13268 SW SHORE DRIVE 13268 SW SHCRE DRIVE
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OF OCCLT�,Arcy
CSR
j Y ` CITY OF TIGARD
OREGON
,.. Owner: Tan Miller Pe---ftNo. 6711
�• 1478 N. Sherwood Bl%-I Sherwood Or 97140 Addr=-gig.. _
Building Address. 1368 S.W. Shore Dr. _ t
Occupariev: R3 Land Use Zoite: R12PD Bldg. Type
Comments:
Certificate is hereby given this 15th day of October -, 19 87
,S.' that said building may be occupied and that it complies with all .
requirements of the Building Code for the City of Tigard, as approved
by the Tigard City Council.
117
1A V
Fite De'-pt Hull B or
C= �a7Cy j
^� Building 3,'Rcisi
A'+
41 Post Certificate in Conspicuous Place
--A �. — —
HGARIN PLUMBING 1.;y rd cit 97223 .tj.
l Y
ntiplicants must IsoW Oregon Registrationto conduct a plumbing PERMIT 639-4175
business(x must be gXopeny u^vnerluperalor nor hiring oulsidc IWIP.
Name cl De olopmerM - Plu-tbing Perm c NO _LL2��_-
_---.f�__---_,-__.--�--- pescrtptlon PRICE�-AMT I
AAdress { r 4
tY ORS 814-21410 CAJAN.
Jab Tax Lot Mop.No
Address _ __ __-___ FIXTURES _ ----
.at 7.50 7�
Sink 7.50
Lavatory 'xv
arthe wnanle � .—__ _ 730
�1 Tub orTuhJShowe(Comb
75p JJ
of ng Addresa s`)warOnty _� _
7.50
Water Closet Lz r
Owl er city/ tele zro --- - 750 _ -
Dishwasher
�D
Garbage Dispo6al r 50 7 J
_ .t 50
-- -- Washing Machine
--� Name Floor Drain y- - - 150 _
Water Healer
Mailing rash ----_--�� 750
Laundry Room Tray ^ �- _ -
r 7 5O
Occupant Oky/State Urinal -_ - -- -
7 50
- --- _--*-- a -- Other Fixtures(SPecity) -
1
?.SO _
7 SO
s __-____ ----- ---- 7.50
Contractor CtyrState
MISCELLANEOUS
- ---- -� city But Ta«No w+r 1 a 100' —_ �0 00
Se
----._-� .
e4wer-es.Addil 100' _ -- 15.00 -
_Mete 2(`.00 2 U
Water Service 1st 1l>D _ --__ -
- 15.00
tkxt that tsrt Inlormatbn Water Service as.Add1,_! ' _
1 thereby arAnow6KVe that tsaoe read Ihia fp. �O.00
gNen is sorted.#W I am neglelwed with dsa State PAAidert t)oard,"also Storm b Wit Drain t M.100'
have a Stale PMxbu
rtsy tycav a n that t» umitws givers arecorrectthat NI Storrs&P•yin Drain Addd 100'oumbwV _ _ 1500
work will be dune in w=rdsnce with MPPkA 4 MoVia-_-`d Of a 25 00
gon Revised Statutes Chwaiers adz and 693 and appea ble aides and�at I Mob"e Horne Spaoe
no tselp will be emplvyad txsless Wmwod under OR.`,643 (t exempt hal' Back FlowPreveltln
State registration.please liiVe reason below) Day"or AnI114 Akion Device ��
140MEOWNERS-I hereby Ow*that I am to Owrser d the PrnPMY de
.ort>ed above,M which tocatloet 1 prapoae to make a Ptur"V Asn lm Any Trap a W este Not 7.50-
my own tole and 906 PrOparh le not bskhg oarw&uc1et1 Ior eW.lease a rw,t CtxxsacMd b a Rxttxe_ -
7 W
Catch Basin -
- a0.00 PM Nr
-__ _ _---- - - - - kip.d ExMA.Pkunbing Hr
l n$P*c*ww _ _ 40.00 Per Nr
rJlsr o1 Plunbkq wttlhh 16.00 min
an Exlswtg --
AUTHORIZED SIGNATURE -- - -�
Dat"
New aft.or Build.Addlilor 16.00 rain
I 1
Describe work new[] Widition l I alter>ttlon L1 repel(n cirelli
bs bon - ---residentialnpn'f�slderrllal
e
l=xMtklp use OI �-
bugAlg or Pf"I'lY - - MOItIAlk"
U"
rA
bum a
arpmperty Td11Al %s
T ttls FWWTM Iya00Rnss evil and scold N work or oonaeUOatln atAt+orsr<ed M nd o"
ensesoed WAW 160 der 4w 9 oenrrt~or WCMA M SU PW%W or atWxkw d
a parkfd of 160 data M.WW Mna aAMr week is uonaedrmd
"VIOL L 0011111,1fT1o«.- -- _ _ DOW Issued " �- tri �1
f
CITY OF i•It / R D PLUMBING; "�� °� � Blvd.
Applicants must Fsuld Oregon Registration to conduct a plumbing PERMIT 639 7d C
R cf7223
Imsiness or must be property owner/operator not hiring rwtside heip.
Nance of Dew:opment - — -
i'lumbrng P,!rmcl No
Adrkesa— ------- `-----_T—
Description p R --
Z3 TS-t c oC11�(
OAS 814-21.610 QUAN. PRICE AM'
Job Tax Lor Map.No }-- --- -- -- --
I Address --
FIXTURES
t-ol Block Subdivision - - -
�in,
N(cr name of business) Lavolory A 7.50 U
Tub or TubtShower Comb y 7.50- 4"r)
mailing AkresA e, - 7.50
Shower Orgy ._- _ - _--
Owner GiryiSieio _ Zip J-- -- water Closet �- 7.50 2
Dishwasher - �- 750 1 ��
Phone Garbage Disposal / 7_50
--- Nemo
Washing Machine
750 7 X-V
Floor Drain 7 50
al king 1W.e,ss Ptsrx,e WelerHealer - _ - 7 50 7JZ.
Uy ------- Laundry Room Tray —�- 7 50
Occupant _
R C /State J Zip 750
Urinal _
Name p -FF mn-- Other Fixtures(Specify) ---- 7 50
7.50
-- Phorse- ---- - 7.50
- - 750
Contractor CMy/Slate _ T1.) ----
__ MISCELLANEOUS
Sewer Iat 100' - — 3000 -
tate s. o ar e�k. iers Bus o Sewer♦a.Addit.100' -_-- - 15.00
(Residential) Water Ssr*)o 1q 100'_ / - -2.00 L'
i hereby acknowledge that I have read this ap Acaftn tract the information Water somoe so.r ddit.2M 15.00 -
given is oorted,that I am registered witt,the caste Builoor's Board,and also Storm A Rain Drains t N.1(0' 3000
have a state PkxT**V keine that the .-ambers given we cared,that all -
pkrm!r sg snore:will be donne in aaoordan,e v fth appNceble provisions of Ore Storrs A P-Jns DrainAddll 100' 1500
g-Revised Strifes Chapter 417 or J e!o ale opp6able codes and than Mobile Home Space2500 -
nn help willbe empioyeo unbss W)wwed under OHS 693 (It exempt from �adcFlowPrevsrstior,
!;tib rogiWarlon,pbalw give reason babw)
M)MFOWNERS-I hereby owtffv time I am Use owner of Use property de Nv400 Or Ano-Pollution Dome — _- 750
ec tied six".at which looatlon 1 propose b make a pkor,-biny kwAs lab-for Any Trap or Waste N&. 7.50 MY own umo and this property Is not bskV onnsrrucsled".zr sale.base rsr rote CA mtocled b a Rxtkxs �- - - - _
Catch Baton 1.50
Insp.al FJM.Pk rnbkV— - _ -- - 40.00 Per Nr
Spedatiy iM4tMsted kupsc oohs 40.0 Par Nr
Aller of Pksrttsksg wMsk,
an Existing Bldg 15 00 syn
--- _ -- New Bldg.or Build.Addtuon 26-W"n
AUTFtOAlZEO SIGNATURE _---- - -------- -- i
Pain
e Lmnl -
Dserxibe work new I-] edditKsn( 1 alMratirx1( 1 rnpai I 1 dwelliuta I — 1S.00
bs done resklential non-nrsklenhel -- --- -- -- -_.__ --
EXIG&V use of
bulAdkV or prot?ertti' __-- - SUS-TOT AI v l'
too W, 4%S410HA N
b�u
.
N01WX ------- _-- -- ----TOTAL-_
Tine psmsM AsoortsM nuts arse sold N worts a oarttiauoaon rrJUsortiad M incl coir,
tlrterwed ttrlMdn 111110 dsrys w M oersalru41nm..►,ork M SUapersdsd a abarxloned Irsr
a 00 kX of 190 Mins at srsy Mee a11ar work M conlrrr4naed
11111PIdAL OONOMflOM_-
Dace I661,er1 _ _ � Z�_ 0 � by
____ ._-,_..._ _.`. -- i� I• �11Y Iii n♦,�,
` ULAN LHLLK NU. _/�•.�____—
L•
for inspections call 639-4175 PERMIT NO. I_
QATE. M.—� 2a,_�7 w-----
CITY OF TIGARU 6�9-�T71 ARI GREEN
TA%MA►
BUILDINGPERMIf —LOTHO. jIL21—suoorVISION --•
P.O. Box 2339i . Tigard OK 97223 _
___• _ lderIr Jae AooAE
OwNERTom MillerBui
�EXP.DATZ
Same SrATE REG.NO.
BUILDER _ --
625-•6157
BUILDER'S PHONE ______._ OTHER
------
<nl ht Design. _ PHONE
ARCjUTECT ,.��� ❑ OTHER O DEMOLITIOr,
STRItiTVAF U9 NEW ❑ R_EMODEL O ADDITION O REPAIR A C MOVE
GARAGE
O OTHER ❑ FENrt
[I�IiES1DENCE ❑ Comm ❑ Eply,ATION� C] IN() O I�EUGIOus ❑ qfAI _—
(N OUPA.NCY .w�LAN0 USE ZONE .
BLDG TYPE _ ,r" �—FIRE IpNE_ _"'�PUN CHECK SY �7J.a:-
C on s t r u c t s i ny I_e f am i I y d we 1
�► e-issue off P rm; �k
�I d u) ' baths-JL Q 000Q
t r ag_ s a aL� 17�ed-.- __ _. ��J
SEWER AREA �
PLAIAIT�,� --- T r M _--�ALLI 7
�f- -ANO,BEQ l00 5 —___.�-- -
OCC.LOAD_ FLO{IR LOAD HEIGHT Fq N STORIES REAR L� IQE "m Ic_piStUE,,��
_ --
6011.0_ING DEPP R1 MENT _ SEI'BACKS ^� �...�.
TNl5 PERMIT fS ISSUED SUBJECT TO THE REQULATIONS CONTAINED IN THE BUIU}INO CODE. AT THE
Pttrnll
THISAE(jPERMITS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT N
P'lanChock D IN COM
`�V-" WOx ALL AP CODES AND ORD HANCES. THE tS5 ANCE Or'ROANCE WITH THE PLANS AND SP -,'HIS PERMECIFjrAsONS IT GOES NOTWAIVE
WfT11 V HANTS CONTRACTOR AND SUB CONT,MCTOR^T1 NAVA CURRENT CITY BUSINESS
P1.Ca;.F" RESTRK-ME CA E LnuSr�O A 1 H EI�T1N0.
rAXPERmms.;L•PARATEFERMI �m �E
kat11REDFO $ R'
Slala Tax_ ssoc 'SOC— A K OR�GNT
Toles
Pt" 147B N. Sherwoo Blvd. Sherwood 625-61E�7
Prspdd� pNONI
Recerpl N° ADORESS
9a1.Due — 1 i —Approvod By_ ------
SSC ___ 5 �w�!
5 0 C - P b RECEIPT bPOC —
- DATE PD
AMOUNT PD._ _ �! -•-
SEWER CONNCC � ION 5 _ �•--
SEWER INSPECTION
SEWER SURCHARGE f
)f
nmIner,te ; ---
CITY OF TIGA,RD BUILDING DEPARTMENT PLAN CHECK NO. : S��a/�,/�.•
PLAN CHECK APPLICATION DATE RECEIVED: 2.r � a
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID!
This is to c:err _fy that the attached _ sets of plans have been submitted for plan
check pursua%c to the Oregon Structural Code and Fire b Life Safety Code, ` edition.
PROPERTY OWNER _ OW14ER'S ADDRESS:
CONTRACTOR: J.L_fTELEPHONE: _ 2-
JOB
JOB ADDRESS: 2- (P 1/32-5 LOT NO. 6 SNAP:
DESCRIPTION OF WORK:
Approvals Required SPECIAL NOTES
QPlanning Dept. 0 Reissue S q i�, �e (c-s
Q Engineering Dept. Q Flood Plain/Sensitive Lands
Q Fire District Q Sewer Availability '
QOther Other
Items Required
QList of subcontractors
r
QBusin,,ss Tax
0 Calcularions
�I 0 Truss Deta;.ls
U 'arking Plan
QLandscape Plan
QOther
CObWNTS
I
City of Tigard Building Department
BY:
%..i 1 v Vr 1111;iAN J Mr—t IANII.ML Vt.hiVll I9
Permit M __�V/'
Description
Table 3A Mechanical Code _ CITY PRICE AMT
City of Tigard 1) Permit Fee 0 •u• 10.00
13125 S.W. Hall Blvd. - _ ---- -– --- —
RO. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223 _-------- —
6.19-4175 1) Furnace to 100,000 BTU
6.00
incl.ducts&vents
2) Furnace 100,000 BTU + 7 J0 Co
incl.ducts&vents
Name of Development` 3) Floor Furnace 6.00
1incl,. I�e.e�tti
Job Address — 41 Suspended heater,wall heater 6.00
Address ( 2 (�8 , (� LQn._ or floor mounted heater _-
Tax Lot Map No 5) Vent not incl.In 3.00
_ Lot Block Subdivision appliance permit —
Name(o name oI busines , / 6) Repair of heating,refr ig., 600
�.G�--� cooling,absorption unit
Mailing Address t phone 7) Boiler or comp to 3 HP 6.00
Owner _ absorp,unit to 100,000 BTU _ _
GryrState ?ip -- 6) Boiler or comp to 3 HP-15 HP 1100
absorp.unit to 500,000 BTU
Nems _ -9) Boiler or Comp 15-30 HP 1500
r 0 absorp.unit 1/2.1 million
McIIIng Address phone 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million
ContractorCityiStete Zip — i 1) Boiler or comp to 50 HP 3t 50
absorp,unit 1,750,000 BTU
State Registration No City Bus.Tax No 12) Air handling unit to 4.50 T
10,000 CFM
13) Air handling unit T- 7 50
I hereby acknowledge that I have read this application that the information given is 10,000 CFM +
correct,that I am the owner or authorized agent of the owner,that plans submitted are in — —
compliance with State laws,that I am registered with the State Builders'Board,that the 14) Non portable 4.50
number given is correct. ,,exempt from State regislratkm piease give reason below, evaporate cooler
----- --------- Vent fan connected n
11_1 3.00to a single duct _
--- ----- - Ventilation system not
16) Included in appliance permit 4' 0
-- -- .-- 17 Flood served by 4,Ln
_ mechanical exhaust
Signature lowrtar or agent) Data1 e) Domestic type 7
50
Describe work U addition L7 alteration U repair F] incinerator _
to be done residential a non-residential U 19) Commercial or industrial 30,00
Existing use of type incinerator
building or properly �J 20) Other i.e.,woodstove,water 450
Proposed use of __ heater,solar,clothes dryers,etc
bulk. ig or property -_ _. 21) Gas piping ono to four outlets 200
Type of fuel - oil ( i natural gas Ill LPG [a oloclia
22) Mote than 4-per outlet
�4Il�E SUB-TOTAL 3/
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION
ON STRUCTION A.:THORIZED IS NOT COMMENCED WITHIN 160 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 411114 OF SUB-TOTAL t� 7
ABANDONED FOR A PERIOD OF 18U DAYS AT ANY TIME AFTER -- - -- ---
WORK IS COMMENCED.
Special Conditions
— - -- . ORta issued by (�u
BUILDING PERMIT APPLICATION DATE______ __. _. _,7s_�._ 4791
THE UNDERSIGNED HEREBY APPLIES FOR A PERMI r FOR FHt WORK HEREIN K.UICATEO BUILDER PHONE k25"_F I_Q
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLA NS Anlr)SPECIF'.3ATIONS. OWNER PHONE____> >�
LOT NO.___-- 421 Ari Gen.
OWNER Tarn Mil ier JOBADDRESS 1:32`68 SW :,tali'" Drive 1S133DA
R�3'i385 7(i - ,— � ARCHITECT --
347P N. SharwoM L.lvd. ENGINEER Kn3ght-75269-21i
BUILDER _ ADDRESS ^Smnannd OR 97140 DESIGNER —_
STRUCTURE UXNEW ❑ REMODEL 0 ADDITION f_I REPAIR L7 RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
_❑`.RESIDENCE ❑ COMM O EDUCATIONAL I7 GOL , ❑ RELI( I PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE UJ SLAB❑ FENCE
t — w
OCCUPANCY _..$3—LAND USE ZONE R12MLDG.TYPE -► FIRE ZONE---PLAN CHECK BY HEAT —
Conntruct Bingle fand ly dwelling w/atteas;head garage, sl.l per epprovle?d plans.
Subject to 95 code. -- REissuF or 6638 Sube jct to Amart $360 ,00
_DO NOMI' ENCROAC.II ON ANY CASEMENTS. NOP OtITLD rOUNDATZON ON FILL.
SEWER PERMIT M 3-1 4 G 9( 1du) 3 lie t h 10 ifliwe
-- 40
OCC.LOAD FLOOR LOAD HEIGHT _ N0.STORIES _ AREA NO.BEDROOMSVALUE _
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR_ 41 LEFT SIDE �' RIGHT SIDE 5
Permit 325.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUII DING CODE, ZONING
40.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HFREB, AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DGES NOT WAIV"-:
SUb•totai RESTRICTIVE COVENANTS. CO"TAACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMI fS RI'aUIRED FOR SEWER PLUMBING AND HEATING.
State Tax 13.00 51.
'""8.00 SDC- b . : � L
Total � U000 _
PD M PLICANTpRAGFN
BY dU pd 40.00 � l.`:y0.(1Q
AP— Receipt No.
Approved --
E _ue338.00 DRESS PHONE.
DATE INSPP, TYPE INSPECTIOt REMARKS PLUMBING [GATE
r— '7
"ontractcr/��
--Ff----
Z �� ��� Permit No. e,,, _
Rough-in
Fixture
Final
4.
Z
HEATING
G � –
O ��'r I — Contractor
—7_, k Permit No. S/ �0 6
Gas or Oil _ —
'�
Rough-in
Final —
SEWER
nn�
f� K� .� final
DRIVEWAY
Final-Y-�
Storm Drainage
(Rain Drei,i)Final
Sidewalk
Curb&Street Final
Approach
BLDG, DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final