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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 6394171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
DLrR
fd4a&
IL
Date:
7�9- Pe,rm I t No.
Inspector
CALL FOR REINSPECTION
CITY OF TICARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.41,71
CONTRACTOR:
Pursuant to Section(s) of the Urlifurm Building Code, the
following itern(s) require correcting:
Poe
------- err-.,�--�-- ---/--
�.o
-
Date:_ -. Perrnit No.___-_
Inspectof
CALL FOR REINSPECTION
PLUMBING PERMIT N
holder of a valid picmbinc contractors license is here.
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 notifier not less ►.han fol.lr
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contracto s and sub-contractors.
���
/ t
O.vner__ �-1�' �"' Address_/ CIM–sS�l� ! S� Date-,s 7—7
NUMBER OF TOTAL PERMIT NO.'S _
TYPE OF PERMIT — Y ITEMS FEE ON EACH ---ANIOLIN'r (Office Use Only)
A l
Sinyle Family 1 bith-each --___-- -,- 25 00
DIwx_Ea:h 1 bath unit 25.00_ ---�
F+,dJitional bathrooms-each _ 10.00 --
htobila Home Snace-each —,—� _ 15.00
INDIVIDUAL_FIXTURE FEES
1 to 50 Fixtures in_1 building-each -_ — - 3.00 —
_51 tn_100 Fixtures in 1 building-each 250__--_ _ -�--y-
,ii)1 ;0 20o Fixtures in 1 bolding-each _ 2.00 -
20i or more Fixtures in 1 building-each _ 1.50
MISCELLANEOUS
8uildinq_Swar-1st 50 It -�� 10.00 Y
Sewer-each addit onal 100 ft. _ _ 10.00 -
water ,elvice to building 9.00_
Private Water Systems-eaci ion it, 1000
r)ther (Soecifyl'. — —__
PERMIT For Plumbing lnspeL tion Phone 6.3.9-41;1
*S Stat__ V u _ Plumbing Contractor By _
OTAL 7� NQ _— RECEIPT NO. Issued By — ' —�`--
;.•;,sa�iA111)►q�M1a�Ift'R .���rM-o,.r�Y►��i17Rt•RyA'�'fT'�IT�'i'�� .-.�� ,-�.-,�,��,.�1y��r.
BUILDING PERMIT APPLICATION coy TIGARD OArE 4/12/ 79 N9 K+�6 1I`
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEaEIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNFRPHONr
LOT Nq
N �.
OWNER L oUUi 9* Juhl ElliJ1't JOB ADDRESS '1u, 5W �f "TW T ' �ROME AbDRE55
ARCHITECT
C,�,;Ir. BI `l,7h,l°TE110 11.�991 3U 55th Ptld ENGINEER
BUILDER ADDRESS E DESIGNER
STRUCTURE ❑NFW El MnDEL ❑ADDITION_ El REPAIR ❑RENEWAL [:]FIRE DAMAGE ❑DEMOL.ITION
REnIDSNCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIO-US❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND — ❑MOVING ❑CONDITIONAL USE IJ DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY__`__.LANp USE ZONE==7_BLDG.TYPE 'r FIRE 20NE PLAN CHECK BY f HEAT i
conmtrt,icfi single family dwelling w/aittach6d garage — b bedLuOms - :� 60thr,.
?f:C i..3FiNCi;TIO ?HELT ATTACH10,
----- ower uaarmia. #10775 — $62b.00 _ gers�e 10'A sga f t•
40 20 2 000.
QcQ-1,Qg9--__-- F.l,4.QB._WAl2___. _._H� QHI
DEPARTMENT _------_—_LVo sTDRIE�_ ARS► ��I c2,�€pH44M�__._YA1.lZE_
BUILDING DH7 -�-
_ _--__.— SET BACKS FRONT 30 REAR LEFT SIDE RIGHT SIDE
Permit -tt!•U0
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE: BUILDING CODE, ZONING
Plan Check l2N•Jn REGULATIONS AND AL"_ APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE iN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IW COMPLIANCE WITH
Sub total ALL. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS T'O HAVE CURRENT CITY BUSINFSF
State Tax • aft I,IGENSE SEPARA�F��ERw11TS REQUIRED FOR SEWER, PLUMBING AND HFATPNG
:�
Total 3 'a.7k' ? "]�C.�(?
By — pi -__
7 A0PI ICAN1 OR AGENT --- - --- --
ApprovedReceilll No '� r
_.._... ,. _.r`«:..wr.«»...r w........ ...... .r......u.n.r- --- ....�w.w..n.o+r..a.•.......r._......,..�...._.e....�,w.....r...n. .
DATE INSP. TYPE INS PECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
Af Ulf A HEATING
Pe,mlt No. /5 _3S->4-77
Gas or Oil
Hough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sideva lk
Curb&Street Final
Approach
BLDG. DEPT.FINAL 'it.-MP61RARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
-7`7
Landscaping
Zoning Final
I
31JILDING PERMIT AFPLICA-111,51) cLJF II,,, .RD [)ATE 1 +n�_-/1----. 19
--'F HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDIClAiED BUILDERPr10NET
-,R A S -"..N A":[) APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICAIICNs. OWtJERPrlJNF 6- - 1"'- -
-
0 CL;7-5 '/ LOT NO
.�D/,l�/SdNGR. ADDFlE55 ���_ _•yn•, c
- ICaI�TLANJ� ARCHITECT
_ per- ✓lJ
"lD'EIR k=r��/h�+ JUI�NIvl 4t.DRk45 ENGINEER_II�J_ /� J.Lt� -�J �n DESIGNER -_--- 1
URE XNLW — OREMCJEL— ADL,lIION ❑REPAIR-- (1=tFNEWAL _ DFINE DAMAGE - DE) PPAOLITION '
NCE [3,'-VM ❑EDUCATIONAL - 0GOV'1 DWFI ICIOU-;0Pl.-I0 DCA- PORT-Fn GARAGE_ D STORAGE DSLAS []FENCE
'7-CND- 411,10V_ING DCONDITIO_NAL USE �DDESIGN Rt VIEW
+ ❑COUNCIL APPROVED - ❑SIGNS ---r_-
�_yP NCY R- !LAh0 USE ZONE "_"^�P-?BLDG TYPE �'` __FIRE ZONE^! PLAN CHECK
- - 3 � �
A!mt IL
---KE LklT
Bl!ILDLNG PARTENT
DEM
_- SET BACKS -FFIONt V REAR �^LEFT SIDE RIGHT SIDE
y THIS PE!IM1T IS ISSUED SUBJECT TO THE RFGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
fPlan Check fJ RFGULATIONS AND ALL ADPL(CABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- t WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIdPLIANCE WITH
' `ub•total 0 42 ``r J ALL APPLI-,RI_E CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT D6ES NOT WAIVE
--- Yt -Q-- RESTRICTIVE COVENANTS. CONTRACTOR AND SLIS CONTRACTORS TO HAVE CUPRENT CITY BUSINESS
SSr.'e Tax I � v LICENSE. SEPARATE PERMITS REDUIRED FOR CS:N'ER. PLUMBING AND HEATING.
1 ro181
By _—
.
Appl uued Receipt No,
:�'JILDING PERMIT APPLICATION CI Y TIC,,",LRD DATE__.—_ _____,. 19 - N9
--AF IINDLRS'GNED HEREBY APPLIES FOR APERM17 FOR THE WORK HERFIN INDICATED BUILDER PHONE
JR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_ —_
L.OT NO
p JOB ADDRESS—, —�,,--- t Qt E ADDRESS
ARCHITECT
ENGINEER
ER _ AbDRE55 -•--- .�._ ______r— -- DESIGNER _
URE _ONEW ❑REMODEL W�0 ADDI I ION _ 0 REPAIR ORENEWAL CI DAMAGE ❑DEMOLITION
r tIDENCE -COCOMM OEDUCATIONAL- OGOV_T nRELIG10USOPATIO�OCAR PORT ❑GARAGE ❑STORAGE OSLAB ❑FENCE
I_3gONp ❑MOVING OCONDITIONAL USE ---_ OUE$IGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
�- PLAN CHECK BY _ _— HEAT__,.
LAND USE 20NE_—.-_,_..._BLDG tVPE_T FIRE ZONE,____ ._ --
S?!-C-_LQAQ .__ _ E.199R1�AR_.—_�._�IStHT__----..— N9.�I9fi�€ _.-__._.__.P_F1F�_._._�11Q.@€_4P�9Lvy_. VALUE --------
` BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT'SIDE
Permit
--- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check RFGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT "HE.
WORK WILL BE DONE IN ACCORDANCE WITH THE. PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Sime Tax LICENSE. SEI'.RATE PFRMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total
By APPI ICANT Op AGENT _--
Apploved Receipt No.
--- AODRSS ----- � V
103;7SSU �iG�-��is-rr�a,ce. -#24*7
4� ,
44101A, F lour 3v A 3 z �Go
/e x a�- � •z
fp
26..sC 'g2� 32 l
Low+r- l�w�s
Cia.�� • .?� x •t� JOSI.
4re
City of Tioard Mechanical Permit " � Fee Permit $3.00
Ll
Naw Installation A Replace ❑ Re.iocation ❑ Addition ❑ Alteration ❑ 4 % S^ate
HEATING TOTAL I
CONTRACTOR *Irl( &� t4 / -,� C'G/VIr_ OWNER d'G'G�f�s rT(.�- IA/ _I
ADDRESS— l L/ �7 .� GL'' G'�`�ir��_ WORK ADDRESS -Rj- s u., VIF" R /ae _
PHONE `""�� �L� � APPLICANT---1�--- �'
Hest Input Rating (BTU Per Hour) 0 _ Vent Size Flue Size's ri
rUFL OIL ❑ GAS F9 ELECT ❑ OTHER M_
ITEM NO. FEE ITEM NO. FEE
Fur Is,uance of Permit _ SEE ABOVE rAir Condition Compressor 1- to 30 HP 10.00
Ne,,, -tp to & inc.100,000 BTU 400-, -- Air Handling 10,000 CFM _ 3.0_0
New- 100,001 BTU & over 5.00 Air Handling Over 10,000 CFM 5.00
Floor Furnace 4.00 Evaporative Cooler _ 3.00
e';all - Fl ,or -Suspend-d r 4.00 Range Vent Fan _ _ 1.0C
Install Vents Only ^+� 2.00 Vent System 3.00
R?ojir - Heat& Cooling 4.00 Hood Commercial _ _ 3.0C
Air Condition Compressor Under 3 HP-4- 4.0_0 Cammercial_Duct System�T IO.00
Air Condit,on Compressor 3 to 15 HP 1 7.50
;NSPECTOR'S COMMENTS
.,ITY BUSINESS LICFNSE REQUIRED FOR ALL CONTRACTORS OR SUB CONTRACTORS ^'
1P?ROVED BY DATE ISSUED BY DATE
iECEIPT NO.
'» Signature of Auplirant
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