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c J INSPECTION NOTICE
r City of Tig, ,d Budding Department
P.O. Box 23397
W Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested��� ��7� Time ✓` A.M.. / P.M.
Address Z 2/ -L� /r'0L�—_ Permit
Owner.� Lot #
P,jilder
The following Building Code defici&. ies are required to be corrected:
Presented to JL7-t Approved
Inspector — – ---- �� Olupproved
Data
CALL FOR REINSPEC770N
YES C1 NO
k'.U.bax lJJ'�l
CITY OF TIGARD PLUM13ING 1:312 90JB31 R1VJ.
Applicants must hold Oregon Registration to conduct a plumbingPERMIT 1'igvd CR 97223
business or must lx property owner/operator not hiring outside help. 639-4175 ���yyy
N 1 eveloponent 5 :3
a4 r7 i Plumbing Permit No.
dress S F- Description
Job - ORS 814.21.4610 QUAN. PRICE AMT
Tax Lot Map.No.
Address _ FIXTURES
Lot Dock Subdivision - -`
Sink 7.50
ame or name of
/�.pness Lavatory 3 Y 7.50
Tub or Tub/Shower Comb. / 7.50
MadM4 Address
Shower Only 7.50 C
Owner City/ tate - Zip Water Closet_ _- 1.50 �Z7Z4
Dishwasher 7.50 !i
- Phone ,tage Disposal A 7.50 7,SZ)
- Name Washing Machine -- , u 7.50 7,5D--
Floor Drain7.50 _
ori ing Address Phone Water Heater -- _ _ - 7.50 ?r
Occupant City/Stale tip - Laundry Room Tray - - 7.50
Urinal _ 7.50
Phone
Other Fixtures(Specify) 7.50
7.50
roes / 7.50
Contractor / ZIP7.50
7 Q , MISCELLANEOUS
City Bw.Tax No. Sewer 10 100' 30.00
State"a.Board No. StatePkxnbers
3� Sewer-ea.Addrt 100 ---_ 15.00
Water Service 1 at 100' / 20.00 �O► 1�!- l73 � --T
1 hereby aeknowMdpo that I have read tis appaceaon.the the kilormallon Water Service a Addit2M 15.00
ptven is correct,Thal I sm nsyisfered with the State 1kAkises Board,sed also Stone 6 Rain Drain 1 at.100' 30.00
hove a,State Pkm*A hg Ikmnae that the rnxnbers given aro aired,that all --
p4umtmV work will be done In rcxondsnoe with rppticat le provisions of Ore- Storm&PrJn Drain Addit.100_ 15.00
90n Revised Statutes Chapto rs 447 and 093 and appbcable owles end that Mobile Home Spam 25.00
no help will be ertghbyed unless loomed under ORS 063 (II eRempt from - -
State registration,please give reason below) Badu Flow Pnwentl on
HOMEOWNERS--t hereby oerWy that I am the owner of the property d@- DeviosorAn#-Pot xk)nDevice 7.50
scribed above.at wthlch oc don 1 proprio b make a pkarhbing installation for Arty Trap or Waal Not
trey own use and this property M not bekhg oo struded tun rake.tease or rer" Corlrte0led to a Rxbjm 7.50
Catch Basin 7.50
_ _-__ -. ---------- __ k".of Exist�Pkambkhg ---- 40.00 Per Hr --_
Specially 1Mp00" - 40.00 Per Hr
_-.-- ---------.-�'�-.--- - AIWr of Pkrn"wMfMn
- an Exlstlng Bldg 15.00 mkt j
AUTHORIZED SI ort New Bldg.or Build.Addition 25.00 RM
Raill
Dsacribs wo rk eddition(] al'Wstion C7 repslt t ) well' 15.00Ir
C�
to be done - residential dentla
- non-f" l ^-
Exllging use OI
Ak*v of pre fty - ------ -- NOTAL
ai�l�li+o«o+opdTOTAL«ey
NOTE _-.. _
ICr " _
ffdtl p0M*beDontes NA and troll to work or aolNrtioron sudtortaed Is not axe
wanosd ttAM 1r10 doom 9 pard6wotlon or wahls Wspanded or stwsdosid la
a perkxf of 180 days at any wne tlaw work M oWMW%ovd
Deur Maued by
t7Cts Ws t h r a� ..
I
4 �s 3�'
BUILDING PERMIT APPLICATION
THE UNDERSIGNED HLHEBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICNTED BUILDER PHONE 245-2525
OR AS SHOWN AND^.PPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 19
LOT NO. R 5` S 1
OWNER Ti7ri hart 174111. JOB ADDRESS 1"279 SryW I31et 'Horning, Toll b
— - -- —---- - ARCHITECT
ENGINEER
BUILDER __ ADDRESS _ _ DESIGNER
STRUCTURE LjNEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIME DAMAGE ❑ DEMOLITION
❑RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ ST09AGE ❑ SLAB❑ FENCE
OCCUPANCY M—LAND USE ZONE 114•S BLDG.TYPE !5?1 FIRE ZONE---PLAN CHECK Bim_..r1CR—HEAT
CAmstrtsct single family *Oe1linR ter/ntteched X'ArRAe, all POs QVPrOve(l Plana.
Subject to 85 code. T--
SEWER PERMIT# 33493 (Idu) 3 114ths. 11�ra 1.lAxnPt'• Aiet3 b � _
OCC.LOAD FLOOR LOAD 40 _H_EIGHT 21 NO.STORIES___ AREA t733 NO.SEDPJiOMS 3 VALUE 78,9(
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR fi(1 LFFT SIDE RIGHT SIDE I3
— — --
01
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING (ODE, ZONING
240*50 REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGRcED 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
bub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
14.80 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax _ "q. `''
Total 625.30 SDC—
PDC# 150.00 -APPLICAhT-ORAQENT
By
1001(x1
—� — — Receipt No. -- -- ------ t 1 r
Approved 575,30 — PHONE
DATE INSP. TYPE INSPECTION -REMARKS PLUMBING DATE
Contractor
n Permit No.
Hough-in
Fixture
/ Final
'r COL
HEATING t
Contractor
Permit No. I I
Gas Oil —_
.� — -- Rough-in _—
f��/r _�.c�__�C K _ —._ ---•— final — -----__
SEWER
— _ _ ------ final
— — -- DRIVEWAY
- Final
Storm Drainage
(Rein Drain)Final
Sidevwlk t;N✓'/J
Curb&Street Final
Approach I
BLDG. SEPT.FINA1_ —r— —TEMPORARY CERTIFICATE OCCUPANCY Finnl
CERTIFICATE OCCUPANCY —
Landscaping
Zoning Final
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k--i I Y ur- I IUAHU N LUHANI(:AL 1'tHM1 I -
Permit M
Ds swiptlon
Te bite JA Mechenlcet CodeOTY MICE AMT
City of Tigard 1) Permit Fee _ 0• -0- 10.00
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 600
incl.aucts&vents
2) Furnace 100,000 BTU 1 7.50
it ducts 6 vents
bprno Floor Furnace
.3-7 Name of Dewe -- � 3) incl vent _ 6.00 -- -
Job AddressSuspended heater,wall heater
2-2 7 — 3 /p �) or floor mounted heater 6 00
Address _ -- ---- -----
Tax Lot Map No Vent not incl.in 300
Lot b S Block Subdr vi 5) appliance permit
Name a name of business) 6) Repair of heating,refr ig., 600
i cooling,absorption unit
MaiAddress Phone 7) Boiler or comp to 3 FIP 6 C><1
Owner absorp.unit to 100,000 BTU
City/State zip 8) Boiler or comp to 3 HP-15 HP 1100
absorp.unit to 500,000 BTU _
Name - 9) Boiler or comp 15-30 HP —T _ 15.00
_ absorp.unit 112-1 million _
Maui�,�Heiress-- Phone 10) Boller or comp to 30-50 HP -—--- 22.50 - -
absorp.unit 1 -1.75 million
Contractor 6iyrStae - --- zip 11) Boiler or comp to 50 HP 31 50 -
_absorp.unit 1,750,000 BTU
Stele raegiafretion No — v City Bus Tax No. 12) Air handling unit to —' , �—
1 ),000 CFM
I ne(etY tuirrowledge that I have read this appkcalion that the information given is 13) tflir handling unit --
to,000cFM + 7.50
coned,that I am the owner or authorized agent d the ownw,that pians sutxnitled are in —
comPaence with State laws,(tat I am registered with the State Builders'Board,that the 14) Non portable 4 50
nrxntwi given is tuned.(N exempt from State registration phase give reason below) evaporate cooler
--- 15) Vent fan connected 300
-- _ y 12 -
-- toes+ngle duct
PP --
16) Ventilations stem not 4�
included in appliance pe rmit
C 17) Hood served by 4.50 [� 1
mechanical exhaust ! JZ
/ i�iahx-9( or-@- 7.50
r --- _— — -Dara type.
)
Descri work I❑ addition p aReration [I repair (1 18 incinerator _ 7.50
to I,e clone - -- residential [A non•resldential ❑ — 19) Commercial or industrial
Existing use of -
type Incinerator 30,00
building or property ---2 a,&Z�_t� -__—._ 20) hOtherle i.e.,t r,clothes
water 450
Proposed use of hewer,soler,Clothes dryers,etc —_
building or property_-- _--, —__-- —_-_-- 21) piping one to four outlets ( 2.00 Z
-Type of fuel- oil ❑ natural gas GU LPG O electric (7 1 -
-J 22) More than aper outlet
NQ11SrF _ -------- SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- - —
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S%p 41t 8URCNARQE + 7
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW tali OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 1 PO DAYS AT ANY T IME AFTER —
WORK IS COMMFNCFn TOTAL
Special Conditions
Dale Issued__ .-_ ._._ by
■
Wpr�S�'IPe� PLAN LHLO\ NU.
for inspections call 639-41.75
PERMIT I:i . 3
CITY OF TIGARD 639.4171 DATE -- --�-
'�' BUILDING PERMIT
P.O. Box 23397, Tigard Olt 97223 TAXMAP--"�-'B LOT NO. —SUBDIVISIONI'-fe G
/ �� JOB ADORLSS
OWNER__ i 7- C'_-� S r
GUILDERSTATE REG.NO. EXP.DATE
BUILDER'S PHONE 2 y
ARCHITECT
PHONE OTHER -
-_____ -
STRUCTURE Q NEW O REkOOEL ❑ ADDITION ❑ REPAIR ❑ MOVE ❑ OTHER C) DEMOLITION
❑ RESIDENCE 0 COMM O EDUCATIOK ❑ IND ❑ RELIGIOUS. ❑ACCESSORY C) GARAGE ❑ OTHER ❑ FENCE
OCCUPANCY LNNO USE ZONE — —(ILDG.IYPE .— FIRE ZONE__—PLA..CHECK BY ►TEAT-�
Construct single fami 1Y dwel I_ ing w�3Si1 -hs�e�9araa� Lll�ierppxr�ae.:d�:�.�c — --
_Sub -P.rt to 85 c9de —_- --
SEWERPERMITx,` ,3,-/,i,_3 -(Idu) baths. traps — cAraae area — --
_OCC.LOAD FLOORLOAD HEIGHT`••STORIES AREA NO.BEDROOMS VALUE
BUILDING ARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
PKml1 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS t,ONTAINED IN THE BUILDING CUUE. ONiHG
REGULATIONS AND ALI.APPLICABLE CODES AND ORDINANCES.AND IT IS HEREBY AGREED THAT THE
PUA Chock WGPIK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH )ILL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
01Ck.F" RESTRICTIVE CO:INANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REOUIREO FOR SEWER.PLUMBING AND HEATING.
Stale Tax t6l--
----- SDC- ___
Total APPLICANTOR AGENT
PDCJ
Prepd.
-- Rete p1 No A00nESS
Bal.Due
l u ue4 B y
SSUC
SOC - �dd ---- RECEIPT N
POC _ - __ L____,_. --- DATE PD.
SEWER CONNECTION 5 AMOUNT PD.
SEWER INSPECTION S
SEWER SURCHARGE S_ _-
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