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CITY OF TIGARD BLDG. DEPS'.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(S`, of the !'niform Building Code, the
following item(s) require correcting:
sem-•_,_:..-�w =lam�_..�'► „� �..
gate: _. _�_ _ Parmit No. -
Inspector` =%
CALL FOR REINSPECTION
Fill
BUILDING DEPARTMENT, TIGARD ��n
r LUMBING PERMIT'
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code. of
Tigard. Such installations require 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 rerlui,-ed
for all contractors and sub-contractors.
OwnerEa` � —___ Address._`�dE._
— _--
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS^ FEE ON EACH _ AMOLIN r
RFS• I D E.NS1A.1.�._.�__.__.__ _�-- __._�__._ _ .._.__� -.-_—.--_ t-T...•
— °ing!e Family-1 bath—each l 25.00
Cu lax—Each 1 bath unit 25.00 Ie�'
Additional bathrooms_—each _ _ _ _ 10.00
Mobile Home 5p3ce•_each T _ _ _ _ 15.00 _ ___ _ {7•
INDIVIDUAL FIXTU_RE9 COMf�ERCIA _ _�
1 to 50 Fixtures_In 1 building—each 3.00
51 to 100 Fixtures in 1 building—each _ 2.50
101 to 200 Fixtures in 1 buildinl—each 2.00
i
201 or more Fixtures in 1 building—each _ 1.50
f
MISCELLANEOUS -----_
Sewer—each additional 100 ft. !_mm _ 10.00
'Nater Service to building �i5•00
_Other ISp?cif _
PERMIT r �� —`", For Plumbing Inspection Phone 629-4 1/1 I�
4 ,Mate V Plumbing Contractor By
�Tr1TA1 pFrFIPT nln Iee„orl nv
'%'�i"�.'j��P7F7P�►'1�'7,�f�.•�'P"^e ..'Rt"R- --F.a:a�+wry:
C iTY �1'' w tl
BUILDING PERMIT APPLICATION �F TIGARD DATE__. 9/19/
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR TNF WORK HEREIN INDICATED BUILDER
OR AS SHOWN AND APPROVED IN THE ACOCIMPANYING PLANS AND SPECIFICATIONS OWNFRPI�i®�E-,�
�4t Lutz A Co, LOT NO.
OWNER JOB ADDRESS "�'��('� � )�I I-�'Y�CIr[�y t't�F10MEADDRE55
j95 "�- =n°^'Ur7� ,r c+ 'r,T. 1RCHITECT
BUILDER 'S�IBC) ADDRESS ► r a j-'f Vt,-'1� ENGINEER
��yy _ DESK+NFR
STRUCYURE UNEW ❑RI MODEL— LJADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE DEMOLITION
D RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOJS❑PA'TIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
LJBOND `❑MOVING ❑CONDITIONAL USE` ❑DESIGN REVIEW_— ❑COUNCIL APPROVED —` ❑SIGNS
DCCUPANCY_`_ LANA USE ZONE l —7pQ.Bl DG,TYPE---FIRE ZONE_ PLAN CHECK BY NJH HEp,T
-- -- 9 gtr.uct single family r. Wolling W/atte-Ched yaregs. 2 iUr.c)ms i
''u•-151sud of Per;;11 i'29016 (1261b sw chicory t curt)
--- Sauer Permit #20360 — 00...j.0
--
x��52 faCq.
o"-LQ9C�.___—_... F!_QQ6�A-D_-_-. 40 HEIGIjT— �'6 AQMgffj€_ 4�runwnn AREA NOB
__��..�YM.$—k__YALE_
BUILDING DEPARTMENT r 2;.,
SE BACKS NT R A LEF Ip Q I 'HT SIDE t�
Permit `16�•QI - , —
I Plan Check 10•p�� TH„ PERMIT IS ISSUED SIJBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REjLILATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
sub-total 176Lit WORK WILT_ BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND INCOMPLIANCE WITH
• ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY RUSINESS
Stdte Tax ''y 1 6 �4 LICEN,. E, SEPARATE PE MITS REOUIRED FOR SFWER, PLUMBING AND HEATING.
Total 4182264 1. .C�[i
PUL #1 6100600
By p1
Approved FI 4ev-,7— APPI (CANT OA Ac,ENT - - -
Receipt No
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contrava
9 /f#.N permit No-zoV4 —_ 4
•—
Rough-in
Sis h KE __ Fixture
-� Final
Q HEATING
3-.2 � c ��L91 1J�3•w�,r�.te_e Contractor
3125-C a aR w�►C d /Q Parini:No
Gs:or ON
-- Raughin
—`-- — -- Final----
SEWER ^
Final —
DRIVEWAY
— �— — Final
Stone Drainage
— (Rain Drain)Final
Sidewalk
--- __ Curb>mt Final —
Approadl
—BLDG.DEPT.FINAL -7 AtPOli CERTIFICATE OCCUPANCY Final
CERTIFiCAVE OC'.UPANCY -- —_
( ' b Land%ming
"j �l Zoning Final
L Oj lIC)Z1I mcc:>}iallica1 r t bT0 Permit_ �QD -
iL� � Fee
�!ew In�.allation [) Fleplace Relocation l Addition C-1 Alteration r � 4%State _!
TOTAL_ - 7"LY -
C`E{5AT I
�rPJ T
RAC
O F :j & � OWNER
WJ
4 _.._._..—..._._,. WORK ADDF;ESS
P1IONI ��_1_LS"' ._�._�_.,�._—__. APPLICANT
I-;cit Input Rating (BTU Per Hnur). —__—.._.._. VwIt Size _.__ _ _ ___ Flue Size
i UEL OIL C] GAS E7 ELECT 0 OTHf:R---•---
ITEM N0, FEE ITEM NO. FEE S'
�r Is>vancc of P?rmit _ r 0 +^_ Air_Cundition_Compressor 15 to 30 HP --� _ 10.00
Naw-•ut_ to &_ inc1.100,000`i�TU 4_00 Air Handling 10,000_CFIVI 3.00`
hew.1_0_0
00 1. RTUIT & over - _ _— Air_flandling Over 10,000-CFM
Flair Furnarl, - 4,00 Evaporativa Cooler
_ _...__.-- .. ---
ai_ _ Floor— - Suspended 4.00Rangc Vent Fan 7..00
Install Vents Only 2.00 Vent System 3.00
Flepair •Heat& Cooling 4.00 - flood Commercial - —_- 3.00_
Air Condition Compressor Under 3 FIP 4.00 — Comnrercini Duct System -- _ 10.00
Air to 1-5H,*P -- — 1.50 �—
�x.=—_'�-=..ac.:_��.i.a�_=�..�r_t=._�rc-r_..e:a_.:_—�..-_- _:.. __ �--=-+sr�.ra^_-sr.�r_._�_..-_ — ---_ _—•—�=
INSPECTOR'S COMMENTS_ ----
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
i FPFtOVED BY_____--_-- DATE ISSUF:0 BY _ DATE --
FIFCFIPT NO.
,„ Signature of Applicant