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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN SWEET
TIGARD, OREGON 97223
PHONE 639-4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Builakig Code, the
following items) require correcting:
A
Date: Permit No.
,Inspector
CALL FOR REINSPECTION
A
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CITY OF TIGARD 'BLDG. DEFT.
12420 S.W. MAI'V s'rREE'I
TIGARD, OREGON 97223
"PHONE 639.4171
CONTRAC 1 CSR.
Pursuant to Section(S) of the Uniform Building Code, the
following item(s) require correctin :
d 2 , 9
I•
Date: 2______ '—��' PermP No.------
I n s p e c t o
o.___—__Inspecto _.
CALL FOR REINSnECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
RHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Bulling Code, the
following item(s) require correcting:
@ Z-`�—s2_%����� ,�`•,�,_
` �t_�
Oate:_�_�p ?JV _ Permit No.
Inspector —
CALL FOR REINSPECTION
Y
Cit of j lciaf d mcclitm caI P211TIIf N.
Permit-
City
e:mit_
YFee_ S.oa _
New Ins;al;a+ion Re ,:ace t� Relocation ❑ Addr' un _� Al;era ion tJ •�-m)6 State
TOTAL $.3?�•___
C--%TRACTOR OWNER _1��1 a�lr.J oMIS
T/� I
ADnRESS Q, nt;� �S ���c .rA-'� NORM, ADDRESSi '� S.I,Ui .C ui�3 -ft
+ PHONE _ _ (a��= � ��i APPLICANT_ :_
'o�� Heat Input Rating (BTU Per H 4 Vent Size 6 n F ue.Size_� _
. i FUEL OIL ❑ GAS ELECT 0 OTHER.___,___.___
... ITEM NO. FEE ITEM NO. FE
K
?._•• For Issuance of Permit ��� 3.Ob Air Condition Compressor 15 to 30 HP 10.0
T New-Under 100,000 BTU _ 5.00 Air Handling 10,000 CFA1 31
F..;
:! • New- 100,000 BTU&over i 5.00 Air Handling Over 10,000 CFM _ 5.(
Floor 4.00 Evaporative Cooler 3.(
Furnace __.--
' = We[: - Floor •Suspended _ 4.00 Range Vent Fan _2.(
Insrall Vents Only �- 2.00 Ven; System 3.(
:�:.• Repair • Heat b Cooling
4.00 Hood Commercial 3(
yt Air Condition Compressor Under 3 HP i _ 4.00 Commercial Duc; Sys-'em 10
4 .-fir Condition Compressor 3 to 15 HP 7.50
i► 11;
INSPECTOR'S COMMENTSCITY BUSINESS LICENSE REQUIRED FOR A!L CONTRACTORS Uf' 3UB•CONTRACTORS DATE ISSUED BY ,APPROVED BY —.RECEIPT rk3O. "y r.—
P i
A00RESS_ PERMIT N0 . r J —
PERMIT CHARGE none.-.-
0 W%,E A
one0WNER _t _ COf1NECTI0f1 FEE .tee) _
PAID 9Y -�d
TYPE OF BUILDINGA�l� DATE CONNECTED
SERVICE RATE INSPECTION FEE �'�
CONTRACTOR _ PAID BY _ DATE
SIZE OF CO ::ECTION ASSESSMENT _ PAID
BUILDING DEPARIMENT, -CIGAHO
NO.
PLUMBING PERMIT
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to he installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified riot less than four
14; hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owners - r)JA „' rn.c+�= c_�S: r - -_- _ Address_
NUMIIEF{ OF TOTAL PERMIT NO'S
TYPE OF PERMIT ITEMS FEE ON EACH AMUUNT I (Office Use Only)
Single_Family-1 bath-each Lam' _ 25,00 9 67 6,E/
Uu lex-_Each 1 bath unit _ _ 25.00
Additional bathrooms--each a 10.00 Cf U
Mobile Home Space-each15.0
0
INDIVIDUAL FIXTUnE FEES _ 1
1 to 60 Fixtures in 1 building-each 3.00
611 to 100 Fixtures in 1 building .arch 2.60 _ __-
101 to 200 Fixtures in 1 building-each 2.00
201 or more Flxjures in 1 building-each 1.50 _
MISCELLANEOUS
Coilarn�Sewer-1st 60 ft; _ _ 10.00
Sewer-each 3ddltionel 100 ft, _ 10.00
Water Service to bulld_l2g � _ _ 5.00 -
Privete Wai.. Stems-each 10(i ft. _ 10.00 _
Other Sec `v�:-
PERMIT _ 'S;61 For Plumbing /n.q*ctio7 Phone 6394191 /
96 State '0 Plumbinb Connector ByV/J
TOTAL RECEIPT NO. Issued By
-�•°�,.,�riF4°�.11F" 'lX�Nr,';�t"�� 4�'�'•'�' '�rV'�5gj ` ]�Iri�lkViT�'��5%pe1;:�°n.r�+�;wr'R'r"""'�4ti+yl�/'�•, ._rr'►'�'!"6aw
BUILDING PERMIT APPLICATION CITY TIG AR® DATE_ � _ 19 7E3 Por
OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE.JL'+.�L'•��t-{
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE ---.-
iii7tillltlq E Inc. LOT NO-.folliklla E Jil? _
OWNER J,!j 9tY(l &M)liA:Nw JOB ADDRL`S5.4 -+ __— 'A110#41II L. JfNOME ADDRESS _
ARCHITECT
ENGINEER
BUILDER xltA9Lill t;.l(Tl @r IEI�.ADDRE((SS- LQ}�� ' � 1; 11ti�1(eltraa Al. DESIGNF.'R --
STRUCTURE ❑NEW ❑RI MODEL EIAL)r)-"ON ❑REPAIR ❑RENEWAL ❑FIRE DA14AGE []DEMOLITION
❑ ❑REESiDENCE ❑COMM []EDUCATIONAL ❑GOV'T IJRELIGIOUS❑PATIO ❑C-R POTJR��--T11 ❑GARAGE ❑ST013AGE❑—^SLAB [:]FENCE
GF,OND MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW L000NCIL APPROVED L,.lSIG(lS
GCCUPANCY--e.,1_ LAND USE ZONE__F�"1 _BLDG.TYPE L)"1 FIRE ZONE—,1- PLAN CHECK BY_!—lLL HEAT
a, F mit g duaallir9(j u/ntt.acha .....Q&LV4A— La lsf uumu•- 3 Laths.. ---
— `.at9b fi 0aTM1t 1755.3 1lr25.0Q :10 • .•
FJ.0QB-LQA.Q-._.-Q.i__._ HF.IGHT i'.') fJ0.SIQBL!<5_ 2 -J98E.A -9-7-_ , p.lQ—UDRO N41-7l—VALupgr ILI e
BUILDING DEPART
MENT — SET BACKS FRONT 4 REAR l:� i F f t It)E �J RIGHT SIDE Ci
Permit � Z7.0[1 -------- _-� -
-- THIS PERMIT IS ISSUED S4BJECT T-) THE REGU( +TIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check .3 JL REGULATIONS AND ALL APPLICABLE CODES A',iD ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND INCOMPLIANCE WITH
SUb•total ��• O ALL APPLICABLE CODES AND ORDINANCE',. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR Aran SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Ta)d .ill L11ENSE. SEPARATE PERMITS REQUIRED FUR SOWER, P1_UMBiNG AND HEATING.
IL
Total ALI, '. 0 D #I y
By --- P1
--_ ----. ----r � APPLICANT OR AGENT -- --------- ---�..—..
Approved 'I� 05 Receipt No. ��
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
—y-- Contractor
3-A-7 , ,tel Permit No. /7; kc) 3-Y'--7`�
ri 46— Rovjh-in
f --7 r--
,, Fixture
Final -
��.y_7y HEATING
�Ar, �N Contractor c
Permit No. /9,Z a;3,r� 5 /S 77
Gas or Oil
— Rough-in
--- Final - - -_---�
SEWER
-- ------------- - -- Final
DRIVEWAY
Final r
Stom Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
^BLDG. DEPT.FINAL -CMPORARY CERTIFICATE OC7NCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
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