14230 SW 117TH AVENUE 14230 SW 117TH AVENUE -
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MESSAGE
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SIGNED_-1-- --
LITHO IN UP A
TOPS IV FORM 3002P
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15F.M01 PEAM'TT
CITY OF TOGA RD A.* PERMS NO. : 5E980156
C17 OF TIMM
COMMUNITY DEVELOPMENT DEPARTMENT DATE I.SIAJEU. P./ F.:/88
13125 S.W.Hall Blvd.,P 0.Rox 23397,Tigard,Oregon 97223.(503)6394175 PA1M. PMT'Nn_ 0 1 5A
,JOB AUDPES� : 14230 SW 11TTH AVE LJ5A NUMBER: 34945
('A' X flol:'11.01 k)l IF;.I L 1* ; UK
LAND LISK:
1.01 F,3.
SECTION: to T*WP: a PN(;', : w
16111JOK 11:3.AL.Os ; A1.110)61 11AIN
USE TYPE: STNI*.'L,E FAMIL.Y
V.; in 1.1 j.)1 :1 U at I I 1. 4110 1, o IL:u)M P 1.y 101:1 t I1 In'1.1 r I t 1 0.,.: 'it I I d r k,:J31 i'I ot 1. 1 ci 41% ci 4' 1 1 tt�- Lill-I T.1"d
Sewerage Agenay . The permit expires U-0 clays from the date ittimi,iod . The total.
'41111141ill Fjoli.cl will Inc* trir+erlwart i-l' tho P"rin-It expires I'lle-i Agitnilcy dommin it(it. giiati, --
akc.t,aw the ar�curacy of the location of the wide *owes- later-&I• . If the sewer is
I 11.11 '1 113 IL.,lit 1.ra rl ak t, 1,t 10 M c-,a%i(I--r,m iA n t 9:1,�-in n , t.h e :1 110 t a 1 1.IV's I, im h M.1:1 -?, -(-'o(...'1 1 11
all. directions from the distance given . If not so located , the instal Irer shm.13
F)tIrchats" a ''Tap and Side �-ifowwjr` Pormit mind thc,± will
INSTAL.A. TYPE : 11-111.11.11'.UING SE-WEP IMPERVIOUS AREA:
1- 1 X I I'I 1011,11 !!b - I I. NAN I
DWRL-LING IJN'( 1*4.-, :
0 FEES :
W glell 1 3.1.1 00
N 14p.30 sw 117th aye C.'ONNECTION CHAVIOV.* $1 , 100 . 00
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R 1.1 gat 1,d N i I Al,I..
PHONE (303) ejZ!%P 5 t)5 6
iM 000 01"1
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R NJ T'AL. $4, 135 00
This permit is issued subject to the regulations contained in Title 14
,f the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It Is hereby
agreed that the work will be done in accordance with the plans and P431-11GH-114
specifications and In compliance with all applicable codes and f i I P*
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work is not started within 180 days,or It work Is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
Permittee Signature
iilllsrwl.l I t- f 4 1 1
ssued By I L114 X-3tp /!-T
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITYOF TIG,e RD No. 29895
13125 S.W. HALL BLVD.
P.0 Date,
1IGARDRD, CRR 97 97223
Name
Address /
Lot Block/Map SubdivIslon/Address
Permit M's Bldg. Plumb Cash Check
Sewer Other Other Rec. By
Acct. No. Description Amount
10.432 Building Permit Fees
10.431.600 Plumbing Permit Fees
10.431-601 Mechanical Permit Fees
10.230.501 State Bldg. Tax
10.433 Plans Check Fee
30.443 Sewer Connection
30.444 Sewer Inspection
51.448 Street Syst. Dev. Charge
52.449.610 Parks I Syst. Dev. Charge _
52.449.620 Parks II Syst. Dev. Charge
31.450 Storm Drainage Syst, Dev. Charge
10.430 Business Tax
10.434 Alarm Permit
10.227 Bail – - --
10.455- Finvt - Traffic/Misd/Parking --
10.230• CPTA Traffic/Misd/Vic. Asst,
10.456 Indigent Defense —�
30.122.401 Sewer Service/USX-
30-122-402
ervice/USA-30.122-402 Sewer Service/City 30%
Sewer Sevice/City Maint.
125 Unmatched
1.124Slorm Drainage — —�-
475
Bancroft Prin. Pymt. ---
40.471 rlancroft W. Pymt.
TOTAL
rDf PARTMENT CC111Y "°
� wr sr agar as,< ass asa acre ss< ase.
'9
CITYOFTICsARD No- 28987 �
13125 S.W. HALL BLVD.
/ P.O. BOX 23397 Dat
TIGARD, OR 97223
Name
Address
Lot Block/Map Subdivision/Address
/q � �(_`
Permit Ws Bldg. _ Plumb Cash Check
_ v
Sewer Other Other Rec. By
Acct. No. Description — �— mount
10.432 Building Permit Fees
10.431.600 Plumbing Permit Fees
10.431.601 Mechanical Permit Fees
10.230.501 State Bldg. Tax
10.433 Plans Check Fee _
30.443 Sewer Connection_
30-444 Sewer Inspection _
51-448 Street Syst. Dev. Charge
52.449.610 Parks I Syst. Dev. Charge
52.449.620 Parks If Syst. Dev, Charge
31.450 Storm Drainage Syst, Dev. Charge
10.430_ Business Tax
10.434 Alarm Permit
10.227 Bail
10.455- Fines -Traffic/Mild/Parking
10.230_ CPTA Traffic/Mlsd/Vic. Asst.
10.456 Indigent Defense
30.122.401 Sewer Service/USA
30.122.402 Sewer ServlceiCity 30%
30.13 — Sewer SevicelCity Malnt.
30.125 Unmatched
1.124 Storm Drainage
Bancro t Prin. Pymt.
40.471 ancro t Int. Pymt.
TOTAL
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175�
Type of Inspection
Date Requested—_ a — /6 -.- Time A.M. P.M.
Ada.ess �l'/ 2 3rd / 7 a Permit
Owner----- 7_7' 1 Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to ❑ Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ No