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13580 SW CRES[1ER DRIVE
ADDRESS^ -� Q � ��e.�r[J�J1.1 /C� _.. PERMIT NO.—
PERMIT
0,PERMIT CHARGE nuns
0'i ti E P,
CONNECTION FEE --_ , — -
PAID BY
i
TYPE OF BUILDING � [DATE CONN: CTED
SERVICE RATE c f�, �. INSPECTION FEE
CONTRACTOR .` PAID BY DATE
SIZE OF CO IN: CTION __ ASSESSMENT PAID
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIaARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following items) require correcting:
Date: -��-��_ Permit No.
Inspector
CALL FOR REINSPECTION
BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT —• �• -
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to he installer) in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector vvho 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 ail contractors and sub-contractors. fi 3
Owner Y L� t ! --, -- Acydress /moi `. S Ll G��C �!✓kc
� . Date� !� L
NUMBER OF ,TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
(Office Liss Only)
Single Femlly-1 beth_asch __�� _ -� _ 25.00
DuPlex-.Each 1 bath unit -" - y 25.00 -
Additionsi bethr0om7-each 10.00
Mobile Home Space-aoch -!y
15.00
INDIVIDUAL FIXTURE FEES
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 buildina-each __ 2.00 -"
201 or more Fixtures in 1 building-each -_ 1 60 - -
MISCELLANEOUS - -
BuIIJ ng Sewer-1st Soft. -�-- 10.00
w `--
Seer--each additional 100 tt. -` - -
-
Water Service to building 5.001Private water SyRtems-each 100 f -
"—_ 10.00
Other-(Specif�(Specify): - -
_PERMIT I
For Plumbing lnshection Phone 633-4171
State Plumbing Contractor By
TOTAL. ) RECEIPT NO. Issuer) By I
x•...�,R«—*w..�ow^'vor•�• ,.a.,.,.._-..._.._ ._ .„.-....._...�, .,.,,ate ... _ .. ...... .........._ _-__. _.... _ __"_._. ,'I
BUILDING PERMIT APPLICATION cOF TIGARD DATES1979
_
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF :JJ . �/
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT NO.
OWNER JOB ADDRESS HOME ADDRESS 'l�L�A
— ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑REMODEL []ADDITION C1 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
0 RESIDENCE ❑COMM ❑tUUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
09OND El MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED SIGNS
v
OCCUPANCY----_LAND USE ZONE_` BLDG.TYPE Jt� FIRE ZONE___` PLAN CHECK.BY i TW HEAT-
-�L L sirlulu t_rrBt Ly (.190 lln�,�t tecfib -,—Ant :�,.r l,.Irtl — !aa�lth.
.^ F,rrwr Fax'^ t r 167110_ — �61U,011
QQC."LOLI]-- -E1.QUR QA!?_— - _LIGHT 10 __—L�IS1.. :Z4Eil€z______AREA_1�1`'1NO-BEDROOM SVALLk'
BUILDING DEPARTMENT SET BACKS FRONT i`l. REAR LEFT SIDE LQ RIGHT SIDE
Permit 4 17.:r UU
THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE RUILDING CODE, ZONING
Plan Check 864 513 REGULATIONS AND ALL APPLICARtE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WIT14
Subtotal 2530 50 ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax firer LICENSE. SEPARATE.PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total • 'fib
BY pl -
-- APPLICANT OR AGENT
Approved Receipt N>
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1
i
F
—DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
y�-7 _ Rough-in
Fixture
• Final
HEATING
Or- Contractor
y 3 —! Permit No. 3 /�L _ 7q P
Gas or Oil /
Roughin
_ 4 �� , y • Final -- —
SEWER
Final --
DRIVEWAY
— ------- —_ Final _ —
Stom Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
\ Landscaping
Zoning Final
i
a1
a .
ii
City of Tigard Mechanical PermitPermit sz
Fee_,_
Naw Installation 1� Replace CJRelocation EJAddition 11 Alteration ❑ _. % State
HEATING TOTAL_
CONTRACTOR lnl I10 , _ F, Q� ,tin 61NNER_�7 Co"--A—
WORK
o"--A—
r
WORK ADDRESS
ICA-
PHONE APPLICANT
_
Hezt Input Rating (BTU Per Hour)___ Vent Si T Flue Size
FUEL OIL ❑ GAS PU ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FEE
Cor Issuance of Permit _SEE_AEOV Air Condition Compressor 15 to 30 HP 10.0_0
�!'N-up to & inc.100,000 B_TU 4.00 Air Handling 1_0,000 CFM + _ 3.00
Neat y 100,001 BTU & over 0 5.0_0 Air Handling Over 10,000 CFM y _5.00
Floor Furnace 4.00 Evaporative Cooler 3.00
,tali -Floor -Suspended 4.00 Rar,ge Uent Fan 00
Install Vents Only __ ~__ 2.00 Vent System 3.CC
R4pjir • Heat& Cooing r 4.0(' Hood Commercial 3.00
Air Condition Compressor Under 3 HP ^� 4.00 Commercial Duct System 06-
Air Condition Compi es;or 3 to 15 r-
I
NSPECTOR'S COMMENTS
'ITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
S.P?ROVED BY DATE ____ ISSUED BY _ DATE
IECEW T NO.
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SinnAh,rP of Annlir-int