10627 SW TUALATIN DRIVE �f IN
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P.Q.Booc 23.39x1
CITY OF TIGA 'RD PI_,UM BI NG IM25 SA "all Blvd.
Applicants must hold Gregon Registration to conduct a pl rrabing Tigam Gi q722.3Iwsines.«inist be i,wopMy owner/operator..al hiring culsi2e help. PERMIT 639-4175
_ Name of Development
/, PlumbinF,Fen nit No. '
AddressG �` Z{ a�r'.t�C, �� ` �,i Des&ptlon
Job � (-����•�--- �c� --r ORS 814-21-81f, OUAN. PRICE AMT.
Tax lot Map.M.;
Address
- FlXrURES_____
lot /-,l Block SubdMslon Sink - �- _ 7.50__
acne or name o r Hess Lavatory -
,J 4V Al (s L C_/� Tub or Tub/Shower Comb. -I 7.50
ess
r'QjG� Shower Only --- -- � --- 7.60
Owner tate lP Water Closet ----- 7.50 --
/
If �� j Dishwasher --- -- 7.50
Phone Garbage Disposal --- L -- 7.50 -
Name Washing Machine - --- --- 7.50 -
Floor Drain 7.50 _
arwtg re5� a✓ftorte Water Heater --- ( --�- 7.50 s--
iSlate!
Occupant ----`-- Zip - Laundry Room Tray -_750 -
C
Urinal _ 7.50
-- ame Other Fixtures(Spedly)
7.56
f
ess KEN 't�P147iTS Pl G. INC.PhoneM �Cor.1rhoor City<State P-0 BOX 23 925 __ .— 7
r MISCELLANEOUS
x No. _;*Vw tat 100' 90.00
�/ : Swrosr-ee.Addit.1 W - - - 15.00
State .. 3. . tale ..s Hue.tic.Ne. -. _.
(Rearden6al) C ?ci //Y f Water S41,10,100 1 at 100---- ( 20-10
1 hereby ackrxtwkx$pe that I haire road Mtts ahpileation.-that the ktforrnatir n Wader Servku ea.Ad&20D' _ 15.61---- - -
given Is oorrecx-MW I am repleiewcd with the Stale Buildse"Board.and Also Storrs&Rain Drain 1 at.100' 30.00
have a Sude Pkxnbktp 11tw o vim the numbers given ars coma that all
- --- --
pkmtbing work veJI be done in or oonlnnoe.wfth applicable p-..isions of Oro- Storrs&prJn Drain AWN.100' ---- -�15.00_
gon Revised Stakdes Chapters 447 a:od 093 ant applicable codes arxi that M"e Home SPS 25.JO
no help vAll t»empksired unless Iloemted undw ORS 603 (if exempt trots - -- ---
Stats reglWation.please Qive season below), Bach Flo%Prewwttio n
HOMEOWNERS--1 hereby oerWy Mild I am 0*owner of the property de- Devhm at An#4310llvillion Devim _- 7.50----
scribed
.50 _sorbed above,at aAdGn location I propose to make,a pkanbMvj ktetaMMlon for Any Trap or waste Plot
my own into wid this property is not being;nortetnioted for.ale,WAse or rem. Connected to a Fixture _ -7,50 _-
Ca"Basin 7.50 _
-- inap_of Exist.Pkxnbktp _40.00 Per Hr. _
Specially _ -40.00 Pet Hr. ---
_ Alter.of IMunthktu wlMtkt
an E.detirtp BMg. 15.00 min,
'��- -- - New or Build.Addition - 25.00 min.
AIJTHORLZED SIGNATURE j D� �--
������ fa[ln l
Desc rbe worts new W addition[] alteration❑ repair❑ d4e].1 .� 15.001
Po2 be dome____-_roskienlial ca non-resider" —
F-)dokq tree of
bt,lt/cl v or V"rry _ ------ --------�- WO-TOTAL I
bll U"of
AftoorppWpertY �►fNl1lOIIAltcO! X —
W)TICE ----- ---
T1ft p.rnwt bwovtes two artrt void*want or oot atruol o n mAhorlxad Is not con -
eterroed wMhbt t80 dwAar M owatudlon or workfe eUerserdad or abandoned for
a period of 190 days of erry rite soler work is eor"nietvad.
t111M4VAL CIOIIDf %M ,_ ______ __
Ota)•Aee 411186 re,
AIA
' 1
BUILDING PERMIT APPLICATION DATE '. _ ,,q /
THE UNDERSIGNED HEREBY APPLIES FORA.PERMIT FCH TF,F=R K FII-REIN INDICATED GUILDER PHONE ;)O4-7543
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHPf E _
OWNER Jay MLller LOT N0. `
Y —_-- �a
_ — JOB ADDRESS �0E�2� S,� . 11.I�tl at in Gl. ��;j—]j
• 97223 ENGINEER
ARCHITECT
EER
BUILDER SA[1K? — ADDRESS 1�.0.iiQX 23291 'jL-!.ard DESIGNER
STRUCTURE IN NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL _❑ FIRE DAMAGE ❑ DEMOLITION
J RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T_❑ RELIGIOUS ❑ PATIO ❑ CARPORT O GARAGE ❑ STORAGE_L SLAB❑ FENCE
OCCUPANCY _" LAND USE ZONE ��.: .�BLDG.TYPE FIREZONE__ PLAN CHECK BY N'. HEAT
(:DI .l'.CiJCt si►�:;l.e ferttiI r �icrt�1.1i rg w/at tayc:tt I ,erave, all per aj)j)V(,:reed ai>;. —
SubjIm—t to 85 ccxie'. Reissue of 69k&3
SEWER PERMIT M 34,563 2 Uuths, 20 taaps Farafie area 540
OCC.LOAD FLOOR LOAD 40 HEIGHT 20' NO.STOPIES 2' AREA 1822 NO.BEDROOMS 4 VALUE 18I,000
BUILDING DEPARTMENT ' ' REAR .��� LEFT SIDE ?} RIGHT SIDE ? '
SET BACKS FRONT :.+
Permit 3f:31.11) 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
p!anCheckW.00 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 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax V`.35 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC— 'M.()()Totalr
By 40.:hl
PDC# TT 1W.00 AF;LIC—ANT OR AGENT.__ ---�--
i
Approved 385.35 V Receipt No. J0DRE88 -----
-_ _ PHONE
DATEI NSP. TYPE INSPECTION REMARKS PLUMBING DATE
— P
Contractor /C
Permit No.
Rough-in
Fixtura
'Iva 0-
HEATING
t
jot j4 Contract(w IdIA^- b12-
Permit No.
Gas(w Oil
ri,)tjgh4n
Final
SEWER
Final
DRIVEWAY
Final
Storm flis ainap
(Ravi Drain)Final
Sidewalk
Curb&Street Final
Approach
13LDGL DEPT.VINALCr TEMPORARY CERTIPICATT OCCUPANCY
,
,"T""CATE Final
OCCUPANCY
I
landscaping
U
Toning Fir,81
q4
CITY OF TIGARD MECHANICAL PERMIT Hoceipt
Permit # —
Description ----�' --_
Tabl_a_JA Mechanical Code _QTY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. ) Permit Fee _ -0 .Q 10.00
_
P.O. Box 23397 2) Supplemental Permit 2.no
Tigard, OR 972.23 --
639-4175 1 Furnace to 100,000 BTU 800
incl.ducts 8 vents _ ✓�
2) Furnace 100,000 BTU 4 -
_incl.ducts R vents
Name 6 Developmant 3) Floor Furnace 600
incl.vent
Job Aodress - 4) Suspend ad lieater,wall heater 6.00
or floor mo pled heater
Add arts 2 7 S w N k i-��, r . - - --- --- --
Tax Lot Map No 5) Vent not incl.in 3.00
appliance permit
LOA Bloclf Subdivision ----
---- ---
Name(or name ofsiness) 6) Repait of heating,refrig., 6.00
„_ _ 7' /�• _ �� 3 cooling,absorption unit
ailing Addrese /1 (� phone -- 7) Boiler or comp to 3 HP 6
Owner _ absorp.unit to 100,000 BTU _ -
rnyist..re T! .00
Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
- Name ----- Boiler or comp 15-30 HP 15.00
9) absorp.unit 1/2-1 million__ - _
Mailing Aridness - F hone t 0) Boiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million _- - �_.
Gontractor Zip 11) Boiler or crimp to!A HP 31.50
_- absorp.unit 1,750,000 BTU -_�
State RepMtwon No _ City etas Tex Nn 12) Air handling unit to 450
I 10,o0C CFM
3 Air handling750
I her That 1(NW rtWi Mtis app!icat+on That the Information 'van Is � -�— - -- -
admaw ' g, 13) 10,000 CFM +
correct,that 1 am die owner of autl -.ad agent of me rywtw,that plans submitted of
compliance with State awe.tut 1 sr.t registered with the State euilderu'eoed,that the 1 Non portable 4.50
rvtxntw given is correct (d exempt from Stale strewnplesuw give reason below) 1 evaporate cooler m
15 Vent fan connected _ 3.00
to a single duct
- - -- 16) Ventilation system not 4.50
--- included in appliance permit
Hood served by
17) 4.50
mechanical exhaust
sgn.tu..(arwrtsr or agem) �- Deie 18) Domestic type 7.50
Describe work ❑ addition E) afteration El repair l 1 incinerator to be done residential ❑ non-residential U 19) Commercial or industrial 30.00
Existing use of type Incinerator --� _I
building or property_ _ _ G0) Other i.e.,wo'xiatove,water 4. qr
Proposed use of heater,solar,clothes dryers,etc`
building or property_ _�._ ._—_ 21) Gas piping one to four outlets ! 2.00
Typo of fuel- oil f I natural gas f-) LPG ( 1 electric Ll _
---- ------ 22) More than 4-per outlet
NOTICE - . . SUB-TOTAL c --�
THIS PERMIT BECOMES NULL AND VOID IF WORK OR COW 4+1r.SURCHARGE
STRUCTION A.'JTHORIZED IS NOT COMMENCED WITHIN 180 _ S%
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL 9 GU
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - - -- ----`"� -.-
-" - 1
WORK IS COMMENCED. TOTAL
Special Conditions
Date issued -. b
L� y-�{
- ��_ .- .-._..
�,pr-kSl7ee�f" PLAN CHECK NU. 1C
for inspections call 679-4175 PERMIT NO. /io,
CITY OF TIGAAC 679-4171 DATE U-- 1-2- 11 -7:1 �,7pv*✓
BUILDING PPE 001T4L' fuoavlSlON
P.O. Box 2 97, Tigard OR 97227 TAXMAP _—LOT NO.
_ JOB Lo L(;0 $.✓V• LfrAL.11,
oWNErI�_ �..,..�_.. --.------- 3c /c, Q 1, _ /7 .77_
BUILDER - I _ � — STATE AEG.NO. ( EKP,iOATE -
7Sy.3
SUILOER'SPHONE
AACHITECT_— -- _ PHONE OTHER_
STRUCTURE NEW ❑ REMODEL Q ADDITION ❑ REPAIR ❑ MOVE ❑ OTHER C) OEMOLITION
IND L7 RELIGIOUS. ❑'ACCESSORY 17 GARAGE (I OTHER ❑ F NCI:
f9£SIDENCE` ❑ COMM Q EOIICATKyN ❑
OCCUPANCY _ae LANG 4":E ZONE �1.Sei BLOG•TYPFIRE ZONE___PLAN CHECK 8Yf
Construct sing'- family dwel l inti attaI
3 --
SEWERPERMITO.3 ,5.6; y' -(ldu) _� baths,_n traps Daragearea_ ----�,-----
OCC.LOAD _ FLOOR LOAD HEIGHT NO,HO.STOWES 2- AREA /g2 L NO.BEDROOMS ZL/ VAL2
-BUILOING CEPA TMENT SET BACKS FRONT REAR -5 ? LEFT SI)E RIGHT SIDE U
ILDING t;l?DE.ZORING
IPUPP-,.,
INEO IN TH
Permit c THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CON"A - E BU
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES.AND IT IS HEREBY AGi EEV THAT THE
A Check (J WOhK WILL BE DONE IN ACCORDANCE WIT"THE PLANS AND SPECIFICATIONS AND IN C'4APLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCEOF THIS PERMIT DOES /'OT WAIVE
CILP1.CF" RESTRICTIVE COVENANTS.OVNTRACTOR AND SUB TRA ORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REOUIRED R S R:PL BIND AND HEATING.
Slat•Tax 3 S SSCC
Total POCJ AVPUCANTORAGEN
P(*Pd.
-- -,
Bal.Due S Receipt No A D FSS /H(1NI
3
Issued 8y____----Approved BY----
S S D C -_ SP So
--- RECEIPT #
0 C .-1
P _----1--1s o.
VATE PD.
SCUER CONNECTION S I�4U _ AMOUNT PO �1
SCIJCR INSPECTION S _ 3-5
SEWCR SURCHARGE S
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