12723 SW SORREL DOCK COURT eb^
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12723 SW Sorrel Dock Ct. '—
{NSP—ECT;UN NOTICE
E
G�Z �--
City of Tigard Building Department
P.0 Box 23397
J Tigard, Oregon 97223
U �r Phono: 639-4175
Type of Inspection
Date Requested
�_ l Time.— A.M. P.M.
–�
Address Permit
______cam--�–�-- -..- '�
_ Lot #
Owner
Buildi/-)d-- —
The following _ ilding Code deficiencies are required to be corrected:
Prestinted to Approved
Inspector / _ / ------- –� Disapproved
Date _ 7
CALL FOR RF'INSPECTION
1-7 Yt-3 0 NO
CITYOFTIOAffn 1,:,E"R N]1'
CITYOF',WARD r.:1" . P t 0 J.0 1`3
COMMUNITY DEVELOPMENT DEPAUMENT P,L-1VJ(-51 0 t03
4,1126 SW Hall BMI P.O.Box 23397.Tlgafd,Oregon 97221(to,))M4475
'C'
1)R Pv, 2 7 2 3 I-W 0 R R E.L. 1)0 GK UT
s 1.)D DT v I:El)Y 0 H.
........... ... . ......... ............... ........
(,'L 013S OF' WORK. -.ADD GARBAGE7 1101411 E I-1011E, SPr4(11E.,E;.
1 Y 171 E (:l F U C,)1'::.. W013HING 11f)CH.
'
OCIC'UPANGY GRP. R,.-' FLOOR TRAPS.,
S1(: RI E".). . ., .. , . . YWTER HEATEF�13. . - - -- LA*I'C I I E.(A 0)1 N13,.
F''IXTURE15— LWJNDRY 'TROYEi- SF* RWIN ')RW[W),.
'3 B., . , 11R�
, 1NKI-3. URINOLE (3 'TRAP<
L 0 V 010 RT E CYTH E R F I X"T U R L�i-
G)EWER (ft:)
WA'T'ER CLOSE'T'S. W P`14'1R LINE (-H;I
D I 1:31AWWRIERS. Rf)I'll *)RO 1.H (ft:)
F*E:.(7 U
C)W 1.) .......... ............
RIJ.1l.-H11;D YWIO Y 11 F., inl(-Kkvit by (iAte e C 1.1 t;
ti`!723 $3W 'i0PREA. D01',K UT PAYM $ 1575 JI-11 06/19/90
P R M'T $ 1.5. OP.)
1* q� 0. 75
TH.'41RD '1N 91223
FI;ic)vit? W- 6,44-7294
C;c)vi-t-r at(:!t(3-r,.. ................................................................................................
0 W N E,R C 0 1,11'R A(,.;,Y*0 R
........ .... .. ................................... ..........
R f.7(.4 t.)I 1�1:7 1) 1:N Si i;, i o N s
This permit is issued subject to the regil',ations contained ir, the F:*JnAl Tvlspec'tinll
Tigard Municipal Code, State of Ore. Srecialty Codes and all other ....... ............ ...........
applicable laws. All work will be done in accordance with ............... .........
approved plans. This per%it will expire if worl,- is not started
within 180 days of issuance, or if work is suspended for morp ............................
than 180 days. ............................
............... ............. ...........
m 1.t t 0 .......................... ...................
............
-k f'e
is si IF,k.k e(I P ...............
a 1 .1. f o-v J 11Is pet iari 6................................. ....................... ......................... ...............
3 9 4:1.5
----- ------
CITY OF TIC ARD PELEIPT OF PPYMENI RECEIPT tAL 00-20152o
CHEC�l APIOUNT
NAME g YAND, PICHARD CASH AMOUNT a 01 00
ADDPESI'."i c 12723 SW SORREL. DOCf: CT r(Avm-NT DATE-' s 06/' I1e'90
SURD I I S 1014
TICIARD, OR 97227.- SAME
PURPOSE OF PAYMEN1 AMOUNT PAID PURPOSE OF F-'AYHENT AMOUNT FP41)
9 o-a I a s"T f�—Lj"i-c 6, i
T-VICLFLOW PREVFNTION DEV;(-F'
101AL F011XJNT FAH) 15. P
f CITY OF TIGARD
PI ,t 1M 131 N(� PERMIT ', � 13125 SW HALL BLVD.
P. O. BOX 23397
Applicants imnt hold Oregon Registration to conduct a plumbing T I GARD, OR 9-7223
business or mrlst hr property owner/operator not hiring outside help.
Nee.,.r><c 4,veblxrwn# _ (5 0 3)639-4175
Plumbing Permit No.
__ (( Doscnpbkxt
ORS 614-21.610 DUAN. PRICE AMI.
ap.
Joh Tar lel MNo.
Mf tree• FIXTURES -
Ld Block etrrttdivlslon Sink 7.50-
-- F�IameTk,r�kame a tskness lavatory -- 7.50
RIChtVd YM1kl `--_ TuhorTuWovrerComb. 7.50
Alar rnq esa 1- Shower Only 7.50
Wat�� — 7.50
0--ler City/Stale — zip ---erCbsel _ —
Dishwasher 7.50
�,-
.J Garbage Disposal - 7.50
Wasting Madune 7.50
Name
g01/y1� Floor Drain 7.50
MaT,ng—Address ------ Phone Water Heater - __7'50 —
• _ ---- Laundry Room Tray -- 7.50
Occupant Cify/State - zip Urinal 1•50
Name —'p one Other Fixtures(Specify) -- 7.50
7.50
ress - P1 w+ 7.50
— —�—_
Contractor CMylState nP -. Iso
MISCELLANEOUS
—1-- City f3tre.Tan No Sa e•1 st IW 30.00
Sewer-ea.Addit.100' 15.00
-
ritete o. tele s �x R�
(Res2ential) Water Service 1st 100' 20.00
Water Serrim aa.Addit.Or 15.00
1 hereby acknowledge that 1 have read#his application.the the intokmation —
9K-en is correct.Utd 1 am regisiered*ith the State BtAdaf s Board,and also Storm a Rain Drain 1 st.100' 30.00
lows a State Pknrr"ng lk)en. that the nkxntms given rue oared.that all Stam 6 Pin Drain Add t.100' 15.00
pkum:tirtg work will be dee in accordance with altpraceble pro-k-d uro -
gnn Revised Statutes Chapters 447 rand 693 and a Wkmbie orales and that mobile Horne Spm -25.00
no help wri be enpbyed unless licensed under ORS 693.(if exempt fnxn
State registration.please give reason bebx). Back Flow Prevention
FKWEOWNERS-1 txxeby certify the 1 am the owrtar Of tlM property k1n-
Device or Anti-Pollulion Device 7.50
scribed above.at whit+bulbs I pnVoje b make a plkrr"tg irntaHetlkx1 kx Any Trap or Waste Not
my owtom end this property is rxrt tekV ccxastnxsed for sorb.lea set a rerH Connected b a Fixture - 7.50
n
Catch Bruin 7.50
kup.of Edet.PkxnbkV 40.00 Por Hr
Specially Requested Inspections 40.00 Per Hr. _
Rain Drain, 1500
Sinyle Pam. Dwlq. —
•AUTHOFiIT_ED SIGNATURE --- - -�' -- Dat"
Deembe work new K addition[) alteration❑ reps'. I 1
19 be dome _ rosidentiul non residential __
MINIMUM PERMIT FEF. 25.00 vis
E�dstklp use of pp
SUB-TOTAL �) U 0 ,5
P use of 5% SURCHARGE _ •7
ter (Wp/opetty__ _L___--- --_..----- --_ - 2 5$ Pl'.AN REV 1 E W _ _
NOTICE: _y_. I----.--TOTAL a � �� /S.
This puff*b000mse nuH k a and Wold N woroonatruadon a thodxod is rant(xxn
merged wMhlrt t W d-)ytspr w oerwhtactlon a work V sWpwlad or alMrxkx+nd w a
s()snarl nr 180 drys d any Nmr dln'Wotk Is 00rrxr`6mod
tt!'fcxAt 0(wtX110"s _ -
Uatn Intuml - - - __ by --
I
z..r3f2' '4,t,�.. •.,.=.idYYiY',i ,?_�+•'&,LRt5 ,,+ ► fz `tit,� ••,iw,"°�_vy
f x't qL`t 1 + 4, Ar
a;•'riw� 4 ''h''a i1���. ;.•`� `~ `J
X-f IE OF OCCUpA,,VCY
All
CE
-k CITY OF TIGARD ► ;�; � ;,
t OREGON
Owner: Don Morissette Permit No.891126
Address: PO Box 19524 Portland G.< 97219 s41
Building Address: 12723 SW Sorrel Dock Gt. ,
Occupancy: R3 Land Use Zone: Bldg. TypeVN - s
Comments:
8th March 90
Certificate is hereby given this day of , 19
" that said building may be occupied and that it complies with allE�
requirements of the Building Code for the City of Tigard, as approved
t
by the Tigard City Council.
/64
1.tr�
�.= �•pit
Fire Dept. Building inspector If
c \ '� a1ef
. ' Building Official ,rl
Post Certificate in Conspicuous Place
k'�"j� . . .,. . � t � - '� F� r U •y3-„-� .�A
i
n:., �r •v .. r r-=4.as t••AV
'
( F �'Ar4:s �r t a • 1..,:it"`7 M$.,L .1`iC, F=t•iy1;1x: 'C`.drI(•af 'a .1' ja
�.. ,, � 4�r �.. '„Y� � .� Yw � -!'' �J `,�- t� '�.. b..rcFF � a• �c s .a� yR�`� C�.7 ,t. Vg�.r"
"ww'�.�^'a'F••y—yO a � �`t1d.,... :�"8r.. 'b•.r. Y , �'w k'Y�'2!v3K'� \
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _ ..
Date Fieq;jested Time A.M.
Address _ � � �� Permit #�
Owner _ Lot #.,
Builder __���J�=�J — �ZA�Ge!►�1'.G-TlC _. —_
The following Building Code deficiencies are required to he corrected:
1
Presented tooApprover'
Inspector r �_I Disapproved
Date .� V
CALL FOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 6394175
Type of Inspection - ----- - -
Dat,- Requested—3_-,-.A — _ me A.M. __,>S. P.M.
Address //T Permit
Owner Lot #
BuilderThe following Build in Code eficiencies arererequired to be corrected:
i
33
iol-j
-- �--- _
M
1 --
Presented to ❑ Approved
Inspector __ lsapproved
Date — � 90 —
CALL FOR MYSPECTION
❑ YE• ❑ No
No
INSPECTION NOTICE
City cf Tigar,; Building Department
P.O. Box 22397
Tigard, Oregon 97223
Phone: 639-4175
Type of nisi-ectic.. —
Date Requested 3� ` � , Time � A.M.._ P.M.
�
Address ��t 7 .Az�/L/— Permit #
Owner -. Lot
Builder __-7 L6!_a2
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector _ V Disapproved
Date J -z—
CALL FR REINSPECTION
L YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department r'
P.O. Box
Tigard, Oregonon 97 97223
Phone: 639-4175
Type of Inspection _
_--��
Date Requested_____.� `� � —�►----- Time..—�~M. P.M.
1,&—, Permit # 2'&
Address
Lot #
Owner-
Builder
T!w following Building Code deficiencies are required to be corrected:
_ ❑ Approved
Presented to —
[J Disapproved
Date
CALL FOR REINSPECTION
)/—YFS ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 9722'}
Phone: 639-4175
Type of Inspection
Date Requested__ Time ���A.M. P.M.
��' ��) Permit
Address # tL`
__ _ ,��" -
Owner_- Lot #
Builder —-. _}l_r— ten<.:�The following Building '-'ode deficiencies are required to be coirected:
—
Presentedto — pproved
Inspector _ Disapproved
Date �41 �-- ---------- —
CALL FOR REINSPECTION
❑ YES 0 NO
- �rrr
INSP C ITE ON NOTICE
City of Tigard Buildinc Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Tyne of Inspection
-� Time A.M. P.M.
Date Requested -1—�----
Address o
Lot #
Owner
Builder
The following Building Code deficiencies are required to be corrected:
- _ Approved
Presented to - "—'
Disapproved
Inspector Inspector —
CALL FOR REINSPECTION
[] YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 972?t
Ph ne: 639-4175
Type of Inspection -�--� -- — — —
Date Requested�=Z Time A.M. _P.M.
4dc1ress _ �" . Permit #Owner Lot
y, _ Lot # �_—
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to L1-9pproved
Inspr.ctor ❑ Diteppreved
Date
CALL FOR REINSPECTION
❑ YEa ❑ NO
INSPECTION NOTICE �7 j
City of Tiyard Building Department
P.O. Bou 23397
Tigard, Uiegon 97213
Phone: V94175
Type of Inspection
Date Requestad// —• L "��' Time A.M. P.M.
Address _1 -�_ _ Z•2�� Permit # �, _
Owner Lot #
Builder
Thf, follov ing Building Code deficiencies are required to be corrected:
i
-------- --
Presented to _. t(Approved
Inspector — [� Disapproved
Date
CALL FOR REINSPECTION
0 YES 0 NO
INSi'ECTION NOTICE
City of Tigard Building Department`/ ✓�
P.O. Box 23397
Tigard. Oregon 97223
Phone: 639-44175
4CGc _-------
Type of Inspect..ion
Date Requested P.M.
– ! Time_ A.M.
Requested_– —
�7 .Permit #
Address __ _ --<-
_ _ Lot #, ------•
owner
Builder
The following Building Code deficiencies are required to be corrected:
--- --– – -
------------
-- - s _�------- ---
y
❑ Approved
Presented to _------ —
��j� Disapproved
Inspectcr
Date
CALL FOR REINSPECTION
❑ YES 0 NO
IN.,PECTION NOTICE
City of Tigai.t Building Department
RO Box 2339;
Tigard, lregon 972.23
Phone 639-4175
'y
2
Type of Inspection OF
Date Requested
7 �U _�/l A.M. P.M.
Address � — Z permit
Lot #
Owner --=-
Builder
TF1 fp40lowing Bwldin C dei �eficiieenciies are required to be corrected:
14
Presented to �� ---- — — t T Approved
Inspector _ ❑ 7isapproved
Date _ ---
CALL FOR REINSPECTION
C=] YES ONO
\w lWr I• W W- W- W s lllq
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
(i✓_ Phone: 639-3175
Type of Inspection �EtP;K-21 E l
Date Requested ate_ A.IbI._ P.M.
Address --z Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector '�
p ❑ Disapproved
I
Date
' CALL FOR REINSPECTION
❑ YES ❑ NO
PL RMIA,
�I� OFTIIFARD CITY&'IM- 11111) I-*,I;-.*1:4M:LT NO
W
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd,,G.O.Box 23397,Tigard,Oregon 97223,(503)639.4175 I)A*T*F:: ISSUED: 0/21./69
C.M . F'
M.Tr.. 0. (39t126
EA 39030
U 1)11 pr 5 S sw 5(:)Ijr*-A- DUCK t;T USA NUMI-91
*TAX MAI:)/L*.'.U*I' 1731. 33AD 141000 91.1B: SUMMEPLAKE. L T P.I HK
LAND USE
LAIT LUZF:
SF.(:,T I ON: 33 T'WI'G I ING-. tw
WORK ('.L-ALj'-.) NEW
tPiVE 'T'YPE::: !:).LNGI,E FAM11 y
ri i f i a d
I'he i&r.)P3Ax'at.l-%t with 90.1 atlid I -0-0--tAL)l cif then 1J
I'l-Iff tt3tat].
Sewer&ga Agency p(,Il-lni.t mxii:)irc!;; U.*�o (ip.Lyla fl--j:jla ttle A.%mmed .
4kilnLik1vit piltiji w:l.].'L 1:)e -F(:irfeitricl J1.4' tIlk-1 1')fml-'MJ.t 0PX4iil"V.j-:j . *rhe Agerlciy dcleei licit (Wo.r
i1irittee chc4 nc^c^urp'.(:!y cl-11 thvlcic-IwticlllIf tho! !tie-WPI" J-%
.1.Ilk,t vi .
, fc-�et J 61
licit Ijc�iitte�d lilt 11.1'19± giveill , thf-,� J.1-1vita-LIJer %ha*11:1. PI-4:11"WeCt
iall. t1ireic.rtli.ari% f",C)", Zj-j*-4 tj-je
. j:j:j.lstaLrioo givoiri . T-r ix)t !:;4:1
P -ii cl l:)nl--jjjit fil,ricl thei AqV.l1C.y w:i.*l I 11-istn'l.1 P1 liiltkpl•ial. .
LlI I-j;IktIj*j ilk —j'au Pat Side 5
INS'TAL.L. - TYPE BUTA L)IN(a SEMEP 'l*M1,I:-J4VT(')l.J!:i AREA :
r:'.1 X*TUPE: LIM:TS
r)t4v'L.1 T N"s UNI.TS
t,l 11:07 13 J...r.)
0 F E-E
W nm:r i, $
N M S 5 E:'T"T E DON Fi "
E p13 BOX 1.91.5p4l UINNE(�TTON C.HAIPME $1. 250
R p u r t 3.ck n d LAAF. TAP 1NSTALL .
Ol T 1-11x.P
C
0
11 DON
T .
R DDONM(:)P*1'.'-5Yi.:
J'*T*F: Bk.).1A-1:)El:V;i I.N(:, .
A p
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T p ii r t lat ii d or 197 P 1,9
0 PHONE (503) P-M-931-1
R I 'IL U FAL. 1. 2 0.5 0 0
This permit 18 ISSUed subject to the regulations contained in Title 14 P"XEIPT NO. 1j)tS—Z)q Z_
of the TIVIC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and RE:QUIRE—IM INSPECTIONS
odes and QUIRE -:LN
specifications and In compliance with all applicable c
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not started within 180 days.orilwork i9suspended or
nhanclooed for a period of 180 days any time after work has
"'om I shall be the responsibility of the permittee to assure
menceiL 0
all requir, �'pectl ns are requested approved
permitgn'ture
Issued By
Cr11 I- 1 OP J WAIL CI ].()N 639--4111-")
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITE OFTIGARDME1,'HANTCAL PEPMIT
CITV—Or TW'ARD V-11EAMI'T NO. M'E891154
COMMUNITY DEVELOPMENT DEPARTMENT OilooN
13125 S W Hall Blvd.P.O Box 23397,Ticiard.Oregon 97223 (503)W 4175
AT E.-: 1:G S-u E 1.) e/2:1.is)
TqTM-T)-RT-.N 0 0 9:1.1 E?6
JUl."! ADE)WESS : V.2723 SW !:iOP1:11;:1I EK.K."K CT
IA)( J.Lil 33AD 1 1000 S U H: 51 JM 11 f-:1 61':I L.Iti?1 Li K
L ANI) USE:
SIZE :
3. V EM N N0
W01PW U.-ASS : NEW FkJPNA(`I--' 0.00K 1. ALP HANDLP ',11.0
1JISSE". IYFIEK: SIWA..F: F:*AM1:1 Y I';1J1:%NAC.E 10010. ATP HANDI-P 10K
(',UN!5'Y . 'TYI:)E::: VN FLO(: P FL)PNACE E'IJAV' .11'.100LE.P
0 C C,ti P .(»P P . : A 3 Hl:::ATEJ:l VI-N1' F A N di
VEN'11 V E N'T . Fj Y S';'EM
BLP/ClOMP <3HP 1*101) '1
NO . STOPIES : 2 l3L.P/(`,(:)MP '.3---J.!iHIP 1W.11NT: PATOP( DOM
OWELL . UNITS : 1. 13L.P/(':(:)MI':' V5--30HI:-' J:N(�*ENIERA'11'011:2(COM
FILIF.A... 'TYPE, (.;AS DI.1:4/(','(*)MP 30-501-11P 11EPA. I.I.4 UN.l.* r!:i
MAX . INPUT' 1811-11/GOMP 1504-11-I1'3 UTHE-A41
DMPI4517 l`:,1P1N(*.; 0011 F:T*S 1
I.11GI-41 PIPESs'?
1,11-:MARKS :
0
IWI
NMO"':l*i''E,'T"rE UON PIE.1:4M $1.0 , 00
R
L 111.1 ROX :1.95P.Z1 PLAN REVIEW $1.0 . 80
j..)(3 1-t I a 1-1 cI FIX1111PIES
1 5 1 ATE. TAX
C CJ'T'Hl:::R
0
N
T
R BELA- Alii-7.ATING INCI.
A
1.5550'-sF PTAZZA AVI-:'.
I C,11 A(*.11KAMW-i OR 1.; 1015
01 PHONE (Z".$W-311 P -
4311.113-1
W9:14-1'63 PAI' I UN bJIIJ A47
This permit is issued subject to the regulations contained in Title 14 r2EcE1P'T* NO.
of the TMC, State of Oregon Specialty Codes,zoning regulations --,,,,•.•,--__
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance w th the plans and 111FIWILIT.141FA) INSPEL"I'llONS
specifications and In compliance with all applicable codes and GAS L.TNF.
ordinances. The issuance of this permit does not waive restrictive PO!3T & PEI A- 1011
covenants Contractor and subcontractors shall have current city ROLA311HI--I N
business tax permits This permit will expire and become null and F'TNAL
void it work Is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to Rssurf,
all required in76ions are requested 7andap ed
Permittee S Mo.
Issued By'
("AL.L. F-1:1111 INSPIEJ-TJON 639-11.1,!�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE? ABOVE
W
CITY OF TIGA RD PLUMBING PEAMIT
C I LT%YI=A M PI".14M1.1' NO. : PIL-891.1.53
.�TW 10
COMMUNITY DEVELuPMENT DEPARTMENT
'3125 S.W Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223.(503)639-4175
DOTE 15SAJED: 8/2.089
P141m , PlIvIl'y' .N-O. 891126
`J(')Ef AIRMESS : JL!723 SW SOPPE'l 1)0(!.K Ulf'
TAX MAPA-01 J-51 33AU 1/1000 SUD SUMME.PLAI,1; l..'1' 21. 8K :
LAND USE :
LOT STIE: :
.1. T Em N0 NO:
WOPW CLANS : NEW WATER (111-05LA, 3 TPAP
USE TYPE : SlAMAH'. FAMILY UPTNAL F-JI(FLAW PPVNT'P
CMNST . TYPE : VN I AVOPA1 014Y .3 'TRAP PRIMIEP
(A."CUP. (3114P. : 143 T11113 511-10WEA i2 GlAi-i'AGE: '114APS
DXF.-MWASHEA
(.'APHAGE.: DISPOSAL
NO. STOWEES : 2 WASH1M.; MOL*J-111141-". I.
[)WE:Ll... . LINIT'S : I LALINUPY TRAY HILA)G' , I)PAIN 11")TA
FLO(JP DRAIN
1:i114111< 5I:-*'W*.-A`4 (VA )
WATEA HEATEP (FT'
OTHER
0 F`EES :
W
N M(:)P15SE,TTF' DON PEPM-1-1, 0
E p(:1 IROX 195241
portlancl F XXTUMES
15TATF- TAX $6. 63
OTHEP
0
N '�HOEMAKE'A HAPOLA)
T '
R SHOF-KMAKEP 1 S PI UM81:140,
A
C p C) 1-MIX 2!50
T *-v::=t nr—,im d K tar 97083
0 1:"I-4(:)Nr--. (503) 630 7*728
R
I NU WPM- TOTAL : •135 . 1:3
This permit is issued subject to the regulations contained in Title 14
of the TMC, Stale of Oregon Specialty Codes,zoning regulations PT NO- 5712112-
and all othor applicable codes and ordinances, and it Is hereby
agreed that the work will be done In accordance with the plar a and PEWIRPE.D 1.NSPE-CTI UNS
specifications and In compliance with all applicable cores and PLP .UNDF.'Wil AR
ordinances The issuance of this permit does not wpl,'-c; restrictive F'11S
covenar Is. Contractor and subcontractors shall have current city WATFA I TNE
business tax permits This permit will expire and become null and 1-N.-8 . TOPOUT
void If work Is not started within 180 days,or if work Issuspended or
abandoned for R period of 180 days any time after work has RAIN DRAINS
commenced. It shall be the responsibility of the permittee to assure F I NAL.
p'If ticins are requested a approved
,111 required I 21p ted 0aa
PvrrniItV(, ,Vqnfure
Issued By
CIAIA- FC.",
SEPARATE PERMITS REQUIRED FOR WC RK OTHER THAN DESCRIBED ABOVE
A
-)EPM T'F N(*.) 6
CITY OFTIFARD COYIAIM H 089 1.J.i.
C �ilw
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: R/F-A,/69
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)639-4175 PRI,M.Pffy,.NO 891126
,10P ADDRESS : 127133 SW 511J Whit...
1 A MAr)/I.-(:)'I* IS3. 33AD 14000 SUB. SUMMERLAKE L'T' : P 3. Bl< :
LAND USE :
1 01' 5117F.'. : VALAJAI XIIJN: 81 ,304 S I.:.*T B A U 1.k 5
FIZON'. : 20 PL'AR: 7
WORK GI ASS : NEW DWEI I... .UN T.I'S I LEFT: a.0 q I wil, 16
USE I'YPE ; SING,1.1;' FAMILY N0 . '3EDR0(3MS : 11 U X'T .WAI L CONS'T :
(:(3N5*T . 'T`YPF: : VN N(J. BA'THS : N: 13 : E W
(XIL'UP .(.1"Al"J.. . 1:43 PP(J*T .OPENINGS :
OCCUP ,I OAL, N E W
'11 011'At. APEA: 1816
N(J. SI'(3PIES: Z2 :P,5 71, - IP-16 140OF UJNSI' : C FIFIE Pli-i"I"?
P0 2N1'.) 600 AREA SEPAP? PAIVD:
BASEMEN'T"? 31:11*.) : (XICUP. SEPARY WA'I*E0 :
MF:'ZZAN1:NF.'.:? SAC-A.M' 'I'
p-I.A301'.4 1 UAD ON P A 6 E 440 F 114 SI' PKI-417 ALARM?
FLOW 11 GPM) DE'TV(.T7 YES
Hr-.:A I* TYPE:: GAS 1-41)CP .ACIGESs-? cmw?
PLAN [,HEI:,K BY : j-1 t
REMAVIKS :
1-**A:5SUE OF NO.
LA5'T* 14EISSUE
F LES :
0 M(3PTS!ii EI'TE: IXIN PEPM11* $13)"? 00
W
N P BOX 19.81f,2tl PL.AN PEVIEW $2 A e.)
E13ta r t I m.n d fill FIPF DEIXT
R 51'A'11. I'AX 1 H
ff 0T,HI;-:,P
C DEVELUPMENT CHANGES :
o M(Jr1ISF-%E1*TF DON 5D(*.,11 S1,0PIVI) $f.*-',,-,30 00
N DUN m(3r4i55r-:i-1-F.:: FAYTI-DE.PS '.r.N(, %IX.'( -*1*TREE:'T) 111600 . 00
T
R 1313 BOX 11.91111r.'341 P1)11111 11 41250 . 00
C A 1.)ri I,V1.lit 1'%4:1 ar. 97,219 P11111PAII) < 41.00 . 00
T FIVIONIn'. (50.3) t'!414 9.510
0 NO. 35333 T1111'AL. : $1 640
R
REC�ETP'T'
This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Spe-isIty Codes.zoning regulations INSPFCA'IONS
and all other applicable codes and ordinances. and It Is hereby
agreed that the work will be done in accordance with the plans and FOUT 1.NG 5 F.:,.W E'..A
specifications a,id in compliance with all applicable codes and FOUNDA11:(3N WALL PAIN DrIAINS
ordinances The issuance of this permit does not waive restrictive PL)SI & BEAM WAI'F:r4 LINF`..
covenants Contractor and Subcontractors shall have current city PI, I4 UNDEPSPLA13 Cl.-TY APPPCH/SW
business tax permits This permit will expire and become null and 51-AB FT NAL
void If work is not started within 180 days.or If work is suspended or
abandoned for a period of 180 days any time after work t as PLR.
commenced. It shall be!ne responsibility of the permittee to assure F-411AMING
all required inspections are requested and approved F I RE VILAUK
GAS LINr-.'.
INSULA1*10N
GYP . 13(JARD
Permittee Ire
Issued By: ;;Ah.l: FOR 1;NSPF-64411411411 6a9 111175—
SEPARA'rE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
i
i
A /
C11DEVELOPMENTPLAN n CIIECK APPLICATION^V cmrortwartfl PLAN CHF_CK I1 COMMUNITY DEPAFITMEN-t" llV PERMIT N ( Z(.-,
/7175s.w.KAej d_P-o.eox13197.1y«do.eV3,n9=.(503)63"1T DATE ISSUED
JOB ADDRESS: ) 7 7Z:. -� ke— 5c)(La(i -i AX MAP/LOT /-S/ - 3 34-4 1'/,
C✓a IL.k LOT: -z- t-ANO USE:
VALUATION: _� 3t'
SPECIAL NOTES
OWNER
_ r I r o . !J �C REISSUE OF
NAME: : --
Z — LAST REISSUE:
ADDRESS:
C FLOOD PLAIN/
— SENSITIVE LAND:
APPROVALS REQUIRED
CONTRACTOR PLANNING:
ENGINEERING:
NAME: _v
_ FIRE DEPT
ADDRESS: —
OTHER:
ITEMS RE(rUIRED
PHONE: -
---- LIST/SUBCONTRACTORS:
AR(;H/ENGINEER BUS TAX:
NAME: _ I I� L ` t �� `l � -�� — ULATIONS:
CALC
—,_—
ADDRESS: TRUSS DETAILS:
PARKING PLAN:
_ LANDSCAPE PLAN: _T_^
PHONE:
• -- OTHER:
COMMENTS: �/� l (''G S or-
PERMIT 0 ACCT H DESCRIPTION AMOUNT AMOUNT p0. BOL. OUE
�
1U-432 OU Building Permit Fees �?��c' —
_. _
10-431 00 Plumbing Permit Fees -� 1 -�
Yu / 'U) 431 01 Mechanical Permit Fees
10-2.30 Oi State Building Tax (5X)
Building _
Plumbing --___fie Aoj
Mech .�)./1! _ t
10-433 00 plans Chkck Fee �•, ' --- �r -
Building
plumbing / Z. /L30
Mech
30-202 00 Sewer Conner-L i f. -�rTj�
30-444 00 Sewer Inspection j5
51-448 00 Street System Dev 0har-*3e --
52-449 00 Parks System Dev Charge (PD(.)
31-450 00 Storm Drainage Syst Dev Chrq
10-230 09 TRFO --•-
10-230 OG Washington County I iro ill (9 )%)
10-270 00 AmarL/Wedgewood "C` —
_ 1 OTAL
RFC
APPI-ICANT SIGNATURE IL l56 ,d 0
Received B y: X.�%t) Date Received:
cn/3587p/18p