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Cvc� buX cJY7 host INSPECTION NOTICE
S�d City of Tigard Building Department ( 1
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested J Time---- A.M.—P.M.
Address ��_� i S� _ _ Permit
Owner Lot #
Builder a'� U lCLL) +Ac-yn 7� r , �� t/, L(' �r,�7 /y 4 lu
The following Building Code deficiencies are required to be corrected:
Presented to Pr Approved
Inspector _ — ❑ Disapproved
Date
CALL FOR REINSPECTION
YES L1 NO
INSPECTION_NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection - - — --
Date Requestbd_— ��'"� C.. �_ Time A.M. P.M.
Address .-` Z?' ' s _ Permit *—
Owner -- -- I -
Builder ���.2�The following Building Code deficiencies are required to be corrected:
Y
Presented to __—�_.�___ u Approvad
Inspector L_1 Disapproved
Date
CALL FOR REINSPECTION
LtT YES Ll NO
i
P.O.Bax 23397
r- ITY OF TIGARD PLUMBING 13125cMHaU Blvd.
PERMITM IT Tigard tR 97��
M
Applicants must hold Oregon Registration to conduct a plumbing 539`-11175
business or must be pmpy owner/operator not hiring outside help.
Nwrw of Dewlppnent
Plumbing Permit No. zL 2-
Aadresz Description
2 2 2 ',D r` ORS 814-21-410 DUAN, PRICE AMT
Job Tax Lot Map.NO. --^-- - --
Address - FIXTURES
hl Block Subdlvlskm __. -_----
Sink / 7.50 -75-6
No.,,,or name or - -- _v -
business) Lavatory7.50 i 7 U
Tub or Tub/Shower Comb / 7.50 7 ��
__—
Shov.erOnly - --- -- -L- - 7.50
Owner City/ tet-3 0--- rip WaterClosel - - -- _3 - 7.50 12
Dishwasher / 7.50 J
— Phone Garbage Disposal -- — -_1.-- - -- 7.50J 9�z
- Nome Washing Machine _-^-- - / - 7.50 9J��
Floor Drain 7.50 _
fAddress - __ » Water Hcater / -- -— 7.50
--- ---------
OccupantCdy/State ------ Laundry Room Tray--- --� �- - 7.50
Urinal 7.50
Name Phone Other Fixtures(Specify) _ _- r--7,50
_ 7.50
er rq Address Phone �-
7 50
COntractor iy-/State rp ----
��- MISCELLANEOUS
City Bae Tax No. Sewer,1 at 100' 3000
Tate and No.- tate s sTW SO~-03,AddA.100 _ _ 15.00
(R tial) Water Service 1 st 100 / _20.00 Vo
I hereby acknowledge that I have react this applicattun,that the Information Water Sennos ea.Addil.2M' 15.00
given is oarsct,Olaf 1 am rsgisiered with the State Builders Board,and also Storm 6 fiairr Drain 1 sl.100' 30.00
th
have a Sta,e pkxnbkV Oconee at the n urntws gh.n are correct,that all
pkxnbwv work will be dais w,accordance with appW-sible provisOns or Ore Storm 8 R Jn Drain Addd.100' 15.00
gon Revised Statutes C+u filen 447 and 893 and applicable codes and that Moblb Horne Space 25.00
no help wig be employedns
urress licensed un dw ORS BOJ. (If exempt frau --- - - ---
State ro&trakn.please give reason betov,). Back Flow Prevention
HOMEOWNERS-1 hereby certify that I am the owner of hero property de- Device or Anti-PolkMion Device 7.50
sorbed above,at which location I pnopoe i to male a pkxnbktp installation for Any Trap or Waste Not
mY own use and this prop"Is rid bokV oonstrugd for sae,lease or ren Connected to a Fixture -
Cakri BasMt__ 7.50
-- - kisp.of Exist Pkrrrbwy W. 40.00 Per Hr.
- -- - Specially Requested InspeCti na 40.00 Per Hr -
- AIIM.of Plumbing w0diin
an Exlalk>q Bldg 15.00 ruin --
AuTi4onizith 8KwATUR bat* Now Bldg.or Budd.Addltlon _ 25.00 nNn.
--- Pain , Sillily f ulil
Dsatxibts work new« addition L� aMMstbn❑ repair( l AA--U im 15.00
_be dons _ residential L7 non•Maidentlal - -
6dstiry use of - ---
tx WoPer1Y =TOTAL / .+
Priciposed to"of
( TCYTAI 162 7 ir
NOTICE -
Ttts1 pwrnrll b000rnae null and sold a worts or oonetrucslan outh"ed Is rk-A oom-
marroad WW h 1110 daya,er 0 oarttrur len or work in suspended r»sk)o Boned lox
s poring of 1110 csaye d any eine crier wurr is orwm"onosd
tlhCIAL OONOf til)"_ _ .-
Dau+ issued
f
BUILDING PERMIT APPLICATION DATE (4641
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOn THE WORK HEREIN INDICATED BUILDER PHONE
657-7444
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPE('IFIC 4TIONS. OWNER PHOT f --
LOT NO.
�_ JOB ADDRESS 1 >>N 1 7 Z —
OWNER 5kwicvr 1lL.ni_�s �_� -' " — �7 � g $1411
ARCHITECT
same [{8 44315 3/4/88 ENGINEER J. Gerrard
DESIGNER
BUILDER ADDRESS ---- --"6'5r3r 295'i"
STRUCTURE 044EW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
a RESIDENCE Cl COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS [I PATIO ❑`CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY F_LAND USE ZONE BLDG.TYPE __5h ___FIRE ZONE PLAN CHECK BY __&CR-HEAT— _
Con eruct single family dwellital w/attachesd �Iraan, m] 1 per t9pp> vco lana.
gitbject to 85 cock. —
SEWER PERMIT# 3 34 7 7(di.t) 3 berth 13 t raps ganige area 462
OCC.LOAD FLOOR LOA_D__ HEIGHT NO.STORIES 2 AREA 7.107 NO.BEDROOMS 4 VALUE 93`;00—
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 44 LEFT SIDEy RIGHT SIDE 24
Permit 415.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
.75 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Z6A
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS, CONTRACTOR A,-40 SUO COIITRACTORS TO HAVE CURRENT CITY BUSINESS
16.60
LICEI�$�"'.,4�.PARATE PERMITS REQUIRED FfjR SEWER,PLIYIMBING AND HEATING.
State Tax _ tt'
703 . 35 SDC- 600.00
Total APPLIAN 'R '
- PDC#
By 100.00 T 150.00- /'
��� �3 S
-� Receipt No. -DDS- _- PHONE
Approved _
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Q !� ContractvC� /6L7' 11 /G-8?
0-12 �1 of(1 �o5f' 4, f Permit No, s�.2
��— u� .yif1 LO?G Rough-in
Fixture —
e oyg� Final —
S�zs`" �.. HEATING
Contractor —
Permit No.
�O--lj �/l► �j// �Kr� Gas or Oil
Rough•in —
I
/Mi/J t✓ ��� Final
ILL
SEWER
11-0-8 ' (A� tiS iLaerrs IE. Final —�
es.,c CDRIVEWAY
Final
_ Storm hrainage
Main Drain)Final
—_ Sidewalk
Curb&Street Final
Approach
BLGDEPT. INAL TEMfir•
CERTIiCATE:�CCU�"ANCYCERTIFICATE OCCUFNFinal
Landscaping
Zoning Final
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PLAN CHLCK Nu.
Lor inspect ions call 639--4175
PERMIT N0.
C "IOF TIGARD 639.4171
DATE
BUILDING PERMIT
P.O. Box 23397, Tigard OR 97223 TAXMAP _LOTNO. g2 SUBDIVISION rn N�uG H/K
A/d
OWNER. r'., N L__ JOBADORESS t� '-- s c i / �_/ s� �� --
BUILDER �5�DL 7 H 00 y'r1 % -M - STATE_REG.NO. `1 '� EXP.OATE
7 q� -It
i
BUILDER'S PHONE ' '
ARCHITECT TO ERRRRI) PHONE OTNI:R _
STRIICTURF_ NEW ❑ REMODEL— O ADDITION 0 REPAIR ❑ MOVE ❑ OTE ER 0 OEMOLITION
ORESIOENCE ❑ COMM ❑ EDUCATION ❑ 1':J ❑ RELIGIOUS. C)ACCESSOkY L)_GARA E O OTHER ❑ FENCE
OCCUPANCY _3 LANG USE ZONE X' 'V -S BLDG.TYPE 'v FIRE ZONE,_ PLAN CHECK BY 14,E AT l� —
Construct single farm ly dwel lino w/attached grgr;age a] I per apprc,v,ari
— Sub.ipet to 85 code - - — - ---- --
SEWER^ERMITI, 33 -/f z' '( Idu) 3 baths, /•J traps garaye arcam'!
OCC.LOAD FLOOR LOAD `,/ 0 HEIGHT NO.STORIES %_ AREA ' t'NO.BEDROOMS VALUE '.j .�
BUILDING DEPARTMEN'T, SET BACKS FRONT :.1- 171 REAR yy LES SIDE RIGHT SIDE
Pa rrit _ yi, THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE OUILDINQ CODE. ZONING
REGULATIONS AND ALI.APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE
Plan Chock 2, 46 9 JWOIRK WILL Or DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICAnONS AND IN COMPLIANCE
.r WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THL'C PERMIT DOES NOT WAIVE
Pt.Ck.Fki RESTRICTIVE COVENANTS CL`NTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERM[T5.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AMC HEATING.
Slats Tax.-- JSoc
SDC ._ __
- -- -
ToIaI (7 APP,►CANT ORAGENI
--.---- PUG
Prepd. O ' -- -- ' —.
--' PNON[
.3S Recelpl No AODRESS
Bal.Due 7
Issued By - --Approved By
SSDC
SOC - _� fir' �' — RECEIPT b
POC — Y'
DATE PD.
SEWER CONNECTION S ' -KAMOUNT PD.
SEUER INSPECTION S� .� S
SEUER SURCHARGE S -"
:0mmente : _ — - — — — _--
(:1 I Y VI- I IUAHU Mh(,;HANI(;AL PhHMI 1
Pormit M
Description
City of'Tigard
Table U nl
Mcchacal Code CITY PRICE AMT
- — ------ --
1,3125 S.W. Hall 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 8 vents 6.00 G
Furnace 100,000 BTU +
`) incl,ducts 8 vents 7,50
1�g Name of Development 3) Floor Furnace
incl.vent 6.00
Job Suspended heater,wall heater 600
Address /,�,�2 3 s r 4) or floor mounted heater
Tex Lot Map No 5) Vent not incl.in
_ 00
Lot Block subdivision appliance permit 3
Name(or name of business) 6) Repair of heating,refr ig., � —
�j,t.-�� .��✓ 00
woiing,absorption unit 133
Halling Address r�gne Boller or comp to 3 HP
Owner 7)
absorp.unit to 100,000 BTU 6.00
ciryistate zip Boiler or romp to 3 HP-15 HP
_ 8) absorp.unit to 500,000 BTU 1 1.00
Name 9) Boller or comp 15-30 HP
- absorp.unit 112-1 million 15.00
Matting Address - 10) Boller of comp to 30-50 HP
Contr2ctor
absorp.unit 1-1.75 million 22.50
----- - -- — —
GiyrStata zip 11) Boiler or comp to 50 HP
absorp,unit 1,750,000 BTU 31•SO
State rtegfatrot No. — city&A TaxAir handling unit to
12) 10,000 CFM 4.50
1 twOby aClnowledge that I have read tiws appi"lron that the informationgiven is 13)— Air handling unittx,nact,that I am Ina mvr,er or autlnonred agent of the owner,that plena submitted aro M 10,000 CFM 1 7.50
_._..
rxxr+p &noa wlth State laws,tha!1 am registered will'the Slate Bulkier•Board,that the 11 Non portable
nn gNon is c orred (11 ove(TO from Slate registration please give reason below) ) evaporate Cooler 4.50
---- - - 15) Vent fan connected
to a single duct 300 4F
--- -- -- Ventilation system not
16) 50
----"----- ------ �—_ aIncluded lot aYrfiance permit
— -- -- -- Hood served by —---- --
17) mechanical exhaust / 4.50 y 1"0
S17nalur+(owrw ix so")--- _ [Hu Dofflos CtypA Y--
Descrlbe work I'( addition O alteration O repair p 18) Incirwallor _ 7.50
to be done residential __ C!lmmerdal or Industrial �—
,f'l non-residential []
19) type Inoinerelor 30,00
Existing use of
building or properly20) Other I.e., iroodsto".Quer
Proposed use of - -— --- - -- healer,solar JapthWiffryers,etc 1 y n°
building Or property--�_- — -
- 21) Gas p1pin9 one to four outlets 2,00
Type of fuel- oil (-1 natural gas LPG (I electric I 1 — - --
22) More than 4"r outlet
MCI —
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUB TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE I• y a
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR — --
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTFR PUN REVIEW 251 OF fSUWTOTAL q
WORK IS COMMENCED -- TOTAL 145- Y of l--,V
.nal Conditions
1)AIR ISSIIe(1 --- --- by
--