12775 SW 127TH AVENUE-1 N
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I1 INSPECTION NOTICE
City of Tigard Buildi-nq Department
Y 13125 Sit Hall Blvd. Tigzrd, Oregon 97223
Inapec''-ion Line/(Rec-o-phone):
66/3J9-4115 Business Phone: 639-4171
Inspect ion:_
Footln,, Plbg. Unde^slab Mach. Rough-in Appr/Sdwlk
l
Found. Plbg. Top Out Gas Line FINAL:
pent/Beam Struet. San. Sewer Framing -Bldg. '
post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfluor Water Line GYP• Bd. -Hoch. j
Date Requested:
Time: _7i�::_AM PM r
Addroas: ar. i #:
auilc+er:—.
THE FOLLOW211a OORR>!� 0118 AR! REQtIIRLD:
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VS+T
Impactor: Dete:
APPROVED DISAPPROVED __ APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CHPNICAL
CITYOFT167ARD . . . . IT• -
{-L-.h2M I"F #+�. . . . . . . MEC91 0192
CnYtyF ARID
COMMUNITY DEVELOPMENT DEPARTMENT anon
13126 SW Hall Blvd. P.O.Box 23397.Tigard.Oregon 0 ({6031 ep"#i 6 DATE I S 51-1 E D: 09/26/91
SITE ADDRESS. . . : J2775 SW 12 7-f H AV F'AFCEL: 2S 104AA-00200
SUB1. T nJ I S I ON. . . . : PF_LLWOOD ZONING: R-4. 5
P1-OCK. . . . . . . . . . . SOT. . . . . . . . . . . . . :51
LLAS'i OF WORK. . :AE,D FLOOR FURN. . . . EVAP COOLERS:
Tyr';_: OF USE. . . . :SF UNIT" HEATERS— : VENT FANS. . . :
(;L;CIJF'ANCY GRP,. . : R3 VENTS WIC) AFI1=rL: VENT SY.:,,TFMS:
STORIES. . . . . . . . : BOILERS/C:OMFrRESSORS HOODS. . . . . . . :
FUEL TYF ES-- -- --- ---- 0-3 HR. . . . : DOMES. INCIN:
: /WOD/ / i 3-15 HN. . . . : COMML.. INCIN:
MAX I NF,UT: BTU 15-30 HF'. . . . : REPIA I R UNITS:
FIRE DAMP,ERS7. . : 30 -50 HR. � . . . WOOI)STCIVES. . : 1
GFlS F'RESSURE. . . : 50+ HV'. . . . : CLO DRYERS— :
NO. OF UNITS----- -- --- AI.R HANDLING UNTT�3 OTHER UNITS , :
F URN < 100K PTU: <= 10000 cf m : GAS OUTLETS. :
FURN > =100K BTU: > 100,710 c:fm :
Remar,<s : wood stove installed in workshop
Owner••: ------------ ----------------------- _._-___._____-_-._-- FEES
WILLIAM HENRY type amount; by date r,ecpt
12775 SW 127TH AVE PRIIT $ 25. 00 BCR 09/26/91 --
5PCT f 1,, 25 PCR 09/26/91 --
T I GARD op S i 223
171hone #:
Contractor,: --__-- --•------___--___._._____.__-
OWNER
[,none #: f t:b. 25 TOTAL
Req
-- --- REQUIRED INSP'EC'TIONS - ---- -_
This permit is Issued subject to the regulations contained in the Woodstooe Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final. Inspection
applicable laws. All Mora will he done in accordance with
aUproved plans. This permit will expire if work is not started
within IAP days of issuance, or if work is suspended for more
than 180 days.
I Nrmittee Signatures
I s-;r_I e 1a P v t
Call for, inspvc.t ion - 639-4175
I
CITY OF TIGARD RECE'IP'T OF PAYME RECEIPT NO. t91-217892
CHECK AMOUNT z 26.25
NAME s HENRY, WTI-LIAM CASH AMOUNT 0.00
ADDREBS : 12775 SW 127TH PAYMENT DATE 09/26/91
SUBDIVISION e
TIGARD, CSR 97223—
PURPOSE OF' PAYME14T AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
l
MECHANICAL.. PE 25.00 ST. BUILD PER 1.25
MEC 91-0192 (WOODSTOVE)
TOTAL. AMOUNT PAIL — — — —> 26.25
CITY O* 2991BUILDING PERMIT APPLICATION of TIGARD DATE -.
THE UNDERSIGNED HEREBY APPLIES FOR APE RNA.IT FOR THE WORK HEREIN INGICATED BUILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFiCFTIONS OWNERPHONI
LOT NO.
OWNER y _ _JOB ADDRESS SW 11""7t k � HOME ADL RESS
ARCHITECT
ED'GINEER
BUILDER rC+ ADDRESS iltyr +� —DESIGNER
STRUCTURE NEW ❑RI MODFL. CIADDITION IL
REPHIFI� ❑RCIF F IRE DAMAGE ❑DEMOLITION
CJtREESIDF.NCE ❑COMM GLJUCATIONAL CIGOV'T ❑RELIGIOUSOR,TIO JCARPORT ❑( ARAGE ❑Si'ORAGEDSLAB [:]FENCE
LJBOND ❑MOVING ❑CONDITIONAL_ USE DDESIGN?F`11-:+ CICOUN,;!:_APPROVED ❑SIGNS
OCCUPANCY_ "!!—LAND USE ZONE,.— BLDG,TYPE...,__ FIRE ZONE PLAN CHEI'K BY_.__ _ HEAT—____
-- --- ,.;C)t19Cwuct
;(>w'e+d ui��.t.Ai.i➢)Is8 E9��?EK:t1•
OCC..L4f11�___ �_FLQS�I�I QAD fj�t HEIGHT 30 N9.UQEU _APEA NO.BEORQgMS
BUILDING DEPARTMENT SET BACKS FRONT '" REAR Vit. LEFT SIDE {_, RIGHT SIDE
Permit 241t(,%.} THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CON !AINED IN THE BUILDING CODE, ZONING
Plan Check 14ta) REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
—^ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANJ SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal l'E t00 ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DGES NOT WAIVE
RESTRICT:VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
-- -- .--------.— �r APPLICANT OR AGEN7
Approved Receipt No.
i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Routh-in
—^-- Fixture
--- Final
-�.____._.— ---- .--------- HEATING — -- --
Contractor
- ---- --- -�----- - Permit No. —_ -
Gas or Oil
Rough-in
-------- -- -Pinel ------
--- —�� - _.—.------ SEWER '— -- ----
_ -- -- Final—�
DRIVEWAY
-- - --- Final ---- -
Storm Drainage
(Rain Drain)Final
Sidevvelk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
M CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
2).it,r
y
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE �`�` ��-i�- 19 N"" 0578
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT I OR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED
/ IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE— —
QWNI.R 1 �r ��f` ADDRESS _ � j ' J BUILDER PHONE_ _
ENGINEER
9lJ1LLtF,1i_. _ _ A��CH11 J DESIGNER
STRUCTURE_ ❑NEW __❑REMODEL _ ❑ADDITION ❑FEPP,IR ❑RENEWAL _❑FI�aR!�E DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM QEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE 0 STORAGE❑SLAB [:]FENCE► BONO ❑MOVING ❑CONDITIONAL USE [:]DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LANO USE ZONE ! -BLDG TYPE _FIRE ZONE_ PLAN CHECK BY HEAT
Ir
r
QCC. LOAD FLOOR LOAD HEIGHT / NO.STORIES , AREA /�6 VAI UE _
BUILDING DfifARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit —_ .— ---__ — - --
THIS PERMI, IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZCNING
Plan Check REGULATIJNS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL.BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
] RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BLISINESS
State LICENSE SEPARATE PERMITS REQUIRED FOR SFW-R, PLUMBING AND HEATING.
Total ii
By
-- ---_...- -- APPLICANT OR AGI-.NT -------. -�_�..-----------
Approved Receipt No
- - - —_ - ------ -----�... ----- - —.— -
AUURESS PI IC)NE
�Tr +ter AI �
PERMIT TO CONNECT 6�f.
Tigard Sanitary District �g
PERMIT' N? 1437 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO T*IE SYSTEM OF TIGARD SANITARY DISTRICT `
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMIE$UNTIL CON.
NECi1ON IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE PAIDl�
•••....................TIGARD SANITARY DISTRICT
.Mwww.
CONNECTION INSPECTED AND APPROVED
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Date -- - - _-- -$uj:*Mnteudent` v_
N
Address Permit No.
Permit charge__r_____
Owner Connection fee
V
�� Paid by
Type of building .o _ Date connected
Service rate Inspection fee
Contractor Paid by --Date _
Size of connection_ "� Assessment_________Paid_
G �rx