10730 SW BLACK DIAMOND WAY I
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1L, 0 SW BLACK DIAMOND WAY
INSPE71ON NOTICE
City of erd Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Typ. ! Inspe
Data Requested ) �x�� Time / A.M.
Address _CS. //� •x 1 �e� �-!_f (lei 1Ld>Lrl' 4� mlt ilt
Builder
The following Building Code deficiencies are required to be corrected:
— d ge- J2 -- ---
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Presented to N _.__ FTApproved
Inspector q ❑ Disapproved
Date / _— ^�, /_
CALL FOR REINSPECTION
❑ YES ❑ NO
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CITY
F TI FA RDMECHANICAL MES9IT
PERMIT NO. : E92694
COMMUNITY OEIVELOPMENT DEPARTMENT c 01111111661101 D IT ISSUED: 12/22/89
13125 S.W.Mall Blvd. F`.,'J.Box 23397,Tigard,Oregon 97223,(503)639. 175
R M.PMT.NO. 892694
JOB ADDRESS: 10730 SW BLACK DIAMOND WAY
TAX "IAP/LUT SUB:
! AND USE: LT: BK:
LOT SIZE..:
WORK CLASS: ALTERATIOM ITEM: NO: NOS
FURNACE (LOOK 1 AIR HANDLR (10
USE TYPE. SINGLE FAMILY FUkNACE LOOK+ AIR HANDLR IOK
CONST.TYPE: VN FLOOR FURNACE EVAP.COOLER
OCCUP.GRP. : R3 HEATER VENT FAN
VENT VENT.SYSTEM
BLR/COMP 0HP HOOD
NO.STORIESr i BLR/COMP 3-15HP INCINERATOR(DOM
DWELL.UNITS: I RLR/COMP 15-38HP INCINERATOR,!COM
FUEL TYPE GAS BLR/COMP 30-50HP REPAIR UNITS
MAX.INPUT 75808 BLR/COMP 50+HP OTHER
FIRE DMPRS? NO
HIGH PRESS? NO GAS PIPING OUTLETS 1
LOW PRESS? YES
REMARKS:
Replace electric furnace with gas
fu-rnace. SFR
FEES:
OPerry Whitworth PERMIT
FN 10730 SW Black Diamond Way PLAN REVIEW 11110.00
N
R Tigard OR 97223 FIXTURES
PHONE 684-7999 STATE TAX $8.10A
OTHER 6.90
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A
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R TOTAL: 618.90
This;,ermlt is Issued subject to the regulations contained In Title 14 RECEIPT NO.
____
of the TMC. State of Oregon Specialty Codes, zoning regulations REQUIRED INSPECTION$ A__
and all other applicable codes and ordinances, and It is hereby
agreed that the work will be done In accordance with the plans and GAS LINE
specifications and In compliance with all applicable codes and MECHANCL.SYSTEM
ordinances The issuance of this permit does not waive restrictive FINAL
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not started within 180 days or if work is suspended or
abandoned for a period of 180 days any time rigel work has
commenced It shall he the responsibility of the permittee to assure
Fill required inspections are requasted and approved
F«rrnitle� ;i re
Issued By
v CALL FOR IN3PECTIOhi 639-417`1
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
L
;1DDRESS ?3 0 J�► jf., .���o PERMIT N0._
P 1.R N I T CHARGE n o n ei
011NER A4A,7Z7 COiNNECTION FEE 6d�f
4 _ PAID BY
TYPE OF 8UI!_DING ^_� r DATE CONNECTED
SERVICE RATE T_�� INSPECTION FEE •`
CONTRACTOR �. PAID BY DATE
SIZE OF CONNECTION A SSESSHENT PAID
-�3y- a s y ,�/fig "a��.Jr
SEWER PERMIT
Uf 4
N" 15866
Unified Sewerage Agency
of Washington County CITY OF Tigard DATE �`� '4v
OWNER: J i in Hnr . PHONE :
OWNER 'S ADDRESS:
'TYPE OF INSTALLATION:
"D>b UILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
D 14EW fBxSINGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO 7-1-70 ) ❑ MUILT. RES. ❑ INDUSTRIAL
FIXTURE: UNITS DWELLING UNITS 1
ADDRESS OF STRUCTURE: A n7lngu R•1 arL, n;Amnod 13
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES IND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION.
PLEASE REFER 'TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 7-
CONNECTION CHARGE _r,nn�
SIDE SEWER INSTALLATION B. Greene
OTHER ISSUED BY
AAOT
AL / $ 625.
LICANT DATE
SEWER PERMIT N? 15866
ADDRESS OF STRUCTURE 10730 511 Black Diamond Way
TAX MAP TAX LOT SYSTEM _ fanno creek
LOT 4 BLOCK OF
APPROV n
DATE ISSUED BY DATE
D. U. 'S _ 1 REMARKS bldg. #2042
BUILDING PERMIT APPLICATION 11TOF Y TIGARD DATETE
THE UNDERSIGNED HERFBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BU I LDE'i PHONE--��
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNEP PHONV
OWNER '' L(1 JOB A LOT IYO.---
orns- 10730 541 Uack ijij1II;j�&QMk:A RESS
ARCHITECT '--
BUILDERADDRESS ENGINEER
DESIGNER
STRUCTURE )(&4tW E]RumnOEL C3 ADDITION OREPAIR 011ENEWAL CIFIRE DAMAGE ChEMOLITION
It RESIDENCE Q COMM-DEDUCATIONAL OGOV'T ORELIGIOUS OPATIO OCARPORT OGARAGE OSTORAGE CISLA13 []FENCE
0BONL? EIMOVING OCONDITIONAL USE DDESIGN REVIEW CICOUNCIL APPROVED OSIGNS
.)CCUPANCY—_LAND USE ZONE—_ —�-'—' FIRE ZONE� PLAN CHECK BY--CLW-- HEAT__
cullatt 8.X(j(j9 family dw011-Liiq w/attachod yera,i)es correct foundation tiall,
od on plefia, four-ation 'Lu oxtenu to uutaide W, a.11 exterior walls,
badrorom 2 bath
I;uwor permit
QC-Ce-LQACL--- FLO H-LOU 40 HE1-Q-1!L--2.UN4bTMLU_1. - AREA 139 7-NDULUBDD-Ma3 VALUE 4t,y 191)0.
BUILDING DEPARTMF
NT-- SET BACKS FRONT 2 0 REAR 33 LEFT SIDE RIGHT SIDE 14
Permit lt)0.00 --- - -----
Plan Check L 0,,0 11 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERFBY AGREED THAT TI-IF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITII
Sub-total 2 0 ALI- APPLICA13LF CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HA11F CURRENT CITY R111,INF1.;q,
State Tax 69 40 LICENSE. SEPARATE PERMITS REQUIRED FOR ';EWER, PLUMBING AND Hlb4 AG.
Total .40 001,061
90*C* #1 Uou.
By
ADPL.f( ANI 7ii AGF T4 T
App,oved Receipt No.
L
DATE (NOP. TYPE INSPECTION REMARKS PLUMBING DATE
S_ Contractor
/ — Permit No. 3(0,-yo c9Q 7Y
Rough-in
Fixture
/! Final
Q H&PTING
Contr.rctor
Pewit No.
Oat or Oil
01 ie,/ v u9 -in
al
SEWER
n Final i
DRIVEWAY
Final
Stom Drainage
(Rain Drain)Final
Sidewalk
Curb 6 Street Final
Approach
SDG. DEET,FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIPICPTE OCCUPANCY Final
Landscaping
Zoning Final
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