inspections
Footing Plbq. Underslab Mach. Rough-in Appr/3dwlk
Found. Plbg. Top Out Gas Litre FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain insulation -Plumb.
Plbg. Underfloor Mater Line Gyp. Bd. -Meeh.
`j yX
Date Requested
: 7 ___Times AM P_M_
Addresst tll ( I ' Permit #t GI`f 10Tj
Builders_
THR FOLL40VING CORRRCTIONS ARE REQUIRED:
i
Inepecto / -_, Datat
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call Por Rainap.
INBPFCTIOII NOTICE
City of Tigard Building Department
1312S BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)t 639-4175 Business Phones 639-•4171
Inspections
Footing Plbg. Unr.erelab Hoch. Rough-in Appr/Sdwlk
(. Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct, San. Sewer Framing -Bldg.
Post/Beam Hach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. ed. -Koch.
Date Requested: _? T� AH PK
Addresst A ele.; �-' Permit ft
Builders
TAE FOLLOWING CORRECTIONS RNIREDtrA
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Inspectors Dates
APPROVED DISAPPROVED APPROVED RUSJECT TO ABOVE
V/ CJ�? Call For Roinap.
XNSPECTION NOTICE \Y
City of Tigard Building Department
131.25 BW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171
Inspection: _
iooti /I Plbg. Underelab Mech. Rough-in Appr/Sdwlk
�,. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
I i rl
Date Requested/: / ) I l�` ' _Timet 6�I�AGM� Q� PM
Address: Jar I I I I '`t _ Permit f:
Builder: {��i y � LY`-kj-�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors / —.____ _ -- Dare: (C.
11PPR01RD DTSAPPROVRD ---APPROVEn SUBJECT TO ABOVE
^ * n __Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SA Hall Blvd. Tigard, Oregon 97223
Inspection Une (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Plbg. Underslab Mech. Rough-in Appr/Sdwlk
l �
Plbg. Top Out Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requented:_ �J rll�� Times I4 AM PM
Address: }I la 1 I l I Permit �q- I08b
Builder: \ �J lAy -12t -7q
T14E FOLLOWING C(P.MCTIONS ARE REQUIREDt
F-
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Inspector• D tat
w APPROVED - DISAPPROVED APPROVED SURJECT TO ABOVE
/) J� Call For Reinsp.
CITY OF TIGARD
MASTER PERMIT
COMMUNITY DEVELOPMENT D,%P,q�R AQ SIT PERMIT #. . . . . . . : MST 94`4080
131Y5 SW Hall Blvd.Tlgard•Orapon 97223.8199`t 03) 9� 71 DATE ISSUED: 03/09/94
PARCEL: 1S134AC-JE009
SITE ADDRESS. . . : 10967 SW 111TH AVE
SUBDIVISION. . . . : JEFFREY ESTATES ZONING: R-4. 5 PID
BLOCK. . . . . . . . . . . LOl.. . . . . . . . . . . . . :009
-------- BUILDING - ________.____.__._.-•--•----.-•-•---_-__._
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 � f
CLOSS OF WORK. :NEW BEDRMS:4 BATHS:c: GARAGE. . . . . . . . . . :420 sf
!-YPE OF USE. . . :SF FLOOR AREAS- ---- --- REQUIRED SETBACKS------, -------
1Y[-"E OF CONST. .5N FIRST. . . . ; 1687 sf LEFT. . :5 ft RIGHT. :5 ft
OCCUPANCY GRP. : R3 SECOND. . . :0 s f FRONT. :`0 ft REAR. . :34 r L
STORIES. . . . . . . : 1 THIRD. . . . :0 s f
HE I GH T. . . . . . . . : 18 ft TOTAL_._--.-..-- : 1687 S f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 85162 PARKING SPACES. . : 1
Remarks : PATH I
_____._._._.___-.--.---•-.---___--------__-.-- PLUMBING
SINKS. . . . . . . . . . : 1 FLOOR DRATNS. . . . :0 BACKFLOW PREVNTRS. . :O
l_AVAFORIES. . . . . :3 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . . . . . . :0
TUB/aHOWER5. . . . :3 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :0
WATER CL OSETS. . :E SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . ' I WATER LINE (ft ) . : 00 OTHER FIXTURES. . . . . :0
GARBAGE UIFP. . . : .1 RAIN DRAIN (ft) . :0
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
MECHANICAL -- _._.------•-------___. ..--•-------____.___ FEES ._________..._...._.......__.__
FULL TYPES------ - UNIT HTRS. . :0 type amount by date recpt
/UPS/ / / VENTS . . . . . :0 TIF $ 152'0. 00 JH 03/09/94 -
MAX INPUT:O BTU VENT FANS. . :4 BPRT $ 391. 00 JH 03/09/94 -
FURN ( 100K . . : 1 HOODS. . . . . . : 1 BPLC $ 254. 15 JLH 02/17/94 94--
F"URN ) -'101rF! . . :0 WOODSTOVES. :0 B5PC $ 19. 55 JH 03/09/94 .
FLUOR F"URN. . . . :0 CLO DRYERS. : 1 SSDC $ 280. 00 JH 03/09/94 -
D( IL/CM., ( 3HP:O OTHER UNITS: 1 PARK t 500. 00 JI-A 03/09/94 -
GAS OUTLETS: 1 MPRT $ 43. 50 JH 03/09/94 -
I)wner^: - "------- ---- ________....__._._..__........-----____MF'L_C $ 10. 88 JH 03/09/94 -
FOUR D CONSTRUCTION M5PC $ 2. 18 JH 03/09/94 -
1- 0 BOX 1577 f='PRI $ 132. 50 JH 03/09/94
P5PC $ 6. 63 JH 03/09/94 -
BL-!)VERTON OR 97075
Phone #: 641-0935
hontr•actor^: --_.________________.___-----•__--.-
FOUR D CONSTRUCTION
PO BUX 1U77
DE.OYERTON OR 97075
Phone #: 641--0935
Reg #. . : 71037 _____..__._..._.._.___.._.___ ______-----.•-_--_--______.....
E 3160. 39 TOTAL
This permit is issued subject to the regulations contained in the - ---- REQUIRED INSPECTIONS -"-- -
ligard Municipal Code, State of Ore. Specialty Codes and all other Foot/fol.ind Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved Past /Beam Stri-Ict Gas Line Insp
plans. This permit will expire if work is not started within 180 Post/Beam Mpchan Inst-dation Insp
days of issuance, or if work is suspended for more than Be S. Plm/r.tndslab Insp Gyp Board Insp
f / F'I_M/Underfloor Rain drain Insp
t er^mttee Siynr,t�_u e : _ / cr
/ 1 Mehanical Insp WatpLine Insp
i.
Pli.imb Tap Out Appr/Sdiglk Insp
Issi_ied By : _. _. ,_.._•�_ F-r-ami.ng Insp Mechanical Final
Call for- inspection - 639 --4175
CITY OF TIGARD SEWER CONNECTION
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . .. SWR94-0086
13125 SW Hall Blvd.Tigard,Oregon 97223s81Q6,k_3)t 14471 DATE_ ISSUED: 03/09/94
PARCEL: 1S134AC-JE009
SITE ADDRESS. . . : 10967 SW 111TH AVE
SUBDIVISION. . . . : JEFF=REY ESTATES ZONING: R-4. 5 PD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .009
------------------------------------------------------------------------------------------
TENANT NAME. . . . . :
1..1SA NO. . . . . . . . . . FIXTURE UNITS. . . .
CLASS OF WORK. . . :NEW DWELL T NG UN I 1 S. . : 1
rYPE OF USE.. . . . . :SF NO. OF BU I LD I NGS: 1
INSTALL 'T•YPE. . . . :LAU5WR IMPERV SURFACE. . : : sf
Remarks : PATH I
fawner: __ _- ---- ------___- -----------------•------------------- FEES - --w---- ---_--
FOUR D CONSTRUCTION type amount by date recpt
P 0 BOX t577 PRl1T $ 2200. 00 JH 03/09/94 -
INSP $ 35. 00 JH 03/09/94 -
BEAVERTON OR 97075
Phone #: 641-0935
Contractor:
CONTRACTOR NOT ON FILE
Phone # $ 2235. 00 TOTAL
Reg #. .
------- REQUIRED INSPECTIONS -- --_--
This Applicant agrees to c,amply with all the rules and regulations Sewer Inspection _
of the Unified Sewage Agency. 1he permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit oxpires. The Agency does not 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 wi install a lateral.
I ' I-M it t r.7 e Si y r I'A 1; i_I 1 I_'
1 t r-a d By
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N Call for inspection - 639--4175
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CITY OF TIGARD -- Rl---.CEII:IT OF: PAYM(-lqJ RFCFAVIT NO. a 94---P49854
C,HF.(',K PM('.)IJNI 145. 39
FOUR D CONSTRUCTION CASH AMOUNT a 0. 00
4DDRF-f-;�l I PAYMF61T t)nTv., 1 03/04/94
SUB D I V 1 3 1 ON
:,tml-',OSF OF PAYMENT AMOUNT PA I D PURPOSE OF PAYMP-IVT AMOUNT PAID
AUll-DING PERM 391. 00 PLUMBING PERM 13p. 50
FTHANICAL PF 43. 50 ST. BUILD PER ps. 36
"l-AN CHECK FE' 15. 03 SEWER USA 2800. 00
3F-WF'H ].NqV.-[---CT 35. 00 PARKS SDC 0500. 00
"'I f)I TRAFFIC FEES t 4 1. .(A 00
-RM DRAIN SDCl 280. 00 RESIDEN'TtAL I
iWiCi TRANSIT TIF FEES 110. 00
j) i 9 JEFFREY ESTATES
10967 9W 111TH AVE
O'rAL AMOUNT PAID bo 14,54 X39
_Residential Building Perm it_pDlication
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address:109 _
Office Use Only
Subdivision: Z E V C—S11AfiES Lot#
Valuation:/ lc�-
..per it #
Owner: F- o a lJ Suctl _ Reissue of
Address:�� O ,P, 6X 1 S..7 -7 Map & TL#,_[51
c yE ro►J 0? 1707.5
Phone: .��S lr�y — 9,E !F�- Approvals Required
Planning `�G'yl� 4 K✓ v�C
Contractor. iOME S L60L)�� Engineering
Address: OthEr
Items Required
Phone: -
I
1/ 037
�
Contr,ictor's License # i' O 3 /�-7 Subcontractors;
(attach copy of current Oregon license) Truss Details
Subcontractors: Other:: ....5
J
Plumbing:
Mechanical: F r/ -i V Furl rU
(attach copy of f'curr t OR Contractor's License)
Architect/Engineer:_ f F T-
Address: _ .(d I le Z:A NA560 OFA!C _
2.70o
Phone: 11 h3 -
COMMENTS: S ,
Applicant Signature & Phone number
Received by:_ �' Date Received:
J
Permit tt Account Description Amount / Amt. Pd. Bal. Due
Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) ,3 ,SO
Mech. Permit (MECH) � b
State Tar, (TAX) �42- .� K,3 G
Bldg: 63
i
Plumb: G'
Mech: �t2 •/1�1
Plan Check (PLANCK) �– GJ, U Z & _/ o 3
Bldg: .j •
Plumb-
Mech:
lumbMech:
Sewer Connection (SWUSA) _ , c7
Sewer Inspection (SWINSP) •3 S Y
Parks Dev Charge (PKSDC) .�� L r 566'
Storm Drainage Chg (SDSDC)
Residential TIF (TIF-R) /�'_ _ l U
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE) —
TOTALS: