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12555 SW 128TH AVENUE I .a ADDRESS: aw 1 H�1 7� J « I:Vewtdslmloro(Imktargetslbuilding.doo Qj w J i CITY OF TIGARD \ OREGON June 1 , 1995 7 RE: BUILDING PERMIT # inspect ion (s) have been conducted on t1-is pr•)j ect . However, we have no record of any subsequent or final i.nspectioas within the past 180 days . Please note that permits become v-,,Id if there has net been an inspection performed for over 180 days . In that case, the b;,ilding Division may require a new application and fees to continue work. A notice of non-compliance again:�t the Fioperty may also be reroz led by the City. Please advise the Building Division, IN WRI1INr, within 15 days of this letter, the status of this project . You may request additional time to compute the project . Respo^d IN WRITING to : Building Division_, 13125 SW Hall Blvd. , Tigard OR 97- 3 . Be sure to .include the following information: 1 . Building Permit # . Address of property. 3 . Your name . 4 . Your phone number B : OJ a .m. - 4 : 00 p.m. CL; If you are ready to schedule your nr.xt inspection, pl;?ase call our 24-hour Inspection Recorder at 639-4175 . n T J C7 W _J login\add_inepectiona 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 TDD (503) 684-2772 — — -CITY CSF TIGARD COMMUNITY DEVELOPMENT DEPARTMENT MASTER PERMIT 13125 SW Hall Blvd.Tigard,O egon 97?23.8199 (503)839-4171 R M I T #. . . . _ ., 639-41 ,; i DATE ISSUED: 08/31/94 PARCEL: 2S 104AD-02200 SITE ADDPESS. . . : 12555 SW 128TH AVE:. SUBDIVISIGN. . . . : BELLWOOD ZON' NG: R-4. 5 BL_OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 49 BUILDING REISSUE: DWELLING UNITS:0 BASEMEN•T. . . . . . . .. :0 s 1= CLASS OF WORK. :ADD BEDRMS:O BATHS.-0 GARAGE. . . . . . . . . . ..0 s.f: TYPE OF USE. . . :SF FLOOR AREAS------- REQUIRED SETBACI/%S-----------_.._ TYPE OF CONST. :5N FT RST. . . . : 119 ,f LEFT. . :0 ft RT.GHT. :0 ft OCCUPANCY GRP. : R" SECOND. . . :0 S FRONT. :IZI ft hC(1R. . :0 t STORIES. . . . . . . : 1 F I NBSMENT:0 s f REOU 7 RED-••---__-_-_---- ViE I GHT. . . . . . . . : 0 ft TO -: 1. 1 ) s f SMOKE; EETF C•fORS, : FLUOR LOAD. . . . :40 psf VALUE. . . . . $ : 3500 PARKING SPACE,-j. . :0 Remarks} : ADDITION OF` 119 SO FT TO HOUSL PATH I PLUMBING SI NI'%S. . . . . . . . . . . 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVN'TRS. . :!Zt LAVATORIEES. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . . . . . . .0 TUI /SHOWERS. . . . :0 LAUNDRY TRAYS„ . . :IZI CPTCH LAAG I NS. . . . . . . 04 WATER CLOSETS-:0 SEWER LINE (ft ) . :0 GREASE T RAT'S. . . . . . . :0 DISHWASHERS. . . . : 1. WATER LINE (ft ) . :IZI OTHER FIXTURES. . . . „ :UI GARBAGE: DISP. . . : 1 RAIN DRAIN (ft ) . :0 WASH I NG MACH. . . :I' GI RR I lu D R A I NS. . :0 _...___------------- IrIECHANICAL -____..-_..___..____.______-__.__.._.__._.___.______.. FEES FUEL TYPES----- ------ UNIT HTRS. . ',0 type amol.rnt by Gate recpt VENTS . . . . . :0 B P R T $ 44. 50 KS 08/31 /94 - MAX IAPU :V.! BTU VENT FANS. . :141 BPI_-(; 11 28. 9131 JF. Ilia/25/ 34 94•--c'tjoIIIc FURN ( 100F( . . .0 HOODS. . . . . . ) B5PC $ 2. .'3 KS 08/31/94 •- FURN ) =1.01ZIK . . :1.1 WOODSTG )ES. :IZI 14,_1RT' $ 25. 00 KS 08/31/94 FLOOR FURN. . . . :0 CL. Q DRYERS. : 21 P5PC $ 1. 2'5 KS 08/31/94 - BOtI_/CMP ( .?.HPIOZI OTHER UNITS:0 GAS CUTLETS:41 Owner: BRAD WE.INILL 12555 SW 12E TH T UARD OR 97223 Phonq #: Contractor: CONTRACTOP 1\401' ON FILE n. 1- Phonp 4: ,i Reg #. . _ __.___._________._____--_--__-.--__-___ $ 101. 91 TOTAL This permit is is.led subject to the regulations contained in theREQUIRED INSPECT IONS - w Tigard Municipal Code, State of Ore. Specialty Codes and all other Fvot/fol.Ind Insp P11amb Final _' dpp.icatle laws. All work will be dont in accordance with approved Post/Beam Strl.lct BI.lilding Final plans. This permit will expire if work is not started within 180 F'i.1/Undovr f l mor Erasion Control days of issuance, or if work is susnded fay. more than 180 da s. r X11 'Imb Top Out Crawl Drain F ,aming Insp Pe!rmit'l.C' L=1.gn I;P" �, J T.ns1.lT.at > OT1 Insp �f Gyp Board Insp 1sS1.1eci By : �,V. - : Rain drain Insp _ Imp-" CITY CSF T I PARD COMMUNITY DEVELOPMENT DEPARTMENT MASER PERMIT 13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)639-4171 PERM I'r #. . . . . . . : IIST94­033 C,3,j -4 DATE ISSUED: 08/31/94 PARCEL- LIF3104AD­02200 fiITE. ADDRESS. . . : 1,2555 SW 128TH AVE UBDIVISION. . . . : BELLWOOD ZONING: R- 4. 5 iLOCR. . . . . . . . . . LOT. . . . . . . . . . . . . :49 BUILDING REISSUE: DWELLING UNITS:0 BASEMEN'l.. . . . . . . . :0 _LASS OF WORK. :ADD BEDRMS:0 BATHS:O GARAGE. . . . . . . . . . :0 a f I'YPE OF USE. . . :SF PLOOR REQUIRED SETBACKS-­­­­­ !'YPE (.3F CONS- . :5N FIRST— . . '. 119 5f L E F" T. . -0 ft "IGHT. :0 ft OCCUPANCY CiiP. :R3 SECOND. . . -.0 of FRONT. -0 ft REvIR. 0 ft '3TORIES. . . . . . I FINBSMENT:O s REQUI !iE T GHT. . . . . . . . . 0 ft *TOTAL-------------- 1 19 s SMOKE DETECTORS. 1`1_00R LOAD. . . . :40 psf VALUE. . . . 3500 PARK ING SP(ICES. . 0 Remarks : ADDITION OF" 119 SO FT TO HOUSE V'ATIA I PLUMBING '31NK5. . . . . . . . . . .. I FLOOR DRAINS. . . . :0 BACI-/,FLOW PREVNTRS. . 'fb ;-AVPT'[)R- II'7S. . . . . :0 WATER HEATERS. . . :0 TRAPS. . . . . . . . . .- . . . . :0 MB/61-411WERG. . . . -0 LAUNDRY TRAYS. . . :0 CATCH BASINS. , . . . . . t111 WATER CLOSETS. . :0 SEWER LINE ('Ft; . :0 GRf7ASE 'YRAVS. . . . . . . :0 DISHWASHERS. . . . . 1 WATER LINE ( Ft ) . :0 OTHER FIXTURES. ,1ARBP6E DISP. . . - 1 RAIN DRAIN (ft ) . :0 WASHING MACH. . . :0 SF RAIN DRAINS. . :0 MECHANICAL FEES UEL by date I.-,ecpt TYPES-­­­­­­ IJ N I I i+r RS. . :0 type amount V E Nr S . . . . . ..0 BPRT $ 44. 50 KS 08/31 /94 MAX lNPUT:0 BTU VENT N'T FANS. . :0 13PLC $ L-8. 93 JF 08,/25/94 94­2560i: FURN ( 100K . . .-0 HOODS. . . . . . :0 B5PC, $ 2. 23 KS' 1218/31/94 BURN W(JODSTOVES. 10 PPRT $ 25. 00 KS 08/31/94 FLOOR TURN. . . . :0 CLO DRYERS. : 0 P5PC $ 1. 25 KS 08/31/94 BOIL./CMP ( 3HP:0 01-HER UNITStO GAS OUTLETS0 8RAD WEINEIL 12555 SW 1Z'8TH TIGARD OR 97223 Phone #' ContrAatorl CONTRACTOR NOT ON FILE CL cc Phone Req $ 101. 91 TOTAL This privit is issued subject to the regulat-utis contained in the REQUIRED INSPECTIONS Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Plumb Final applicable laws. All work will be done in accordance with approved Post/)deani St rust Building Final plans. This peroit will expire if work is not started within 180 F_ Uiderfloor E.-usion Control jays of issuance, or if work is sus(;�d for',.n'ore than,I 1/'�J-1121m/b"Top Out Crawl Drain P��As, F'.v�amjnq Inap Permittee Sign E t 1___/I psu).a4- ion Trtsp - 1 '�v I Gyp Board Insp fssupd By : Rain drain Insp It ! fur' !1'5PFUt !%111 Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 (503) 539.4171 Jobsite Address: , Z J J v IrZSubdivision: t )(J )C)G1 Lot# Office Use Only Valuation: ��..� - Planck/Rec # _ Permit # i)- J Corner Lot? Y 14, Flag Lot? Y Reissue of iJ� Map & TL# 5161 ` AIC' 0Z'?& Cwner: –� ly n _ Approvals Required Address: �z Planning — r-- , / 1 -'rv' Engineering a_ Phone: –' / J q _ Z Other _ Contractor: -</-T 427 Z' Items Required Address: -- Subcontractors Trws Details Phone: – Other Contractor's License # (attach ropy of current Oregon license) Contact Name & Phone: Subcontractors: Architect/Engineer:CL Plumbing: Address: re Mechanical: (attach copy of current OR Contractees License) �- Phone JOB DESCRIPTION: W - ----- J Applicant Signature & Phone number Received by: _ _ Date Received: 14 MORDICOMOEVIRESAPP Permit# Account Description Amount Amt. Pd. Bal. Due ,VI/ -023 Bldg. Permit (BUILD) Plumb. Permit (PLUMB) Mech. Permit (MECH) State Tax (TAX) �3• �' Bldg: J q Plumb: /• g � Mech: Plan Check (PLANCK)' Bldg: l 3 Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSDC) — Storm Drainage Chg (SDSDC) Resident,,:) TIF (TIF-R) Mass Transit TIF (TIF-MT) Commercial TIF (TIF-C; Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-0) Water Quality (WQUAL) ^_ n. Water Quantity (JVQUANT) _ > Fire District (F RE) Erosion Cntrl Permit "=RPRMT) W Erosion Planck/USA (ERPLAN) Erosion PlancK/COT (EROSN) TOTALS: O L q ✓ �3 �� • / `;) 1 , CITY OF TIGARD B!'!LGING DIVISION RESIDENTIAL PLANS SUBMITTAL APPLICANT NAME: PLAN CHECK # ADDRESS: S L f PHONE # `) 7 07 DATE RECEIVED: RECEIVED BY: CHECKLIST (All items must be in packet before plan will be reviewed) Y E 5 NO N/A 1 . ] [ ) [ ] 3 FULL SETS OF BUILDING PLANS (No red line revisions or tape-ons). 5 SITE PLANS (including tax lot and tax map number, easements, erosion control provisions, floor elevation of garage and main floor, set backs, drive-way location, north arrow, scale, location and terminatio-i of rain drains, corner elevations, and contours if over 15% grade). 3. ( ] [ ] ] BUILDING PLANS SHALL REFLECT TOPOGRAPHY OF LOi (if house is designed for a flat lot and the lot is not flat, revised drawings are required. No red lines accepted). 4. K_.J [ ] [ ] REVISION TO PLANS MUST BE FOLLOWED THROUGH FROM ROOF 'TO FOUNDATION (detailed sections may be different frorr, the originals as a result of your changes. These portions of the structure that are affected by the change need to be reflected on the plans. No red lines will be accepted). a s 5. FLOOR PLAN(S) y 6. [ [ ] [ ] FLOOR FRAMING J s 7. [ J [ ] [ ] TRUSS JOISTS (engineering, details and layouts) w -� 8. [L J [ J [ ] ROOF FRAMING PLAN (all hips and valley supports indicated and detailed). — OVER — 9• ROOF TRUSSES (engineering, details and layouts) 10. COMPLETE CROSS SECTION(S) 11. [ ] [ J [ j ALL 4 ELEVATIONS ARE SHOWN - 3 ELEVATIONS FOR ADDITIONS AND REMODELS 12. [ ] [ ] BASEMENT WALL, FOUNDATION AND RETAINING WALL. SECTIONS (will need engineering if walls are 8 ft. high or higher) 13. [ ] [ ] [ ] WALL BRACING (structure must meet table R-402.10, revised alternate method 93-7, or a lateral design shall be provided) 14. [ J [ ] [ ] ALL DERAILS REQUIRED BY NO. 13 ABOVE SHALL BE INCORPORATED INTO THE PLANS. (Attachments must be clearly legible and fully referenced in the pians). 15. [ ] [ ] [ ] BEAM CALCULATIONS (all beams over 10 h. in length or any beam that supports a point load). 16 [' ] [ ] [ ] ENERGY CODE PATH IDENTIFIED DO NOT MAKE CORRECTION IN RED RED WILL ONLY CAUSE DELAYS hk 41"W LL CL J J F' Permit No: Address:I ___Issued by: Date -- FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 313: 1 . CI I own, reside in, or will reside in the completed structure. 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A.L I My general contractor is _ __ , Contractor registration number_ _ I will in-,truct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.T1 I will be rr,y own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the C-mstruction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have gad and understand the Information Notice to Property Owners about Construction '.esponsibilities nn the tz tz reverse side of this form. Jig ure of Permit Applican ' Date �"-_S� CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639.417 Inspection:— Footing Susp. Ceiling Sprink. Rough-in Appr/ dw Foundation Plbg. Underslab Mech. Rough-in Fireplace Post/Beam Struct. Plhg. Top Out Elec. Rough-in FINAL: j Post/Beam Mech. San. Sewer Gas Line 9. Plbg. Underfloor Rain Drain Framing Alarm Wate, Line Insulation �j10fe—y� Underflr. Insul. Shear Wall Gyp. Bd. -Elect. Date Requested: (.' / �l� Time;a% AM _ PM Address: Builder: Permit #: THE FOLLOWING CORRECTIONS ARE REQUIRED: Iy C y ,l���Uwrcl�rr ----------------- L Inspector: —- _ bate: ROVED ,DISAPPROVED _APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPE_CPION NOTICE City of Tigard Building Department 13125 SA Ball Blvd. Tigard, Oregon 97223 Inspection Line kRec-O-Phone): 639-4175 Business Phone: 4171 Inspection•__ Footing Plbg. Under_elab Hoch. Rough-in Appr/Sdwlk Pound. Plbg. Top Out Gas Line FINAL: t eam Stru San. Sewer: ranting -Bldg. t Be Hoch. Rain Drain Innulation -Plumb. ; Underfloo Watorr Liine� Gyp. Bd. -Hoch. Date Request ed:� ---Time: AN _ PH Address: / �� _✓ /� _ Permit :_ �-7 Q Bullder: THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: �. Dates APPROVED DISAPPROVED APPROVSD DDBJWT TO —Ca:1 Per Reinap. CITY (7FTIGriRD - RECE=IPT OF' PAYMENT RFC:FIP'T' NO. 93,-P35M AJyJnUNT s 0. Oki NAME WEvINEI..., BRAn CASH Am(Dtjhj a 26. 85 ADDRESS 0 U2555 SW IPAT'' PAYMENT DATE` x oi,, s/9;3 FUNDIVIF..;ION TIGARD, OR 9',c'.2,i- PURPOSEW or myMENI' PMOLINT PAID PURPOSE". OF PAYOWNT AMOUNT Ph ID PLUMBING WERE ........... _..._�.....-.c'9i.00 ST. PUIL_D PER 1. 25 IOTA(.. AMOUNT PAID - - > ?_6. r''.5 C:1 I"�r' t1F T 1 flf lFtU RE CE' l P i C;4 1='W'YMk:N( k2L•.l.:k-.i l'1 NO. :94 ir'`'Ea; 1;11(-.(,K oML11 IN I a 0. 00 NAMES a Wh.IWI,, BRAD I...N3:.41 Nlhl.11.11'J 1 M)DRESS A .l2st.�`i ;iW 1 r".'E3'fFl I-IV I-'NYhII:N I W-1 l F C 06/3) /';)4 I)tVI1.iIIJN a I lliA 111, (:ir<t::f.)C)N 9 7::'.x±,5- PURI-'OSE OF' PHYMV-N T F1M1:11.IN( PW x 1.) PUkF-'OSt-: l lk 1='W r Mk N I fahtl.11.Jt�l 1 I'c-I.I t M y V,94-03 31 44. 50 PL LJM@ 1 NG Ph RM 1{1.111.0 PFR 3. 48 N r r J L7 W J PAID U '7p r � 11:1 I cal 1�M1'lUN'f _ ._. _1 . � U.1 TY I.A. '11, 10011,11 N.CI I I. I Cu 1'I I r Ml N I PI I I .I t' I Nt 1. ,1!1 I .I; ►IMi It INT n-+ 1111''N . i� WFAN11 1. t.11',II +11110.11,11 W i;',iIll I'I1 II! I'II DI) II I + I11m, CIK tVIl.il11III 1 '1IYMI-N1 I11'11ILIf•II 1't1I I 111444114 111 1,4-hPIVNI Fit'+1111IN1 14-1.1 1) 1 11 ( :K I.F a Ln J r.. :G C9 W _J 10 1 Flt. 1'11 11 II IN I 6'F11 U r'►:�. �1 d y INSPECTION NOTICE City of Tigard Building Depart xten 13325 BW Ball Blvd. Tigard, Oregon 9/223•___.---- Inspection Lino (Rec-O-Phone)t 639-4175 Business Phone: 639-4171 Inspections Footing PlbgUnderrsllabMach. Rough-in Appr/Sdwlk Fo.nd. / _CPb .— J Gas LineFINALt t'Oet/Beam Struct, San. Sewer Framing g. Post/Beam Hoch. Rain Drain Insulation -Plumb. Plbg. Underfloor slater Line Gyp. Bd. -Hoch. Date Requesteds /L� Time: AM __PM Addresss ��� � jT 7-A Permit Builder: TNM FOLLOWING CORRECTIONS ARE REQUIRED: LLJn. V) J — c7 J Inspector: Date: �Li7L 'T— APPROVED !_ DISAPPROVED —_ APPROVED fUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Bui.ldinq Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Roc-0-Phone): 639-4175 Business Phone: 639-4171 Inspection: Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk F ount. Plbg. Top Out Gas Line FINAL: Po�s�'Beam Stru San. Sewer raining -Bldg. Post/B Mach. Ratn Drain Insulation -Plumb. I-el Unuerfloo Water Line} Gyp Bd. -Meeh. Date Requested:_ /Wy / / Time: AM _ PM AddrenB: .) S /,2 Permit 1: '4' Build,ir: T3E FOLLOWING CORRECTIONS ARE REQUIRED: a ►r - CL F-- t/7 _. F- J ♦-r C7 W J Inspector: - _-- ---,__`_-- Date:� -iAPPROVSD - DISAPPROVED APPROVED SUR.TECT To ABOVE Call For Reinep. INSPECTION NOTICE City of Tigard Building Depwtaent 13125 SN Ball Blvd. Tigard, Orem 97223 Inspection Line (Rec-O-Phone)s 639-4175 Busineed Phone: 639- 17: Inspection: Fp6ETnTg� Plbg. Underalab Mach. Rough-in Appr/Sdwlk gcun Plbg. Top Out Gas Line FINAL: Poet/Beam Struct. San. Sewer Framing -Bldq. Poet/Beam Hoch. Rain Drain Insulation -Plumb. Plbq. Underfloor /Vater Line Gyp. Bd. -Hech. Date Requestedr / / J I _Time: G AH PH Address f', I�jTTT(�/ cPermit Is__/�/ - �✓ � 1 Builder:-- THE uilders _THE FOLLOMING CORR.RCTIONS ARE REQUIRED: ci i� F-- r w J Inspector: `� Dates_ C APPROVED DISAPPROVED APPROVED SUBJECT TO REW Call For Roinsp. �F Permit No: '� •\ Address: : O issued by:_____ Date: ----FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERIY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, URS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical. and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 36: 1 . [ I own, reside in, or will reside in the completed structure. 2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. AJ C I My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Constrcrction Contractors Board. OR 3. B. --) 1 will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office iasuing this building permi, of the name of n. the contractor. I L I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on We �- reverse side of this form. J LU J Sig rlA-tur-e or Permit�Applicari Da e CONSTRUCTION CONTRACTORS BOARD 0244,1 8/91 WHITE COPY TO ISSUING AGENCY PEMAIT FILE PINK COPY TO APPLICANT CITYOFTIOrARD C"YOFTWARD COMMUNITY DEVELOPMENT DEPARTMENT 011160H PLU11BING PER11IT 13326 SW Hell Blvd. P.O.Elm 23397,Tig",Or"m 97223(603)639-4175 PERNIT -it. . . . . . . DATE IG5(_JEJ): 01/05/93 SITE ADDRESS. . . : 12555 SW 11281H AVE PARCEL: 2SI04PD--02200 �iUBD I Y 15 1 ON. . . . : BEL LWOOD ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :49 CLASS OF WORK. . :ADD GARBAGE DISPOSALS. hJOBILE H014E SPACES. TYPE OF USE. . . . SF* WASHING MACH. . . . . . . : DACKFLOW PREYNTRS. . OCCUPANCY GRI-6. . R3 FLOOR DRAINS. . . . . . . . 'I RAPS. . . . STORIES. . . . . . . . .. I WATER HEA'TERS. . . . . . . CA'T 01-4 BAS i * N F I X TU RES------- LAUNDRY TRAYS. . . . . . : EF RAIN DRAINS. . . . . SINKS. . . . . . . . . . . 1. URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . LAYATOR I ES. 01-HER FIXTURES. . . . . I­UB/SHOWERS. SEWER LINE (ft ) . . . . WATER CLOSETS. WATER LINE (ft ) _ . : DISHWASHERS. . . . RAIN DRAIN (ft ) . . . . : Remarks: PLU1y1BINb ALREADY STUBBED 11\1 SETTING FIXTURES ONLY Uviner: FEES BROD WEINEL type amount by date recpt 12555 SW 128TH PRIVIT 6 25. 00 JH 01/05/93 5f')C'l 1. 23 JH 01/05/93 TIG,IRD OR 97223 Phone * : W H L H ----.-.-----------------------._------.... FSI-lone #: $ 26. 25 TOTAL Reg #. . : 00000 RLUUIRED INSPECTIONS This permit is issued subject to the regulations contained in the 'I op­o�lt 1n5p Tigard Municipal Lade, State of Ore. Specialty Codes and all other Fin�Al Inspection applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. Por,mittee Siynatut-e : Issued By: Lall for inspection 639-4175 W