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12205 SW 127TH AVENUE-1 ' X � `% 61 r�)ovi4 61w!5 kv x 0 co \< fell 14 67 A �O .54, IIooi� 14 c-, 1-3- 21 &o N6,rR�4 6-ri o H 4 r-�, Re ro veioo /L rL-A 1�5 T'o a e, I� x 6 WR6 H. :ton A14— t2 L4 ' RADF- PMU�\,100D. CAY for PlLei 6 1 t-i P,6o H &a 4 A 2 >e 0 L.5 06 15 1Z JO I Sf PF BTU M 43,X44p to-,o. -x q E5L1-)6 K I W4 ...... :Z,K 1 [-4 J(T�2f12 ZAJJ . -FA LL.t:i, 0 C A, 4.6, r6l + j ! �I c. + I� � � my � -- , 2- x4 2-x 4 44 +10 rA P i�l LL I [i D NC�A \Vi I�� Lt���.T �x�:T'e� `v I H Pow ,� . 'r r L L '� 'r� 1 112 x 101'r I \\/A e—,- ILI' IF APPROVED FOR COMTRUCTION Z QQ — A CITY OF TIGARD Q• I S IORACnE OHL%f S I Iv kRMIT NO p -2 40- SITE ADDRESS 4 F BY..., E X17 .--____.___.�._ .DATE_ --7G 11 6 OIL, VACOF�: Flm��K 16 L L 2 SC A L 1E APPROVED BY DRAWN 1 A, DATIE ' REVISED 60 R u e-1 T'11 0 p 4411 , ��� 12- tYt5O -6*� 2-w e�15-&VIF K"roH 01:� 9760!71 PH L� fA, I �q- 6 t'.) 2- e"77-1 it DRAWING NUMBER A IS X 24 PRINTEU UN NO 1000H CLEAMPRIN't • -A Twkot t j A06 Ji1111 11111Ir�Il � ril �'I III ' Il � r1 � '� t r � 111 � 1 1li•j'r� l I � III � � 111 ���1 IIII1 11'I III 11 � 111 III 11 III III III r) I 111 III 1 � 1 ISI 111 III Iir 1 -111111 NOTE IF THIS MICROFILMED 2 3 4 5 6 7 8 9 i)o 12 DRAWING IS LESS CLEAR THAN THIS NOTICE , 17 IS OUE To TNF QUALITY OF THF ORI( INAI DRAW ING. 60 8J LZ 92 SZ b2 EZ 22 12 02 61 131 LI 91 si t, I EI z 1 1I 01 6 9 L 9 s tp c bL 1111111 if III III if I I if I I if I I IIIIIIIII 11111411111111111111111111111111111 1 11111111 1111111111 if 1111111111tIIIIIII III II IIII,IIIIIII I I 111 1111 1 ifiIII if 111111 111111 if I III III 12205 SW 127TH AVENUE IJ EA W I I EQ �4 c,. � � w' a R• �; tri 'j !� F� •� w n t v r c:a Q _ t -- E rn � N { i �\ r !� �► !-i l I r n � I 11S t BUILDING PERMIT APPLICATION TIGARD DATE `�&-2 t� THE UNDERSIGNED WEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER VWON OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHOAF LAT N0. o vNER 8,(1 to /.2 7Ly ARCHITECT ENGINEER BUILDER s✓(/��=!. �C1�L ADDRESS _ DESIGNER STRUCTURE ❑ NEW ❑ REMODEL t'OaTION ❑,REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEIAOLITIC RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FE.NG OCCUPANCY LAND USE ZONE 61D43\TYPE ,��' - PLAN CHECK BY HEAT � SFIWER PERMIT, I _. OCC.LOAD FLOOR LOAD HEIGHT VO STORIES AREA NO.BEDROOMS VALUE _ BUILDING DEPARTMENT SET BACKS FRONT rZ-I) REAR LEFT SIDE J RIGHT SIDE PormH THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZONfI n REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TI �Plan Chock �`S, 2 d _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAM WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAI! Sub-total 3, 3-S RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 13USIN13 LICENSE SEPARATE PERMITS REOUIREO FOR SEWER,PLUMBING AND HEATING. Stbta Tax • lJ 2� SOC— Total � 5 - ` PDC# APPUCANT OR AGENT By _ Receipt No. ADDRESS PONE Approv SSDC --- $ 5 D C PDC SEWER CONNECTION 5 SEWER INSPECTION SEWER SURCHARGE comments : J D( ham- HkillOING RCCEIPI `. DATE NAME: -� - -- - -- - ACCT. M OFSCRIPTION AMOUNT 10-432 Building Permit Fees - 10-431-600 Plumbing Permit Fees f — 10-431-601 Mechanical Permit Fees 10-230-501 State Bui _ding Tax f 10-433 Plans check Fee 30-443 Sewer Connection (20X) f 30-202 Sewer Connection (80X) f _ 30-444 Sewer Inspection f 51-448 Str-aat System Dew. Charge (SOC) f 52-449-610 Parks I System Oev. Charge (PDC) f -- 52-449--620 Parks IT System Oev. Charge (POC) f 31-450 Storm Drainage System Dev. Carry (SSDC) f — 10-230-505 TRFO (95%) f 10-479 TRFD (5%) f 10-L30--506 Washington County Firm 01 (95X) f - 10-478 Washington County Fire N1 (5L) 10-1.20 Amart/uodgowood f — TOTAL (b•/1214P) w w wr tar Itrw we■r City of Tigard INSPECTION RE® UE ST f or IINSPECTION TIME : PERMIT NO. : DATE: ql]V?-y DATE ISSUED:_._L—L OWNERS NAME ADDRESS ' -----) x32(2 I CONTRACTOR TEST. Air ❑, water p , Visual p , Laboratory P RESULT. Approved ❑ Disapproved ❑ , Pending,[�r' SKETCH: I I INSPECTOR DATE I [d4,TF Attach supplemental fest data hereto] �cc City of Tigard INSPECTION REQUEST for i I INSPECTION TIME:—,,:Lee PERMIT NO. : 73 ..3 7 1 DATE: /s"/ �� DATE ISSUED'.—Z —3 OWNERS NAME . ADDRESS : -- CONTRACTOR :_ I 1 TEST. Air ❑, Water Ll , VisuaPET—, 'Laboratory ❑ RESULT. Approved ❑ , Disc pprovod Pending ❑ I I I SKETCH: I I INSPECTOR DATE Attach supplemental tesit data heret] Address-,2,05 S.W. 127t_hPermit No. Fin+,�_,,,.,w„�_„_�,w�, Permit charge Owner was Brav_on Rui 1_.��.� Connection fee �._-C�_,�.� Paid by Type of building _r r lsirian;.eDate connected Service rate 3. 0 Qs r,mo:thInspection fee Contractor , yUraxQygyl,dr Paid by �ti, date Size of connection `: .,_ ,_ Assessment paid I Tigard City of T ig � INSPECTION REQUEST for INSPECTION TIME :—/.",-/o____— PERMIT NO. : fL&o9' DATE . 3 Z203/­ ;`Y.- DATE ISSUED:-i:-' I OWNERS NAME ADDRESS '. _ �-'✓ �.�� lr_.�, I CONTRACTOR :- LA TEST. Air ❑ , Water ❑ , Visual 1-3';Laboratory ❑ RESULT. Approved 0 Disapproved ❑ , Pending [] I SKETCH* I I I i INSPECTOR DATE CNOTF : Attach supplemental test data herelJ City of Tigard INSPECTION REQUEST for INSPECTION TIME :IL-1- rti'0n-PERMIT NO. : `/J- 7 I DATE: -. �//73 DATE ISSUED:�1z OWNERS NAME : ADDRESS : CONTRACTOR :_—_� _ �.1 I ITEST. Air O, Water [I , Visual g;'Laboratory Q RESULT. Approved I-"; Disapproved 0 rending ❑ I SKETCH: i I I I I INSPECTOR DATE 50TE : Attach supplemental test data heref1 City of Tigard INSPECTION REQUEST for ( calk t -- INSPECTION TIME : E/70AL PERMIT NO. : Z 3 DATE: ,3 �'� �3 DATE ISSUED: ' OWNERS NAME ' Y.c' 41kwc lrx, ADDRESS : ;.,2-,ZX5— S'CuCONTRACTOR :— - is c e'"- TEST*. Air ❑, Water ❑ , Visual-J; Laboratory ❑ f� RESULT: Approved 0 Disapproved ❑ Pending [] I SKETCH: INSPECTOR DATE OTE : Attach supplemental Peet data heret] I c � 1 City of Tigard INSPECTION REQUEST for IINSPECTION TIME : .�sN _ PERMIT NO. : -71-39— DATE : -J-ZaL_-L DATE ISSUED: OWNERS NAME : I ADDRESS : .— I CONTRACTOR : ITEST. Air El, Water ;'Visual8—,--Laboratory E] RESULT. Approved 0--, Disapproved [j , Pending C7 I I SKETCH: I I I I INSPECTOR DATE I [NOTE Attach supplemental test data heret] 1 tll6 it is � 0• Irl 4 R I City of Tigard INSPECTION REQUEST for INSPECTION TIME: �J 3 f, PERMIT NO. : 3 L DATE: 13 Z , DATE ISSUED - + OWNERS NAME : ADDRESS: - CONTRACTOR : — TE ST ONTRACTOR :TEST : Air ❑, Water E] , Visual -oratory p RESULT: Approved C7 "; Disapproved O , Pending E] SKETCH, INSPECTOR DATE (NOTE Attach supplemental test data beret] MMUMM PLUMBIVG P ;T PLIC; T N Jurisdiction ©f o. Type of Fixture Fee Permit No. 73'3 F -f Nr0 Permit fee Water Closets Toilets �� Permit Issued i Bath Tibs ,2 e, n Approved by +� Lavator Wash Basin •oto Building Perm Z 3 Shower '' n o Receipt No. 76:2� in s Dishwashing it s Kitchen C' Si s r inary Location of Building /02,;Z0, L[) Sinks, ar —. Sinks, 5102 Automatic Dishwasher Disposal )� Laundr Trays Name & Add ess )f Owner Drains Floor ,z n n «e rains Area _ Drains e riger Rain Drains Ak k 5 n Automatic Washer C Name & A ress UL111 a.ins rin i.n Founta ins oda ______ Hot Water Tank _ - _�� Water ServiceSize Urinals _ Buildin New-Catch-Basins - Y51-d- Ts a Lawn Sprinkler System _ Sw;.mming 110cOther _ -Sprinkler stem This permit becomes null and void if work or construction authorized is not commenced within 60 days, or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond. I hereby certify that I have road and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not, the granting of a permit does not presume to give authority to violate c,r cancel the provisions of any other state or local law regulating construction or the performance of construction. SYgaaturp of pli:ant �--' o � � ter twr � t� twr �r j I I City of Tigard I INSPECTION REQUEST for I INSPECTION TIME: L 3o PERFAIT NO. :_ -' I DATE: ;2 DATE ISSUED :_ -- OWNERS NAME : ,j Z, ADDRESS: �� �� e k�x/ %._.__-_-.___.._ I CONTRACTOR : Zi _«- _ TEST : Air pr Water0 , Visual LT",Laboratory ❑ RESULT: Approved Er Disapproved ❑ , Pending u SKETCH: I I I I I I i I INSPECTOR DATE I `NOTE Attach supplemental test da;a bereta� I P*7"r UNIFIED SEWERAGE AGENCY racy __. 4804 WASHINGTON COUNTY DArF CITY OF Tigerd - -- — APPLICATION FOR SEWER CONNECTION PERMIT OWNER: ---J- W.-JIFSgegn awLido --- OWNER'S ADDRESS:_—___7603 S.E. Powell Blvd. _- STREET Portland oreaon —--— CITY STATE BUILDING SITE: LOT-..-Tb.-.— BLOCK _____—__ ADDITION ._Beuwood Ii _— TAX LOT NO TYPE OF OCCUPANCY . Aesidesee ADDRESS Bellmd n- addreee pending DWELLING UNITS 1__.__-_. ._ _—.._—_____—__ FIXTURE UNITS _ SURCHARGE IF APPLICABLE PERMIT FEE.. 4ij} ------- INSPECTION FEE a5 TOTAL DEPOSITED 450 (NEW) (EXISTING) BUILDING SEWER SYSTEM The Applicant agrees to comply with all rules anAlt tions Gt the yc>ilu worage Agency. APPLICANT _ r SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM LINE SIZE We INSTALLER J. W. hmynon RECEIVED BY_ _ ``tc�/ veef �EN GR V AGENTI COMMENTS. I)PC A ktt///,//////���` Jai. This Applirahon and permit expires In ninety (90) days The amomit Haid will I,n IGrfeiwd Should expiration occur. i CITY OF TIGARD 11420 E. W. Main street TIGARD, OREGON 97247 APPLICATION FOR BUILDING PERMIT New Construction X❑ Demolish ❑ Addition ❑ Remodel ❑ Move❑ ZONING^ � DATE ISSUED­ _ BUILDING PERMIT DATE RECEIVED 2-15-'li BUILDING FEE $ No. PLAN CHECK BY FS OTHER $ VALUATIO14 $ 29,215 TOTAL $ ,__�_ RECEIPT No. %Y 31, TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT M j, MAP A 2S1 4AA CENSUS TRACT W-1) _ JOB N Architect or Fngineer D. R. Moyd — Address _Yorl<1gBs;. exon Phone _t,�,-hyal ()w n e r —__._ G..i no, Address (hu3 S.E._Puucll, Portland, Oregon Phone 777-395b Builder name _— Address �,Q __- Phone BUILDING USE Singe Res. Multi Res. ❑ Comm. ❑ Industrial❑ OCCUPANCY GROUPS_ No. of Stories 2 Total Height_ Area of LotZSjX) � Type of Construction V Floor Area Bim_ 1 /e,b ___ Z 100tl Set stacks: Front �U 3ack Sl L.Sidel-_ R.Side 2� Private Sewer Pipe Size 4^ Sewer USE Tom_ Septic Tank ❑ Water Service Pipe Size 3/4 Storm Sewer ❑X Ditch ❑ Drywell❑ Street and Curti Requirements undor zona runtinn_ _�_� Driveway Width i_' _No. of Parking Spaces 2 SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION 1 NO OCCUPANCY UNTIL RELEASED BY CITYfyi ADDRESS ASSIGNED` lot T6 _ Bellrood II - aadress endln& FIELD CHECK BY DATE PERMIT APPROVED By It is understood that all work will conform with applicable codes and ordinances of the State of Oregon and the City of Tigard,, Oregon, and t. t the building will no: be ofx upied until a Certificate of Occu y -been i ued by the City of Tiaarr' duildinq Inspector. • 5�q—nature c) App�ca 71 so I Avoid Verbal Messages A--1 'j CITY OF TIGARD To: r' -- — - from :__ Subject: Vic• .�_— � �_.�� Date:_ i T /�� • / I I t I I 1 i r MK $ wlkK , �LuNT 12205 'S \V. IZ.7rh Avl�_- TI614 p Dr<61/100 , 97223 251 4 A 500 f N rev yr&KT7 � ,Tni�A,Gi15 LINDf;r{ .Vl � V: + _._12' __. G�V�LLINLi I�� �v