9841 SW KIMBERLY DRIVE 1t a s en � a.i
984:1. SW KIMBERLY DRIVE
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ADDRE5_, f �J 4� PERMIT NO ._---- - 4-
PERMIT CHARGE �onF
CONNECTION FEE
PAID BY
TYPE OF BUILDI 'IG ��q, '---- DATE CON0,ECTED
SERVICE RATE INSPECTION FEE cx
COKTR Il.T OR _ i _ PAID BY DATE _
SIZE OF CONI d' :TION A55ESSMENT PAID
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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 Itern(s) require correcting:
�It
Date: Permit No.
Inspector
CALL FOP REINSPECTION
BUILDING PERMIT APPLICATION C0F TIGARD DATE_.._ / �"/ 19IC1
HE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. GWNERPHONE-
�y
y
OWNER .?Ift;.6 filoor'e JOB ADDRESS 9841 SW- KAOL,I Orly_ tHOME ADDRESS
ARCHITECT
ENGINEER
BUILDERr-t _ ADDRESS 11700 SW 114th Piui, ' DESIGNER _
STRUCTURE ONEW 0 • mnDEL C3 ADDITION ❑REPAIR ❑RENEWAIlL ❑FIRE DAMAGE []DEMOLITION
CIRESIDENCE ❑COMM OE. , 'ZONAL OGOV'T 0RELIGIOUS OPATIO (:]CARPORT rr1_ GARAGE OSTORAGEOSLAB OFEN',F_
UBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW UCOUNLIL APPROVED ❑SIGNS
c
GCCUPANC,Y°�`a_LANU U5E ZONE f�« 7 _—_BLDG.TYPE FIRE ZONE_._._ PLAN CHECK B�. �'
sirk�jjy 1"emily I:wrljjnQ ujsttachre� Uvdmm - ►Jex,►„
;s;;'won 11ormit . 16724 f+.': .00,
GCCJ�Q9a �F.LSzQB�,QBD__ - _40 HEIGHT �Q.yr^_iSLE3LF� AFIEA �1dr�4�E�Q.QL�_� _�Al.��'��� "Ix•
BUILDING DEPARTMENT SET BACKS FRONT .32 REAR 2G LEFT SIDE 7' RIGHT SIDE 9
'�
Permit 1203,06 -
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUIL JING CODE, 70NING
Plan Check 101• aU REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT I.iF
– WORK WILL BE DUNE IN ACCORDANCE WITH THE PLANS AND:,PECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 304,�',o ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax��; 8.12 I_ICf NSF.. SEPA E EQUIRED FOR SF WE R, PLUMBING :NO HEALING.
_ gw"�l1
Total ,:31262
de
By
----- - ApPLILT OR AGENT'
Approved ' ' '� Receipt No.g, s
alw �r rase Iw aar ti r
DATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
_q�a Contractor
Permit N..
'ice.20 i Rough•in
Fixture
Final
_ HEATING
— _ Contractor
s Permit No 1T7
5� 32_
Gas or Oil
Rouyh•in —
Final — --- —
SEWER
,— Final
D VEWAY
_ --�- Final — W
_ — Storni Drainage
(Ra in Drain)Final -
-
Curb&Street Final
______ _ Approach
BLDG. DEPT. NAL TE:'MPORARY CF_RTIFICATE OCC NCY —
CERTIFICATE OCCUPANCY S� Y ' _ _ Final
�? Landscaping
Loning Final
-.'JILUNIG PERMIT APPLICATIGIN cU Y ;,f.'.RD DATE---CJ2. .rl_.__.,s2`L N2
!
HEREBY APPLIES FOR APERMIT FOR THE '.V0 K '-I:REIN INDICATED BUIIDERPHUNe�,��-d��
:R As SHC,%'N AND APPROVED IN THE ACCOMPANYING PI.�NS R�JD SPECK ICA.ICr`S. OW ER?HiDNE
�? I.OT NO—
ARCHI-t'ECT
ENGINEER
1/-� ... DESIGNER�_�_�_
Uh5 CRNEW _ ❑REM_C•r,EL _ _DODGIIIIION _ CR_EP_AIR_r, t�_1�F%FNVAL t,..lFIRE DAMAGE n ❑DEMOLITION
,1( `I:;_-NCF r]C7MM-OEDUCATIONAL ❑GOWT ORFuG10USOPA_TIC-L.:C4a PORT -0GARAGE ❑STORAGE L.USLAS ❑F_NC=
°OND ❑MOVING ❑CONDITIONAL USE ODESIGN P.VIEW ❑COUNCIL APPROVED 0SIGNS
LAND USE 7.ONE,;R� 7 AtrDG TYPE -^� FIRE ZONE `� PI.AN CHECK BY HEAT—.,_ _
---___s.�.�S2�1a5��[5..� _t�.r����..L._E.'a'��..�r�//.►��1s�...�AT��r• Ir��_.�'Q'.r��� ._._.
_f199A1.29tLf ' N
CA 1.1 -..�s.fz_._...N.Q T-1d, EIS--
! BUiL0ING DEPARTMENT-y gET BACKS FRONT �2REAR G LEFT SIDE 7 `� RIGHT SID: -
-'e1m,i
THIS PERMIT IS ISSUED 5.18JECT TO THE REGULATIONS CONTA;NED IN THE BUILDING CODE, ZONING
Plan Check REGULAIIONS AND ALI. APPLICA9LE CODES AND ORDINANCES, AND IT IS KEREBY AGREED THAT THE
—�� WCHK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WISH
I S4h•tptal s`� ALL APPLICARLE CODES AND ORDINANCES. THE ISSUANCE 0'; THIS PERMIT DOES NOT WAIVE
-- J-�� RESTRICTIVE COVENANTS. CONTRAC70A .AND S'.IS CONTRACTORS TO HAVE CURRENT CITY BUSINESS
F'i to Tax y•, iR LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND F.EATING.
Total
By.___.�._
App+oved Receipt No
ADOPUKS
I;�� �L
:3'JI1 DING Pf=RMIT APPLICATION `uF TIC ,-IRD DATE_- �__ 19 ___Y N9
'HE UNDEW 'I,NFD HEREBY ADPL CS FORA PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE____
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIFICAI IONS. OWNER PHONE-__
LOT
HONE __.—
LOT NO.-
R JOB ADDRESS _ HOME ADDRESS
- ARCHIIECI
j ENGINEER
ER ADDRESS _ _ _ DESIGNERn
UAE —ANEW . 0PEMODEL 0ACUITION - LJ REPAIR, r[)RENEWAL u ❑
IIRE DAMAGE DEMOLITION
�SIDENCE ❑COMM ❑EDUCATIO'NAL ❑GOV'T OREliG10U! DPATIO MAR PORT n- GARAGE ❑STORAGEOSLAB ❑FENCE
�_390Np - OMOVING 000NDI7IONAL USE ODESIGN REVIEW ❑COUNCIL APPROVED- C_]SIGNS --
_ PAN�Y�.�l�A_ND USE ZONE_,_.-__t__,BL DG I YYPE_Y-.--_F IRE ZONE_...- PLAN CHECK BY HEAT-,____.,_,
r
1o(' 1.QAQ __.AREA____-
BUILDING DEPARTMENTSET BACKS FRONT REAR LEFT SILE RIGHT SIDE
THIS PERNIT IS ISSUED SUBJECT TO THE REGULATION? CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORCIP,ANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILT.BE DONE IN ACCORDANCE WITH THE PLANS Ano SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE IS.UAnI`�E OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONIRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REOUIRED FON SEWER, PLUMBING AND HEATING.
Total
Y
APPL ICAN1 OR A NT
Apploved Receipt No.
ADDAE55 �_._.-_.�-----_�_. _-�+i-TC�wF---- -----------
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�.► rrs �r �r e. �r �r r# � .arr
l � � t � 41tL. 1)L �.l.r( Ptr:1)it N,0 H Fee
Pa3�': Ir i:31i0liOn��c1c b^P lJ Rcloca-;on Addition ❑ Att9roU3n ) 3`:stat.— 2
s TOTAL-
-L� .
Ap7^n ��1S_ WORK ADDPr4SS�
G
PHONE ����0�, � ___ 'LICANT
AP,
Hea. Inpu: Fazing lBTU Per Hour) i Vent Size Flue Sipe_
FUEL OIL GAT-76, ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FE
3 For Issu3ncc of Permit Air Ccnditic;r Compressor 15 to 30 HP
!- .New - Un:iv. 1TH,00a ETU ` 5.00 Air dandling 10,000 CFti! ��`3.
I�•.v t0:,,0�J0 �STU & ovar _- _� -- V"`-.l_. 5.00! Air Hiind ingOver 10,000 CFM # 5.
Floor Furnace 4.00 Eva,,rative Cooler 3.
Wall Floo.. Suspended __---W_� 4_00 Rangg_Vent Fan
^stall vents Ont). --- - _ - ---.12.00 Ven;System
Rc*Zir • at & Goofing _ _ ---_ 4.00 _Hood Commercial _ - 3
Air Condloon Com^,rt,scor Unit r 3 HP~jr.-._�_ 4.00 _ -Commt_rcial Duc.Systern� - r - lig.
Con-i:ion Comp,essor 3 to 1S HP - i .7.50-
.� i.ilJ:.t•.••�•....2`__ _ _:':'21��._tai:• :t_.."L...�..!'_�'iY.�... .. ._ ....�.:T.'i�_Y:::i'_.'.J•C.'.^.ti�-"L.:.T31����.�•t...-••._ -
INSPEc rows
CIT'r RUSINESS LICENSF. REOUIREO FOP ALL CONTRACTORS OR SUBCONTRACTORS
APPRO\- c 0 FY DATE __ .� ._...___ ISSUED BY---, DATE