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INSPECTION ';'IME' __lLA__ PERMIT _-__--
DAT E: 17: rzr i- DATE ISSUED :_.L_L_ I
OWNERS NAME ' ---,------- _
ADDRESS: L� ��_ _ ��►� I
CONTRACTOR : --
TEST : Air 0 , Watery] Visual 0 , Laboratory Ei
RESULT: Approved V, Disapproved ❑ Pending L7 I
SKETCH:
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INSI✓L_':7TOR DATE I
LNOtEAttach supplemental test data tierei
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LOW.....i...v ....�. ..._
P:.OMUING PE1V V•RMIT I
hoider of a valid plumbing contractors license is hcreay
aithorizcd to cause piumbirtc work as herein noted to be irs,a,,cd in accordance with the plumbing code c`
Tigi rd, Such installations require inspc:ion by the C-►r Inspector who shaA be notified not less than `our
;4, hou-s prior to the tirne the instaiiations are ready &or inspLction. City of Tigard Business License required
for ail contractors and sub-contractors.
%ner . --) ��C�fs~`� Lsc� Addre,�,�%"
1UMEa OF T07 PERMIT ?:C.'S
TYPE OF P211h,11T I Ile ,',.i a C.% EACH AV,OU-NT jCli(if0 Use
.�.r—r..
5,Di is T I A L —.._ S J
Sin-,lo i-n.?lily-1 ba:F—ench
Guo'ax—EArh 1 bath unit 75.00
Ac.d.t;or:, bith.00MS-01ch / 1C.00
_V.cb a Homi S`ce Coct I 15.00
;.NDIVIOUAL FIXTURE FEES
1 to 51 Fixtures in 1 building,—each
31 to 'C7 Pix-Mas in 1 buildinj=v- 'Y
:n :00 FI,kur0.4 in 1 b•ii;cJ;n6- _.. _ 2.CQ
2" or rrorc ,-ix:ures in 1 build in c-ch I w� 1,50
autdi,.g Sowcr-1s; 50 `t.
--' Wrtr—Tach nddiUonal 100 rt. _—
it.-Sorviee to bui!din3- rl_ 5.0
?r,ve:e Water systems—each 'JO rc.____. I 10•x;'1
For Plumbing Inaoaction Phone OJ-41J1
e f Plum�ir;, Contrzc.or By
—077_ ��,1 _ AzCciP NO. itsucd By -- — ---
-- C) l` �f f 1ciL-Ir � MechanicalPttt miN �1 Permit_��SN_�0�_ _
Z- Fee
New Ins;aLat on
X. Ren!ace L-'.� Relocation ❑ Addition Aheration .J State__._-_�. �.
COTRACTOR v.� Ot1'tvER
?.
%-VORK AIJDRFSS/ � SiA
ADnRLti" APPL ICANT
PHONE .
Flue.Size � - --
Heat Input Rating (BTU Per N JUf)___.._� _�j�✓�_._- Vent Sirr ` _ �_.__-.
•. FUEL OIL LI GFS ELECT ❑ OTHER _ -. - - - ---
ITEM NO. FE
ITEM NO. FEE
- - -' 3.00 Air Condition Compressor 15 to 30 HP - 10"1
For Issuance o., Perm, _-[_.-_- -- - 3.(
New Under 106,600BTU 4.00 Air Handling 10,000 CFM
New• 10U,00D BTU & over 5.00 Air Handling Over 10,000 CFM 5'
_
400 Evaporative Cooler _ 3
_ Floor Furnace
Range Vent Fan 12 i
Nall • Floor -Suspended_ 4.00 _
• Install Vents Only ^2.00 Vent System _ 3
_ Repai- • Heat & Cooling - 4.00 ^_Hood Commercial 3
4.00 Commercial Duct System
/Air Condition Compresso• Under 3 HP _ _ - F
-Air Condition Compressor 3 to 15 HP
INSPECTOR'S COMMENTS_ -- - - ---_ --- --"-"'- --�
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
B
t'. DATE _ ISSUED BY- GATE
APPrZOVEU BY
y' RECEIPT NO. --
"Kr,4 w;,;;yti■`a,aStl r9'•,air ipEaw'L�?t.�""`�,aj"��� '" '%JPiiiR:d:,,ce•r r.�-� - , ._.. .___......_.__-�.�.-„_.r+v,,,,.
►y N9
BUILDING PERMIT APPLICATION "OF
'y TIGARD DATE19
THE UNDERSIGNED HFREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13UILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE T
LOT
OWNER bob Goddard —� JOB ADDRESS 13355 y4! Lienwei! LoW ADDRESS _
ARCHITECT
t _
BUILDER !�F!(flG ADDRESS'101 EJUX 9C1, "'19W Org ENGIN"ER
DESIGNER
STRUCTURE — []NEW ❑RI MODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DFMOLIIION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV” ❑RELIGIOUS❑PATIO JCARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY. � LAND USE ZONE f1�lo� BLDG.TYPE ._FIRE ZONE—r! PLAN CHECK riY_h r.l HEAT
-- :119 FU(.:t single family dwelling w/attachod gar"9110, 3 8edroum 1 Bathe
Sewer Pux mit 203417 $70b*00
4CS�.J9flQ. F�LQOR LOAb V
_ i6 N.4,�Is1RIES L ��NO.BEDROOMS 1%qL�____
BUILDING DEPARTMENT 20 42 34
SET BACKS FRONT BEAR LEFT SIDE BIGHT SIDE
Permit 9.20,x•Q�l - ---- --_._� --
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 102• )n REGULATIONS ANr' 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
Subtotal .3()7, ,,(l ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TMJ HAVE CURRENT CITY BUSINESS
State Tax X3.10 NS6. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
a,... -
Total �d()0.00
31:+. �U �,�t.�. 1 �,.'Q()�CIU
By p1
APpLICANI OR AGENT
Approved -_� t (;id leceipt No. � �
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATC
--. -- ------_-- Contractor43 k ---^--
Ttv 22
--- _ — Permit No, zoos- u;,yo
;1 c /W — --- Rough-in �
/ —.
C L -- Fixture • 1_ -----
7f Y Q S Z/n... ----—— Final L___
HEATING
i -7•s fir C
Contractor n
♦/^/9'71 !w� of3A�ar.^��• — —_ Pormit No. 1-711 –14 7� V
Gas or Oil
/�•2 7.77 C� 1 V'E•a✓'a`+/ 1S Si Il�t� --.�._—
� C ��-- --------
Rough-in —.—_.—
Final
SEWER
---.._ Final
DRIVEWAY
-- --- —�--- ___—_— Final
--�— ----a— — Storrh Drainage
(Rain Drain)Final
— --- --i
Sidewalk
Curb 8r Street Final
Approach
13LM DEPT.FINAL TEMPORARY — CERTIFICATE OCCUPANCY Final
�J CERTIFICATE OCCUPANCY n
/P n
Landscaping
Zoning Final
K.