11881 SW 126TH PLACE-1 Uuuu uu u : u -7 � u . y
CITYOFTIVAh12��� 16A
CI*RTIFIC.'ATE OFiRD OCCUPANCY
UPANC..Y
COMMUNITY DEVELOPMENT DEPARTMENT 0"*0" RM 3.1 #. . . . . . . : IvISTr)1...0004
13126 BW FWI Bbd. P.O.Box 23397,11gaid,Oregon 97223,1603)8394176 v �/
DATE 05./17/91
!TE ADDRESS. . . : 11801 SW 1.'--_6TH PL. PARG"EL.: l 133DD-128014
SUBDIVISION. . . . s VILLAGE AT G0MME':R LAKE" PARK 4 ZONING- R 4. 5
I-ALOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . 1165
GL-ASS OF WUIir._ :NEW
TYPE" OF USE. . . :c,;F
OCCUPANCY r RP. :R:3
OC:CUE ANCY L..OAD: l lfi 4
1'I-;,1014T HAME. . .
Remarksi 1991 STREET OF AFFORDABLE HOME-" SHOW
OwnL%r._ _....... ........ ................_.__...._.__, _._.._...._..__. .. _-
5CHUMACHER CUSTOM HOMES
1430
SE CRYSTAL 7PRINGS
PORTLAND OR 97236
Phone #a 761-6643
Ccyntrac;tori .__.. ._._.._...--
SCHUMACHE=R CUSTOM I-40MES
14,302
SE CRYFTAL SPRINGS"
PORTLAND OR 97i236
Phuvve #t 761—F%844
rtPy #. . : 6c"326
Uc:U Ltpanc•y of thv, above ref erenc,ocl bm11dinq is hpr••eby given, auld c_Prtifiew
the campliance with the r;tate Of Oregon Specialty Codes for the group,
or.`L;r, pancy, .and VNH Ullider- which the rpferpn..pcl permit WAS icSU d.
FIRE DERAR'fME'NT BUILDING IN£FIECTnR
` C;ULHDINC ( CIAL
PO`37 IN CONSP I Ll1DU5 PLACE
IMS:!ECTZON NOTICE
City of. Tigrsd Building Departme':t
13125 SIN Hall Blvd. Tigard, oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-41
71
Inspection:__ _ —.----
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing ""z—(-
post/Boom Mech. Rain Drain Insulation -plumb.
Plbg. Underfloor Nater Line Gyp. Rd. C-Meoh.
Date Requested: Times —7W1—'AM PM
Address:
Builder:
THE FOLLOWIIIQ OORRECTIONS ARE REQUIRED:
i
7t
Inspectors --_.. — -
Date:
*�pyEQ DISAPPROVED APPROVRD SUBJECT To ABOVE
CA11 For Reinap.
INSPECTION NOTICE
city of Tigard Building Department <�
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: —_ r 17 47r?C
Footing Plbg. Underalab Mech. Rough-in Appr/edwlk
Found. Plbg. Top Out Gas Line FINAL
Poet/Beam Struct. San. Sewer Framing /-Bldg.
Poet/Beam Mech. Rain Drain Insulation lumb..)
Plbg. Underfloor Nater Line Gyp. Bd. -Koch.
Date Requested: Time I /PH
Address: n �X ")"7 Permit f$#SZZ `OC�
�r
Builder• ? L L /FEZ
THE FOLLOWING CORRECTIONS ARE REQUIRED:
-P Sao
Inspector
,�_APPROVZD DISAPPROVED APPROVED SURJRCT TO ABOVE
call For Reinsp.
� ■I t � � Rt t � i
INSPECTION NOTICE
City of Tigard Building Department
13125 Sid Hall Blvd- Tigard, Oregon 97223
Inspection Line (RE_---o-Phone): 639-4175 Business Phone: 639-4Y71
Inspections _----- `'
Plbg. Underelab
Mech. Rough-in ( Appr/Sdwlk
Footing
Pound. Plbg. Top out
Gas Line FINAL:
Post/Beam Sc- ict. San. Sewer
Framing -Bldg.
Poet/Beam Mach. Rain Drain
Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd.
-Koch.
—Till: �AK PK
Date Requested: �
.04 � Permit #t Y
Addrese:
Builder:
THE FOLLOWING COhRECTIGNS ARE RRVIRiDt
r
4.
J --
Dates y _z
Inapectort I
APPROVED DISAPPROV=D APPROVRD SUBJECT To ABOVF.
Call Tor Reinsp.
t ! F W
I
I
l
t
INSPECTION NOTICE
City of Tigard Building peParUeent
13125 4$1 Ball Blvd. Tigard. Oregon 97223
Inspection Line (ROC-0-phone): 639-41'75 Busineres Phone: 639-4171
Inspect ion:^ " i r
Mech. Rough-in
Appr/Sdwlk
Footing
pl.bg. Underalab g
Found. plbg• Top Out
O,la Line FINAL:
post/Beam Struct. San. Sewer
Framing -Bldg.
post/Beam Mech. Rain Drain
Insulation -plumb.
-Mech.
plbg. Underfloor water Line OYP• �'
�AM — .PM
Date Requeeted= -
Permit
Address$
d� l 2 fP l
Builder$
THE POLIA41HO RRECTION8 ARE REQUIRED=
1
�— D l' �f�'v r..2 �F.�1 o c..✓ oaf✓�
rtA411 ---
�-
Inspectors
APPROVED
DISAPPROVED �D SUBJECT To ABOVE
Cell For Reinep.
INSPECTION NOTICE
city of Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inapr--tion Gine (Rec-O-Phone). 639-4175 Bueineee Phone: 639-41.71
I
Inapsction: ---- ---------
Footing Plbg. Underslab Mech. Rough-ir: Appr/Sdwlk
Found. pibg. Top O.St Gan Line FINAL:
Poet/Beam struct. San. Sewer / / ,framing -Bldg.
Post/BeaHoch. Rain Drain (/ neulation Plumb.
m
Plbg. Underfloor Nater Line Gyp. Bd. -Nech.
AM
Dnlo Requested: TimetPN
`�/
Addreaet r (1' Permit
Budde':! l
THE FOLIAY41NG CORRECTIONS ARE REQUIRED:
�tt
L<,c r,C
��7/LeYt7J L2,j!Y rr Tf! -
Inspectnri Datet_?� S
�"Ap¢iIOVID ___ DI/11tPQOVfD APtRO�V�D /DDJICT TO 11x0117
Call Ior 1PAinep.
INSPECTION NOTICE
city of Tigard Building Depa--t -nt
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phoae): 639-4175 Business Phone: 639-4171 M
1
Inspection:
Foot inq Pl.bg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
i
Poet/neam Scruet. San. Sewer. Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water/Line Gyp. Bd. -Meeh.
Leto Requested: ��} / ! -� // mee _�AM PPM
Addresn: CrYl
Builder: GlZ-
w
TBE FOLLOWING CORRECTIONS ARE IREDt
Innper:tor: _ _ _ Dat.e:,�/��
APPROVED DISAPPROVRD - IPPROM til !lA'" T TO ABOVE
call Por Reinsp.
w
INSPECTION NOTICE
City of Tigard Building Department
13125 Sit Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-phone): 639-4175 Business Phone: 639-4171
Inspection:
i
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Can Line FINAL:
C Poet/Beam Struct. ) San. Sewer Framing -Bldg.
Poet/Beam ech.' Rain Drain Insulation -Plumb.
Plbg. Underfloor / Mauler Lire Gyp. Bd. -Hach.
Date Requestedt 1 �Z.u7. ( Time: �_AMN PM
AddresR: Ii
�4
it I I , ,r lax
/Per/mit fl:. , UG �
_Ia _
Builder: �� �/�. �V
THE FOLLOWING OORRECTIONS ARE REQUIRED:
Inspector: /` — Date:. z�- r
APPROVED _ - DISAPPROVED APPROVED SUBJECT TO ABOVE
—Call For Rei.nsp.
I
WIN
--�----
f
I
i
I
S
�NSYECTION NOTICE }
city of Tigard Building '+.�..nt
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-?hone): 639-4175 Business Phones' 39-41 1
Inspection: —
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found.
Plbq• Top Out Gas Line FINAL-
post/Beam
Poet/Beam Struct. San. Gewer Framing g.
post/Beam Mech, Rain Drain
Insulation -plumb.
- Underfloor j Water Line Gyp. Bd. -Hoch.
-
_ AM PM
Date Rogaestods_
Address s a Permit #
Builders --
THE FOLLOWING CORRECTIONS ARF. REQUIRED:
Inspectors _ Dates z-Z
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
III 1w, law 1W
INSPECTION NOTICE
city of Tigard Building DepartM18"t
1.3125 SW Hall Blvd. Tigard, oregon 97223
Inspection Line
/({�Rer_-O-Phone): 639-4175 Business Phones -4171
Inspection:
Footing P1bg. l�nderelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Ed. -Koch.
Date Requesteds �Z(J Times AM /PM
Address:___.ZZS�r !�4� Permit is� 511_
Builders—hti��c�-�'c----..
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
Inspectors _ -- Dates
ROVED M hAPPROVED — APPROVED SUBJECT TO ABOVR
Cell For Reinop.
i
INSPECTION NOTICE
city of. Tigard Building Department
13175 SM Bell Blvd. Tigard, oregoo 9722.3
Inspection Line (Rec-O-Phone): 639-4175 Bueiness Phone: 6 9-4171
Inspection:_` —
FootingPlbg. Underalah Mech. Rough-in Appr/sdwlk
Found. Plbg. TOP Out Gas Line FINAL.
J �
Poet/Ream Struct. an. Sewer j Framing -Bldg.
Poet/Beam Meeh. Rain Drain
Insulation -Plumb.
� -Mech.
Plbq. Underfloo eter/Lino f Gyp. Bd. �� f/J
Date Requeetadt I- L 7" ` Time*-t - PM
Address: / l d �/ � � �� •�it 1,111_ —�yo
Builder:__
THS FOLL400WING CORRECTIONS ARE REQUIRED:
Inspectors_ Datet�� _
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
r i`-
t�
INSPECTIONN OTICE
t
City of ' igard Building Departaent %f
13125 Sit Hall Blvd. 'Tigard, Oregon 9722.1
Inspection Line (Rer..-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
ound.' /`; JC �/Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor water Line Gyp. Bd. -Neck
Date Requested: T,rim�st AM��/��,,��,, / PM
Address:
Builders xNvV4^Q,(+-_e_
THE FOLLOWING CORRECTIONS APE
REQUIRED:
1.7
Inspectors Date,
APPRGRD DISAPPROVRD 7IMMM?U SUBJECT TO AROV6
call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Doting Plbg. Underul.ab Mech. Rough-in Appr/SdWlk
Plbg. Top Out Gas Line FIMALs
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water L.tne Gyp. Bd. -Mech.
Date Requested: l-/i-/i I�/ N�imes �_AM PM
Address:--- / �� �r�lL � -_/Pe,rtii��s
BuilderL7Z�CG��!
THE FOLLOWING CORRECTIONS ARE REQUIRED-
494D
EQUIRED:44D
Inspectors
Cft,,PROVED nTSAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
1-ITY OF' TIGARD RECEIPT OF I AYMENT RECEIPT NO. k 91 --20041 2
CHECK AMOUNT : 4.139.80
NAME SCHUMACHER CUSTOM HOMES CASHAM01-INI 0.00
ADDRESS 14702 SE CRYEITAt SPRINGS ST PAYMENT DATE 01/091191
SUBD I V 15 1 ON
PORTt-AND,OR 9-72-b 1188I SW 1226TH PL
r"UPPOSE OF F"AYMENT AMOUNT PAID PURPOSE OF' PAYMUNI AMOUNT PAID
00
PUILDING PERM MST91-0004 4-:.:(-' .,)(0 r1RM 140.UMP PE
MECHANICAL.. PE 36-00 1,31 . BUILZ FT.--k 30
Ft AN CHECK FE I US.50 lGEWER 05A 154.10.(14")
SFWER INSPECT 35. 00 RESIDENTIAL. TRAFFIC FEEAS 1250.0()
Mv,";S TRANSIT TIF r-EEI-3 .1 f-)() ST ORM DRAIN SDC 3-0751. 00
Al..1 k
; AMOUNT PAID X41.59. B(i
W1111 ! IN W
circ OFTIFARD 111ASTER ; %:RII1IT
CCFTYOFTWARD V,10117 , .. • • .. . . .
COMMUNITY DEVELOPMENT DEPARTMENT ORIOM
13126 SW HWI Blvd. P.O.B.23397,Tlpd,0". F ,�fK*),5�4, 175 ' rSUEDn 01/08/91
7�7
DATE .1 1;
S:)J, I E% ADVR[�SS. . 11.881. :3W I 26T I I k A R C',E L.-, .1.SJ 3 1)D VS J.6'--';
r:i0E(DIV18T0N. . . . : VILLAGE AT SUMIIILRI.-(-)K[:-* 04 ZON I W3-
L.0 C Y.. . .. . . . . . . . : 1.-(71.6 5
BUIL.DING
RE.T.M3LIE DWEL-LING UNITS: I BASEMEN I.. . . . . . . . ...0 S f
CLASS OF WORK. NEW BE 1)R III S)-J BATHS:2 GARAGE*. . . . . . . . . . :520 5f
TYPE OF USE., S F F1_0OR R E 0 LJ I R 1::'D S E T P A C K IS-------
TYPE OF CONS*T :5N F".R ST., . . , : :1948 S f L.FFT 5 ft RIGHT. -5 ft
OCCUPANCY GRP. :R3 S;�,C 0 N 1). , (a i FRONT. PO ft R[:41 R..
STOR I ES. . . . . . . .. I T!-11R1). . . . 0 S f RE llL)T R E D
HEIGHT. . .. .. .. . . . :16 ft T OTA L-- •-•----- -- 1.`)413 Sf SI1OKE;: DEQ TEXTORS. -.Y
FI..00R I-OAD. .. . . :40 psf Wil.-LIE. . . . . $ 98968 PARKING SPACES. 0
Reniark.s,-. 1391 STREE.-.1 OF AV'FORDADLAH0111::: SHOW
PL.UMIHING
Si I r? FL.00R DRAINS. . .. . -0 BACKFLOW PREVNTRS. :(a
I AVATORIF."S. . . -.3 WATER HEATERS. . . - I TRAPS. . . . . . . . . .. . . .. . ..0
T 1.)P/E;H 0 W E.RS. . . . ::, I ()UNDRY TRAYS. (a C A T C:1-1 P OG I N 0
WATER CLOSUTS. . -.2 F`.WER L.I NE (ft-) 0 GREASE" TRAPS. 0
D] SHWAG)HERS. . . . » 1. WATER LINE:' (ft) . -. 1,00 0 T H E R F 1.X T 1.)R ES., 0
(3)A R P A 0 E. D1 S P. . . I RAIN DRAIN (ft) . -.0
WASHING PIAL!-I. . .. : :1 S 17' RAIN D R I N G. . g I
MECHANICAL. FEES
F(JEI._ UNIT H TR 13) :14 type all)01.01t by date recr.).t
V E 1%IT S . . . . . :0 F:IAYM 100. 00 W-T 12/21/90 207836
-;,. . .- 1/90 20 16,36
11 A X I N 1:`L)T:0 ItTU VF:-'NT 13 171 A y 11 2..`.'0. 0(a JL.H 12112
FORN < J.00K . . : I HOODS.. . . . . .. . .1. FiPRT $ 430. N
F'URN >=400K . . .-0 WOODSTOVES., .0 RPLC $ '279. 50
F*L.0 0 R F L)R N. . . . :0 CLO DRYERS. : I E45PC $ 21. 50
1?()1I_/CMP ( 13IAP.-W (ITHER LINTTS:O SSDC' $ 375. 007
GAS C)IJTL,-.IS-. 1 PORK q; 250. 00
11PR7 $ 3 6. 0 0
SC.'HUNACHER CUSTOM HOMES III P I-C $ 9. 00
1.4302 M L.)17,C, 1. 80
SE CRYSTAL. SPRINGS PPR1, 1F 140. 00
PORTIJAND OR 972 36 !"'5r_,,(' $ 7, 00
PI-imie #: 761-6843 T I F $ 1350. 00
Corl,(;rartar.. --------- PAYM $ P'549. 80 :11...H
SCHUMACHER CLIS1011 HOMES
1430P
SE: CRY,13TAL. SPRJ:NGG
POR11.014D OR 97236
Phone #t 761-6843
Reg 0. . : 62528
2899. 80 TOTAL.
This permit is issued subject to the regulations contained in the REAW I RFD T NSPECIT ONS
-
Tigard Municipal Code. State of Ore. Specialty Codes and all other F00t/fOL111(i IIISP Fi-replaee trisp
applicable laws. All work will be lone in accordance with approved Past/Beam Strt.tct Gas Line Trisp
plans. This permit will expire if work is not started within 189 Post/1540an) Meetiall 11-1st.11Atiat) :11)S
days of issuance, or if work is suspended for more than 189 day's. P1rn/Ltridq.41,At) *111-4p Gyp
Yp Boa-rd Insp
t3
r:,i.,M/IJridPrf1ar RAJ.vi cl-rotivi T
Pwrp.ittep Si4ilatt.1-er: 11 e c,h a ii i r A Tn9p Water I.-irie T.1.1%P
Plumb Top Ot.tt Appr/ScIw1k Insp
Isst.ted By" Franii.iiq liisp Mer_Ii,-Aiii(-,--).1 F* i ri a I
Call for inspr(-tion 639---4175
W
SiL.WER CONNECT ION
PERNT T
E:'R 11 I'T # SWR91-000(2
arf OF TIGARD
�crryoifwwtD
COMMUNITY DEVELOPMENT DEPARTMENT 0214CON 1)0 T I S S 1.) 1) 01. 08/91
13125 SW Hell Blvd. P.O.Box 23397,Tlgarc,Oregon 97223 (SM)5394175 7��7
—T-unREEL
SL)FDIVI'13101q. . VIA LOGE F SU'11MEALVIKE 04 ZONING:
FiLOCK. . . . LOT. . . . . . . . . . . . . : 165
E N 0 NT Iq A 11 E., .
LJSO NC). 43136 F:'.TXT(.JRE IjNl'rS. . . 9
C1.1-419S OF' WORK. .. ,. ::NEW DWELLING UNI'TS. . ', I.
'T'YPE OF' LJSE. . . ,, -. .-SF NO. OF" F4U1LDTNGS- J.
I N C)TA L L I'Y 1.41. B L)S W R 1.11 PE R V S L)R F'A CE. f
Reniii-rks: 1991 51'REE'T OF' AFFORDABLE HOME: SHOW
S:;CF(JMACHER CU51'OM HOMES type a In c)LI.11 t by cl -Ate -r e c�p t
1 43 Oc.1 PRI11, 4i 1 1500. 00
4:-' GRYS'T*A1 SPRI.NGE) INSP $ 35. 00
F)OWT1 AND OR 97P-36 F,f)y N $ V5)35. 00 JL.H 01/08/91
Ihc)vie #.- 761-6843
.............
CO H I R 0 C T*0 R N 1: 'J.Lr:.
E.
�j 1. J.L r.
9; 15.3 5. 00 r 0 1'n L
q RE.CMIRED INSPECTIONS
This Applicant agrees to comely with all the rules and regulations Sewer Tits pec.,tiort ........
of the Unified Sewage Agency. The aervit expires 129 days from ...... .........
the date issued. The total amount oaid will be forfeited if the
oermit expires, The Agency does not guarantee the accuracy of the ......
side sever laterals. If the sewer is not located at the measurement
given, the instiller shall prospect 3 feet in all directions from
the distance given. If not so located. the installer shall purchase ...........
at "Tap AM Side Sever" Permit and the Agency will install a lateral. .......
1::1 e-v m j.t t e e !..')i q ii�.%t t.t-r e ......... .........
i:;t,t e d B y r. ....................................................................................... .......
Call. -fc)-T, j.iispectiori 639---41.75
t �
PLUMBING PERMIT
CITYOFTIOARD PERMIT #. . . . . . . : MST'T 1-0004
CRY
COMMUNITY DEVELOPMENT DEPARTMENT O�iE T T F ISSUED: 01/08/91
13125 SW Hall Blvd. P.O.Box 23397,Tipaid,Orepon 97223(503)639.4175
�
SITE ADDRESS. . . : 11881 SW 1'26T H ISL. PARCEL..: 1 S 134DD-1 :800
ciLlBD I V I S I ON. . . . : VILLAGE AT SUMMERLAVIE= 4 CITY OF TIGARD ZONING s
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 1.6b
l LASS OF WORK. . : JEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . 31 BACKFLOW PRE:VNTRS. . :O
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . s0
;3TORIF_S. . . . . . . . : 1 WATER HEATE:RS. . . . . . s 1 CATCH BASINS. . . . . . . :0
FIXTURES----------------- LAUNDRY TRAYS. . . . . . 10 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . :2 GREASE: TRAPS. . . . . . . s 0
LAVATORIES. . . . . :3 OTHER FIXTURES. . . . . ..0
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :2 WATER LINE (ft) . . . . : 100
DISHWASHERS. . . . : 1 RAIN DRAIN (ft ) . . . . :0
Remarks : 1.991 STREET OF AFFORDABLE HOME SHOW
OWNER:
SCHUMACHER CUSTOM HOMES PAYM $ 100. 00 BL.T 12/21/90 207836
14302 PAYM t 250. 00 JLH 12/21/90 207836
SE CRYSTAL SPRINGS BPRT $ 430. 00
PORTLi tw HPLC f 2'79. 50
Phon r V B5PC $ 21. 50
SSDC f 375. 00
Plumbing Contractors---_______.___ ...__._.__.._ PARK f 2'50. 00
rfrnT * ,16, 010
Name: -_�f,. ;s lolaN, k 11 _ MPLC ! 9. eta
Address a YAJ ,6 Qj ,L,ge M3PC $ 1 . 80
City ,. ".ve4,.&,1rn _____5t at a s -_ PPRT f 140- 00
/ !
Z i p: : fAg/' r _._..__Phon e0 h,y_s2-Zins? P!5PC s 7. 00
Reg #: 4'c9e)-Qa ' . . . Additional. fees not shown here. . .
------ - REQUIRED INSPECTIONS - -- - --
This permit is issued subject to the reg-
ulations contained in the Tigard Municipal Foot/found Insp Gyp Board Insp
Code, State of Ore. Specialty Codes and all. Foot/found Insp Rain drain Insp
other applicable laws. All work will be done Post/Beam Struct Water Line Insp
in accordance with approved plans. This Post/Beam Meehan Appr/Sdwlk Insp
permit will expire if work is not 0-arted Plm/undsl.ab Insp Mechanical Final
within 180 clays of issuance, or if work is PLM/Underfloor Plumb Final
,suspended for more than 180 days. Mechanical Insp Building Final
Plumb Top Out Erosion Control
Framing Insp _
Fireplace Insp
Gas Line Insp _
x _ �_ _��o Insulation Inspn1.lthorized Plumbing Contractor Signature
Call for inspection - 639-4175
Contractor Notes :
Building Permit No.
COUNTYWIDE
TRAFFIC IMPACT FEE Planning File No.
PAYMENT OPTION FORM
Tax Map& Lot No.
1/
Da
/cue/ " c' X;4 L'� .-
Project Name
I realize that I must make a decision on payment of the Traffic Impact Fee (TIF) at this time. Therefore I
request the following (Choose whichever option or options are applicable):
1 Cash or Check
EJ Credit Voucher
[� Bancroft or Installment Payments
and/or
The Ordinance allows for deferral of payment of the TIF until issuance of the occupancy permit if the
TIF is greater than $5,000.00. If the TIF meets this requirement, I also request this option. I under
stand the TIF must ;;e pain pri-i to issuancc of 3n occupancy permit. also understand that the TIF
will be recalculated based on the prevailing rates at time of payment. Please be advised that TIF rates
may increase up to six percent each July 1 st. This rate increase is not subject to appeal.
OW PLI OWNER'APPLICANT
CC: Building Permit File
Payment Option Notebook
form hf02
1wr � wr � �■r � � �
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I Sw 11aU awa. PLNCK/RECT # Z .
CITY OT TIGAR 1'013.)x23197 PERMIT # ,rr
COMMUNITY 1 ENE'LOPMENT I)EPARTMEN,r Illgard,Oragon97223
(503639-4171 DATE ISSUED
JOB ADDRESS: I/ / SILK ��� �� �- TAX MAP/LOT 161 - 33 DD
SUB: S( eni 6C^ 4-1TL� o l LOT: �_ LAND USE: _
VALUATION: -
OWNER SPECIAL NOTES
NAME: _ _ _�- REISSUE OF: .—
ADDRESS: _ LAST REISSUE:
FLOOD PLAIN/
PHONE: _ SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
GAME: PLANNING:
ADDRESS: c — ENGINEERING:
FIRE DEPT:
PHONE: �1.- �- (� ..� OTHER:
CONTR. BOARD #: (rJ EXP DATE:
xz �ZDL �,1-0 ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: (c (%f �Lc( ►r16, -7 iV� LIST/SUBCONTRACTORS:
MECH: iE/1'1/1 C<'yly�r� 3. Ig-gI BUS TAX:
/1RCH ENGINCER CALCULATIONS:
NAME: _Sc' c`T7 �£nT�rJx� G ��s.s� TRUSS DETAILS:
ADDRESS: `1C C �L7f /'Oi,qtccyt► OTHER:
PHONE: �.,.5�J- /73
PROPOSED BLDG. USE:
COMMENTS: I -ZA
l _
APPGA SIO ATU Pt
Received By: _ _ Date Received: 14�
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees
-- �
10-230 01 State Building Tax (5%) 3a.30 Jv,sU—
Building _;Z/ Su
Plumbing c!
Mechanical
10-433 00 Plans Check Fee
�zJY.S
Building 7 ,750 �'
Plumbing
Mechanical
10-230 06 Fire
<v-vvoL 30-202 00 Sewer Connection
30-444 00 Sewer Inspection
-3
25-448-02 Commercial TIF Fees —
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
.Z S
u
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) �' J
31-450 00 Storm Drainage Syst Dev Chrg
(ssoc) -
-3 7,5,--op
24-445-01 Water Quality (Fee in lieu of) -
24-445-02 Water Quantity (Fee in lieu of")
l of nl.
nm/35,8111.Will
ITY OF TIG)ARD OF PAYMENT REC'ElPf NO. 90 -20703,6
CHEC ' AMOUNT
NAHL SCHUMACHER CUSTOM HOMES CASH AMOUNT
ADDI,:ESS 14304-1 SE !.31-RIN(R3 12-T PAYMENT DAA E: 1 a'/21 1?
SUBD I V 131 ON
POR7LAND. ON 97�` b- W391 ISW 12614-4 PL
Purmfl�- E OF PAYMENT AMOUNT PA. I D r"Llr(I"OSE (Y7 PAYMENT AMOUN'r PA:r 1)
PLAN CHECI!_fir-'.._..
I R k 00.k.)(-) PARK.G SDC,
Wit)L AMOUNT PA[D
l• � � l• � e
GJZADIN(' FIZ0SIQN CON'I'IZ( I, INI, )IMA'I'ION
GENF�JZAI.COKIRACI'OIZ /NAMI:&ADD ESS: CASEFILE NO.:
( _LLb ILLS PERMITNO.: —
__�.- --- ----
APPLICANTNAME AND ADDRESS:
EXCAVATION CONTRACTOR ------- —
NAME& ADDRESS:
ODWNI-.R NAMI:AND ADORF.SS:
TELEPHONE NUMBERS:
APPLICANT: 1 �' �' �v �Y PROPERTY DESCRIPTION:
OWNER._ `Jed, __ STREET ADDRESS AND CROSS STREET/L OCATED
GIN M- AL CONTRACTOR:_ - -
EXCAVATION CON-IRACIX)R: --
srEPt1OB:
1 ILGAL DESCRIPTION:
24 HR/AFER HOURS EMERGENCY TAX LOT NO.:
CONTACT PERSON,TITLE,TE-j-E-P1 I )NE: 1/4 SECTION:
SITE SFLE,ACRES:
DISTURBEDIWORK AREA,ACRES
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SIDE R NS TO:(CIRCLE ONE)
MI
(NOTE:PLRTS MAY BE REQUIRED) 'CATCA BASIN D :H PIPE CREEK
(CIRCLE ONE)( hVATE PROPERTY
F1QN/SEDIMENTATIQN CQNTROL (ESD)MEASURES
MTNEMIFM ESC REQUIREMFINT'S MINIMUM ESC REQUIREMIWI'S
DURING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILM:11 CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC
PERIMETER RUNOFF CONTROL. FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OPERATION OF PERMANT FACHMUS
CONSTRUCTION SEQUENCE OTI IER._
OTHER-- --._.--- __--
P' AN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH TECHNICAL GUIDANCE HANDBOOK'.
EROSION CONTROL PIAN DRAWING,AS REQUIRED,HAS PLAN CONST RU(.'IION NOTES COMPLETE.INCLUDING EMERGENCY
PHONE NUMBER. SCIIEDULFISTAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURE-'.AND
APPI JCABLE,STANDARD NOTES.
I HAVE READ AND Will.COMPLY WITH THE ABOVE AND WILLCONSTRUCI'AND MAINTAIN FSC MEASURES AS NECESSARY
TO CONTAIN SEDIMEN-ON 711Fi CONSTRUC-110N SITE.
WP�ATURF I TSIGNATURE:
OITICIAL USE ONLY.
RECT II'T DAII: ACCEI'TTD
FEE NUMBER RECLI VI: ) BY
CI'ITY OF TIGAUD
PLUMBING IT'R M IT 13125 SW HALT. BLVD.
P. O. BOX 23397
Applicants must hold Oregon Registration to conduct a Plumbing T IGARD r OR 97223
txssintss a must lx prottcrty osvtxY/operator not hiring outside help.
flenteoloeveloixnent _. — (503)639-4175
-- ---- -_ flumbroN Pcrmil No- _
AifrSress (�s[Yipugrr � '
_ CMS of 4-211610 DUAN. PRICE MAT,
Jots Tax Urx - - Map.No. - -
Addroas
nxTUf4LS
tat (Rock SrbdrAslon —-
---- 1�wme'�nwme--To �uswtess� Lavatory .3 7.50 J`,�)L
Tub or Tub(Stt)wer Comb. .Y 7.50 ? y U
ass —
SttowerONy _ 7.50
Owner Clty!Stete Zip water Closet- --- - ,�_ --- 750 /J�
--- Oishwashar / 7.50 L'
phone Garbage Disposal 7.50
Name Wadrng Madwne --- 750 - 7.5 r
Floor Drain —7.50
�ZAV ss Phone Water l4eater — --- 7.50 7 j f
Oocu ent qy — Laundry Room Tray - 7-50
P C /State -
tkinal 7.50
- Kame phone Other Focbxes(Specify) 750
750
.TTanTuiq Address Phone — —
7.50
Contractor Ctty/State ----� 26p -- -- 7.50
MISCELLANEOUS
--- - City okw Tax No. Sewer 1$I 100- --— — — 10.00 ---
tate s�3o-art No-`---�urte P�iwt�iers-Ikn.T,c^�To l S.-.-ea.Addit.100 15.00
Water Service Is11Do* 20.00 U -
I hereby adahowledge tfhet 1 have reed tNs s(V6c tdaL the aha kdonnalion Water Semioe aa.Addd ' 15.00
given is Donees that 1 am reQisferedi ith cit.Stats flralder s[ioand, ► .r also
have a SWe Sloan 6 Ficin Drain 1st 100' - 10.00
Pkattbkh0 Goerhse drat d»nc�xhdsers pi,�en req rxtrr�r� w0
Pknnt)irq wak whit he date in socor denoe with a ,r,:--, SAmm b Pin Drain Adds.100' 15 00
Lia+F1evisM SU*Aes Chapters 447 and M and appAC.able ood- A
— elp wa be eff%*vyed unless lomared urder ORS 6'01.(d e* m Moble wiorne Space - — --- 725.00h
State regiOrstbm please give reason below)- F1adr Flow Prov whoon
Nt)#Af MNERS-I hereby Cwtifpdtd 1 ern dw owrw d the,sm xty de- Device or An b4lotkAion Devic+ 750
--bed wbrne.M which bc*don I=to maks a pkanbkt0 c r P•radon kx Any Trap or Waste Not
my own use"arts property b not beky corednxsed for Jai•+,1, se«rent- Connoted b a F uctur t 7.50
- ---- - - -- CaFchBaAn -- 7.50 ---
kw.of F xW-Pka b:q --- -- 4 3.00 Per K. -
-- ---— - Specialy Requested U-pardon u '40.00 Per fa. ---
-- Rain Drain,
single Fan. Ovlq. 15.00
AtR140fAZED SIONATURE
Descnbs work new[] addition(] a1Mra'io0 nsp ❑ ---
1�be tette residenliel nonivsldontiat
stye of MINIMUM PERMIT FEE 25.00
x6Odklp or Pro(sorty_ - _ _ -- -- - SUB-TOTAL U
of 5% SURCHARGE C L)
�
tw plv-dy-- -- 2 5 t PLAN REVIEW
FK7V10E
F7 _
ftrfa parent t>easntrre nun.n t veld d wrxk er aerhetruodon r.thortx.e V rot oorrh TOTAL /rI v
Ilertged n4rlhkh/t1+0 r1 ayer+r K nervdrssr�ksn nr v+.ork/.Mwrswv3d a ritwnclfxtnd ks.
r Pwks•1 r.t IM A.ya M«ry Wths efMr t..cxk la rxs�tvh..rrs.d
t1YCL11 00N0RI()?43
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