14764 SW 117TH PLACE ADDRESS:
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CERTIFICATE OF
CITY OF TIGARD OCCU. . . . MST95--0298
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COMMUNITY DEVELOPMENT DEPARTMENT DATE_ ISSUED: 02/16/96
13125 SW Hall Blvd.Tigard,Orpon 97223.8109 (503)630-4171 PARCEL: GS 1 1 Ol1D-08000
:SITE ADDRESS. . . : 14764 SW 117TH FSC..
':)UBDIVXSION. . . . : PIP 1995•-015 ZONING: R--4. 5
tll_OCm. . . . . . . . . . . LOT. . . . . . . . . . . . . 1. e?
CLASS OF WORK. :NEW
I`YPE OF U`"3E. . . :SF
OCCUPANCY GRP.
OCCUPANCY LOAD:2
Remarks : PATH I
Owner,
C'DWARD JOHNSON
1.7577 SW GILBERT 1_N
PORTLAND OR 97229
VIhone 1#: 690_9123
,TEFF WORTH & CO. CONSTRUCTION
13915 SW SECRETAR I ET LN
BEAVERTON OR 97005
phone #F: 5N3641 --35210
210
Peru #. . : 471.29
chis CertifiQate grants occupancy of the abo,re referenced building o- portion
i,hereof and confirms that the building has been inspected for compliance with
the State of Oregon Specialty Codes far the group, oelc,upancy and use '-Inder^
t,►hich the ;-eferenced permit was issued. I)
1+UTI..DING INS-�C:C:Tf7R E�tIIL.DINC3 E`FICIaLY-}
POST IN CONSPICUOUS PLACE
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech, Rough-in Gyp. Bd. -Bldg.
San. Sewer r3s Line Appr/Sdwik Reins.
Other: ._ _ --
Date: _ `'� A.M. —P.M. Entry:
Address: _
Tenant: —__ Ste:___ MST: _
BUP: —_
Con/Own: ._ MEC:—
PLM:
ELC: _.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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Inspector _ Date: =.
APPROVED ___DISAPPROVED/CALL FOR REINSP. CF CO
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 Pibg. Underslab Mech. Rough-in Fireplace
Pos!/Beam Struct. Plbg. Top Out Elec. Rough-in
Post/Beam Mech. San. Sewer Gas Line -B g.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: :L — J k, `1 Time: AM PM
Address:
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Builder: 1U tz f1k /( /ZU_ erlj mT�-�� D 2 `% S-
Builder:
FOLLOWING C(:,ARECTIONS ARE REQUIRED:
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APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-/OJ-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Fooling Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Slrl A. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam P': h. San. Sewer Gas Line BI
Plbg. U .jeriloor Rain Drain FramingatJ
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Alarm Water Line + Insulation - ech
Underilr. Insul. 4 Shear Wall Gyp. Bd.
Date Requested: Time: AM PM
Address:_
Builder: _Permit #: 7 U�
THE FOLLOWING CORRECI IONS ARE REQUIRED:
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Inspector: �/� Date: ? �� ( k►
_APPROVED _DISAPPROVED:_ PROVED SUBJECT TO ABOVE
all For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Fhone: 639-4171
Inspection:
Faoting Susp. Ceiling Sprink. Rough-in Appr/Sdwllc
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. Underiioor Rain Drain Framing -Plu
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: c)_J �-Time: AM PM
Address: L� l�, L
Builder: Permit #:THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector_— 7 — -- Date',
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
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'Call For R iinsp.�-
CITY C TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 6394175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation P(bg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Eler,. 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. Elec
Date Requested: c i C fTime: AM PM
Address:
Builder: 16 11c�0 / JZUPermit r , f G yL_1�
THE FOLL ING CORRECTIONS ARE REOUiRED:
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Inspector: r� C Ltd_ Date:
—APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
—Call For Reinsp. ) �7/I
CITY OF TIGAFD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprin'K. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mecn. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. Sar. Sewer Ga:; Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mach.
Underilr, Insul, Shear Wall yp Bd�.� -Elect.
Date Requested- Time: AM PM
Address:_, ! V7 Y-f,
Builder: Permit #: C c' c) C1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector
APPROVED DISAPPROVED AN1 R0.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 ec Rough-in(/Ik') 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 ChuaUo -Mech.
Underilr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: � L Time: AM PM
Address:
Builder: Permit
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date:
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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CITY OF TIGARD BUILDINu fNSPE.CTION NOTICE
Inspection Line (ROL 0 Phone): 6.?�-4175 Business Phone: 639-4171 �t
Inspection: _ I
Footing Susp. Ceiling Sprink. Rwigh-in Appr/Sdwlk
Foundation Plbg. Underslab Mach. 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 raming �J(,Z -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: c _ Time: rAM PM
Address: � (� �� � Z Z C� I�–�_
Builder: —Permit #: 57 U ,
THE FOLLOWING CORREC'IONS ARE REQUIRED:
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Inspector: i Date:
APPROVED DISAPPROVED Z—t IFTI OVED SUBJECT TO ABOVE
____Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE l
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
PoGt/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam klech. San. Sewer -Bldg.
Plbg. Lriderfloor Rain Drain Framing -Plumb.
Alarm Water ' ;,,ie Insulation -Mech.
Underflr. Insul. Shear Wall Gyp, Bd. Elect.
Date Requested:_���/��q;� _Time: AM PM
Address: l y 7C,,e V l
Builder: Permit »:
THE -FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date: //1/_y��
4e4PPROVED —DISAPPROVED APPROVED SUBJECT TO ABOVE
`Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
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Inspection line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: 1 Q
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Footing Susp. Ceiling rink. Rough-i AppriSdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplax
Post/Beam Struct. Plbg. Top Out , Q Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas Line -Bldg. ('f
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. ear Wall '� Gyp. Bd. -Elect.
Date Requested-,��� a � � Time:1—AM PM
Address:- / 7 _ � 'Y� _
Builder: (pq Permit #:5-
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:
,APPROVED _DISAPPROVED 'APPROVED SUBJECT TJ ABOVE
_&II For Reinsp.
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CITY OF Ti 3ARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4 /
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdw!k
Foundatior Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. 'op Out �. oug _fin-- 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: / -711 7�L
Permit #: 614 U T4
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:_ Date:LlPrl
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_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 AppriSdwlk
Foundation Plbg. Underslab Mech. Rough-'n Fireplace
Post/Beam Struct, Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech San. Sewer gas Line Bidg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulatic n -Mc-ch.
Underflr. Insul. Gyp. Bd. -Elect.
Date Requestr.d: zZ1U1f 9 J Time: AM PM
Address:/y 7(-o l/ / / 7 PZ —
Builder: y/ ::R,5 d ' Permit #: qs;. d Z_9�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector:
—%YYFiOVED 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 Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mach. an.Sewe Gas Line -Bldg.
Plbg. Underfloor n Drain Framing -Plumb.
Alarm Insulation -Mach.
UnderfIr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: C Tirne:4AM PM
Address:
Budder: — Permit #: _�—
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector._ Date:
APPROVED —DISAPPROVED _APPROVED SUBJE T TO ABOVE
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_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Imipe(;tion Line (Rec-O-Phone):
-639-4175 Business Phone: 639-4171
Inspection^'.
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Undersiab Mech. Rough-in Fireplace
Post/Beam Struct. PI op Out Elec. Rough-in FINAL:
Post/BenmptgM ch) Sail. Sewer Gas Line -Bldg.
Plbg. Underfloor> Rain Drain Framing -Plumb.
419M Water Line Insulation -Mech.
Underilr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ 16 12 C) /y Time: _AM PM
Address:— _ Z l / (/` -moi
Builder: Permit #: C-� J
THE FOLLOWING CORi.E(I'TIONS ARE REQUIRED:
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Inspector: Date: /,�j
L-A/PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp,
CITY OF TIGARD BUILDING INSPECTION NOTICE _7
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 39-4171
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Apnr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
ea Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer R (h Gas Line -Bldg.
Plbg. Underfloor ain Ura' �ft Framing -Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. ?hear Wall Gyp. Bd. -Elect.
Date Requested: `j Time: AM PM
Address: I L4 l I (j 0
Builder: Permit
111E FOLLOWING ;ORRECTIONS ARE REQUIRED:
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Date:
_APPROVED 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
rost/Beam Str 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.
Underilr. Insul. Shear Wall Gyp. Bd. lect.
Date Requested: �— �^�G Tim O _ PM
Address: X 4-�
Builder: (10411 — 1��_D 2_U Permit #: — 4 2-4�
THE FOLLOWING CORRECTIONS ARE REQUIRED.
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Inspector: — _ Dater
_APPROVED _DISAPPROVED 42�APPROVED SUBJECT TO ABOVE
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—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 QWater Line- J Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: C,( l ' 5 Time: AMPM
-7 �y ( ) lC CMZ
Address: `
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Builder: -� �-�^' - 7 �� L' Permit #: J
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: Date:
!/APPROVED 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:
r-ooting __ 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 -Plurrrb.
Alarm Water Line Insulation -Mach.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: �� ` -���/ Time AM kt .LPM
Address: I x-11 4`q In ('I
Builder: 1-1.11- k Permit tt: t• `�� s 'UZ�
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Date:_ T _/-'APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD PERMIT It. . F'. . . :
CdMMUNITY DEVELOPMENT DEPAR,TLWNT DATE ISSUED: 09/06/95
13125 SW Hall Blvd.Tigard,Oregon 87223.8199 (503)839.4171
PARCEL: 2S110I3D-00000
T TEI ADDRESS. . . » 14764 SW 1. 1.7TH PL
>UBDIVISION. . . . . PF' 1995--015 ZONING: R--4. 5
BLOCK. I . . . . . . . . . LOT. . . . . . . . . . . . .
BUILDING
REISSUE: DWELLING UNIT): 1 BAS1-,MENT. . . . . . . . :0 s f
CLASS OF WORK. :NEW BEDRMS:3 BATHS:3 cArr2AGE. . . . . . . . . . .56,21 s f
TYPE OF USE. . . :SF FLOOR AREAS_..___..._..._._....._. REQU I FRED SETBACKS-
T'0-JE
ETBACKS-_..____._._T`0-JE OF CONST, :5N F'IRST. . . . : 1351 S LEFT. . :6 ft RIGHT. 0 ft
OCCUPANCY GRP. : R3 SECOND. . . : 11130 S.F FF?ONT. s L-v ft REAR. . :50 f1:
STORIES. . . . . . . :2 FINBSME:NT:O S REOUIRED-._._._.-.--
I IE:I G14T. . . . . . . . .2'8 fit TOTAL _- ---_:113(31 S f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 psf VALUE. . . . . $ : 161472 PARKINS SPACES. . - I
Reamav-ks: PATI` I
PLUMBING
SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PR1`VNTR . . : 1
1AVATORICS. . . . . :4 WATER HEATERS. . . : I TRAPP. . . . . . . . . . . . . . ..0
TUB/SHOWERS. . . . LAUNDRY TRAYS. . . : 1. r,ATCH BASINS. . . . . . . »0
WATER CLOSETS. . :3 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :0
1)1SHWASHERS. . . . : 1 WnTER LINT: (ft ) . : 1.00 OTHER FIXTURES. . . . . .0
GARBAGE DISP. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : 1 )F RAIN DRAINS' . . - 1
MEC14ANICAL .._._._.__.____.__._.__..._..._ _.._.__._.__.._.._._._.._._ FEES
7UF_'71_ TYPES------ UNIT HTRS. . :0 type amo�.tnt by date r•er_pt
/GAS/ / / VENTS . . . . . :0 TIF $ 1590. 00 B 09/06/95 95-270179
MAX INPUT.0 BTIJ VENT FAN . . - 4 SWM $ 180. 00 B 09/06/93 95--270179
FURN ; 100K . . :0 HOODS. . .. . . . : 1 SWM $ 100. 017.1 B 09/06/95 95-270179
FURN ) =100K . . *. I WOOD5TCVE=;. :0 1B, PRT $ 589. 00 B 1219/06/95 95--270179
FLOUR FURN. . . . :0 CLO DRvER'3. : 1 SPLC $ 382. c-.'O JD 07/31/95 95-2686E3LI:
POII_/CMP ( 3HP:01 anirp twh L s: 1 D5PC t, 89.1 4.0 B 09/06/95 95. 1'270179
GnEi OUTLETS: 1 PARK $ 500- 00 P 09/06/95 95- 7'70.179
4;x. 1210 S 09/06/9 5 15-27017n
CDWORD JOHNSON MPLC $ 11. ; 5 B 09/06/95 95-270:179
17577 SW (3ILBf.-_RT I...N MSp'C $ 2. 25 B 09/06/97-1 35--270179
3BTH $ 225. 00 B 09/06/95 95--;270.179
POr:TLAND OR 971229 P 5 P C $ 11. 1`:5 B 09/06/95 95--2701 /1)
Phone #t: 6901-9123 EROS $ 64. 00 S 09/06/95 95--2701.79
contractor » __..._.._...._....__...__. __._ ._ _--_ ____r'RG'f' $ 20. t301 B 01"3/06,/'35 9S-c'7017
JEFF" HJORTH & CO. CONSTRUCTION ERPC $ 20. 80 B 09/06/95 95-270179
1.3915 SW SECRETARIET I_.N
BE:AVERTON OR 97005
a Plnone
ccReq #. . 471i;'9 __.-_._.___.____..______.__-_._...._--_______._.__.___.....
V $ 3769. 95 TOTAL
?- r:is perait is issued subject to the regulations contained in the ----- - REQUIRED INSPECTIONS -- -
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Tigard Municipal Code, State of Dre, Specialty 'odes and all other Fr,oting Insp PlL1mb Top Out
applicab!e laws. All work will be done in accordance with appr•oyed Fol_1ndation Insp Framing Insr.
plans. This perait will expire if work is rot started within 190 Post/Beam 5)truct Fireplace Insp
LAJ days of issuance, or if work is suspended fr,r sore than 180 days. Port/Beam Mec-han Gas Lint, Insp
Crawl Drain Tns�_11at, ion InSI.
ret•miti:eP 8i )1At0-1V.P : Plm/i_tndslab InsF Gyp Board Inap
PLM/Uncier-floor Rain c)rain Insp
.T.ssi-ted 'By : �`__. _ hler_1.,anic-al Insp Water" Lina Insp
Call for inspection - 639--417,1
CITY OF TiGARD r!~Wl,R CONNECTION
PERMIT
PERMIT #. . . . . . , SWR9�5--0u�='6
CCfMMUNOTY DEVELOPMENT DEP ►RTMCNT DATE ISSUED: 1719/06/95,
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)630.4171
PARCEL: 2SI I.OBD-04000
ITE ADDRCSa. . . : 14764 SW 117TH PL
SUBDIVISION. . . . : PP 1995—ID15 7.ONING. R---4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . .
TF_NANT NAME. . . . . :
USA NO. . . . . . . . . FIXTURE UNITS. . . .
CLASS OF WOPi;. . . :NEW DWrLLING UNI"rs. . : i
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. ., . . :BUSWR IMPERV SURFACE. . r
Remarks : PATH I
Owner: —._____.___.__________—___._____.___._..___._._..__ _.._..____...W._.__.__.. FEES
EDWARD JOHNSON type amol.knt by date rer_pt
17577 SW GILBERT LN PRMT Is 2200. 00 B 003/06/95 95-2701.79
INSP 1. Y 5 0 B 09/06/95 '35--2'70179
r'opn.AND OR 97229
r1hone f#: 690-9123
C;a n t r^ac:t o r,.
CONTRACTOR NOT ON FILE
------------------------------------------
Pti on e #: t/ 2235. 00 TOTAL
Rey #. . .-
----
. . . ----- REQUIRED INSPECTIONS .-_._. .._
This Applicant agrees to comply with all the rules and regulations Sewer In;pec_tian
of the Unified Sewage Agency. The permit expires 180 days from
the date issued. The total amount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals, If the sewer is not located at the m!asurement
given, the installer shall prospect 3 feet in all directions fro
the distance given. If not so located, the installer shall purciase
a "Tao ,nd Side Sewer" Permit and the Agency will install a lateral.
r- r..ai i t't E'e i n a t�_c i-e
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Call for, inspection - 639--4175
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Residential Building Permit Application
City of Tigard
13125 SW Mall Blvd Oa a
Tigard, OR 97223 �y L_
—
(503) 639-4171
Jobsite Address(�_ 7 11 !"
Subdivision: r�r , ,m
p P)J Lot# ��- Office Use Only
10j� `�� 7z` Contact Date I i Initials
Valuation: r Result
New Construction Only: (Square Footage) Planck/Rec #
Permit # 11 s f A
House: 2 Garage: _ 7 Reissue of
Corner Lot? Y Flag Lot? Y �> rP TL# _ Z.',I It' 6[') " ,tbtj
�'nc
Plat # Ic''S
Owner To tiwSt" _
Address: ) IS'7 7 10k, Approvals Required
Planning Setbacks Solar 41�
=1— Engineering
j I ��1 L� —�j 1 2 3
Phone: Other._1,
Contractor: Items Required
Address: 170 1 S r.J �c��a"ue � L � Subcontractors
Truss Details
Or c�7��lJ Other
�� Notes lj5 (V\Nl t 1AA `r FIrG�w? fon
Phone ( ) �� 5_2 U
Contractor's License #_ 7 2j — T -� A�r
fa�tach copy oo'current Oregon license)
Contact Name: J-11
Contact Phone: ( ) Ley
Subcontractors: Architect/Engineer: awl j 1_ 5kc
Plumbing: ��� - Gt��• �^^ �'' Address: —
L Mechanical:
(attach copy of current OR Contractor's License)
Phone:
—' JOB DESCRIPTION:
Ct
y/� 35Zfj
—' Applicant Signator Applicant Phone number
Received by Date Received. 0 9 5/
Permit # Account Des:-riptlon Amount Amt Pd. Bal. Due
"U a Bldg. Permit (BUILD) SAX• S�`� /�
Plumb. Permit (PLUMB) -2 L 25
� �r
Mech. Permit (MECH) �' -Y L
State Tax (TAX) -1�/ C Z . yU
Bldg: may. ti�
Plumb: 1 J Z
Mech:
Plan Check (PLANCK) •c.l j
Bldg:
Plumb:
Mech:
Sewer Connection ;SWUSA) � (�
Sewer Inspection (SWINSP) 35 7 3
Parks Dev Charge (PKSDC) �G� _ S U d
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)
Water Quality (WQUAL) /
Water Quantity (WQUANT) 0
d
Fire Life Safety (FLS)
r
Erosion Cntrl Permit (ERPRMT) �^
h
-' Erosion Planck/USA (ERPLAN)
W Erosion Planck/COT (EROSN) '
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TOTALS:
r C 1 I Y 1.IF I J.1 l4m) Irl IT I I I 11V PA I P1 GF)1'I NO, a 9ti—;'1 1 46L)
I IFIMl, q NJ f. RTH & I,(I 1 A 0. 111U►
140DRES's i 131s1,t' SW 8l C;12F::'1 PHILT LN PAY14N) DHI1 - >' 10/ 114/9"
BEAVERTON OR I UBD I V I H I ON y
9 7005-
(.IF' F-AVMrr:'NT AMOUNT PA1 U PUHPCI81F" OF F-'F?YMF Pd( AM1..1UN I PAID
185. VIII St. 14011-D Pf'.H 9..
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CITY OF TIGAPD REC""IPT OF PAYMENT iECFIVT NO. 395— -,6666o
CHECK AMOUNT a 850. 00
NAME t HJORrH AND COW"ANY CASH AMOUNT a 0. 00
ADDRESS t CONSTRUCTION, INC. PAYMENT DATE s 07,.'3J /95
13915 SW SECRETARIET LN SUBDIVISION
BE AVFRTON OR 97005—
PURPOSE OF PAYMENT AMOUNT PATD PURPOSE OF PAYMENT AMOUNT PAID
250. 00
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0-4
CD
cc:
PnRTITION PLOT 1995-015 LOT e
TOTAL AMOUNT PAID -- — -- wi 250. 00
LI1Y OF T113F; RD PFt.r 11 ,1 Itl• 1,I1r1111,1I FSI 1.i IP] Nr.;. :9"'S--.'!N1
r,F•I.J,;K 1-1MIJUNI a :i
N11ME t HJORT'H & I..UMPANY I.;1.INS1 . t;1itylI HMt.II -11• s 0. t(11(1
HI►1)RESS : 1,3915 SW LANE. I41YME:.N1 1.1141V.. a 09/VW,r9.',
BEAV1 H 1 UN, OR biJk�1 t 1 V 11'i!I IN o
17005--
PURPOSE
:k7VI05-.PURPU'.' E UP PAYMENT HMIIUN I C N1 D I•LIF1WIS1 UI Pt•O(ME-.N I HtICA IN I I'l I I I I
Elt.t].I..pTNl3 FBF F'tM !`_,HH. 111171 I4.UME31NI) PF F'tM . 4u"I
Of
P�WCHFINICAL. PF. 4``i. (414 :.yl . bUIL.0 PER y,._, ` 0
i- IT HN I.VEC:K FF 143. 4.) (0314 r?r.'V11/1. 00
d WER I NSPLnC r 35. 00 4 i tE1K`3 11UI.; NOW. 011
►-
Pf W T nF•N•i TAI ! ROI I I t. W 9 1470. 00 WKS IRONS 11 11 F I F F b 1 civil. N0
I I. I I (WA1. I I v 11 u; 1 I . I f Y F 1_ ' t So. 1710 I-k-4) IJUAM i 1 I Y Hit. (I I. 1 1 1.1 10111. 00
LNI SIuN (AINIHItI k+_r1M1FrF4 64. 00 1=R SIaN U tN1MM Iq 11N I.K &W. Mo
w F:NUf3[F?N I:I IN F N.I.1I_ 20. 80"1
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t4764 KW 1. 1 7tH PI_. W r 95-0298
W I i'H IIMo INT x 4 i 1 D - W A ";754. 95
Solar Balance Worksheet
Address
Box A calculations: North-South dimension for the lot. Box A:
This dimension is determined by finding tha midpoint of the North lot line and drawing an
intersecting line perpendicular to that point. Measure the distance from the midpoint of the
North lot line to the South lot line along the described line. ft
Box B calculations: Shade point height from your structure. Box B:
1. Determine whether measurements will be based on the peak or eave of your
structure. The orientation of the ridge is also important. Which describes
your lot?
1 a: If the roof line runs North-South, measurements will be based on the peak of the (Circle one)
roof.
1a lbs 1c'
1 b: If the roof line runs East-West and the roof pitch is less than 5/12, measur,.ments
will be based on the eave.
1c: If the roof line runs East-West and the roof pitch is 5/12 or steeper, measurements
will be based on the peak.
ft
2. Measure change in elevation from front property line to finisned floor elevation.
+ � ' ft
3. Measure distance from finished floor elevation to the affected peak/eave.
ft
4. If the roof line runs North-South, deduct three feet. If the roof line runs East-West,
deduct nothing.
5. Subtract one foot for each f jot of difference in elevation from the front property ft
line to the rear property line, if the lot slopes up from the front to the rear. If the
lot has no slope or slopes up from the rear to the front, deduct nothing.
6. Total figure for box B: __ _ it
CL Box C. Distance to the shade reduction line. Box C:
Measure the distance from the North property line to the foundation. _ ft
F—
,—' i 2. Measure the distance from the found;,ion to the affected peak or eave. + ft
r
141 c9 I - - - - — — - -
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3. Total figure for box C.
Elev. _ SS.o�
E lev,
88?S \
sewer,
EO , ,(
ascvheM�' _ r
re Nat k � Se�b��k �
� Ca A ptcK � �-°h�
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two biowl ho"e. I
Floor EIN ( at
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Ele✓
- mo
Greys. O
�— I 'l�.5' sj i N ErUs�oy► Cor`}vo�
I
+ Drive
ioo.o� 48.o E16v.
Lo f a J. 014f 199s-o�_S
ScAie 1" =2.0
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IERMIT
CITY OF TIGARD PLUMPING p . . .
PERMIT #. . . . . . . : MST)5-'21.=9;:
DATE ISSUED: 09/06/95
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171 PIERCE_., , 31 117_BD--171$01710
ITL ADDRESS— . 14764 SW 1. 147TH rel_.
_!BD I V I S I ON. . . . : PP 1995-015 ZONING: R-4. 5
i_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . . u
CLASS OF WORK. . :NEW GARBAGE 1)I SPOSALS. . : 1
'TYPE OF USE. . . . :SF WAZA-11140 MACH. . . . . . . : 1 BACKFLOW PRE VNTRS. . : 1
OCCUPANCY GRP. . : R3 FLOOR DRAINS. . . . . . . :0 'T RAFIS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . :' WATER HEATERS. . . . . . : 1 CATCH BASING. . . . . . . :0
FIXTURES - _---------- LAUNDRY TRAYS. . . . . . : 1 sr RAI1\1 DRAINS. . . . . : 1
S1 NKS. . . . . . . . . . . I GREASE TRAMS. . . . . . . :0
LAVATORIES. . . . . :4 OTHER FIXTURES. . . . . :0
TUB/SHOWERS. . . . : SEWER LINE (ft) . . . . ;0
WATER CLOSETS. . :3 WATER 1_I IE" (i=t ) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : PIATH I
OWNER :
EDWAR.L JOHNSON TIF ffi 1 ^0. 00 S 219/06/95 95 c:7017�)
17577 SW GILDERT LN SWM 1, .180. 00 B 09/06/9 ; 95--270179
SWM ? 12117. 071 D 09/06/95 95-•272117';,
PORTLAND OR 97229 BPR'T q 508. 00 B 09 /06/95 95-270179
Phone #: G90-9123 bPLC f 38;-1. ;__0 .J P, 07/13.1/95 95•-26F3G3.:.
DSPC t 21. 40 8 09/06/95 95--27017'•)
PIUMbi.ng Contractor, : -__._-_._________.... PARIS 5010. 00 S 09/06/95 95--271211.`/",,
MPRT .g 45. 00 B 09/06/95 95-270179
•i:�m �A e : ►►1cw1� l,.)�n��c' MPL.0 11. 25 11 17.19/116/1)3 95- 021701*7r.?
Addre,..ir, /v4,44; No) LVsl �'�.-l� p�_• _._.__� M5PC c`:. 25 B 1719/06/95 95-270.179
C:ity :_ '�n. �I� SLate ^ 3BTH 6 225. 00 D 09/06/95 95..2:7101703
Zi.Pz_._ 772 Z-1 Phone#: n�4.�.%69.3P5PC 11. 25 B 09/06/95 95-2721179
Rey �: _... :3'f 7 s Z. ___. Ad d i t i o n A l F e a s not shown here. . . . . . . .
--------- REQUIRED I NSPECT I ONfi -- -- --
This permit is i�isued subject to the r eg-
l.ilations contained in the Tigard Municipal Footing Insp Insulation 'nsr,
Code, .state of Ore. Specialty Cedes And all Foundation Insp G ,p Board Ins[
',her applicable laws. All work will be done Frost/beam Struct Rein drain Insp
Accordance with approved plans. This Post/Beam Mechan Water Line Insp
,emit will expire if work is not started Crawl Drain Water Se-vice Ir
: this 180 days of i.ssuAnc_e, or if work is Plm/1.lnds1,1b Insp Appr/Sdvilk Insp
_,'..Ispende ' for more than 180 days. PLM/Underfloor Mechanical Final
Ihech.zmnical Insp Pll_1mb Final
n Plumb Top Out Building Final
c1f P -aminy Insp Erasion Control.
ul) I/ LL '` F i.r e1,lace InsFI
G r I.-ine Insp
J -thor I Pi Ing Contractor Signature -
CAll for• inspection 639•-4175
Contract:lr Notes .
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Community Development RESTRICTED ENERGY ELECTRICAL APPLICATION
_ r 13125 SW Hall Blvd.
Tigard, OR 97223 PERMIT# :1 R 9 E- 0.16 S
Phone(503) 639-4171
FAX(503) 684-7297 DATE ISSUED_/O O – !25-
TDD
9STDD No. (503)684-2772 //
CITY OF TIOARD Inspection (503)639-4175 ISSUED BY �eS Sc.kn•r,1 t"
PLEASE COMPLETE. ALL SECTIONS
1. LOCATION OF INSTALLATION 4. TYPE OF WORK
(o y Pi.
Address RESIDENTIAL—Restricted Energy Fee. . . . . . . . . $40.00
„� " d r (FOR ALL SYSTEMS)
City State Zip Check Tyne of Work Involved:
PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND EXPIRE IF WORK ❑ Audio and Stereo Systems'
IS NOT STARTED WIIHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR
180 DAYS. Burglar Alarm
El Garage Door Opener'
2. CONTRACTOR APPLICATION ❑ Heating,Ventilation and Ai• Conditioning System*
n
Contractor 'OI' d t^O _Type_ 644 tna.l� ❑ Vacuum Systems'
�.�.s f. II J ❑ Other —
Address 13115, SkJ _ Sure Vo��tJF Lr
Date.— /O /9 S COMMERCIAL—Fee for each system . . . . . . . . $40.00
(SEE OAR 918-260-260)
Property OwnerEcf r✓�4712-4)
^!c� .� o+
1, s + Check Iyne of Work Involved:
T
Contractor's Board Reg. No. 7/ Z 9 ❑ Audio and Stereo Systems*
�/ ' 3 SLD ❑ Boiler Controls
Phone# ❑ Clock Systems
❑ Data Telecommunication Installations
3. OWNER APPLICATION ❑ Fire Alarm Installation
❑ HVAC
Print Owner's Name Phone No ❑ Instrumentation
Address ❑ Intercom and Paging Systems
❑ Landscape Irrigation Control"
City State Zip ❑ Medical
This permit Is Issued under OAR 918.320.370.This applicant agrees to make only ❑ Nurse Calls
restricted energy installations(100 volt amps or less)under this permit and to do the ❑ Outdoor Landscape Lighting'
following:
1. Only use electrical licensed persons to do installations where required.(Certain Protective Signaling
residential and other transactions are exempt from licensing.These have ❑ Other _
asterisks(").All others need licensing).
2. Call for an inspection when all of the installations under this permit are ready
for Inspection at 503.639.4175. ❑ Number of Systems
ty 3. Purchase separate permits for all installations that are not ready for Inspection
►r when the inspector Is out to Inspect under this permit. •No licenses are required. Licenses are required for all other Installations.
fes- 4. Assume responsitpllity for assuring that all corrections required by the Inspector
are done,and
5. Assume responsibility for calling for a final inspection when all of the corrections S. FEES
,., are completed.
J
The person signing for this permit must be the applicant or a persona. Enter Fees $ 0
authorized to bind the applicant.
Uj
—� LW h. 5% Surcharge(.05 x total above) $ .cif
Signature
TOTAL $ 2-. Do
Authority if other than applicant
ENERGARCHP
CJ I Of- Ut-)(041) OF PAYMFNI W k,+.I PT NO. a 95—P11481
AMI)ILINT 00
N(4Ir11z_ w KJORTH k LO G(ViH AMOON"rs Uh, ow
PAYMENt DA 10 10 9',S
' DIVVi IIAN
1005—
PAYMVN I- AMOUNI FIRM PURPWA III 11for-PNI NIVIIA111,41
11(.1141t oil I '( RM11 40. Q10 !-ill. Will 0 !'1 It OfA
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14764 SW 1. 1illf Pit
TWOL 14MOUNI 1:101.11) 4P. 00
V�
Community Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd.
Tigard, OR 97223 Planck/Rec. # 95-- a 71y8G
Permit # 4a/'95-- Oy(yi
Phone (503) 639-4171 Date Issued lo -- yd )s
CITY OF TIGARD FAX (503) 684-7297 Issued by c hu- lcs-
TDD No. (503) 684-2772
Inspection (503) 639-4175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development lac 4� L /kis Number of Inspections per permit allowed I J
Address l y 7 b y S 1.0 // 7 f 1• Service included. Items Cost(ea) Sum t
City/State/Zip d (/f 4a. Residential- per unit
1000 aq II or less $11000 _0_
Name (or name of business) F cadditional 500 rut if or $2500 -1
Rion thereof 1
Commercial 13 Residential [� Each Energy $2500
2
Each Manul'd Homs or Modular
Dwelling Service or Feeder $6800
2a. Contractor installation only: 4b.Services or Feeders
Installation,alteration,or relocation 2
Electrical Contractor Cie c 200 amps or less $6000 2
Address_S 9 3 b NW tri IIs Cr k, ie j 201 amps to 400 amps $80 00 2
401 amps to 600 amps $120 00 2
CityFO S L �c State C_) Zip 1 601 amps to 1000 amps $18000 _ 2
Phone No. 3S 7-3 3tz8 Over 1000 amps or vans $34000 _ 2
Contractor's License No. 31!- l C Reconnect only $5000
Contractor's Board Reg. No. qy/1 S 4c.Temporary Services or Feeders
Installation,alteration,or n itwn 2
Signature of Supr. Elec'n + 200 amps or less $50 00 2
201 amps to 400 amps $7500 2
License No. z gs 8 S V Imne No. 401 amps to 00 amps $100 00
Over 600 amps to 1000 •olt6
2b. For owner instvilntions. a"W above
4d.Branch Circuits
Print Owner's Name New,alteration or extension per panel
Address a)The fee for branch circuits with
purchase of servke or Feeder W. 2
city State ZIP_ _ Each branch arrud $5101)
Phone No. b)The fee for branch c,rcurls without
The installation is being made on property I own which is purl branhase of circuit
°'feeder a..
Fust branch cncud $,95 00 �
not intended for sale, lease or rent. Each Additional branch circuit $500
Owner's Signature 4e. Miscellaneous
(Service or feeder not included) 2
3. Plan Review section (if required): Each pump or irrigation arcfe $4000 _ 2
Each sign or outlins lighting $4000 _
Signal cimwt(s)or a limded anergy 2
Please check appropriate item and enter fee in section 5B. panel,alteration or e,dension $4000
_4 or more residential units in one structure Minor Labels(10) $10000
Service and feeder 225 amps or more
4f. Each additional inspection over
System over 600 volts nominal
the allowable in any of the above
22 Classified area or structure containing special occupancy
�! as described in N E C Chapter 5 re,i v 1 a ti"" $3�00
� r",tilt„,
cit „dant Ess 00
} Submit 2 sets of plans with application where any of the above
F' apply. Not required for lemporary construction services.
5. Fees: �
J NOl ICE 5s. Enter total of above fees $
5%Surcharge(05 X total fees) $
w PERMITS BECOME VOID IF WORK OR CONSTRUCTION 3u $
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter
r line A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FON Plan neviviAw it required(Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS S $
Subtotal
COMMENCED f"1 Trust Account 0 $
Balance Due $ y Z S
wee.w- r+W 1'T am