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/ I N�' BUILDING DEPARTMENT, TIGARD NQ,
�',� / PLUMBING PERMIT
_ holder of a valid plumbing contractors license is hereby
authorized to cause plurr'`ling wor as herein noted to be insta'led in accordance with the plumbing code of
Tigard. Such installatiorr require inspection by the City Inspector who shall be not!•ied not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all c4rltr,;qkr
+d s -contract _
/ / job
/a
/Q Dat
r Addessl�Owner ----NL,M13EFi AFTOtALITEMS FEE OSI EACH AMOUNT PERM � -
�_$inot0 Fami+v-1 hath-each 25.00
Oupl�•-Each 1 bath unit _ _• _ 25.00 ;
Add Nona) b•:ihroome-s.ch �_- - 10.00_
i-�`-
_ Home space-each T 15.00 <f
INolvlouAl FIXTURES COrVIE:RCIAI
1 .o 50 F ixti ree_in t bulldi -each _� x•00
�_s1 to 1013
Fixtures In 1 buildin -each 2.50 -- '
I Jul to 200 Fixtures in 1 building each -
001 or more_=ixtures m 1 building-®,�' _ 1.50
1141SCELLAME0Us _
I�Stw> -each aCditional 100 ft.
�.Wa:er Se.mice to bvi!din9 F - / 5.00 S
_-Ocher ISo�•if ): '-"'� J
PERMIT_ D a
For Plumbing Inspection Phone 639.4171
I 4 d St ate �_G Plumbing Contractor By
l —TOTAL 1 3 (qi RECEIPT NO. Issued By
i
i y of Ttvar"` d Mechanical Permit N? Permit
Dery Installation Flepl,ce F_1 Relncaaun ❑ Addition L7 Alteration ❑ 47.State _
TOTAL--
HEATING
OTAL _HEATING ��- 4
-
CONTRACTOR X ur, a C c OWNER)4
A.CIOR ' '.m) / i/ � ._ - WORK ADURE YS,
APPLICA',N'r � hl "G
Feat Input Rating (BTU Per Hour) 4 v Vent Si!e —�" Flue ize !;-11
_
l UEL OIL T3 GAS 0 ELECT Ll OTHER _
ITEM NO, FEE ITEM NO. FEE i
,-or Issuance or Permit E ABOVE Air Condition Compressor 15 to 30 HP _ f0.00
1, ,r-up to & inc .100 t 000 BTU 4.00 __Air Handling 10,000 CFM^ 3.00 +
�,. _ I
N2vv-100 z 001 STU s& over 5.00 _Air Handling Over 10,000 CFM 5.00
Floor Furnace _ 4.00 Evaporativa Cocler _ 330
;la!I - Floor • Suspended4.00 _Range Vent Fan r 1`.00
Install Vent;Only _ 2.00 Vent System 3.00
Peoair Heat& Cooling 4.00 _Hood Commercial _ _ 3.00
Ai•_C-nd� ion Compresscr Under 3 HP _ 4.00 _ Commercial Duct System
Air Condition Compressor 3 to 15 HP 7.50
!I�;,PECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR A' '_ CONTRACTORS OR SUB CONTRACTORS
/11PROVED BY DATE ISSUED BY DATE
:'FCEIPT N0.
1 Signature of Applicant
,
8,4e
6 Ft
BUILDING PERMIT APPLICATION TIGARD DATE_- x` l1g 8U 334
THE LIN DERSIGNED HERESY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 64.1-09-1]
OR AS SHOWN AND APPROVED IM THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _—
LOTNO. 3 .L 1nSAms Ter.,
OWNER i,.inlTett JOBADDRESS 10405 $[l Creat Court
- ARCHITECT
ENGINEER
801110 _ ADDRESS f3t7� SQ Murreyt RVtn. DESIGNER Piercy Barclay
BUILDER —-----_ ------ - --- ---._—
STRUCTURE _ Lail NEW _ ❑ REMOCEL _ ❑ ADDITION ❑ REPAIR ❑ RENEWAL [J FIRE DAMAGE ❑ DEMOLITION
3 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ G�J'T ❑ RELIGIOUS L] PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE D SLAB❑ FENCE
OCCUPANCY �-~i.LAND USE ZONE f�_r_BLDG.TYPE �''O FIRE ZONE '� -PLANCHECKBY �� — HEAT_9Aa
(.onstruct singly fa ing 1.1 attachad garage. 3 Bedrooms 2 Hathee
SEWERPERMIT# ;"C] [, — i50��1C3 -_-W-qI"Ufa
OCC.LOAD FLOOR LOAD 40 HEIGHT 14 NO.STORIES AREA 1!.)O1 NO.BEDROOMS 3 VALUE 459 r SUU .
I—� BUILDING DEPARTMENT SETBACKS FRONT 2n REAR 20 LEFTSIDE 23 RIGHT SIDE lG
Permit _ 6207.00_ THIS 'eERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF BUILDING CODE, ZONING
REGULATIONS AND '•.L APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 103.50 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
. J[3 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
: 10
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUIWNESS
— LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4X8•20 7r'tUG.i3U
SDC —
Total f-315.78 _
PDC# Sion,QO APPLICANT OF AGENT
AY P 1 ,
pproved
dWh R3ceipt No. �� '� AODREt38 -- - ---- PHC;NF
r�
DATE INSP. TYPE INSPECTION REMARKSPLUMBING :ATE
Contractor � - —�-
0 c _ Permit No. 33Y I. Q-yr
_ Rough-in -- —
01-yK-�O Fixture
..1..�wll.� OIC Final —
�b AIL 0 t _ HEATING
GAS-h Contractor
Permit No. 2.rjZ ybY �-li $O
;at or Oil --
Rough-in �—
Fmel
aF.WE:2
—_--�— Final _
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
— -------- -- -- - Sldewalk - --
Curb&Street Final
Approach
BLDQ DEPT.FINAL TEMPORARY CERTIFICATE OCCUIP _ —
CERTIFICATE OCCUPANCY Final
V L.andscaprng
II7_oninq Final
L.