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INSPECTION NOTICE
�-� City or Tigard Building Depa,tment
P.O. Box 23397
2 / Tigard, Oregon 97223
Phone: 639-4175 I
Type of Inspection I I
Date Requested Z - / Time -"— A,M. P.M.
Address Z 2_ Permit #_� Z—
Owner _--__-- !_ Q L2'
Lot #
Builder
The following Building Code deficiencies are required to be corrected:
r_.�r .� e,✓L u,-.;
Presented to
�L ;—' Approved
In +f
J / proved
Date
CALL ;h�'101��CTION
YES (�] No
I NCCl97u�v
City (-)I. HOARD PLUMB Titer
.yxrikarxs must hold Oregon Registration to conduct a plumbing PERMIT &19A175
txnlncss of must be property ownerloperstor not hiring outside help.
Nara Of[HwbQnNnl 7
-1IumbhnK Permit No.
"`'Z*L- y 5�J 1 OASup�21-Et0 GUAM. PRICE AMI
Job Tarr Lat Map.No
Address
FIXTURES
LM Dkx-k Stbdivlabn Sk7.50
ic _
- art» or name _ ss Lavatory i 7.50 -
1/J
Tub or Tub/Shower Como, �_ _ _ 7.50
W,.iwp ass ShowerOniy -- ` -750
- J WaterCbsel 3 7.50
Ownerity/ tate ZIP --- - - - ` -- 750
Dishwasher
---------�
NK" u --- Garbage Disposal -- 7 SO
- Name - Washing Machine 77 f - 1 50
Fbtx Dram _ _ _ ?50
i inq dSS" ---- Phone Water Neater
Launory Room Tray ?,50 _
Occupant City/Slate ZrP - -_--- 7 SO
Urinal _ _
-- Name Other Fixtures(Specih) -- 750 _
WI;VAdd(OS3 Phone
� �-, - ---- ___----- --- 750
750
Contractor Csy/State Zip
MISCELLANEOUS
_ City Boo Tax No Sewer i et 100• �0 O0_ -
G. Z�- Sewer-ex Addit.100 _ _. _- 1500
tab s -�a1e s BUS BE _-_
(Reedsntial) Water Sewlos Ise 100 - _ _ -.2000
1 hereby scluawladp.tut 1 haw read this WpNr-~.Hurl the Information Water S•wia sa.Addis 2010 - ---15.00
given is Oorraol thM I am reglsiered with ttw Stab B.rilder'a BOard,and ebb Rorie i Rah DrNn 1I 100' -
neve:SW Plumbhp lowee tui to nunhtwo given ars OOrteu.thel at 1500
Pk0 V A*hg wort'04 be done In am!>rdemv with applicableP OWIlli rn d Oro- Siwrrrl i Aye nrtkh Adds 100' _- _
gon RevtW jUrkiles Guilt my"7 ane C93 and apps sable bode.and 1101 Mobile Nora Spam 25 OO
no two w*be enpioyed trnlsta Mcereed under ORS 003 (M exempt emfro- - --__
Slate rtgb+raebn,pleat+give rsaeon below). Balt Flow Prtrvw*w
Ho OAEOwhtERS-1 hereby osr*y that I am the owrw of the property ds- Devloe or And-l"okhon D*V" 7 -
tcrbed above,sa wRMch locatrxh 1 prvpcee to mike a plunhbhg holaKatlon Ior Any Trap or wast Not
ITT poet us*and tie propwty Is not being MostrucMd Torr sale,laaas Or r«ht Conneclad to s Recut 7.50
►` Af,=ti x. lTi Ll , t.LLc. Catch Basin - - 7 S0--
Mea.of Exist.Ptun long 10,00 Per MM
rya Rnn!!d M►et`-w,% 10 00 Per to
AJtw of Karl"whin
an Exlserq Btdg - _1 S 00 inn
AUTMORVED SKM"TURE �1 Deft Now Bldg.of P W.Addttkm - _4100 non
fariul _
Deecrbe work new sddition C7 aftwation❑ repair U7 dwell _ LS.ra)
19-020t residential(] noes al rl —_
E.xw"use of
W tip of"DPwb _--------- — ----
HTCE - Vol"oOT
T?ft Pttr W Isttotltss stent and bco ff wu*or rho wrw@on atleht omo Is not oorit.
UMrreslttllllM'it 1�O�IR1w 1 osrt/rtsatlofl Or woAt r slstpwded a absnrtor'rd ler
tl Perla M r ser fins aftr WM*y CWVW16tosd
MMoant.otrMlolHol0- - —-- - Dat. In"!
- - - - - 77
BUILDING PERMIT APPLICATION 4lATE_— 1..� �s_-__ S$62
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE 639-6861
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OQWLNEQR,P�}ol _�
OWNER .0 Contractors JOBADDRESS 12274 Sw ] it it LQ /N ri�rn�lCr9�rZv
V Box 23454 Tigard OR - ARCHITECT fi L. Taft 41844
ENGINEER
BUILDER ADDRESS _ DESIGNER
STRUCTURE I� NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
L I RESIDENCE ❑ COMM Cl EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB[] FENCE
OCCUPANCY _,— 3 _ LAND USE.ZONE BLDG.TYPE _ FIRE ZONE--.-.PLAID CHECK BY 7 HEAT
_;��ts� _.1 . i.ncj.lr fetmi�dwez.lin w attach d �c�r�tq4, all per �aved platin
i;ubit'ct # 85 cc�de. -- - - -
SE:WERPERMIT# 34015 3 baths, IItraps garage area 419 _
OCC.LOAD FLOOR LOAD _40 HEIGHT _ 20a NO STORIES 2 __ AREA 1844 NO.BEDROOMS 4 VALUE 82000
BUILDING DEPARTMENT SETBACKS FRONT FEAR 15 i_FFT SIDE 5 RIGHT SIDE 5
382.00
Permit _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CON iA'NED IN THE BUILDING CODE, ZONING I
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
Plan Check 24 _, Yl 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 AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State rax 0. 10 SSI)c 2
SDC- 600.00
Total 649.40 -- - -� ` .: �-. , ,�-�;l• __-____
PDC# T 150.0*hICANT OR AGENT
By _
Receipt No.,�~-?�
Approved _—_� . DDRESS PHONE
i 1 aw !1 w
DATE INSPP, TYPE INSPECTION REMARKS PLUFJl8fNG DATE
Contractor �D L3__ 97
l — Permit No. _Tey 5
Rough-in Dumc.s- "�
Fixture
Final
-
/L-Z r+e� i, r , •+ HEATING
X Contractor
q. zs-87
Pei mit No. Li -f
Gas or Oil
Rough-in -
J
Final
SEWER
Final
DRIVEWAY
Final
,Qtj / Storm Drainer
(Rain Drain)Final
Sidewalk
Curb&Street Firal
-- — Approach
BLOC. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
L.andsc:aping
t _ Zoning Final
f
CG TY OF TiGARD MECHANICAL. PERMIT I
Permi8
Description ----�__
Tabir JA Mechanical Code _ _ QTY PRICE AMT 11'
City of Tigard 1) Permit Fee -0- -0- 10.N 1
13125 S.W. Hall Blvd.
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223 —
639-4175 1) Furnace to 100,000 BTU 6.00
incl.ducts&vents` ly
Furnace 100,000 BTU +
2 incl.ducts&vents 7.50
Name of Develop,,ent3) Floor Furnace 600
ac) D em �/` , incl.vent -v - -
Job Address - _ )4 Suspended heater,wall heater 6.00
Address or floor mounted heater
Tax Lot Map No. 5) Vent not incl.in 300
Lot Block Subdivision AJoen r' appliance permit
Name(or name of business) 6) Repair of heating,refr ig., 6.00
_ fir.?y-Cs Ytfi L cooling,absorption unit _
Mailing Address Phone 7) Boiler or comp to 3 HP 6.00
Owner absorp.unit to 100,000 BTU
city state �Zlp 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name, Boiler or comp 15-30 HP
C9) absorp,unit 1/2-1 million 15'00
Mailing Address Ph" 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million
Contractor City state Zip 11) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU
State Registration No City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
I —
1 herebyacknowledge 13 Air handling unit 7.50
edge that I have road this application that the information given is ) 10,000 CFM
correct,that I am the owner or authorized agent of the owner,that plans submilted are In -
compllance with State laws,'hat I am registered with the State Builders'Board,that the14) Non portable 4.50
number given Is correct (if exempt from State regist•khon please give reason below) evaporate cooler
Vent fan connected 3 r1,
1 300
to a single duct
- ----- — -- ) Ventilation system not
16 included in appliance permit 4.50
T - t 7) Hood served by 4.50
mechanical exhaust J/e'<
net re(owner or agent) Date 16) Domestic type 7,50
Describe work n addition [.I alteration [7 repair p incinerator
to be done residential non-residential 11_ 19) Commercial or Industrial 30.00
Existing use of type incinerator
building orproperly_ �` r" ,_ ) Other i.e.,woodstove,water
--'---_-- ------- ----_-- 20 heater,solar,clothes dryers,etc. 4.50
Proposed use of ---- —building or or property __. - __.._.._` 21) Gas piping one to four outlets 2.00
Type of fuel- oil I I natural gas Fri, LPG l I electric (I — — -
22) More than 4-per outlet
NOTICE -
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID III WORK OFi CON - --
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN lot) 10a SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAI.
ABANDONED FOR A PEFAIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED TOTAL.
Special Conditions
l t
CITY OF TIGARD BUILDING DEPARTMENT PLAN CHECK NO. :
PLAN CHECK APPLICATION DATE RECEIVFP:
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID:
This is to certify that the attached sets of plans have been submitted fqr plan
check pursuant to the Oregon Structural Code and Fire & Life Safety Code, _�� edition.
PROPERTY OWNER:OL- OWNER'S ADDRESS :
CONTRACTOR: TELEPHONE:
JOB ADDRESS: LOT NO. MAP: J "1
DESCRIPTION OF WORK:
Approvals Required SPECIAL NOTES
0 Planning Dept. 0 Reissue
OEngineering Dept. G Flood Plain/Sensitive Lands
O Fire District O Sewer Availability
OOther G Other
Items Required
GList of subcontractors
OBusiness Tax
Calculations
GTruss Derails
O Parking Plan
-0 Landscape Plan
0 Other
COMMENTS:
A
City of Tigard Building Department '
BY:
I'
LA,� - I'LAN LriLLN NO. �'L 7--
for inspections call 639•-4115 .�
PERMIT W.
CITY OF 17GAR0 639.4171 DATE ---
BUILDING PERMIT
P.O. Box 23397, Tigard OR 1197223 TAX MAP LOT NO. .�7 SUBDIVISION Ilk I.1 ��
OVaNEPt 41L72 6"')�vtrTO/t /✓G JOB ADDRESS
BUILDER ��� Cen f/�C�!'t� , ��✓G STA!
REG.NO. EXP.OATf. --
BUILDEWS PHONE G 3 9" G l /
ARCHITECT AAy2 PHONE Lr S� �1 C' OTHER
-- --
STRIICTUAE C7 NEW ❑ REMOO'EL ❑ AODITNNH ❑ REPAIR ❑ MOVE ❑ OTHER n DEMOLITIOf
Q RESIDENCE ❑ COMM ❑ EDUCATION C] INO • ❑ RELIGIOUS. ❑'ACCESSORY O GARAGE 0 OTHER ❑ FENCI
OCCUPANCY r LAND USE ZONE BLDG.rYI$E FIRE ZONE PLAN CHECK BY Ll— AT GU----
Construct single family dwe11 inQ atta"h ;aLa�rrt all�}•er approve'- ad p!' i-.
subject to 85 code.--- -- -
L'
SENr EA PERMJT JI •{ldu) baths
. 3u r. aar aga area -�� u
-, , ra5 _ _
OCC:.LOAD FLOOR LOAD HEIGHT_ NO.STORIES AREA Yy y c NO.BEDROOMS _VALUE 42 OS�S.�
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SHOE
PrrnNl U THIS PERMIT IS ISSUEIa SUOJEVT TO THE REDULATIONS CONTAINED IN THE BUILDING :ODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES.AND IT IS.HEREBY AGREED THAT THI
PfanClMck �' �� WO11K WILL BE GONE IN ACCORDANCE WITH"I"PLANS AND SPECIW-ATIONS AND IN COMPLIANCI
WTTN ALL APPLIC-ABLii CODES AND ORDINANCES.THE ISSUANCE At THIS PERMIT DOES NOT WAIVI,
Ft Ck Flri RESTRICTTYE COVENAIM CQNTRACTOR AND SUf2 CONTRACTORS TO HAV
TAX
CURRENT CITY BUSINES
TAX PERMITS.SEPARVE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATIN4
SIato Talc /`�� S'S'OC'
SDC ------—
Total APPLICANT OR AIiFNT --_-
-- PD01
Pf9pd. f 0 0. 00 AOORFSS
Racalpl No
Bal.Oua
1.•uod 9y.__�_ _Jcpwov*d BT--------
SSDC --- S
SCLC - --� RECEIPT #
PDC -� _�
DATE PD.
SEWER CONNECTION S AMOUNT PD..
SCWCR INSPECTION 4 s3
SEWER SURCHARGE t� 1�
:ommente: _ t '�