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CITY OF TIGARD CERTIFICATE MJF'
OCCUPANCY
COMMUNITY DEVELOPMENT DEPAR����T FERMIT #. . . . . . . :
MS79.3...411 n ,
13125 SW Hall Blvd.Tigard,Oregon 27223.8199 (;03
1 �l3P1�171 [LATE ISSUED: /1 /'
, }
PARCEL.: r I:+103AB-03:.30iD
S I TE ADDiiES S. , , 11976 aW 1 13TH PL_^ w
SUED I V 15I ON. . . . : ME::AD0Vt3L_A[)E ZONING:R-•4. 5 Fir►
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :002
C:LASq nr WORK. :NEW
TYPE OF USL::. . . :5F
OCCUPANCY ORP. :R3
DCLJPANCY LOAD: 121 4
TENANT NAME. . . .
Remarks : PATH I
Ownerc
I.L.OYD C OLSON
13141 SW TE'L)FE_L. HILL- F'0
BEAVF. RTION 13R 4 Y01017
Phone #: 6�'O-P400
Contractor:
01-SON DEVE.LOPME.NT
WT 1 BOX 948
nEAVERTON OR 97005
Phone #s 628--2420
11su #. . t :529p0
Occupancy of the above r-Pfer,elrced building is hereby given, anti certiFit -
the compliance with the State Of Oregon 5per_ialty Codes for the gror1p,
occupancy, and use under which the referenced per-mit wet, issi..led.
FIRE DEPARTMENT ' UILD1 C' INSPECTOR
.LiIl.b � O ICIAL
POST IN CONSPICUOUS PLACE
MAZ�TE R PERiM
CI1Y OF TIGARD . . . . . . . .IT
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 DATE ISSUED: 04/15/9"
L L: L. . -S!a. . .' " -;6
_W 11'31'j : PARCEL: t 0 SALA
;iJO'-)I V I b LIN, MLADOWGLADE ZONING- R--4. 5 PD
BUILDING .........
f i d U. DWELLINU UNI T.`5: I I.A A 3 E-i 11"J4 T. . . . . . . . :0 f
i.:Ln i' OF WORK'. NLW bLijilrdri.3 2-%ATHS.E GARAGE.. . . . . .. . . . .473 Sf
'Y "A" LjLiL. FL11AR REQU I RED SE"j'13ACKS-
UF CONS' . .5N FIRST. . . . . 1598 s LEFT. . .5 ft RIGHT. -7 Ir L
,,35 ft riE(4n. , a
R SECOND.
. . . . . . . . THIRD. . . . *0 Sf FREQUIRLX
j d. S f SMOKE DETECTORcb. .y
VOLUE. . . . . 4 . 82020.1 PA41KING SPACES. . : I
,�LUGR LOAD. . . . ;40 p: ,f
F"WH I
Pi-UMBING
G I N 111 5. . . . . . . . . .. N I -"-'LLJUR 13A(.I'Nf-'I-UW PR[-VNTR.']?. . .0
Ln V P r 0 R1 El7. . . . . .L WATER HEAMRS— . 1 TRAPS. . , . . . . . . . . . . . 9 0
TULVL31 . . . �t-: UWNORY I'ROY I-3., . , ;0 LATCH OAS INS. . . . . . . ..le)
WAW ER C'LubEl f3. . BLWER LINE (ft i . :0 ORLASE TRAPU. . . . . . . :0
D 1"J'I IW(-"c:j'�4E P5. . M I C I'.U R L
WOTER LINE ( ft ,� ., 104. IR F x
DAPORUE DISP. . . : i RAIN DRAIN (ft ) . C
WA5111NG INACH. : 1 '--'F RAIN
ML.CHANICAL FE LS .........
UNIT I F1 RE. . :0 type ainr.,r.lrlt oy date
G A 2� V E.N 1*,Ir>. . . . . . :0 T I F 4 1460. 00 JH 04/15/ -
V r L) VEI'4" i ONS. b F,R X13 00 111 04/15/1) .-
I-U RN < 1001'-' . .. i HOODS. . . . . „ : 1 B'PL L $ c:46. .-30 JLH 04/01 /93 93 - 0,5
1-"UR"" 111001-� WUUI)STOVE!.;. :0 51-11: $ 1 1). 10 '1 i..1 0-11/1 b"93 -
L.U,j R F U RN. 0tiDL $ 280. 00 JIA 04/1 5/1'1:;CLU DRYL-RS. : 1 S
buil..' Gtyll ' "zi P.v." OTHLY UNITS. I PARK t S-40. 00 J11 04/ 1", f),
GOS OUTLLI S. I MVIR"r, $ 40. 50 JH 04/15/x3
i MPL.C $ 10. 122 .J.'1 0 4/I t.'/-0
-LU'+')J L M5PL2; $ ". 0:� JH 04/15/93
F."rART 1; 11.7. 312) .)II 0 4 15/9
Z. 88 JH
c, e
Ln
306`1. 44 I'L)TAL
15
issued �-'jl!Ct to tht !'1g'4Ati01S contained k the PLOUIREV INSPECTIONS
coc!r' of are. speclillt) L0006 and All other Foot/found Insp F-ireplace Iy)sl:)
LL dPfjjjL"j6f if law.;. V tr, k will be dyne in accordance with approved P:jSt/Livam Sbrijct Gas Line Insp
This persil will expie if work is not started within IN PE)st/oeam Mectiall Insulation incp
iesuancv, or if ►c6 is suspended for more thAp IN days. P1M/UT1dS;ab Insc) Gyp So,-ard Insp
PLM/Uncjei•r i am, Rain draiTl 111
Hectlan- cl ! I n t p W.--%ter- Lir-e ln�
1,11k.unb TOP clut Oppr/Edwlk In i
j F''-aml. nu 1tikjp �'e ch a n i c:a I I"�i
I f I r s ri f-., t r, 4175
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rea-O-Phone): 639-4175 Busineas Phone: 639-4171
Inspection:_
Footing Plbg. Underslab Mech. Rough-in (( Appr/Sdwlk
Found. Plbg. Top Out Gas Line
Post/Roam Struct. San. Sewer Framing
Poet/Ream Mach. Rain Drain Insulatton -P1uo�).
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: ! �U `t3 ,Time: , PM
Addre""' I}lq"Ili IJ-5 ��, Permit 11 �� ����
Builder:_. ot_L'X"�
TRE FOLLOWING CORRRC710NS ARE REQUIREDs
v7
Cu
111
Inspectors__
y APPROVED DIAAPPROVED APPROVAD SUMIRcT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
city of Tigard Building Departaent
1.3125 RW Ball Blvd. Tigard. Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
inspection:
Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gas Line FINALt
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Rech.
Date Requentedls 77 1' F __Times ►- AMq > ^ PH
Address: _( 41 II� 1 I`2!` f.l I ` Permit
Builders
THE FOLLOWING CORRECTIONS ARE RSQUIREDt
Uri
F--
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J -
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Inspectors -S/ _ Dates-9 7- 3- 7-3
J1PPRi0VlD �DIRAPPROVED APPROVED RURJ1tCT TO ABOVZ
L /Call. For Reinep.
INSPECTION NOTICE
Cita of Tigard Building Departarsnt
133125 BR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plb3. Underalab Hoch. Rough-in (Appy/Sdwlk
Yound. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Pust/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line Gyp. Rd. -Hoch.
Dnto Requesredt_ 1� _Time: /� AH _-PH
Address �/I � V ]I� Permit �t1_��___
Builder: I(�� l� V 15n,�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
/ � l
ineportor: 11 Lel Dates L!
__APPROVED DISAPPROVED -+ APPROVED SUBJRCT TO ABOVE
Call For Reinep.
1NSPECT 2M N,)T. CE
city or Tigard Building Department
13125 OW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Busineso Phone: 639-4171
Inspection:__
-,l
Footing Plbg. Underslab Hoch, Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation --Plumb.
Plbq. Underrloor Nater Line Gyp. Bd. -Hoch.
APM
Date Requested:_ ,� Time$ AM
Address: '- Permit #$�j�3 7
Builders \.r -
THE FOLLOWING CORRECTIONS ARE REQUIRED:
S' - o " h2,oNy aAc,co _ At/Ii c
AC.L 6 r S our
A PV/e)A C.f
V)
J w _
cc
C7
J AC O
— if G-v I? �3C�
Inspector: L,I- ►J � Date:_ zz
__APPROVED DISAPPROVED 1/ APPROVRD SUBJECT To ABOVE
Call For Reinsp.
I
INSPECTION NOTICE
City of Tigard Building Department
1-3125 Ste Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plum►,.
Plbg. Underfloor Nater Line dyp. Rd.� -Koch.
Date Requested: f !L-J Ti,.. AK pK
Address: permit fs�-� D✓�1 7
Builder:--1r,,"4_21)-
THE FOLLOWING CORRECTIONS ARE RRQUIRRDs
I nepector s_� _ _ Dates
_A_.PPPR.OVEED. DISAPPROVED APPROVED SURJRCT To AS"
_^alt For Rsinsp.
INSPECTION NOTICE
City of Tigard Building Departnact
13125 SR Hall Blvd. Tigard, Oreton 97223
Inspection Line (Rec-0-Phone)i 539-4175 Bnsineas Phones 639-4171
Inspections
Footing Plbg. Underslab Nech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Stnict. San. Sewer ` -Bldg.
Post/Beaa, Hoch. Rain Drain Insu� -plumb.
Plbq. Underfloor Mater Line Gyp, Bd. -Nech.
1.1ts Requested: ;7 - G `7-3
Addreess // 1�7/�(P��,� Pet�iE �t,�y�`��/ 7
Builder:. ,/►/y�l
TAE FOLLOWING OORR:'C/TIONS ARE REQUIREDs
- /yl ----- --- -
Inspectors ✓ "7 Dates
PPROVED __ DISAPPROVED - APPROVED SUBJECT TO ABOVII
C411 For Reinsp.
INSPECTION NOT
City of Tiga d Building Department
13125 811 Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phane): 639-4175 Business Phone: 639--4171
Inspection:_ _
Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
1
Post/Beam Struct. San. Sower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Mech.
Date Requesttedt_ //,15- Z `g/—:21 Time:
AMn ,_ -_ PH
Address: [ 9 / LO // /�Jr- _ Permit #:
Builder.: �L�
THE FOLAWING CORRECTIONS ARE REQUIRED:
1-
v
J
r-y
Cil
U'
W
J
Inspaotorl_ Date: - Z y- i T
APPROVED DISAPPROVEn APPROVED 9UBJFCT TO ABOVE
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 9W Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 635-4171
Inspections
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gam Line FINALS
Post/Beam Struct. San. Sewer rasing -Bldg.
Post/Swam Mech� Rain Drain Insulation -Plumb.
Plbr(. 7nderfloor Nater Lina Gyp. Bd. -Hoch.
Dal-'a Roquesteds -l Times AM PM
~
A7drees: Peeeit �t
Builders
T8/ FOkJOWI�1NG CORRECTIONS ARE RRMIREDt
r&_ 2n 1QLapa1 irvs _ s.I�.� .
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R:
H _
to __
Y
►r
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CIO
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Inspectors (;,I ' ----- Dates�_i2
APPAOVLD _ DISAPPROVIM APPROVED SUBJECT TO ABOV9
Call For Rainap.
INSPECTION NOT�_CE
City of Tigard Building Departaeat
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 639-4175 Busineee Phone: 639--4171
Inspect ion:_
Footing 41bq. Underslab Mech. Rough.-in Appy/Sdwlk
Pound. Plbq. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Dost/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. nd. -Mach.
Date Requested:_ )�/-� ( � / Time: / AN J_PM
Address: I//� /[ 2 / / �� .'` r Permit
Bu i 1 der:_
THE FOLLOWING CORRECTIONS ARE REQUIRED:
co --� ---- ---— --- -- -
C
J
Inspec ortc Datet 7
lutpllOYID DISAPPRO.RD APPROVED SUBJECT TO ABnV2
Call For Reinsp.
INSPECTI_O_N NOTICE
City of Tigard Building Department
1312.5 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections _
ootin Plbg. Underslab Mech. Rough-in Appr/Sdwlk -
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Ream Hoch. Rain Drain tnsulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. M h.
��Date Requested: per= [�
Permit
Builder:
THE FOLLOWING CORRECTIONS ARE RRQUIRED: ----bb��
LD
It!
Inspectors
41_� APPROV=D DISAPPROVED APPROVED SUBJECT TO 1►hOVE
Call For Ralnap.
INSPECTION NOTICE
City of Tigard Building Department
13125 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Busineee Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mach. Rough-1.n Appr!Sdwlk
�F�ouund. Plbg. Top Out Can Line FINAL:
(_Post/Beam 8tru San. Sewer Framing -Bldg.
et/Beam Meeh Rain Drain Insulation -Plumb.
1Dg Onderll Nater Line Gyp. Bd. h.
Date Requestedt H TL". AN PK
1 � —oi9 7
Address: Permit �s
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
�i
Un
Inspectors —9
APPROVED DISAPPROVRD APPROVED RUBJECT TO ABOVR
Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SU Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Inspection:_ _
a Footing Plbg. Underelab Hoch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Lias Line FINALE
Post/Beam Struct. an. Sewer Framing -Bldg.
Post/Beam Mech. Main Drain Insulation -Plumb.
Plbq. Underfloor water Gyp. Rd. -Mach.
Date Requested: "7z,
Time: AM
Addreo: • e Permit I t / r cl,'L /
Builders T .
THE FOLLOWING ODRRECTIONS ARE REQUIRED:
fi
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N
I—
CA
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J
Inspector: Data:
2L--APPPAYM DISAPPROVED APPROVED SU 710 ABOVE
Call For Reinsp.
CITY OF f I CARD -- RME I KAT OF' r-)AYMENT RFCF I PT NO. 193-23,90e6
CHECM AMOUNT s 49':0. 44
hdFTMF" OLSON, LLOYD GASH AMOUNT r 0. 00
ADDRESS PAYMENT DATE 04/ 15/941,
SUBDIVISION r
,URVA312E OF V'AYM6;NT AMOUNT PAID PUH1SE OF PAYMENT AMOUNT PAID
�- ;UILDING PERM 382.00 PLUMBING PERM tt7. 50
un
MECHAN I CAI.. PE 40. 50 ST. BUILD PIER 27. 01
►— 'LAN CHECK FF 8. 4.,E SEWER URA 2100. 00
—r A—WER INSPECT 35. 00 PARKS SDC: 500. 00
m 41'ORM DRAIN SDC 280. 00 RESIDENTIAL T ROFF I C: PEES t350. 00
Lo LL MASS TRANSIT TIE FEES 110. 010
J
LOT 2 MFADOWGLADE
11976 SW 113TH PL.
TOTAL AMOUNT RAID 4950. 44
CITY OF TIGARD — RFCEIPT Or PAYMENT RECEip'r NO. s93-236534
ClAl=CK AMOUNT s c'50. 00
NAME s OLSON DEVEL-OPMENT GO CPSH AMOUNT s 0. 00
ADDRESS n 13141 SW TFLJF -L HILL RD PAYMENT DA-rt..: s N4 0 1 3
BEAVERTON, OR SUM I V 181 01\1
g7007—
a i Or PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
cn r:11-1=1N CHECK Fr 4—PR 250. 00
LLl
11.976 SW It3rH PL. , L.or 2 Mt-'-f)DOW(3L.ADE
TOTAL. AMOUNT FSA ID — -- -- —
CITY OF TIGARD SEWL.R GONNELTION
PERM I"'
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tlgard,Oregon 97223*6199 (503)539-4171
L
"E ADDRE S6. I I 97V -)W A k4 b 0 :5;41 JL
UOD IV I S I U1141. ZONING: f7._4, 5 FI)
. . . . . . . . . . . LOT. . . . . . . . . . . . . . D0
i.-AANT NAML. . . . .
L i) Nil. . . . . . . . FIXTURE UNYIS. . . :
DWELLING UNITS.
1'r,"L OF USE— NO. OF' BUILDINGS; l
IN`VrALL TY1*-,L-. . . - UU3WR 11YIPLAV 6URf-P)CE.
coar-ks : PATH
F[I-Eb
C OLSON type amol.mt by date
t 41 ]W TE UFEL I-11-._I.. RL) PRMT 4 2100. 00 JH 04/1;�/93
-
i NSP s 35. 00 JH 04 15/93
.—ane
u!)G v-,act a r
1\40"i ON FILL
L'135. 0121 TUTP;
REQUIRED INSPLCTIONS
7lfi Applicant agree: to comply with aii the ruies and reguiations Sewer Inspec-tioti
:he 'W'nified StO.&JE Agency. The permit expires 1U days `rob
date issued. The total amount paid will be forfeited if the
per#it expires. The Agency does not guarantee the accuracy of the
S;de sewer laterals, if the mer is not located at the measurement
given, the installer shall prnipect 3 feet in all directions from
11`e distance giver. If not so located, the installer shall purchase
a ap and Side itwer" permit and tbogency will install A I at ers I
Ili j, L t P e S= n r-i t;.o LA
JAY
ol' 1 r)s pe(.-t i an 639-4175
13125 SW Heli 1Nvd. PLNCK/RECT #
CITY OF TIG' ARD PERMIT # �y3
COMMUNITY DEVELOPMENT DEPARTMENT roRa«,s7u3
(503)63"171 DATE ISSUED
JOB ADDRESS: l Irl r7 (�- ti' ( ( TAX MAP/LOT 2 sza3A�—��3ay
/,
SUB:�LE � ����1- LOT: Z _ LAND USE:
VALUATION: v 2 Z
— i
OWNER SPECIAL NOTES
NAME: N REISSUE OF:
ADDRESS: I S.w : ~�s' - -Q ��-t�, LAST REISSUE:
Cl 7 JJ FLOOD PLAIN/
PHONE: `�r 2— 2� SENSITIVE LAND:
TRACTOR (� I APPROVALS REQUIRED SU�9/OLY�
NAME:--- �-�. c��' 1 .-i.s�►.,� _� f PLANNING:
ADDRESS: ---1 '-1 ENGINEERING:
FIRE DEPT:
PfWWE: 1"o I e, c r__��a-- rs< er•,,r 40-�Jt tTa,-
CONTR. BOARD #: C EXP DATE: LI s � �' ��Iw(o
ITEMS REQUIREDoL5L` e�
SUBCONTRACTORS: PLUMB: I,ti� awl Corp" � LIST/SUBCONTRACTORS:
MECH: l �F' Q-�%. BUS TAX: _
ARCH EMGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
N PHONE:
,H r
ca PROPOSED BLDG. USE:
COMMENTS:
APPLICANT SIGNATURE --
Received By: _ ( I -C� Date Received:
l -
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees 3�f2.• '�`� 3$Z •�---
10-431 00 Plumbing Permit Fees ,SU l ,S ej
10-431 01 Mechanical Permit Fees a )y _ u•
10-230 01 State Building Tax (5y) �•�� _ � 7, v/
Building /0
Plumbing x-87
Mechanical •�3 —�
10-433 00 Plans Check Fee
Building
Plumbing
Mechanical _ o'l '
10-230 06 Fire
�,01(-rI 30-202 00 Sewer Connection .2
30-444 00 Sewer Inspection _ 3j
25-448. 02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees _
25-448-01 Residential Traffic feesi
2.5-448-05 Mass Transit TIF Fees
52-449 00 Parks System Oev Charge (POC) S G a _�w
31-450 00 Storm Orainage Syst Dev Chrg
(SSOC)
C/1
L 24-445-0I Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
LD
TOTAL_
nm/3587P.WPF