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INSPECTION NOTICE
City of Tigard Building Department
P.O. BL,( 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of laspection
Date Requested Time L�A.M.—_P.M.
�� W ` 1 /—`5 r Permit
Address _ '
Owner-- — I_ot #_
Buildor —.__ ` m*'
The following Building Code deficiencies are required to be corrected:
Presented to /� Approved
Inspector _, ___— [ I Disapproved
Date
T
CALL FOR REINSPECTION
YES ❑ NO
r�==__ I
i'.O.li.,x 1-3.1t-41
CITY Of= T'IGARD PLUMBING Ti -94 M
Applicants must hold Orrgon Registration to coMuct a plumbing PERMIT 6.xA175
business or mu_:t be property owr►er/operator not hiring outside help.
Name of Quveloprtent Plumbing Permit No. --5-3—L
Addeea � Z 1%— �1:. OfiS9��2Do1-010 `DUAN. PFl10E AMT
Job Tax Lot Map.No.
Addraas FIXTURES
ltrt Bock Subdrvaskxi ink ---- - li 1.50
sure(,x name of btisiness) Lavatory---_ -- k 7.50
_�A,)t��. Tub or Tub/Showef Comb 1 7.50
u uig ress -
ShowerOnly 750
OwnerWaterc"al
City/.tete Zip -- -- _
O L - Dishwasher - -- -_ - 7 50 - --
Phone Garb-eDisposat
Was...,V Machine
IFloor Drain _ _ 7 X'
ai,ng ress Phone Water Heater _ 750
Occupant — -- -- laundry Room Tray-_ -- 7 so
P C�Iy/State ZIP 750
Urinal _ _ _
--._ ame �y 1 e _ Ottw Futures(Speuty) _ _ _ 750 __--
r e ss Phone 7 so
Contractor Cfty/State Zip 7 50 ( -
- Lofts clic- 9-1 Off_ MISCEI.LANEOUS
Coy Butt Tax No _T
100' ?0 00
tats _ s TTo tate ,rr-ae� i,sT�c�7o `e"«-as AAddit 100 _ - - 1500
(Residential) CJQQ WSW Service'st100 �' - 2000 r
I hereby ad-owMdps that I have read ttwh app*cA*-n.that the inforr"bon Water Servce ea.Ad612M' - -- 1500 _ -
av'en is otxrect,that I wn mglste+ed wkh the Stats Bwdoev Bond,and also Storm 6 Rain(rain 1 rpt. 100 3000
haw a State Pkmt*V ticenso that to numbers g1ven aro oci ect.flat atI -- -- --
Pkmx>,np wank will be done in eoaxduKe with applicable prwlakx+s of Ore- Storm i P-in Oram Addlf 100 - — 1500
Son R--ed StakMs CYV< wt a47 Ind M and wv&cabb codes and thtt1 Moblle time Space 25 00
no help ww be ertpbyed r dens Mcereed u rder ORS 693 (M exorno frrm -- ------ ---._.
State-0stetlon,please plw reason below) Bade Flow Prevwvbw
"DUU(NNERS-I hereby owWy rw I am the owner of the property de Device or M6.-PoMtRnn pollee --- _.... ?s
aatbwd above.It which tocatbn I propose to nuke a pkaril*V krstaaabon kx Arry Trip or W saw Nd
MY own use end fda pmpsrly IS not bs&V oonetrvcfed kx ails,lease or f" Connected to a tiftov 7.50
----
Catch 3aaln - _ -- ?so --
-- kap oh Elder Pkir dng - 40 00 Per I4r
- ---
Specially� — - 10 00 PM W
AAn d Pkmdrq w10rn
an Exiting t31dg ------ 15 00 non
A DIED RE w New Bldg or Bund A"llon - 16-00 rine --
- �LLY�iirt,sirx�lefatit _ .
Dte w[xk new[ ) addition(7 G)Wi"on O rerAwr U dell 15.0) -
be done
_ realdtentlal(� reel reeldMtlal — _ �-- _—
Exk"tate of - ----
tPA*V or piror-,lY
Pfqppftd tNs of
-- ---
tx _
TTtla panwa 00", NA and void f wow or oonNuc t n asOmftad r fol oort+
tamanoaa*WdM UO da aw a oog to ucft7f or tclarft 1t1 aeft a1APOV abandoned br
a partod d W hays M"ane alb►w wt Ill CC1napkil ed
M01111C1AL OOhOftKM
--
-- _ - --_ ---- - ---- cs1•H 111.
d.� � � yr � �uNea-�u1 �vi��,fn�►�vtV�� r'�t�lllll o �� �� y
Pormit N
Description
City of Tigard —
Tah4e aA Mechanical Code QTY PRICE AMT
— --
13125 S.W. Hall Blvd. 1) Permit Fey -0- -0- 10.00
P.O. Box 2.3397 - —
Ttgard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU
1) incl.ducts&vents _ 6'0 G
2) Furnace 100 000 ETU +
incl.ducts&vents
Name of Development ) Floor Furnace
�✓ 3 incl.vent F
Job Address 4) Suspended heater,wall heater
Address 7./ S T or floor mounted heater 6.00
Tax Lot Map No.2 S/—-V A Vent not incl.in
00
Lot Block subdivision 5) appliance permit _3
Name'ar name or business) Repair of heating,ref r ig.,
6) cooling,absorption unit 6.00
Malli,pAddress phom 7) Boiler or comp to 3 HP
Owner K • ���"7absorp.unit to 100,000 BTU 6'00
^uyrstate Zip �Boiler or comp to 3 HP-15 HP
8) absorp.unit to 500,000 BTU 11.00
Name 9) Boller or comp 15-30 HP
absorp,unit Y:-1 million _ 15.00
i
Malling Addnp PhoneBoiler or comp to 30-50 HP
10) abso,p.unit 1-1.75 million 22.x0
GontractorGty,stale Zip ---�- Boiler or comp to 50;AP
11) absorp.unit 1,750,000 BTU 31'50
State RegistrationNo coy t ,a.Ta.No 12) Air handling unh to ^--
10,000 CFM 4.50
I hereby acknowledge vial 1 have read this RPP4k;sI"1 that the Information green Is 13) Air handling unit
10000 CFM 4 7.50
xxred,tial I am 0-owner a dxhd the aurired agent n owner.That plans autxnMte4 an ,
kh �._---
compGance whh Slate laws,that I am registered wllh the State E+rrik}ern'Board,thatthe Non portable
number given is unrecl (If exemfrom State registration pease give reason below) 14) evaporate Cooler ,'�
pt
---------------
t 5) Vent fan connected
- - - -- to a single duct s3 00
-- __---- - - -- Ventilation system not
— 16) Included In appliance permit ;
17 Hood served by �o
s�h� 3r g7 ) mechanical exhaust-4 / 4,50
signals-(owner a aparN) � % ats Domestic type ----_
Desrxlhe work addition p 811dration C1 repair Q 18) Incir*mt(x 7
to be done 9f sfdential non-residential F) Comn Kda or industrial
Existing use of ) -- -- t 9) type Incinerator --------- - 30.00
'wiling cr property_ � 4'- Other I.e.,woodstove,water
Prgtosod use of 20) heater,solar,clothes dryers.etc. 4'50
building cc pn wtv
21) Gas piping one to four outlets 2.00
Type of fuel- oil f 1 natural gailiAn' LPG 171 electric O -
22) More than 4•per outlet
HM
THIS PERMIT BECOMES NULL AAN VOID IF WORK OR WN- --- SUB-TOTAL ? S"
STRUCTION AUTHORIZED IS NOT OOMMENCED WITHIN 180 4%SURCHARGE •S^
YS, OR I- CONSTRUCTION OR WORK IS SUSPENDED ORpl A!1 REVIEW 26%OF SUB-TOTAL �j 3
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -- -------_.-- 4— ------
WORK IS GOMMENr;FO TOTAL
at Conditions
-..- _ lhllr15S1ua) by
r
WA
CITY OF TIGARD BUILDTNG DEPARTMENT PLAN CHECK NO. :
PLAN CHECK APPLICATION DATE RECEIVED:
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID:
This is to cartify that the attached sets of plans have been submitted for plan
check purse:ant to the Oregon Structural Code and Fire & Life Safety Code, 5— edition.
PROPERTY OWNER: OWNER'S ADDRESS:
CONTRACTOR: TELTWONE:
JOB ADDRESS: ok — r 3 /o+ LOT NO. 6 MAP:
DESCRIPTION OF WO!U : tQ
Approvals Required SPECIAL NOTES
OPlanning Dept. O Reissue
(� Engineering Dept. O Flood Plain/Sensitive Lands
Fire District O Seger Availability
Other
O Other
Items Required
GList of subcontractors
OBusiness Tax
0 Calculations
0 Truss Details
01 Parking Plan
QLandscape Pian
O Other
COHW NT S
City of Tigard Building Departwnt
DYs -
Wprk5hec4- FLAN CHECK NO.
for inspections call 639-4175
PERMIT N0.
CITY OFTIGARD 639.4171 DATE -
BUILDING PERMIT
P.O. Box 2339/,
ox2339/, Ti/gard OR 917223 TAXMAP'-S/-5""O LOT NO. 142
OWNER-T-1-.
—
JOB ADDRESS 12-t,�Z—�-��3/sT P1 p
[WILDER W ( 0 � -T�►� � d _- —_ STATE REG.NO.ACL -EXP.DATE �y --
BUILDER'S PHONE �G,,
ARCHITECY�!�,/ - PHONE_ ZV- TOTHER _-
STS E d NEW ClREMODEL C) ADDITION ClREPAIR ❑ MOVE U OTHER C) DEMOLITION
"SIDENCE ❑ COMM ❑ EDUCATION ❑ IND ❑ RELIGIOUS ❑ACCESSORY Cl GARAGE ❑ OTHER ❑ FENCE
OCCUPANCY�'�-�L—._LANO USE ZONE AL 'L-�1T&.TYPE �''� FIRE lONF PLAN CHECK BY' ,`r tif-AT
Construct single family dweiling w/atta_ched Qarage, all ,n__r_capproved p 1aAc -- ----
Su 'ect to 85 code -- - _
SEWERPERMIT# �. ; r-/ y ' '(1du) baths -�?_._ ----- -
tra 5 ya age arra
OCC.LOAD FLOOR LOAD `/ c-'_HEIGHT NO STORIES AREA NO.BEDROOMS 3VALUE
BUILDING DEPARTMENT - SET BACKS FRONT % REAR ? tl LE�-T SIDE RIGHT SIDE
Permll D 1� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATION.;CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES.AND IT M HEREBY AGREED THAT THE
PUA Chock 2.5 2�— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE.
WITH ALL APPLICABLE CODES AND ORDINANCES. THE WUANCE OF THIS PERMIT DOES NOT WAIVE
PI.CIL F" --- RESTgjCTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
SK TAX PERMns.SEPARATE PERMITS REOUIREO FOR SEWER.PLUMBING AND HEATING-
State Tax /S -,SCK-
SDC- _LIC___
Total 5 i1PPANT OR AGENT
- N[X",I
elpl No AGGRESS
PHOW
Bal.Due S 5 S
Issued By___-_----,Approved BY
S5DC
SOC -
RECEIPT k
DATE PD.
SEWER CONNECTION 5 '745 — AMOUNT PD.____ __
SEWER [N5PECTION S 3S
SEWER SURCHARGE S
a m m e n t e : ----_---- — --
1l w- WAw 4 W K
BUILDING PERMIT APPLiCATION DATE
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED LUILDER PHONE
OR AS SHOWN AND APPROVED 111 THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
�r <
fYCOrrlg 1ti11 LPT N0
OWNER JOBADDREa3 131Ftt Ave. }'Arnin?
-
I u Oi+ ARCHITEC" piarcy & RsIrC1+eY
ENGINEER
GUILDER '' ADDFtSS PO Boa :3454, Tigard DUSIGNEt 610-4551
STRUCTURE (3 NEW_ ❑ REMODEL ❑ ADDITION ❑ REPAIR -T C_; RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
L].RESIDENCE ❑ COMM Cl EDUCATIONAL F-1 GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY -li3.._- LAND USE ZONE -2A.S BLDG.TYPE --5-11 -FIRE ZONE FLAN CHECK BY _lJG); HEAT
(7vnstruct Aiw,ie� imily dvellinP w/attached garage, all per apprkmed plans.
Subject to t',5 code. _
SEWER PERMIT# 3309 1 (1 ria) 3 Withe, 14 traps, raraee arca 450 -
OCC.LOAD FLOOR LOAD 40 HEIGHT- 21 N0.STORIES 1. AREA 1895 N0.BEDROOMS 3 VALUE 94 9600
BUILDING DEPARTMENT SET BACKS FRONT 29 REAR .31 LEFT SIDE 10 RIGHT SIDE I�1
Permit 388.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
75220 REGULATIONS AND ?,LL 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. THD: ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
15•5, - LICENSE.$EPIA�tATE P RMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stele Tax 600.U(i
655.77 SDC -
Total _ _ - r0.PDC# 150000 APPLICANT OR AGENT
By 1"100.1"100
--- -- Recsipt No. E88 -
Approved SS5.72 PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING' nr /G� 7 DATE
`T 8� Contractor/l�CXu�'-C.r2
1 WAc 7 Permit No..f21
+�7/G �ifl.�i ¢eR w�i wp y Rough-in
-AJ'VFixture
Final
HEATING
Contractor
Permit No. y19
$—2y4 <_Z4 __ Gas or Oil
0% Rough•in
1-• y 0-, ,�- �t�� Final
SEWER
Final
DRIVEWAY
Final
—__ Storm Drainage
(Rain Drain)Final
—_ Sidewalk
Curb&Street Final o
-- — .—.—�_ -- - Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CER71Flf.A'PE OCCUPANCY
Landscaping
Zoning Final
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