16732 SW 72ND AVENUE BLDG 16 }
F
ADDRESS:
SW 7Ze"
isVecordsVnicroflm\fargetslbuilding.doc
r
li 111 IIII IIII IIII ills IIII IIII IIII
C M
LEGIBILITY STRIP
o i � 3 � �ul u1�1i11 ull�llllllll�liii�liil�iillluil�iiilllill�lliljilli�llil"�iiii�lin�lnl�lli�� �ill�
to I I I 13 14 I Is 17 Ile 1'9 20 21 22 23 24 25 26 27 2e 29 30
'�mm.i cm
01
i
i
i
[Jill
I 1 4 . t I 4 q � H 0 N I B 41 O e
�1�J�1�J�,Lia,LLLIIII_(w.1.1.�.1.�1�.1,�1�,.>�.X11,L�a��I,1�la��.�h�1.�h�1�1.>,Uh..ISIh�,� �.�l�.l.�.l�.a��_>1,� �.��.l�ll_I. .1 II �oz25X
"Ooll, "Oil 1,
M1. _ .... - .� ... ., .. ,... -. wiMMM+fXa!•Ap!4R}pAlhniw.d�!!�`��k'M*'�.
. !law om._ .., .. - , ,. � - wnnq.ww.gw.u,.y,,.. ..».,..„.�n,y er:.uWe �.,,. ,r►�Wp,
�`grMv +° pre �.
rxKory1,P10
w � �,
r- _ �� ..._....
I I
OA
Oast 2.6 TUN GASPACK r-1
MODKL DINA030
I98 Lbs 24* tG
l i V► I
99 TheCq
I26•
96 lbs 96 lbs �rr�
4~ E.., o
Ij I • -
C%wmMUTIff 0 p
Cit
_a CORNER WEIGHT DETAIL p Co
M 1 I SCAIX N.T.B. Cq_ _ r-
V C)
I
�~ l
PERMANENT ATTACI•D(ENT TO ROOF CURB. -- -- O
INSTALL 010 DRNE SCREW THROUGH 16 GA. �� N� L) �
FFACTORYORY CURB RAIL OF UNIT INTO 18GA. AxalsLAC »otTa - _
#10X1 SELF TAPPING DRTVE SCREW ROD - DOLTS
TYP. OF 8 (4 EA. SIDE)-----,^ -RSIs111C BIACI E—+
otoo
PYP. HVAC UNIT BLW, % ►++
U141T =011112 �_` 0 U
HURvis-
J
CURI1 — 0
ROOF C UNIT HEATER DETAIL _ d
BT_U SEISMIC DETAIL scAU: N.T.S.Mi
�7
M 1 SCALE: N.T.S.
1,
I
'-o•
TO 20 J. ,-r
GAS METER J;'�•/ UR-I
LEGEND: NOTES: c
,II
(E) EX13'I7NG10
TOTAL BTU = 150,000 BTU 00 ■
;I (R) RELOCATE TOTA! GASLINE = 100'-0' m M
(REM) REMOVE I
1
_ ® SUPPLY GRILLE I -
-+2•r
14-0 E RZrUW GRILLE a �a
i
I OT THERMOSTAT
9 P.O.C. POINT OF CONNEcnON
14
N
�-I EQUIPMENT SCHEDULE:
,o., TAG MFG. M1DDEL # VOLTAGE
MCA/FUSE COOLING HEATING�%FM MIN.OSA WEIGHT REMARKS _ Z
(f)
AC-1 YOYORK01NA0208-230j10
30/2.5-TON 18,3325 -29 MBTU 43 MBTU ID00 205 390 LBS- 4
v
EF-1 GROAN 888/EX. FAN 120 VOLT - - 60 - _ '�
10 10 UH-1 MODINEPAE100A0108 120 VOLT - 105 MBTU 730 - �0,
3sb 2
I
_ NOTES: �1
—� W Q
(1) PERMANENTLY LABELED FOR AREA SERVED
P2) VENT TO EXTERIOR
� RI a i
z
0
HVAC - FLOOR PLAN U� .� 4
-
IN 1 SCALE: 1/8" - J'-0" SLI
NORTH �,
�9 mly OF TIGASu i
AppIbvod....... .. .... . . ... .. ..... ( I A
F all Approved... A, 9
Conditionally �.� �
� ) por onlytho work as�e,r,nbCd In:
)ERmT NO._Wgl f ... ..I[
X08 Lotter to: F()110'N......... I CAD N0.
Attach...............
PROJK7 NO. 2196
Job Addr95 }iQ��' pate. gtiva
lay. -- -- - selW NO.
mi
y.
N Ill I�� I► Ir,
I'(1 I ..I I
r
OF
LEGIBILITY STRIP 5 6 7 e s 10 11 1 2 13 14 1e 17 1e 19 20 21 22 23 24 25 26 27 2e c.. 3C
8I I I C+I
HON ® 106
��.�11.,(,1.,J,l[dI1., 1J�I1.�la.t�.L11ia.�,1.1.1�t1 LLIJ IJ.111.111111�.�11�1�Ub,U,11�11Ij11,1.1.�1.1,�-l.>_l]1 11 1 1 1 1 11TI I i I i I i I I I i I III I MTI I i I III I i I i I I I i I I I �� i I I I I I I I I I I I 11 �b1 I i I i I I I i I,I I I i I i i I Lia.l.l.�-1 t L���a�1�.(�L��j ll�.1��i L�.l�a�la�.11 LI�I � I
oz25X
11.. l'
r
�f
i
ADDRESS:
A
d
H
N
s
H-
J
O�
LO
J
01ocord*Tlicrof1mVarget;Wuiiding.doc
I
00co u
v
3 N N d p
7 j
c� O � O
ll O N L u
E E
C E
°ao mac °) � c
asNamm � ro
c o
x N c c C". E o c
a O
E0
C 1« L y ca)
j
o tau"D 2 uaEt o
Z Oncn2 rntn3 5c4 rn
n 0) C)
a o) rn rn rn rn rn ao ao o co
rn rn rn rn
R. N N N N
Oj
a
C
C' Fes- Vim- "'� ��.. U U U � U L)
v >o >
ti
G aI
a U < < < Q a ( < < <
+i!► G, o d d d w LL n a< nom. a
ti
T m
U
W $ i' .2 F- u o 0 o D o
� v
d
o,0 o
in
cC a o)
cu
U rn rn rn ct C9 (10
a) o s 0) rn d
N
U
Q
d
m
0
c
n'
n
J
Ct7
C7C
111 a a 0
Z.J > u J
N N
o � �' E > j .
0 0 y c m c c
a u u N ym pv� u. LL u. iL
'Q �j fn tU tU ryN _W N
p Q 0. wQ• LL' w CJ w w
ry Ln r) 0 0 0 0a T� N rn rn N w N t-
>_ U u U U U U U U U U
W w w w w w w w w w
v
5
v
a O
m
F-
.0 F-
a Z
p W
t �
Z
g�
J
c
a_
LL
O�
O C N O
Z N P
N r`
ro
z z z a-
0 m m r°
CLr o
ro v
o
x
J
N
M
O au cn (n w U) cn (n (nn 0
U (1) n a v; (n (n (n (n
O o w a a a a a Q a a a a
T
U m
v
L11 ca s n. o o o a a
r O i J J (n (n (n J J
z 0 m m Cts (Y F- F-
ro
*k c o p
rn
� N F-
cn a a�
ao (1
n 0) 0) 0) m
N Uii N 4J �( a5
O � 47 � � Q1 � •�- 07 Qt 01 � �-
V)
W N
U
w
F-
0
o
x o U
> w Ir 7
y Vl N C G7 N �-
C U61 N _N _N a pO1 y N � 2
O c ro a a. � ❑. � � a � �i
EL O N 7 C C
a h y $ y a J y
C5 tn _
O O
O Q a Of x O LL 0 LL 0 U
cD LO r apo (n 'ri 91 (D o U) o
O N O O
U O U U U U U U U U co
U U U U U U U U U U U
;
)
°
R3 d § d §
\£ \ \ 1: 1: F- {
_
} \
�
�
CII)
C)
C)
�
CO
2 »
< « c « &
� o R /
m �0 0
\
CL
n \ r §
q ) ) d
k U )
V)
.� r4
> 0
2
2 /
c
S
\
/ 2
/
( 7 c � k
a cl
f $ in )
�
E \ < }
\ \ � @
$ 3 § u § Q G
} } ) ) ) }
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: 6 " S cn A.M. P.M. MST:
Location:_� .� ', S•,J %Z.=� *yr 9-16 BUR
Tenant: Suite: _Bldg: __ MEC:
Contractor: ae�_,-A r>FAJE Phone: PLM:
Owner: Phone: ELC: Q C.;P 17
cJ-77`x
SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL eftlICTRAL SITE
Site Post/Beam Post/Beam Post/Beam er Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service: MISC.
Masonry Ceiling Rain Dwain A/C UG Slab
Shear'Sheath Fire Spklr/Alm Crawl/Found Ur Heat Pump Low Volt
Approved Approved Approved v Approved
Appr/Sdwlk Not Approved Not Approved Not Approved ed Not Approved
FINAL FINAL FINAL INAL FINAL
ELC' 077
r
T G &Al .36 �� /s✓ �i'o1J� O,�
LA �-
O Call for reinspxro�w
O Reinspection fee requited before next inspection O Unable to inspect
Inspector _� ` Date: 'j � Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24Hour InsnPction Line: 639-4175 Business Line: 639-4171 — -
' BUP
Date Requested_ AM_ PM BLD
Location Al Z3�- > �,J ���� Suite �L�_— MEC _
Contact Person Ph _ PLM
- (.
Contractor , �� -'41 E�,h�t,'E�- _ Ph . .2 3L� 'c' ' - SWR
ELC
BJILr)ING Tenant/Owner _
Retanuny Wali -- ELR - -v-_
Footing Act ess: FPS
Foundation -
Ftg Drain C �1it�` - �. c►7/ V{.
Crawl Drain Insp tion Note§.
SGN —
Slab - __ .� `C- /6EA? M�' SIT -_
Post& Beam
Ext Sheath/Shear I ------
Int Sheath/Shear
Framing --- ------�_.__.--
Insulation _
Drywall Nailir-,
Firewall -�
Fire Sprinkler -__ _ --- --- - --- - --
Fire Alarm 1�=
Susp'd Ceiling - ----__ --- --- - - -_� _
Roof
Misc: -
Final -- ---____
PASS PART FAIL ------ - - ---- -- -- -
PLUMBING
Post 8 Beam - .------ - ----- ___.
Under Slab
Top Out _--
Water Service -
Sanitary Sewer -- - ------- ---._----
Rain Drains --
Final
PASS PART
MECHANICAL
Bost& Beam ,_- -- --- - -- ----
Rough In
Gas Line ___. -�- -------.--- -
Smoke Dar.,pers
- Final - ----- -- ----_-___ -
PASS PART FAIL
rSLiECTRICAL
-
-. Se Vlci�-
.ti Rough In -_ -__-_.- --- -----
c~n UG/Slab -- - - ----- - —
y Low Voltage
Fire Alarm
F.
mASS ) PART FAIL ------
'S-
-S RE
-' Backfill/Grading - - -- --�-�---------
Sanitary Sewer
Storm Drain I ) Reinspection fee of$ required before next inspection. Pay at City Hall, 13.125 SW Hall Blvd
Catch Basin inspect-no access
Unable to ins
Fire Supply Line I )Please calf for reinspection RE:_ __- I ) P
ADA Approach/Sidewalk Date Inspector 61,14" ,z Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
W
CITY O F T I G A R ® MECHANICAL
DEVELOPMENT SERVICESPE RM I T
PERMIT #. . . . . . . : MEC97-0329
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 09/16/97
PARCEL: 2SI13AD-01800
SITE ADDRESS. . . : 16732 SW '72ND AVE #B-16
SUBDIVISION. . . . : ROSEWOOD ACRE TRACTS ZONING: I—L
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 11 JURISDICTION: TIG
----------------------------------------------------------------------------------------
CLASS 0 WORK. . :AL-i FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :COM UNIT HEATERS-- 1. VENT FANS. . . : 0
OCCUPANCY GRP. . :B VENTS W/O APPIL: 0 VENT SYSTEMS: 0
SIORlES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0-3 HP. . . . : I DOMES. INCIN: 0
:GAS 3-15 HP. . . . . 0 COMML. INCIN: 0
MAX INPUT: 3000,00 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : N 30-50 HF-,. , . . : 0 WOODSTOVES. . - 0
GAS PRESSURE. . . : M 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITE---------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN < 100K BTU: 0 10000 cfm : 0 GAS OUTLETS. : i
FURN '/ =100K BTU: 1 > 10000 cfm : 0
Remarks : Mechanical TI
Owner: FEES
PACTRUST type amoi-int by date t-eept
15350 SW SEQUOIA PKWY PRMT $ 31. 50 JSD 09/16/97 97-299274
STE 300 PLCK $ 7. 88 JSD 09/16/97 97-299274
TIGARD OR 97224 5PCT $ 1. 58 JSD 09/16/97 97-299274
Phone #:
Contractor: ------------------------------
PROTEMP ASSOCIATES INC
807 NE COUCH ---------------------------------------
$ 40. 96 TOTAL
PORTLAND OR 97232
I-''hone #: 233-6911
Reg #. . : 000388 ------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws, All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Final Inspection
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in MR 9552-MI-010 through DAR 9 401-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(5031246-9187.
Issue By : Permittee SignatlAre :
S S
4.................4........4..................... ..................... +
Call 639-4175 by '0:00 p. m. for- inspections needeci the next bi-isiness day
C
Ls4.................................. ................#...................F++++++++4
Plan Check# _C�
n' OF TIGARD Mechanical Permit Application Recd ByP-Od
3125 SW HAL,_ BLVD. Commercial and Residential Dat-+Recd
flGARD, OR 97223 Date to P E.�� t
(503) 639-4171, x304 Date to DST (2 -
Permd#
Print or Type Called j S/U
_ Incomplete or illegible applications will not be accepted , �,�-7
Name of DeveiopmenuProjeo Description
.5[ALIFE_ Table 1A Mechanical Code CITY PRICE AMT
Job Street AddresaA73� ,i,1 ` une# A) Permit Fee ^' 0- -0- 10.00
Address 0&EacKj i US- I _ 1
Bldg# caty,State Zip 1 ) Fumace to 100,000 B'j U \ 600
isy R q7U.C/i including duds b vents _ _
�r i, Name for name of business) 2.) Furnace 100,000 BTU+ 7 50
V lr P4'f-r including duds&vents
/
Mailing Address 3) Floor Furnace 600
15350 -k A 3_G ) including vent
cdy,state Zip Ph a 4) Suspended heater,wall heater 6,00
7_16/1,0_6 R ZG h�3 (p� or floor mounted heater I L`
Name(or name of business) 5) Vent not included in appliance permit 300
Occupant Mailing Address 6) Boiler or comp,heat num- ,ir cond 600
to 3 HP:absorb unit to IWK BUT"
coyrState Zip Phone 7) Boder or comp,heat pump,air cond 11 00
3-15 HP:absorb unit to 500K BTU**
Contractor Na11e 8) Boder or comp,heat pump,air cond 1500
(Prior to ( �jT} �'� �. ��. .5-30 HP,absorb unit.5-1 and BTU"
issuance Mailing Address 9.) Boder or comp,heat pump,air cond 22.50
applicant _ 30-5.,HP:absorb unit 1-1.75md BTU" _
must provide all crtyisute Zip Phone 10) Boder or comp,heat pump,air cond. 3750
contractor (%«p )FZ Gi7 Z Z3 3-(d`9 1 1 >50 HP;absorb unit 1.75 mil BTU-
license Oregon o�n��Cont,Board uc# Exp Date 11.) Air handling unit to 10,000 CFM 450
information 1 C C,
for COT COT Busness Tax or Metro# Exp Date 12) Air handling unit 10,000 CFM 7.50
aatabase). t-{ p U
Architect Name 13) Non-portable evaporate cooler 4 50
or Mailing Address 14) Vent fan connected to a single dud 71
3.00
_ 3_
Engineer Ctlyrstate p Phone 15) Ventilation system not included in 4.50
_ 1 anoliance Denmit
Describe work New/R Adr lion O Alteration O Repatj� 16) Hood served by mechanical exhaust 4.50
to be done Residential O Nun-residentially
Additional Description of work 17) Domestic incinerators 7.50
18) Commercial or industrial type 3000
_
Incinerator _
Existing use of 19) Repair units 4 50
building or property
20.) Wood stcve 450
Proposed use of 21 ) Clothes dryer,etc I 4 50
building or property
22) Other units 4 50
Type of fuel-oil O natural gas/Q LPG O electric O 23) Gas piping one to four outlets t 2 00 z .-
I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(each) 50
information givens correct,that I am the owner or authorized agent of i
m the owner,that plans submitted are in compliance with Oregon State OTY SUBTOTAL �r
laws `
Signature of Owner/Agent Date 'SUBTOTAL _
0 .- L---9- 8 -Zel-G 5%SURCHARGE `_ Ili
Co ct Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
v J0I+0J Ai>. Tvt 5 Z-3-5 &Ct I ' TOTAL qp 1
dsrrnechpmt doc (rev 9 'Minimum permit fee is t25+51� surcharge cY
OP
oi"Residential AIC requires site plan shong placement of and
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Request V r l l A.M. P.M. MST: _
c
Location: BUR
Tenant: Lam-- Suite: Bldg: P-)- MEC:_
Contractor: Phone:
Owner: �' Phone:
Li t,
1,Q,�-L �LC�S GT ELR:
SIT:
BUILDING BLDG(con't) PLUMBING XECHA ICAI U ELECTRICAL SITE
Site Post/Beam earn Post/Bcam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water I.ine
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump Low Volt _
Approved roved Approves' Approved Approved
Appr/Sdwlk Not Approved pDLved Not Approved Not Approved Not Approved
FINAL _--NF1 FINAL FINAL FINAL
J
7
J -
C1 Call for re' n O Reinspection fee of S required before next inspection O Unable to inspect
Inspector: Date: �� Page _of
CITY CF TIGARD
DEVELOPMENT SERVICES F' PERMIT
13125 SW Hai.Rlvd., Tigard,OR 97223 (503)639-4171 F'ERM I T T ##.. .. .. .. . . . : F'LM97-034
DATE ISSUED: 08/21/97
PARCEL: 2S 1 1.3AD-01800
SITE ADDRESS. . . : -tf,73 SW 72ND AVE #B-18
SUBDIVISION. . . . : ROSEWOOD PCRE TRACTS ZONING: I-L
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 11 JURISDICTION: TIG
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :COM WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . :
OCCUPANCY GRP. . :B FLOOR DRAINS. . . . . . : 1. TRAPS. . . . . . . . . . . . . . : 0
STORIES. ., . . . . . . : 0 WATER HEATERS. . . . . : 1 CATCH BASINS. . . . . . . : 0
FIXTURES----------------- LAUNDRY TRAYS. . . . : 0 SF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . 0 URINALS. . . . . . . . . . . 0 GREASE TRAPS. . . . . . . : 0
LAVATORIES. . . . : 1 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 1 WATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarks : Existing plumbing replumbed due to burn--out
Owner-: ------------------------------------------------------ FEES ---------------
PACIFIC TRUST REALTY type amount by date r^ecpt
15115 SW SEQUOIA PKWY PRMT $ 36. 00 DST 08/21/97 97-2,98500
200 SPCT f 1. 80 DST 08/21/97 97-298500
TIGAIRD OR 97224
Phone #:
Cont r•ar_t or-----------------------------------
DF_AN WARREN PLUMBING
:3111 SE 113TH
PORTLAND OR 9720: --------------------------------------
Phone
-------------------------------------
Phone #-. 236-4152' $ 37. 80 TOTAL
Reg #. . 000001
----- -- REOUIRED INSPECTIONS -- ---__
Tnis permit is issued subject to the regulations conta;ned in the Rough-in Insp _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top-out Insp
applicable laws. All work will be pane in accordance with Mi sc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuan^e, or if work is suspended for mors
than 180 days. ATIENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 752-000, Trough OAR 952-0001-0088. You may
obtain copies of these rul,- irect questions to OUNC by calling _
(503)246-1987.
Issued By :__ C Permittee Signatut-e: _
f+.r•+++++++•+++ +f++++++++++ ++++++++++++++++++++•*++++++++++++++++++++++++++++++
Call 639-4175 by E-:OO p. m. for- an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++; .+++++++++++
rarararaE
':TY OF TIGARD Plumbing Application Recd 8v
13125 SW HALL BLVD. Commercial and Residential Date Recd ,Z
IGARD, C'R 97223 Cate o
(503) 339-4171 Cate:o CS'
Pefm t s �/1q 7--
Print or Type Related;'wR:
Incomplete or illegible applicatic is will not be accepted Catlea _
�yi .Sr7/7(V, f� (G� jL 14, - A!OL U
Name A 0evelopmenuProject �j FIXTURES (Individual) -�-- QTY PRICE AMT
Job R 'iLi 1`LT�I` Sink 900
S:reet Aadress Lavatory `I
Address °� Suite 1 r _ _�— 9",
3, ` S L�,i -7,'Z uo or ruorShower Girl) 9 00
16-8L1q a C,tyiSnie yip Shower Univ 900
T, ~�f� I Water Closet
Name I 9.00 C�-
L.t c�-T Disnwasner 7 00
�lamr Adaiess Garoaqe D soosal
Owner 9 3 Suite 9 CO
W Washing Machine -900
CavrS ate Zip I Phone Floor Cram 9'J0
O C' '
_
Namri J 9 00
6-
900
Occupant Mailing Address Suite Water Heater 900 C
Laundry Room Tray 9.00 J1
C tyrState ZIP Phone Urinal
9.00
_M Name Cther Fixtures(�uecfv) 900
GvA►4r•1,:= L t3 9A0
Contractor Mailing Address Suds — 9 00
9.00
�
(Prior tc issuance QfuiSlate Zip Phone
J
frac:ols
lit must J I T L"'H C ..--I
ae an Cregon Const.Cont.Board l ic.ls Exp Cate 900 I
c I ?, T�2—
Sewer
.00
license Plumbtn UC.fi Exl. pate Sewer• 1st tEaUdiElional
'7
nformation
-each
'or DT C..T Business Tax o Metro I Exp Date
oatacase) ) C'� ) Water Service- 1sr t00' 30.00
r _
Name - Nater Service-each add tional-00 25 00
_ I
,Architect Storm S Ram Drain- 1st 100' 3000
or Mailing Address I Suite Storm A Rain Dram-each additional 100' 25.00
Engineer CiMobile Home Space I I 25 00
yrState 24 0 Phone Commercial Bac,='ow Prevention Cevice or Anil. ( 15 00
Pollution Deoce
=escnbe,vork New Z Addition C 4aeratlon O Recau 0 I Residential Bacxflow '•evention-'evrce' i I 5•�0
t0 co lone. Residential 0 Non-residential 0 I any Trap or :.as:e Nct Connec;ea!o 3-,xrure I I g O0
Acci1'onal desenatlon of work _ / L _
R t. �!•,tl�•l� ,[�<f S'T/n�fir- Zaicn 3asrn 900
_ I I
I'-/•xT LA-r, E S r nsp.of existing�umorng I 40.00
-fl cennr
SOeaat
x�sanq use of y Requested Inspections i I a0 L'0
�udaing or )roverty
Ram Cram mo±ilii single family dwelling I 30 x
ccosed use of Grease Traps I 9 co
7uilding or prooerty
QUANTITY TOTAL
Are you caoomg movtrg or replacing any fixturesli Yes No lsorrea,.x nsm w rah ,
(If yes see back of form 'SUBTOTAL
�e eoy acknowledge:ha! have read this aupucation,that rhe information
;rveri s correct that t arr ne owner or authorized agent of rhe owner and 511a SURCHARGE
:hat plans submitted ire - -omplionce with Oregon State Laws. _
SI a of OwnerrAgenLA
t I pate PN REVIEW 25°4 OF SUBTOTAL
�e°Ufe�pnh 9xture Cr! '�'ai S
L TOTAL I -2
Contact Person Name phone ( 3 7
'Minimum permit fRe ;325 5",surrnarge except Residential Backflow
Prevention Device .vricn is 515- 5%surcharge
'fists plmaco doc 5.98
LEASE QQMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced j Qty
Sink - I •
Lavatory _
Tub or Tub/Shower Comhination j
Shower Only
Water Closet
Dishwasher _
Garbage Disposal
Washing Machine
Floor Drain 2"
_3"
Water Neater
Laundry Room Tray
Urinal _
Other Fixtures (Specify)
OMMENTS REGARDING ABOVE:
I
CITY OF TIGARD 639.4171 6055
BUILDING PERMIT i.,;,.. Line 631V-4175 DATE is
BacTAX MAP.,-k__1aLtla_ LOT NO. i t�[►__ SUBDIVISION
OWNEP, t�rue_.t.____ JOB ADDRESS jiq_35._S{Y.__72nklt__,4vp,- ,►,, *}
BUILDER _I'•l.,• i;reenSTATE REG.NO. EXP D
BUI LDER'S PHON E
ARCHITECT .-asktaogiw'i4AIt.A _ ____.___ PHONE OTHER
STRUCTURE I.1 NEW } REMODEL I.1 ADDITION REPAIR MOVE ! OTHER DEMOLITION
RESIDENCE '1 ! COMM EDUCATION IND 1 RELIGIOUS ACCESSORY GARAGE OTHER LJ FENCE
OCCUPANCY —.L-2 LAND USE ZONE I-r' _9LDG TYPE Si yu ZONE PLAN CHECK BY I,1.1 J HEAT
1pru,nt .jguifi ,! td, an aL.,Lrn� :,iij ji. ru ini ut,ir.>:nnra
,.attlal r �r,•: ,:�� t re�tiic,_a fir_''wr�_-LiLu_wall_ Ler irag a Milan -„u 'rl.P1J ra.uyir.,rw„rr_
t+o tenant
SEWER PERMIT k
OCC.LOAD FLOOR LOAD Conc HEIGHT NO,STORIES 1 AREA"�'U NO.BEW1,,OOMS VALU9 ?k' _
f BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 35•S" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
F RF.OULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check ' ' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
— - W!TH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DUES NOT WAIVE
PI.Ck.Fire_ .•�:�_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
—L _ TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 1•a4
—'SDC—
Total o X41 - - oDCM APPLICANT UR AGENT
Prepd. -- ,
Receipt No ADDRESS PHONE
WI.DudticK
1111.4J Issued By ' Approved By
DATE INSP. TYP PECTION �_ REMA14KS PLUMBING DATE
Lr 7 •'`y�L [Rough-in
ntractor
- 1Q -�!� �.�� - __ rmit No. —
Fixture
Final _
HEATING
- - - -v--- Contractor
---- -- - ----- Permit No. -- -
rias or Oil
Rough-In
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Dialn)Final
Sidewalk
Curb 6 Streot Final
CERTIFICATE OCCUPANCY
�r Anproach
BLDG.DEPT,FINAL CERTFTEM OCCUPANCY Final
Landscaping
Zoning Final
IYY OF TIGARD 639.4171� DATE ILDING PERMIT In
TAX MAP � " '� 4-60T NO. t SUBDIVISION
i.,WNER rraC7 }} JOB ADDRESS -��nl' rJ
13UILDER Y T L STATE REG.NO. EXP.DATE
GUILDER'S PHONE Z �
ARCHITECT 0 - - PHONE 2� �1��4 OTHER
STRUCTURE ❑ NEW 6 REMODEL ❑ ADDITION ❑ REPAIR ❑ MOVE ❑ OTHER C7 DEMOLITION
O RESIDENCE IN COM;"A ❑ EDUCATION ❑ IND ❑ RELIGIOUS ❑ACCESSORY (3 GARAGE ❑ OTHER ❑ FENCE
OCCUPANCY �'�- ,LAND USE ZONE J- j BLDG.TYPE Z--±J—FIRE ZONE PLAN CHECK BY a !- HEAT
ADD Fes" i1A,.f✓
SEWER PERMIT I
OCA'.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS - VALUE
r-- 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
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES„AND IT(S HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE Wit H THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Pl.Ck.Fire RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CnNTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REQUIRED FOR EWER PLUMBING AM^4EATINO.
to Tax
SDC— ^ _
OT!tal A PPLIC AN T
ON -
,.Ipd --- PIXA T6
Recelpt No. ADDAE PHON
tial.Due
Issued By .Approved By
`'SI)C --- $
SUC
PQC
SEWER CONNECTION 5
5EWER INSPECTION $
n SEWER SURCHARGE S _-
G�