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AGCRE55 C�� _ PERP1IT NO .---
__�_ PERMIT CHARGE none
-04 OUNE > ,wea,7 C0r�r:EC T T ON FEE
PAID BY
'TYPE OF BUILDING � .c�. _ DATE CONNECTED
SERVICE RATE _ 34,—C-,/- INSPECTION FEE
CONTRACTOR �r PAID BY DATE
SIZE OF C0'J'J'CTION � S5E5S"IENT �_� PAID
BUILDINC DEPARTMENT, TIGARD
PLUMBING PERMIT '
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing v)ork as herein nutwl to be installed in accordi-ice with the plumbing code of
Tigard. Such installations require inspe,_tion 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. 1,car Ak-
c.-
Owne_r.�? dw °l '.Z�_ Address 1 Q Date_-n VI-C'
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMI iITEMS FEE ON EACH AMOUNT _ (Office Use Only)
single Family--1 bath,eech
Duplex-Each 1 bath unit
0 25.0 _ -- ----`
_ s— --
�do�tionsl bathrooms-•each 1 - t0.00 l .
Mobile Hcme Space-each -� -- -- ~ 15.00
INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 buildin -each �. 3.00
51 to 100 Fixtures in 1 buildin -each - 2,50
-101 to 200 Fixtures in 1 building-each _ _ 2.00
201 or more Fixtures in 1 building-each 1.50
MISCELLANEOUS
Building Sewer-1st 50 ft, �_Y-- 10.00
_Sewer-each additional 100 ft. _ 10.00 _
-_Water Service to building _ _ 5.00
Private Water stems-each 100 It.� _-� - - 10.00 �y ��-
Other IS eci( ! -'- - !— -
I
PERMIT �-00 For Plumbing Inspection Phone 639-417t ' '
3%State - — c•�2'9( Plumbing Contractor By __CANB'Y, OR POW
-TOTAL �Ln•� RECEIPT NO. Issued By
City of Tigard Mechanical Permit Permit 53,09
Fee____u__gp0
New Installation Replace ❑ Relocation ❑ Addition ❑ Alteration ❑ 3%State-�r---��__
_ TOTAL
CONTRACTOR
171k S �Gfl...T�yG _Y OWNER
T
ADDRESS WORKT 's
ADDRESS1QQ!�c � !1)_ ARjezSL_�9�K_LL�
PIIONF _� �/ '//J
Heat Input Ratir.g (BTU Per Hour).__.„� ?Do _ Vent Size _ Flue Size__ _
FUEL OIL ❑ GAS ❑ ELECT �, OTHER
ITEM NO. FEE ITEM NO. FEE
For I5SUance of Permit 3.00 Air Condition Compressor 15 to 30 HP 10.00 k
New-Under 100,000 BTU�Y 4.00- Air Handling_10,000 CFM _ 3.00
New 100,000 BTU F<over _ _5.00 Air Handling Over 10,000 CFM 5.00
Floor Furnace _ 4.00 - Evaporative Cooler v 3.00
Wall -Floor -Suspended -_ _ _ _ 4.00 Range Vent Fan - _ _ 2.00
Install Vents Only ^T- _ 2.00 Vent System V� —A 3.00
Repair - Heat& Cooling _ -� _4.0_0 Hood Commercial
Air Condition Compressor Under 3 HP �- 4.00- _ Commercial Duct System_ - 10.00
Air Condition Compressor 3 to 15 HP 7.50
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE RE13UIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY_ _ -�� DATE __ ISSUED BY_ i�— - DATE
RECEIPT NO.
774 Signature of Applicant
I "y TIG,�F�D OATS.
RU LDlNG PERMIT APPLICATIONof 19?
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE
OR AS SHOWN AND APPROVED IN THE ,ACCOMPANYINC- PLANS AND SPECIFICATIONS. OWNERPHONE____
LOT NO.
OWNER t;:!it:;;.. r ,- JOBADDRESSlitg:in r+Ll L,Li"On b'ei1r. HOME ADDRESS
ARCHITECT
ENGINF_ER
BUILDER L;L1 Y''la .,,J , ADDRESS __— DESIGNER
STRUCTURE ONEW ❑RumnDEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE (:]STORAGE❑SLAB ❑FENCE
❑BUND OMOVING ❑CONDITIONAL U..3E ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
UCCUPANCY__LLiLAND USE Z0NE*:1=—BLDG.TYPE_ _=FIRE ZONE—_i PLAN CHECK BY-1_L_ HEAT \. J.6s l;
---- .�netruct dliplex w/attachad garage - `, Ondroom - :l usth.
of Lot
---_-__-- Plumulnu [Lepnit paquirtsd for liuuav --
-- --- �r��►e►r 41I;,rm9,t 1'7A�;';► - 'r1Z�s.Ll7
I:�f3re7tF1 I �` . to
occ�AIZ_._,._F1Sl4R LOAD_�1E _ _ " L�aK.T_� V�VQ, -IQP_! S� ARBAlIS2_3E1�g44M�---_�:'9L�1 �►
BUILDING pEPARTMENT SET BACKS FRONT_ REAR _-v—LEFT SIDE !- RIGHT SIDE "0
Permit 11191 611 --
THIS PERMIT IS ISSUED SL13JECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Pian Check ��•�� 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
Sub-total Mi.DO 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 7•do LICENSE. SEF,.RA(F. PERMITS REOUiRED FOR SEWER, PLUMBING AND HEATING.
Total— 216, , , 1)G. I z WIDOW
By
-- APPLItANT OR AGENT
Approved t1lip Iden Receipt No
DATE INSP. TYPE INSPECTION !-- REMARKS _ N PLUMBING 13ATE
Contractor
Permit
Permit No. 6 6`40
1- Y"2
7
Rough-in /�9
e ___Z7
� �-.- Fixture
---
Final
Ste=/ far -all AV 11 a�� �i ti —
HEATING
Contractor n
-- -----—-- Permit No.
-� Gei or Oil
Rough-In
Final
— -- - - - SEWER
-- --- J DRIVEWAY
---- - ------ -_ --- — Final
Stonin Drainage
`- (Rain Drain)Final.
-- --� `
Sidewalk
Curb&Street Final
- _--_- - APPioach
BLDG DEPT'.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY —
i
,,
Lend,capinp
Zoning Final �_-