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12870 SW CHICKORY COURT
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address Permit #--
Type of Inspection
The following Building Code deficiencies are required to be corrected:
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Presented to _-�__.__-----------_-_-_-_._--- 1-jspector
Date
CAL-' FOR REWSPI -7700V
13 YES ❑ NU
v..
BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT N9
np t Q�Q holder of a valid plt,mbing contractors license is hereby
a-ithorized to cause plurrihing 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 required
for Ill contractors and sub-contractors.
Job
Owner A�� K L�'Mc�s Add ress.l?rW1Q___',:0_+3 — atP
NUMBER OF TOTAL T
TYPE LIP PERMIT 1'fI:MS FEF ON EACH AMOUNT
9 ENTIAL
Single Family bath-•each l _ ;5.00
Oupl4x•-Each 1 bath unit _ 25.00
Add�i nal bathrooms—eech 10.00 _
.10obiie 1. )me Space•-eech 15.00
INDIVIDUAL FIXTURES COMME.RCIP,L —
1 to 50 Fixtures in 1 buildi —each .� 340 -
FY51 to 100 Fixtures in 1 building—eacn 2.50
l_101 to 200 Fixtures in 1 building—each 2.00
201 or more Fixtures in 1 bulidin —each( 1.50 MISCELLANEOUS
Ssw-?r—eech additional 100 ft. _10.00
Water Service to building!—� _ _____5.00
,Other (S ecil ):
t PERMIT !!R For Plumbing Inspection Phorre 639.4171
4%S+ate Plumbing Contractor By
TOT AL RECEIPT N0, Issued By
i
(,,,,i ty 0i I IOc11,0 Mechanical per, Per it-
Fee
Nc,.v Installation-v—replace ❑ Relocation n Addition 1-1 Alteration [] Q State_ 2�
i TOTAL___ 7•Z e_
HEATING
CC)N I-RACTQ F OWNER L
i �
f�'rURE� -----_�__ WORK AD[1liE r �4/
PHONE APPLIC• N'r�
i•:e.3t Input Rating (BTU Per ;: +ur)� _ _ _ _._ . Vent S ze Flue Site
i UEL OIL CJ GAS T01— ELECT OTHER
I rEM NO. FEE ITEM 140. FEE t,
For issuance of ParmitJ��_�_._ _ EE 0 . Air Condition_Compressor is en ,Q HP110.00
��levr�up'to & iric 1.X00 0�'J hTU — _ _ ��1.00 Air Handling 10,000(:FM_ 3,00-)
N.•w_100,001 BTU s & Duet —_ __ .t:0 Air Handling Over 10,000 CFM 5.03
Floor Furnace_ _ _ _ _ 4, vaporative Cooler
',ball- Floor •Suspended _ 4.00_ Range Vent Fan2.00
Install Vents Only 2.00 Vent Syster,t 3.00
Reoair -Heat& Cooling_ _ 4.00_ Hood Commo_rcial _ 3.00
Air_Condition C_ornpressor Under_3 lhIP 4.00_ _T Commercial r)uct�System _ �y i_ 10.00
Feir Condition Compressor —
IN:,PECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOw ALL CONTRACTORS Oil SUEI-CON rRACIORS
/J'P20'.'E0 SYr_ DATE � ISSUED BY DATF _
F1F.CEIPr NO.�
��� Signature of Applicant
i
rnpnrT•r.+wpppll�N'r iynv w ,�.�+pair.Gi'•"�`.f�wY{ryJJI%�'o"r sip"w W,_..t... .. ._ _,.._. . -�w. _�,,. a.�-�;
BUILDING PERMIT APPLICATION " TIGARD DATE__ . __- 9/0 ____, 19 19_
64s1. 644)1.
'HE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK Hr REIN INDICATED BUILDER PHONE
OH AS SHOWN AND APPPOVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONET
LOT NQt+T'r
OWNER ruLhon, JiK JOB ADDRESS I(.".)7i) SW � _` � HOME ADDRESS _
--�
1719s Sac/ _'c5ArdN�Nt.-nC, ARCHITECT'
ENGINEER
BUILDER _"may ADDRESS " DESIGNER
STR_UCTURELJ
_ NEW ❑FI MODEL ❑ADDITION _OREPAIR ❑RENCWAL ❑FIRE DAMAGE 0DEMOLITIO1,
❑ RESIDENCE []COMM C:UUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE (✓]STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL I WE ❑DESIGN REVIEW [,COUNCIL APPROVED _❑SIGNS_
i��J lig% rill ag ' i.lrH
1-41.1J
OCCUPANCY ..,_LAND USE ZON'__ BLDG.TYPE _FIRE ZONE_ PLAN CHECK BY HEAT
''onstavct dingle family ►luAlling wolattached g3rags. 3 ®adruums 3 butht:.
--issue of Permit, ;;.2127 (10012"a Sul Sumlaat Lal<,- Dr.i%je)
SdMfalr Periait 203(6'.;
4U ?n 3 ��3�1C3fy.
c�ct#.L( J))---_r.1.2SZHJ.SLAP — � 1SzH?_---_ _ _1VQ—ST9gF$____.�1P A_ IQ:gELEQ4M�_._1(Al�.
BUILDING DEPARTMENT SET BACKS FRONT 38 REAR LEFT SIDE U RIGHT SIDE
Permit It;90131) =LT nrl
— lie Q THIS PERMIT 19 ISSUED SUBJECT 1'C 'tHE REGULATIONS CONTAINED IN THE BUILDING CGDE, ZONING
i!an C►'eck REGULATIONS AND ALL APPL,"ABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE. DONE I•J ACCOR1ANCF WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total� l;q� ALL APPLICABLE CODES ANF ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRFNT C.Tu' BUSINESS
State Tex �� I I LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING
By
APPLICANT OR AGENT
Approved Rp(el ,1 N��
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-,��-3-1,9 o v r � _ Contractor
Permit No. aO �. 4111'a /I-1' 2 f
Rough-in
Igor 141. iti Fixture
Final
/(,G ko (� e Vpr- HEATING
Scor gcah - -- contractor
Permit No.
,ate Gas or Oil
Rough-in
final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Firal
1
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