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INSPECTION NOTICc
City of Tigard Building Depanment `�
P.O. Box 23397
Tigard, Oregon 972.23 (`'
Phone: 839-4175.,E
Type of Inspection -
Date Requested ` /tj o Timet } A.M.
Address Z 303 z ( ice,<i C i 2 tJ`)'I T _ Permit # -5 '0 ,3�
Owner L/.M C>�y __ lot #
Builder �r 1 �, ' J n ----
The following Building Code deficiencies are required to be corrected:
R IZW
Presented to — IrrYt-irpp►oved
Inspector —fes u Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department -1♦� �'
P.O. Box 23397 C
Tigard, Oregon 97223
Phone: 639-41.75
Type of Inspection _ < .l L 1,d C)C 1�. J ) 1 �,��,.t "k
Date Requested_ J 2 Z- 1 Time�f A.M.. __P.M.
Address 1--so-5Z d'Yi CX'L-1 Permit #t -� t--•��-1
Owner-- --- --- -- ---- —T--- -( -- Lot #----
3uilderThe following Building Code deficiencies are required to be corrected:
00, 01
Presented to �_ ❑ Approved
Inspector 1 /
❑ Disapproved
Date
-�—
CALL FOR REINSPECTION
0 YES ❑ NO
rrsi sire � sw wR aw r• s esir trs#+ rri
INSPECTION NOTICE
City of Tigard Building Department pi-n
P.O. Box 23397 {
Tigard, Oregon 97223
Phone: 639-44]1775,7
Type nf Inspection �JL�.
Date Requested �W
_ TIM A.M. _ P.M.
Address ' ���>-r=3
_. Permit #
Owner _ Lot
Builder �'77
The following Building Code deficiencies are retiuired to be corrected:
Presented to �'�—`� ---�--��
cT F+pproved
Inspector ,- _ El Disapproved
Date -- �L---�---.-�--_ —
CALL FOR REINSPECTION
O YEa C] No
eif i>Q At err eerr net #� � ele w
INSPECTION NOTICE
City of Tigard Buildinq Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested ' I lTimm�l A.M.. P.M.
Address Permit #_�1
Owner Lot #
Builder
'(he following Building Code deficiencies are required to be corrected:
Presented to _ P'Approved
Inspector Ll Disapproved
)))
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
INSPECTION NOTICE Liv
City of Tigard Building Department
P.O. Box 23397
Tigard Oregon 97223 \
Phone:639-4175
Type of Inspection
Date Requested`� ' Q Tims__ A.M �_� P.M.
Address,,/,-1LV:3.2 Permit #
Owner_---" 0 Lot #
Builder —
Th,, following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector .- Disapproved
Date --
CAII. FOR REINSPECTION
❑ YES EI No
ai
INSPECTION NOTICE
City of Tigard Building Department n �
P.O. Box 23397
Tigard, Oregon 97223 1
Phone: 639-4175
Type of Inspection s Q �-
Date Requested 22 - �. I Time .y A.M. P.M.
Address u �- L C�.•C / r�JrZ! Permit # ��
Owner _ Lot #._
c
Builder �-
The following Building Code deficiencies are required to be corrected:
i
Presented tn 1 -___ ___ Apgroved
Inspector
Date `"� ✓�� _
CALL FOR IjEINSPECTION
f-.;R 'YYEES ❑ NO
INSPECTION NOTICE �J
City of Tigard Building Department
P.O Box 23397 I
Tigard, Oregon 97223
Phone: 639-4176
Type of Inspection __ �'� jur ��r� �1.PiC
G"
Date 9equested _—_---3 =l� Timet A.M. P.M.
Address _ "�c CGt T Permit # R 54,01.33�
Owner Lot tik�
Builder
The following Building Code deficiencies are required to be corrected:
Presented to — —_- _--_- _- Approved
Inspector Disapproved
Date
CALL FO!
,REINSPECTIUN
YES L7 NO
.ss �. s ass s wse s� v
INSPECTION NOTICE
City of Tigard Building Department n
P.7. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection Y y LC
iC,
Date Requested Time A.M. P.M. !/
Address 3s--2 i//f" 21Q? Permit # f��7
Owner Lot # _
Builder
The following Building Code deficiencies are required to be corrected:
Cj
Presented to _ ❑ Approved r
Inspector �_ Diapproved
Date
CALL FOR REINSPECTION
CES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23397
Tigard, Oregon 97223
Phone:cj 639-417,5
6339-417
Type of Inspection _ C r
I ► `-���p�---
_ �
Date Requested -(
0 - n � Time -A.M._ P.M.
Address _%/ ��.�j�T ��Cy� Permit *_L_ J (f
Owner__�_ _ Lot #�-
1 Gly I
Builder —l�C-'�I � � I I� L i ---------
The following Building Code deficiencies are requhid to be corrected:
Presented to _- __ __ __ _ -- - _ Approved
Inspecto -_-_ - -- ! Disapproved
Date —
CALL FOR REINSPECTION
❑ YES ❑ NO
asst s, asst sus
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone. 639-4175
- �Type of Inspection ��, L-
Date Requested S, / �_ Time_ �+� A.M. c P.M. 1
Address ,�'�����. ( C�_�G Y/� �C1Y) Permit # :1
Owner (� Lot #
Builder
The following Building Code defi6encies are required to be corrected:
Presented to
- _ F) Approved
Inspector _� Disapproved
Date c=
7
CALL FOR REINSPECTION"
0 YES 0 NO
INSPECTION NOTICE
�J
City of Tigard Building Department r"r I—
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
`1
Date Requested Z .�//� '> Time A.M. P.M.
Address �'� 3� CCf•C��'1T1 C%)7 ` _ Permit # (2 3��
Owner_ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented tc _ Approved
I ispector _ ,i� LI Disapproved
Date _ / „� _ � TZ,
CALL FOR REINSPFCTION
❑ YEi 0 NO
r-.'.It.JTAJ*.)TNG VICAMT.T
CITY OF T'GA RD CITY Pa 1:4.7.1"IMS'T' NO : 13IJ89013A
COMMUNITY DEVELOPMENT DEPARTMENT
13125 S.W.Hall Blvd..P.O.Box 23397,1 igard.Oregon 97273.(503)5394175
ADDPEIS!'? 130'32 !.jW LAUPMONI DP
VAY MAP/LAYT 150.330C, VT 1 6*1* !.AJMMI:_J-4L.0Kr-.: PAPK L'T : 17 DK :
I IND 045E.: : 1:11P1aD
1. U'1' FiT zr.:. : Vol (IMAX)IN : 111 (38 ,000 SE I UAC,I<5
114ON I' ! E10 PE".Ap :
1101-IK G1, o'515 . Nl::.W 11WEA. I.. . UNT'VS : 1. I—EA:11' 1.el lQ1.GII-111,
T*YPE. : S11NIGA-E. FAM11-Y ND. PEDIA:1101`45 : 1:.:X T .WAI L. ( OW)"!
GONUT . T'YF'I;:: ! VN NO EWFI-15 : 3 N : 15 : 1::: tj
occur, r4i::tr, : mli PP01* OPE(4-
.: TNG S'
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NO . 5S'T0P:EF:!:i : P 1.5i 1, 9'45 I%IO(.')F C,C)INS"I' : Ili
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PEUSGUE OF NO. 6569
I A51' PEASSI.A.: (313 0 0'13 F,
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R IL:Ox VVIN.?el 9lr.?50 00
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C farla I.]Ia.I-1(i lar' 97r?.1 Y P PE:P AT I)
1:1-1(JISIF 11,50*3) 211,1-1431.14
O
RI 1 P101" ON NO :3!:i°.4:33 '1 D T AL $1. 356 C35
This permit is issued subject to the regulations contained In Title 14ne:uET.GAY' 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 with the plans and If-0O'1'1:N(:; 5 F.::1.4
specifications and in compliance with all applicable codes and F'OUNDAIJON WALL IIAIN DRAINS
ordinances The issuance of this permit does not waive restrictive P11:119 I & W AM WA'I15:R L.TNR
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and PI 8 . LINDEP!:iI.-AD (:;1: 1'Y 0PI:*'P(.H/GW
void If work Is not started within 180 days,or it work is suspended or 51.A F% F':I:
abandoned for a period of 180 days any time after work has PI...W . I'LlIPOUT
commencepl.,Lt shall be the responsibility o permittee to assure I'P 0 M.I.N
all require in ections are requested O" roved
dap 1;; 1:PE:F)L A(::F:'
GAS L-ENE:
- 'ENS111..AIA014
GYP. 00AWD
Permittee ature
Issued By =I —r7l 1. .1 r4'L)1..1: 1
SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWER PERMIT �
CITY OF TIGrA RD cm-0►1®xmo I� ��MI T' Nq. : r N9ai l
anew+ DATE 1:SSl.IED: 1/e6/l�9
COMMUNITY DEVELOPMENT DEPARTMENT PRIM. PMT.NO . 890134
13125 S.W.Hell Blvd.,P.O.Box 23397.Tigard,Oregon 97223.(503)039-4115
J01".4F11:)t)F!E::ca�i . 1.:3a3e SW 1_.AUPMON•T Dsq USA NUMBER: 3 1'70
1 r`►X MAP/1-0,11, 1.S 1.:3:4DC: SUD:: V:I: -1.,.AG;C::: AT SUMME"PLAKI:' PARK LT : 1 7 SK:
1. U4r) 0S(ill . PIeP0
1 (r! 53 rr::.
10 N :33 I'Wr', : at RNG : w
t4i+il< Ca. ASS : NEW
IIc,JI:. i'YG'w S:CNGLE. W'AMTL..Y
iI,F:; a►I,,l,'I ic�atr►t a+yrerr w tca e:cinply w:J.th at,l.l. r•t.tle,lw aLr►ei r•eagmli%tie►n% cif the Url:lf:l.Wd
';o:wa;:r +a.C�ee Agenr►t~41 . 1'I1er !►ear mi.t esxlairretls IAMciatyts fl"(3m the cla4t" iwtetae►ci . The tat.at•l.
en,Iltlt►t Ernticl will. befur—reai.te►cl 1.1' than per-mitetxpir,en.w . The Al;leal►�y clues, glua►r�w
a►f, r.r;, rrr t.l,rs rets»t.tr,&Cr y (3# tl•►ca lac:�aeLi.rar► cl-li the 19icie► meweel^ Iiatmr•m.l.ta . If tl-le 9+etwear- i.%
IIt,1, II►t::n►t,e�r.l at, rhea Ineaainit,Ireame»r►t, gli.vean , the: :i.r1n►tw.lienr• what,1:1. p"l3wPOct :3 41001, in
ia1 1 cii.r•rer••t3.l3nw fl-tim 010 rligitm.rlr:a given . Ill not. 1a43 locateect , the install-11ear' ml•180.1.
IaI.I1 t. l,tamtat a►. "lar.) arid Side t'aeewear•" 1:)pt•mi.t w.nci the Ag1e iiQiij w:11•:I.:1. inwta►.:ll. at lnkterrr'le.l .
1I
1:Mph.RVIOl.J5 AREA:
I I X T t Ira4 l INI:T5 : 'I'F: EC
NFANT IMPRC)V :M :Nl
I It•11' I I I:N(,; UNI I'S : 1.
1:7VES
MOP IF,I:T'T,E:: DON PEi,PM1'1' *35 , 00
E9t:)X 1.952,11 CONNECTION C:HARGEi:
$113,00 . 00
NI...XNE4: TAP 11415 T'AI...L» ,
F t)rt t 1 1 x►r►ci L)11
R
OTHER R $:360 . 00
` M(Ir, l•r,r+r:::1 1 r: DON
c�
N ')(')N M01.43:11 SE'T'T'E SUILDEAS INC.
Ifl 11c) F1(:)X 1.9.JFc�A1
l,t►r 1,'► nt r►ci c3 r 5►7 t i eY
`T 1:,140NV 1 .503) "r..41 9314
Fa
1" I'IgATTON NO 35533 TOTAL: tMi ,��5 , as
RECEIPT NO. le),Q351
T r,s pwrnit IS issued subject to the regulations contained in Title 14 ""'»'»»�
,if thF, TMC, State of Oregon Specialty Codes, zoning regulations gE.Ql.IIRE:D INSPECTIONS
and all other applicable codes and ordinances, and it Is hereby I.OUT TNG SEWER
.jq,nad that the work will be done in accordance with the plans end r:•OUNDA'TION WAI_l.„ RAIN DRAINS
;I,erifir•aUrms and in compliance with all applicable codes and POST R BEAM WATER LINE
„rrlinanr ns The Issuance of this permit does not waive restrictive
ivvriwits Contractor and subcontractors shall have current city PL..13.11NDEASLAEi CITY APPRC:M/SW
t uvness tax permits This permit will expire and become null and SL.AN w INAL.
v ,id iI work I%not started within 180 days,or If work is suspended or PI.9 TOPOI.I'T
,hanrlr,nrrl Inc a period of 180 days any time after work has FPAMING
n nIt-nced II shall he the responsibility of the permittee to assure
.n reglllrerl it ctions are requested and roved. r Tr1 ,PL..ACE:.
GAS 1...INE'.
T N"(IL..A'T'T(JN
Cyr . BOOM)
1'n„niflen �+ ntl irr'
('IR YN�"�f-'1_-7t'1N 6:X51•»47'%"'>, � �.
,hart By
SEPAP.ATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
C11Y OF TlGA RD MI::.CHANI GAL,
PEPM:UT* NO . ME81001.37
C,
COMMUNITY r""*a-L )PMENT DEPARTMENT
13125 S.W.Hall Blvd.,P.O.Box i33 7.Tigard,Oregon 97223.(503)639-4175 M , 1:*,M'Y' NO 09013-el
,J013 AD1)RE.:4.515 : :1.3032 SW LAUPMON'T' 1)1!
IAX MAP/1.011' T S J.33Dc" SLID: V TI I AGE. AI !A.J11MLWI-.AK1::. V,i)PR 1. 1
I AND LJISE : 14:1.2 P1)
I. 01' SIZE :
NO: Jr i
WIRK CL.ASS . Nl;;:W J::LIPNf-)CE (1.001< ATP 1--IANLA P ::1.0
TYPIE-" : 153:NC;L.E 1*AM:1:1..Y 100i(+ 1. AIR HANDI-P 1.0K
(XINST . l'Yl:.Ir:: : VN I:-'I OUR F*1)r4NA('.'F:: EVAP . (:J:)(JLr.-:P
(NA"UP. (.44) . ! 1-43 HEATEP Vli':N T' FAN
VENT VF-*.N*I* . SYSTEM
1:31...W/CXIMP (.31HP 1-11001) I.
ND . S'TOP1 LS 2 M1. 1:1/(::OMP 3-1,11WIP 1:N CJ:N Lf 4 AT 0 P(D 0 M
DWELI UNII'S : t 81 A i CHIMP :1.5 30HI::, INC,11411I.N.4ATOP((:,(')M
A. TYPE.
A.1" '0MP 50HP PE-PAIP UNIV:)
GAt 19- 4/'�*' 30
MAX . TNr1(.1*r E41 14/(:';C)MI:% 0 •1-Ito 0 T*11E 1:4
I. INV: L)MPPG'? C','AS 1::ITVI:[N(*.;
I I
1.Ow
0 M C I 141151 E'T I'Ili-". DON rwnmrr 411.0 .00
W lata P1 AN RE:V.rr--:W $8 . 63
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R 1:10Hux 66,409
A I"ci I- 1.1,jit I i(-I Or )7260)
C 1:11-IONE ( 50,*4) 115-5Y1.9
T
0 NO . 010211-3 1*01 AL: $41'el . 13,15
AmmxPT NO. 1(—')Z
This permit Is issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes. zoning regulations IN(SPECTILINS
and all other applicable codes and ordinances, and it is hereby (;;Ari LINE
agreed that the 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 does not waive restrictive ACKMA-F-IN
covenants Contractor and subcontractors shall have current city 1::JNAL.
business tax permits. This permit will expire and become null and
void If work Is not started within 180 days,or If work Is suspended or
abandoned for a period ol 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required I s ctions are requested and approved
Permittee SignatureV
Issued By- I L,i)L I I* UP ION 639—zll 7-1)
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
PLUMEr]*N(.. PEAMIT
CITY OFT167ARD C 0 11 i:)M:I:'T' NO - 1='1...(E3901„36
COMMUNITY DEVELOPMENT DEPARTMENT UATE 154SUED; 1/26/69
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223,(503)639-4175 1411.M I:*JM T .NO . 89013A
JOB (d)OPE.SS : 1,303P. 15W 1 .1-^101'11MONT DP
I Ax StAil: VILA AGE AT VIARK LT : 17 191!
I AND (.15L : P4 1.P PI)
'I:TE M NO:
WNW 01 ASS : Nr-:W WATER CLAMET 3 TPAP
USE— l'YPF** : STAGLE: FAWLY LJIF-41NAL 1310:11-01141 I-'I-"4VN'T*P
TYI::1-.: : VN L.AVOPATOPY '1141AP 1:)P]:Mk:;R
CAA 1;:, . (.71 F11:1 : A3 UJ13 GNEW:51": T'PAPS
GAWWAGE
NO. !.i*T'(:,IWTr-,:5 : 21 WO-L-4.13:14C11 MACA-11NE: I
DIWIFI.A... . UNI: F15 : I I AUNDPY 'T PAY RLDGA)PAIN MIA
DRAT'N
S 3'.r,K (ITT)
WA11:J4 FIRATEJ4 :1, 511-1114IM/14A1N (FT
OTIALA
F FES
0 DON PEPMTT $1,32 . 50
W
N 1--)1:1 130X 1.95pl
E pl*11'1''Inlmj I [XI'LIPE-Al
R
5 T'ATE TAX $
C
0 !11ADE:MAKE..'-:14 HAPOL D
N
T
R SOX F?50
A
C d 9*1023
T I '10 3) 6:10-_%'/'28
0
R 1 R01 1 CIIN N('.). 39;.' P '11 OTAL 1.319 . 13
ne'(:.E'T1--r No .
This permit is Issued subject to the regulations contained in Title 14 ..•_••••••.............................
of the TMC. State of Oregon Specialty Codes,zoning regulations 1:4-:1401AWD TINISPE.C,T*T(:)N 15
and all other applicable codes and ordinances, and it is hereby
agt ad that the work will be done in accordance with the plans and
specifications and In compliance with all applicable codes and A F?VAM
ordinances The issuance of this permit does not waive restrictive WA*1 IT P 1.. 1:Nr-.-.
covenants Contractor and subcontractors shall have current city TOPOUT
business tax permits. This permit will expire and become null and
void it work is not started within 180 days,or If work is suspended or PATIN DRAINS
abandoned for a period of 180 days any time after work has V*TINIAL.
commenced.It shall be the responsibility of the permittee to assure
all required,Dilections are requested And approved.
Permitlee at i I
Issued By L 649
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OFTIGrARD PLAN CHECK APPLICATION
�CITYOFTWAR)D PLAN CHECK #
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT 0
13125 S.W.Hall Blvd,P.O.Box 23397,Tigard,Otegom 97223,(501)639-41 FS DATE ISSUED
.JOB ADDRESS: iAX MAP/LOT
L 0 kXL W--T
LOT: 17 LAND USE-:
VALUATION:
OWNERSPECIAL NOTES
NAME,
Or.l UYLIDIZ j F
0 f REISSUE OF:
ADDR[ss4 , LAST REISSUE:
: o -,),-)q F24,
FLOOD PLAIN/
L
SENSIIIVE LAND:
PHONE:
APPROVALS REqU_Iff_'D
CONTRACTOR PLANNING:
NAME: FNG1 R' LRIN
ADDRESS: FIRE DEPT
01HE R:
PHONE'. ITEMS RU.QUIRLD
I IST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
NAME : CAI,CUCATIOPI5:::::
ODDRESS: JRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN:
PHOW : 01HLR:
COMMENTS:
P[ RM1.1 N ACCT 0 DESCRI P-[ION AMOUN-1 AMOUNT- PD. BAL. DUE.
10---432 00 Building Permit Fees
..............
10 431 00 PItimbing Permit I oes
10 -431 01 Mechanical Permit Foos
10- 230 01 State Bui Wing -lax (b%)
Bu i Id i rig
Plumbing clp
Me C h
10433 00 Plans check Fee 3
Ru i Id i rig �
P I umb i rig
Moch
13 30-207 00 Sewer Connection
30-444 00 Sewer Inspection
51- 448 00 Street System Dev Charge (SI)C) ——-----
52-449 00 Parks System Dov Charge (Pf)(,)
2,
31-..450 00 Storm 0rF,-iinaqo Syst liev Chrg (SrSDC)
10--230 09 T R I-'D
10--.230 06 Washington County Fire. 01 (9596)
10220 00 Amart/Wodgewood M 3Q
r 'I OTA L
REG N
n11P1_k'10NE I(,Imfl I Ulil
By! Dato Received:
cn/31j87P/18P
I aOWNEM MMMMMMMLML��MMLMmmw.�
13032 SW LAURMONT DRIVE
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INSPECTION NOTICE
i
City of Tigard Building Department
P.O. Box 23397
?igard, Oregon 97223
Phone: 639.4175
Type of Inspection
Date Requested Time----A.M._ P.M.
Address l 3 .3 L- !�-ati UVL+ Permit
Owner _ Lot #y
Builder
The following Building Code deficiencies are required to be corrected:
i
4
f�J
Presented to ❑ Approved
Inspector _ _ _ Disapproved
Date - —
CALL FOR REINSPECTION
C-1 YES 1:1 NO
s �
CITYOFTIFARD
PLAN CHECK APPLICA'I10N
PLAN CHECK N `-
COMMUNITY DEVELOPMENT DEPARTMENT awnA� DATEIISSUED
1 125 SW Hell Blvd. P.O.Bax 23397,Tigard,Oregon 97222(SM)6304176 � — —�—
JOB ADDRESS: TAX MAP/LOT S/ - .3 _—
SUB: liiig� �.� ,Sr.,�,�,� la/,� PorC LOT: LAND USE: R
OWNER SPECIAL NOTES
NAME �t '�«.�,_f i; r T c- REISSUE OF':
ADDRESS: LAST REISSUE: _
—_! FLOOD PLAIN/
_ SENSITIVE LARIO:
PHONE: _
;APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: _ — ENGINEERING: _
ADDRESS: FIRE DEPT _
OTHER:
PHONE: I ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX: _
NAME: _ _ CALCULATIONS:
ADDRESS: TRUSS DETAILS:
PARKING PLAN: —
LANDSCAPE PLAN:
PHONE: OTHER: --
COMMENTS:
PERMIT # ACCT N DESCRIPTION AMOUNT AMOUNT PD, BAL. DUE
10-432 00 Building Permit Fees
. 10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees 0, 2►�
10-2.30 01 State Building Tax (5X) _,2 �•S� ___�7j ?
Building //r
Plumbing
Mech _ .;T_�-3
10--433 00 Plans Check Fee SD,13 — _/0./3
Building —
Plumbing
Me c h /() , 1-3
30-443 00 Sewer Connection (20%)
L_ 7 30-202 00 Sewer Connection (80X) ' �U - - ►
30-444 00 Sewer Inspection — &y
51•--448 00 Street System Dev Charge (SDC) _(::w C/0
52--449 01 Parks I System Dev Charge (PUC)
52--449 02 Parks II System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chr•g (SSDC) U
10-230 09 TR1=D (95x) -- -- — ---� �-
10--435 00 TRI70 (5X) ----- �- - --�--
10-230 06 Wai;hington County Fire N1 (95X)
10-435 00 Washington County Fire N1 (5%)
10-220 00 Amart/Wedgewood �-
1 OTAF_
RFC y
APPLICANT SIGNATURE
Paco i vod BY : — ------ -- -- -- Date Rece;ved:
h t./15 R IP
PLAN CHECK NU.� T"
for inspections call 639•-4175 PERMIT N0.
CITY OF TIGARD 639.4171 8-24 1•
BUILDING P RqMIT DATE /-� SL
P.O. Box 397. Tigard OR 97223 �f/�l TAX MAP .r tOTNO. /7 SUBDIVISION
OWNS SS(�S 1�L G�'"�__ _ JOG ADDRESS -1,3032 e-it ua mi ata
BUILDER STATE REO.NO. EXP.DATE BUILDER-2 PHONE At
ARCHITECT __ PHONE OTHER ._
STRUCTURE 41NEW ❑ REMODEL ❑ ADDITION O REPAIR O MOVE O OTHER O DEMOLITION
O RESIDENCE O COMM O EDUCATION O IND • O AEUQIOUS. O-ACCESSOAY Q GARAGE O OTHER O FENCE
OCCUPANCY LAND USE ZONE-'„! BLDG."PE "` FIRE ZONA_PLAN CHECK BY �' IOAT
Construct single family dwe11Ing w/attached Caranp- all per mpprouerl pians,
SEWER PERMIT11.3 •(ldu) baths., trans garage
OCC.LOAD FLOOR LOAD HEIGHT ' . NO.STORIES ) AREA . -NO.BEDROOMS VALUV—QaW
BUILDING DEPARTMENT SET BACKS FRONT - . REAR LEFT SIDE - RIGHT SIDE
PermIj `' — THIS PERMIT 13 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE.ZONING
-; REGULATIONS AND ALL APPUCABLE CODES AND ORDINANCES.AND IT 13 HERESY AGREED THAT THE
Plan CMek 7 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WfTH ALL APPLICABLE CODES AND ORDINANCES.THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PI.Ck Fki -- RESTRICTIVE COVENANTS.Ob CTOR AND SUS CONTRACTORS TO HAVE CURRENT CITY BUSINESS
t , TAX PERMITS.SEPARATE PERMI S O ED FORS PLUMBING AND HEATING.
Slate Tax SSrx
Total SOC—
A PPLICAN T OR AGE-1 y—
POC
Prapd. PN(1NE --
,-, Receipt No ADDRESS
Sal.Due ` d�
laaued 9y Approved By—
SSDC --- $
RECEIPT #
DATE Pb. cT3
5CWER CONNECTION S AMOUNT I'�
5FLIER INSPECTION 4 _3
EWER SURCHARGE
ommente; �,r�c ra I' r'c_ra T S L,� �,• ��`7-.�0 _ .
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