14390 SW 86TH AVENUE r
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14390 SW 86' H AVENUE -
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ADC�HE5S PEPIMIT NO. / 74 3�i
_ PERiNIT CHARGE none
OWNER � � — CONNECTION FEE
PAID 6Y «-"
TYPE OF' BUILDING dtteubv, DATE CONNECTED _
SERUICE RATE ,L?t_ � It:SPECTION FEE
CONTRACTOR PAID GY � DATE
SIZE OF COtIr�IECTION _ 1 ASS:.SSMENT _ _ _ PAID _
WjFjqffW�W-XW-A1W1
BUILDING DEPARTMENT. TIGARD ;
NO.
PLUMBING PERMIT 1
holder of a valid plumbing contractors license is hereay
vJthvi i2Fo' to cause plumbing ',,vork as herein notsd to be insta,.eo i1 acco;oanCe V'llth the plumbing code ofi
TiQ.' d. Such installations require inspection by the City Inspector who snail be notified not less than `our
,Alhours prior to the time the installations are ready''for inspection. City o` Ti and Business License required _
fog a;i contractors and sub-contractors. � �.
rivir-aS-L�N iiy.�,� ii S f Addrer ' y Dasa
NUYIlar, of r' I..At- i PERMIT 100:5
7^(PIa Or PcR4tr7ITEMS '.E ON 2ACN AMOUNT (Office Use r)niy)
li.I .L12 :N I IA)
Sir•;le P n ill-1 bath—each uZ- ^:,.CO C>
0u,cx—Crich 1 bath unit 2 0 I
Ar:d,t:on1; bathrooms—veal 10.00
. ,i •:OC1 t 5,ao;.r,— :.� � 1:;.07 _
;i71IVIGUAI FIXTURE FEES I I
1 to 3n F;xtures in 1 buildin,—oathlit
to 'i.0 F;XSures In t building—each �__._._._—_ i 2.50
^.00 7ixtures in 1 buildin?—an''i I 2,00 i 1.
V! a• Tore rixtures in 1 buildin —enCh 1.50 � i —
;,WF. I.VANE0US �
$c"irr-1st 50 ft. _ 10.C,0 ~
jzv mr—each additions; 100 ft.
Sr!-vira to buildin;.L
W,;'er Systems— ch ;JC N. 10.c7
-- — For Plumbing Insp e.—ion Phone 639.41:71
�- Contrcctor 3 f
`�i-i1 ____�. RZCE;PT N0, Issued BY
C:TY OF TIGARD—12420 S.W.MACH—TIGAUD,OPkUON 972.4-�
RECTIP!
AMOUNT: $_Z:��-
------DOLLARS
NAME: 44g,tt,c u CASI+
ADDRESS: ky 4.014 of d CHECK:---
2
/ -0 OF
FOR: ACCT. +! -PERMITS SI)RCHARGE _AMOUNT ___
SEWER BILLINGS 40-364
BUSINESS LICENSE 05-331
PLUMBING PERMIT 05-332 S 2, k(-)
MECHANICAL PERMIT 05-332
Bl'.LDING PERMIT 05-333
SEWER CONNECTION 40-363
SEWER INSPECTION 40-365
SYSTEM DEV. CHARGE 25-366
PARK DEV.CHARGE #1 30-367
PARK DEV. CHARGE #2 30-368
ZONING ADJUSTMENTS Ob 362
TOTALS c;?, 2o, &n
RECEIVED BY:
PERMIT NUMBERS Wh-IONFID:
Number Amount Numbet Amount Number Amount
7 s__
RECEIPT 0
1510"
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 item(s) require correcting:
1000,1001,
Date:,-- Permit No.—
Inspector
CALL FOR REINSPECTION
W? 2304
BUILDING PERMIT APPLIC N SOF
O1T FY TIGARD D A T '7 19
THE UNDERSIGNED HEREBY APPLIES FOR
AP RMIT FOR THE WORK HEREIN INDICATED BU I LOER PHONE'OR AS SHOWN AND APPROVED IN THE AC .0MPANXIUG PLANS AND SPECIFICATIONS. OWNER PFJQkQ7
4\440V
LOT NO.
OWNER.,if)nnestiarg (;orI5Lr.Yo6fA6*RESS14.1')0 136th AwumUO HOME ADDRESS
ARCHIT17CT
RUILELER ESS SLI Pacei )r* byt.n. _ DESIENGINEERGNER 1 �rcy ay
STRUCTURE CINEW El RI MCIDEL OADDITION OREPAIR QnENEWAL [:]FIRE DAMAGE QL�MOLIIION
_1SL _
0 RESIDENCE 000MM CIEDUCATIONAL CIGOV'T ORELIGIOUS CIPATIO CICAR PORT 0(-,,-RAGE EISTORAGE[ _AB F1 FENCE
0SOND OMOVING LICONDITICINAL USE ODESIGN REVIEW EICOUNCIL APPROVED EISIGNS
3UI'
OCCUPANCY-. LAND USE ZONE BLDG.TYPE --FIRE ZONE- -PLAN CHECK By HEAT
/4littach,ad .jars .qs* 4 :'Jscjrt�ume 4 Liatho.
13swer Permit ' 1745,, — Z,12 ;°-,.00
2
OCC FL AREA]
4 _-YAL(Ic
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT 19 1SSI)FD SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check trio REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICA(IONS AND IN COMPLIANCE WITH
Sub-total ALI APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTPIACTOPS TO HAVE CURRENT CITY BUSINESS
State TaA LP.NSF.. SEPARATE PERMITS PrtnuiRED FOR SEWER, PLUMBING kND HEATING.
ji '' 't I
Total • 61do.00
By APPLICANT OR AGENT
Approve d Receipt No.
ago=, .�A
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor --
�—iJ/L PermirNo. /6/,7 ) /1- 30-7E
i two_ Rough-in -
�- v Fixture
t7 Final
HEATING
As
Contractor q
Permit Nod
Gas or Oil I
-- Final _ s_—.- - --------
—� SEWER
�— �—.-__--- - ------- Final
_ — DRIVEWAY
Final
Storxt Drainage
(Rain Dein)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE
CERTIFICATE OCCUPANCY EO7v Final
Landscaping
Znning Final
tw ar ■Ilr Its
Jit • F ce
Ne%-. Irj.%%l4!ion Rf:�:dC[ 17' Relocation Q AC111tron kltt.•rdtlon !--i :Salt., ---t•1.
IOTA' -11 ---- -
CC%'TP.ACTORr _ �,Ny_t�ph, h'�G��J AoN4'►�-',C. er;.:�R, FN.(� �2E1>! '_ _CANS
AD"IRE .� J_____ CIACkAM AS O QSr WORK ADDRESS I'4'- a W 5b th
- �"f' (C� j �� .q. G�
PHONE 65.0 4 gI�� •'V V APPLICANT ::2 0, .
Heat Input Rating (BTU P H sur► /3 _ Ven; Size Flue ize
— - //
FUEL OIL ❑ GA D, SELECT C'' -OTHER C--
ITEMNO. FEE ITEM NO. FE
For Issuance of Permit 3.00 Air Condition Compressor 1510 30 HP 10.
New- Under 100,000 BTU � _—� _00 Air _handling 10,00_3 CFM
� 3
y New- 105-,,000 BTU & over - 5.00 • Air Handling Over 10,000 CF IV,
Floor Furnace 4.00 Evaporative_Cooler _ 3
Wall - Floor Suspended � 4.00 �Range Vent Fan .
—
tnstalt V•en.5 Onli, 2.00 Vent System 3
Repair - Heat F: Cooling 4.00 Hood Com_mercial__
r^ 3
Air Cond tion Compressor Under 3 HP ~j 4.00 Corrrmercial Duct System - 1
'Air Condition Compressor 3 to 15 HP�--- 7.50
w INSPECTOR'S COtPfti^ENT5 _ —_
=4' CITY BUSINESS LICENSE REOUIREO FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY-- — DATE —_-- -- ISSUED BY DATE
RECEIPT N0. � ��--- — a v r
774 Signature of Applicant
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