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INSPECTION NOTICE
City of Tignrd Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone. 639.4171
Type of Inspection -------------_ _ �ct 'aW_.
The following Building Code deficiencies are required to be corracted:
y
Prosrnted to Inspector
bate
CAU_ FOR REICTIOI,
❑ VES UqNO
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INSPECTION NOTICE
City of Tigard Building Denartment
12420 S.W. Main St.
'Tigard, Oregon 972.3
Phone 639-4171
Address___ - , ----____-- - ?" .5 Permit
Type of Inspection
The following Buiiding Code deficiencies are required to be corrected,.((z
Prevented to Inspector
Date
GA'l FOR REWSPECTION
YES 0 NO
BUILDING DEPARTMENT, TIGARD - _.._ ..
?
PLUN1131NG I ERM'T
I l �• ' '2�' holder of a valid plumbing contractors license is hereby
autharizcd to rause plumbing wark as rein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require ins ction by the City Inspector who shall be notified not less t;ian four
(4) hour; prior to the tirre the installations are ready for inspection. City of Tigard business Licen;e re u;; ;
for all cpgtrac orAnd sub co�ltrac Gs. 4=9-1
-�� `Owner h �L.n�t _`--Wdd.ess _' _r" Date_�a / —
NUMBER OF TOTAL - ERMIT NO:S�
TYPE OF PERMIT(/ ITEMS FEE ON EACH AMOUNT _ (Office Use Only)
A E 10 E N E IAL -- 2 _. _–_
Single Family-1 both-each __ 25.00 _ '✓r 00
Ou lex-•Each 1 bath unit 25.00
Additional bathrooms-each I to 00
Moodie Home Space-each 15.00 _-
INDIVIDUAL FIXTURE FEES
I to 50 Fixtures in 1 building -each _ _ 3.00_
51 to 1_0_0 Fixtures in 1 buildingeach 2.sn
101 to 200 Fixtures in 1 buildin -each 2.00
_201 or more Fixtures m 1 building-each 1.50 -
MISCELLANE0US
Building Sewer-1st 5ft. 10. 0
F Sewer-each additional 100 ft. _ 10.00
Water Service to building _ 5.00_
_ Private Water Systems-each 100 ft. M _ 10.00
Other fSpecify): _
PERMIT i�• ,� ForP/urntting Inspection Phone 629.4 171
3%State Plumbing Contractor By
TOTAL - , RECEIPT NO, Issued By
Om I-m'.allation ❑x Replace ❑ Relocation❑ Addition ❑ Alteration ❑ DATE: _—
HEATING Imperial Mech. Dave Emmett
CONTRACTOR _ OWNER-
ADDRESS
WNER-ADDRESS PO Box 06327/97206 JOB ADDRESS
PHONE APPLICANT 10455 SW Grant
777-3801 Imperial Mech.
Heat Input Rating(BTU per Hour( Vent Size Flue Size
FUEL OIL❑ GAS ❑ ELECT ❑ OTHER
ITEM _ NO. - FEE ITEM Y NO
For Issuance of Pern.;'.: _ SEE BELOW _ Each Air Handling Unit or Duct System 7.50
New up to & incl. 100,000 13TU 6.00 Commercial Hoot System_ _ 7.50_
New 100,000 BUT's & over _ 7.50 _ether E uiCLient • Each 4.50
Woodburning Stove 4.50 1_Trip Inspection _4.50 _
Wall-Floor- Suspended _ 6.00 Air Condition_Compre;so; • up to& incl. 3 H.P. 6.00
Vent System w/Fan _ 4.50 Air Condition Compressor-3.1 to 15. H.P. incl. 11.00
iiC"aii -Flat Cooling 600 -
CITY BUSINESS LICENSE REQUrP.ED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comments:
FEES _ 06 —.—.- ---— -- __
SUB_-TOTAL _ , OU
16 STATE �/ Issued By
25%PLAN CHECK _
TOTAL REC. # — - ---- _ _.-
KNAUILMELMILXWJ
BUILDING PERMIT APPLICATION TIGARD DATE 3L4 »_(il 3646
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INOIGATED SUILDE9 PHONE 641-0943
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER," ____-_- ^
LOT NO. 9-W1n8ame_- parr•
OWNER `'Ive Ctralett JOBADDRESS 104;;5 54' iarant Court
r AARICHITECT
BUILDER same _ ADDRESS 600 SW MuT'raV, B%itn Dm!!"aw
STRUCTURE I NEW _11 REMODEL ❑ ADDITION `❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑_DEMOLITION
kRESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO_U CARPORT ❑ GARAGE N STORAGE ❑ SLAB❑ FENCE
OCCUPANCY `=LAND USE ZONE_ R"? e3LDG.TYPE _ :jN _FIRE ZONE==PLAN CHECK_BY _ dwh.,HEAT--Q&8 —
Construct oingle family dwell qj u/sttached garag4. 3 Be_diuoms 2 E�atha•
SEE CORRECTION SHEET ATTALH�D. - -
SEWER PERMIT# 231292 - $7E,0.00 --
OCC.LOAD FLOOR LOAD 40 + HEIGHT 14 NO.STORIES 2 AREA 1365 NO.BEDROOMS 3 VALU11$52:200.
`BUILDINri DEPARTMENT SETBACKS FRONT Ii REAR z LEFT .IDE l2 RIGHT SIDE l 2
Permit 6191,00 --
• THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE, ZONING
REGULATIONS AND ALL APPLICABLE CODEF AND ORDINANCES, AND IT IS HEREBY AGREED THAT EHE
Plan Check _ 96,50 WORK WILL BE DONE IN ACCOLDANCE WITH THE PLANS AND SPECIFICAT;ONS AND IN COMPLIANCE
WITH ALL APP((CABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub total +JS9• :7Q RESTRICTIVE COVENANTS. CONTRAC"rOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax ?. 72
LICENSE.SEPARATE PERMITS REQUIRED FOR SEVIER,PLUMBING AND HEATING.
!t' ,
SDC- $400.09
Total _ $297. 22 _
BY p - PDC# Z $100. [10 APPLICANT OR AGF_N
-- -
Approved tJWt1 Receipt No.
— PHONE
DATE INSP. 'TYPE INSPECTION REMARKS PLU BIND DATE
2-14�_ 7 OContractor
-- — Permit No. .�-(.�
V-lI� r��i �4.s►� - ; Rough-fn
-- -- Fixture------� -- —
� � ^ - Final_
HEATING
Contractor
Permit No. C) 7 -6��/
Gas or Oil
Rough-in
Final ----— -__—
v SEWER
— -- Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCT
CERTIRICA'TE OCCUPAH. Final -
ndsraping
Zoning Final
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