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15650 SW GREENLEAF COURT t
City of l-i��;;'e1 MCCIILM Cal PL. N? Pe
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New Instal;atio' Re:,!acc a neL�GutiOn ❑ Addrt on 'Y Alteration }ALL State_
TUTAL
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TRACTOR —Ci OWPJcR
A[)nriFSS� 2. 7Ck..A.,AA IL WORK ADDRESS )
PHONE „',�_y/-�� APPLICANT �T-�. �- � �flL1� a�,�,1r)D�j
Heat Input Ratirg (.,TU P(<r Hour) Vent Size
is FUEL OIL CJ GAS ❑ ELECT WAK OTHE;'r�—
EM NO, FEE ITEM NO. FE
For Issuance o! ?rrm^t W 3.00 Air Conditio^ Compressor 15 to 30 HP Y1- 10.(
_
' New- Un,1er 100,000 BTU
5.00 Air Handling l0,OG0 CFM_ 3.(
New- I110.0[If?BTU .y ovor _ _ 1_ 5.00_ Air Handling Over 10,OCJ CFM S_(
Floor rWnace _
_ _ 4.00 - Evaporative Cooler 3(
11lall Floor - Suspended4.00 Range Vent Fan 2
�c Install Vents Only — --� _-�—_2_00 Vent System_ ---i
Re —�
s-• par - Heat & C7ooiing _ 4.00 Hood_Commercial~ 3
_ _
'it" Air Condition Compresso• Unoei 3 HP 4_.00 Commercial Dur; System 10(
r Co„d� io
tn Compressor 3 to 15 HP
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r' INSPEC-.OR-S COMMENTS
CITY BUSINESS LIf-LK''SE REOUIRED FOP ALL. ':ONTRAC:TORS OR SUB CONTRACTORS
r
t AFi'ROVED BY ___ DATE _ ISSUED BY DATE _
" RECEIPT NO.
S t) _ PE PrlIT N0.
1 �- ---__
ADORE S5, -
PERMIT CHARGE Wane
' CONNECTION FEE
OWNER
PAID BY
DATE CONNECTED
7Y1'E OF BUILDING
INSFEC7IDN FEE _.
SERVICE RATE
PAID BY _
DATE _ ___,______
CONTRACTOR _ -- PAID Sa(`1ENT —
SIZE OF CONNECTION _ — ASSEE
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JOHN E. IIEINI,ROT P01ING, INC, BUILDING DEPAK-1-MIA , TIGARD NO. �
P 0 BOX 129 PLUMBING PERMIT t
.. ...........
NEWBERG, ORKON 1115? _-� holder of a valid plumbing contractors license is hereby
authorized to cause plunbii g work as herein noted to be instal'ed in accordance wi'', the plumbing code of
Tigard. Such installations require inspection by the City Inspect)r who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Eusiness License required
for all co tractors and sub-contractors.It -
�= _IAV Date_ 7 --
Own ck .dk 12'B �� —�---_ Address/� 1 � - _
NUMIIFR OF AtO AL PERMIT NO'S
TYPE of I ERMII ITEMS FcE ON EACH AMOUNT (Office Uso Only I
11P E-N T I A L -
"
Sin to Family-1 both--0arh 25.00_Duplex-Each 1 both unit _ _ `Y 2.5.00
Additional bethroum.i-each 10.00
_Mobile Horne Space-each _ _ 15.00
INDIVIDUAL FIXTURE FEES
1 t_o 50 Fixtures in 1 bui10inRZr, ;h _3.00
51 to 100 Fixtures in 1 building-each _ 2.50
101 to 200 Fixtures in 1 building-each 2.00
201 or more Fixtures in 1 5uildin -each _ _ 1.50
MISCELLANEOUS
Building Sewer-1st 50 ft. _ 10.00
Sewer-each additional 100 ft._ _ 1 10.00
Water Service to h.ddin j 5.00 _
Private Water Systems--each 100 ft. — —_ 13.00 _
Other (S ecif __. r _
PEF'. 411_ .�/ ell For Plumbing Inspection Phone 63941.91
96 State ,/ �fy— Plumbing Contractor By CQ
TOTAL '�� RECEIPT NO. Issued By
I
y.ul4+r.16, r.•.
BUILDING PERMIT APPLICATION 11T TIGARD DATE 9—lb-76 is
OF
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PFIONE�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF '
I n-o'NO. _
OWNER °! _ JOB ADDRESS t 'f3(1.j,t.1• I il4bME ADDRESS _
r v ARCHITECT
ENGINEER
BUILDER ��11 ADDRESS _ DESIGNER
STRUCTURE UNEW ❑REMODEL ❑ADDITION ❑REPAW URENEWAL ❑FIRE DAMAGE ❑DEMOLITION
0 RESIDENCE ❑COMM OCDUCATIONA!. ❑GOV'T ❑RE.LIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCP
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE— BLDG.TYPE FIRE ZONES PLAN CHECK BY HEAT
264 Unit: "I at ;.'1d6. '1 Thia9 is la 2 G—dx oom 2 b ato two stagy unit ,t'
i P0[J int. of livilig spac, with a do ibla rja$rs(c e.
r.
UCC .L"A _� 1.95?R L.QAIL_ _ HEIGHT__ NQ.STQRI-ES 0., ABkA d4.9.EI2HQQMS VALUE�3�339000.—
BUILDING DEPARTMENT SET BACKS FRONT I11 f+ REAR 221+ LEFT S10"Mlb""1 RIGHT SIDE Ci lSF�wFI,t,
Pelmit 139*00 — — — — ----
10400 THIS PERMIT' IS ISSUED SUBJECT TO THE RFOOLATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan CheckREGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— - WORK WILL BE DONE IN ACCORDANCE WITH TI,E PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Srlb-total ALL APPLICAB . CODES AND ORDINANf ES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Stale Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total 153r47 x6 .' Itaq 2".,,00
By - - --
a_.._._,.-_._�_ APPLICANT OR AGENT
Approved LT Receipt No.
PRORE —-
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