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12098 SW 113TH PLACE r i � •.tit , ADDRESS: IM -S Ie�W I/3 4AW 2 J r�] CD W `r isVeco rdsVnicrofInAtarge(sY)uilding.doc CITY OF T I GARD CLRTIVICATE 01 OC(.1JI'-`0NCY COMMUNITY DEVELOPMENT DEPARYMENT Pi RMYT #» . » . . . I . . . ! ms1,3c.: 0, 13125 SW Hall Blvd,Tigard,Orogon 97223.8199 (503)639-4171 DATE IESUCII., 04/08/93 17`E ADDHL`ili: . VW')b ::)W 1131H Pt. 'JUBD I V 1131 ON. ME(d)OWGLODE YON(NG., R FITI 01-Of-'K. . . . . L.0 T. . . . . . . . . . . . . CLASS OF' WORK. aNEW fypF cir USE. . . c�;F OCCUl-"ANCY GRI-1. iRli OCCUPANCY L.0"D c 0`28 4 t FAANT NOW. . . Ownere I-LOYLI Ot-SON 1 141 SW 113TH f1t, 1AGAR(7 OR 1.)72t-,4 "hone Ot 6P.13-24NA Contract or OLSMA DEVLLOPMENT RT I UOX 94A BEAVERTON OR 1)"1005 Phone #.- (,28-CA20 Reg #. . : 52988 Occupancy of the Above roferenced bui Iding i s h,�rfjby qI v,pn, and voi-t -L i L t. the compliance Plith the f.state Of Oregon Specialty Codes foo, tht� gr ol.ip, o(:cupancy, aiid ua+, uit-Jer which the refert-nced permit war. issued. DEPARTME'N'T 1301 L-1)I qSV )JUJI-DING OFMF !.Cb)l i-IMi7 IN Corfl, 03 LL) INSPECTION NOTICE City of Tigard Building Department 2.3125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk Found. Pty g. Top Out Gas Post/Beam Struct. San. .'ewer Foaming Poet/Beam Mech. Rain DrAn Insulation -Plumb. Plbg. Underfloor Water /Line / Gyp. Bd. -Meeh. C` Date RequeeY.ed: -3- _Time: AM __,_PM Addreee: I �Ci1 7`1 Permit Buildet: THE FOLLOWING CORPEC''TIONS ARE REQUIRED: J i Inspectors 4-1"PROVED DISAPPROVED APPROVED SUnJECT TO AROVE Call For Reinap. INSPECTION NOTICE city of Tigard Building Department J 13125 SW Ball Blvd. Tigard. Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underslab Mach. Rough-in Appr/Sdwl Found. Plbg. Top Out Cas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Ream Mach. Rain Drain Insulation .-Plumb. Plbg. Underfloor Wat Line Gyp. Bd. -Mach. Date Requested: L �� Time: _—AM PM Address: / Permit R:.�— Builders TIIE FOLIAMING CORRECTIONS ARE REQUIRED: F-- .J G] ILI - J Inspector: " fly 7210m,4-<; Date: __11:�"PROVRD DISAPPROVED APPROVED SUBJECT TO ABOVE __Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 1.3125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phoney 639-4171 Inspection:_ Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Ream Struct. an. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain , Insulation -Plumb. Plbg. Underfloor ater Line Gyp. Bd. -Mecca. Date Requested: A/ - 7 •Z --Time: __--AM 3—PM Address., / _ 3 � � Permit 1:�U _ [7 Builder: TRE FOLLOWING CORRECTIONS ARE REQUIRED: Ae Inepec::or:- /-�_ V_ � _ Date: --.---- —�- _APPROVED ,-- DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinep. INSPE^TION NOTICE Ile City of Tigard wilding Department 13125 EW Hall Blvd. Tigard, Oregon 97223 • Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspections F ti.r7 Plbg. Underslab Mech. Rough-in Appr/Sdwlk Plbg. Top Out Gas Lina FINAL- Pont/Beam Struct. San. Sewer F-;aming -Bldg. PostJ'Beam Mach. Rain Drain Insulation -Plumb. Plbg. Onder.floor Water Line Gyp. Bd. -Meeh. Date Requested: _ /4/ /^ /'�; 2 __Timor _AM PM Address:1 (� 9" �� ` / �� Permit #:_-7 C/Z Builders THE FOLLOWING COARF.CTIONS ARE REQUIRED: Inspectors _ n..:es f� 11PPMM DISAPPROVED rPPROVFD SUBJECT TO ABOVE Call For Reiuep. INSPECTIOd NJTICE City of Tigard Building Departarnt 13125 Sit Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Bueinees Phone: 639-4171 Inspection:_ Footing Plbg. Underelab Poch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Cas Line F NAL: Post/Beam Struct. Sen. Sewer Framing -Bldg. Post/Beam Hoch. Rain Drain Insulation -Plumb. Plbq. Underfloor Water Line Gyp. Bd. \/-Nech. Date Requested:— f Time: IC AN —_ PM Address:—/� L� 1 Permit f777s--TTT-Cl�4--- i Builder: THE FOLLOWING CORRECTIONS ARE ISQUIRED: Cl: LA H 03 C7 LL) J I Inapeotort Date, ' ----- , APPROVED DI8 VEO APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 1.37125 Sit hall Blvd.. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection. _ -- Footing Plbg. Underslab Mach. Rough-in < Appr/Sdwlk ) Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Strict. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water 9Line Gyp. Bd. -Nech. Date Requested: / 21 Times 4—AN __PH Address:_ cl /. Permit 0s_ 2- Builder Builder•THE FOLLOWING CORRECTIONS ARE REQUIRED: i NI f c w i tr cp 1-- C� W J Inmpmtort "PROM DISAPPROVED '--/APPROVED SUBJECT TOf'+ABOV2 call For Rel-nap. INSPECTION NOTICE N City of Tigard Building Departmenc /\ 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Lire (Rec-O-Phene): 639-4175 Bueinesa Phone: 639-4171 Inapect ioe:� Footing Plbg. Underslab Koch. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Stru^t, San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor slater Line Gyp. ed. -Meeh. Date Requested: Time: AM _PK Address: G� Q -1/'r-�= Permit i:g �7 Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: H J G7 C7 U.1 ------_. __.._. ---- ----_._.._--- _ ---- — J Inspectors APPROVRO DISAPPROVRD - APPROVED SUBJECT TO ABOVE Call For Relnnp. NI SPECTION NOTICE ��r City of Tigard Building De^artment 13125 Sit Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rc -Phone)s 639-4175 Business Phone: 639-4171 Inspection• _._ - -�- FootingLbg. Un erelab Mech. Rouq-t-ir� Appr/Sdwl.k Found Plbg. Top Out Gas FINAL: Poet/Beam Strvct. San. Sewer -Bldg. Poet/Beam Hoch. Rain Drain Framing -Plumb. Plbg. Underfloor Hater Line Gyp. Bd. -Heah. T Date Requested: i(� Time: AM PH Address: (J��J Permit !s%z �)� `_ Builder:_Jk �1 THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: cJ �t�r ��l" __—_ Dates APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Peinap. INSPECTION NOTICE city of Tigard Building Depart"Ont 13125 SW Ball Blvd. Tigard, uregon 97223 Inspection. Line (Rec-o-Phone): 639-4175 Bueinees Phone: 639-4171 Inspect icns--^� — J"—J — Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk. Plbq. Top Out Gas Line FINAL' Found. Fremin -Bldg. Toot/peam Strutt. San. Sewer `�\ Insulation / -plumb. Poet/Beam Mech. Rein Drain 'J �� -Kath. Plbg. Underfloor Water Line Oyp• Bd. - AM PM Date Time: .�--_• Requested: _ Permit Address: Builder: TNR FOLLOWIN0 CORRECTIONS ARS REQUIRED: .J 0 W �---— 9 Date t 1_lt�--- Inspectors _----+�i�-'y-- — APPR.oVED __-_, DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reins?. INSPECTION NOTICE City of Tiger. Building Department 13125 SW Fall Blvd. •iyard, Oregon 97223 Inspection Line (Rer-,)-phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbq. Underslab Mech. Rough-in Appr/sdwlk Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Rain Drain Insulation 1 -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Nech. Date RequestedscT c" /f Times AM PH Address: ! ��L1 f*\ ��-" Permit #: !�� ' 01 ri Builder: THE FOLLOWING CORRECTIONS .ARE REQUIRED, �1 L A-�r c, -tel «JJ Inspectors —,---_ nates-.—__-- APPROVED - r D7.11 ROVED APPROVED SUBJECT TO ABOVE For Rninsp. INSPECTION NOTICE City of Tigard Building Department- 13125 911 Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: i Footing Plbg. UndernlabMech. Rough-in Appr/Sdwlk. Found. Plbg. Top Out Gas Line FINAL: Post/Beam Struct. San. Sewer , Framing -Bldg. Post/Beam Mech. Rain Drain ( �eulati-n -Plumb. �t Plbg. Underfloor. water Line Gyp. Bd. -Hoch. Sate Roqueeted:_ ZZ __ 11 Time: AM PM Addreea: _��f� Permit �:`4 Builder: THE FOLLOWING CORRECTIONS AP.F REQUIRED- inspectors EQUIRED:Ine ctorsDater /' A1rPROVID DISAPPROVED APPR(')VF.P SUB.IRCT TO ABOVE _Call Far Reinal). INSPECTION NOTICEl- City of Tigard Building !Departabent 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639--4171 Inspection•_ Footing Pibg. Urderslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Past/Beam Hoch. Rain Drain Insulation -Plumb. <!j d rfloor �; Water [Line Gyp. Bd. -Koch. DaateeRRequeste�ds /`/� Timer INC AM PM l.ddress:_ 7 k__ 13 Permit Builder: THE FOLLOWING WRRECTIONS AFP. REQUIRED: Inspecl or*_ _--- __. Date- l --- APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE ��LL Call For Reinsp. INSPECTION NOTICE City of. Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspections__ i Footing Plbg. Underelab Mach. Rough-in Appr/Sdwlk Found. Plbg. Top OutGas Line FINAL= oat/Beam Struct. San. Serer Framing -Bldg. oat/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Hoch. Date Requested: J / L��- Time: _AM PN Address: Permit tie . a y Builder:__C—�3t'/ TIDE FOLLOWING CORRECTIONS ARE' REQUIRED: O. V) — Y F- J C7 W J Innpootort APPROVED DISAPPROVED APVROVSD SUBJECT TO ABOVE -`Call For Reinap. CRYOF TIGAIt® MASTER PERMIT e C11Yj0FTWWARD PERMIT #. . . . . . . : MST92-0,249 COMMUN" DEVELOPMENT DEPARTMENT 0216m 13125 SW HW;8W. P.O.B.23397,Tiwd,Og.97 3 DATE ISSUED: 11/04/92 L)ITE ADDRESS. . . : 12098 SW 113TH PL PARCEL: ES103AB-+16005 �UBD (V IS I ON. . . . : MEADOW GLADE ZONING: BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . :5 BUILDING REISSUE..: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 sf CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 GARAGE. . . . . . . . . . :400 sf TYPE OF USE. . . :SF FLOOR REQUIRED SETBACKS----------- TYPE OF CONST. :51\1 FIRST. . . . :740 sf LEFT. . :5 ft RIGHT. :5 ft OCCUVIANCY GRP. - R3 SECOND. . . -690 sf FRONT. :20 ft REAR. . :75 ft STORIES. . . . . . . :2 TH I RD. . . . :0 sf RE OU I HE 1 GH1.. . . . . . . . :28 ft TOTAL------: 14,30 sf SMOKE DETECTORS. Y FLOOR LOAD. . . . :40 psf VALUE. . . . . $ . 7`960 PORKING SPACES. Remarks: PATH I PLUMBING 51 NKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNJ RS. . :0 L.AvA,rORIES. . . . . :3 WATER HEATERS. . . : 1 TRAl-*,S. . . . . . . . . . . . . . :O I UB/SHOWERS. . . . :2 LAUNDRY ['RAYS. . . :0 CATCH BASINS. . . . . . . :0 WATER CLOSETS. . -.3 SEWER LINE (ft ) . :0 GREASE IRAPS. . . . . . . ..0 DISH14ASHERS. . . . : 1 WATER LINE (ft ) . : 100 01-HER FIXJ'URES. . . . . :0 GARBAGE D I SP. . . - I RAIN DRAIN ( ft ) . :0 WASHING MACH. . . : i GF RAIN DRAINS. . : 1 _._____•--_--.---.____ MECHANICAL FUEL TYPES-------------- UNIT HT R 13. . :0 type amul-Int by date r-eept ,GAS/ VENTS TIF $ 1460. 00 JH 11/04/9L — MAX INPUT:0 BTU VENT FANG. . -4 LAPRT 111 352. 00 JH 11/04/92 — I URN ( I V710K . . : I HOODS. . . . . . : 1 BPLC $ 250. 00 JLH 10/23/92 23305.s I_ URN ) =100K . . :0 WOODSTOVES. :0 B5PC $ 17. 60 JH 11/04/92 — 1LOOR FURN. . . . :0 CLO DRYERS. : I SSDC $ 280. 00 JH 11/04/92 — b(JIL/CMPI ( 3HPI:0 OTHER UNITS: 1 PARK $ 500. 00 JH 11/04/92 — GAS OUTLETS: 1 lvlVI R T $ 43. 5V JH 11/04/92 — L)wner,: MPLC $ 10. 83 JH 11/1714/92 — LLOYD OLS014 m5PC $ L. 18 JH 11/04/92 — 131.41 SW 11311A PL PP RT $ 132. 50 JH 11/04/92 — VI 5 P C $ 6. 63 JH 11/04/92 — T I CARD TIGARD OR 97224 Phone #: 623-2420 OLSON DEVELOPMENT RT I BOX 948 BEAVERTON OR 97005 N Phone #- 628-2420 Reg 0. 52988 ------------------------------------- $ 3055. 29 TOTAL This permit is issued subject to the regulations contained in tl-e ------- REQUIRED INSPECTIONS figard Municipal Code, State of Ore. Specialty Codes and all other Foot/fvLtnd Insp Fireplace Insp applicable laws. All work will be done in accordance with approved POSt/DeaM Stt-LICt Gas Line Insp plans. This pewit will expire if work is not started within 180 Post /Beam 11echan InSUlation Insp days of issuance, or if work is suspended for more tha 180 days. Plm/Lindslab Insp Gyp Board Insp 1PLM/Underfloor, Rain drain Insp Permittee Si gnat ime : ,5� Mechanical Insp Water- Line Insp Pli-imb Top Ok.tt t)ppt,/Sdwlk Insp By ; Ft-aming Insp Mechanir-al Final Call for, inspection 639-4175 ----------- CITYOFTIFARD SEWER CONNECTION CIiYQF app !=E R Ih I T COMMUNITY DEVELOPMENT DEPARTMENT 0016m PERMIT #. . . . . . . : SWR92-03:34 M26 bW Hen Bkd. P.O.Bac 23307.TlgaM,Orpon 07273(603)830-4176 6v - r 2 !..)ITE ADDRESS. . . : 12098 SW 113TH PL PARCEL- c'S 10 3AB--Iy;G005 ,)UBDIVISIOIN. . . . : MEADOW GLADE ZONING: DLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :5 1ENANT NAME. . . . . : (JSA NO. . . . . . . . . . : FIXTURE UNITS. . . (.:LASS OF WORE. . . ::NEW DWELLING UNITS. . : 1 TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1 INSTALL TYPE. . . . ?BLJSWR II,,IPERV SURFACE. . : : 15f kemat-ks : PATH I (Jwner: -.__.________ ___---------______.--____-_ ________..__..----...___.- FECES ---------------- I--LOYD OLSON type , moi-int by date recpt 13141 SW 113TH PL F'RMT $ 2100. 00 JH 11/04/92 IIVSPI $ 35. V,10 JH 11/04!9 ' - 1IGARD OR 97224 - I1hone #: 62'8--2420 t:;ontractor-- --------------------------------- [:C:NTRACTOR NOT ON FILE I Ione #: $ 2135. 00 TOTAL keq #. . . REQUIRED INSPECTIONS -- ----- Ihis Applicant agrees to comply with all the rues and regulations Sewer Inspection of ;he Unified Sewage Agency. The permit expires IN days from _ -- the date issued. The totcl amount paid will be for`eited if the pereit expires. The Agency does not guarantee the K-uracy of the ^_ — side sewer laterals. if the sewer is not located at the measurement given, the installer shall prospect 3 feet in all directions frnm the distance given. If not so located, the installer shall purchase - a 'Tap and Side Sewer" Permit and the Agency will install a lateral. Permittee Si gnati_tre I s s)_i e d B y . ~ Call for insper_tion - 639-4175 c.� �l) J mom CITY OF T r LARD — RECEIPT Orr PAYMENT RECEIPT NCI. 02-233404 3:3404 CHECK AMOUNT s 4919.09 NONE: t OLSON, LLOYD CASH AMOUNT s 0.00 ADDRESS s PAYMENT DATE s 11/04/92 SIJHD I V 15I ON s PURPOSE: OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAIL �- BUILDING PERM 352.00 PLUMBING PERM MECHANICAL PIE 43.51? ST. BUILD PER 26. 41 PLAN CHECK FE —10.32 SEWER USA C'100.00 -� SEWER !NSF'ECT 35.OQI PARKS SDC 500.00 STORM DRAIN SDC 280.00 RESIDENTIAL TRAFFIC FEES 1350.00 MASS TRANSI1 TIF r EES 1111.00 LOT 5 MEADOW GLADI-- 1.2099 SW 113TH Fel. TOTAL AMi 1JNT PAID — — —3 4919.09 CITY OF TIGARD — RECEIPT OF PAY14FNT RECEIPT Ni". a92-233053 CHECK AMOUNT 250.00 NAME a CIL,ON, LLOYD CA6H AMOUNT 0.00 ADDRESS PAYMENT DATE a 10/23/92 SUBDIVISION a i'URPOSE OF PAYMrNT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT RAID ON CHECK FF- 250.00 i.r)T 5 MF"ADOW GLADE TOTAL AMOUNT PAID — — — —; 250.00 J AY PLNCK RECT #CITY O TIGA,RD 1J125 SW Hall Dtwi. / COMMUNITY DEVELOPMENT DEPARTMENT li�Oregon 97113 PO Box 23397 PERMIT # (503)639-4171 DATE ISSUED JOB ADDRESS: Z q S_W 1 13-t7t- p _ TAX MAP/LOT 03 SUB:7'V-QC^-0G--- LOT: .S LAND USE: VALUATION: 136- ;,Uy v OWNER SPECIAL NOTES NAME: D C-, CJ Leo r) REISSUE OF: ADDRESS: l 31 LI S,V�-' , I ( 3 L _ LAST REISSUE: FLOOD PLAIN/ PHONE: 7 8- Z `� ? _ �� - 2-3 Z I SENSITIVE LAND: _ CONTRACTOR APPROVALS REQUIRED NAME: _CELS J C-� V C C, PLANNING: _ ADDRESS: _� _ ENGINEERING: FIRE DEPT: PHONE: _ OTHER: CONTR. BOARD #: ?G EXP DATE: y 3 Q 3 ITEMS REQUIRED SUBCONTRACTORS: PLUMB: ^ C./ A-Tl S Co LIST/SUBCONTRACTORS: _ MECH: BUS TAX: RCN ENGINEER CALCULATIONS: _. NAME: Ci.,,_� Q� cam-c.�'J TRUSS DETAILS: ADDRESS: OTHER: Ln PHONE: PROPOSED BLDG. USE: _ COMMENTS: 9PPLICAN SIGNATURE Received By: Date Received: % -�_Z3 ' Z PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE �NfQ� a 10-432 00 Building Permit fees .35� r� 352. �� 10-431 00 Plumbing Permit Fees L. �'L r' J/ 3Z �� 10-431 01 Mechanical Permit Fees 3 '� / _ -v 10-230 01 State Building Tax (5%) Building / ,G,o Plumbing 6 Mechanical 10-433 00 Plans Check Fee X39, Building ,l2 � rJ / Plumbing Mechanical /el", eS' 10-230 06 Fire 33�( 30-202 00 Sewer Connection 0 2,100 30-444 00 Sewer Inspection 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 Fees %5 sy /3Sbr 25-448-05 Mass Transit TIF Fees • I 52-444 00 Parks System Dev Charge (PDC) )y 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) --V L 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) TOTAL AL1 L.0j E v Zj nm/3587P.WPF