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CITY 4F TIGARD
COMMUNI"FY DEVELOPPi ENT DEPARTMENT
13125 SW Hell Blvd.'Tigard,Oregon 97223.8199 (503)939.4171 PLUMBING PERM I T
PERMIT #. . . . . . . : PL1+194--0171-i
639-•4171 DATE ISSUED: 08/17/94
PARCEL: 1 S 133DD--1'75' 0
SITE ADDRESS. . . - 13.6913 SW 128TH AVE
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 5 ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :211
CLASS OF WORK. . :ADD GARBAGE DISPOSALS. MOL1I'.E HOME SPACES. :
TYPE OP USE. . . . SF WASHING MACH. . . . . . . : BACKFL_`iW PREVNTRS. . : 1
OCCUPP JCY GRP. . :R3 FLOOR DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . .
S'I`OR i E i. . . . . . . . :2 WA T'EER HEATE=RS. . . . . . . CATCH BASINS. . . . . . . .
F=IXTLJRI=S---..------------ L INDRY TRAYS. . . . . . : SF RAIIV DRAIN i. , , . :
SINKS. . . . . . . . . . . URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATORIE=S. . . . . : 01HER 1-:IXTURES. . . . . .
TUB/SHOWERS. . . . : SEEWLR LINE (ft) . . . . :
WATER CLOSETS. . : WATER LINE ( ft ) . . . . :
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Rema1^E<a : SPRINKLER PERMI-T
Owner: - - __..__._._.____.___.______.______.__.....__._________._._- -- FE:
ALBERTO GRACIAN type amor_int by .,ate r^ecpt
11898 SW 128TH AVE PRM7' $ 15. 00 JG 08/17/94 -
51''E',T 0. 75 JG 08/ 17/94
TIGARD OR 9723
Phone #: 590-6417
Cont ^act or c --__.-._-.-.----------------------.—
OWNE::R
Phone 1#: f 15. 75 TO'1-AL
Reg 1#. . ,
--------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the RP/Backf low Prev
Tigvd Municipal Code, State of pre. Specialty Codes and all other Final Inspection
applicable laws. All Mork will be done in accordance with
approved plans. This permit will expire if work is nit started
withir 180 days of issuance, or if work is suspended for more
than 18N days.
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f'e r m 1 t t e e I.1 r^e :
I s s i_i e d By
Call for inspection - 639--4175
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City 61'Tigard PLUMBING PERMIT Planck/Rec. #
"13125 SW Hall Blvd. APPLICATION Permit #
Tigard, OR 97223 ---
(503) 639-4171
escrlptlon --�
ORS 814-21-610 _ ---- 1 PRICE I AMI
,lob 11-72- FIXTURES
Address Sink - --- �- .
Lavatory 7.50
—'� r"r ( u or u lower om
# J v Shower Only 7.50
°• ater oset 7.50
Owner 'l 0 I �� Dishwasher 7.50
Garbage Disposal
it CA CL1j ioic? Washing Machine � 7.50
0-0 fain
later eater 7.50
■■•
" - '^• Laundry oom ray
Occupant ring 7.50
�� •'° utTer Fixtures (Specify) i.
7.50 ^�
T
7.50
1. W VI.0-,q� MISCELLANEOUS
Contractor —
Sewer 1st 100 30.00
.,. ,..,., ,-- —r� r■. ewer -ea. Addit 17 15,00
Water Service 1st 100' 20.00
hereby ac now ledge that I have re,,, this application, that the Water Service ea. Addit 200' 15.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st .00' 30.00
1 am registered wRh the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 15-00
number given is correct. !If exempt from State registration, please
give reason below.) Mobile Home Space 2500
Back ow Prevention —
�� Device or Anti-Pollution Device 750
a ny rap or Waste Not
Connected to a Fixture 7.50
Describe work new addition a eratlon repair Catch Basin —
to be done residential Vnon-residential Q _40-.N__
Insp, of Exist. Plumbing per hr
40.00
Specially Requested Inspections per hr
Existing use of -- nRain Drain, singe family
building or property /`� _ dwelling 15.00
Residenti3l backflow prevention
devices 15.00
CL Proposed use of
building or property
1— *(Except rest ent a _Fac fl&w
prevention devices)
J
N3TICE *Minimum Fee $25.00 SUBTOTAL j
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IFLLj
—� CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS PLAN REVIEW 25% OF SUBTOTAL
COMMENCED.
TOTAL
Special Conditions
Date issued _! by
.oma
CHN OF TIGARD CERTIFICATE OF
COMMUNITY' DEVELOPMENT DEPARTMENT OCCUPANCY
13125 SW Hell Blvd.Tigard,Oregon 97223.8199 (503)639.4171 PERmu #. . . . . . . : MwiT'13--956c'
6-�V- 41 '11 DATE ISSUET)c 04/213/94
PARCEL: 1 S 133DD--1 7504
;:ITL ADDRESS. . , : 11898 SW l28TI-) AVE
SUBDIVISION. . . . . VILLAGE: AT SUMMEN. LAKE PARK 5 ZONING:R-•4. 5
BLOCK. . . . . . . . . . s LOT. . . . . . . . . . . . . :211
CLASS OF WORK. :NEW
TYPL OF USE. . . :SF
OCCUPANCY (313P. s R3
OCCUPANCY LOAD:22:7 4
TEN.I)NT NAME. . . e
Remarks ; PATH I
Owner.:
DON MORISSETTE !-TOMES
15555 SW RANGY RD
SLI I TE. 201
-AKE;: OSWEGO OR 97035
Phone #: 620--7538
Cont ract or:
CONTRACTOR NO r ON Fl
Phone #:
Reg #. .
Occupancy of the i4bove rr,eferenced [building :is hereby given, and certifies
the compliance with the State Of Oregon Specialty C,)des for the grolApl
occupancy, and I.1E4e under r)hich the ref"Prenred permit was i sg1aed.
IRE DEV'K ii TMEN7 I^i I NS 'ECTOR
UI I G F CIAI_
CL POST IN CONSPICUOUS o'LACf--_'
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INSPFCfION N(YfICE
City of Tigard Bu3idi2o Departaant
13225 vW Ball Blvd. T14k,rd, Oregon 97223
Inspection Line (Rec-o--Phone): 639-, "' Business Phone: 639-4171
Inspections
Footing Plbg. Unders W, Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Beam Struct. Say:. Sewer Framing CEBldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line q Gyp. Bd. -Meth
Date Requesteds O - / �fJ Times _�n
Address:_ ^/v O // PBtmit is 23
Builder: I _�� �1
THE FOLIAR NG CORRECTIONS ARE RE�)UIRED%
Vim'
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Inspectors �. Dates__f
PIlDVlD DISAPPROVED i APPROVED SUBJECT TO ABOVE
V
----Call For Reinsp.
NSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Kech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Caa Line NAL;
Post/Beam Struct. San. Sewer. Framing -Bldg.
Post/'Beam Mech. Rain [train Insulation
Plhg. 7nderfloor Water Line Gyp. ed. -Koch.
Date Requested: /L L � Tim- AN _PH
7p
Address: -�7 is ���! /U
Builder: !2 / F, Z5
THE FOLLOWING CORRECTIONS ARE REQUIRED:
ea -tT4 1Xr—ZA
-- - -
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Innpector: /</J _ �j Date:_
APPR0IRD DISAPPROVED APPROVED SUB.TE(-r To ABOVE
Call For Reinnp.
CITY OF TIGARD MASTER PERMIT ✓
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : IYIST93-9562
13125 SW Hell Blvd.Tigard.Oregon 97223.81Am•"iG-y16bd-4171 DATE ISSUED: 12/16/93
PARCEL: 1 S 1:33DD-•175O0.1
SITE ADDRESS. . . : 11898 SW 128TH AVE
SUBDIVISION. . . . : VILLAGE AT SUMMER LAKE PARK 5 ZONING: R '4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :211
BUILDING -- ---_-- --_.__.__._.________....____._-_-•----.__...._.
REISSUE: DWELLING UNITS: 1 BASEME:IAT. . . . . . . . .IZI S
CLASS OF WORK. :NEW PEDRMS:4 PATHS: 3 GARAGE. . .
CLASS sf
TYPE OF USE. . . :SIF FLOOR AREAS --_------ REOU I RED SETBACKS------•-_-.---.-_..
-1"YP'E OF CONST. :5N FIRST'. . . . : 1350 sf LEFT. . :5 ft RIGHT. :5 ft
OCCUPANCY GRP. : R3 SECOND. . . :930 S FRONT. :20 ft REAR. . :39 f I.
S T OR I ES. . . . . . . :2 THIRD. . . . :0 s f REGIUI
HE I GHT. . . . . . . . :._7 ft TOTAL-._._-.-.__:2280 s f SMOKE DETECTORS. :Y
FLOOR LOAD. . . . :40 ps f VALUL. . . . . $ : 3. 12980 F'ARK ING SPACES. . : 1
Remarks : PATH I
F'LUIYIBING
SINKS. . . . . . . . . . : i F=LOOR DRAINS. . . . -0 BACKFLOW PREVNTRS. . :0
LAVA fORIES. . . . . :4 WATER HEATERS. . . : 1 TRAP'S. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . :4 LAUNDRY TRAYS. . . :0 CATCH BASINS. . . . . . . :O
WATER CLOSETS. . :3 SEWER LINE (ft ) . :O GREASE TRAP'S. . . . . . !0
DISHWASHERS. . . . : 1 WATER LINE (ft ) . : 100 OTHER FIXTURL•S. . . . . :0
GARBAGE DIST'. . . : 1 FRAIN DRAIN (ft ) . :IZI
WASHING MACH. . . : 1 SF RAIN DRAINS. . : 1
----------------- MECHANICAL ---____.______._------___.___.__.____-- FEES
FUEL. TYPES------- ------- UNIT HTRS. . :0 type aincl_u1t by date r,ecpt
/GAS/ / / VENTS . . . . . :0 TIF' $ 15,20. 00 JH 12/15/93 --
MAX INF'I.IT:O BTU VENT FANS. . :4 BPRT $ 465. 50 JH 12/1.5/93 -
F-URN ( 100K . . .-0 HOODS. . . . . . : 1 BF'LC $ 302. `8 JLH 11/0--1/93 93-2 4"
FURN ) =-1O0K . . : I. WCIODSTOVES. :0 B5P'C $ 23. 28 .JH 121115/93
FLOOR FURN. . . . :0 CLLI DRYERS. : 1 SSDC $ 280. 00 JH 12/15/93 BUIL/CMP' ( 3HT':0 OTF,ER UNITS: 1 F'ARFC $ 250. 00 JH 12/15/93 -
GAS OUTLETS: 1 MPRT $ 45. 00 JH 12/15/93 -
Owner,: - - _._____ ______._._____-.---____.._.-MPEG $ 11. 25 JH 12/15/93 -
DON MORISSETTE HOMES M`P'C $ 2. 25 JFI 12/15/93 -
15555 SW RANGY RD P'P'RT $ 155. 00 JH 12/15/93 -
SUITE 201 F'SPC $ 7. 75 JH 12/15/93 -
LAKE OSWEGO OR 97035
Phone #: 620-7538
Contractor': --- --- --____._____------ ___--
DON MORISSETTE BUILDERS, INC.
15555 SW RANGY RD.
#x'01
LAKE OSWEGO OR 97035
f-'hone #: 620-7538
c
__--...
_.. _---------....----_—__-------.�------
Reg ti. . 1JJ3.5
$ 3062. 61 TOTAL
This permit is issued subject to the regulations contained in the ----- - REQUIRED 1NSF'ECTTONS -- --
Tioard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
J applicable laws. All work will be done in accordance with approved Post/Beam Str^1_tct Gas Line Insp
plans. This permit will expire if wor4 s not started within 180 Post/Peam Mechan Ins,-Elation Insp
days of issuance, or if work is suspende for more than 180 days., F'lm/i.tndslab Insp Gyp Board InEip
PLM/Underrloor Rain drain Insp
F'er^mittee Si gnat Mechanical Insp Water Line Insp
Ple.tmb Top Oi_tt Appr/adwlk Insp
Issi.ted Byes _-_..._._. _ Fr aming Insp Mechanical Final
j. J' Call fur inspection -- 639-4175
CITY OF TIGARD SEWER ERMIIECI"ION
F'ERIhI l"
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . . SWR93-048-/
13125 SW Hell Blvd.Tigard,Oregon 97223*81"' �0:y'Aii4171 DATE ISSUED: 12/16/9S
PARCEL: 1S133DD-17500
SITE ADDRESS. . " : 11898 SW 128TH AVE
SUBDIVISION. . . . , VILLAGE AT SUMMER I-AKE PARK S ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :211
------------------------------------------------------------------
TENANT NAME. . . . . :
USA NO. " . . . " . . . . " FIXTURE UNITS. . . .
CLASS OF WORK. . . :NEW DWELL I NG UN IT;. . : I
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :HUSWR IMPERV SURFACE. . : f`
Remarks : PATH I
Owner: -- ----______.__________________•------.__..___._...__....__..._-____ FEES
DON MORISSETTC HOMES type amount by date recpt
155 55 S SW RANGY RD F'RMT $ 2200. 00 JH 12/15/93 —
SUITE 201 INSP $ 35. x20 JH 12/15/93
LAKE OSWEGO OR 970315
1--'h o n e #.-, 620-7538
Contractor: --------------------------------
CONTRACT-UR NOT ON FILE
---------------------------------
Phone #: $ 2'235. 00 TOTAL
Reg #. . "
_ ------ REQU I RED INSPECTIONS
- - - -
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 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 located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and theNg ncy will install a lot mal.
Permittee Signature,
I s s r_I e d B Y . _........ __...
V Call for inspection — 639-4175
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Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard; OR 97223
(503) 639-4171
Jobsite Address: o 3 kam-_
Ofnce use Only
Subdivision: (✓ -< ���`'� Lot# c9,
Planck/Rer.#
Valuation: /l2098a.
- Permit #M3 L�
Owner: Reissue of
Don Morissotte Homes
Address:^ 15555 SM fl'nrnV Rd., gir„ 991 _
Lake Oswego, OR 97035 Approvals tae uq lrewJ
e < Planning � G
Ptxme r
Engineering�.
Contractor: Other
Address.
Items Required
Subcontractors _
Phone:
Truss Details
Contractor's License #
(attach copy of current Oregon license) Other
Subcontractors: s
(� pkiv s14E Noiozw S bA; Ar Pr)
Plumbing:
Mechanical:
(attach copy of cufrent OR Contractor's License)
Architect/Engineer:
Address:
IL
�- Phonp:
COMMENTS:
J
p -7 5 3
Applicant Signature & Phone number
Received by: Date Received:
Permit # Account Description Amount Amt. Pd. Bat. bue
m5i93 -05GL Bldg. Permit (BUILD) .5,16
Plumb. Permit (PLUMB) SS•uu _ /55..�
Mech. Permit (MECH) t�S•�° !�S.do
S!..!e Tax (TAX) 53, ZY 33,Z Y
Bldg:
Plumb:
i
Mech:
Plan Check (PLANCK) _313, 20 Z.�-�._ G 3• �'3
Bldg: 02, S F
Plumb:
Mech: _1.2,
Sewer Connection (SWUSA) u
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC) _
Storm Drainage Chg (SDSDC) �-�� _ _ °zy—
Residential TIF (TIF-R) _L�!/ d N/
Mass rransit TIF (TIF-MT) /0
Commercial TIF (71F-C)
Industrial TIF (TIF-1)
n Institutional TIF (TIF-IS)
rt
Office. TIF (TIF-0)
!� Water r)o (WOUAL)
J `
Water Quantity (WOUANT)
w
-' Fire District (FIRE) _
TOTALS: .52V c' �(Y [ •yr