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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 6394171
Addre.s
--- :•` M_ _ .__ __ Permit #---�
Type o' Inspection
The following Building Code deficiencies are/I required to be corrected:
.Y,
We-
Presented to_ Inspector
DatS
(AL FOR RF1WFCT10N
I� YFS Q NO
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main S^,.
Tigard, Oregon 97223
Phone 639-4171
Address #
Typo, of Inspection
The following Building Code deficiencies are required to bu corrected:
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fim
Presented to Inspector
Date
CALL FOR REINSPECTION
b YES El No
INSPEC'('ION NOTICE
City of Tigard Building Department
12420 S.W. Main St,
Tigard, Oregon 97223
Phone 839-4171
Address^--.--_� .`''� r -` _ .� Permit #
Type of Impactihol _.—._—� ,,r`•'i _____. _-- ----.-- __ _ _
The following Building -or4e deficiencies are required to be corrected:
""-- _s._.,.�,.�f-�+�:.--r:+.-..._._ r`::.'- r..�'a ^�tyr';_•1A°1,�..t t��.'_�! 'f':��'1. 1, _� �c- ,r'_�.. .r
Pf eSen tAd t0 Inspector ^1f
Date
G41. FOR REIIUSPEC'TION
C7 VES 0 NO
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MIN I. REINHARDT PIEI"BiNG, INC,BUILDING DEPARTMENT, TIUARD
P. 0. BOX 1?9 PLUMBING PERMIT NO.
NE14'SEnC, O"ICD 97117
- holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified riot less than four
(4) hours prior to the time the installations are ready for inspection. Cite of Tigard Business License required
for all contractors and sub-contractors.
Owner-__f n� AddressL (� ;r-�.I r3 �,`/ aid tc�L2
NUMBER OF TOTAL. rPERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
(Office Use Only)
Si In Fames —1 beth—each 16.00 -- r
Ouel�xlEsch i both unit _ _ 26.00 _
Additional bathrooms—each 1
Moblle Hnma S ece-each _��
INDIVIDUAL FIXTURE FE:S
1 'to 50 Fixtures in 1 building_ench _ 300 --
61 to 100 Flxture2 In 1 buikll —each 2 50
101 to 2T) Fixtures In 1 bulldiny�aech 1
201 or mors Fixtures in 1 bulldlr�► —each y� 1.60
MISCELLANEOUS
aWIdlny Sewer-1st 60 ft. 10.00
S6wrr—each aduitional 100 ft. 10.00 _
Water Service to build_ Irk _ 6 00 �► r-
Private Water Stist11m:—each 100 ft. ^� 10.00
Othnr S If
PERMIT / tri' For Plumbing 1174pecr%an Phone 639-0191
°� State /
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City Of Tioard Mechanical Permit No. Fee__ 4Mo
New Installation Replace ❑ Relocation ❑ Addition Cl Alteration ❑ 4%Stat,_—_-A
HEATING TOTAL__
CONTRACTORv �,g,c�_� ' � OWNER�uM_A�[1w1 _��_�►��ia��_
WORK AODRESS � tom, C�1.1� �+.�+;„pOOcJ
PRONE f�2 t�'� —�---- �_ APPLIC:ANT__�����_��'d'.L���
Heat Input Rating I'i'rU Psr H } �_ Vent Size a Flue Size1
i U E L OIL rJ GAS I ELECT ❑ OTHER,,_ — -
ITEM NO, FEE ITEM NO. FEE
.-or Issuance of Permit EE AE10—v _ Air Condition Compressor 15 to 30 HP 10.00
New-up to &_ inc1.100,000 BTU _�� 4.00__ Air Handling 10,000 CFM 3.00
New_100,001 BTUs & over 5.0q Air Handling Over 10,000 CFM 5.00
ricer Furnace 4.00 Evaporativa Cooler 3.10
,;'/a!) - Floor • Suspended 4.00 Range Vent Fan 2.00 '
Install Vents Only 2.00 Vent System 3.00
Fleoair • Heat& Cooling 4.00 _ Hood Commercial _ 3.00
Air Condirion Compressor_Under 3 HP _4.00 Commercial Duct System 10.00
Zr Condition Comprossor 3 to 15 HP 7.50
INbPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS Oil SUB-CONTRACTORS �—
i41PROVED BYDATE ISSUED BY� DIT
_744
iIECEIPT NO.
"' Signature of Applicant _
BUILDING PERMIT APPLICATION TIGARD DATE_-__ _ 7�4_-'19 b 3091
THE UNDERSIGNED HEFEBY APPLIES I ')R A PERMIT FOR 1 HE WORK HEREIN INDICATED BUILDER PHONE _.639"3101
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHON1 -
LOT NO..
OWNER Tualatin Kiev. CO.lOBADDRESS lb9010 SLI Oak Meadow Lane Summ-erfia Il—
ARCHITECT
ENGINEER
BUILDER same _Y ADDRESS 15300 SW 116th AVG DESIGNER •D•l.. —._ —
STRUCTURE _ EX NEW ❑ REMODEL ❑ ADDITION 1-1 REPAIR ❑ RENEWAL CJ FIRE DAMAGE_ ❑_ DEMOLITION
INMESIDENCE ❑ COMM ❑ EDUCATIONAL 1.7 GOV'T ❑ RELIGIOUS 17J PATIO ❑ CARPORT E] GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USE ZONE R-7PD BLDG.TYPE yPJ—FIREZONE_ 3—PLAN CHECK BY DL1�1 -HEAT__�'Jc'__
Construct single family dwelling w attached �sra s. 3 Bedrooms -- 2 Baths.
Re—Issue :►P _King (:ity Permit #1249 (1613 SLS Pacific Iiwy)
SEWERPERMIT# 21.1:j6 ^ j7Q1L.0Q N6xy-� v—
OCC.LOAD FLOOR LOAD 41) HEIGHT_ 12 NO.STORIES 1 AREA 1109 NO.BEDROOMS 3 VALU644 r 600.
BUILDING DEPARTMENT SET BACKS FRONT Or 9t REAR /►'' /G I Ff T SIDE ��G► RIGHT SIDE A0 �
Permit1 72•n0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN TILE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREKD THAT THE
Plan Check 10.00 1 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ 182.00 RESTRICTIVE COVENAW, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State tax 41`" 6.66 LICENSE.SEPARATE PERMITS ACQUIRED FOR SEWER,PLUMBING AND HEATING.
Total � 2180. 00 3DC— 400000) `
PDC# II $1001• ��4P�lICAIVTOR�CiENT
Receipt No. r _
Approved f f / AODRE88 __ _ — ------PHONE _
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
*CA -TpLdar Fixture
Final
HEATING
11 Contract0f
Permit No.
ft— a
Gas or Oil
-tOLA
Rough it
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidavielk
Curb A Street Final
Approach
BLDG. DEPT.Irl CERTIFICATE TEMPORARY Final
CERTIFICATE OCCUPANCY
dd Lancbcmping
Zoning Final
,A—A
14
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Amt.
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BUILDING FER�'�'IIT ^F�.iCATION `oF TIGANI�tD DATE __._. ,g 1, .
BUILD,
til"I H p �
THE U - SII;NFD H: ESY „PPLIES FOR APERMIT FOR THE WORK FICHEIN INDICATED OWNLERHHN
OR MS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. L0TI FT?roN
`I _`- ^,/��, LOT NO
lip �WIA I V� •�.JO. L09 Ar]OMESS s����`�1.DO��Gr /'`rc'4�`o�„QN
ARCHITEIT
ENGINFER
7CQ _ �a►�e, ���4E>,s 1�San S1V II(�--=Ave. DFcI��,�R .tic .._______._
1CTUR[_ NEW- --�
_ Rt' 00121 OADDITION ., _ clPE,rAIRr-� ORENEVIAL OFIRE DAMAGE � OEMOLIT13N
ILIENCE �OCLIMM ❑EDUCATIONAL L1GOV'T`OFIE LIGIOLI5L]PAT10_L'CAR POFTT OGAPAGE O STORAGE OSLAd ❑FENCE
c•yv R-3 LANO t,c.. .--�, ! "F� UI.Dc:, "Pc .I` c��t ,..,,F: PLA N�C'HEEfCK B�� —MEA.t_
cavttiti",4 13,12 -..,�� ✓weal -
u a V _ dm8
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L9?17.._ �t�,C+raLna� op
40 ~1 HT �/Z. NQ �II,R,ES _4�A�I�Q_ NQ SE�Drpp4MS _3 vaLl�=l/ (-
HUILDINGGet �nrVENT I ` rS FRONT 442.,, 11-AR /� -r.,.LEI SIDE J glGrlTSIDE
lilt — 1_,2,00 . -
c',W,IT 15 15SUF.D SUd1fCT TO THE REGULATIONS CONT41NF0 1N *-"e BUILDING COCE. ION.NG
I Check �Q_^00 1INNS AND At L APPLICABLE GOOFS AND ORDINANCE-5, ANU If IS �trt8r AUREEL) I"Ar THE
,,
.r_ __...� �.+ t.l EiE DJ'vE 1N A[CURC'A'vCE WIiH THE /LANS:.'JDSDECiFIGATICNS .NG IN COMPLIANCE Witt-!
--total t '�'(�O 'LICABLE COD9S AND ORDINANCES. THE ISSUANCE OF THIS «EFb,1T DOES NOT WAIVE
�_.. U� i1VE COVENANTS CGNTQACTOR AND SUB COTITRACTORS TO HAVE CURPENT CITY BV.,1NESS
re Tax �y, CJ SEPARATE PERMITS ReCnt'1REO FOR SEWER. PLUMBING AND HEATING
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