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INSPECTIONNO IT CE
City of Tigaif! Building Department
P.0. Box 23397
Tigard, Oregon 97223
Phone: 839-4175
Type of Incpectian
Date Requested S 8 7 —
:ss�� ,,�_ Time _lam A.M.c--- -P.M.
Address _LG.1 T v � ry��--77y arx e Permit #
Owner
--- _.._ Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to i
�__----, Approved
Inspector _
C Disapproved
Date
CALL FOR REINSPECTION
C� YES ❑ NO
INSPFCTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone. 639-4175
Type of Inspection
Date Requested �- ! me Am. ---P.M.
Address jJL Pr.rmit k a
Ovwner_ _- ------- - ----- lot #--- -
Builder
The following Building Code deficiencies are required to be corrected:
Presented to __ _ __ Approved
Inspector ___ I I Disapproved
Date
CALL FOR REINSPECTION
❑ YE= ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested ---_ _—__� _ Time A.M.
Address ��� � � ��`- Permit # _
/ t
Owner — ��/GZ-�.:s .� - Lot #M.
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to --_ —. — proved
Inspertnr LI Disapproved
Date
CALL FOR REINSPECTION
0 YES C] NO
1 �
INSPECTION NOTICE
City of Tigard Building Department
P O Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested Time P.M.
Address
Permit
Owner _ 1 l _ Lot #
Builder ` \,,.L`1 .
The following Building Code deficiencies are req, ed to be corrected:
Presented to of_
Inspector
Date
Disapproved
CALL FOR REINSPECTION
❑ YEE ❑ MO
� w
INSPECTION NOTICE
City c( Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested �. Time A.M. P.M.
Address . ! Q Permit
Owner — Lot #
Builder
Tha following Building Code deficiencies are r squired be corrected:
Presented to 114� proved
Inspector ��
_ _ I I Disapproved
Date37-9
CALL FOR REINSPECTION
0 YES ❑ NO
� +rw saw sri
INSPECTION NOTICE
City of Tigard Building Departm,+nt
P O. Box 23397
Tigard, Oregon 97223
lPhone: 639-4175
Type of Inspection
ue(stte�eQQ� T-ima
—
A.M._ �P.M.
Date Req
Address Permit
Owner.
�
Lot
Builder —)2� —, -� O
The fnllowing Building Code deficiencies are required to be corrected:
Presented to _---- �ppmved
Inspectorr(CALL
Disapproved
DateFOR REINSPECTION
❑ YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
P O. Box 2.3397
Tigard, Oregon 97223 L�✓
Phone: 639-4175
Type of Inspection _- i;� "� - -- - - ---
Date Requested.._ V��� '�_ Time _A.M. ..�_ P.M.
Address 7,'- l 4�CJ']Jhp, L?�, Permit #
Owner--- — t/t/ C`.c�(.i 7 Yt�(itp �. Lol r
Builder
The following Building Code deficiencies are required to be corrected:
Presented to pproved
Inspector --- _ - Disapproved
Date
CALL FOR REINSPECTION
El YES C7 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-41755 _
Type o; Inspection
Date Requestedp �7 Time�y�'A.M. P.M.
Address ���a (� � C
Permit #�� Z---
Owner ��1� t-Gt Lot #
Buildar
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector / J Disapproved
Date -------�r—–F�G_'
CALL FOR REINSPECTION
❑ Yet 0 NO
jp�w WE MW
INSPECTION NOTICE
City of Tigard Building Department
P.O. tdox 23397
Tigard, Oregon 97223
Phone: 6 -4175
Type of Inspection --— -----L'-f
Date Requested —_ � Tim/e� A.A.M. P.M.
Address [/( � (! _[_LY'Pe rmit # v
Owner _ _ Lot #
Builder — --- C_ ------ �I)Qe; —�—
The following Building Code deficiencies are require to be corrected:
Presented to _ _ proved
Inspector _._ _ ❑ Disapproved
DateI
CALL FOR EINSPECTI N
C_1 YES ❑ NO
CITY 4F TIGARD MECHANICAL PERMIT Receipt #
Permit# t
Description
City of Tigard
Table 3A Mechanical-Code QTY PRICE AMT
— ---- — —
13125 S.W. Hail Blvd. 1) Permit Fee -0- -C- 10.00
P.O. Box 23397 — -
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
2) Furnace 100,000 BTU +
incl.ducts&vents 7.50
Name of Development 3) Floor Furnace
incl.vent 6.00
Job Address — 4) Suspended heater,wa!I neater
Address or floor mounted heater 6.00
Tax Lot Map No 5) Vent not incl.In —
_ Lot Block Subdivision appliance permit 3.00
Name lot name of business) 6) Repair of heating,refr IQ.,
cooling,absorption unit 6.00
Owner Mailing Address phone 7) Boiler or comp to 3 HP
absorp.unit to 100,000 BTU 6.00
City State Zip8) Boiler or comp to 3 HP-15 HP
absorp.unit to 500,000 BTU 00
Name 9) Boiler or comp 15-30 HP
absorp,unit L�-1 million tl .00
Mailing Address Phone 10) Boiler or comp to 30-50 HP
Contractor absorp.unit 1-1.75 million 22.50
cuy state zip t 1) Boiler or comp to 50 HP
absorp.unit 1,750,000 BTU 31.50
Stets Registration No City BUB.Tax No. t 2) Air handling unit to
10,0_00 CFM 4.50
I hereby acknowledge that I have read this application that the information given Is 13j Air handling unit
correct,that I am the owner or authorized agent of the owner,that plans submitted are in _ 10,000 CFM + 7.50
compliance with State laws,that I am registered with the State Builders'Board,that the 14 Non portable
number given is corred.(If exempt from State registration please give reason below)- ) evaporate cooler 4.50
----- --` 15) Vent fan connected —
to a single duct 3.00
Ventilation system not
_ 18) included in appliance permit 4.50
" �' 17) Hood served by
�Y mechanical exhaust 4.50
SlgnatuYe(owner or agent)_ DateDomestic type
Describe work Fl addition FJ alteration I-1 repair [J 19) Incinerator 7.50
to be done _ residential UI non-residential p Commercial or industrial
Existing use of 19) type incinerator 30.00
building or properly 20) Other i.e.,woodstove,water
Proposed use of heater,solar,clothes dryers,etc. 4.50
building or property -
21) Lias piping one to four outlets 2.00
Type of fuel— oil ❑ natural gas I 1 LPG I I electric ❑ — -
4^t More than 4-per outlet
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 401.SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER --------Y
WORK IS COMMENCED, TOTAL
Special Conditions
----_ Date issued by
6522
CITY OF TIGARD 639.4171 DATE 19
BUILDING PERMIT ; f ! over Laudfn.,
TAX MAP LOT NO. 'r'ti SUBDIVISION
OWNER_-_----ek "�ryr►1tt�+r JOB ADDRESS 10878$SW Doti r Ct• -
BUILDER _____. _.-__�! -______- __-___ _ STATE REG.N0.3321A _-_-_ EXP.DATE __Ii.111 I --
BUILDFR'S PHONE
A."Cii;TF_CT. __ _ PHONE ____ _ —_OTHER _-.-
STRUCTURE x 1 NEW i REMODEL 11 ADDITION Ci REPAIR L MOVE ( 1 OTHER DEMOLITION
f RESIDENCE L: COMM EDUCATION IND r RELIGIOUS Cl ACCESSORY 1 GARAGE LI OTHER FENCE
OCCUPANCY `'3 LAND USE LONE BLDG.TYPES FIRE ZONE PLAN CHECK BY Lf_i HEAT
(.urlsltruct ain),Io family dwelling wjattarhea jara all Iser at) ruveu plans. Abject to 1i'i cocr. i
SiUIL:: ---
1
SEWER PERMIT 3 bath, 13 L>raar ahnjA d_ .;priAy.aa dfitj -
OCC.LOAD FLOOR LOAD 4(; HEIGHT iU NO.STORIES 1 AREA2301 NO.BEDROOMS 4 VALUASf
BUILDING DEPARTMENT ! SE1 BACKS FRONT U REAR LEFT SIDE RIGHT SIDE
44`),5(1
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
3k+�1.5�3 REGULATIONS 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
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PI.Ck.FireRESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY EUSINESS
'-- _ TAX PFRMITS.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 11.62 4:wC 1�)U.uu
SDC— buU.GO
Total APPLTCANNfiO�AQEIVT
PDC#
Prepd. LUU•UU It 1510.UU
Receipt Nq ADDRESS PHONE
Bal.Due b52.9U I ►`• Z-y t�.
Issued By. Approved y___. —
DATE INSP. TYPE INSPECTION PLUMBING
-
�, _. UMBING DATE
or 11
Contract—or���—+��)
X25, Rough-in
fixture
— rnal
HEATING
_ racier
rmit No. 114cam' �—
y_9 --
_ !t Gas or OII
Rough-in
Final
SEWER
Final
--_ DRIVEWAY
_ Final
Slorm Drainage
-- (Rain Drain)Final
— Sidewalk
Curb 6 Street Final —
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
"--- Zoning Final
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