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INSPECTION NOTICE
CAty of Tigard Building Department
13125 SM Ball Blvd. Tigard, Orerjur 97223
Inspection Line (Roc-O-Phono): 639-4175 BuLInaee Phone: 639-41,1
L Inspection'-- �-" ' * _L C
Footing 1 P" derelab Mecli. Rough-L, ApFr/Sdwlk
b9
Found. Plbg. Top Out Gas Line /FINAL:
Poet/Roam Struct. San. Sewer Framing ( -Bldg.
PoHt/Beam Mech. Rain Drain Insulation -Plumh.
Plbg. Underfloor Nater Lino Gyp. Rd. -Mach.
Date Requeeteds & e7 Time: AM _PM
Addrese: ���, e�d _
Ruilder:- � -�
THE FOLLOWING CORRECTIONS ARE REQUIRM
I`
_ C_. -- -- ----- ------—---—
I
Inspector: / Date: �
APPROVED DISAPPROVED APPROVED SUB.7ECT To ABOVE
----Call For Reinsp.
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INSPECTION NOTICF, r /
City of. Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:.__-_-
nspection:.—,_ r -- —
✓
o
Foting P1. Underalab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Goa Line FINAL:
Post/Beam Struct. San. Sewer Framing ` -Bldg. .
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Undcrfloor Water Line Gyp. Bd. -Mach.
Date Requested:- _ �Times� AM PM •
Address: arm
/1
Builder: yC� V, _ _ •
THE FOLLOWING CORRECTIONS ARE REQUIRED:
NJ./ 4 -7614
i
Inspertor: Date:^ ✓
APPROVED DISAPPROVED APPROVED SUBJFCT TO ABOVE
Call For Reinap.
i
4W
S.
�.
INSPECTION NOTICE I
City of Tigard But_.'-'.+g Department
13125 SM Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone;: 639-4175 Business Phone: 639-4171
Inspection:_ 17
_ �,� !"
footing ) Plbg. Underelab J Mech. Roush-in Appr/Sdwlk
' Found. Plbg. Top 'Jut Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mech. Rein Drain Insulation -Plumb. I
i
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Roque-ted: -7 7,2 7 �,� __ Timet AM PH
Addreea LG Permlt
Builder: �,'
THE FOLLOWING CORRECTIONS ARE REQUIRED:
t
7
Inepertor: r
_ �Svl\---- Date:_���`
'.-�--__APPROVE.: DISAPPROVED —__ APPROVED ,SUBJECT TO ABOVE
Call. For Relnsp.
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aTYOF TIGARD BUILDING PERMIT
CIRYOFTI�i4RD l..l(1vl1 1 #. . . . . . . . BUP'j;?-0.180
COMMUNE:Y DEVELOPMENT DEPARTMENT oamooM
13126 SW Hdl Bbd. P.O.Bac 23397,TOW,Oregon 97223(603)6394175
SI•fE 1=iDDPES:': 116,_7 SW L001TTA AVE PF-iR(-C=1_:
SULADIV'SION. .. . . : L_QMITA TE:RRnCE ZONING: R-4. 5
I'.. . . . . . . . . . .. I. OT. . . . . . . . . . . . . :0
REISSUE: FLOOR FaI EAfi _.._..__.__-..._.- r:XT1=_RIOR WAL-1- r,ONSTRUCTION--
C,LASS OF WORK. :ADD FIRST. . . . 1 432 sf N: S. E: W. i
TYPE OF USE. . . :ACS: SFC:OND. . . : s f QROTECT
l•Ya-,E OF' LON5-C. :5N "THIRD. . . . : s f N: S: E- W: i
OCCUPANCY GRF . :M1 TnT1=11_- --••-.--: 4..,c s f ROOF CONST: FIRE RET?
OCUUF'ANCY LOAD: BASEMENT. : sf AREA SECS. RATED:
aTOR. : 1 {iT. : 1c.' f't GARAGE_'. . . : f O(.:CIJ SEC'. RATE I)
BSMT?: MEZ Z?: RECD BETPACK5---___..-__ REQUI RE.D-.___________________.
F I...00R LOAD. . . . : p!5 i- LEFT:4 C t RGHT: ft FIR SPK1_: SM014, DCT. . : �
DWELLING UNITS: FRNT:x 0 ft REAR: 15 ft FIR ALRM: HNDICP ACC:
RE ODMS: LATHS: IMP SURF AC1=: PRn CORK: PARKING:
4000
remarks : C:onstr^1.1ct accessor-y pole stuct�rre. See VAR92-017115 for- set-back
approval.. tr1actur-e to be att-ar..hed to 1:Fira mian r••etsidence
FEES
VIRGINIA DALE type amo!_Int by daetN I'ec,,Pt
1162-1 SW LOMITA AVENUE PRMT f 44. 50 BCR 07/0//92. --
NLCK 8 28. 93 -- 06/ 19/92 228719
T IGAPD OR 97223 3Pf-,T $ a. 23 PC-,R 07/07/92 -
PIone #:
(:;ori t ract or:
1',CON-0--Fiala INC:.
1.995 SW 19c_ND
F'O BOX 620-1
ALOHA OR 97006
F='hone #: &49--'5454 75. 66 TOTAL p,',,
Req #. . : 51042
__.___._-• RE PW RED INSPECTIONS
-- ---This permit is issued subject to the regulations contained in the Foot/tol_u•Id Insp
Tigard Municipal Code, State of Ore. Specialty Codes era all other Fr^aminr( Irrsp
applicable laws, All work will be done in accordance with Rain cJra i n I n s p
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days.
f='rzrmittwe !�.;lranr�t�rr•fa : C�It:� �. ._...____. _
I s s i.t rad LAY
Cal 1 fare inspection - 639-41 '7
7ow"11-
1312.5 SW 11au Blvd. PLNCK/RECT #
CITY OF TI GARD PC.lox 73397
Tigard,Orcgon 971?3 PERMIT # f 9.2 � J' /,p O
C01N1i�1f1N11T D1•;VP LOPMEINT DEE ARTh1EN'I' I
(503)639-4171 DATE ISSUED
i
�-ijm ADDRESS: _ ��L i� „L..Ohl / d' 4z,_ TAX MAP/LOT
SUB: LOT: _ _ LAND USE: —
) VALUATION: AP OVEJ f0 ISSUE
[EB4=1n___7h/_q OWNER S SPECIA
NAME: DA 4- _ REISSUE OF:
ADDRESS: .�,� L Q�2� A LAST REISSUE. _
1� ,6c FLOOD PLAIN/ ,
PHONE: - IS11:3 SENSITIVE LAND:
CONTRACTOR .1 APPROVALS REQUIRED
NAME: _ � C'C•rtJ'-(,' /� /UL% . PLANNING:
/ADDRESS: _-:4.�[�� ��/. '� ENGINEERING: _
l'd,w [� �C_� FIRE DEPT:
PHONE. �� L� 5 OTHER: Am V"RG—' --__
CONTR. BOARD #: 52 EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH/ENG -NEER CALCULATIONS:
NAME: __ _ TRUSS DETAILS:
ADDRESS: OTHER: I
PHONE:
PROPOSED BLDG. USE:
COMMENTS: /. /���"iiZ► 'a/4'� _ 1
Lot
APPCICANT SIGNATURE
Received By: _ Date Received:
L
r
I r
PERMIT # ACCT # DESCRIPTION AMOUNTAMOUNT PD. BAL. SUE
s� y!
10-432 00 Building Permit Fees -
10-431 00 Plumbing Perm',t Fees
_ 10-431 01 Mechanical Permit Fees _
10-230 01 State Building Tax (5%)
Building
a
Plumbing
Mechanical
10-433 00 Plans Check Fee
1
a
Building
Plumbing a
A
Mechanical
10-230 06 Firc _
30-202 00 Sewer, Connection
i
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL
nm/3587P.WPF
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�° 11
44.
1
CITY OF TIGARD -- RECEIPT OF PAYMENT RECEIPT NO. a 9E'•-c'r 9a8;2
CHECK AMOUNT a 0. 00
WAME. t DALE, VI Rb I N I A E. CASH AMOUNT a 58. 43
4
(4DDRESS a 11627 SW LOMITA AVE. PAYMENT DATE: t 07/07/9e f
ISUBDIVISION x �i
TIGARD, OR 97223—
i w
"URPOSE CIF PAYMENT AMOUNT PAI b PURPOSE OF PAYMENT PMCIUNT PA 10
r IJ J L17 I NC L fim _..._.._.4 4. SO ST. BUILD PER 2. 2.
PLAN CHECK f=1 11. 7� •
1 �
1
t
11627 SW 1-01III'A WVE7NI_11=
92-0180
TO T'AL. AMOUNT PAID - - - 3 3E11. 3
�d
J
I T
i
CI'T'Y OFTIGARD FSECJ'-'IPT OF I'AYMf N1 REc IF'T NO. 198-P28719 i
CHECK AMOUNT a 17. 23
MIME DAI...E, I3I114NIY' CASH AMCJLINI a 0. 00
ODDRE:SS a i tt,27 SW LOMI'T'A PAYMENT DATE-.' 06/ 15/9P I �
SURD I V 1931 ON
TIGARD, UP
�t
i 1 URPOSL CIF PAYMENT' 01MOUNT FSA I D PLJP OSE OF' PAYMFNT AMOUNT' PAID
............�..,. _., _.. .., ...- ..._ .._...._.. __.._.._.. __.__ __.._.........._._.._. ..._.
� t
PI.14N CHECK FE= 17. ::'3 �
1 I
1 y
l l
1
TOTAL AMOUNT F'A T I.) - - ) J7. 23