11397 SW IRONWOOD LOOP 11397 SW IROIAMD LOOP
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City of Tigard
f,) � ANS' EC Tlo N REQUEST
for
INSPECTION TIME : PERM!T NO.:
DATE: S LZ(-- DATE ISSUED:
OWNERS NAME : -`) OK [ T/f
ADDRESS : -'5 .4Z L&L—l/��.�'cx1C�
CONTRACTOR :-- _ ���'��
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TEST. Air D , Water ❑ , visual'm , Laboratory ❑
RESULT: Approved l , Disapproved ❑ P gndinq Q
I SKETCH:
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I INSPE'ITOR DATE
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City of Tigard
I 'i"JS°ECTI A REQUEST
for
�NPE^TION T'ME: ?E?;v11T NO. :�
DATEDATE ;SSJED
OWNERS NAME : �---
a D C R E S S:sL .
CONTRACTOR
TEST : AiWc`9, wiau,c:X/D-,3t0iv
RESULT: Appmwed
SKETCH.
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INSPECTOR DATE I
LOTE; A•tGca fvi?!emental test Mata bei , i�
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City of Tigard �
INSPECTION REQUEST
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for
INSPECTION TIME: _ PERMIT NO. :
DATE ' ---/.--./--- DATE ISSUED .-.-I--/-
OWNERS
SSUED ........1-/-OWNERS NAME '
ADDRESS:
CONTRACTOR : __ - I
TEST : Air ❑, Water10 Vlaunl n , Laboratory E)
RESULT: Approved (.1 Disapproved O , Ponding ❑
SKETCH: t
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INSPECTOR DATE �
FNntF Ptta:!h stapplemen+^_i test data hereto1
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CITY OF T_[GARD MECHANICAL PERMIT
PEP.MPT N0. _._ RECEIPT N0. _ _----
DA'T'E
AY _� _ y FEE --�- --- -- -- ..
1. Permit shall be obtained prior to commencement of installation:
Permit shall be obtained fov all appliances which are to become
a fixture to the building.
3. Relocation, replacements, alterations, or changes to buyers and
duct work •i1equire permits.
' 4. All work to be concealed must be inspected before cover 11P•
rJew-install atioil � Replace � Relocation LJ Additi n � Alteration
CONTR.- - - ----
OWNER `r 1,j-iZ - ---- --
SOMERSET PLUMBING b NEATIN WORK ADDRESS
ADDRESS
BCAVERI'ON, OREGON APPLICANT
TELEPHONE NO.
FURNACE - MANUFACTURER X-__�__ ___., TELEPHONE N0.
HEAT Input
rating (Btu PerHour
MoZ Vent Size Flue Size
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FUEL OIL t_J GAS l�C..� ELECT IJ OTHER
TOTAL SQ. FT. Top Floor _ _ Main Floor Baser.�ent � --,
'--� GENERAL
ITEM N0, FEE ITEM. N0. FE9, I
For Issumnce of Permit .00 Boilers Over
New - Under .100 000 Btu 4.00 A r Handling 10000 CFM
New - Over 1.00,000 Btu _ .nn Air Handli Over 10 OUO CFM
Floor Furnace .00 �. Eva_porative Cooler .-
wall-- Floor - Susnenn eco _ T+.00 Vent—Fan _ 0
. T - Ven S�sfe-"M
Tns�`]a��Tents T7'00 Hood
Re air - Heat do Coolin � +• 0
Bo ler- s Jn er 3 H _ 4.00 �_Domes�e Inc�nera or w rO.00.
---re--3 3 to 1 H 7.50 Comm.Inc sera or .���
BoiUtTe- —No ,�sea
Bo. era 1 to— 0 Hp 10.00 .�._._. _._.._._ --
Bo r s o-50 HP
I1vSPECTOR' S COMMENTS
APPROVED BY w _ DATE �A ISSUED BY DATE
Signature of Applicant
wl s w ra eIr m W W
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE — 19— N2 0331
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
a 45 Lri1jjJ.*w. wd 5ukd ,
OWNER _ �jf'..z ; 1,LI♦ ------ADDRESS 11 1�uti• l _--� A)ILDERPHONE _
ENGINEER
RilltUf-- ' r—t ARCHITECT DESIGNER
❑ ❑
STRUCTURE NEW REMODEL _ IJ_A_Df--1
_DI1ION _ ❑REPAIR LihENEWAL DFIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL. ❑GOV'T ❑RELIGIOUS❑PATIO [:]CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCcE.
—❑BOND ❑MOVINGY ❑CONDITIONAL USE DDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _
QCCUPANCY_—LANA USE ZONE:____71_=:__BLDG.TYPE y FIRE ZONE PLAN CHECK BY T b HEAT_
1375 61q• ft, frems Owelling with Attsc:hed garage —
__ according tu I' oprove d plane
----- -- --— I b4dll't3AIFA
CC LOAD FLOOR LOAD__'W ILA HEIGHT _ NO.STORIES � AREA 1775 VALUE
BUILDING DEPARTMENT SET BACKS FRONT 2E) REAR LEFT SIDE 15 RIGHT SIDE
Permit -- ----- ------------ --- —THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALI. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— WORM.WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— -- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES3
1%State LICENSE. SEPARATE PERMITS PEOUIRFD FOR SEWER, PLUMBING AND HEATING.
Total-- ��—
By _..__-._
APPLICANT OR AGFNi
Approved Rer.eipt �u.
ADDRESS
ij
DATE' INSP. TYPE INSPECTION REMARKS PLUMBING DATE
6-1111 Contractor
Z30• G :&577 Permit No.
R -in — --
�f„/�• - iy( -- Fixture -
Findl
HEATING
_ --- -
Contra
02SeL& --
ttLr•�� (� Q�xa,t (.(i•� Q� Permit No. 20q _�-
/�, .�� ►��t' - _�- Gas or Oil TIP 7 23
_
- — - —« — Rou h-in— -- -- ---
i Final
SEWER c.)j< $.aa-7S
Final --------
- --- J --- - — — —
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Fir,al _
- — -- --- -------- — -
Sidewalk
Curb &Street Final _
-- — — —-- —---- -- -- broach
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final — -- —
Landscaping
Zoning Final I
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PERMIT CHARGE none
O U N E R ___._.-w..._....__.._ ..... _ ..._ __. C N N N E(', 1'I fl N F i s E _ .S.2.S—
PAID BY
TYPE OF BUILDING t._, Uq fF CONNECTED
SEIZUICE RATE �T�. __._._. .. _. . INSPECTION FEE 's""��...._.
CONTRACTOR ....... _ !.�"r,�. �1 ��_.°_.., PAID BY _o _ MTE
SIZE OF CONNFUMN ,_._._.._.. _. ASSESSMENT
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