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11165 SW 123RD PLACE-2 L: `i ef rj ti . j M f�• in •I Y• ^C• 11165 SW ' PLACE �T�41- ff t CITYOT' / CERTIFICATE GF FFARD r OCCUPANCY �CC�YOF'TI6ARD PERMIT i1. . . . . . . z MST90--0156 COMMUNITY DEVELOPMENT DEPJk31< HENT o�ao« 1a12sSwHdihIva. P.O.Box 2.3397,Tigard,orQw 97223 (6,03)?,V4>>e �` DATE: ISSUED: 09/28/90 511E: ADDRE:.SS. . . a 11165 SW 123RD P1- PARCEL_: 1S1:34C:D--09001,) SUBDIVISION. . . . a ANTON PARK ZONINGS R--7 BLOCK. . . . . . . . . . a LOT. . . . . . . . . . . . . a52 CLASS OF WORK. aNIEW TYPE OF USE:. . . a S OCCUPi1NCY 0RP. cR3 OCCUPANCY LOADa220 4 TENANT NAME. . . a Fe�mark33►a ;JEF'FREY P F ISH OAK SPRINO!".-r DEV.FTSH LONST. 10211 SW BARBUR BLVD. Ip6A PORTLAND OR 9'72.19-0000 Pham On 30:3--245-5633 Contr actor a JEFF'REiY P FISH i FISH CONSTRUCTION CU 10211 eW BARBUR BLVD. PORTLAND UP 97219-0000 Phone Ma '503-•245-5633 Rep H. . a 62417 Occupancy of the above refe•rRnr_ed building is I,,-reby given, and certifies the compliance with the State Of Oregan 4,pAcialty Codes for the group, occupancy, and uwW under which the refrp. enced permit bias iS*Ltvd. F'?RE DEPARTMENI 'WILDING INSPECI'GR ..__._- BUIL NCi G • CIAL POST IN CONSPICUOUS PLACE. - - - -- --- - -_---- .--- --------. Jit iI I INSPLCTION NOTICE ;,i! J L City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 972, i Phone: 639-4175 Type of Inspection Time A.M._._ P.M. Date Requested � 1 i Permit # Address _ �/ .0 Lot # Owner�. -- =a6e, "—� Builder Thr following Building Code deficiencies are required "o be correct`e . Approved Presented to i [I Disapproved Inspector -— Date _ �` •'°'��'_ �L�J CALL FOR REINSPECTION ❑ YES 17 NO i INSPECTION NOTICE City cif Tigard Buildi^g Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested ,�l` � �l -�!U Tim � A.M. P.M. _ Permit #k Address �L� Lot #_ Owner — —� Builder �— The following Building Code deficiencies are required to be corrected: i Approved Presented to / Disapproved Inspector 711 + Date CALL FOR REINSPECTION ❑ YES C lifO 4<. INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Time A.M. P.M. Date Requested r d Permit #_ZL Address J L_SL f.ot # Owner Builder�"� ' The followin Building Cad deficiencies are required to I _ � t � (A r C.r k l Approved Presented to disapproved Inspector _ Date —' � '� •_`1t7 CALL FOR REINSPEC770N E� ❑ NO INSPECTION NOTICE : City of Tigard Building Department , P.O. Box 23397 Tigard, Oregon 97223 Phone: 639 4175 C Type of Inspection Date Requested. �(f 71 A,M_-- P.M. 77 Address ,�/ L `� – Permit # Owner___ / Lot #_ Builder _ - _. -------- —The following Building Code deficiencies are required to be corrected: s i k An ye T [ &Lzr rpt d Ic _ �I-`i_�x -F t� 1Z- k�i=.._l� 1 �►�'C''C� V/�J--�--�-- � _ [.y A 4- Presented to �{l.Approved Inspector ___ [_� Disapproved Date ----- /s e CALL FOR REINSPECTION [] YEs 0 No INSPECTION NOTICE P City cf Tigard Building Department P.O. Box 23:97 /r Tigard, Oregon 67223 Phone: 639-4175 Type of Inspection — Date nequested ��_SZ��'fL_ Time A.M. P.M. Address ____ Z1Z ::T — 3 d -- Permit Owner ___� Lot # _ Builder --- The following Building Code deficiencies are required to be corrected: Presented to _ Approved Inspector ❑ Disapproved Date CALL FOR REINSPECTION F-1 YES C--1 NO INSPECTION NOTICE V1�1 i City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection .— Date Requested_ Time A.M. P.M. Address ���1�'-`--- �� Permit #670-O!ESE Owner_ Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to � II Approvers Inspector '� _ LJ Disapproved Date CALL FOR REINSPECTION ❑ YES 0 NO r INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone: 539-4115 Type of Inspection C� Date Requested _ Tuns A.M. .M i d Address Permit Owner Lot #_ Builder --- -- P Th.- following Building Code deficiencies are required to be corrected: - -- Jop Prc•ented to pproved Inspector U Disapproved i Dote { Q --- CALL FOR REINSPECTION 1 C7 Yes 0 NO L INSPECTION NOTICE City of Tigard Building Department �J P.O. Box Tigard, Oregon on 97 97223 Phone: 639-4175 Type of Irlspec ion Time.—_ A.M. _P.M. Date Requested ,i ' � Y Permit Address /Z� -- Lot # Owner Builder The following Building Code deficiencies are required to be correrted: F 47 r I `) i Prtentedsented to Ins �— � Appf011r1� Dlappfewd �� X Date , � – CALL F'O REINSPECTION YES ❑ NO INSPECTION NOTICE �,r1 City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection — Date Requested --�. �/ - U Time A.M.—_P.M. Address ._.�1��- — r�— r�_—._-.�_� Permit Owner.— _ _� --__ Lot # _ Builder The following Building Code deficiencies are required to be corrected: 4 Presented ton Approved Inspector .:.. ❑ Disapproved Data CALL FOR REINSPEC77ON YES I I NO I I I I I INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 i . '- Tigard, Oregon 97223 Phone: 639-4175 i Type of Inspection Date Requested Time. A.M._ P.M. Address Permit �J # Owner Lot.--- --— — — —' Builder _The following Building Code deficiencies are required to be corrected: w� �a�✓s::s''s, Acv `T n iL/�.0 .�L� 37--1 FS71) I i - i i Presented to } Approved Inspector _ / [J Disapproved Date --- CALL FOR REINSPECTION ❑ YEa 0 No MEOW i INSPECTION NOTICE City of Tigard Building Department P.O Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested Address SPS �"d Permit #Q Owner_ v� _ Lot # Builder -- ---•— The following Building Code deficiencies are required to be corrected: Presented toApproved Inspector ` _ �__--- -- - — -, ❑ Disapproled Dote _-._-- CALL FOR REINSPECTION ❑ YEt 0 NO 7 i INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 63;1-4175 Type of Inspection ___ Date Requested_—____ _.6 1. (L_-- Time._-- A.M. n P.M. s. Address --/- �_ —-- Permit Owner— -_- ----_- _ — Lot # • t Builder ----- The following Building Code deficiencies are required to be correct, Presented to _ ___ — Approved Inspector --- r -_--_-_ -- �_� Disnpproved r Date C y G CALL FOR REINSPECTION ❑ YES 0 NO W_XWTWU _ WUW_Aa CITY0F TIVARD MASTER PERMIT F'L R 111 T #. . . . . . . MST90 0 1.56 WYOF TWARD 1-'RI'M. PERMIT #. » MS-1-90 P)V55 6 C.'OMMUNFTY DEVELOPMENT DEPARTMIUffDATL- 90 ­ ISSUED: 05/24/ 13125 SW rWl Blvd. P.O.Box 23397,Tipird,Orel 97223(603)6394175 �t� .J I I I... R.1)VHE.5":i. . . SW IH3RD PL PARCEL SUBDIVISION - . .. . ZONING: BLOCK. . . . . . . ., „ „ „ LOT. . . . . . . . . . . . . .. ................. H U11 DING REISSUE: DWELLING UNITS: I BASEMENT. . ., . . . . . :O Sf C1 ASS OF WORK. ::NEW BI:­DRMS-3 BATHS-3 (31111-W)GE. .. . . . . . . .. . :428 Sf TYPE OF' USE. . . -,SF' F-L.OLIR REQUIRED SETBACKS---------- T*YPE OF CON ST. ::45N FJRST. . . . ...658 of 1...11. FJ. ,- - 10 ft FSIGHT. ::5 ft ")CCUPlAN[',Y GRP. iR3 SECOND., ,. . :586 Sf F*RUNT. 20 f t REAR. . 130 ft S TO R 1:E S. . . . . . . ..0 THIRD. go sf R E.0 U I R D– FICIGH1.. . . . . . . . ..20 ft of SMOKE DETECTORS. :Y I' L!3OR LOOD. .. .. .. -.40 lis-f VALUE.. . . . . $: ,591.3;:`2 PlnRKING SP0CE!:3. . -.0 PLUMBINC7 S 1:N K ra. . . . . . . . . . .. 1 FLUOR DRAINS. . . . :© B(;;.::;F'L 0 W 1-0 F�E V N VR S. 0 LAVATORIES. . . . . e3 WATER HEW ERS. . : I T R $3. . . . . . . . . . . . . . :0 TUB/SHOWFRS. . . . 12 LAUNDRY TRAY;::. . 0 CATCH BASINS. . . . . . . :0 WATER l`.LOSET18. . :3 SEWER LINE' (ft) . :0 GREASE TRAPS. . . . . . . ..0 1)*11.3 H W 0 S 14 E R 13. . . . .. I W 11::,R L I N f A., - 1.00 OTHER F*IX*T(.)Rl-.:S. . . . . :0 GARBAGE DISP. I RAIN DRAIN (ft) . »0 WASHING "IACH. . . I SIT RAIN : 1. ML`.C1AAMICAL. ...........I.............. 1:"E E 9 F'UEL U N I 1 1-4 TR S. . :0 type .A 11)o Ll 11 t b,y (i;A t o� 'recpt /UAS/ VEMTS . . . . . :0 PAYM $ 100. 00 JLH 05/11/90 c*?00*?09 MAX I Nr-'lUT :0 I'll I U VENT F-011S. . - 3 B I..,R T F'U 1--�N ( 10 0 K . . -. 1 HOODS). . . . . . : 1 Ei P 1.C $ 2013. 45 F (JRN )=100K (A W 1)0 1)S)TO V E S). 10 I4;~. PC $ W5 F LOOR FURN. (d CI...0 DRYE RS. : 1 S TD C $ 600. 00 L-*IOIL./CMF:l ( 3HP-0 OFFIER LINITI-3:0 SSDC $ i:.150.. 0 W G A`� 0 U TL E TS 3 1 PORK $ 2:1.Jo. 00 Owner: .............. 111-'R'1 It 36. 00 ,ji::-rvRE:y F, r- IS. H HPLC $ 9. 00 OAK SPRfNGS DEV. FISH CONST. WWI" 1, 1. 80 .10211. SW 11ARDUR BLVD 106A PPR 1 132. 50 1:)ORTLOND OR 97219 00�0 P 11.5 V,(11 ti (.,,,. 63 Phorie Oe 503­245­56313 Y P RT K 15. 00 C:o vi t r a c t o-rs F1 A Y 11 1.73;3. 03 J L H (%)S/24 9W J E F F R,EY 1::, F- I S H OA( GPRINGS 1)1:.V. F*],*SH CC)NSI ., 1,0211 SW PARDUR BLVD. 1-1:1IRTL.AND OR 9121.9 0000 1*1[iovie ": 503-­245--5633 ker 0— c ISWO" ............. P coz41l 18.43. W.3 TC)TOL., This permit is issued subject to the rejulations contained in the .......... REOUIRE.1) INSPEC"11ONS Tigard Municipal Code, State of Ore. Specialty Codes and all other f`oot/foL(iid ;Crisp Mprhariical Iiisip applicable laws. All work will be done in accord with approved Wt-r "Proofing Elso, PiLtnib Tor) 01.11t a not 0' gone in plans. This permit will expire if work is not art within IS@ F., t/,J.,J e.R nj I 1_1.3 p F`rinniiiq Irivip sp De ed f days of issuance, or if work is susp4eed more at, 169 days. Urawl Drain F`ireplAcp Iiisp Dsmlt Sl.ab Gas Livie Iri�ip Ile rilti.ttee SJ ........ ............... P1.m/(AI'1deri0 ab i.vi T11SL1I.,itLi!)11 Irisp PILM/Widerf.loor Gyp Boa-rd Insp ISSUed Bye F'tI1q D-flaill Hsnilt RAiri drain 11.1sp C',A.1 I for' iiispec:tioii C 1*3 9 CITYOF TIFARD SEWER I`CONNECTION ' RM F'F.M 7:T CfTYOF T16gi IRD COMMUNITY DEVELOPMENT DEPARTMENT 1='E RMIT' N. . . . . . . » SWR90-•0173 13126 SW HWI Bhrd. P.O.Box 23a97,TlQard,Oregon 97223(603)639-4176 f.'I;T.M. r'ERMIT #. » MST'9W 01.56 --- _.. 6,:S,.)-` ��.1.' �I. _ DATE:: ISSUED: 05/24/9 :ZITL ADDRESS" . . » 11165 SW 123RD P'L. PARCEL: 15134CH...(;) C)f)r? SUBDIVI SIC)IN.. .. .. „ : ANTON F'ARK ZONING: R—i 'TENAN'T' NAME. . . . . USA NO. . . . . . .. — . -40686»40C•.,86 FIXTURE' UNITS. . . C:L.ASS OF: WORK. _ . fl*W DWELLING UNITS. . .—J. rYF'E Of 1.J5E:. . . . 11 SFNO. OF' BUILDINGS» 1 IN117TALL TYF'E. . .. ., -BUSWR II'IF'ERV SURI=ACE. . » Isf kema•rks: Owne•r•» _..__._....._.....__._._........._..._._._.._.__.._._._..__.._........_._._. ... __..._...__._. ...__.____.__— F'E:E:S ._._......_......_____._.__.__ JE::F'FREY f? FISH tYI)e <aIII c)unt I3y date -ree I.)t OAK SPRINGS DE:V. FISH CONST. F'RMT $ 1250. 00 / SW BARI:+UR BLVD. 106A INSF' $ 35. 00 V'ORTI._AND OR 97219-0000 F'AYM $ 1285. 00 JL.H 05/24/90 f'hc3tae ": Coritracto.r. -____..._._.._._.._....___.._,...... .....___.._._.._.._..____. CONTRAC rOR NOT ON I:. 1:L_E I'hUnr' Na $ 1.285. 00 TOTAL Ftcay N. » » ............._. RE(WIRED INSPECTIONS _._..._.._. This Applicant agrees to comply with all the rules and regulations Sewer ticrl of the Unified Sewage Agency. The permit expires 120 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 lcce ed at the measurement given, the installer shall prospect 3 fee+. in , 11 direction,; from e distance given. If not so located, the rn al shall purchase a "Tap and Side Sewer" permit and the enc winstall a lateral. ___.___._. ""'" �"" _.._._._ .___._„...•........ G'c,r m i.t:t o ef c i. q n a i,c.c-r.e» ......__.__ ....................._.._........................... :1a S c.c e ci r{y � ...._.W... f.;a11 lc�r :i ns;I�ectian - 639 4175 Cl'T'y OF Tlf-3ARD RECKIPT OF PAYMENT PECU i r r rio. go-2oic,4) CHECK AMOLIC,11' 3018.07 NAME t FISH CONSTRUCTION CO CASH AMOUNT i 0. 00 A D ro P F 5 B : 102"1 1 SW BORBUR EA-W) PAYME'rl r DATE 05/A'24/90 POPTLAND, (—.)F,' 97-.19— J 1 16)5 SW 1,27'RD Ft PURPOSE OF PvVvM:7NT ktl(:)L)t,)T PAID PUPPOSE OP PAYMENT AMOUNT FAID 8 71—E—D.I Wrj 9 0 01'16 3)13.00 FL11B PERM 50 MECHANICAL PE, :116. 00 ST. FOATLD PER :14. FLAN CHECK FF 127. 45 SE Wk" USA X150. —,EWER INSFECI :715.00 STREE1 SDC 600. 00 OP,..S SDC 250.00 STOPM DRAIN SOC PMOUNT Pf.-OE- 7.01 B. 07. RYI: CITY OF TIGARD RECEIPT Of PAYMENT RECEIPT NO. YO-200704 CHECV,. W1001,17 ; 100. 00 FVr'H CONSTRUCTION CASH AMOUNT 0. 00 Hf-DRES1,F) z 10.211 SW SARr-"UR BLVD PA Y M E t J I' ()A T r-.,.' 1190 1 W. 91.03D 1 s I cip) SU I TE 206A PORTLAND, OR 97/2719- LUT 52 ANTON PoRf, F"URPO(SE OF F-'A'yMEl-JT AMC)!NT Pt.'VID PURF'OSE OF PAYMENT opmui*4'r PA I D IAN CFIEU-; F1' 100.00 1i.-TAL AMOUNT PAID t 00. 00 y W w I pp �I-' P'L�+N CIR)CK APPLICKrION CITY O TIFA RD 1� t»2s sw.►doe B7d. P.O.Boit 27397 PLAN a U)CK ti /4 a c ,9m3 pIIa,= $ COMMUNITY DEVELOPMENT DEPARTMENT C� DAaTLssum JOB ADDRESS: /4')J :- .W 123 �r It��tc�, TAX N AP/Il.7r /S/-314 C 13 1U u t1 SUB: LM: ? LAND [)5E: VAUJUION: -Ty OWNER ( SPDCJAL NUITS NAME: cJrroz f RZrSSKJE OF: — ADDRESS: ✓ IAST REISSUE: _ SENSITIVE UND: PHONE: APIRVALS RDOUIRED OOMIRACIUR / / / PIANNII�: NAME: 7th �p., tr��c'14 c - - ADDR]:S3: 4OZ11 FIRE DEPT PIONE: 737 ^ BUaDERS BMRD 1: v.7 yi 7 Earn DATE: 1/ fes' i.IST/ - BUS TAX: I�RC3i .NG7NF.ER _, CADCLUATICNS: NAME: _ { ,moi ��,i{7J/ri� TR= DEM=: ADDRESS: 011 R: -- MKWE; COMME<fI'S: ' ,H .,1JB(XMIRAC'IURS: PLLM: 4 f� S I Go/ll�irr'�/ -/- C/� MDQi: 1'>�z'L� f /I'7l L) /41 -2- - �d PFIdrr ACCT if D>;3CRIPTICN ANOINT AND(NP PD. BAL. DUE r1:fyu-0/S•(. 10--432 00 Building Pei-nit Fee, _ 10-431 00 Plumbing Permit Fees / •�, .5Z �L.�u 10-431 Ol Mechanical Permit Fee-, 10-230 01 State Building Max (5%) y vY Building / •L 3 / Plurbing lo, to-3 v� Mode _ / &-v _ 10-433 00 Plans Check Fee � ��'"' z N i, /6U /d N � Building a3 "/.7,.7- */j C,�N y Plumbing __ Medi y c . -c 17 3 30-202 00 Sewer Cbrnection ,;2 S L> / 5 u 30-444 00 Sewer lrrq ection �� -35- 51-448 s51-448 00 Street System Dev Charge (SDC) cvG n v r 52--449 00 Parks System Dev Charge (PDC) u 31-450 00 Stonn Draink-ge Syst Dev Cztg (SSi'.�) _-�P 5 L a 512 10-230 OG Fire -� 70TAL ,3 / ,U 3 .5 U ------------ RIx { ��/b )U 7U c> APPLIcAwr SIGNAIURE•; noceived By: _ Date Received: of/3587P.WPF 7