8975 SW PINEBROOK STREET r,
8975 SW PINEBROOK STREET
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CITY OF TIGARD 639.4171 DATE _ .19
BUILDING PERMIT
`�J 1 �,/ TAX MAP LOT NO _. _.__SUUB(?IVISIOJN� ��- "
OWNERU �u'4 — _tel I JOB ADDRESS _� .3-'�"=J—' _"'a'w�'�
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BUILDER _ � ��� ��L D L� STATE REG.NO. -T_ -EXP.DA i E
BUILDER'S PHONE r :1.�� ---
ARCHITECT _ _— PHCNE — _OTHER
STRUCTURE Cl NEW ❑ REMODEL_ ADDITIGN O REPAIR ❑ MOVE ❑ OTHER ❑ DEMOLITION
❑ SIDENCE ❑ (AMM ❑ EDIICATIOA Cl IND ❑ RELIGIOUS ❑ACCESSC 1Y Q GARAGE Cl OTHER Cl FENCE
OCCUPANCY ':�LAND USE ZONE IZ- L_BL DG.TYPE T N-FIRE 70NE—'—PUN CHECK BY �-W HEAT 4-1&' _
40
SEWER PERMIT M
OCC.LOAD FLOOR LOAD HEIGHT — NU.STORIES ARFA- A iL NO.BEDROOMS VALUE 00a
T
BUILDING DEPARTMENT SETBACKS FRONT RELEFT SIL`Et Z RIGHT SIDE ,
Permit V THIS PERMIT IS ISSUED SUBJECT TO THE Rl.u'ILA IIvmS l J"ITAINED IN THE L;UILDING CODE,ZONING
REGULATIONS AND ALL .'PLICABLE CODES AND ORDINA1/OF`1. AND R IS HEREBY AGREED THAT THE
Plan Check Clio 3 WORK WILL BE DONE IN t.CCORDANCE WITH THE PLANS AND SIPECIFICATIONs AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ()RDtI"AM.CES. THE 1.'-UANCE OF THIS PERMIT DOES NOT WAIVE
PI.CIL Fk_e__ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB COMTF W.TOP3 TO HAVE CURRENT CITY BUSINE�5
TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEWER,"LUMBiNO A4R1 HEATING.
State Tax (� _
— - —�-L-�l- 7 SDC-
Total APPLICANT fIAAGENT �---- ��
Prepd. - — - �� --- ---- -- - --
_� Receipt No. ADDRES i - PNON�
(Ml.Due l/__'_
lmed By pproved By _.
SSL)c --- S
S o C
Poc -Ar--
SEWER CONNECT at.N S
SEWER INSDEC i 101"]L�� _ 911&AAA
SEWER SURCHARGE �-�'°
CITY OF TIGARD BUILDING DEPARTMT.NT PLAN CHECK NO. :
PLAN CHECK APFLICATION DATE RECEIVED:
17
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P.0 Box 23397, Tigard OR 97223 P/C nEPOSIT PAIL,:_
This is to certify that the at,ached seta of plans have been submitted—for Flan
check pursuant to the Oregon Structural Code and Fire b Life Safety Code, mss-edition.
PROPERTY OWNER: 1 I 4 , kWjfirj OWNER'S ADDRESS:
CC.4TRACTOR: TELEPHONE: — 5c ' '
JOB ADDRESS: ?J U //lrQ. bti ebk LOT NO. S MAP: 0
DESCRIPTION OF WORK:
Approvals Required SPECIAL NOTES
Planning Dept. O Reissue
OEngineering Dept. O Flood Plain/Sensitive Lards
0 Fire District 0 Sewer Availability ,
0 Other O Other
Items Required
UList of subcontractors
OBusiness Tax
L� Calculations
0 Truss Details
O- Parking Plan
0 Lat.4acape Plan
J O Other
� I
COMMNTS
City of Tigard B f its Department
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CITY OF TIGAHD MECHANICAL PERMIT Iruuuipi N ----
Permit 8 -1-77 /
Description
Tjqble 3A Mechanical Code
City of TigardCITY PRICE AMT
--_---- -- -
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0• 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 'l Suspended heater,wall heater
Address IJa (�. 4) or floor mounted heater 6.00
Tax Lot Map No. 5) Vent not incl.in
Lot Block Subdivision __ ,)liance permit 3.00
_
Nem (or name of business) � �� 6) Repair of heating,ref,11
k t.1G� _ holing,absorption. .. 6.00
Owner Malang Adores - p►bne -- - 7) Boiler x comp to 3 HP--
absorF,unit to 100,000 BTU 6.00
city�state — Zip 8) Boiler or comp to 3 HP-15 HP
absorp.unit to 500,000 BTU 11.u0
Nemo9) Boiler or comp 15-30 HP
absorp.unit 1/i-1 million 15.00
MaII,n Address Phone 10) Boiler or comp to 30-50 HP
absorp.unit 1-1.75 million 22•50
Contractor CltyfState , - 11) Boiler or comp to 50 HP
absorp.unit 1,750,000 BTU 31.50
gate Registration No. City Bus.Tax No. t 2) Air handling unit to
1 n,t)00 CFM 4.50
I hereby acknowledgo !rat I have ,sad thisAi►handling unit
application that the fnlorrnalion plv9n Is 13) �,� } 7.50
correct,that I am the owner or authorized agent of the owner,that plans submitted art,in --- �0 CFM
compliance with State laws,that I am registered witn the State Builders'Rogrd,that the I s Non portable
number given is omred (If exempt from State regist ation please give reason .below 4,5(1
1 4)
evaporate cooler
-- 15) Vent fan connected
rn0l� to a single duct _ _ 3,00
16) Ventilation system not
Included In appliance permit 4.50
17) Hood served by —
mechanic.sl exhaust 4.'50
slgr{elp►e(owner a aQenq ._—_ .--------- --Ua�o J Domestic type - -_
Describe work ❑ addition Cl alteration -_ rtrpair._j 16) nnci^sator 7_50
to be done residential non-residential I I _ -
---_.� _ 19) Commercial or industrial
Existing use oftype Incinerator X00
building or properly _ Other i.e.,woodstove,wateT�
Proposed use of - _•fir.solfllfclothes dryers,etc. 4.50
building or property
--- 21) Gas piping one to four outlets 2,00
Type of fuel- oil ❑ natural gas ❑ LPG ❑ electric ❑
—r 22) More than 4-per outlet
Non ---
THIS ''PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUB-TOTAL V J
STRUCTION AUTHORIZED IS NOT COMMENCED W17HIN 180 4%SURCHARGE s
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER PLAN REVIEW 1t8%OF SUB-TOTAL
WORK IS COMMENCED. TOTAL iYe
Spadal Conditkxts
---! -- - -- - Date Issued by - -
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for inspections call 639-4175
CITY OFTIGARU 639.4171 DATE "� RMIT NO.
BUILDING!' i,MIT ,S,/• //�B / e7 7'r N'p/dpi/ll,✓/�R/Z
P.O. Box 2l�13yjTigard OR 97!221 TAX MAP _ `WTN �SUR01"�tS10W,
OWNER !�) >41 f /`. �J z L_ #09 AOORESS A�/ -7) ��y/, 11r, ' ZIC
BUILDER /ti�� ���� q� / `- STATE REG.NO. ,. EXP.DATE
BUILDER'S PHONE CI /' 1�7 z z -
ARCHITECT ��dn/!•� __� PHONE._. OTHER _
STRUCTURE ❑ NEW n REMOOEL l AODITION U REPAIR ❑ MOVE ❑ OTHER ❑ DEMOB IIIUf+
Lor: CE ❑ COMM ❑ EDUCATION _❑ IND • ❑ REIJGIC`US. 0-ACCESSORY Q GARAGE O OTHER (1 FENCE
OCCUPANCY - LAND USE ZONE 11 ) BLDG.TYPE '�FIRE ZDI`'G.=:_.�P1LAN Cf 1ECK IIY �0AT
-- • /
SEWER PERMIT I, 4 �,�� me d c
ov
OCC.LOAD FLOORLOAD HEIGHT ,Z ` NO.STORIES ARE a� NO.BEOROO S VALUE-V, SO?
BUILDING DEPARTMENT .SET BACKS FRONtLA4 LEF7FS'QG�-- At�1i�
Perfnit l J 1 L-16 THIS PERMIT;;ISSUED SUBJt:CT fO THE REGULATIONS CONTAINED IN THE 'BUILDING COOS,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANQES.AND IT IS HEREBY AGREED THAT THE
PBanCheck I WOIU;WILL BE DANE IN ACCORDANCE W1Tf1 THE PLANS"D SPECIFFCATMN.i AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND OROINANCES. THE ISSUANCE OF THIS PERMIT DOES %OT WAIVE
P1.Ck.F'ri RESTRICTTVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITI BUSINESS
TAX PERMITS.SEPARATE PERMITSM-01"RED FOR SEWER.F, UMBING AND HEATING
Slate Tax (p , / 0 ssoc_ /� «
S.7 SOC_ , . . J _ __ _.. --
Total APP' AN ENT11 - /
Pcepd. 1 � �cJ/7J ( _ �It7
S6 p
AOORESS rrC Nf
Bal.Due Recelpt No
issued By. --_-Approved By
,SDC $
� RECEIPT M____.________.___�._.__
O'
DATE PD.
C'JCR CONNECTION b AMOUNT PD.
FUER INSPECTION
EWER SURCHARGE S
ado
Immente;
CITY OF TIGARD BUILDING DEPARTMENT PLAN C%ECK NO. :
PLAN CHECK APPLICATION DATE RECEIVED:
P.C. Box 23397, Tigard OR 97223 PIC DEPOSIT . a'D:
This is to certify that the attached _ sets of plans have been submitted for plan
check pursuant to the Oregon Structural Code and Fire & Life Safety Coder edition.
PROPERTY OWNER: /i <i OWNER'S ADDRESS:
`�1
' TELEPHONE:
�j' .3 `�CONTRACTOR: �—
JOB ADDRESS: LOT NO. & MAP:
DESCRIPTION OF WORK: z-
Approvals Required SPECIAL NOTES
OPlanning Dept. O Reissue
O Engineering Dept. 0 Flood Plain/Sensitive Lands
0 Fire District O Sewer Availability
Other Other
Items Required
lam/ List of subcontractors
Business Tax
Calculations
OTruss Derails
O Parking Plaa
QLands ape Plan
(� Other
COMMENTS:
City of Tigard Building Departme.it
BY:
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�"�` ... �► wv4 + ^.,y'�,y,u.r� • s;; +$•ny�P..`.{��Mti.rM •T� {•n7'�+• '\'�-•• arl Lit �•1ZL1 �.�`��•
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.4171
!Address Permit #
Type of Inspection ---
The following Building Code deficiencies are required to be corrected: ._____
Presented to. �-_ --- --- ----- Inspector __------------. --------__--- -_ _ —___� _ - _--
late
CALL FOR REIAISPEC77ON
(] VES ❑ NO
BUILDING PERMIT APPLICATION TIGARD DATE- �9'si.I 3061
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HI_REIN INDICATED BUILDER PHONE U48-1251
OR AS SHOWN AND APPROVED IN THE ACCOMPAN!ING PLANS AND SPECIFICATIONS. OWNER PHONE 639-4472_
OWNER Sod Pa"11'serger JOB ADDRESS 8975 SW Pinelrrook Ct. LOT NO. =+L1 Pitti;hrook
ARCHITECT
ENGINEER
BUILDER (7(,Pm111nitr_C0f18t. ADDRESS 2645 Sts Laurel Ct. 'Ill DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL 12 ADDITION ❑ REPAIR Cl RENEWAL O FIRE DAMAGE 11 DEMOLITION
Ek RESIDENCE ❑ COMM iJ EDUCATIONAL_❑ GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE ❑ BLAB❑ FENCE
OCCUPANCY R" rLANDUSEZONE 11-L—BLDG.TYPE 5'j—FIRE ZONE 3 PLAN CHECK BY �'ITI HEAT
_—_— Construct Pamily PAM 4 ' itcri, Oininn e�tensior_• to eXiat, ai:)::le family
clove 11 inr;. T�
_--- lihe. correctiwi Rheet Attacl•md. --- +—
SEWER PERMIT M
OCC.LOAD FLOOR LOAD HEIGHT 11. NO.STORIES I AREA 400 NO.BEDROOMS VALUE IS?
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE I
Permit 64.0'9 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGRFFD THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THF. PLANS AND SPECIFICATIONS AND IN COMPLIANCE
• -� WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTOPS TO HAVE CURRENT CITY BUSINESS
�..f - LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING..ND HEATING.
State Tax
�f1.5f, SDC-
Total
By
PDCN APPLICAN I OR AGENT - �`--
' �
Receipt No.
Approved A �—�__-_�- ---__-.PHONE._—.
DATE INSP. TYPE iPON REMARKS PLUMBING DATE
Contractor -
Permit No.
3-4- O _ BSc t:4 1A Te ,— Rough-in-- -----
�_ Fixture _`—
S_ZO.� • Final
HEATING I S WRQ
Contractor OrX�
-- Permit No. /777 .fir
Gas or Oil
Final
SEWER
— Final -
_ - --- DRIVEWAY �--- --"
Final
Storm Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Aoproech
SLDG. DEPT.FINAL �—TEMPORARY CERTIFICATE OCCUPA�L`r
CERTIFICATE OCCUPANCY V J Final
--
Landscaping
Zoning Final
1f1L _ Q �
BUILDING PERMIT APP LICA-(ION "'y TIGARD OATS ..I-TISK- 7 14 vo_ 1�T`•' ,�a�pr r
THE UNCII, HSIL)NFDHLFE6Y AF'PLII.S FOR APERMIT FOR THF WORK HEHEIN INDICATED 8U11.E)LKPH014F �/w /
S
OR SH1 "N AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. 0V.'NLF?PNr�r1F- `.6'�f fl.�
l!'Jti
LOT NO 20_--SOlu _.
-_'
ARtC111T ECT
/ ENGINEER
. DFStGrvER .._ . . -----.,.r.»-�.--•--- -•---_.
t!UCTUI?E ( �'. ✓ ��RI a+nDEl ADDITION I�I i PAIR _ _❑_RENEWAL _ ❑FIRE DAMAGE— (]UEMOI.ITQN
ESIDENCE ❑t.r FIEDUCATIONAt OV T ORELIGIOUS(]I'ATIO UCARPORT ❑GAPAGE ❑STORAGEOSI.AB—C]IENCE
'rL'F'a�.-• 1`-3 R- T OI DG TrPE , il.. ;t)NE 1? PLANCHECK EIvNw-#- HEAT__._.+
i_�,WER_-RERMT
.0 40 E1Q4HT NU SI,,H:E- AREA460 NQ 9�pR0Uti"S v4L� i !goo
HUIL_DIN'� Gc =.�".'ENT KS Fri )NT +^' IjE-AR ,�8 LEFT SIDE �' RIC,HT SIDE1�
lit
I� - I ,MIT IS SUHIFCT TO THE RFGULATIONS CONTAINFO IN THE S IILDING CODE,
tan Check too - I1ONS AND At L APPLICAM E LOOFS AND ORDINANCES, AND IT IS r'•EPEBV !GREED TpV,1 THE
t L BE. :10NE IN ACWR[14tiCE WITH THE PLANS ANDSPECIFICATION; AND IN COMPLIANC.F YJI'1H
tin-total �� �Q LICAFILE CODES AND OHOINANCES. THE ISSUANCE OF THIS FERMIT DOES NOT NAIVE
_rIvE CnVF%ANTS C'UNIPACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES!
:ate Tax z j(D SEPARATE PERMITS RE001RED FOR SEWER, PLUMBING AND HEATING.
otal ti
1pprovFC du
MC -
)DC -
;EWER r ION
iEWER INSPECTION $
iEWER SURCHARGE—6
Dmments: VOIC-e-2
_00
I
Building Permit No.
Location
Date.
Statement of Exemption
From Builders Board
Registration
I� fi� f'f� � • �l7
4L
_ am personally exempt from registration
with the Builders Board for the following reasons:
( x ) I am performing work on property I own, a residence that I reside in,
and/or a residence that I will reside in. I will be my own general
contractor and will hire subcontractors who are registered with the
Builderg Board.
I own, reside in, and/or will reside in the —mpleted dwelling.
i
My gens--ral contractor is:
Name
Builders Board Registration Number
Registration Expiration Date
All subcontractors who work on this dwelling will be registered with
the Builders Board.
s
I
Signatur —"