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CI .. Y OF TIOARD YVC
OREGON
j 0%"ner:....T.D.C. .........Permit No........957..... .
r• Bl...lding Address..... ................................. ...
y
Certificate is hereby given this_ ....9th. day of-_Rava.mb.ar........... 19..7.7
I that said building may be occupied and `
that it complies with all requirement- of I i
the Building Code for the Cii�,y of Tigard,
I as approved by the Tigard City Council.
Buildin? Inspector
l
rpt ,
�__ •../�w�.� ��.:�_���`i_.��__: '�'�'+�' :...�TI199 444"' "�'
JOHN E. RUNHAROT PLUMBING, 1NI BUILDING DEPARTMEN i , TIGAHD
P. 0. EOX 129 PLUMBING PERMIT NO.
NEWURG. HKON 9113?
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
"figard. Such installations require inspection by the City Inspector who shall be notifieJ not less than four
(4) hours prior to the time the 'installations are ready f inspection. City of Tigard Usiness Licensa required
for all contactors and subcontractors, �t— x,270. 1
Own AddresI., Date�__�76 _
NUMBER OF 4fOTAL PERMIT NO.'S
"OE OF PERMIT _ ITEMS FEE ON EACH r AMOUNT (Office Use Only;
-B-LS I D E N T 1 A L.r---------- — ---� --Single F6mily-1 been-`each u��— 25_00
Du lex-Each 1 bath uni; 25.00
Additional bathrooms-each e 10.00 �jf, O U ~-
Mobile Nome Space—each _ _ 15.00
INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 buildine-earh 300
_-5_1 to 100 Fi�:tures in 1 building-earh —_ 2.50
101 to lob Fixtures in 1 b•jilding-each 2.00 -_
201 or mora Fixtures int building-each _ 1,50
MISCELLANEOUS_
Building Sewer-1st 50 It. -10.00 — —
Sawor-each additional 100 ft. _ i0.00
Water Service to building _ _ ~5.00
Private Water S:ysterns-each 100 ft`
Other (SS a if
PERMIT _ LV For. For Plumbing lnsoection Phone 6394191
X+ Stste 1,6 Plumbing I'orittactor By
TOTAL 'RECEIPT NO. Issued Lc,
.M�s�rr+r"YNN'�IIM�AM1n,!h°!w•,r.,�...w r -•,r''-. w
1 � --'4iAMPW C"''*IF:Mf�f�'`lgtv,mpnw,F"'wrFwNic.""1ypw'Y.�'•'.y,r...,..; .....,.a - .���h..,
CITY OP
BUILDING PERMIT APPLICATION TIGARD CATE All� �_. N° 0957
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED lri'�C,��31[j1
OR AS SHOWN AND APPROVED IN TI4E ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _
f a rtys•QWNER �iL� � « 11�
ADDRESS -BUILDE'2 PHONE. —
h ENaINEER 9e nnott
BUILDER _��--yy DESIGNER
STRUCTURE _ I.JNFW _ ❑REMODEL []ADDITION ❑REPAIR _ ❑RENEWAL ❑FIRE DAMAGE ❑_DEMOLITION
U
RESIDENCE []COMM ❑EDUCATIONAL ❑GUV'T ❑RELIGIOUS❑PATIO EICAR PORT ❑GARAGE OSTORAGE❑SLAB ❑FE.NCE
,-QBOND ❑MOVING- — ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE.ZONE. _BLDG.TYPE_ FIRE ZONE_- PLAN:NECK BY HEAT
Const, 1 {. .hah 8 ?�5 t1 R1';
C LOAD FLGOR LOAD _ HEIGHT NO.STORIES ARE VALUE
_ dU1L-6- DEPARTMENT - —
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
kerm it �I i it u« - - --
Plan Check I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,
AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALI APPLICABLE CODES AND ORDINANs:E;;. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR •IVD SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
196State - 3wS�3 LICEN f PAjff4j!fRMITS REQUIRED FOh 7EINER, PLUMBING ANn HEAPING.
Total 134.Q3
APF ANT on AGI Nr - -- - ------
Approvers Receihf No
ADDa ss - - - --- --- -.
DATE INSP. TYFE INSFECTION REMARKS PLUMBING DATE
17 Contractor
-- Permit No. or-
Rough-in
Rough-n
Fixture
.d_14 �,' _ Final
HEATING
Contractor
Permit No. �-3�_ ���/ �f-�d�.76
Gas or Oil
Rough in --
Final
SEWER
Final _
DRIVEWAY
final
Storm Drair�c___v
(Rain Drain) Final
Sidewalk
Curt,&Street Final
_
Approach
BLDG.DEPT. FINAL TEMPORARY CERTIFICA" OCCUPANCY Final
CERTIFICATE OCCUPANCY
11- 11-7,7 Landscaping
( Zoning Final
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