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INSPECTION NOTICE.
City or Tigard Building Dapartmnt
13125 SW Ball Blvd. Tiger-,, Oregon 97223
Inepeation Line (Rec-O-Phone)s 639-4175 Business Phones 639•4171
Inspections_
Footing Pl.bg. Underelab Hoch. Rough-in Appr/Sdwlk 1
Found. Plbg. Top Out Gas Line FINALS
Post/Beard Strutt. San. Sewer Framing -Bldg.
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Post .eam Hoch Re'.r Drain insulation
Pl, i. under?!, ,r Water Lit.a Gyp. Bd. -Mech.
co Requestedt_ - Timet -:AV �PK
Address-L
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-permit
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TBE "LLOWING CORRECTIONS ARE REQUIRED:
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!nspentors Dates_
APPROVED DIAAPPROVEU__--J APPROVED SUBJIM TO ABOVE
\ Call For Reinep.
INSPECTION NOTICE
el.ty of Tigard Building Departemt
w 13125 Sit Nall Blvd. Tigard, Oregon 97123
# Inspectio: Line (Rec-O-Phone,)s 639-4175 Business Phone: 639-4171
Inspections
Footing Plbq. [• rslab Mach. Rough-in Appr/8dw1k
Found. Plbg. Toll Out Gas Line FINALs
Post/Beam Struct. San. Bawer Framing -Bldg. E
Post/Beam Hoch Rain Drain Insulation .-Plumb.
Plbg. Underfloor Water Line Gyp. Bd. --Meth.
Data Requesteds �� V�� __Timet AN Pit t
1 a Address Permit ft_ 4�
" Builders � l��c�� �
THE FOLLOWING CORRECTIONS ARE REQUIRSDt
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L.Y�(f /I1Z� ---- Date:
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INSPECTION NOTICE
City of Tigard Building Departaent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-C 'hone): 639-4175 Rumness Phone: 639-4171
Inspecti.on•_�_
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Footing P1bq. Underelab Piech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALt
Post/Beam Struct. Sar.. Sewer. Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb. •
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Requested: / —•—Titoee AN x _PH
Addresse/2-2�� Ste/ ���'�SCldw^ Permit it-9
Buildec:
THE FOLLOWING CORRECTIONS ARE RRQUIRED:
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Inspector: LDate:
__APPROVED - DISAPPROVED APPROVED SUBJECT TO ABOVE
call For Reinap.
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 9W Hall Blvd.Tigard,Oregon 97223.8199 (503)850-41'1 r
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd.Tigard,Oregon 97223.8199 (503)839-4171 hi;'rl}.i Adt, f'r'4w,«..
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; I..,I T'Y OF` T I GARD RECU I P"T CIF PAYMENT RE-1, N)T NO.
CHECK AMOUNT a IA00
+l NAME'. Vol-K9 RP 40Y CASH AMOUNT a I'N. 75 �^
:_s I AUDRIF'S!; a PAYMENT DATE 05j/1,3J93
' w I SUBDIVIBInNA.
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a ! PURPOSE OF` f'AYMFN'r (wnum �:,A I r) PURS-'t]SE OF P(4'f M1=N•T Ah.':1LIJ,4 T PAI D
w I PLUMBING P' 15. 00 ST, BUILD PER 75
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TOTAL IIMIIIINT K IA I L) - -? 19. 75
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INSPECTION NOTICE
City of Tigard Bs.ilding Departoenc
13125 SM ELL11 Blvd. Tigard, Oregon 97223
Inspection ;,ine (Rec-O-Phone): 639-4175 Businone Phone: 639-4171
Inspection:_
Footing Plbg. Underalab Mech. Rough-in r/Sdwlk ,
Found. Plbg. Top Out Gas Line FINAL%
Poet/Beata Struct. San. Sewer Framing -Bldg.
Post/Beam K,4ch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Ina Gyp. Rd. -Mach.
Date Nequeeteds / Times AM PM
Addreees _ Y�?� Permit fs
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED%
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APPROYEo DISAPPROVED APPROVED SUBJECT TO ABOVP
_Call For Reinsp.
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ItiSPECTION NOTICE
City of Tigard Building Department
13125 Sit II011 Blvd. TLgerd, Oregon 97223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
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Inspection: —_—_ _ _—_�----- — —
Footing P1 Undersla Mech. F.ough-in Appr/'Iwlk )
Found. Pl.by. Top Out Gas Line FINALS
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Poet/Perm Struct. Snn. Sewer Framing -Bldg.
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Poet/Beam Mach. Rain Drain Insulation -Plumb. .
Plbg. Underfloor Watsr Lina Dyp. Bd. -Hach.
p'S (.� Time: i"� `
Date
Requested:— AM PH���"��� ' t
�" l mit �_�• ZIN
Address: —
Bullder: ---
THE FOLLOWING CDRRECTIONS ARE REQUIRED:
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Inspector: ��__-- —`_ � .�— Date:_,
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
___Cal I. For Reinap. i
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4 INSPECTION NOTICE
St City of Tigard Building Department
2 13125 SN Ball. Blvd- Tiger 1, r-regon 17223 ;,,I
j Inspection Line (Rec-O-Phone): 639-41'/5 Business Phone: 639-4171
Inspection:__ —_-- ---
Footing Plbg. Underalah Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Bea Struct. San. Sewer Framing -Bldg• x
et/Beam Mech. Rain Drein Insulation -Plumb- ;
Plbq. Underfloor Nater Lina Gyp. Bd. -NecF.. w, ■
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Date Requested:
,/ � 3 Times --— �PH
Address: 12-Z--b-7
THE FOLLOWING CORRB.TIONS ARE REQUIREDt
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Inep'star: - — y� Date:
APPROVED DISAPPROVED APPROVRn SUBJPCT TO ABOVE
Call For Reinsp. i
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JN;PECTION NOTICE._ I
City of Tigard Hnilding Department
13125 H1i Hall vil.od. Tigard, Oregon 97223
Inspection Line (Rec.-O-Phono)s 639-4175 BueineBn Phone: 639-4171
Inspection:—_ —_— --- ----
Footing Plbg. Underelab Mech. Rough--in Appr/Sds,.1k
Found. Plbg. Top out Gas Line FINAJ.:
Post/Ream Struct. San. Sewer Freasing -Bldg.
Poet/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. derfloor zWater Line Gyp. Rd. -Mech.,
Date Requested: ✓� z — _ Times —_ _AM PH
Address:-1 �-3_ / vL'7�_ - �rj�='¢ermlt ?s��6�,2 41
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Builders_
THE FOLLOWING CORRECTIONS ARE AUEQUIRED-
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Inep-4ctors�—�G�_—
" APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
--Call For Reinsp.
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INSPECTION NOTICE
City of Tigard l.ALlding Department
13125 BN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-n Phone): 639-47.75 Busiuene Phone: 639-4;71
Ineper_ti• n:
G'ootincj Plbg. Underelab Mach. ?sough-in Appr/Sdwlk S
Found. Plbg. Top Out (tae Line FINAL:
Poet/Beam Struct. San. Sewer ( Framing -Bldg.
Poet/Beam Mech. Rain Drain �Ineulatic,i -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Pate Requested: 7� —Time: AM PM ,
Addreee:�,._7 /Jj�fy�_i Permit ��
Builder.:
THE FOLLOWING CORPCCTIGIS ARE REQUIRED:
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APPROVED °� DISAP OVER — - APPROVED SUBJECT TO ABOVE
Call For Reinep.
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t INi^i'R'ION NOT7�
City of Tt,jard Building Department:
13125 AO Ball Blvd. Tigard, Oregon 97223
Inspection Line (Roc-O-Phone): :39-4175 Business Phonet 639-4171
.Tnspectlont� _-- _—
tooting Plug. Underalab Hoch. Rough-in Appr!Sdwlk
Found. Plbq. Top Out Cas Line FINAL:
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Post/Beam Struct. San. Bower Reeling -Bldg.
„ I Post/Beam Hoch. Fain Drain `'InnulatIon -Plumb. I
Plb Underfloor Nater Line Gyp. Rd. -Hoch.
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Ditto Requostedt � _ TiOMs / AH PM
Address: i-C _ Permit
Builder:,
THE FOLI.OWING�OORRSCTIONB AM RRQUIRBDs
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Date=
_-APPROVED,APPROVED —� DISAPPROVED T, APPROVED RUBJECT 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 Phone: 639--4171
Inspectionc�_
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Foo::inq Plbg. UndeLslab Rough-i Appr/Sdwlk
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Found. Plbq. Top Oit e FINALc
Poet/Beam St,ruct. San. sewer -Bldg. I
Post/Beam Hoch. Rain Drain Insulatir-,n -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hoch.
Date Request«+ds 2 - z —Time: —A11 --PH
Address: J ._'�/K = C�� i?L iPermit 1: !J�-�/
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspeclors� Date:
11RMMU -,"018APPROVBD APPROVED SUBJECT TO ABOVE
��«:if ,,1 /►^�llc.�i . � Call For Reinnp.
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INSPECTION NOTICE
city of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phones 639-4175 Bunineas Phone: 639-4171
Inspection:—
Footing Plbg. Underslab Mach. Rough-in Appr/Sdwlk .
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam struct. sen. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb. �` ■
PLby. Underfloor Water Line Gyp. ed. -yerL.
Date Requested. c7 Times
Addre,ia s /�
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED%
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Inspector•_ Date:
4;
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
_—Call For Re nap.
INSPECTION NOTICE ry
City of Tigard Building Department
13125 811 Ball Blvd. Tigard, 0r.r9on 97223
rnapgction Line (Rec-O-Phone): 639-4175 rrjeinese Phone: 639-4171
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Ir,spect ion:r
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
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Found. CIPlOutbg. Top Gan Line FINALS
Poet/Beam Struct. sari. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requested: __ _Ts AM PM ■
Addreess i mM it ts_
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Builder:__/< ----
TBE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: — _ Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_-W-Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Departsent
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspe.,.tlon Line (Rec-O-Phone)s 639-4175 Buoinesa Phone: 639-4171
Inspections - --- --
Footing LPlbg. Und slab Mech. Rough-in Appr/Sdwlk ,
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
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Post/Beam Mach. Rain Drain Ineulatlon -Plumb•
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Plbg. Underfloor Wate Lir Gyp. R- -Nech. w
Date Cequested:,_
PM
° Addreee: 1� ^�J- s 'n Cr Permit 11s U� _
Builder: Q ' I L 'T} Y4 r' -• r
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THE FOLLOWING CORRECTIONS ARE REQUIRED:
� Inspector: _ _ ___ Dates
—� APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Buair:ees Phone: 639-4171
Inspections ---
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framtng -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Data- Requesteds 12. 1-3l X17_ Times _AM 1M
Addreass 7 7p-7 Permit Vit) '?�f
Ruildert
TM rOLLOWING CORRECTIONS ARE REQUIRED:
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Inapectors� Dates_____- _
L JAPPROVE') DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
:3115 BW hall BL-Id. Tigard,g . Or egon 97:.13 �.
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
In,poctior.: _
Footing Plbg. Underalab Mec Rough-in Apic/Sdwlk ,
Found. Plbg. Top Out Gas J1 FINAL• 6
Post/Beam Btrn) San. Sewer
Framing -Bldg.
Poet/Beam Mach. ) Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date Requeetedr-� 1�//� Z -_Ti.. -�AM PM
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Address: 1 /Z _/ I�. /.f.. --1_
_ — Permit # 02
Builder: ( t r h I-- `l�''}_1
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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! Inspector: Date: Z 9
APPROVED DISAPPROVED APPROVED SUBJECT 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)s 639-41.75 Business Phone: 639-4171
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Inspections
Footing Plbg. Underalab Mech. Rough-in Appr/Sdwlk
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Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
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r''•"-�' ` � Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor� Water Line Gyp. Bd. -Hoch.
Date Requer.mus_ ? �� C� Z Time: AN PM '`{
Address: z � LCV 1AT1LN\_0 LIQ-4-0. Permit
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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hAPPROVED DISAPPROVED _ - APPROVED
SUBJECT TO ABOVE
_Call For Reinsp.
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INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223 „
Inspection Line (Rec-O•-Phone): 639-4175 Business Phone: 639-4171
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f Inspection:
f ooting Plbg. Underslab Mach. Rough-in Appr./Sdwlk
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eFound. Plbg. Top Out Can Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg. -
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Post/Beam Mech. Rain Drain I� iuletlon -Plumb.
Plbg. Underfloor ? Water Line Gyp. Bd. -Hoch
Date Recnveetads__ —Time: AM PM
Address:_ ��/3-���_ .r,�/-/r permit �s Y
Builder:
THF FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors
Date: is 9 Y
4.,.,.. ,. y APPROVED DISAPPROVED _— APPROVED SUBJECT TO ABOVE
Call For Retnap.
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CITYOFT16VARD (A
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COMAWNITY DEVELOPMENT DEPARTMENT an MM � MASTER PERM1"f
1'l126SWHam Blvd P.O.BacOW,TOW,Orep n 97223(603)639-4176 PERmI f #. . . . . . . : 1151'92-0244
639••-4171 DATE: 11,SUED: 10/28/92
SITE ADDRESS. . . : 12237 SW LANSDOWNE LN I'ARCEI_: 2S 10:3BC-07"700
SUBDIVISION. . . . : FYRESTUNE ZONING: R--4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 16
BUILDING
REISSUE: DWELLING UNITS- 1 BASEMENT. . . . . . . . :0 s f
CLASS OF WORK. :NEW BEDRMS:3 BA71-1S..3 GARAGE. . . . . . . . . . : 747 sf
T Yf='E OF USE. . . :SF FLOOR r9REAS---- -- - REQUIRED SFl"HACKS _
TYPE OF CONST. :5N FIRST. . . . :2345 9f LElFT. . : 15 ft RIGHT. :5 ft
OCCUPANCY GRID. R3 SECOND. . . :0 sf FRONT. :30 ft REAR. . : 15 ft �
STORIES. . . . . . . : 1 TH I RD. . . . :0 sf RE(_U I REI) -- -_____________--•-
HEIGHT. . , . . . . . :21 ft TUT AL_-------:2'345 5f SMOKE DETECTORS. -.Y
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FLOOR LOAD. . . . :40 p s F VALUE. . . . . $ : 12:1316 PARKING SPACES. . : I
Remarks: PATH I
SINKS. . . . . . . . . . ..: FLUOR DRAINS. . . . :(Zi BACKFLOW F'REVNTRS. . :0
LAVATORIES. . . . . :5 WATER HEATERS. . . : 1 TRAPS. . :0
TUB/SHOWERS. . . . :3 LAUNDRY TRAYS. . . : 1 CATCH BASIIJS. , . . . . , :0
WATER CLOSETS. . :3 SE::WEH LINE (ft ) . :0 GREASE TRAPS. . . . . . . .0
DISHW(:)SHER;i. . . . : 1 WATER LINE. ( ft ) . : 100 OTIAFIi FTXTURES. . . . . :0
GARBAGE DISE'. . . : 1 RAIN DRAIN (ft ) . :0
WASHING MACH. . . : l SF RAIN DRAINS. . : 1
MECHANICAL. _..__.___________.__ _.___.__..._...._____. ._____.. FEES -_.__........____..- -----
FUEL TYPES-----__.-.-._.___ UNIT HTRS. . :e type amoI.(nt by date recpt
/GAS/ / / VENTS . . . . . :0 TIF $ 1460. 00 JH 10/28/92 -
MAX INI''IJT':O 13TU VENT F'ANS. . -4 BPRT $ 488. 00 JH 1(Z(/28/92: -
FURN ( 100K 1 BPLC; $ ;',17. 20 JI_H 10/19/92 232810
FURN ) =10(711( . . : I WOODSTOVE11- :0 B5P(: $ x=4. 40 JH .10/`8/92 --
FLUOR FURN. . . . :0 UL.0 DRYERS. : 1 SSI)C: $ ,'80. 00 JH 10/128/92 -
BOIL/CMP ( 3HP:0 OTHER UNITS: I. PARK $ 500. 00 JH 1.0/29/92: -
GAS OUTLE-15: 1 MPRT $ 45. 00 JH 10/23/92 -
Owner; --- --- -_..._.__.__._____.__________.__._.__._._-_.-- MPLC: $ 1. 1. 25 JH 10/EA/92 -
MICHAEL W. HUMPHREY 115PC.:: $ L. 25 JH 10/28/92 -
12385 SW 121ST AVE F'PRT $ 170. 00 JH 10/28/92
P5PC; $ 8. 50 JH 10/28/92'
TIGAriu L'1R 972=3
Phone #: 634-9737
Contractor:
M HUMPHRE:Y ROSEWOOD F-..VF::LOPIrIENT CO
12385 SW 121ST AVE
TIGARD OR 97223
Phone #: 684-•972;7
Req #. . : 46568
______.y` 3306. 60 TOTAL
This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS -
Tigard Municipal Code, State of Ore Specialty Codes and all other Foot/fol.tnd Insp Fireplace Insp
applicable laws. All work will be ( :ne in accordance with approved Post/Beam Strc.(Ct Gas Line Insp
plans. This permit will expire if work is not started within 180 F'ost/Beam lylechan Insc_clation Insp
days of issuance, or if work is suspended for more than,100 days. P•lm/UndSlab Insp Gyp Board Insp
�-I FILM/Undevf I o o r Rain drain Insp
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Perittee Sicgnatt.n-e : 411i!,tiL'' Ihechani(-_,al Insp Water Line Insp
-- PIUmb Top OUt f)ppr /Sdwlk Insp
Issc-(ed Py: _ . Framing Insp Mer.hanic,al Final
---'�:r? —� B.r�. ! Fis�t?fnt''1__!-f•Tr--
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C17YOFTIFARD SEWER CONNECTION `
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT amooa PERMIT #. . . . . . . : SWR92r-0326
1017:6 ow Hd bbd[P.O.Bair UW,Tlpwr Orown ti7ZZ3(600)6344176
! __ 6 s9-4171 ALL_ T,� 1 `n e t tri :A/c). � 1
SITE ADDRESS. . . : 12237 SW L_ANSDOWNE LN VIARCEL: ?S 1.0:3BC-0.770E �
SURD I V I S I ON. . . . : FYREST'UNE ZONING: R-4. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 16 �
- ------__..__--------------_.._-__....._..________-_r._._.__....._...._..__
TENANT NAME. . . . . :
USA NO. . . . . . . . . . . FIXTURE UNITS. . . .
CLASS OF WORK. . . :NEW DWELL I NG UN I Tli.. . : .1
TYPE OF USE. . . . . .SF NO. OF BU I L D I NGS;: 1 ,
INSTALL_ TYPE. . . . rBUSWR IMPERV SURFACE. . : Isf ,
Remarks. : PATH I
Owner: ------------------------ __r---_-_.- ----- --- FEES
MICHAEL_ W. HUMPHREY type amol_rrrt by date recpt
1.2385 SW 121ST AVE: F'RMT $ 1.00. 00 JH 10/28/92 -
INSP $ 15. 00 JH 10/28/92 -
TIGARD OR 97223
Phone #: 684-9737
I
Contractor: --_..__-•---_.__.__._.----_._..-_ _ ________
CONTRACTOR NOT LIN FILE i
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.-'hone #: $_.-.:-:1,x5. 00-T17CWL_______________..
Rey #. . .
RE OU I RE D I NSPL CT I ONS --- -_-
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 188 ,lays 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 to:aced at the measurement
given, the installer shall prospect 3 feet A all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" permit and the fgency will install lateral.
F'e r m:i t t e e S i y~i a t l.r r e�—
I s s i-red B y :
Call for inspection - 6:39-4175
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PLNC RECT
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CITY OF TIGARD u1PO Box 23397
COMMUNITY DEVELOPMENT DEPARTMENT Tip,.rd•OmVn9nz3 PERMIT h'LSf�1Z" d�y(�
(50P 1394171 DATE ISSUED
JOB ADDRESS: J�2�2,3 7 TAX MAP/LOT .2510 3 O c- 077e O
SUB: ��rc_ s-��L,r _ LOT: 4 LAND USE:
VALUATION: `% .S, 11-0
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OWNER SPECIAL. NOTES
NAME: L'�� c_(� r�c �^� -c'� REISSUE OF:
ADDRESS: I•� Z b- � S,LJ`f„7/ s /! LAST REISSUE:
FLOOD PLAIN/
PHONE: y,? 7 _ SENSITIVE LAND:
7
A
CO1 ,TRACTOR 1 APPROVALS REQUIRED 5u3 F? �-
�'.- AME: . c 5c c �.c� 1i�C VC(T►-mac )•'� PLANNING:
(�\ ADDRESS: ENGINEERING:
FIRE DEFT:
PHONE: _ OTHER: __-rt r- — �xG
CONTR. BOARD EXP DATE: Z,
C
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: r- w cs } ���.�y,��; LIST/SUBCONI•RACTORS: �If �frF�a4si �,
Z � �
MECH: - ac-cr BUS TAX:
ARCH/ENGINEER t,r- CALCULATIONS:
z NAME: TRUSS DETAILS: ,
ADDRESS: OTHER: _
PHONE:
PROPOSED BLDG. USE:
COMMENTS:
G.✓ Lt 11
APPLICANT SIGNATURE
Received By:: l
Date Received:
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PERMIT # ACCT N DESCRIPTION AMOUNT j AMOUNT PD. BAL.
DUE
10-432 00 Building Permit Fees -
h' 10-431 00 Plumbing Permit Fees
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10-431 01 Mechanical Permit Fees `_ -
10-230 01 State Building Tax (5%) 3��i i' 3S•/?
Building � •`I° ��
Plumbing LJ-_11o
Mechanical z.if f
'I m
10-433 00 Plans Check Fee rz,y q3 1-11'
Building _;Ke
D /
I Plumbing
Mechanical /1, t-�- /!
10-230 06 Fire
3�,,R a32 30-202 00 Sewer Connection -- .2/&V
30-444 00 Sewer Inspection -
25-448-0? Commercial TIF Fees - -
yr 25-448-04 Industrial TIF Fees —
f 25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees —
25-448-01 Residential l'raffic Fees 13'�D --
25-448-05 Mass Transit TIF Fees �-^-
52-449 60 Parks System Dev Charge (PDC) —
31-450 00 Storm Drainage Syst Dev Chrg
CP
24-445-01 Water Quality (Fee in lieu of)
' 24-445-02 Water Quantity (Fee in lieu of)
i
TOTAL e _ l j
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nm/3587P.WPF
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PLUMBING PERMIT
1
PERMIT #. . . . . . . : MST92-0244 [
DATE ISSUEDs 10/28/92 i
SITE ADDRESS. . . : 12237 SW LANSDOWNE LN PARCELt 2S103BC-07700
SUBDIVISION.. . . s FYRESTONE ZONING: R-4.5
BLOCK.. . . . . . . . . : LOT. . . . .. . . . . . . . :16 !
- ----- .
- ------
CLM88 OFWORK. . tNEW GARBAGE DISPOSALS sl �
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . :1 BACKFLOW PREVNTRS.. tO
OCCUPANCY GRP. . tR3 FLOOR DRAINS. . . . . . . 30 TRAPS. . . . . . . . . . . . . . :0
STORIES. . . . . . . . tl WATER HEATERS. . . . . . :1 CATCH BASINS. . . . . . . 10
FIXTURES------------- LAUNDRY TRAYS. . . . . . :1 SF RAIN DRAINS. . . . . :1 t
SINKS.. . . . . . .. . s2 GREASE TRAPS. . . . . . . :0
LAVATORIES. . .. . :5 OTHER FIXTURES. . . . . :0
TUB/SHOWERS.. . . : SEWER LINE (ft) . . . . t0
WATER, CLOSETS. . :3 WATER LINE (ft) . . . . t100
DISHWASHERS. . . . :1 RAIN DRAIN (ft) . . . . t0
Remarks.: PATH I
OWNER: ----------------------------- -----------------FEES----------------
MICHAEL W. HUMPHREY TIF $ 1460.00 JH 10/28/92 -
12385 8W 121ST AVE BPRT $ 488.00 JH 10/28/92 -
BPLC $ 317.20 JLH 10/19/92 232810
TIGARD OR 97223 B5PC $ 24.40 JH 10/28/92 -
Phone #t 684-9737 SSDC $ 280.00 JH 10/28/92 -
PARK $ 500.00 JH 10/28/92 -
Plumbing Contractor:----------------- MPRT $ 45.00 JH 10/28/92 -
I MPLC $ 11.25 JH 10/28/92 -
Namet CUZ, Ccs ��) Cc,n2� MSPC $ 2.2b JH 10/28/92 -
Address: P1 P)c-/ �j10 PPRT $ 170.00 JH 10/28/92 -
City: {;51 C- 1)A State: LI PSPC S 8.50 JH 10/28/92 -
Zips Phone#t_(-.30-rj,.JL4L'
Reg #s 3 214(a I1 13
t
------- REQUIRED INSPECTIONS -------
This permit is 3.ssued subject to the reg-
ulations contained in the Tigard Municipal Foot/found Insp Rain drain I-.,sp
Code, State of Ore. Specialty Codes and all Post/Beam Struct Water Line Insp
other applicable laws. All work will be done Poet/Beam Mechan Appr/Sdwlk Insp
in accordance with approved plans. This Plm/undslab Insp Mechanical Final
permit will expire if work is not started PLM/Underfloor Plumb Final
within 180 days of iss•:ance, or if work is Mechanical Insp Building Final
suspended for more than 180 days. Plumb Top Out Erosion Control
Framing Inep Crawl Drain
Fireplace Insp
Gas Line Insp
Insulation Insp
x y �',!,-4%'� Gyp Board Inep
Authoriked Plumbing Contractor Signature
Call for inspection - 639-415
Contractor Notes:
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n�'SYI,.r I
j CITY OF TIGARD RECEIPT OF PAYMENT RECEIPT NO. s92-233145
CHECK AMOUNT o 5191.50
NAME. s ROSEWOOD DEVELOPMENT CASH AMOUNT a 0.00
ADDRESS t 12385 SW 121ST PAYMENT DATE : 10/28/9? -
SUBDIVISION s
TIGARD, OR 97223—
i
i PURPOSE OF PAYMENI AMOUNT PAID PURPOSE OF PAYMENT 14MOLINT PAID -
i ILDING PERM k8H.00 PLUMBING PERM 170.00
IMECHANICAL PE 45.00 ST. BUILD PER 35. 15
PLAN CHECK FE iEl.a5 SEWER USA 2100.00
SEWER INSPECT 35.00 PARKS SOC 500.00
STORM DRAIN SDC 880.00 RESIIIENTInL TRAFFIC FEE�i 1350.00
MASS 'RANSIT TIF FEES 110.00
!r
i
t_.UT 15 FYRESTME
1 C.'0137 SW LANSDOWNf
TOTAL. AMOUNT PAID 5191.50
CITY OF TIGARD — RECEIPT OF PAYMENT RECEIPT 140. :9G-232810 '
CHECK AMOUNT : 250.00
NAME. s ROSEWOOD DEVELMMENT CO. CASH AMOUNT : 0.00
ADDRESS s 12385 SW .121ST PAYMENT DATE s 10/19/92
11GARD, OR SUBDIVISION a
PURPOSF OF PAYME:NI AMOUN1 PAID PURPOSE 0(- PAYMF"NT AMOUNT PAID
_ r
PLAN :.NE:CK FE 1Q:-39R
12237 SW LANSDOWNE !_N.
1i 5•:
?,•C;, -TOTAL AMOUNT hAID ... _ ._ ._1 P50. Q►0
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