10995 SW 78TH AVENUE 10995 SW 78TH M`"NUE
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CITY OF TIGARD 639.4171 6388
BUILDING PERMIT DATE
TAX MAP IS1.36(;A LOTNO�002 SUBDIVISION
OWNER jirmd knyrinlgin _ JOBADDRESS
A1 Frvmherm Cwwtrtxtion 44176
BUILDER _ STATE REG.NO. _- ---_-_ ___ EXP.DATE
BUILDER'S PHONE 87"3380______-
ARCHITECT_ PHONE _____— OTHER
STRUCTURE NEW ! REMODEL K, ADDI TION REPAIR MOVE OTHER DEMOLITION
Ll RESIDENCE COMM 1 1 EDUCATION IND RELIGIOUS ACCESSORY F.I GARAGE OTHER f 1 FENCE
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CHECK SY HEAT
ti �
COl18trUCt .i?t'CUCtilpe attached to w"' fly C er w&jk per &Vproye'd pla11m.
SEWER PERMIT M
OCC,LOAD FLOOR LOAD HEIGHT 12 NO.STORIES i AREA 516 NO.BEDROOMS VALUE 5000 i
BUILDING DEPARTMENT j SET BACKS FRONT ' HEAR /' LEFT SIDE RIGHT SIDE �' t
{
Permit_ SA 00 HIS PERM11 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
Plan Check 3Y.lf3 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
PI.Ck,Fire RESTRICTIVE COVENANTS. CONTRACTOR AND SUB COATRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS_SEPARATE PERMITS REQUIRED FOR SEW[R,PLUMBING AND HEATING.
State Tax 2.02
-- -� �
PbCIV SDC—
Total ti •3S APPLIC:ANTORAGENT
—
Prepd. -
- -- -- / —
B85.3" Receipt NoJ , 1.,a y./ ADDRE88 _ -------_----._- _ _ _ --- — PHONE
Bal.Due A5.3
-� Issued By----Approved By
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DATE — INSP. TYPE INSPECTION REMARKS s PLUMBING DATE
24110
Contractor
Permit No,
Rough in
—Fixture
Final
HEATING
Contractor
Permit No.
Gas or011
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL I F-M- PORARY CERTIFICATE OCCUPANCY Final
CERTFICATE OCCUPANCY
Landscaping
Final
CITY OF TIGARD 639.4171 DATE
BUILDING PERMIT TAxMAP `�OTNO. %e_ ��'� SUBDIVISION
OWNER 1`� z - VU-o r _. JOB ADDRESS
BUILDER _:�,: /"'s''�.'c7i�t i-//_-��� � -- '^''' �-- STATE REG.NO.
y/" -- EXf.DATE s- �sZ Y
BUILDER'S PHONE �? "' i )-1 J
ARCHITECT_ i,HONE ---------OTHER ----
STRUCTURE ❑ NEW O REMODEL ❑ ADDITION U REPAIR U MOVE L) UTHEFt C1 DEMOLITION
❑ RESIDENCE Cl COMM O EDUCATION O IND O RELIGIOUS ❑ACCESSORY U GAVAGE U OTHER�L7 FENCE
OCCUPANCY LAND USE LONE BLDG.TYPE FINE(ANF KLAN CHECK BY HEAT
SEWER PERMIT
OCC.LOAD_ FLOOR LOAD J HEIGHT NO.STORIES ^—AREA NO.BEDROOMS _ VALUE
BUILDING DEPARTMENT SET BAP," FRONT REAR LEFT SIDE RIGHT SIDE
Permit TH�ISPERMIT I5 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUIL04NO CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS 14UEOY AGREED THAT THE
PtanChock WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SpMFICATION3 AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES- THE tSSUANCE Of THIS PERMT7 DOES NOT WAIVE
PI.Ck.Firs RESTRICTIVE COVENANTS.0.ONTRACTOR AND SUS CONTRACTORS TO NAVE CURRENT CITY SUSINESS
TA)PERMITS-SEPARATE PERMIT:i REOUIRED FOR SEWER,PLUMBING AND HEATING.
Stele Tax___ --_--- SDC
Total APPLICANT OR AGENT
POC,
Prepd.
-
- ---- ---- —� Receipt No ADDRESS
dal.Due
-
Issued BY------- ------Approved Y._
SUC
IOC - � -
SEWER CONNECTION 5
SEWER INSPECTION _f —
SEWER SURCHARGE 5
Comments:
- ---
T IT
-�
INSPECTION NOTICE
City of Tigard Building Department Z'Iv-6
LM P.O. Box 23397
Tigard. Oregon 97223
Phone: 639.4175
Type of Inspection -,, e _
Date Requested____ _ Time A.M___P.M.
Address J�/�[__ Permit #_
Owner Lot #
Builder ---
The following Building Code deficiencies are required to be corrected:
Presented to A
Inspector - -
-- Approved
--. — � I Disapproved
CALL FOR REINSPECTION
0 YES U NO
W W s i + air lI a■r
CITY OF TIGARD MECHANICAL PERMIT Receipt# d�
c,
Permit# `l 0
Description
City of Tigard
Table 3A Mechanical Code CITY PRICE _AMT
----_-- --
13125 S.W. Ha!I Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 2.3397 —� -- — –
Tigard, OR 97223 2) Supplemental 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 or Development Floor Furnace
3) incl.vent 6.OQ
Job Address J Suspended heater,wall heater
Address 4) or floor mounted heater 6.00
Tax Lot Map No. Vent not incl.in
Lot Block Subdivision 5) appliance permit 3.00 —
Name(or name of business( 6) Repair
f heating,
eatin,r unit
nig6.00
ool ng
Mailing Address phone _ Biller or comp to 3 HP
Owner i 7) absorp.unit to 100,000 BTU 6.00
city/state Zip Boiler or comp to 3 HP-15 HP
8) absorp.unit to 500,000 BTU _ _ 11.00 -
Name g) Boiler or comp 15-30 HP
absorp.unit 112-1 million 15.00
Meiling Address PhoneBoiler or comp to 30-50 HP
10) absorp,unit 1-1.75 million 22.50
Contractor City State ZipBoilerorcompto50HP
11) absorp,unit 1,750,000 BTU 31.50
ate Registration Nr, City Bus.Tax No. 12 Al.,lhandling unit to
St
) 10,(100 CFM 4,50
I hereby acknowledge that I have read this application that the information given Is 13) Air handling unit 7.50
correct,that I am the owner or authorized agent of the owner,that olans submitted are In 10,000 CFM i-
compliance with State laws,that I am registered with the State Builders'Board,that the Non portable
number given is correct.(If exempt from State registration please give reason oelow). 14) evaporate cooler 4.50
Vent far,connected
' 15) to a single duct 3.00
16 Ventilation system not
) 1.50
included in appliance permit
17) Hood served by
_ mGG ;tan ical exhaust
4.50
Signature(owner or agent►.,, Date 18) Domestic type 7.50
Describe work ❑ addition L I , alteration F1 repair ❑ incinerator _
to be done residentialiJ non-residential ❑ Commercial or industrial
Incinerator 30.00
Existing use of � !3) type
building or properly _ 20) Other i.e.,woodstove,Water 4.50
Proposed use of heater,soliltr,-lothes dryers,etc.
building or property 21) Gas piping one to four outlets 2.00
Type of fuel- oil C 1 natural gas I 1 LPG f 1 electric ❑ --
22) More than 4-per outlet
NOTICE --._—
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- — -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK I: SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -
WORK IS COMMEr:%.;ED. TOTAL
Special Conditions —
_—__--- nate issued ` by -
1
INSPEC i ION NOTICE
City of 'Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection . GY-- -- --
Date Requested t�� Tiime—i/ A.M.----P.M.
Address —�1_J��1—'___c--L) Permit
Owner_> ___ Lot #_-- _---
Builder
The following Building Corle deficiencies are required to be corrected:
Presented to pproved
Inspector —_ Disapprovsd
Dater /` �—
CALL POR REINSPECTION
0 YES ❑ NO