10567 SW TUALATIN DRIVE ■
10567 SW TUALATIN DRIVE
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INSPEcllio N NOTICE ( r
City of Tigard Building Department
13125 IM Hall Blvd. Tigsrd, Oreqon 47223
Inspection Line (Rec-43--Phons): 6.'t9-4175 Rugines" Phone: 634-4171
Inspection:
Footing Plbg. Unaerslab Mach. Rough-in Appr-/Sdwl.k
Found. Plbg. Top Ort Gas Line FTNAL:
Poet/Beam Struct. San. Sewer Framing -81do.
Poet/Beal Mech. Rain Drain insulation -Plumb.
Plbg. Underfloor Neter Lin,, Gyp. Bd. -Mech.
Date Requeated:_,/0 —01/ —Times —AM PM
Address: _'a'G� ,-�� ( , Pbrmitt:
Builders -------
THE FOLLON:NG CORRECTIONS Agit REQUIREni
J —
Inspectors r
at9;l
�—APPROVED -- DISAPPROVEDAPPROV1, SUBJECT TO ABOVE
-----Call For Reinsp.
6TA
v
CITY OF TIVAPD My0 PLUMPING F'E Rh-I T
� �� PERMIT #I. . . . . . . : P L M 9 1 --1211-3 6
COMMUNITY DEVELOPMEMT DEPARTMENToil ca
13126 SW Hall BNd. P.O.Box 28397,Tgiud,Oregon 97'.0 (103)d31?-4175 �_
II. 41 i 1 UA'rE'_1111
ITE_ ADDRESS. . . 10567 SW i•UALATIN DR PARCEL: 2SI I.,AD-06100 1
RUBDIVISION. . . . DOVER LANDING ZONIN13: R--4. 5
E+I_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . ..44 ------ —
GLP.5S OF wom-,,. . :ALT GARBAGE D I SPOSOLS. . : MOBILE: HOME SPACES.
TYPE OF USE. . . . :SF WP.SHING MACK. . . . . . . a BACKFLOW PRE=VNTRS. . : I
OCCUIDANCY GPP. . :R3 FLOOR DRAINS. . . . . . . . TRf)P,S. . . . . . . . . . . . . . .
STORIES. . . . . . . . : WATER HEATERS. . . . . . : CATCH BASINS. , . . . . . a
FIXTURES----.---------- LAUNDRY TRAYS. . . . . . : SF RAIN DRAINS. . . . . :
S T NKA;. . . . . . . . . . : UR I NAL.S. . . . . . . . . . . . . GREASE 1 RAPS. . . . . . . :
LAVATORIES. . . . . a OTHER rIXTURE.S. . . . . ..
TUB/SHOWER5. . . . a SEWER LINE (ft ) . . . . :
WA'T'ER CLOGETS. . : WATER LINE (ft ) . . . . r
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Remarks : SPRINKLER SYSTEM
Owner FEES
RICK LBk
N type amol_tnt by date recpt
10567 SW TUA!_gTIN DR PRMT E 15. 00 JLH 0 /26/91 —
SPCT E 0. 75 JLH 07/26/91
TIGAPp OR 97224
Contractor:
OWNi.R
I t1 one #: 15. 75 TOTAL
------- REQUIRED INSPECTIONS -------
Tn1s permit is issued subject to the regulations contained in the Final inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. Ali work will be done in accordanue with
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 divs.
I'er•mittee Signature :
isso_ted By :�
Call for inspection — 639-4175
W W W A w w
CITY OF TIGARD
PLUMBING PERMIT 13125 SW HALL BLVD.
P. O. BOX 23397
Applicants must !hold Oregon ttegfstration to eondua a plUmWng T I GARD r OR 97223
buunesS or nuns be property owner/operator not hiring otrtside Wp.
r Nameo<Oevebffnell (503)639-4175
I Plumbing Permit No.Doscriphon
�-
Addross - -
Job ORS o14-2i-wo QUAN. PRICE AMT.
Tax lot Map.Pio. - --
Addroae
FIXTURES
lit Mock StA)cWson - - -
Sink 7.50
_- N&nwa""twits -_ lavabry 7.50
2" Tub or TtofStmwer C4xnb. :.so
USG Sthower Only _ _ -_7.50 -
Owner WalerGlosd 7.50
972 er 21f Dishwash — _--- _ 7.50
Y Phone GaAarps Disposal 7.50
2L3 yz��
a WashbV Machine 7 50
Floor Drain- - - - 7.W
rt+ss Phone --- WakwWater _,— 750
Occupant City/State zip lAundry Room Tray ---- ---- 7.50
Urinal_ 7.50
a me '�- O*w Rxl res(Spe&y) - 7-50
1�vTirigess --
7.50
phone - -- - - -
7.50
Contractor City/State ZIP ----- _- -_--_ -----750 -- ----
WSCELLANEOU �-
C:ity Moa.Tax No.- Sewer 1 s1100'
tele Sewer-*&Add4100' --- 15.00 --
(F*'_�'da0 - - -- Water SerAos 1 st 100' -- 20.00
I hereby r d nowfodps flat 1 here road Itis Wale►Sennos a&Addit 2 ' 15.00
.ppFcasr-.n,th.t a.s int«ms;rion
given is coned,OWA am registered with the Stale BulWo Mooed.and&I&-) Sk mt&Rain Drain 1 st 1 oa� 50.00
have a Stab PlurrtMng k nee ow the nunA tts giran aro oonvd.that ell --
' P'xnbqsg work writ be dome in eocontar"with a ppiceble provisions of Ore- Sk mt 6 twin Drain Addil.100' -- 15.00 --
Pon devised Sty"as Chaplers 4 47 erxl t3ani end app&**cods and Ohm mob"I flute Speoe 25.1110
no help wM be empbyed fillets kensed under ORS 693 (II exempt horn
State re91,90-atitm.phase give reason be". Baric Flow Prevention
WWFf)AW=RS-1 hereby arrhly that 1 am the owner of the property de- Device or Anti f' lkkon r vice 7.50
a«bed abov a.at wttldh ocaaon 1 propose lu make s plumbkV ir»talsdon or Any Tap a Weew Not - -
my 7wn vee aril Itis property Is not bekV corn marled for tale.base or rsnl :wtrtsc.'fsd b e Fa4re 7.50
--- -- --- - -_-- - __-- CaldtBasin 7.50
Insp.off)M.PkxWng 40.00 Per W
-- -------- ---___..__.._.-- c lty40.00 Per fM.
Altar.of Pkw**p within - _
en Eoo*p Bldg _ 15.00 min.
AUTl*YilZFO.WNATURE -- lWe New Mag.or Mufld.Addhon - 25.00 mkt.
13Wn DZM, ' ole Lemli .
Deicribe work new❑ addition Q atleration(3 repair❑ d-el lir 15.00
Ire dim - - reskfefdial Fl" nonTeeidet AI _______ - - - -
I-Altro use of
btAdingrxt>"3pec1Y___----_-- i_--,-- $25.00 minimum SUB-TOTAL
F'ra i 0"of y--�-- 5� SURCHARGE
txil *R ofpiopetty--,_.._— --- ---- -- 25% PLAN RBVIBW
NOT1CtE - - - -- - ------- --- ----
Thew Permit beoorotee nu$and wvid r wxt or oongruodon ac4wUod Is not corn TOTAL
nVottaed tvkftkt 100 deyw w•orpvdnr7fon or work f.eteperahed or atwWo_hed kir
a fOAM ret 190 days e1 airy Mr.atter wo"k le oonrwwhosd-
WvrtALOOHOfTlOtt3._. --------
DaM Issued _ by __
CITY OF TIGARD RECEIPT (IF 1='AVIIENI RECEIPT' NO. 19 1--2 t'577a
CHECK Amatim'r - 15. 7`rNAME, a t-ONERGAN, RICHqRD
ADDRESS 10567W TUALATIN DR CASH AMOUNT 0. 00
PAYMENT DPTE e,7/26/'91
1311
TIGARD, OR 97224-- USD I v 1 11;TON
1-wURP()SE OF PAYMENT AMOUNT P A 11) PURPOSE OF PAYMENT AMOUNT PAIn
Ci PERM- 19. 00 31". BUILD PEP
0. 75
SPRINKLER PERMIT
TOTAL AM0L1NT PAID 15. 75 ( -
CI7Y OF 71FA RD MECHAN I CAL
RD P UR M I T
COMMUNITY DEVELOPMENT DEPARTMENT am*" 1ERMIT #. . . . . . . .. IIEC91-0118
13126 SW HWI Blvd. P.O.Bar 23307, pI,TIM,Onigon 97 (SMN
)O4175 47
:il.TE ADDRESS. 10567 SW TUALATIN DF) PARCEL: 25115AD-061061
SUBDIVISION. DOVER LANDING ZONING.- R--4. 3
BLULK. . . . . . . . . . .. LOT. . . . . . . . . . . . . .44
CLASS OF WORK. . :ALT FLOOR FURN. . . . i EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . . VENT FANS, . . -
OCCUPANCY GRP'. . : R3 VENTS W10 APDL: VENT SYST5PIS:
5 TOR I EfS. . . . . . . . .. SO I L E RS/COMPRESSORS HOODS. . . . . _ .
rUEL 0-3 HP. . . . : 1 DOMES. INCIN:
IELE 3--15 Hl-",. COMML. INCIN-
MAX INPUT: BTU 15--30 HP. . . . REPAIR UNITS:
FIRE DOMPERSI. . : :30—�:*,0 HP. . . . WOODSTOVES. . -
GAS PvaSSURE. . . : 50+ HP. . . . : CLO DRYERS. . :
NO. CC UNITfi-------- AIR HANDLING UNITS OTHER UNITS.
F"URN ( 100K BTU: 10000 cfm : GAS OUTLETS.
H.WN ) =100K Lk*TLJi > I0000 k:•fm-
F-!efffar-ks : AIR CONDI'TIONEP/NEW THERMOSTAT
owner FEES
RICK & MARY LONEGRAN type aMOUnt (jy date t-ecpt
10567 SW TUALATIN DR PPMT 1 16- 00 JLH 07/10/91
5PCT $ 0. 80 JLH 07/10/91
116ARD ON
r-,hune #.-
CLIMATE CONTROL HTG & A-(,,
3315 NW 261H AVE
POPTLAND OR 97210
Phone #.- C-�`3-4393 1 16. 80 TOTAL
Rep #. . : 62196
REQUIRED INSPECTIONS -------
This pi;*At is issued subject to the regulations contained in the Final Insoection
Tigard Ainicipal Code, Gtatt Of Ot'P, Spl!C161tv Codes and all other
aPplicablt law,. All work will be doni: in accordance with
aprjroyed plans. This permit will empire if mirk is not started
within 181 days of issuance, or if work is suspended for More
than 161 days.
..........
Permittee Siqnat,.tr-r
rss�.teij By :
Ea� l for, nspection C-339-4175
CITY OF T IGA►RD MECHANICAL PERMIT Hecetpt # ------------_--.---
1312 5 'SW HALL BLVD.
i
P. O. BOX 23397 11ln1' Daacriplion
T IGARD, OR 97223 c_t I U Table 3A Mechanical Code _ OTY PRICE AMT
(503)639-4175 1) Permit Fee ' o 0 10.00
-- Name of Development 2) Supplemental Permit 3.00
Lof,jt2 R G-f W I
Job Address 11 600
Furnace to 100,000 BTU -
.
incl.ducts 8 vents
Address _I -AL) I ukL- A-r- (J D "`
Tax Lo, Map Nu. 2) Furnace 100,000 BTU + 7.50
incl.ducts&vents
Lot Block Subdivisioft
Name(or name of business) 3) Floor Furnace 6.00
incl.vent
Mailing Addressl Phone 4) Suspended heater,wall heater 6.00
Owner -5 S-23 -- 2U 6 or floor mounted heater
city/state Zip 5) Vent not incl.in 3.00
appliance permit
Repairof heating,refrig.,
Name(or name oft siness 6) 6.00
cooling,absorption unit
Mailing Address Phone 7) Boiler or comp to 3 HP I 6.00
Occupant absorp.unit to 100,000 BTU
Ciry/Stale Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name 9
) Boiler or romp 15-30 HP 15.00
absorp,unit 1/2-1 million
L_L t Vel OQ T 6r`,1�"T�
Melling Address Phone 10) Boiler or comp to 30-50 HP 22.50Ut Z23 3 absorp.unit 1 -1.75 million _
Contractor Boil jr or comp to 50 HP 31.50
City/State Zip 11) absorp.unit 1,750,000 BTU
ibjeLAND -7/0 Air handling unit co 4.50
State Registration No. City Bus.Tax No. 12) 10,000 CFM _
G 21 ?6 Air handling unit
1 hereby acknowlodge that 1 have read this application that the Information given is 13) 10,000 r.FM + 7.50
coned.that I am the owner or authorized agent of the owner•that plans submitted are in
compliance with Stale laws,that I am registered with the Stale Builders Board,that the 14) Non portable 4.50
number given Is correct (If exempt it)m State registration please give ranson below). evaporate cooler
--- _ ----- ----.._..-- -- -- 15) Vent fan connected 3.00
to a single duct
16) Ventilation system not 4.50
included in appliance permit
Hood served by 4.50
'(�- // 17) mechanical exhaust
vi _
Signature(ownerr or agent) Date 18) Domestic type 7.50
Describe work ❑ addition ❑ alteration ❑ repair LJ incinerator _
to be done residential L-1 non-residential O 19) Commercial or industrial 30.00
type incinerator
Existing use of
building or properly __ _— 20) Other i.e.,woo ,water 4.50
heater,solar,cllothesothes dryers,etc.
Proposed use of
building or property _ 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas ❑ LPG ❑ electric ❑
— 22) More than 4-per outlet
NOTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- 5%SURCHARGE TV-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTEP TOTAL__T__
"zU
WORK IS COMMENCED.
Sneclal Condit*ons
_—__ _ Date issued by
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`, �l�\�—,1O�����„L r,:�. .� ��;-7f".����, —��;;��-C7--�'.rr���1 � N �T�r1 Si'• 1t"l� (�� ��Al
'�7 Y r'�•`C�' �y���'W-,tSf Off''!R lPpi � � e � �. :"M. '�. _.M��� • S�.-�r�,. /•/\'/
CITY OF TIGAR D PLUMBING 13175 w HAA 111%d.
Applicants must hold Oregon Registration to comiud a plumbingPERMIT TigardCR 972-23
75
business or must be property owner/operator not hiring outside help.
Name o1 Derabpmsnt 143-3
��.y e/'� Plumbing Pe mil No.
p
Addroei Z6 7 R-r OR 6S 14.21.610 QUAN. PNK;E AMT
Job lax Lot Map.No.
Address
FIXTURES
La �Z Block SubdivisionSink - ----- 7.50
ams or name siness — Lavatory -- - - 7.50
1 �- > Tub or Tub/Shower Comb r 7.50 7,5L
mailng Address Shower Only - 7.50
PI D B0 232 - - — -
Owner / tate WaterCbset 7.50 2 e
(�9 p� 9 l.2 2 3 Dishwashe, � � _ 7 50 _ _-5
Phone _Garbage Disposal ' 7.50 7:
3 Ll 7 Szf J Washing Machine I - 7.50 �.
Name --- -
Fbor Drain _ 150
al i••"I
7C.1(lress Phone Water Healer -_-.- .- - �- 7_50L
Occupant CityiStale --- - rip - Laundry Room Tray --- -i 7.50
Urinal 1.50 _
amq / PFone Other Fixtures(SpeciM) -- - 7.50
malloing-'Address Ph" - ---- — 7.50 _
7.50
Ci(_ ?.W
Contractor /state Dp'77'6,1\ -OR O R q1 zZ 3 MISCELLANEOUS
'CRY-Bus Tax No sewer 111100' 30 W
E' / -7 Seww♦a.Addit.100-
15.00
M s &A teP ms us --
licee a P13 Water Service 114 100' i - -20—°°-
I hereby acknowledge that I have plod Ihb apnication,ti,a N»kdormatlon Water Serviov-m.Addt.X0' -
giwn is oon*ct.that I am registered with".w Sots Builder's Board.am also Storm a Raft Drain t at.100 50.00
hese a Stale Numbing iosnes that the nur,kh..s QKW are oon**",that an Skim 8 Pyo Drain AddH 110' -- 1500
-
Pk-bing wor, will be dons in amwdanoowwpNcebls prV Wil ss o10re . _ _ ___---- --
gon H-400d S•*luta Chapters 447 and 093 and applicable,codes wld that Mobile Home-aaoe 2s oo
nn help will be,"vbyed unim W*nsed under ORS 699 (11 exempt from - - -- - - _.-- ----
State regletralb,n,pleses g�v#reason btilow) Back ow Prevention
osv+a 7 50
KOMEOWNERt, -I h reby aarWy#WI am the owner of the property de- _ evice ot vice__ -.
sat and above.r 1 whloh locxatxs I propoN b rrnaile a r+r.n 7k1g k1raWMbn lex I Any Trip or Weele Not ---- - - __
my iwwt uas Mx Nile property M not being wnrtrucked for RHs.Maw Or rent Co►xMiclad to a Fb*" 7.50
Catch Basks _ 7.50 --
kyp,of E".Pkartling -- 40.00 Per Hr
Specie Requened Inspedlons -- - _ 40.00 Per sir
Aver.of PMmrnbkq wiNMn
an Existing Bldg15.00 Inln
--
AU''NORIZEO StGK%'t Dnjra. i Daft NO Oft.or Build,Ad~ - - 16.00 im
�� — ------ ��c�•e falulY _
Describe work rmw addition❑ aMerauon❑ reryalr(l dweLlin9..-__--__-.--- 15.5)
tQbs dons - reelderltial Mz� non-lvsidetltlal -.-- -
�
Extatlrlp Lae of
` _
^.Alder or propp-,y____ - __ ____- __ t11A•TOTAL :> Z c
narlcE __ _
'Tisa parrrli beoonsatl null arxi 1 �MOAt a tlarfaaU0N011 NiNnr�asd kf nvl Dom
ittlartrta0 WNW IWO days p r N nsnairl 0gW or Marls 1s*Apwwled cr aborklo sed la
spa of t!0 Days M"On%,ltlbr work Is oer N irsoad
- - -- Oat laatlad 4vZb,
V
11'.11 Also 111'ras-
t i / Nfflff
BUILDING PERMIT APPLICATION DATE _ JL11y 19 � "4 5
684-
THE UNDEnsIGNED HEREBY APPLIES FOR A PERMIT FOR THE`A'ORK HEREIN INDICATED BUI'-DER PHONE ---$3
OR AS oHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT N0.
OWNER 11 `..: i i�rr JOB ADDRESS 1056-t SW 't'lalatiil Dx i.va 2t;llav" !
-- ARCHITECT
ENGINEER
BUILDER — _ ADDRESS --_ DESIGNER
STRUCTURE NEW Ll REMODEL Li ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
a RESIDENCE G COMM ❑ EDUCATIONAI. G GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT I-1 r-ARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY t't-� LAND USE ZONE R4 •5 BLDG. TYPE SI IRE ZONE —_PLAN CHECK BY �C7R.H�EAAT,.� -_
(�nt�£4t't^tart' 'nq1 II':1liTV� t�L/fl71;�-it/attached ��� �+►��a-.---
'"!_+hinct. to 65 code. RETS£13F of 6011
SEWER PERMIT_# 34011 3 baths, 12 traps ga-tngel area 412 u —
OCC.LOAD _ FLOOR LOAD 4 0 HEIGHT `2'O NO.STORIES 2 AREA 164�-NO.BEDROOMS 3 VALUE` 7600n
BUILDING DEPARTMENT SETBACKS FRONT 20 REAR `t2 LEFTSIDE � RIGHT SIDE �'• � r]
.IJ�a —_—� -
Permit 361 .00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
40 0t? REGULATIONS ANO ALL APPLICABLE CODES AND ORDINANCES, ANn IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL gE DONF '"' ORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPUCAF 3 AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVE NTRAC70R AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
0,• LICENSfi.SEPARATL --UUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 8. �!` :, �On
419.05 SDC-
Total PDCM T T 150.00 APPLICANT ON A(3FNT
By 40.00
Receipt No. r ---- —
Approved 379.05 ADDRE89 PHONE
r
DATE INSP. TYPE INSPECTION REMARKS I PLUMBING DATE
ront.actor
Permit No.
Flough-in
Fixture
Final
HEATING
tract 1. 9 1 -1 7D
�Ze�--
ermit No.
Gas Or Oil
Final
SEWER
Finel _Z12 -L2
DRIVEWAY
Final
Storm Do ainage
Main Draint anal
Sidewalk
Curb&Street Final
Approach
DEPT.-
-fEMI;-&Wi�RY CERTIFICATE OCCUPANCY Find
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
I
a 11
Ila
CITY OF TIGARD BUILDING DEPT' .:TMENT PLAN CHECK NO. : -
PLAN CHECK APPLICATION DATE RECEIVED: 9
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID: '/Q
This is to certify that the a,-:ached __ sets of plans have been submitted for plan
check pursuant to the Oregon Structural Code and Fire & Life Safety Code, V ;_^ edition.
PROPERTY OWNER: OWNER'S ADDRESS : _
CONTRACTOR: TELEPHONE:
JOB ADDRESS: /U T �Q LOT NO. & MAP:
DESCRIPTION OF WORK•
Approvals Required SPECIAL NOTLS
OPlanning Dept. O Reissue
OEugineering Dept. O Flood Plain/'Sensitive Lands
O Fire District O Sewer Availability
O Other O Other
Items Required
List of subcontractors
vBusiness Tax
0 Calculations
OTruss Details
0 Parking Plan
OLandscape Plan
O Cther
COMMENTS:
City of Tigard Building Department
BY:-
L•
CITY OF TIGARD PLUMBING 13125 cM H&U Wvd-
Mplkanh mm Wd Oregon Reglstration to condud a pluntbintTigsrd M, 97223
PERIdI IT 6:g-111?5
business or must be property owner/operator not hiring oullide hclp.
Name of Dweiopr enl
4:
2y mems FMumbrnµPermit Nn.
Aft"a_ Description
S G 7 j L> OAS 814.21-010 OUAN. PRICE AMT
Job tax too --' Map.No.
Address
- FIXTURES
t.ol Biosis Sart>'Oivlslon -
Sir* 7.50
Name nuns ss Lavalary v —_ _- 7.50
Tub or Tub/Shower Combs _ _ 750
s Shower OMy
Owner / ute --lip —— Walw C40801 - - — - 7.50 3-
_-- Dishwasher - - - 750 /
Garbage Disposal .2-50 I
WasNngMachme 7.50
Floor Dram 7 50 I
a 7,,n-9-;Ir—es s� -- - --- 1'ttcxie4 --" Water Healer--- - - - 750
Occupant -- Laundry Room Tray 7 50
OCCU
p 'a,y/Stals - Zp -- - _ -
Urinal 750
Oitw Fixtures(Specify) - 7 50
es3 750
Contractor /Stale - Zip 7 50
_ MISCELLANEOUS
-------- ----- :Ay Bua fax No
Sower110 100. - 3000 -
s Ekis Lic 90 Sawer•es MOA 100• -- - -- 1500
((iesdsnbell Water SwvkA 131 100
Waller Service ea.Addit�' 1500
I hereby eckrrowbdgs OWI have rand thea sglpNcaso.t,tinct lets krlormatlore _ _-- _ _ --
glwn is oorred.bO 1 am ropivived with to Stall WkWe Board.and also Storm a Rain Drain 1 at.100' 30110 _
two a Slab Pkx,#A kenee that ew nuffbers gtwn cre correck ow ati Storm a Pyr,Orale+Add1 100 --- - 1500
cxdanoe
pkrnbwig work wd be dons in aooYOM applicable fm 's d Ore-
gon Revised Stef4Aas s 417 and M and appk@ble cots"and Thar hlabMe Nome Spada 2500
no help wi be wrtpbyed unless Noerwd wxW ORS 093. (11 exempt fromBarin Flow PravwMion --
Stab regissraslon,please"reason below)
HOMEOVVNEM -1 hereby oerWy taws I am lee owner CO to pMpwwty ds- Devise orArni•PobotionDewos -- - 50
sorbed shave,M whish Im r so m 1 propr»e to malas a p6mvt g kw%Wk*n kx Any Trap or 1Nesb^lest
"q o"m use and 0*proparq►In no bOV oorwMnaeled toe sale,lama w rw" OtrnMrid b a Fitm" - 7 50
catch Sall+
inep of a". - — � . _ 40,Orr per 1k
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CITY OFTIGARD 639.4171 PERMIT N0.-
BUILDING PERMIT GATE ��--__ CV'�l
P.U. Dox 23397, Tigard OR 97223 TAXMAP,:Et� 40LOTNO. / SUBDIVISION Lon
lt. ;
owNCR___ I ,D roe AooaEss /61 7 S' Icy'It� -
BUN.DER IV,1 ' l f'r p�L, ``C STATE REG.NO. _ EXP.DATE
BUILDER'S PHONE __ J 7N 3 ..�.�----
ARCHITECT—_._ _ _ PHONE ---OTHER
STRUCTURE HEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ MOVE O OTHER 0 DEMOLITION
(:]'RESIDENCE, ❑ COMM ❑ EOMATION ❑ INO ❑ RELIGIOUS. ❑ACCESSORY G GARAGE O OTHER O FENCE
OCCUPANCY `y LAND USE ZONE X y BLDG-TYPE T "� FIRE ZONE. PLAN CHECK BY
Construct single family dweil1ng w/attar_het nar�pp_,�1_l_p&,r afp,r-ou-ed_p.l-in.c-.— --
S_ h-P�t_Ls2_8 5 C s7 d e,_ 41- j S-T Ii t ------
(S� t 5 set F
SEWERPERMIT I, 1.,, . � -(Idu) _ baths, /,2. traps garage areaOCC.LOAD FLOORLOA_0 Y HEIGHT -1 NO.STORIES %•' AREA/, N0.13F.DAOOMS `Z VALUE
BUILDING DEf ARTMENT SET BACKS FRONT 2 (r' REAR LEFT SIDE RIGHT SIDE S
rP1.
rmll 3 G THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIOI4S CONTAINED IN THE BUILDING COOS, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND OR .NANCES.AND IT IS HEREBY AGREED THAT THE
anCrvck WO1IK WILL BE DONE IN ACCORDANCE WITH THE PL..NS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDIHANC THE ISSUANCE OF THIS PERMIT DOES NOT WAIVF
Ck Fk* RESTRICTIVE COVENANTS.CONTRACTOR AND S CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMrrS.SEPARATE PERMITS REOU(RED FOR EWE PLUMBINO AND HEATING.
Slate Tax' SS OC
SDC— Q.
prope
Recelpl No
A ORESS �. PNONE
Bal.Due
-- Issued By ---_--Approved By--
S S Dc
y—SSDc
S 0 C -' '� 6 �' �,
s RECEIPT b _
P 0 C - - /
DATE PD.
SEWER CONNECTION S / el p _ AMOUNT PD.
SEUCR INSPECTION S 3+5
SEWER SURCHARGE S
o mm e n t e r
1
CITY OF TIGARD MECHANIC. _:EMIT --
Permit k '
Description
Table JA Mechanical Code _ _ _ CITY PRICE AMT
City of -Tigard — � -� -
13125 S.W. Hall Blvd. 1) Permit Fee 0 •0- 10.00
P.O. Box 23397 — -
Tigard, OR 97223 2) Supplementhl Permit 3,00
639-4175 Furnace to 100,000 BTU -
1) incl.ducts&vents / 6 00
Furnace 100,000 BTU +
2) incl.ducts&vents 7.50
Name of Development Floor Furnace -- -- -- ---
incl.vent
Job Address Suspended heater,wall heater
/ 4) or floor mounted heater 600
Address / 10 s Qs ; s _.
Tax Lot Map No 7 Si'- s � Vent not incl.in
5) appliance permit 3.00
Lot Block Subdivision
Name(or name of business) 6) Repair of heating,refr ig., 6.00
7� cooling,absorption unit
Halling Add ss Phone Boiler or comp to 3 HP
Owner 7) absorp.unit to 100,000 BTU 6.00
City/State Zip - 8) Boiler or comp to 3 HP-15 HP-` 11.00
_absorp.unit to 500,000 BTU
r' „e _9) Boiler or comp 15-30 HP
absorp.unit Ya-1 million 15.00
� Boiler or comp Mailing Address Phone 10) p to 30-50 HP 22.50
absorp.unit 1 -1.75 million
Contractor cifyrstate -- --- Zip - Boiler or comp to 50 HP - - --
t 1) absorp.unit 1,750,000 BTU 31.50
StAle Regi9lrafkm NO City Hus Tax Nn ) Air handling unit t0
12 10,OOO CFM 4.50
I herebyacknowledge 13 Air handling unit
edge that I have read this application that the information given is ) 10,000 CFM + 7'50
r�rrecf,that I am the owner or authorized agent of the rwvner,that plans submitted are in ----
compharwe with State laws,that I am registered with the State Builders'Board,that the Non portable T
number given is corred (if exempt from State registrafinn please give reason belnw) 14) evaporate^ooler 4.50
) Vent fan connected 3.00
_.
to a single duct
- Ventilation system not
16) included in appliance r t 4.50
/ - - Hood served by --
__ ' 17) mechanical exhaust / 4.50 y •?
S(gnet6A.( r egeni) Date Domestic type
18) incinerator 7.50
Describe work � addition L I alteration O repair [1 __
to be done residential Z non-residential O_ Commercial or industrial
1 ) type incinerator 30.00
Existing use of _-- YP
building or properly^-_ 20) Other i.e.,woodstove,water 4 50 ? `
Proposed use of _heater,solar,clothes dryers,etc_
building or property�_- - _.. - 21) Gas piping one to four outlets 2,00
Type of fuel- oil ❑ natural gas ] LPG I I electric (7 -
22) More than 4-per outlet
NQTICE --- — --- ------ -
SUBTOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK Oil CON ------ - ---- --
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ _ 5 4%SURCHARGE �
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL >`'
ABANDONED FOR A PERIOD OF 1 BO DAYS AT ANY TIMF AFTER - -- --- - -
WORK IS COMMENCED TOTAL cc) '
Special Conditions
--- - - --- Date Issued byt