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CITY OF TIGARD
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, C Ion 97223
Phone: ,39-4175
Type of Inspection
Date Requested Time A.M. P.M.
Address -1/-2/— "-./ 2�.,�2 Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _ �___....._,.__ ._._ Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES 11 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 -
/
Phone: 639-4175
Type of Inspection
Date Rcquested_-___ � - / Time A.M. P.M.
_ r �
t
f' 4 , Address ! ' '_�.z_ �� �Z C Y[/y'L.� Permit
Owner l -Lot#
Builder l c��1 3,V 2 3 /-y 6)u r ,Qr �cj 3
� G The following BJ��ildinq Code deficiencies are required to be corrected: ?Iceh hl/r`O
(2)
771-
J
d
y Q yy
Iy 7
r?��
Presented to __ _ n Apprered
Inspector q� ��_� lzrDi"pH•oved
Date
CALL FOR�REINSPECTION
P! YES ❑ NO
MI:KCI--1AN1(:',AI-. PERM11'
CI_ �M.Uf NO : ME890elP
CSF TIGrARD .111�� 1�)El"
orrMorr
COMMUNITY DEVELOPMENT DEPARTMENT DATE ViSUED
COMMUNITY
S.W.'SHall Blvd.,P.O.Box 23397.Tigard,Oregon 97223,(503)63CJ-4175
Cl.
ST
I 6X SUB .
NO : NO
FURNACE'. <100k AIR VIANDI 14 .0
SINGI.AE 1:!'(-)M:I:l y FUNNA(.A.'. J-00K+ All.4 HANDI-A 1,0K
F1.•.009 F1.34NACA1, C1.1AV-1.COL11.-IF-J-4
VE.N*f' FAN
WATE R
VENT ENT . SYS
BLA/L'OMP (31-11P H0113D
81.4.0GUM.171 3-1.5HP 3.NG-3:NE:W01 0P(1:)('.)M
ii-JEA—I... .LINJ:T'G : 1.)LP MIUMI-3 V..) INGINIEPATIAIII COM
El R/ClOmp '3 WHP WEEPAIP! UNITS
FILA MIMP
OUTLEAS
I IJ111'' OMPPW?
PEAMIT
0 $10 , 00
0
V w It . JAMES F, I HUDI V'P.A.IMIA,
N I'l AN HEVIEW
V
�,,, :)W <^ YHE:0 1 ME. ST 1111,11 . 50
E
.R1 97R23 1:i TATE: TAX 111 . 73
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PECAKIPT w.
This permit is issued subject to the regulations contained in Title 14 ......... .......................
of the TMC. state of Oregon Specialty Codes. zoning regulations
and all other applicable codes and ordinances, and it Is hereby I!1:::QUTI:0.:,'D INSPECTILONS
acIrepci that the work will be done In accordance with the plans and 1100CIIIA 1,14
,
specifications
and In compliance with all applicable codes and FINAL.
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits.This permit will expire and become null and
void if work Is not started within 180 days,or if work is suspended or
abandoned for a period of 1FJ0 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
Per Signal ure
Issued By T I ON 75
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
ui I Y ur- i IUAHU MECHANICAL PERMIT
Permit N �J tL U
oescriplton
Table 7A Mechanleat Code CITY pfwe -INET
City of Tigard ._._�......_.._....��...._.,....... -..--
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 —'
Tigard, OR 97223 2) Supplemental Permit 3,00
639-4175 Furnace to 100,000 BTU
1) incl.ducts&vents _ 6.00
Furnace 100,000 BTU -f
2) incl.ducts&vents 7.50
Name of Development Floor Furnace
� 3) incl.vent _ 6.00
Job Address4) Suspended heater,wall heater 6
Address _���KVQ or floor mounted heater
Tax Lot Mrrp No. Vent not incl.in
La Block Subdivision 5) appliance permit 3.00
Name lot name of busi ► Repair of heating,refr 1g.,
�- r L t G 6) cooling,absorption unit - 6.00
Maki rw g Addrou — Prow
, , 7) Boiler or comp to 3 HP
Owner _ absorp.unit to 100,000 BTU 6.00
cityistate Boiler or tom to 3 HP-15 HP
-T- 8) absorp.unit to 500,000 BTU 11.00
Name 9) Boiler or comp 15-30 HP
'b(' �E of f v e r(-r,5 y.c absorp.unit 1/2-1 million 15.00
Mailing Addresa Phone I Boiler or comp to 30-50 HP
A l 2,3S S S .__ _ _ 10) absorp.unit 1-1.75 million 22.50
Contractor CRylState L *1 - ZIPBoiler or comp to 50 HP
7�0 n 11) absorp.unit 1,750,000 BTU 31.50
Stale Registration No. /city Bus.Tax No. 12) Air handling unit to
5 i / a I q 10,000 CFM 4.50
`!! I r
l herewl
by sC�neetige net 1 neve read Alts t,Oicatbn nrrnanon et n»k+ta9►wn N Air handling unit 13) 10,000 CFM + 7.50
correct,that 1 am it*owner or suthtxwr
lzed age,i of the owr ,Ihat plans submitted are h
compliance with Stale laws,that I am reglatr ad with Mw Stats Builders'hoard,nal the Non portable
number given is cones.(II exempt hom State wistratbn please give ressor+below). 14) evaporate cooler 4.50
Vent fan connected
—� - — --- -- --'- 15) to a single duct _ 3.00
) Ventilation system not
16 included in appliance permit 4.50
Hood served by
17) mechanical exhaust _ 4.50
Signature(owner or agent' Date Domestic type
16, 7.50
Describe work Q addition F1 alteration alteration ❑ repair ❑ _
to be done_ residential ❑ non-residential Q Commercial or industrial
Existing use of l —�Y-- 19) type incinerator �r�_� 30.00
building or properly Other e.,woodsfove,wpter
Proposed use of 20) heater` +3lethesffryers,etc. 4.50
building or property _ 21) Gas piping one to four outlets 2.G0
Type o1 fuel- oil I_l natural gas Cl LPG Q electric U3 _ '-�
22) More than 4-per outlet
NOTICE ----- - —---- ____ _
_-- SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED iS NOT COMMENCED WITHIN 180 S%p 4�SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 100 DAYS AT ANY TIME AFTER —
WORK IS COMMENCED TOTAL
Special Conditions
-- — — — Dale Issued by
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection
jDate Requested_ 'S P a Time---A.M. � P.M.
Address
Owner tot #
Builder
The following Building Code deficiencies are required to be corrected: j
Presented to Approved
Inspector _.__ __ _,__�.�___—_—� �_� Disapproved
Date —
CILL FOR REINSPECTION
E-1 YES JA NO
J
SEWER PERMIT
Uf
Unified Sewerage Agency DATE
of Washington Coouuntyy� CITY OF _
OWNER: l s�; %e:nh FA 1'k&ft.J5 PHONE, ��0• b
OWNER 'S ADDRESS, _ I d aS 9W
TYPE OF INSTALLATION,
❑ SIDE SEWER ❑ LINE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY':
❑ NEW ❑ EXISTING �INGLE FAMILY ❑ COMMERCIAL
� EXIST. (PRIOR TO 7-1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS L%e
ADDRESS OF STRUCTURE , 0133 ROMM& -
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
When calling for Inspection, please rotor to the Permit Number. The Application expires In one hundred twenty (120)
days. The amount paid will be forfeited should expiration occur.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer Is not located at
the measurement given, the Installer shall prospect three feel. In all directions from the distance and depth given.
If not so located, the Installer shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will Install a lateral at the lo:ation specified by the Installer.
FEES,
PERMIT FEE s r
CONNECTION CHARGE
LINE TAP INSTALLATION
ISSUED BY
TOTAL S
APPLICANT DATE
.00
SEINER PERMIT
ADDRESS OF STRUCTURE Lv S 34, Vdia4pe 5f-
TAX
f-TAX MAP l J/ -.LLc- -- TAX LOT SYSTEM
LOT BLOCK OF
APPROVED BY DATE ISSUED BY r DATE
D.U. 'S ON& REMARKS M11. n�g 4 9*16. 4ak - s
s w w w w w w w w
. r
BUILDING PERMITAPF'LICATION TIGAP0 DATE 111��_� .19
I HE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TIME WORK HEREIN INDICATED BUILDER PHONE .604
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICAT;ONS. OWNER PHONE
*^`w\ 9 - IV "-
�Q!,� 1/ T"LOT NO.
01v1jNER .. dAJC FQ0)0ugJOBADDRESS I� 7 - 7 to 1— "
ARCHITECT �j
BUILDER
80(48-5 &Ild4'"710DRESS �/d.2 Y►1 ^'i DESIGNER ENGINEER 4&1der'7
STRUCTURE ❑ NEW REMQDEI ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO, ❑ CAR PORT XGARAGE ❑ STOR ❑ SLAB❑ FENCE
O:;CbPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_' .PLAN CHECK BY^ _HEAT'� _
Ono I
See
SEINER PERMIT N
OCC.LOAD FLOOR LOAD eV!!C. HEIGHT— NO.STORIES ! AREA 2 * NO.BEDROOMS VALUE i<7.7�•'
BUILDING DEPARTMENT SETBACKS FRONT .2' REAR LEFT SIDE RIGHT SIDE ,5
Permit A •-fo THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
(Plan Check I ORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
p' WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUIiNCE OF THIS PERMIT DOES NOT WAIVE
5utotal D •�O RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
/. ! LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
j State Taut •
� SDC—
Total � -- —
PDC# APPLICANT ON AGENT
DY _proved
Receipt No. ADDRESS F 'SNE
Ap
�iDC
IPDC - $
SEWER CONNECTION $
SEWER INSPECTION $
SEWER SURCHARGE $
BUILDING PERMIT APPLICATION TIGARD DATE "_ is.�''2 4234
FHE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED HUILDEH PHONE 12206c 1ij
OR AS SHOWN; AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS '-)WNER PHONE._fa2f1-__q0'4
LOT N0. _ j,A Q- ;►L:►:_--
OWNER I'avc L. Fauto'is JOB ADDRESS 10135 S.W. iatberxacr StripeC
ARCHITECT
ENGINEER
BUILDER Win 'Sanders Contractor ADDRESS 4165 `'W 91st Place DESIGNER Samisrs _
STRUCTURE ❑ NEW M.REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE U COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO 11 CAR PORTC GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY'C 1 _LAND USE ZONE R=�BLDG.TYPE _ __ FIRE ZONE-. PLAN CHECK BY If HEAT
hot mipdesl Carport to Garage per plan+s 5 cods'
See Correction Sheet attached
SEWER F_RMITN
OCC.LOAD FLOOR LOAD_ HEIGHT_1 X NO,STORIES �_ AREA 234 NO.BEDROOM_S VALUE
BUILDING DEPARTMENT SETBACKS FRONT 2'J REAR — LEFT SIDE - RIGHT SIDE
Permit _ '=t•a(' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check Iia• (`f WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
46 613 WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub total _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
_ J 1.16 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
ti9.' soc—
Total _ __
PDCq A PLICANT OR AGENT.t
By
--
Receipt No. —•---
Approved V ADDRESS - PHONE—
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
U,
Contractor
Permit No.
FR ough•in
Fixture
(mal
HEATING
Contractor
PormlINo.
Gas or
Oil
Hough in
Final
srWER
TFinal
DRIVEWAY
Final
Storm Drainagr
(Rain Drain)Final
Sidevmlk
Curb&Street Final
Approach
DEPT.TETA,30RAR FINAL Y -CERTIMCFATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final