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11896 SW 126TH PLACE ! 11896 SW 126th Place — CL w N ..a N m I CEPTIFTCATE OF CITY OFTIVARD OCCJPANCY CRYOFTWARD OR COMMUNFTY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . MGTc)l----QA0L4 13125 SW HrAl Blvd. P.O.Box 23397,T4)md,O"Mpn 9=(5W)0(44175 3IT[-' f-41)D LESS. . . : 11896 SW 126TIA P(- PARCEL: IS133DD-121000 SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING- R-4. 5 BLOCK. . . . . . . . . . I L07.. . . . . . . . . . . . . . 157 CLASS OF WORK. :NEW Tyr)F OF USE. . . :SF OCCUPANCY Gr%l' . .R3 OCCUPANCY L.Oc4D: il8 4 ,rP--.NANT NAME. Owner .' �-ARRY R. CHRISTENSEN CONST 176715 SW IVY GLENN DR ALOHA OR 97007 t*'jj(r)jjL- 03 64c.'--92791 LARRY R. CHRISTENSEN CONST 17675 SW TVY GLENN DR H1..OHA OR 97007 Phone #: 642--9R`--'79 !-53@99 ucc-upancy of the above referenred building in hereby given. and ce-tifies. the compliance with the State Of Oregon Specialty Codes fort the group, occupancy, and use under which the referenced permit was issued. L FIRE DEPARTMENT 1) DING BLI LDING 11:T At.. POST IN CONUPICUOUS PLACE INSPECTION NOTICE City of 'Tigard Building Departuent 13125 SR Ball dlvd. Tigard, Oregon 97223 Inspection Lira (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection-_ — Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Cas Line FIMALs Poet/Beam Struct. San. Sewer Framing Bldg Poet/Beam Mech. Rain Drain Insulation Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Meoh. Date Requested: 7 �T1�t� PM Address: (L �� Permit #:�,� Bu l lder i� t��, >c_ . TNR *OLLONIMO CORRECTIONS ARE REQUIRED: _ v 1 i Inspectors bates b DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. ,I — 107,10 2,,Q1 11: 12 V AEATILATOR X001 � Yrr J , eatilatore N rTRI memorandum :\ HEATILATOR INC., DIVISION, HON 1 DU� FS dote January Se 1990 ta. Featilator bietrict managers and Heatilator Custortcr Service Department from Dave Pomeroy, Associate Product Mw,-er we}ocr Bearth Extensiot, Requirements for Vented Decorative Gels Appliances The safety standard governing decorative vented gas applianceF is ANSI Standard Z 21.50. The standard requires that the floor temperatures be kept below a specific tezrvr%tore rise.. oUr appliances meet that requirement therefore-, not require a hearth extension. We are withdrawing our recommendations specifying hearth extensions on our decorative vented gas appliances. Future printings of installation instructicns will have the recnn¢ttendation renin,ed. The only exception, is the GC200 direct vent gas fireplace . .Although, not required by the safety standard we will continue to recommend the use. of a hearth extension. Shoup you rewire wy further informsttionr please contact me. c� DP/lm t Post-it"brand fax transmftW memo 7671 N at pages Fro IM" __. Dept. PMAMS N I 112. 1 11: 43V HEAT TI:.-->,TnR nil2 The table below shows only those components which may be safely used wi;h these decorative gas eppliarces ��--_-- I Catalog Number Descrlptlon �F 'G 1 12H G112HAL� IT` 1ar�d FreplacF — G360ST G360STL I See-Thru Freplace G760CH G760CHL Bay Firep!ace G920FL G920FLL I Peninsula Fireplace TK53D Polished Brass Front Trim Kit for , G112HA,'L, G360ST11- & G920FL/L TK54B Polished Brass End Trim Kit for 0112HA,'L& G920FL/L TK55B Polished Brass Front Trim Kit for G760CH/L ID4 Insulated DuctOutside Air UD4 Uninsulated Dict-Outside Air RC4 Remote Control Kit JK4 _ Junction Box Kit (Required with RC4 Remote Control K!t only) �._._ II, GENERAL INFORMATION This instal-ation must conform with local cedes ur, n the absence of Iota' codes, with the National Fuel Gas coed ANSI Z223 1-1968 or, in Canada, current CAN/CGA-6149.1 and B149 2 Installation codes. INSTALLATION AND REPAIR SHOUI-D BE DONE BY A QUALIFIED SERVICE PERSON. THE APPLIANCE SHOULD BE INSPECTLD BEFORE USE AND AT LEAST ANNUALLY BY A QUALIFIED SERVICE PERSON. MORE FREQUENT CLE=ANING MAY BE REQUIRED DUE 10 EXCESSIVE LINT FROM CARPETING,BEDDING MATERIAL,ETC. IT IS IMPEHATIVE THAT CONTROL COMPARTMENTS, BURNERS AND CIRCULATING AIR PASSAGEWAYS OF THE APPLIANCF nF KEPT CLEAN. L _ This gas appl anr.e roust not be connected to a chimney flue serving s separate sold fuel burning app'iance. Provide adequate C!BArar*i .PS around the air openings into 'he combustion chamber and adequate accessitil., ciearancAg for sere ting and Groper operation MOi•rum clearances to combustibles are. Too of unit 0",Floo>��Back 1,7 S des 112", Ceiling 30'. NOTE: A clearances to glass panels are shown In Table 1. --- -- Ti-,e appli,jr,�e rrus; oe i'stal ed on a f P.t 30110, continuous surface(i.e wooCl, r11et[il, cpnrr�e�~` A1r Provide for adequate cor•,t.ustion arid ver•1;ii8tiorl air. rlca �.r 1-or Natura Gas, the mnrrm.•m rnlAr rias supply pressure is 4.5 inches water coi-nin. and the maxirnurr i-et gF, oressurelsI 1.0 inches water color-n,fnr the purpose Of input adjustment. Inpit rate s 28,300 BTI-1/HR For LP Ga, the water cr.11.n1n pressure niust be Irl 1'.0 inches minin,,um t^ -40 Inches maximurr. A 1!8'' NPT olugged tapping Is prov�dAd on the gas control valve, near tee Outle; to the Ma;n Burner ;mmeaia;e uost'eam of he gas supply connection to the applla.nee accessible fe, a test gage connection For high elevation,refer to ANSI Z222 1-1988,appendix F,`or reslzing orf ce A derotito orifieo is suppled with o1 unit. DUE TO HIGH TEMPERATUHF-S, THE APPLIANCE SHOULD 8E LOCATED OUTOF TRAFFIC AND AWAY FROM FURNITURE AND DRAPERIES. 2-2C-90 A 2 1441 r INSPECTION NOTICE City of Tigard Bul.l.dfng Departjwnt 13125 Sill Hall Blvd- Tigard, Oregon 97223 Inspection Line (Rec-O-Phone) 639-4175 Business Phone: 639-4171. 1 �— Inspect Lon• -- /— ` Footing Plbg. U elrelab Mach. Rough-in `( Appr/Sdwlk Found. 1?1bg. Top Out Gas Line FINAL: post/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mach. Rain Drain Insulation -Plumb. Plbg. Underfloor Water`Line Gyp. Bd. -Mach. Date Requested: �� J r/n Tom= AM F!1 Address: z /0 l ' �r�_l/ /" i! #7 Builder: _ THE FOLLOWING CORRECTIONS ARE REQUIRED: I►- Inspectorf�. A-L_ j APPROVED DIBAPPR D `aPPROVED SUBJECT To ADM Cell For Reinep. a INSPECTION NOTICE City of Tigard Building Departjent. 13125 SM Hall Blvd. Tigard, Oregon 97223 Insptc,-ion Line (Rec-O-Phone)z 6 9-4175 Business Phone: 639-4171 Inspection:_ � C Footing Plbg. Under. ab Mech. Rough-in Appr/Sdwlk Vcund. Plbg. Top Out Gas Line FINALI Post/Berg- St-uct. San. Sewer Framing -Bldg. Pest/Bears Mech. Rain Drain Insulation � -Plumb. Plbg. Underfloor Water Lino Gyp. Bd. -Koch. Date Requested$_ -�5 l Time: AM Address:_ //i�r �j ---- Permit #1 CIS /_Z)7G Builder: _-- THE FOLLOWING CORRECTIONS ARF. REQUIRED: Inspectors AppilOV=p DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. INSPE_CT_I0l1 NOTICELL/ City of Tigard Building Department 13125 Sit Hal-1 Blvd. Tigard, Oregon 97223 Inspects.on Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 inspection: —. -----_ Footing Plbg. Underelab Mech. Rough-in A@P r Sdwlk Found. P1bg. Top Out Gas Line lINALi -Bldg. Poet/Beam Strut. Framing San. Sewer _ Post/Beam Mech. Rain Drain Insulation -plumb. Plbg. Underflcor Water Line Gyp. Bd. - �_� `I I ----T ime i .� PM Date Requeetedt �� Address: f '' ✓Jt Permit Builder._-- THE FOLLOWING CORRECTIONS ARE REQUIRED: OIL jjj inepeatori �� _ Date_' ' !~ DIBAPPROdRU APPROVED SUBJECT TO ABOVE /�APPROVRD Call For Reinep. i i i i CITYOFTIGrARD CITYOF TWARD COMMUNITY DEVELOPMENT DEPARTMENT On 4 13126 SW FWI Blvd. N.O.Boot 23397,ToLvd,Orpon 07223(603)6.99.4176 PERMIT #. . . . . . . PLM91 _-00 r '. 639-4i71 DATE .SSUED: 05/14/91 SITE ADDRESS. . . : 11896 SW 1 1`26TH PL PARCEL: 1 G l 33DD—.1._:G,14), LIUBD I V I S I ON. . . . : VILLAGE AT' SUMMER LAKE PORK 4 ZONING: R-4. 5 +LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 157 :LASS OF WORK. . .-NEW GARBAGE DISPOSALS. . : MOBILE HOME SG1AC:ES. : TYE=4E OF USE. . . . rSF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . : 1 )CCUPANC:Y GRP. . :R3 F1..0OR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . .. ,-"JURIES. . . . . . . . : 1 WATER HEATERS. . . . . . : CATCH BASINS. . . . . . . r IXTURE:3----- --_-- -- 1.._0UNDR\' TRAYS. . . . . . : GF R(aIN DRAINS. . . . . : . INKS. . . . . . . . . . : URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . : ..AVATORIES. . . . . .. OTHER FIXTURES. . . . . : f US/SHOWERS. . . . i SEWER LINE (ft) . . . . i OATE,R CLOSE IG. . : WATE.R L1NE (ft ) . . . . : DISHWASHERS. . . . : RAIN DRAIN (fit ) . . . . : emarl<s : SPRINKLER SYSTEM )WTI et,: --------------------------------------- __,.._.____.____—_ FEES; ..AR.RY R. CHRISTE:NSEN CONS1" type amount by date r•pcfjt .17675 SW IVY GLENN DR PRMT t 15. 00 J1_H 05/ t4/91 — ,3PCT $ 0. 75 7LH 05/lA/91 — 1Loi-IA nR 97007 �It-i ane #: 642-9279 01VERSIFIED LONDSC:APE; CONTR. 18805 CnMELOT LANE H 1 LLL BORO OR 91123 _____----__..____—__. . ("',hone #: 628-81138 $ 15. 75 TOTAL :ie q #. . : 5877 - ------ REQUIRED INSPECTIONS This permit is issued sub iect to the regulations contained in the Final Inspection 7igard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with Aoproyed plans. This pere't will expire if :rk is not started within 198 days of issuance, or if work is suspended for more than 188 days. e r m i t t e e IssuedBy .. ___. _... .._._.. ..._.___.... ..___.._... __.__._._ _ _._ _�...__.�_._. Call far irisvection — 639-4175 i i 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:_ —- — Footing Plbg. Underslab Hoch. Rough-in Appr/Sdwlk Found. Plbg. Top (-It Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Post/Beam Mech. Ra/n Drain Insulation -Plumb. Plbg. Underflooraa�� Nater Lina Gyp. Bd. -Mach. Date Requested= ,5 I I -Time- Permit 8 Builder: l ,"" `•`-�-'�� THE FOLLOWING CORRECTIONS ARE RFOUIRED: Inspector:_ . __ Date: S X APPROVED D19APPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 Sq Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-o-Phone): 639-•4175 Business Pbone: 639-4171 Inspection: ----- ., Footing Plbg. Underslah Mech. Rough-in QC:Appr/Sdwlk Found. Plbq. Top Out Gae Line FINAL.- Post/Beam INAL:Poet/Beam Strur_.t. San. Seiner Framtng -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor //Hater Line Gyp. Gyp. Bd. -Nisch. Date Requesteds _�% �7 TimesPH Address:__ u 6 `/ , =7—#. -/ / liu�`7 Builder: zz�L11,,1 ✓ THE FOLLOWING CORRECTIONS ARE REQUIRED: �= Inspectors_ [,r - `LGt Ly�tiy Dates [ APPROVED DISAPPROVED APPRMRD SUB.ISCT TO ABOVE. Cell For Reinep. mm fw 's INSPECTION NOTICE city of Ti-gird Building Dvspartaent 13125 S`1 Hall Blvd- Tigard, Oregon 977.23 Inspection Line (Rec-o-Phone): 639-4175 Bunine®s Phone: 639-4171 k" Inspection: _. Footing 1?lbg. Underslab Mech. Rough-in Appr/Sdwlk Found. Plbg. Tap Out Gas Line FINAL: Post/Bea=n Stt-uct. San. Sewer Framing -Bldg. Poet/Ream Mach. Rain Drein Insulation Plumb. -Koch. plbg. Underfloor Water Line / oyp• 8d• ^�4 -// Time, pM PN Date Requested= (J Permit Addreea: //� Builders_ Le THE FOLLOWING CORRECTIONS ARE REQUIRED= t ,� an. Date= — Inspector= t APPROM DIBAPPROM n SURJRCT TO ABOVE call For Roinsp. INSPECTIQN NOTICE City of Tigard Building Departime'at 13125 Bit Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-41 Inspection: Footing Plbg. Underelab Mech. Rough-in 11ppr/aftlk Found. Plbg. Top Out Cas Line FIKALt Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain _ Rauiation -Plumb. Plbg. Underfloor water Line Gyp. Bd. -Koch. Date Requested: Address: � l�` y-/`"� Permit #t r Rui lder 16 /�/„- !!w /•1 THE FOLLOWING OORRECTION13 AM REQUIRED: Inspectors Date: yAPPAO{IBD DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. MF INSPECTION NOTICE City of Tigard Buildfog Department �^ 13125 SM Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-- 71 Inspection: _ ' AP Footing P1 4lnderflab CKh. Rough-iti Appr/Sdwlk Found. Plbg. Top Out `Oa-sTin. CFINALt Foot/Beam Struct. San. Sewer <__Z�lraming, -Bldg. Poet/Beam Hech. Rain Drain Insulation -Plumb. Pl.bg. Unde:floor Water Line GYP• Bd. -Hoch. Date Requested: yv �� _Timet AM PM Address d -/ __--_L+� Pecmit Rullder: THE FOLLOWING OORRECTIONS ARE REQUIRED: Ari .tl1J.L �J�s� tyaLC C tW2 civ� :T �C 6-0) I inapect:nri _. Detet�! .� APPROVED -_ _ DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Relnop. INSPECTL0N NOTICE City of Tigard Building Departsent f 13125 on Ball Blum. Tigard, Oregon 97223 Inspecti-on Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: V \— Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Much. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Ed. -Mach. Date Requested: - (Cl ' el' Time: AM ,PM Address: 1 �T?'(Cf + 11 _ Pormit 1 s Builders1 Cst�s51 tASE� THE FOLLOWING CORRECTIONS ARE REQUIRED: L CA Inspector: _ _. Uatesl� 9� _ APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE Call For Reinep. R 4 � x INSPECTION NOTICE �! City of Tigard Building Department Y 13125 BW Ball Blvd. Tigard. Oregon 97223 Inspection Line (Rec-O-Phone)s 639-4175 Business Phone: 639-4171 Inspection: - Footing slab Mach. Rough-in Appr/Sdwlk Found. 4 Slbg. Top Out Gas Line FINAL: Post/Beam Strut. San. Sewer Framing -Bldg. Post/Bea¢ Hoch. Rain Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. Bd. -Hoch. Date Requested: Time: AM PH Address: C CP f�L/ Permi, Puilders TBE FOLLONT'Ai CORRR ONS ARE REQUIREDs %%�- iInepeotors Date: �PROVEb DISAPPROVED APPROVED SUBJECT TO #AM Call For Reinsp. i k INSPECTION NOTICE City of Tigard Building DepmrtiMs"t 13125 SN Ball Blvd. Tigard, Oregon 9:7":! Inspection Line (Rec-O-Phone): 639-4175 Business Phcne: 639-4171 Ins per,t ions_ -- Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struck.' Sen. Sewer Framing -Bldg. ---------------- st/Beam Mach. Rain Drain Insulation -Plumb. /� Plbg. Underfloor Water Line Gyp. Bd. V u/0 -Meth. Date Requesteds � v� Addreeas J /�r-1�/// Permit #t Builders �s�lJ1•�1 THE FO TWO CORRECTIONS ARE REQUIRED: i Ile, 47-- Inspectors _ _ Dates APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. W /W INSPECTION NOTICE City of Tigard Building Department 13125 SN Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-417). ,II f Inspection:___ __-- — Footing Plbg. Underslah Mech. Rough-in Appr/Sdwlk Found. Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. post/Beam Ha-chh., Rain Drain Insulation -plumb. .(Plbg- Underfloor) Nater Line Gyp. Bd. -Mech. PH Date Requesteds Tlme= Address: ecmit !: _7 Builders THE FOLLOWING CORRECTIONS ARE REQUIRED: i'. i Inspectoei `' APPROVED 77DIMPPROVWD _ APPROVED SUBJECT TO ABOVE Call For Reinsp. INSFgCTION NOTICE City of Tigard Building Depart—nt 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec-0-Phone): 639-4175 Business Phone: 639•-4171 Inspection: — Footing plbg. Underslab Mach. Rough-in Appr/Sdwlk Pound. Plbq. Top Out Gas Line FINAL: -Bldg. j Poet/Beam Struct. �San. Sewer F-aminy -B Poet/Beam Mech. in Drain Insulation -Plumb. Plbg. Underfloor Nater Line Gyp. Bd. -Mach. Date RecluoetadtT1.1 Addrese:_ '� f `� / Permit Builder:_ THE FOLLOWING CORRECTIONS ARE REQUIRED: i Inspector: _ Date:�� / APPROVED DISAPPROVRD —_. APPROVED SURJRCT TO ABOVE Call For Rsinep. i i I INSPECTION NOTICE city or Tigard Building Departaent 13125 SR Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 Inspection: _ --- �Foo..d ptima Plbg. Underelab Mech. Rough-in Appr/Sdwlk . ! Plbg. Top OntGas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldg. Poet/Beam Mech. Rain Drain Insulation -Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: 12 Tlmet�f_t'�AM/}�/ _PM Address: �� V l 121, Permit Bui lder:_ THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector! Dates G �-y/ Ar rR�n'F(� nrsAF'vnnvFn APPIMMU et16MM 'M RMA ('A I I For Re I nep. i CITYOFTIGARD MAS'CF.R PERMIT i CRY COMMUNITY DEVELOPMENT DEPARTMENT oaoA� F k I?I1 I T #' • • • • . • : MST91- 0►�14 13126 SW HWI Blvd. P.O.Bot 23397,TOW.OrOW 97223(60310.' -4176 c ! �. DATE ISSUED: 01/30/91 SITE ADDRESL . . . 1189C., SW 126TI-41 PL PARCEL: 1 S 133DD-12000 SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5 BLOC=K. . . . . . . . . . s LOT. . . . . . . . . . . . . : 157 BUIL.DING PE I SSUE: DWELLING UNITS: 1. BOSEMENT. . . . . . . . :0 s f CLASS OF WORK. :NEW BEDRMS:3 BATHS:` GARAGE. . . . . . . . . . :522 St TY1-'E. OF USE. . . :S;F FLOOR APGAS._._._..__._._.._.._. REQUIRED RED ----_- 1vt'r' OF CONST. :5N FIRST. . . . : 1811 Sf LEFT. . .5 ft RIGHT. :5 ft UCCUPANCY GRP. :R3 SECOND. . . -O Sf FRONT. :20 ft REAR. . -32 ft STORIES. . . . . . . : 1 THIRD. . . . :0 sf REQUIRED________________-.-- I4E T GHT. . . . . . . . : 18 ft J OTAL.__--------_.._-: 1811 5f SMOKE DF_TECTORG. :Y FLOOR LOAD. . . . :40 psf VALUE— — $: 92702 PARKING SPACES- 30 Remarks : PLUMBING SINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . -0 LAVATORIES. . . . . :3 WATER HEAT'ERS. . . : I TRAPS. . . . . . . . . . . . . . :0 -TULA/SHOWERS. . . . ::.3 L.()UNDRY TRAYS. . . : 1. CATCH BASINS. . . . . . . :0 WATER CLOSET S. . i 2 SEWER LINE (f t ) . :0 GRE=ASE T RAVS. . . . . . . :0 DISHWASHERS. . . . : 1 WPTE'R L I NF (ft ) . : 3.00 OTHER FT XTURLS. . . . . :0 GARBAGE= DISP. . . : 1 RAIN DRAIN (ft ) . :0 WASH I NG MACH. . . : 1 SF RAIN DRQ,::NS. . : 1. MEC;HANICAL.. ._-_.____._._.._.__.,_.__._., ___. __.___________ FEES 1`UE=L TYPES------------ UNIT 1-4TRS. . -0 tyre amounf by date r'ec.-Pt /GAS/ / / VE=NTS . , . . . :0 PAYM $ 100. 00 JLH 01 /18/91 20878F_s IM()X INPUT :O BTIJ VENT FANS. . : ' BI='R1- $ 412. 00 ! i 17URN ( 100K . . : 1 HOODS. . . . . . . I BF'LC $ 287. 80 / F'URN ) =100K . . :0 WOODST'OVE S. :0 B3PC f 2-10. (;0 FLOOR FURN. . . . :0 CLO DRYE=RS. : 1 SSDC $ ;75. 00 i B0l'I_./CMr- ( 3HP:0 OTHER UNITS.-O PARV $ `=;00. 00 ! l GAS OUTLETS: 1 MF'R•T $ 38. 00 C]wner°: -___ __-.._..._._._.._._...__.__..._._.________,._.... _ ..___.._ MPLC 4 9. 00 ! / LARRY R. CHRIST'ENSEN CONST M5NC $ 1. 80 17675 SW IVY GLUNN DP PPRT• $ 114.0. 00 F15PC f 7. 00 +�I...OI-EA OR 97007 TIP s 1330. 00 (-'hone #: 642-9279 DAVM f 3019. .:'0 JLH 01/:30/91 i_ ARRY R. CHRISTENSEN CONST 17675 SW IVY GLENN OR r)L.OHA OR 97007 (-)hone #: 642-9e'7W Req #. . : 53099 t 3119. 20 TOTAL This permit is issued subiect to the regulations contained in the ----- -- REQUIRED INSPECTIONS ------ Tigard Municipal Code, State of Ore. Specialty Codes and ali other Foot/fot.md Insp Fit-eplacp Tnst) appl+;able laws. All work will be done in accordance with sooroved Post/Beam Struct Gas tine Insp olais. This permit will expire if.workRAiLrat started within 180 Post %Seam Mechan Insulation Insp days of issuance, or if work 1! ded f e p s _. P1m/#_indslalb Insp Gyp Poar-d Insp M/Under-f 1 clot- Pain dt-a i n T n n u "ermittee -hanical Insp Wafter- Line Insp �jumb Top Out Appr-/Sdwlk Insp E en E1ye F',-amino Insp Mpchanir_al 1"incl I all, f ot- insneut i ori 1;,�,9 -4175 CITY ® SEWER CONNECTION OGARDFTIf-' I T �� PERMIT #. . .. . . : SWR91_001.E COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 01/30/91 131258W FMe Blvd.P.O.Box 23397,Tip M,Orepon 976M(W3jW 4175 -'?TE ADDRESS. . . : 11896 SW 126TH FAL PARCEL: 1S133DD-12000 3UBD I V I S I ON. . . . : VILLAGE AT SUMMER LAKE PARK 4 /ON I NG: R-4. 5 13LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . 1157 TENANT NAME. . . . . : USA NO. . . . . . . . . . :43159 FIXTURE UNITS. . . : !:'L.ASS OF WORK. . . -NEW DWELLING UNITS. . -1 TYPE OF USE. . . . . :SF NO. OF BU I LD I NGS: 1 INSTALL TYPE. . . . :BUSWR IMPFRV SURFACE. . : 12emarks: Jwnter. -------------------------------------- __.---- --_----------- FEES ______-___—__—_- ARRY R. CHRISTENSEN CONST type amarAnt by date recpt 17675 SW IVY GLENN DR PRMT f 1500. 00 I NSP 35. 00 ! / ALOHA OR 97007 PAYM $ 1535. 00 .JI_.H 1711 /717 fA I Phone #: 642-9279 Contractor: CONTRACTOR NOT ON FILE: 1='h o n e #: f 1535. 00 TOTAL_ Req it. . . REQUIRED INSPECTIONS ._.._._._._._.._ ?his Applicant agrees to comply with all the rules and regulations Sewer Inspection ^f the Unified Sewage Agency. The permit expires 128 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 :s not located at the measurement_ given, the installer shall prospect feet in all directions from the distance given, If not so locat , the installer shall purchase a "Tap and Side Sewer" permit and a nc will 1 a lade r"(11 m i t t e e S i.g n a t'r r r Fav : Call for inspection — 639-4175 PLUMBING PERMIT CITYOFTIGARD ;CAOFTNFARD PERMIT #. . . . . . . : MST91-0014 COMMUNITY DEVELOPMENT DEPARTMENT RFOON DArE ISSUED: 01 /30/91 13125 SW FWI Blvd. P.O.Box 23397,Tlp rd,Oregon 97223(603)839--:175 ^SITE ADDRE.S�-i. . . 11896 .SSW 126TH Pl_ PARCEL: 1 S 133DD--12000 SUBDIVISION. . . . : VILLAGE AT SUMMER LAKEPARK 4 ZONING: R--4. 5 BL0CK. . . . . . . . . . : LOT. . . : 157 CLASS OF WORK. . :NEW GARBAGE DISPOSALS— : 1 TYPE OF USE. . . . zSF WASHING MACH. . . . . . . : 1 BACKFLOW PREVNTRS. . :O OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . .. :0 TRAPS. . . . . . . . . . . . . . :0 STORIES. . . . . . . . : 1 WATER HEATERS. . . . . . : ]. CATCH BASINS. . . . . . . :0 FIXTURES - -- -- -- LAUNDRY TRAYS. . . . . . : 1 SF RAIN DRAINS. . . . . : 1 SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . 10 LAVATORIES. . . . . :3 07HER FIXTURES. . . . . .0 TUB/SHOWE'RS. . . . : SEWER LINE (ft ) . . . . :0 WATER CLOSEIS. . :c WATER LINT: (ft ) . . . . : 100 DISHWASHERS. . . . C1 RAIN DRAIN (ft ) . . . . :0 Remarks: OWNER: LARRY R. CHRISTENSEN CONST PAYM $ t00. 00 JLH 01/18/91 200786 17675 SW IVY GLENN DR RPRT $ 412. 00 / 1 BPLC f 267. 80 ALOHA OR 97007 B5PC $ 20. 60 / ! Phone #: 642-9,_'79 79 SSDC $ 375. 00 PARK t 500. 00 Plumbing Canty attar s---_..__._.____._.---..__. MPRT $ 36. 00 ! / MPLC ♦ 9. 00 / ! U' _ -- MSpC $ 1. 80 / ! Address :_ C_� Cl 1__kkN PPRT f 140. 00 1 / City :_��. E;tate:-4�I;� PSPC f 7. 00 --- 7. L __ ipe - C2_ Ph G -2'- ° TIF f 1350. N0 Req #:_-'k 14 PAYM $ 3019. 20 JLH 01/30/91 -- -- -- REQUIRED INSPECTIONS -- This permit is issued si..lbject to the reg- i.tlations contained in the Tigard Municipal Foot/foiind Insp Rain drain Insp Code, State of Ore. Specialty Codes and all. Post/Beam Stri.(r_t Waiter Line Insp other applicable laws. All work will be done Post/Beam Mechan Appr/Sdwlk Insp in accordance with approved plans. This Plm/un(Jslab Insp Mechanical Final permit will expire if work is not started GLM/Underfloor Plumb Final within 180 days of issuance, at-, if work is Mechanical Insp Building Final Suspended for more thorn 180 days. Plumb Top Out Erosion Control Framing Insp Crawl Drain Fireplace Insp f3as Line Insp S Insulrtion Insp Gyp Board Insp Outhorized Plumbing Contractor Signature Call for inspection - 639- 4175 Cantractor Notes : 1 W4 CITY OF TIGARD -- RECFIFIT OF POYMENT RECETPT NO. :91-8092'i?I CHECK AMOUNT - 4554. 20 NAME LARRY CHRISTENSEN CONSI' CASH AMOUNT - 0. 00 ODDRESS s PAYMENT DATE : 01/30/91 SUBDIVISION 3 sw pi- (.",URPOSE OF PAYMENT AMOUN I' PA 1.D PURPOSE OF PAYMENT AMOUNT f'AlD BUILDING PERM MST91 -0014 412. 00 PLUMBING PERM 140. 00 MECHANICAL FIE 36. 00 ST. rAJILD PER 29. 40 PLAN CHECK FE 176. 130 SEWER tJc,')A 1500. 00 SEWU-Ji INIERPECT ;35. 00 RUSIDENTUAL T'RAFFIC FEES 1050. 00 MASS TRANSIT T11' 1---EEG 100. 00 STORM IDROfN 13DC 375. 00 PARKS SDC 1500. lao FOTAL AMOUNT PAID 4554. 20 � I� i� (• I< I• � i1 t PLNCy�RECT # - 7W 13125 SW Hall BW- "rCITY OF TIGARD Po so:Z3397 ��97223 PERMIT # I.)f,;�,ac�-• --- COMMUNITY DEVELOPMENT DEPARTMENT (So3)63"171 DATE ISSUED JOB ADD ESS: _�1 �(/G' ''Y-�r 1 /�� TAX MAP/LOT /.5�� 3 3 O la Qy �l( LOT: LAND USE: SUB: L — VALUATION:— ALUATION:— 2 SPECIAL NOTES OWNER REISSUE OF: -- NAME: �-�/`�' /" • ��'�c5��`�'� �6'�� ADDRESS: , - 75- QJ /V� �nCe _ LAST REISSUE: -- //L, Cf-7 c 7 FLOOD PLAIN/ PHONE: �l( ZSENSITIVE LAND: _— ---- CONTRACTOR APPROVALS RE_OU l RED NAME: _ 1 /� 1i'�,' -_� �lr 9&j C®� PLANNING: -- ENGINEERING: ___--- ADDRESS: FIRE DEPT: ---- __� PHONE: OTHER: CONTR. BOARD #: -------- - S?jU EXP DATE: - — I,TEMS REQUIRED SIII;CONTRACTORS: PLUMB: / ' Z� r LIST/SUBCONTRACTORS: MECH: /�//1 r -- BUS TAX: _� ---- — — A(tCH ENGINEER CALCULATIONS: --- /�f L` TRUSS DETAILS: NAME: ADDRESS: _ �D �INCc� L'c� _ OTHER: - --- f ®+e- 2-71?-2 PHONE: _— (L L/C PROPOSED BLDG. USE: '✓�'� — COMMENTS: APPLICANT SIGNATURE Received By: Date Received: PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE 10-432 00 Building Permit Fees L-�/z I G'' ' c`, 10-431 00 Plumbing Permit Fees L.--A-0 1 °° ' vJ Ud _ 10-431 Ol Mechanical Permit Fees ✓ 3 ��' ' 10-230 01 State Building Tax (5%) - Building aJ Plumbing Mechanical 10-433 00 Plans Check Fee j L� Building Plumbing Mechanical 10-230 06 Fire --- W►' 30-202 00 Sewer Connection o 30-444 00 Sewcr Inspection 3 25-448-02 Commercial TIF Fees 25-448-04 Industrial TIF Fees ._.,._.. r 25-448-06 Institutional TIF Fees _ 25-448-03 Office T I F Fees ----------- 25-448-01 Residential Traffic Fees 25-448-05 Mass Transit TIF Fees /" �� -- v 52-449 00 Parks System Dev Charge (PDC) i Sia Su 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) 24-445-01 Water Quality (Fee in lieu of) 24-445-02 Water Quantity (Fee in lieu of) .. 101 At_ 44; _ S nn,/V)HIP Wri CTTY OF TIGARD RECEIPT OF PAYMENT RECEIPT NO. 9 1-,R08788 CHECK AMnUNT FIVA0. (60 14 A m E LARRY CHRISTENSEN CASH AMOUNT 0. 00 PAYMEN'r Dm,E 01 /1A/9:L SUBDIVISION LOTS 157 & 162 PURPUSE OF PAYMENT AMOUNT PA I D PURMSE OF PAYMENT AMOUNT PAID V.i.'-.iTN I-27R 100. 00 PLAN CHECK FE 1--26R 1.00. 00 AMOUNT PAID