Certificate of Occupancy ADDRESS:
i.',recordsln,ic,iof!m\t3rgets\building doc
-TTY OF. TfGARD MECHANICAL PERMIT `�' ip`" - ----___-
-3125 SW HALL BLVD. Permit* .------
O. BOX 23397 � ! 3 D Description
IGARD, OR 97223 1 /� Tate 7A Mechanical Code CITY PRICE AIS`
r5U1)639--A a 75 1) Permit Fee -0- -0- 10.00
2) ;supplemental Pennit -_--- 3.00
.drb
/� I' Furnace to 100,000 BT(I 6.00
Address V()o Irl �L1 U I t�C'1 1� 1[ i id ducts&Nrents
Tax Lat Map No. ) Furnace 101,000 BTU +
2 7.50
incl.ducts&vents
d
LIM Ok+dt Subdivision - — - - -- ---
-_ IMame(or imm of limble" 3) floor Furnace 6.00 `�?�il
, I-�n Lvl t I r j 5 inr.I.vent --_._ -
M ROW 4) Suspended►•eater,wall heater 6.00
Owner 5��k 4 b Ij ( l",C L or floor molmted heater -
5} Ve it not incl.in
ah� 3.00
T 1 i �� n _7 z 2 1 appliance permit -- I
Name(a me d bu**ss) r 6) Repair of heating,refr ig., 6.00
cooling,absorption unit
fhrorb 7) Boiler or comp to 3 HP---- 600
comp;JpM( - absorp.unit to 100,000 BTU
I 8) Boiler or tr 3 HP-15 HP l;.00
absorp.unit to's00,0018TU
Nam -' Boiler or comp �9-30 HP 15.00
y' absor.7,unit 1/2-1.Million
�I (' VY � w_ 0 d4tlt �ODtt-rt - - -
t *WV Adaesa Phone 10) Boiler or comp to 30-5o HP 22.50
abso(p.unit 1-1.75 million
Contractor 11) Baler or oomp to 50 HPCRVIWAW 31.50
� �(.�
d �� � '. �, 1 absorp.unit 1,750,000 8 T'�l
state No. �6us lax Na. 12) Air handling unit to 4.50
10,000 CFM _ _
$�Z
12-72- Air handling unit —
I hmeby adanwledge ow 1 Nava rad tis apo ition VW IM Warma§a+given is 13) 10,000 CFA + 7.50
amed,that I am ire owner or audvvized agent of Ce owner,that plans submitted are in --- -- --
ccmpiaooe with Stale taws.that I am regislernd wilt the sure Builders'Board,thal the 1 b) Non portable 4.50
raarbw phren is coned.IN exerno from Stab registration please pine reasar below) evaporate cooler
15) Vent fan connected 3.00
to a single dud
--_---_� ----.---- -.--_ .-_._---- 16 Ventilation system not 4.50
included in appliance permit
_-_._-------_----- --
17) Hood served by
b.50
mechanical exhaust
siprs ace(ow<w ot.para) oaM 18) Domestic type 7.50
Ck• ribe tmxlc (I additionCJ alteration C repair [I incinerator
to be done residential 0 v non-residerdial EJ 1 g) Commerciaf or industrial 30.00
ExisOng use of type incinerator
buiiding or property` __ ?0) Other i.e..woodstove,water 4.50
heater,solar,clothes dryers,etc.
PnNxned use of _ -
building or property_ _- ._. 21) Gas piping one to four outlets 2.00
Type of fuel- oil [] m<:tural gas I_PG p electric 0 ---�- -
-- -� 2,22.) More than 4-per outlet
Nf'TIgE -- SUWTOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON -~ ---- -
GE
STRUCT10N AUTHORIZED IS NOT COMMENCED WITHIN 180 _ -- 5'K SVgCHARAUTHORIZED
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER --- —
WORK IS COMMENCED. TOTAL
Special Conditions
---- ------ — Date issued__�— ^_ r__by_
Address �� .5�,,�> �- ��� l�«�� � _�;�1=srmit No. /Dlo(o ,S
/ Permit charge 22 0
Owner ��-a� �c �_ Cnnnection fee
Paid by
Type of building il_�� Date connected
Servi ; � rate Inspection fee
Contractor _ Paid by Date
Size Or L,onnection _ Assessment paid �____
INSPECTION NOTICE �
City of Tigard Building Department
13125 ON Hall Blvd. rigatd, Oregon 47223
Inspection Line (Roc-O-Phone): 639-4175 Business Phone: 639-4171
Inspect ion t
Foot' ,Ig Plbg. Underelab Mech. Rough-in Appr/Sdw1k
Pound. Plbg. Top Out Gas Lina FINAL.
,(
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Ream Meeh, Rain Druin Insulation -Plumb.
Plbg. Underfloor Nater Line C� Gyp. Rd. -Mech.
tatu Requested: (.]– 1 o f I / n Tie& (� AN PN
AddresetS�'<� l�lcle1• ,tiUIG �•P.tmit�r–
Builders, jyY�Q a7 6,19
d
TIM POmONING CORRECTIONS ARE Riv2IIRED=
lie L11 11 01" 1 jjr %oevi,cc OLOC(
u! ! - ,
C11�'Yt4�t , I� (c < t 1
61
Inepecton
Data:
APPMM DISAPPROVED —� APPROVED SUBTECf To A
Call For Reinsp.
NS PISCTIOtI 1/0`PICE
City of Tigxd Buildipq Department 1
1.3125 Sti tL:ll. : lvd. Tigard. Oregon 97223
Inspection Line (Roc-o-Phone): 639-4175 B: aineae Ph.no: 639-4171
Inap..et!.on:
Footing Plbg. Onderelab Koch. Rough- AQQr/Sdwlk
Found,
Plbg. Top Out Gas Lina FINAL:
Post/Beam St:ruct. Sen. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation
-Plumb.
Plhq. Underfloor Nater Line
Gyp. Bd. -Meth.
Date Requested:_ Time:
PH
Addrees: �, Permit f: r�
Z'JA --L_"--�---
Builder: L00,
THR FOLLOWING CORRECTIONS ARE REQUIRED: --
71-7
CO �i
tnepe^tot•_ ( �— � `_ /.���` C�j
Date:
_APPROVED --- DISAPPROVRD _ J--APPROVZn SUBJECT To ADM
_____Call For Reinsp.
MECHANICAL
OF T'VACirfRMIT
RD CrTy PERMIT 4. . . . . . . t MEC91-0015
COMrAUNrry DEVELOPMENT DF42,NENT GRIG*N
13126 SW rill8fvd. P.0 Box M
23397,Tiq& ,Oragm V=(6W,;,639-4176 DATE 15SUED. 01 /28/91
ADUHLbS. . . .' 15b80 SW ALL)ER16ROUK DP. PARCEL: 2S111DC-0330:
SUBDIVISION. . : GUMMERFIF-1-D NO. 7 ZONING: R-7
BLOCK. . . ION.___.. :
. . . . . . . . LOT. :386
CLASS OF WORK. . :ALT FLOOR FURN. . . . : EVAP COOLERS:
TYPE OF USE. . . . -SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . :R;3 VENTS W/O ADPL: 1 VENT S�STEMS-,
STORIES. . . . . . . . . BOILERS/t�MPRESSORS HOODS,. . . . . . .
F(Z',L TYPES---- el-3 HP. . . . DOMES. INCIN:
: :GAS/ 3- HP, . . . COMML. INCIN-
t -J-l"
WiX INPUT: BTIJ 15-30 HP. REPAIR UNITS:
F :R(-. DAMPERS?. . : 30-50 HP. . . . WOODSTOVES. . :
GAS PRESSURE. . . s 50+ HP. . . . . CLO DRYERS. . -
NO. OF AIR HANDLING I-IN I TS OTHER UN ITS. : 1.
FURN ( 100,11, I3TU* 1 <= 10000 rfm- GAS OUTLETS. : 1
FURN ) =100F, BTU- Y 10000 cfm:
Remarks : FUPNACE, VENT, WATER HEATER
Owner.- --- --- --------------- FEES
D. HOFFMAN type amalint by date recant
15580 SW ALDERBROOK PRMT $ 25. 51L'-
5VICT $ 1. 28
TJG()RD OR 97E24 PAYM $ 26. 78 JLH 01 /28/91,
Phone #:
Contractor-
COLUMBIA HPATING
8900 SW BURNHAM
SPACE E-ilo
TIGARD OR 97223 -------------------------
Phone #v 624-2704 26. 78 TOTAL
Rem #. . : 38026
-------- REWIRED INSPE(,TIONS
This pervit is issued subject to the regulation contained in the Final Inspection
Tigard Municipal C,;Jv, State of Ore. Specialty C','es and all other
applicable lasts. All work *ill be done in accordance with
approved plans. ThiE permit will expire if work is not started
within IN days of issuance, er if stark is suspended for we
tti'an IN davi.
Permittee Signati-tre 714—
By -
Call for insvection 639-4175
CITY OF' 'T'I OARV - RE-C:E I VIT OF PAYMENT RECEIPT NO. :910c)07
CHECK AMOUNT z 18
NAME: C,n1..UMB I A HF:, TING CP:13H AMOUNT a 0. 00
ADDRESS a PAVMENT DATE : 01
SUBDIVISION
1`.5`.°aO A'-DE:RB ROOK
I-URPOSE OF F'P!YME:N*l AMOUNT PAI D PURPOSE Of' PAYMENT A14OUNT POI D
1. 26
TOTAL AMOUN-T 6-nm - i 26. 78
,JOHN E. RERAGIROI Pl;l`#Dillri, )ti(i BUILDING DEPARTMENT, TIGARD
P. q. 6oY 1129 PLUMBING PERMIT NO.
91132 holder of a valid plumbing contractor; license is hereby '
authorized to cause plumbing work as herein noted to be installed in accordance with the plurnhinrl code of
Tigard. Such installations require inspection by the City Inspectr- who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.� �f ���� ✓ /���Q�
Own �
;;! ,t�iQ[/ Address
NUMBER OF TOIAL
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office
llsoOnly)a Onl
11LETIAL y)
N
Sin IR Fnmilj�7 l both-each 25.00
Duplex—Each t bath uni, 25.00
Additloral bathrooms—each 10.00 Q —
Mobile Home S ace—each 1500 —
INDIVIDUAL FIXTURE FEES ---
1 to 50 Fixtures in 1 building—each 3.00
_ 51 to 100 Fixtures in 1 building—each — 2.50
101 ;0 200 Fixtures in 1 buildin9—each 2.00 _
201 or more Fix.ures in 1 b rilding—eoch
1.50
MISCELLANEOUS _
r39ildln9 Sewer-1st 50 ft. _ 10.00
Sewer—each additional 100 ft. 10.00 _
W,iter Service to building5.00
Pri%c.i Water Systems—each 1G0 ft. 1000
Other ry' ecif
PERMIT ) For Plumbing /nsoect;on Phone 6394191
- State Q Plumbing Contractor By.%
TOTAL n RECEIPT NO. ISSuVj Ey �""
CI Y QF TIGARD V C �t
v
c. OREGON Y
Tualatin Development Co.
Owner:...... ..Permit No.... 1119
S
�•', Building Address.-.._..15580.. SW. .Alderbrook.,Drs.............
.� Certificate is hereby giver, this.l.5..........day of....March ................ 1 .....77 � r'
`� that said building inay be occupied and
IC that it complies with all requirements of �
the Building Code for the Cicy of Tigard,
1
( as approved by the Tigard City Council. r
Lit
•�� i� $u3?ding )nspertor
't
Ike.. `/�l-�:.�'4�* ••.1�`��� - � ./4�4` - »�-?t vs'"�.�y. v "•' ,,may Y � �v�.�`Q as\
IS \ l+y,�u r •`� •_ f. t� � , . .. .. .-.,iF• `~ Y `tire '•�./r `4� .`. \.
City of Tigard
INSPECTION REQUES T
for
INSPECTION TIME: PERMIT NO. :.__,_._._
DATE: 7 DATE fSSUED :__,L..L_
OWNERS NAME : , —1
A,D D R E S S: —L&r._-_,E'�O �►.m
-- �.�z ,F r et-r.� 7
C 0 N T R A C TCS R A rz R 10
TEST : Air p, Woter[] , VieualXl/ Lobr)rator.v [] _
RESULT' Approved Disapproved C Pending p
SKETCH. a
f
ez.
INSPEC—T R� DAY ,r7
COTE: Attach fupplem#rtal lost data hp►et]
i
C itY of Tigard
INSPECTION REOUEST �
for
INSPECTION TIME :
PERMIT NO. .
DATE:! BATE ISSUED:...1__L__
OWNERS NAME: -2,
ADDRESS : L_ i =� •y�o_ .�i �f
I CONTRAC'r0R : � ���-i"u� 7a� �� �`Z
fTEST: Air ❑, Water ❑ , visual)d, laboratory p
RESULT: Approved Disapproved ❑ , Pending rJ
SKETCH.
I
I
I
INSPECTOR DATE_
COTE: Attach lupptomenta( test data h-ret
1
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JOKY E. RIM:VAN PEO!^OING, INC. BUILDING DLPAHTNILN f, TIGARD
P 0 ROY 179 PLUMBING PERMIT NO.
NEVI6ERG, OREGON 91131 ----
holdel of a valid piumbinn contractors license is hereby
authcrized to cause plumbinn work as herein noted to be installed in accordance with the plumhinrl code of
Tigard. Such installations .•eq.,ire inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all co tractors and sub-contractorsOwnaL . f
- _... Addressate_.tl��� �
NUMBER OF TOTAL PERM-, NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (office Use Only)
RLSIVENIIAL -
_ _
Single Family-1 beth—each _ ✓ 25 00_ .i, L�7
Uuplax–Foch 1 bath uni; _2_5.00
_A.dditional bethroorne_each _10.00 ,LO• UU
Mobile Home Space each 15.00
INDIVIDUAL FIN TUNE FEES _ +
1 to 50 Fixtures in 1 bv..,;ing—each 3.00
51 to 100 Fixtures in 1_building7eech I` 2.50 ^
101 to 200 Fixtures in 1 building—each_v r 2.00 _
201 or more Fixtures in 1 building_each _ 1.50
Mlsc" I.LANE0US _
Buildir. '',ewer-1st 50 ft. _ 10.00
LtOP'h"r
wer- :h additional 100 ft. — _ 10,00
oter Service to building 5.00^
ivate Water Systems—each 100 ft. _ _ 10.00
(5 self � —
1'ERMIT_ Q6) For Plumbing Inspection Phone 619.41QI �7
9b Stets Plt nbing Cr,, tractor 8y
TOTAL ALL
' RECEIPT NO. Is, Jed By `_ �
City of Tigard
I
INSPECTION REOUEST
for
INSPECTION TIME : f ", PERMIT NO. :
DATE: 24 DATE ISSUED:—L,_1
OWNERS NAME: -
ADDRESS : __< P '` �+G —_� 4
{ CONTRACTOR : TI'r
ITEST: Air ❑, Water p , Visual ❑ , Laboratory p
RESULT. Approved ❑ Disapproved [I , Pending j
SKETCH:
t
INSPECTOR DATE
1
[NOTE Attach supplemental toot dojo horet]
r�• T CITY 10-0-76BUILDING PERMIT APPLICATION of TIGARD DATE 1119
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE A.CCOMPA14YING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.___
OWNER loolt.-Ire .1k)Up t-1-'' JOBADDRESS J.)_. 60 ''' i}rli LJtJk' Ft111 tADDRESS _
ARCHITECT
emEl ENGINEER
Same a AnDRESS DESIGNER
STRUCTURE ❑
C34EW REMODEL ❑ADDITION ❑REPAIR ❑ ❑
RENEWAL [IF IRE DAMAGE ❑DEMOLITION
D14ESIDENCE OCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PAT 10 ❑CARPORT ❑GARAGE I,.JSTORAGE❑SLAB []FENCE
❑BOND ❑MO`/INC ❑CONDITIONAL USE [:]DESIGN REVIEW _ ❑COUNCIL APPROVED []SIGNS_ 3 is Tit
OCCUPANCY I.AND USE ZONE BLDG,TYPE FIRE ZONE__ PLAN CHECK BY H_EAT __-.__
w +; ,386 MK V He-issue name as 1"'a13 SU `iummerfield Lane _
Frame dwellin u attached Garage � 3 bedroom Zj hath
OCC-LOAD _ __fLQQR L QAD HEIGHT STQRIES
NO. A[iEA
.�_ 20 DO'Iy9 @EpP�Q.tyLs 3 VALUE 3:-,,:'iO3e 0i
�_ ___ _
BUILDING DEPARTMENT SET BACKS FRONT REAR �j LEFT SIDE 4 RIGHT SIDE
Permit
1pQ� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check • REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sul)total ALL APPLICABLE COVES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT VvA.IVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY ALISINESS
State Tax 4e 6!..' LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 15ye6S
g.:
ArPP' ICANT On AGEN1 - - - -- - -
Approved I T4LI Receipt No i
ADDRESS PHONE
BUILDING PERMIT APPLICATION coF TIGARD DATE 10' 19,76 19 f
THE UNDERSIG14ED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE —
LOT NO.
1u:,1L..n .)UV. (,,:, 1.) i60 `.,i) Altjurbruok i
OWNER _ JOB ADDRESS FIOFIE ADDRESS _
ARCHITECT
�SllTlr.i ENGINEER
BUILDER ��y1�� ADDRESS DESIGNER
�tS--TttRUCTURE CiWW 1:1 REMODEL ❑A.DDITION OREPAIR ❑RF'..WAL []FIRE DAMAGE []DEMOLITION
CIRESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ORE' ,GIOUS❑PATIO ❑CARIORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
r BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
3 LTU --
OCCUPANCY _LAND USE ZONE --BLDG.TYPE—_ FIRE ZONE PLAN CHECK BY - HEAT______
I_,�t 396 MK U Re-issue same as 1 )13 SU Ewinmerfield Lane -----
-- Frame dwellinrj u/°attsched �3 bedroom Z* hath
QCC-LQAg .FL0QNLOAD 2!0 (}Z( 3,)i303.01
_ _—..�.�.LGH? T I" AREA _` Q,�EDROOMS VALUE
BUILDING DEPARTMENT ----T
-- SET BACKS FRONT REAR LEFT SIDE 01RIGHT SIDE
PE rmit 1A:�10ti –� -- ----- — —
Plan Check .65 HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CGNTAINED 1N THE BUILDING CODE, ZONING
HIS
AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SIM CONTRACTORS TO HAVE CURRFNT CITY BUSINESS
State Tax 4o65 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUM81NG AND HEATING.
Total 159e65
By
--- AP CANt OR AOEN1 — -^ --�
Approved E Y�r Receipt No. •
AD -- --- P. .----- __._
DATE INSP. TYPE INSPECTION REMARKS � PLUMBING DATE
Contractor
Permit No.�
_
Rough in
Fixture - —_- —
/' — Final____
HEATING
Contractor
L
tic 4 i Permit No. ,11 iG
Gas or Oil
Rou "in
Final
SEWER
_ Final
DRIVEWAY,7
_ Final
Storm Drain
Rain Drain) Final
Sidrwalk
Curb&Street Final
A oath 1- 3 -I& LCA
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Lanrtscapinq •
Zoning rival
10669
UNIFIED •_. ._WERAGE Ada
10-8-76
WASHING ,, ON COUNTY DATE _ _ -- -- --- E
CITY 0I= -- ---- -
- -
I
APPLICATION FOR SEWER CONNFCI-iON PLRMIT
T.D.C. --
OWNER:
OWNER'S ADDRESS: --- -----..--- _-- -
STREET
-- i IP
t;ITY -- --_ _ -
-- --- STATE
BUILDING SITE: LOT-. BLOCK ._ _. ADDITION
TYPE OF OCCUPANCY residence
— --
I TAX LOT N0. - -- _
ADDRESS -
DWELLING
DDRESSDWELLING UNITS 1- -- -
_ FIXTURE UIVI"S -- ---
SURCHARGE IF APPLICABLE
575. 00 25• I-�9TOTAL DEPOSIT,-_-D (00.00
PERMIT FEE _ INSPECTION FEE ----
�
(NEIN) (EXISTING) BUILDING SEWER SYSTEM - Fanoo Creek
The Applicant agrees to comply with all rules and regulations of the Unifir d-Se1.verage Agency.
APPLICANT - ks
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
I_IfJC SIZE _- -- --- �
__ INSTALLER
RECEIVED BY - - - — - --
(AGENCY 6i6U AGENT)V
COMMENTS:
Th;s Application and permit expires in one hundred and twenty (170) days.
The amours paid will be forfeited should expiration occur.
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