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INSPECTION NOTICE
City of Tiga d Building Department
12A20 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
lype of Inspection
Di,ie Requested Time A.M. P.M.
Address
3_3-5JlPermit
Owner
f3uilder
The following Baildhq Codr deficiencies are required to be com-rected:
Presented tr, Approved
Irlspe(lor Disapproved
Date
CALL FOR REINSPECTION
4Yes 0 140
City of Tigard Mechanical Permit
New Installation D Replace Relocation u .Addition U Alteration G DATE:
HEATING
CONTRACTOR ,a-.f _1OWNER
f
AD0RESsJOB ADDRESSL.__ t'.•,`r ;• f�"AIs...,• � _ , . _.___.
PHONE----.- _ _: ;: i -l' ___ APPLICANT._-.—: —
Heat input A;rting(BTU per Hour) Vent Size. —._..�. . ^' _ Flue Sire
FUEL 011_ GAS ELECT OTHER
ITEM NO. FEE _ — ITEPA ~— NO _FEE
For Issuarce of Permit SEE BELOW iEarh Air Handling Unit. or C,uct Sy stern —7_V.) _
New-tic) tc & incl. 100,000 BTU __ _ 6, _ _Commercial Hood System ^� 7,li v�_
New 100 J00 BVT's & over ~—_____ _ 7.50 Other Equipment Each _4.60____
Wcodburning Stove _ 4.50— I Trip Inspection 4.50_
Wall-Flocr Suspended — 6.00 _Air Condition Compressor - up to& incl,3 H.P, 6.00
VentS rLs.ern H 'Fen 4.60 _ Air Condition Coinpressor•3.1 to 15.N.F.incl. 11,00 _
Repair:Heat Coolm9 _ 6.00
CITY BUSINESS LILENSE. REQUIRED BY ALI CON'i RACTO � .SUB~GC' rn TORS ! !
PERMf f'ISSJANCE 10
.00 Comments: -
FEES_-- -� __..�. �_ — _ _•_ ---_ _ _. — _ _ __�..____�__��_ ___�_
SUE-TOTAL
_ % STATE
.j§ PLANI,GHECK(_
'0TAL---.... �_.� REG. # _ ._ __.�___ ---
- _ '— S'�igneture,_--of Applicant
�I
BUILDING PERMIT APPLICATION TIGARD DATE -,laxf r ra 1112 4086
THE UNDERSIGNED HEREBY APPLIES FOR A PER,1AIT FOR THE WORT' HEREIN INDICATED DUILDER PHONE 620-0588
OR AS SHOWN AND APPROVED IN THE ACCOMPANYINr; PLANS AND SPECIFICATIONS. OVVNE'4 PHONE
40 I''�CTs
O✓VNER Jay Killer JnBAC�DRESS •G33. 8.W.8.W. !$1Ntnlxnd Drive LOT N'J.- j
ARCHITECT
Sam 8.0. Haar 23s fil
ENGINEER
BUILDER _ ADDRESS DESIGNER Killer
STRUCTURE - - II NEW Fj REMODEL ❑ ADDITION, ❑ REPAIR D RENEWAL C] FIRE DAMAGE DEMOLITION
IN RESIDE'JCE ❑ COMM i.1 EDUCATIONAL ❑ GOV'T O RELIGIOUS-❑ PATIO ❑ CAR-PORT ❑ GARAGE J STORAGE f_] BIABLD FENCE
---_
OCCUPANCY —;�,'�_LAND USE ZONE^R":�_BLDG.TYPE A!_FIRE ZONE PLAN CHECK BY �I iHEAT
Oonatr>uc:t Single latrtilr Otl MAJI W/att&cb*d garagr
See c:ormition *heat attached _...3 ftdroom
SEWERPERMITM8 23926 - �L Garoq* 972 sq. ft. ,—
..� � ---------- ,
40 14 ._.------- --- -- --
OCC.LOAD FLOOR LOAD _HEIGHT NO.STORIES 1 1898 3 ,��700 AREA NO.BEDROOMS _ VALUE _
BUILDING DEPARTMENT _ SET BACKS, FRONT 18 REAR xg LEFT SIDE - 5•s RIGHT SICtE 15
Permit
373.00 - -- - - -
4 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING C07'12. 'PON!"IG
Z4i.45 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREV6 ;H,Ar THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THk. PLANS AND SPECIFICATIONS AND !N C6113LIAN17E
WITH ALL APPLICABLE CODES AND ORDINANCES. 1'017 ISSUANCE OP THIS PERMIT DOES NOT WAIVE
Sub-total ty13•.r5 RESTRICTIVE COVENAN rS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
z 14.92 ^�LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PI_UtdBING AND HEATING.
. --- - q,v'Irl
Total
630.:17 SDC-
PDCM APPLICANTDp
By dmjAO Nfi�
A Receipt No
Approved _
PP dh ADDRESS _ -- _ --- -
PHONE
i
DATE INSP. TYPE INSPECTION REMARKS PLUMDING DATE
Contracto
of Permit No-3//.L,
�Y � Rough•in
Fixture
Final _
PIC
F16AT1 G
-ql Contracso
cS=9o-o^2 'iP tom^ Permit No. ,2610 �.by d=/9-E7Z 1`
Gas of Oil
Final (v 9y �J��Y /'�'�✓ /�
SEWER
Final /?
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Flnal
Sidevmlk
Curb&Street Final
Approrfch
BLDG.DEPT.FINAL TEMPORARY _ CERTIFICATE OCCUPANCY
CERTIFICATE 01-CUPANCY Final
Landscaping
Zoning Final
Cl.ai-lky Of 'r,"ga- rd Mc'd I a n gk
NO.
Now InstIlleian Replacu [J fielccatiou Additim, L, OATE:
HF'ATING
CONTRACTOR
_ QZ
Float Input flatinU(BTU per Iluu-) im4xx>
FUEL 011. GAS)o r-.LL-Cl' [j u I l-IL-11
ITEM F E E Ill,cm N . —FEE
Ta—C�_ ,X-i*r-,-H a r i_dI 1 n q_U,_n i—to_rD Duct t 0 1
�nrlw'mnre of crip'll—, ___57EE BELOW
QW
my)to & incl. 100,000 HTU
Jnf,,C
rdal flood System 7.50
Wavi00 BUT'3 Pt aver Odwr l."Cluipf"ClIt - Each
4.50
Woodborninq tne
'cl
Trip lj�specttyn
... ._0
r
Wall-
Compres.mr - up to Incl. P. 6.00
Vent System w/Fan
Air Cor
olrmr�nsor, to 15. H.P. Incl. 11.00
W-R7 ACTORS !
)Lji, V�
CITY FJUSIC41. 3S LICEIT 011SUB-CONTR
Cominew'; pa `� _ w._
;SUII-TOTAI.
% STATE Ily
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