10440 SW CENTURY OAK DRIVE N
v
to
s,
o..
IEi C) c J u? d 1
rl
s
_ W
J �
`r
X
10440 SW CENTURY OAK DRIVE
2AI8C xvo mniNsD MS ObbOT
JI
a
r to
31
nj
i
1�
r
i N 1
t
> o
A 0 H :0
-14 n z � vi �1
m r a4 Sol
a
s�
3
,ZIP1Y1-
CITY OF TIGARD 71ECHANICAL PERMIT
DATE_ J7 r PERIM T NO. -aGI 'M RECEIPT NO.
BY FEE
�(' ; , � N { r//l Cry ------, ----•
_. � � �
1. Permit shall be obtained prior to commencement of installation.
2. Permit shall be obtained for all appliances which are to become
a fixture to the building.
3. Relocation, replacements, alterations, or changes to burners and
duct work require permits.
4. All work to be conr;ealed must be inspected before cover up.
New Installati n � Re 7_acE ❑ -Relocaticn ❑ Addition U Alteration
C ONTH. c Kit,* �...____ ,. OWNER --t- . .e z ___._-------
X�
ADDRESS WOKK ADDRESS �! /s/l • !� :�l <'fLADDRESS �-:r;';'Ls'f. ,�)• C� �_��k" � �
APPLICANT _ �l
14
TELEPHONE NO. � �t--�
FURNACE - MANUFACTURER '�Z;, _ �'C ci'r /c_%, TELEPHONE NO.
HEAT Input rating (Btu Per Hour) ���^mr Vent Size _ _ Flue Size
FUEL OIL L, GAS ELECT Q OTHL;:
TOTAL SQ. FT. Top Floor Main Floor �1��' Basement _� t
GENERAL
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _ .00 Boilers Over 0_��____ 95 n
New - Under 10C,,000 Btu X4.00 Air Handling 102000 ;FM
New - Over 100,000 to .Tir Handling-Over 10.000 CFM
Floor Furnace _ ) Evaporative Cooler
Wall - Floor - us en e T+- .� ent FaH
Ins a ei. s Z Ven System _ _ U
Repair - Heat & Cooling 4.00 Hood
Boilers Under 3 Iii _ 4 00 DUmes-T�_TncUeraforr _ 0
Boilers-3�0--1 H _ 7.50Comm, ��ncinera�or — 20.0
Boilers-75-to -10 ~ x.0.00 , er o_tL_�isle33—
Bo=ers 30 to p =5�
INSPECTOR'S COMMENTS
APPROVED BY _ DATE ISSUED BY D�A`1'3
Signature of Applicant '-'l(
am � sa
II
i
Cit of Tigard
Y g d
INSPECTION REQUEST �
for o
INSPECTION TIME: /_,.� PERMIT
DATE: s �7� DATE
OWNERS NAME .' —
ADDRESS:, -7-
CONTRACTOR :
AMEADDRESS:, -7-CONTRACTOR : _ j4 �`- Alt!-:2�lllx
TEST : Air ❑, Water❑ , Visual ❑ Laborwor _ I
RESULT: Approved , Disapproved ❑ Pending
lz
SKETCH.
i
I
I
INSPLCTOR DATE !
EOTEAttach supplemental test data bereta0 I
1
I ALL SPACES MUST BE ENDORSED
IPRIOR TO APPROVAL OF TN'-:3E PLANS
PUpLIC WORKS4�
DEPT. BY_ _lily
PLANNI'!C D-PT.
f '•.L''� L1 't.
Tic-, =p ..
L;7 : G:.3
D.
f i
II
of Tigard
! NSPECTI®N REQUEST
for
NSPECTION TIME. . 6.? PERMIT NC. .
DATE : JAT�c -S
�.._._ (,,SUED :--��
t)WNFRS gAME :
AhDRESS: /-E'
0N rRA('T0R
'R•0 . V. c; r�
RESUL?" . rovedx, );.,uppro.ad G efldi ig
SKETCH.'
f'
INSPECTOR
DATE
COTE . At;ocn supplemental test aata hereto,
City of Tigard
INSPECTION REQUEST
1 for
i INSPECTION TIME :4-. -,�4 ►3ERMIr NO. . . .
DATE . ')ATF ISSUFU'__,"
OWNERS 'NAME '
A D D R E S(3 11�5�5�?S��C T�z�►
I C, )N1 RA CTO R
I
TFS1 � . Nester ; , Iq ,. ..
RESULT Npprulven $< ,
SKETCH.'
- NSPECTOR DATE
5 )TE : Attach sapnlementc� : o•r rPro t]
I
i
City of Ticjnrd
NSf ECTION REQUEST
for.
INSPECTION TIME :&/EN-M, PERMIT NO. -
i DATE : 3 //;% DATE I:iSIJED'
OWNERS NAME '
I ADDRESS :
ICONTRACTOR :-- -------_—___-- —_-...
ITEST .A r ;.j, Water , WisvGxfI La'* .rctcr� I=,
RESULT.' ApprovedDisapproved ,, �-ndinc J
SKETCH:
44,
I
I
I
YZ-123
NSPECTOR DATE
NOTE Attach supplemental test data heret]
a
i
City of Tigard
s
INSPECTION PEO, VEST
I for
INSPECTION TIME : NERMII' NO. —
DATE.'
_
r DATE: ,�7" _ DATF ISSUED
OWNERS NAME ' .rooc .
ADDRESS : _ L y
TES-1 iuiter Ln i
RESULT Li pprover+ 1
I SKETCH:
1-07 -4 y
IC-S,
I
i
I
NSPECTOR DATE
ENOTE: Attach supplementor test .: ops+ neret]
HAMM` PERMIT AMICATIM
Nk, t Ito!rri t No
Pewit fec
Permit lov,jud
cess: -er L/
L-72t
It J% ir.r P!:L Ir or' ta
I -
pr>jl r
;1;:d ld J I' W.'I K '1' 1 '.h' l- 'L of"I, ommenced- within
i,--i t,i is Fi,o,^ •idl. I I x pii :od .-( 120 days sitt.
F:`It?ITrt.J wed.
A . t., LI ent, i L., t"-- a $1.
I I r(I.O. And t No rLw i ;(j w,tj m,., w t tic same tj be true
(I law-5 )!k 4 f :1,r, t.f w.,,r k vi 11 be
i t tot,d bvr- in a r-ti, t a not presume to
:A fk!I t (,-i Local I!Aw regulating
0(
3161-11 i,!' ApIJ :11
d
i
' City ofTigard
INSPECTION REQUEST
for
iINSPECTION TIW PERMIT NO. : .�--
DATE : _ PZ DATA ISSUED'_- -�-�--
OWNERS NAME.. :
I ADDRESS :
CONTRACTOR :- --
i ' .a r J Water -L]
TEST' La'- :ratorl [.1
' x' Disa rover+ 1
RESUl1' : ppProvec.+ VP Fending 3
I SKETCH:
I
i
i
I
t
I INSPECTOR DATE
�ttnch Supplemental test Auto keret]
1
lit.. I
City of Tigard
INSPECTION REQUEST
far
INSPECTION TIME : /�•�'� PERMIT NO. :
DATE: Z A-3113 DATE ISSUED : Z
OWNERS NAME :
ADDRESS: 7- •"-mf-0e-/>A't �-.)
CON TRACTOR : SCG
'i EST Water E) , V;suai,VT, Laboratory r]
RESULT : Aporovedld :lisapproved G Pending p
SKETCH: f�� V:d _ y�EiL�
N
�i
F n & e,.
J,
INSPECTOR DATE
NOTE: Attocn suppiementol test da!a beretu]
i
CITY OF TIGARD
12420 S. V.. Main Street
TIGARD, ORIGON 97223
APPLICATION FOR BUILDING PERMIT
New Construction ❑ Demolish ❑ Addition ❑ Remodel ❑ Move ❑
ZONING` RX V-D DATE ISSUED 7-17-73 BUILDING PERMIT
DATE RECEIVED BUILDING FEE $ ,up No.73` I F4
PLAN CHECK $
F Ya F VALUATION $ 17,316.00
OTHER $ 1000
TOTAL $ 76,00 RECEIPT No.__,O./ k
15;-23
TWO SETS OF PLANS AND PLOT PLANS MUST BE BURNISHED WITH APPLICATION
LOT M 44 MAP M !61 10ll CENSUS TRACT W-ri JOB N
Architect or Engineer _ z ,a�„tin Deyelpymari��.-
Address 151X ;.W. lluth Ave., T &rd, Uregon -Phone-
Owner—
honeOwner ;,a De
Address —Phone—
Builder
honeBuilder
Address_ _ _ Phone
BUILDING USE Single Res. ❑ Mulci Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP_ No. of Stories 1. Total Height_ lj_ Area of Lot
Type of Construction XXKXXKXXXDMaD0= V Floor Area B _ 1 1170 2
Set Backb: Front lU _ Bacx 2b_ L.Side U R.Side 11
Private Sewer Pipe Size _4!` Sewer Kjrja rity Septic Tank lJ
Water Service Pipe Size 3/411 5tcrm Sewer a Ditch ❑ Urywell❑
Street and Curb Requirements_ __EXi,;tinE:
Driveway Width __10 — —No. of Park-ng Spaces Z
SL'PARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED 1U44U 9.w. century Usk Ur.
FIELD CHECK BY EC - _ _DATE_ 7-17-73
PERMIT APPROVED BY 6&1017 _
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the buil'ding will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
Signature Applicant