12635 SW GLACIER LILY CIRCLE 1
12635 SW GLACIER LILY CIRCLE
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WILDING DEPARTMENT, TIGARD �D
PLUMBING PEWAIT
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
i igard. Such installations require inspection by the, City Inspector who shall be notified not less than four
(4) hours prior to tho rime the installations are ready for inspection. City of Tigard Business License required •
for all contractors and sub-contractors.
/�Z�9C)�/riARA mcf deb �G S �c/teDat 7 �p
Owner_...-_ ___ _ Addres;�_ �� �� - - e-bW--. -
�._._.............. -.._...._.._ --_--• .•-.._.
NUMBER OF ..._,. TOTAL .._. ..�...,.��� I.
_TYPE OF PERIIA11 ITEMS FEE O_N_EACH AMOUNT
Sin%la FArntly. 1 bath--ench _ 25.00_ _ F<''.7 f
__Rug Lo 1 bath unit _i _��5.00 — __— . ,� '
Additional hathrourns each _ _ 10.00__
%lo Its tlntn 5t� ..,_ . eleh -�— 15.00
INDIVIDUAL FIXTUFI6lCCJIYI(~IEftCT�I
1 to 60 Fixtures in i bt Ilding✓each _ —__3.00
61 to 100 Fixtures In 1 buildin _each 2.60
101 to 200 Fixtures In 1 buitdinj-each �� _ — _ Y2.00
201 or more Fixtures in 1 buildin. each 1.50 ' �"--
ti115CELLANEOUS
5_%.er_each`dditional 100 It, ~+ 10.00
_Water Service to buitiiinp_ _ _� _..__ 6.00��_ •—__ _—!_ ___��^
Otht,�Sk, rilyl:
PERMITSO 00' ForAurnbingInspection Phone 639.41/1
------_ _
4 State+ 00 Plumbing Contractor By It-arc.
-TOTAL 5 •p0 RFCEIPT NO. Issued By
.. ., ., ... - .-..._� ........ .... .-.pp.,,+erv. ......,..... „ r ....,. .a7ifl Tll�gRc.+n!ue�.!I+.w•!•r,...F..•T„'��.vr.F.lq�`A�y'f/'!�'•:.^.'?{;4•na..��r
INSPECTIGN NOTICE
City of Tigard Building Department
12 :0 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address — '�.r [� �s:S �.� . r'fsL'.G r.� C rrf �- Perm'h #k_
Type of Inspection
The following Building Code deficiencies arp required to bo corrected:C' A � r- --';,�.r�=a �.;� � --- t-` ••
.____`—____ _ • .� M_F--•�lrl��.'�. e.1"�' ----y`=mow %.'" .��r�.+ �i�' �_^__—
Presented to. _ _-_–---–__--— --.-- Inspector
Date --- —..-- —
CALL FOR REIWECT/ON
U VES D NO
q ,
))(,� 3 'dl )) rn Permit 53.00
rill ..� ;, -
v t. Fen
In;tall,r!i, C1 Eir.,,l [�� Relocation [. / I, iti�n r. I Alt,r•i';(-n F ) 47,St.+tr
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I :t r fn F rting )BTU Per Hour)_ �Q� Vent .`;i,, Flue `.,ii- - --Y
FUEI. OIL El CAS [;- ' FE.CCT C.l r)tIIER
Il"EPlI
NO. FCE' ITE'(11 NO. ,FF:r
1'r or'Po _ 1;F; Ai)UVF; Air Cnnclit,,n C:c,u, t e .ar 15 t.) 30 ill' 1(l UO 1
11- up & incl, 100,070 Mol 4(1'1 i( Ali- I I,tncll ng 10,000 I:t 1'.l _ ._._ 3.00 )1 z
lUl'�00.l N!U': d OVcr L(iiI ii Air Il,�rn ,n'
ll :)Od`r 10C��1t)Cf 1�1 r,OU
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I1;SPUMO(?'S COMMENTS
CITY E11.lSlrICS'; (.ICr.NSE FIFC.)MU) FOR AIA C:Ordlll.,\r:lO11,; ri11 S;lIDCON IF1ACf0FIS
APPFJO`/EU BY DATE: IS U r) 111'
FtECCIPT NO.
714 Stjr,.,rtuie of ,Applicant
BUILDING PERMIT APPLICATION TIGARD DATE—.--- ,19_ 311-73
THE UNDERSIGNED HEREBY APP-,IES FOR A PERM!T FOR I I'E:WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND i',PPROVED IN THE ACCOMPANYING PLANS AND SPFCIFICA IONS. OWNER PHONE
LO T NO'J.�"A lla r t
OWNERTraCj9ltifark Humuu JOBADDRESS 1LU.'J :a'uj ij1at,iwL Lai.1.1 L! 'iia Summur Lake
ARCHITECT
ENGINEER
BUILDER some ADDRESS 7165 511 ;.apdbu rg 5i . DESIGNER
STRUCTURE UNEW ❑ REMODEL ❑ ADDITION U REPAIR r-, RENEWAL U FIRE DAMAGE ❑ DEMOLITION
( RESIDENCE ❑ COMM CJ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _fi" LAND USE ZONE E'"'7lll BLDG.TYPE ar` _FIRE ZONE PLAN CHECK BY til"I' HEAT
Construct sinal® family dwelling w/attached�c €arages 3 CedrOame 3 Oathta. _
SEE_C1541RECTION 5HEE7 ATTFCHI7Q.
SEWER PERMIT N 21901 - U 705.OU
OCG.LOAD FLOOR LOAD 41) HEIGHT .171 NO,STORIES 1 ARFA NO.BEDROOMS S VALUE
BUILDING DEPARTMENT '>��
—_ _— —� SETBACKS FRONT REAR LEFTSIDE RIGHTSIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
1113.so REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Pian Check _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WI rH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ 5Gl� ;�1� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,,PLV.%18Ir�Q AND HEATING.
State Tax f 0 j6 LE_Et;1N NE_ 1t,I+f:i ` Ei16h ;>klttl.H'lily L Jf 41l)U.UU
Total 36Ea
SDC— $4006611
8.C �� .� C. •� _
By
pl PDC Sl(?O�CICIPPLI'CAN7ORAGENT
- — f)I EH Receipt No.
Approved v l ADDA998 riir NT
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
T r — —� — -- -- --`• Contractor -- --
Q M k-. - - — Permit No. ;' /76 S.2
f-,�/�d4Idle
�I�Mr ,��wl��LLts `Q� LN• Rough-in --- -- — U/�
-- S/?>•� /6 9w /f !�' /s_ - t(lAfi� ett�i!___ Fixture --- - --
_ _ w►M; .Z•w � ��•l���ttfles�'� _ Final --
A1p tus.as� [s�(�_?� .flhT[r✓ rf'a7td..�.� HBATINO
Contractor
Permit No 1206 /o -SD 'J
'eeaQ PHak. Me, Gas or Oil
lough-,n
Final
• -- —SEWER -
Final 0
DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final
S idewal k
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OC NCY Final
T
CERTIFICATE OCCUPANCY / - �y�
c` Landscaping
7oning Final
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