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BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT
�- r �:✓ _ L_k.1n�1._,tl>�"_L�._.___-_ W___, holder of a valid plumbing contractor, license is hereby
authorized to cause plumbing work as herein nntec: to he installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owner.Jr�t✓� 3,�<_�G _ AddressLb�'i 1�� L��z ��111 ,��,Jc,,�s Date _2 - 2.
Nt'M8F.R OF TOTAL PERMIT NO:S
TYPE OF PERMIT ITEINS FEE ON EACH AMOUNT (Office Use Only)
Single Family-1 bath-each _ 25.00
Ouplex-Each 1 bat!, unit `- _;2 J 25.00 t
Mobile Home. Space-each — 15.00 — -
INDIVIOUAL FIXTURE FEES _ _ —
_1 to 50 Fix•ures in 1 ouilding-each _3.00
51 to 100 Fixtures in 1 building-each --, �— 2.50
101 to :00 Fixtures in 1 b_uildin -each Y - 2.00
201 or more Fixtures in 1 building_each _ 1.50 —
_MISCELLANEOUS -- ----- -_— " —
_Bt ildi. n�5ewer-1st 50 ft. W - 10.00
Sewer-each additional 100 ft. -_ 10.00 -�—
Water Service to buildinA__ _ 5.00 _
Private':Vater Systems-each 100 ft. ,- 10.00
- Other S ecir 1' �# —
-d.f#
PERMITj 6i for Plumhiny lnspertion Phone 6;94111
o State _ :�' e7 Plumbing Contractor By __
CANBY, OR 97013
+TOTAL ' ' RECEIPT NO. Issued By _-
,
I L Y Fte
CJ RrIoci.6on 0 3':-'- IS
10 T A L–If 52S=W_m,_L
�1 �� �1 ,�T�� -5 7A
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WORK ADD RE ISS
-)P.Ess
PHONE
APPLICA1`1'1--
Vent SizeFitip Size
;ie:a' Input Rating (BTU Per 1�Our)_:5AO.__?__��__
(-;AS t L54 orliz,l
FLIi-L OIL Cl ELECT
ITEM NO. FEE ITEM No. F F
Air Condition Compressor 15 to 30 HP
For Issuance of perml.. .1
4.00 Air Handling 10,009 CFM It
_U 100.000 B T U 5.00) -*A',_rHandIinqC1ve. 10,000 CFM 5.
Ns.-w- 106,000 BTU & over
4.00 Evaporative Cooler
Floor Furnace2.
1 4.00 Range Vent Fan
�us nded
Wall Ven', Sys;em 3.1
Install Vents Only
Repair - Heat & Cooling I 4.00 Hood Commercial— 3.1
— Under 3 HP
4.00
CenimarcialDuct System 10.1
Air tIon Compressor
V,, Conation to 15 HP .50
INSPECTOR'S cor,,,m.ENTS__
CITY BUSINESS LICENSE RrOUIRFD FOR—ALL CONTRACTORS OR SUB CONTRACTORS
M APPROVED DATE ISSUFD BY— DATE
_—
RECEIPT N 0.
Signature of Applicant
774
.rV-►"q.'^''�eir"•W�.'�', ""_._.'..''`�.'_' w"'�."*i'+c_."y�r'"�_^'r,�lw' gT"Or*?"'�R�nF---_-7 "NCOC' �g�a
BUILDING PERMIT APPLICATION 11TTIGARD DATE_._- ; 75
-_._.__-- . 19_
777— )6 3
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER.PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHp JnEr trW
1 n LOT NO.
'
OWNER Aac ''j3A.1 L1VIN10
At
1M ADDRESS 10C,, it +e.Gfllrt �;S HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER 9t(1riWC1L',�� ADDRESSt141+�j SL 60th.P�- t;, DESIGNER _ r
STRUCTURE_ ❑NEW ❑REMODEL—�❑ADnITION ❑REPAIR ❑RENEWAL. []FIRE DAMAGE JEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAIS PORT ❑GARAGE—❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL. USE El DESIGN REVIEW ❑COUNCIL. APPROVED ❑SIGNS
OCCUPANCY LAND USE 7.0NE ` _BLDG.TYPE _.FIRE ZONE—' PLAN CHECK BY HEAT__
-- t,rrtstr U(.t ulapl.nu u/f ` Eachad IAsrfiyja +mICGCuums Uffit hs. -
---- I'D" of ;102m.1t �, )71 101110 Garden usLrl•: i"1.1_ot 10)
---- — Sauer aarrit aV1F�7�Q._-� ltlfY1�91Y S12-5!).U0
,goo.fT_L2P 'fir__NHT 20 NQT.4QJ€ _�_A�►� ti 44MS YLA __
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Pefmit on
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS ]ONTAINiED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 11' IS HEREBY AGREED THAT THE
A_RK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal 27 1.100 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— – RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6 60 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total — - 2.33.60 L,
By _ P1
Arnl n AN, rin W,t 11t
Approved TW Receipt Nob'Z7
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
---- Contractor
S-10 79. -
�� Permit No.
Rough-in
Fixture - -
Final
HEATING
Contractor
--- — — Permit No.
Gas or Oil
-- -- ----- - — Rough-in
"- -� - Final
-- -� SEWER -—
-- - - ---- Final ".Z -27
DRIVEWAY
Final
— ---- - Stonh Ureinega
-�— �- - -�^-- _— (Rain Drain)Final
--- _--- `�__._ ---- Sidewalk
- -�� Curb&Street Final - -
- — Approach
BLDG. DEPT.FINAL TEMPORARY - CERTIFICATE OCCUPANCY Final --_
CERTIFICATE OCCUPANCY —- - --�
Landscaping
Zoning Final