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CERTIFICATE Of-
OCCUPANCY
C11Y OF 'ri%.WARD PERMIT f►. . . . . . . t MaT94 42I3E4
1 COMMUNITY DEVELOPMENT DEPARTME�!T PATE ISSUED: @2/16/1)5 �
I15 '^h SW Skil Blvd.Tigard,Oregon 07223+8199 (503)834-4111
I PARCEL.? 2r102DD--01'11?l
IL, (-iUDRLLb15. . . s I Ei::,i f ::W I1)L 14L.YNL CT _
J JBDIVISION. . . . c FINLEY PAR[< ZONINCsR-•7
! BLOCK. . . . . . . . . . . L-01.. . . . . . . . . . . . .003
� [:L.faSC�OF*»WORK. ciUEW_,.._....__.....,_.._.__._.....,.,,�_.__..�...w,._..._.___..,__.._.____.__.....__..___.._�.___...___.. ..,_..__......_._.._.. .._ y
I YPE: I-IF' USE:. . . t 5F r■r
XC LJPiNC'Y GRP. c R3
UC;C;UPONCY LOAD- 113 4
IENANT NAME.
r Qpmarkb c PATH E
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IM MILLER
i l30R7 wiW TIMARA LN
r 1GARD OR 972i2, 4
! I-Ihonc #7 5598-8574
!;ont r,ulc t _.__ .........._. ._
l ",.M MIL_L_F:R
1.3027 OW TIMAPP LN
I IORR0 OR 97224
Phune #s 98--8`514
17eq 0- 1 64687
1 Occur~,ancy of the dbove re!fererwp .l t7a..I,ilcliny is hereby y.ive!n, n,%nd coatifies
trio t2oMpli.ance with the State (If Ot-eyonpec';alty Xcudes for the group,
,c�c1.lp�Ir)cy,, anti 1.Ise �_Inder- lmhlc�h the r-pfpv-enr--ed pet'llit was , IV-SIled.
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection-
Footing Susp, Ceiling Sprink. Rough-in
Foundation Plbg. Underslab Mech. Rough-in Firep! ce
Post/Beam Struc,.. Plbg. Top Out Elec. Rough-in PJ
Post/Beam Mech. San. Sewer Gas Line
Plbg. Underfloor Rain Drain Framing e'_ ui
Alarm Water Line Insulation . e-M)
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: zv�— ? �9S /' Time PM
Address: S S� 0 `LL � 3
Buildor... L - a Permit#: - U
THE FOLLOWING CORRECTIONS ARE REQUIRED:
'rCi Arg
In pector - Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NOTICE i ;1,4 s,"arta p
Inspection Line (Rec-O-Phone): 639.4175 Business Phone: 63 4171 f
a a1 -�F ai
Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struc..t, Plbg• Top Out Elec. Rough-in k FINA
F'ostrBeam IlAech. San. Sewer Gas Line �Idg,
1 ISF� KIS
?Ibg. Underfloor Rain Drain Framing (P mb _> 2 p;
._.� n i a
Alarm Water Line Insulation --mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
l I2�`Prl
Date Requested:
Time: AM PM y
Address: / T / / � �. �J j;� ��
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Builder: ;� Lf
1— f Permit
THE FOLLOWING CORRECTION ARE REQUIRED: �,i
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Inspector: Date:
,APPROVED
—DISAPPROVED _APPROVED SUBJECT TO ABOVE l
V Call For Reinsp.
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CITY OF TIGARD BUILDING INSPECTION NDJICE ,
Inspection Line (Rec-O-Phone): 639-4175,--Business Phone',6 9-4171
Inspection:
Footing Susp. Ceiung Sprrn . pr Sdwlk.
Foundation Plbg. Underslab Mach. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post'Beam Mach. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -PlUmb.
Alarm Water Line I;-,sulation -Mach. T';.
?R
Underflr. Insul. Shear Wall Gyp. Bd. Elect.
Date Requested: ( l '�t Time: AM PM r"
h
Address:
Builder:_ (LPeimit #:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
1
Inspector: Date:
�
RPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
i
INSP&CPION NOTICE
:Zity of Tigard Building POPartUm"Ot
131.:25 Elf Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-n-Phone): 639-4175 Buninens Phone: 639-4171
Inspection:
Footing Plbg. Underelab Mech. Rough-in Bdw k r
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/neam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Rd. -Hoch.
Date Requested: _ �I I� TL7.c: `"//1 PH
Address:__ �t/ / //��'` Q l/' Permit /: 7
Builder: _
THE FOLLOWING cORREMIIUNS ARE REQUIRED:
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Inspector:_ `1 _ Dates
DISAPPROVED TJ�.. "PRr"3D 8vW2CT TO ham
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Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Dm,art:atnnt / S
131.25 SN Ball Blvd. Tigard, oregon 97223 }
Inspection Line (Rec-U-Phone): 639-4175 Businena Phone: 639-4 It
Inspection•_ -- a�---------- ---
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -.Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line C�' _Bd.i -Mech
Dale Requested: _TimeOZLA.
PM
Address: (]� �! �rmit
Huilder: d7, 10 (p 7r
THE FOtJOWING CORRECTIONS ARF. REQUIRED:
Inspecto :_ Date:/
APPROVED DISAPPROVED APPROVRD SUBJECT TO A
..---Call For Reinap. }
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INSPECTION NOTICE �^\
City of Tigard Building Departwrent W
13125 SW Ball, Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
inspection:
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL: ''•
Post/Beam Struct. San. Sewer Framing -Bldg.
e1
Post-/Beam Mech. Rain Drain in ai9(TLion~ "--.,"-Plumb.
/-Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: l Time: AM !PM
Address: }
Permit f: �`�
Bullder: -7T
THE FOLLOWING CORRECTIONS ARE REQUIREDs yy{P
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Inspector: —A__ i
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.___ L.� Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinnp,
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INSPECTION NOTICE
City of Tigard Building Departz•ettt
13125 SW Ball Blwd. Tigard, Oregon 97223
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Inopection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Ino"ction:e— -
Footing Plbg. Underrlab Hoch. Rough--in Appr/Sdwlk
Found. Pjbq. Top Out�' Can Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet Beam Hoch. Rain Drain Ineulatlon -Plumb.
Plbq. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requeetedt12, Time!��l y Tlme1►M PH
Permit i s
Builders / L1
TBE FOLLONING CORRECTIONS ARE REQUIREDt
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Inspecto'r: /
V 1TPPRCVED DIS..PPROVED APPROVED SUBJEC9'111"'TD ABOVE
Call For Reinsp.
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INS ECTION NOTICE
City of Tigard Building Department .o
13125 SW Hall Blvd. Tigard, Oregon 97223
X__ _
Inspection Line (aec-o-Phoi., )s 639-4175 Busineat. Phone: 639-4171
Inspeection:
Footing Plbg. Underslabh. Rough- Appr/Sdwlk
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Found. Plbg. Top uut Gna Lin FINALS
i
/ ru San,, Sewer i _Bldg.
t ech. 1�V
Rai.W Drain Insulation -Plumb.
Plbg. Underfloor U Water Line Gyp. Bd. -Hach.
2 '7�
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Date Requested: Z Time: AM PN
Address:L#-_� _VTI__i: ( Permit r:_'9 _-C_
Builder:_-7 G'�'
THE FOLLOWING CORRECTIONS ARE REQUIRED:
"L2/.14
Ile
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1A CC 2
57.
Inspector: Date.1/Z G
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APPROVED — DISAPPROVED APPROVRn SUB.TRCT To ABOVE
-----Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Departsont_
13125 6W Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rev-O-Phone): 639--4175 Buninean Phone: 639-4171
Inspect ion:��__—.� ------- ---
Footing Plbg. Underalab Mach. Rough-in Appr/Sdwlk
Pornd. Plbg. Top Out Cas Li..e FINAL: ai'+
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P+�eCjeenm Bt San. Sewer Framing -.Bldg. C
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Rain Drain insulation -Plumb.
Plbg. Underfloor Water Lind Gyp. Bd. -Meeh.
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Date Requested:. Time: AM
Address• 551 (�f
--- � �7 i Permit
qi E. Builder:
a +�
THE FOLLOWING CORRECTIONS ARE REQUIRED?
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Inspectors � � Date•
'�i.i•r1x 7Lx
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APPROVED 1�ISAPPROVED APPROVED SUBJECT TIC) ABOVE
_
Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SN Hall Blvd. Tigard, Oregon 972.23
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inepection:---
Footing Plbg. Underelab Hech. Rough-in Appr/Sdwlk
Found. �/%(lbg. Top Out Gas Lina FINAL: M
to'F �t a
PogCl6inam Stru . --'ean. Sewer Framing -Bldg.
(l
° r, t ost/Beam Meq Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Meeh.
4, Date Requested: 6 4 // 4� Time: AM PM
//_ A //
Address:
Permit
�_ —)
j Buildgr:
THE FOLLOWING ODRHECTIONS AAE REQUIRED:
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Inspector: L Dates J )-
APPROVED rSAPPROVED APPROVED SUBJECT To ABOVE
V Call For Reinep.
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INSPECTID0 NOTi?E
City of Tigard Building Dlepartaent /
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)c ,39-4175 Business Ph 4171
Inspections___
Rooting Plbg. Underslab Hoch. Rough-in Appr/Sdwlk
Pound. OZ;P Gas Line FINAL:
Poet./Beam Struct. San. Bower Framing -Bldg.
Pout/Beam Mach. Rain Drain Insulation -Plumb.
Under.Ploor_) Water Line Gyp. Bd. -Meth.
Date Requested:_ _ _Z " Times AM PH
s
Addr®ss:__y�1 _MQ�t��'V/n Permit /s L___y 364
Builder:_ __
THE ROL' OWING CORRECTIONS ARE REQUIRED:
Inspector;
—_.-_ Date:
_�A�pROVRO DISAPPROVED - APPROVED SUBJECT 7'0 ABOVE
_--call For Reinap.
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INSPECTION NOTICE*
city of Tigard Building Department
13125 611 Ball Blvd. Tigard, Oregon 97223
Inspection Line (pec-O-Phone): 639-4175 Business Phones 639-4171
Inspection:_.^ _-_.----
Footing Pltg. Underel.ab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gaa Line FINAL:
Poet/Beam st.ruct. C.�niSewe Framing -Bldg.
Post/Beam Mach. R4jjn Dom¢} Ineuletion -plumb.
Plbg. Underfloor t(g_er�LI§e
/ Gyp. Bd. -He h.
Date Requested: i161d-7f > Time: �(/"` ____PM
Address:
2-5
�( Permit I:_-/�-v
Builders `.-' -s��__THE FOLLOWING CORRECTIONS ARE aBQUIRED:
Inspect s�l '_ --- - Data; �
APPROVED DISAPPROVED APPROVED SURJRf_TT TO ABOVE
...`._call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Ph 39 4171
LAI
Inspection: -- — — — Y
�P��oEing Plbg. Underelab Mach. Rough-in Appr/Sdwlk
CoE n a Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line J Gyp. Bd. -Hoch.
Date Requested: f /� 1^// Time: AM PH '
.Address: -I [ i !.�11,1L� [ �-Permit t:!_L._=_.>�
B,:I lder:
-- THE P"LLOWING CORRECTIONS ARE RE(,)U7RED:
inspector: 1:� Date-
_T APPROVED DISAPPROVED APPROVED SUBJECT 7'O ABOVE
call For Reinep.
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CITY OF TIGARD 40
COMMUNITY DEVELOPMENT DEPARTMENT PLUMBING PERMIT 7
PERMIT #. . . . . . . : MS'r94-0361f
13125 SW Hell Blvd.Tigard,Oregon 07223•B1110 (503)530.4171 DATE ISSUED: 10/03,!,94
PARCEL: 2S102DD-01900 •
S I TE: ADDRESS". ., . : 08514 SW MERLYNE CT �
SUBDIVISION. . . . : FINLEY PARK ZONING: R--7
J)LUt_K LOT
. . . . . . . . . . . . .
.__.._.___.00_t,__...___________,_____._________._.__.__.__.__.._. •
CLASS OIC WORK. . .-NEW GARBAGE DISPOSALS. . : 1
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . 11 BACKFLOW PREVNTRS. . : 1
OCCUPANCY GRP. ., : R:3 FLOOR DRAINS. . . . . . . :0 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . .. 1 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :0
FIX 7URE:S----------------- LAUNDRY TRAYS. . . . . . :0 SF RAIN DRAINS. . . . . : 1
SINKS. . . . . . . . . . : 1 GREASE TRAPS. . . . . . . :0
LAVATORIES. . . . . :2 OTHER FIXTURES. . . . . :0
TUI /SHOWERS. . . . : SEWER LINE. (ft) . . . . :0
WATER CLOSETS. . :2 WATER LINE= (ft) . . . . : 100
DISHWASHERb. . . . : 1 RAIN DRAIN (ft) . . . . 10 r,
Remarks: PATI-{ f3
OWNER:
1"IM MILLER TIF $ 1550. 00 JF 10/03/94
j 130i; 7 SW TIMARA LN BPRT $ 386. 00 JF 10/03/94
BPI_C $ 252. 20 JF 09/20/94 94 -r5695t.•
TIGARD OR 9722'4 B5PL 4, 19. 40 JF 10/03/94
Phone #: 598--8574 SSDC $ 280. 00 JF 10/03/94 -
PARK $ 500. 00 JF 10/03/94 -
Plumbinq L:ontractc,r :---_.._.._._._..w_____.___ _r MPRT. $ 40. 50 JF" 10/03/94 -
/j, MM
$ 10. 13 JF 10/03/94
Name- _.. _ _ _ M5PLI 41 . 0;3 JF 10/03/94 -
Address _ _ __ 2BTH $ 195. 00 JF 10/03/94
r'ity:_ . `�tate:_._ P5PU $ 9. 75 JF 10/03/94
Zip:__ Phone#: EROS $ 40. OU JF10/03/94
Additionni fees not Chown here. . . . . . . . .
Rely #:.__._._._..._ _ _._._..._.____.._....._.____...�_____
RECIU I READ INSPECTIONS
This permit is issued sub iert to -the req
,_clations contained in the Tigard Municipa) Foot/found Insp Rain drain Insp
Lade, State of Ore. 13pecialty Codes and all fast/Beam Struct Water Line Insp
other applicable laws. All work will bQ done Post /Beam Meehan Appr/Sdwlk Insp
in accordance with approved plans. 'This Plm/undcsiab Insp Mechanical F= inal
permit will expire if work is not started F,LM/UnderfIoar Plumb Final
within 1.80 day_ s. of issuance, ar if work is Mechanical. Insp Building Final
s,.tspended far more than 180 days. Plumb Top Out Erosion Control
Framing Insp Crawl Drain
Fireplace Insp --
? Gas Line lnsp
Insulation Insp
Gyp Board .Insp
Authorized Plumbing Contractor Signature
Gall for inspection - 639-4175
Contractor Notes :
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CITY OF TIGARD
MASTER PERMIT
COMMUNITY DE%ELOPMENT DEPARTMENT I-b.RMIT #. . . . . . . : MST94 03174 �
13128 SW.Hell Blvd.Tlpord,Oregon 97223.819! J§03)46Pi/1171 DATE ISSUED: 10/0.3/94
PARCEL-: 2G 102 DD--01()00 �
STTE ADDRESS— : 08514 SW MERL.YNE CT
SUBI)IVIS.IDN. . . . : FINLEY F'ARN. ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . 003
--__-__-- BLJILDING
_ -_-- - --
REISUE: DWELLING UNITS-. 1 BASEMENT Sfr"'__
G)
CLASS OF WORK. :NEW BEDRMS:2 SATHS:2 GARAGE. . . . . . . . . . :3,99 sf
TYPE. OF UIi . , . ;SI" FLOC R AREAS- -- ----- - - REQUIRED SETBACKS-_._.___..___._
TYPE OF CONST. :51\1 FIRST. . . . : 1213 sf LEFT. . .-8 ft RIGHT. :6 ft
OCCUPANCY GRP. :R i SECOND. .. . :0 s f FRONT. .4.'O ft REAR. .
STORIES. . . . . . . : .1. F I NBSMENT:0 5f REQUIRED-------_-_.-._-___--__ -t
HEIGHT. . . . . . . . : 1.3 ft TOTAL------- - - -: 1213 sf SMOKE DETECTORS. :Y
FLOOR LOG1U. . . . :40 psf VALUE. . . . . $ : 84925 PARKING SPACES. . : 1
Remarks : PATH ,3
PLUME INN - - -___---_._. -------------------
G1NIJINS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . : l -------
LAVATORIES. . . . . .2 WATER HEATERS. . . : 1 TRAPS. . . . . . . . . .
:0
TUB/SHOWERS. . . . .. LAUNDRY TRAYS. . . -0 CATCH BASINS. . . . . . . .o
WATER CLOSETS-2 SEWER LINE (ft ) . :0 GREASE TRAPS. . . . . . . :ib
WATER L.I NE: (f t ) . : 10v.- OTHER FIXTURES. . . . . .rJ_i
GARBAGE DISE='. . . : 1 RAIN DRAIN (ft ) . -0
WASHING MAC H. . . : 1. SF RAIN DRAINS. . : i �
-------------- MECHANICAL - __..__-_________.______._..._...__ - FEES -
FUEL_ TYPES-•----------.-.-- UNIT HTRS. . :0 type amount - by date - -- r-ecpt _- -_ ►.
/GAS/ / / VENTS . . . . . :0 TIF $ 1550. 00 JF 10/03/94
MAX INPUT:O BTU VENT FANS. . -.3 BPRT• $ 388. 00 JF 10/03/94
FURN ( 100K . . : 1 HOODS. . . . . . e1 BPLC $ 252. 20 JF 09/20/94 94-256958 ,.
FURN ) -100K . . -0 WOOUSTOVES. :O B5PC $ 19. 40 JF 10/03/94 --
FLOUR FURN. . . . .0 CLO DRYERS. : 1 SSDr $ 280. 00 JF 10/03/94 k
BOIL/CMP < 3Hr :0 OTHER UNITS: 1 PARK $ 500. 00 JF 10/03/94 -
GAS OUTLETSei MPRT $ 40. 50 JF 10/03/94 -
(Jwnpr: 9, 10. 13 JF 10/03/94 -
TIM MIl_t_E R M5pC $ 03 JF 10/03/94 -
13027 SW TIMARA LN 2BTH $ 195. 00 JF 10/03/94 -
P5PC $ 9. 75 JF 10/03/94 - y
TIGARD OR 97224 EROS $ 40. 00 JF 10/03/94 -
Phone #: 598-8574 ERF'C E 13. 00 JF 10/03/94 _.
Contractor: _____._________.__._.._.__..___ tiC $ 13. 00 JF 10/03/94
TIM MILLER
13027 SW T I MARA LN
TIGARD OR 97224
Phone #: 598-857'1
Ret) #. . - 64687
$ 3313. 01 TOTAL
This permit is issued subject to the r•eyulations contained in the -- --- - REQUIRED INSPECTIONS - - - --
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/for.lnd Insp Fireplace Insp
applicable laws. All work will be done in accordance with approved PC it/Beam Strutt Gas Line Insp
plans. This permit wiil expire if work i- notante w :n 180 Posit;/Be,•am Meehan InSUlation Insp
days of issuance, or if work is suspended fnrpXdays. E'lm/r_mdslab Insp Gyp Board Insp
E'I_M/Underfloor Rain drain Insp
F'ermitte_�p fa:ignCat�lre : _ Mechanical Insp Water Cine Insp
_
Iss,_1ed By : Plumb Top Opt Appr/Sdwlk Insp
F'� � r-amin Ins Mechanical Finan
Cal 1 for inspection 639--4175 f
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CITY OF TIGARD SEWER CO NECTION
r COMMUNITY DEVELOPMENT DEPARTMENT PERM I T
13125 SW Hall Blvd.Tigard,Oroyon 07223.8109 (503)630.4171 PERMIT #. . . . . . . : SWR94•--0326
63") -4171 DATE ISSUED: 10/03/94
PARCEL: 2SI02DD-01900 �
SITE ADDRESS— :: 06514 SW MERL YNE CT
SUBDIVISION. . . . : FINLEY PARK ZONING: R--7
BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . .00:s
- NAME . -------------------.-----------.----------
TENANT . . , k
USA FIXTURE UNITS. .
CLASS OF WORK. . . :NEW DWELL I NG UN I TS. . : 1
TYPE OF USE. . . . . :SF NO. OF BL I1 .21I NGS: 1
INSTALL TYPE_.. . . . :IILISWR IMPERV SURFACE. . : :of
Remarks: PATH B
1IM MII._1_F_'R type amoi_rnt by date recpt
13027 SW TIMARA LN F!RMT $ 2200. 00 JF 10/03/94 -
.1N`il-{ $ ;35. 00 JF* 10/0:3/94 -
TIGARD OR 972: 4 R
Phone #: 598--8574 {
L:ontr-ar_tor; _._._._....____-_.___.—_—___--_-_____
(--Oh1TRPCTOR NOT ON FILE
2235. 00 TOTAL_
11eq
- ---- -- REG?UIRED INSPECTIONS
This Applicant agrees to comply with all 0e rules and regulations Sewer Inspec2tinn
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 iii all directions from
the distance given. If not so located, th insta le s 11 purchase
a "Tap and Side Sewer" Permit and the A y 11 a lateral.
G'ermattr?e 13i.i.ri,a+:; �.
i s _r e d 13 y : ✓_..._._____.__._.
r' Call for, insper_tion - 639-4175
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Residential Building Permit Applications , .',' •
City of Tigard 00, i
13125 SW Hall Blvd. "
Tigard, OR 97223t,kN,r.{ •
(503) 639-4171
Jobsite Address: _ •
Subdivision: .— ,I a ``Y Lot# ,0 Office Use Only �J
Planck/Rec#
Valuation: 1� pQ/J '�--
Permit # M 71 3 lc z
Corner Lot? Y N —
Flag Lot? Y N Reissue of
Map & TL#
Owner: %'� I 411116"A — Approvals Reg ulred
Address: _— -- Planning,/r,,
J"
n / - Engineering
Phone: / L( " 06 Other
Contractor: ✓ C0,5 • Items Required
Address: �. — Subcontractors
-- Truss Details _
Phone: _ �I��� 1`�-!�� Other —`
Contractor's License #
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors:yl ( Architect/Engineer:
Plumbing: 1�`L �(. h� I,�l Lv�. 1L\ Address: _
\./Mechanical: 14 c
(attach copy of current OR Contractor's Lic e)
Phone:
JOB DESC PTION:
<:�;-z-j—
_Anpl4afit Signature & Phone number
jReceived by: _ �— Date Received: _
N NW0POIC0MDMRFSAPP
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71
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Permit# Account Description Amount Amt. Pd. Bal. Due
Bldg. Permit (BUILD) 3
Plumb. Permit (PLUMB)
Mech. Permit (MECH) dlo,yv
State Tax (TAX) 3/•I b, ,� 3/ l y ✓
/ r►
Bldg: IJ
Plumb:
Mech: - 6 3
J
Plan Check (PLANCK) ` �°Z,� �Sy, 12 -3341
Bldg: '17-11
Plumb:
i
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Mech:
—%-V2l -03 L Sewer Connection (SWUSA) 2-26,o
J
Sewer Inspection (SWINSP) _ -3 3 �/
I �
Parks Dev Charge (PKSDC) 5 y 0
Storm Drainage Chg (SDSDC) Z 1"
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) 1 2 U
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-O)
Water Quality (WQUAL)
Water Quantity (WQUANT)
Fire District (FIRE) /
Erosion Cntrl Permit (ERPRMT) Ll 41
Erosion Planck/USA, (ERPIAN) I / 3
Erosion Planck/COT (EROSN) _ 3__ "
TOTALS: 5 5�c1,k u 1 / 2 S v
V�
r4+ tW �w a b�sd K r '',
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xb,rti
AH at
PLAN CHFC RC FEES LIST °r 44 •
PLAN CHECK # -Y_3 _ PERMIT # DATE
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JOBADDRESS YS 14 J u.)�f Pi��n c r � TAR/MAP/LUT-2—}/U L.12 1.2_ 0l
SUBDIVISION LOT # LAND USE
rd �• �'v
VALUALATION N Z (f SETBACKFRONT 'U' REAR y U LEFT �' RICMT
WORK CRASS ,1, , HEIGHT TOTAL AREA
USE TYPB FLOOR LOAD a r,' 1ST_
CONST TYPE 5,11 HEAT TYPE G,.S 2ND
OCCUP GROUP '/Z-3 DWELL/UNITS 3RD
1{
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WCUP/LOAD # BED ROOM -� BASEMENT
# STORIES I # BATHS GARAGE
PERMIT # DESCRIPTION AMOUNT AMOUNT PD BAL DUE
11151y l BUILD PERMIT FEES l'
PLUMB PERMIT FEES
-- -- MECH PEFMkIT FEES ;,. 7) V
STATE BUI I,D. TAX(5t) _ / � y 3t , }
BUILDING,1
PLUMBING
MEC HIANICAL
PLAN CHECK FRES ,I(.z ,33 1 sy 12, 3 3
BUILDING -2S2, 20
PLUMBING_
MEC14INICAL
SEWER CONNECTION
SEWER INSPECTION
STREET SYSTEM DEV
STORM DRAINAGE SYS
PARRS SYSTEM DEV C,L)
EROSION PERMIT u u
EROSION PLAN USA i3 _ j 3
ERSOION PLAIN COT r 3 r 3
TOTAL
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City of Tigard Planck/Rec. #
1312.5 SW Hall Blvd_ �
Tigard. OR 97223 PLUMBING PERMIT APPLICATION
MECHANICAL PERMIT MINIMUM $25,00 PERMIT FEE + ST. SURCHARGE
APPLICATIONlzmmI _
Shell* Famif�ResldNtgv On!
Table 3A Mechanical Code CITY PRICE AMT
O 1 BATH HOUSE$140.00 O 2 BATH HOUSE$195.00
1) Permit Fee -0- -0- 1 10.00111 3 BATH HOUSE 5225.00- Fee includes as plumbing ra nits in the dwelrrg and the first 100 fer!t
2) Supplarnaital Permit 3.00 i of water service, sanitary sewer and storm sewer. Sea fees below. -
FIXTURI-'% OTY PRICE AMT
1) incl.ducts 6 vents / 6.00 ��.i Sink - / 9.00
umoco-T1Rr,MIMT«`--- lavatory , ._ 9.00
2) incl.duces b vents 7.50 Tub or TublShowmr Comb. 9.00
Floor urn�O° -- Shower Only 9.00
3) itch vaex 6.00
w eater Water Closet 9.00 J y
4) or Scor mounted heater 6.00 Dishwasher / 9.00 �>
« not M.m - -T Garbage Disposal / 9.00
5) appamwe per 3.00 Washing Machine 9.00 c
w of hea-C^j.ratn9- Floor Drain 9.00
4) 000lk .absorption unit 6.00 Water Fbater 9.00 c
Uoder Or corny, pump,air
7) to 3 RP*+sore unit b LOOK OTU 6.00 Laundry Roam Tray 9.00
Boiller or . iiii Pump,ar a-3ix - Urinal 9-00 -
8) 3-15 HP absorp unit to 500K BTU 11.x+0 Ods Fixtures (Specify) 9.00
or comp.beat pump.air cond. 9.00
9) 15.30 HP obsorp unit.5-1 mi BTU 15.00 ---
w�pump.air ___-
- 9.00
endeir or comp.
10) 3050 HP absorp unit 1-1.75 mi BTU 2250 -- 9.00
I Boder or camp.beat pump,aur�i .- Sewer 1st 100' 30.00
11) >50 HP absarp unit 1.75 mil BTU _ 37.50 Sewer..era.Addit. 100' _ 25.00-Air MndkV unit to -
12) 10,000 CFM 4.50 Wafer Service 1st 100' 30.00 c.
Air x und ---_ '-"- Wa1w Service ea.Addle. 200' 25.00 __--
13) 10,000 CTM+ 7.50 - S 6 Rain Or 1st 10(Y 30.00
14) evaparals cooler 4.517 Stone b Rain Drain Add* 1 NY 25.00
- Mobile -
on n con nee - Mobileh� - 25.00
-
15) to a sirglo duct 3.00 ---
en system no - Back Fiow Pre%vfn tion 1
16) incMxled in appliance permit 4.50 Device or Arkl-Pollfion Device 9.00 -
- Hood wvwd by - - '-- - - Any Trap or Waste Not
17) mechanical exhaust 4.50 ` ,I) Connected to a Fature 9.00 --
Cornmercial or ikkistnal Catch Basin 9.00 --
ie) type incinarabr 30.00 _ Insp. of Exist Plumbing 40.001hr
er i.e.,woods water - Ay R�e3� 40 001hr
19) heasrr,solar,clothes dryers,ale:. 4.50 -
---- - ons
Rain [rain, sigh famUy dwelling / 30.00 .T ,
20) Gas piping one to bur outlets / 2.00 Residential backflow prevention
devices 15.00
21) More than 4-per outlet
•(Exrept res/den8al backflow
- preventeon devices)
Minimum Foe$25.00 SUBTOTAL l v
- •NUnimum Foo (25.00 SUBTOTAL
5%SURCHARGE (� _
PLAN REVIEW 25%OF SUBTOTAL /I / S%SURCHARGE
TOTAL PLAN REVIEW 25%OF SUBTOTAL
TOTAL
Special Cnnditions
Date issued - _! -by ---
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WOW. a HILLER, TIM CONSTRUCTION GASH AMOUNT a 0. 010 •
Ir•dttl)f3E�',f t PAYMENT DATE.
SUBDIVISION t
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I1'UHF'OSE OF PAYMENT AMOUNT PATI) PI.JRI=(A,F.,. CIF PAYMENT AMOUNT PAID
1_i)NNC3 P-E M 4�^M 4•-0 364 :31.313. 00 PI UMB I NO PERM � 1195. 00
LI",HANIC;AL. PE. 40. 50 ST. BUILD PFR
F,I...AN CHI-J"K FF: 1. .3:3 SP.'WER USA SW1394..,,(A;326 c."2100. 00
NE-3PF C:1 35. OLA I-'ANIS'•, SOC„ 500. 00
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