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16125 SW GRIMSON COURT
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CITY OF TIGARD Plumbing Permit jilt,
Building Department No.
Pesidential LA Commercial
New Installation R3place 0 Addition FJ Alterati(;,, ❑ Date
Licensed , 1�1
Plumber 4 Owner
Address i J, Job Address. "'t
t- —°d
Applicant
CITY'BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
ITEM NO. FEE TOTALITEM NOTOTAL
Fixtuies-Traps 7.50 sevver: FEE F�,st I nO ft. 30.00
Dishwasher 7,50 Each Addit. 100 ft. 15.1)0
Garbage Disposal 7,50 Ejector Pump 7.50
Water Heater 7.50 Water:First 100 ft. 20.00
Backflow Preventer 7.50--- --1— Er.-,!h/', Jit.200ft.. 15.00
Storm :n Drain:First 100 ft. 30.00
*17 I.. Each A.- .. 200ft. 15.00
Mobile Home Space 25.00
Other(Sper"y): Rain Drai, -Single Fam.Dwelling 15.00
PERMIT FEE Comments:
STATE
Issued By:
Receipt No. Applicant I
TOTAL For Plumbing Inspection Phone 639-Al 71 Signature 'T
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address �,! �. -�•. _ Permit
Type of Inspection
The following Building Code deficiencies are required to be corrected;
_r�^ ..'_rfr6•, Fps 4r_. � _„w-�.. .nim. ._ _,_._.u..�l,,.�gi;,�',. !L — ....—�
44
Presented to_...__..��_� ��.___—_____� Inspector
Date
C4LL FOR REIN PEC770N
[ VES Cl NO
CITY OF TIGARD BLDG. DEPT
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
RHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s� require correcting:
Date: -y-` - Y` ` -- -- Permit No.
Inspectd?`�_--- -
CALL FOR REINSPECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
Date:_ .�# - Permit No.
Inspector
CALL FOR REINSPECTION
BUILDING DEPARTMENT, TIGARD N?
PLUMBING PERMIT
_. �,L�c%1111 __ holder of a valid plu►ribing contractors iir_Ense is hereby
authorized to cause plumbing work astkrein 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 the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
� Job
Owner_ .�''' �i �it _Address___ ?S y�lz �
NUMBER OF TOTAL
TYPE OF PERMIT ITENIS FEE ON EACH AMOUNT
ngle Family•-1 bath--each _ 25.00 _ �' F.4
(�1.;r
Oupl±,x-Ee;-.h 1 bath unit _ _ _ 25_00 1: k f
_Additional bathrooms-each 10.00
Mobile Hort a Space-each _ _ 15.00
INDIVIDUAL FIXTURES Cn(~�lylE�C1AI
I to 50 Fixture. in 1 ty
ilcrinI7each 3.00
51 to 100 Fixtures in 1 building each — -- 2.50 __ �__ � ` � ;,.•.,,�,
101 to 200 Fixtures in 1 building-each2.00
201 or more Fixtures in 1 building--each 1.50 - -- --�--
R1 I S C E L 1.A N E O U S
Ss_w_or-each additional 100 ft. 10.00
_'Nater Service to building
LL
_Other (5peciry) -. --
PERMIT For Plumbing Inspection Phony'639-4171 �) f
__4y.State Plumbing Contractor By e _r
,rOTAI - _- RFrFIPy Nr) Imiod RV �� I
I
BUILDING PERMIT APPLICATION TIGARD DATE ie3070
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE (.'32
-2 . �'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPF ,IFICATIONS. OWNER P � E PICT
_
OWNERER 'fob ':alson JOBADDRESS 16125 SWGrizison (.t,. LOT NO. —�.—�
Tonin 6 C060t.ry ttemadeleri 15900
BUILDER ADDRESS DESIGNER ;,`iercy & larcley_-`
STRUCTURE l NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
CT RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T El RELIGIOUS ❑ PATIO ❑ CARPORT_❑_GARAGE_Ll STORAGE ❑ BLAB❑ FENCE
OCCUPANCY -2---3 -LAND USE ZONE "-7 1.?_BLDG.TYPE 1.+ `FIRE ZONE--l--PIAN CHECK BY U4SIl HEAT r,
f:an str ij t Single 1-ar,tily 11"lliIA-1 W/attaclte:t correction tihalgt attar bed
3 4e;itoortif3 - -- ----
SEWERPERMIT# 21143 _OCC.LOAD LOAD FLOOR LOAD tiff HEIGHT 1.4 - NO.STORIES _I- AREA 3 133 NO.BEDROOMS 3 VALUE 56,1M
BUILDING DEPARTMENT SET BACKS FRONT '10 _ REAR LEFT SIDE ' RIGHT SIDE 5+
Permit 20.5-- THIS PERMIT IS ISSUED SUBJECT TO TNF REGULATIONS CONYAINED IN THE BUILDING CODE, ZONING
102,50 REGULATIONS AND ALL APPLICABLE CODES AIJD OPOINANCES, AND IT IS HEREBY AGREE.)THAT T HE
Plan Check WORK. WILL BE DONE IN ACCORDANCE WITH THE FLANS AND SPECIFICATIONS AND IN COMPLIANCE
30700 WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT Cl','Y BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
Total 3 .70 SDC-t,:,n �, y._�_ wr,�. �_s--•...
- -- - PDC#1()()• 911 APPLICANT OR AGENT ----- y---�
By------ �-t- - v�
1711 Receipt Na --
Approved `' ADDRE7l8---- --- '---- PHON
sl��r
DATE INSP. TYPE INSPECTION REMARKS _ PI.UMBING DATE--
Contractor —
c( � �_�►w _— Permit No. :;l-0 6 6 �,(00
j�
�_ --
Rough-in
3^ --—
Iv /
/ Fixture _.
Final --
,v
HEATING
0/2
Contractor
w'� P1(s /pM rz -U2
�/•Y•�r / �I.• 0 � — -- Permit No. J� c�J Y' �32,
"_JF. — Gas or Oil
Roughin
Final
_` — — ------ SEWER —
— -- — — Final
—^ DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
ELD124 D<PT.FINAL TEMPORARY CERTIFICATE OCCUPAp{CY Final _
CE►.'TIFICATEOCCUPANCY�
Landscaping
— � Zoning Final
r. y/ 1 Permit $3
(_; (y of Tigard Mechanical Permit N,1) Fee_
New,Installation Replace ❑ Relocation ❑ Addition ❑ Alteration ❑ 4%State— :Aa
H LAT 1?;G a
TOTAL- .-__W_
CON TRACTOR ��- - -u-L_� __—_ OWNERA
gl Af WOR ADDRESS / I -
PHONE_.�L'lQ ------ APPLICF�NT -//�_ -- - --- -—
Heat Input Rating (BTU Per Hour) Vent Sipe _ _ _ _ Flue Size _
FUEL OIL D GAO� —ELECT CI OTHEk�_—_
_I
ITEM NO. FEE ITEM NO. FEE
For Issuan-:e of PQrmit SEE ABOVE Air Condil m Compressor 15 to 30 HP 10.00(
New-up to & incl.100,000 BTU 4.00 Air Handling 10,0_00 CFM 3.00 1.
Ple.,•l Q0,OU1 BTU's & over 5.(10 Air Handling Over t0 000 CFM ._ 5.00
r,r"or Fwn_:r:, _ n, n0 Evaporative Co_ol3r3.C`)
Oall - flour •Suspended 4.00 R_anye Vent F_dn 2.00
Install Vents Only - _ _ - 2.00_ JVent System 0—
--+ ----��—�- 3.6- �
Repair- Heat& Cooling _ 4.00_ Hood Commercial _ _ _ 3.00
�\ r_Cundition Compressor Under 3 HP-_ 4.00 - Commercial Duct System
Air Condition Compressor 3 to 15 IP_ _ 7.50 _ w---�-
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INSPECT00'S COMMENTS
CITY BUSINESS LICk"NSE REQUIRED FGP pLL CONTRACTORS OR SUB-CONTRACTORS
APi'''nVF.D BY _ DATE ---- ISSUED BYDATE
RECEIPT NQ•__��_��.___-- lQG'C_. l
71d pnature o` licant ��