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INSPECTION NOTICE
City of 1;gard Building Department
P 0 Brix 23397
Tigard, Oregon 97223
Phone 639-417E
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Type of Inspection
Data Requested ' Time A.M. / P.M.
Address —.1 Permit
Owner �! -e�` ' —..----- Lot
Builder — - .------ --
i hP followinq Building Code deficiencies are required to be corrected:
Presented to rTApproved
Inspector �� --��--- [._� Disapproved
D-'te
CALL FOR REINSPECTION
L] No
13m 3V 1 11 F1 W.
CITY OF TIC;ARCa PLUMBING '
Applicants must hold Oregon Registration to conduct a plumbing Ticim l M 97223
business or must be property owner/operator not hiring outside help. PERMIT 639 41175
Naar of DewbpmerM(� o2 S%" 2--
t7 _ PlumbmK Ptrmil No -t_
Address -1--1 P-., �W— �,S� cellORAS 8�1t4-21 810- DUAN. PRICE AMT
Job Tax Lot Map.W. -
Address
I of 01oc�C Subdrvlabn - FIXTURES _
Sink ( 7.50 1-59
Rama a am
ne nassV,.-50
Lavatory _ 7.50 _
R Q• Yk j( y Y fjV • Tub or TubtShower Comb 7.50
eat • _
--T --- -
Shower Only - L _ 1.50
Owner / tl3`—i a--- _-_ zip W61WCb8e1 _ �_ _ 7.50 I S 00,
llishwashw - - 750 I.5o
Phone Garbage Disposal --- (- --_ 7.50 .7.
Name WiL%Nng Machine - - - - --_7.50
Floor Drain _7 500_
ess
— --I—t �e----- Water Healer - ---- I 7 50 7
Occupant CIty�Sute ------- Les -- - :sundry Room Tray- .-- - -- 7.50
Unnal 7.50
ame ,vm Other Fixtures(Specify) _ 7.50
Tbl-jai - _ 7.50
Phone ^— 7.50
3 6 0 SW CIA(loti 7.50
Contractor /Stas zip ,, ,I _
MISCELLAN17OUS
--� City Ecus Tax No S~191100'
stateo----% te TNun�a�uiT�c tiewer♦a�AcfiiN 100 15.00
WmW Service 1st 100_— 1, - 20.00
I hereby acknowledge that I have read Iits
.Lapplication,OW"kekxmatbn WmW S«wioe ea.Addn.XD' 15.00
QIVW it orxreck tial I am tegfalwed With the Stale 9erWWs Board.and also Skm g Rein Drsk•tat.10C' 90.00
hevs a State Pkrmbhtp Barrs OW the nurnbws gkw are correct.OW all -
Pkxr,bktp work will be done in w=rdance with apolemble provkiorr of Ore- Stone i Pyn!Fain A&M.100' _ 15.00
9-I'Um bad gt*kA*s GYuplers 447 and 093 and appketile 1x1des and that Mobile Hom Space 25.00
no help*8 be w%*Dyed unless Moeneed undw ORS 03 (M exernp!from —_--- -----
Stale rtglgraOM please(!ve reason brlow). Back Flow Prove n%-)n
HOMEOWNERS-I heisby ow"tmd 1 am the owner of the property, : Device or An#4''olksion Device-- -— — 7.50
sorbed above,al vAdd looaaon 1 progoee somake a plurnbirV krAsNallon kx Any Trap or Woo*Not
RV Own use and Ihle property M no!h"rxxrhvrNrd for eaM,lease or rerN Can iod b e Fixkrn 7.50
t
Cah Bash_- - - —- 7.50
-------- - -------- -- --- l^aP d fxMl.Pkanbktq---- 10 00 PM Hr -
--_—- -..---.— --------
Requested Irrpoolkxr 10.00 Per Hr _
___ .-.- ---------------------- __-- AMae of Pkw"V WMfsn
15.00 min
an Erde�tildes — _
AlfT1tOPIZEO SKMTURE 1�' -- Deft New Oft -&M.A k"on 25.00 min
E fatal
Describe well« rlaw(_j .sort ( � a*"Wn❑ repak I a++el.1v _ 15.(!0 .cic
b�dorl�_-- rosldardlal nrxl•rdeta—]
Esd1"use of
t0 or ply - OWTOTAL Z.s
NeWmed U"of 4%KWANAOM
or PAGitltty _.-... - -- TOTAL
NoTme
TW ptsrtetg 1111 tq MA oriel W W M work erowwWualon sowisad ionot oom
NMreed W t M0 d%vAx N of v*uaWn w wo*im oApwWw or abwlttoned(ell
a parbd d MO On M wN ties Ow work M mvft A and
J11Aa Itatnd
CITY OF TIGARD MECHANICAL PERMIT
Permit a y l 14
Dearxlptlon^ -
Table 3A dMuhanical Coda CITY rims AMT
City of Tigard �—
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 2339
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU � q�
1) Incl.ducts b vents / 8'00 �{
Furnace 100,000 Bl U +
Incl.ducts 8 vents 7.r�G
Name of DevelopmentFurnaceFloor Furnace
�L2 n�0 3 3) incl.vent 8.00
Job ^ fR9aSuspended
4f or ioor munted heater)heater
6.00
Address /�'� f�
Tax Lot Map No. Vent not incl.In
Lot /U�Y Block Subdi"ton 5) appliance permit 100
Name(or name of business 8) Repair of hewing,refr Ig., 8
cooling,absorplinn unit
.00
Mailing Address Piton Boiler or comp to 3 NP
Owner 7) absorp.unit to 100,000 BTU 8.00
city/slate DoBoiler or comp to 3 HP•15 HP
8) absorp.unit to 500,00('BTU 11.00
Name — — Boiler or oomp 15-30 H P
9) absoh
absorp.unit' -1 millMm 15.00 10 -
Mawng A�rete ptq� ) Boiler or oomp to 30.50 HP
absorp.unit 1-1.7'5 million 0
22'50
Contracttxy State Dp 11) Boller or comp to 50 HP -
absorp.unit 1,750,000 BTU 31.5
State RegistrationNoCity Bus Tex No 12Air handling unit to
10,000 CFM 4.50
ling —
heeby rackmwledge that t nve eread this appM ation that tt. xih-rAir handunit
tatlon glvr,n s 13) 10,000 ling + 7.50
correct.that I am ttin owner a M
aulrized agent d tit owner,IMI dned darn BkOYT rm in
cornpkenoe with State tow,that I am regiatered with the Slate RW1d*rs'Et,wd•&%f tfw Non portable
number given is oared (H pt from stale regFatration please give reaaWOW)ow) 14) evaporate cooler 4.50
) Vent fan connected
15 to a slnle duct �— 3.00
) Ventl'ttlon system not
--- 18 Included" in eppllonce-permit 4•�
1 Hatd served by
mettankal exhnH_ist 4'50 Y._
slgnahme(owns or sow) Domestic type
Describe work ❑ e eiteretiai ❑ repair ❑ 18) Incinerator 7
to be done residenttal non-residential ❑ _ i 9) Commercial or Industrial 30-00
Incinerator
Existing use of moi•, - type
building or property_ -••y'l Zi'C) 5 ?0) Other I.a.,woodstove,water 4,60
Proposed use of --- heater,solar,clothes dryers,etc
building or property 21) Gas piping one to lour outlets !AO 'r
lype o11ue1- all ❑ natural gas ❑ LPG (7 electric El --_._-___
22) More than 4-per outlet
N13" �
Tl-IIS PERMIT 9E1,`WES NULL. AND VOID IF WORK OR CON- - ---- -•--
SUIT-TQTAL SZ'
STRUOTION AUTHOR12ED IS NOT C OMKENCED WITHIN 180 4%SURCHARlQ11111 l y
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDFP OR PLAN RfilIM1E1111 N%OF SUWTOTIAL 7 r
ABANDONED FOR A PERIOD CIF/a0 DAYS AT ANY TIME AFTER -- --�------
WOW IS CX)MME.NCED. UVI
`
Date issued "1_'�-_�_.by_
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BUILDING PERMIT APPLICATION DATE-__—_' 7 _ -,is OP770
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE(16«-277 __
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER Py01
LOT NO._. 1�7ES_ Cotnwa 3
OWNER_ Vr11.l.ey Tltvosttne�ggDDRESS 13938 SW Cnist Ct. _ ?�b-V
— — -----ARCHITECT+ Plan 47500-2A
3C'Uno 00 50173 P.O. Box 4. G 11 Tual . ENGINEER P4 ir & Barcla
BUILDER ADDRESS DESIGNER Y Y
STRUCTURE ® NEW _ O REMODEL O ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
fA RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO C' CARPORT ❑ GARAGE L7 STORAGE ❑ SLAB F-1 FENCE
25*
OCCUPANCY - —LAND USE ZONE R_ LDG.TYPE ori FIRE ZONE---PLAN CHECK BY E� HEAT. `'
ConsT::uct single famj].y dwolli.ng w/attachad garacTc, 4AU )Or approved plans.
Svbjcc:t to 85 code. REISSUE of 6733. SlIbjoctto Amart
UC) NOT PLACE FY?UtiITA7'IUN ON FILL.
I.. MAINTATN AM, I P-SM'IENTSI' -r FI,11'I OR12 n . u aka
SEWER PERMIT N 33455( ldu) 2 bath. 8 ta'Zaia3 C1' 1;Lltjfi'
OCC.LOAD FLOOR_LOAD_4 C HEIGHT 1 F NO.STORIES 1 AREA 1165 NO.BEDROOMS 3 VALUE 67000
BUILDING DEPARTMENT SETBACKS FRONT �n R-!+R )�i
DEFT SIDE � RIGHT SIDE 7-5
Permit _ 324 .00
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATvf1NS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORU�NANCES, AND IT IS, HEREBY AGREED THAT THE
Plan Check_ 40,00 WORK WILL BE DONE_ IN ACCORDANCE WITH THE PLANS AND SPEC!FICATIONS AND IN COMPLIANCE
WfrH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND Cl'R CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 13.36 :;DC;
: SUC.- 6f)C..v�.
Total 277 ,315) _
40By nQ PDCk 1 150.DO APP LICANTORAGENT — —
Receipt No.
`
Approved 337.36 ADDRESS — - ---� ----~--��— PHONE
DATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
/amu o rii4c _ -_ Contractor
o Permit No. 7, 7—
Rough-in Rough•in
4 � ----
Fixture
Final
HEATING
7T ---
Contractor
7 Permit Na.
Gas or Oil -
1
Rough-in
-_-- Final
SEWER -
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk Y
_ Curb&Street Finisi
Approach J� f 7_ ✓-L 7
PJL.Dt;i. DEPT. FINAL TEMPORARY CEF!TIFICATE OCCUPANCY —'
CERTIFICATE OCCUPANCY Final
y Landscaping
Zoning Final
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