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CITY OF TIG,ARD MECHANICAL. PERMIT Receipt#
Permit #
Description —
Table 3A Mechanical Code _ CITY PRICE AMT
City of Tigard 1) Permit Fee -0- -0- 10.00
13125 S.W. Hall Blvd. _
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.0,,)
639-4175 1) Furnace to 100,000 BTU
incl.ducts&vents �•OG
2) Furnace 100,On0 BTU + ,
incl.ducts&vents 7.50
Name of Development Floor Furnace 3) incl.vent 6.OU
Job Address --- _-- 4 Suspended heater,wall heater
Address _ �) :f C{� �/J /- ) or floor mounted heater 6.00
Tax Lot Map No. Vent not incl.in
Lot EElock Subdivision 5) appliance permit 3.00
Name(or name of business) 6) Repair of heating,refr ig., 6.00
cooling,absorption unit
Mailing Address Phone Bailer or comp to 3 HP
Oa er �) absorp.unit to 100,000 BTU 6.OU
Cay,state zip 6) Boiler or comp to 3 HP-1511P 11.00
absorp.unit to 500,000 P,U _
Name Boiler or comp 15-30 HP
9) absorp.unit 1/2-1 million 15.00
Mailing Address Phone 10) Eloiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million
Contractor City,Stale --- 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 hereby acknowledge that I have read this application that the infoi ,wlon given is 13) Air handling unit 10,000 CFM + - 7.50
correct,that I em the owner o,authorized agent of the owner,that plana submitted are In --
compliance with State laws.that I am registered wl'h the State BuildersBoard,that the14) Non portable 4.50
number given is correct (If exempt from State registration please give reason below), evaporate cooler
Vent fan connected
-- -- --- ------- - 15) toasingleduct 3.00
_ i---—= Ventilation system not
16) Included in appliance permit 4.50
17) Hood served by
mechanical exhaust 4.50
Signature(owner )r agent) _ Data ) Domestic type 7.50
Describe work O addition LJ alteration ❑ repair E] 18 incinerator _
to be done residential L] non-residential [1 Commercial or industrial
--- - -- _ - 19) 30,00
Existing use of — type Incinerator
building or properly— __-�� ?0) Other i.e.,woodstove,water 4.50
Proposed use of "---' heater,solar,clothes dryers,etc.-
building or property - 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas U LPG ❑ electric L I --
22) More than 4-per outlet
NOTICE —
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- - ----
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS S,'ISPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL
- r
Special Conditions
- ---- —.-. Data issued------ by -- —
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INSPECTION NOTI"'E
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
39-4171
Type of Inspection
Date Requested Time A.M. "Y P.M.
Address
Permit *--t2J'�
Owner Lot
Builder
I The following Building Code deficiencies are required to be corrected:
00
Presented to /o/Approved
Inspector U Dkopproved
Data
CALL FOY REINSPECTION
'. YES 0 NO
F I.
INSPECTION NO-TICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested
Address Time �AM-_P.M.
*,K; -L;�P
Permit
Owner
Lot #
Builder
The following Building Code deficiencies are required to be corrected.-",.
Presented to oved
Inspector UPProved
Date
ALL FOR REINSPECTION
DYES ONO
INSPECTION NO'i ICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection . 6 -
_ (��� -
Dme Requested Time. A.M. P.M.
Address � i � �' l�.'�/a,.
�'—== '-----__ Permit #�._�_Owner.— Lot #
Builder —'
The following Building Cc)de deficiencies are required to be corrected: _ --
r � I
Presented to
Inspector R_ .�--1
Approved
❑
Disapproved
Date
CALL FOR REINS ECTION
(� YES NO
I
f
iVl� SPECTION 'VOTICE I
City of Tigard Building Department I.
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested
Z—fC Tame A.M.---P.M.
Address Permit # '
i
Owner
Builder
fThe `,flowing Building Code deficiencies are required to be corrected:
( Presented to _ ❑ Approved
Inspector ' Disepprovad
Date _-- ,/�—,�O �"���
CALL FOR REINSPECTION
�^E8 C] NO
BUILDING PERMIT APPLICATION TIGARU DATE.—_-jul" 21 ,19 ±3_. 4527
THE UNDERSIGNED HEREBY APPLIES FOP A PFRMIT FOR?HE"ORK HEREIN INDICATED BUILDER PHONE _?_4."7505
OR AS SHOWN AND APPROVED IN TIME ACCOMPANYING PI-1\NS 'SND SPECIFICATIONS. awNER PHONE— _
l(-T NO._ ROU 2�;I 12C —
OWNER "etro �Icmisiwi It1C.. JOBADDRESS )5660 $14 19t',_i�Vt3. _
ARCHITECT
ENGINEER
BUILDER ;orx' ADDRESS 9600 S14 Capitol 1ir�. DESIGNER,—
STRUCTURE [R NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM f7I EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO_❑ CARPORT ❑ GARAGE D STORAGE ❑ SLAB❑ FENCE
OCCUPANCY '4`1__LAND USE ZONE " __BLDG.TYPE _ FIRE ZONE PLAN CHECK BY ' ` HEAT
_— ronstinict Garage nnd_shtlp_ hldr. roll. n►r plans nevi code.
SEWER PERMIT M "
OCC.LOAD FLOOR LOAD _ coria WEIGHT ' NO.STORIES Is ARE0.BEDROOMS I VALUE 17 h 7�
BUILDING DEPARTMIcNT SETBACKS FRONT REAR SIDE _ RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
t�� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY�4GREED THAT rHE
Olan Check-- _b ,_ 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
.4 Sub-total 162.51 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE-SEPARATE PERMITS REQUIRED FOr SEWER,PLUMBING AND HEATING.
State Tax 3. 14
SDCTotAl 100.4 --- _
By
diii j PDCrt A PPI IGANT OR AGENT
Approved
— Refcvipt No. ADDRESS -- - ------__� _---- PHONE —_�_
r r W q ► w r
0.14TE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
G'I — Contractor Permit No. _
Rough-in _
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWIR
Final
DRIVEWAY
Final
Storm Drainage
Y � (Rain Drain)Final
Sidevialk
_ Curb R Street Final
Appror,ch
BI.DG.DEPT.FIN'•L �— TEMPORARY CERTIFICATE OCCUPANCY Fine
(CERTIFICATE OCCUPANCY
Len*ceping
ZoningFinal
� iw I� � � a a[ 11n► � u
3UILDING PERMIT APPLICATION 1IGARD DA-rE July 2 4526
THE UNDERSIGNED HEREBY APPLIES FOR A PEPMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE 246-250i
09 AS SHOWN AND APPROVi.D IN THE ACCOMPANYING PLANS AND SDECIFICA TIONS OWNER PHONE
LOT NO. 1_-_1,500_.3 1—1�__
OWNER_ �n_.�10 1lptA91S17 lA@QADDRESS 1`>h '•1 `;'; C�i +V�
ARCHITECT —_
BUILDER ENGINEER
ADDRESS 950�J Std rapitl1 i1�rj►. DESIGNER _
STRUCTURE X NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL El FIRE DAMAGE ❑ DEMOLITION
0:RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO J CARPORT ❑ GARAGE 0 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USE ZONE ft'* BLDG.TYPE— 5'' —FIRE ZONI-- -PLAN CHECK BY
COnmtruct Sin;{le Fmmily OwrllinY uj'attacflej ;7ara ,,e - -
' SeT7tic rank to ?m Issed; 3 ledroan 2 tants
SEWER PERMIT#
OCC,LOAD FLOOR LOAD 40 HEIGHTit NO.STORIES Z AREA NO.BEDROOMS •1 VALUE
r BUILDING DEPARTMENT SETFjM;KS FRONT A_! REAR
_ _ LEFT SIDE RIGHT SIDE
Permit 39 1*00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODER AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 254. 15 WORK WILL BE DONE M ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CON,,'3LIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERPAIT DOES NOT WAIVE
Sub-total 645.!r) RESTRICTIVE COVFNAP;TS. CONTRACTOR AND SUh CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Stag Tax 15.64LIrENSE.SEPARATE PEROITS REQUIRED FOR SEWER,PLUMBING,AND HEADING.
6tiU. ;'��
SDC— 400.130
Total
PDC# !T I(K).()o APPLICANT OR AGENT
By _ ft+nj
Approved AC6 Receipt No.
--- — — PHONE
� f
iiiiiiiiiiiii,w � t1t t� tel► OF
BUILDING PERMIT APPLICATION 'riGNRD DATE IYtly 2 3 to .13 4526
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FO:1 THE WORK I1EREIN INDICATED 13UILDERPHONE ?46-3505
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER
9tztto,FIQUit;li• r
iz 1000ADDRESS i 15ff, %111 %9tl� ,1ye. LOT NO._ 1�.QQ U1-12�
.
ARCHITECT y -
BUILDERr'$L1N ADDRESS 9600 St-4 (capital `twry. DESIGNER
STRUCTURE ® NEW ❑ REMODEL _ ❑ ADDITION— ❑ REPAIR — ❑ RENEWAL _( ' FIRE DAMAGE ❑ DEMOLITION
U RESIDENCE ❑ COMM 1-1EDUCATIONAL ❑ GOV'T 11 RELIGIOUS ❑ PATIO 11CAR PORT ❑ GARA13E E STORAGE_ ❑ SLABi 1 FENCE
OCCUPANCY ~•j LAND USE ZONE ..BLDG.TYPE _-!"'--FIRE ZONE PLAN CHECK BY ' HEAT—7"23
Coonetrdet Odin;le Fenily I)-\4ellir4, 1.j: stt eiled varas;c� — ---- —__---.Sortie Cany; to be ager l 3 lednxm 3 Lathe
Fix. unit„
SEWER PERMIT#
OCC.LOAD FLOOR LOAD {t) HEIGHT_ 14 NO.STORIES 1 AREA NO.BEDROOMS 3 AVALUE
BUILDING DEPARTMENT_ SET BACKS FRONT REAR LEFT SIDE _ RIGHT SIDE
Permit '391100 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 254. 1 5I REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPFCiFICATiONS AND IN COMPLIANCE
1 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 645. 1-,7 RESTRICTIVE. COVENANTS. CONTRACTOP AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
15.�G 1 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total 1160. 19
SDC-- 400.00
PDC# l T 100.00 APPL'CANT OR AGENT �By
Receipt No.
LApproved
- PHONE
OAT E� INSP. TYPE INSPECTION REMARKS PLUMOING DATE
--� �L�4t�� — -- _�� Contractor o — --
�o'� PermitNo. 3 0 4
s• 1 Rough-in
Fixture
c► P Final —
GI HEATING
Ccntractor �-
-— Permit No.
�� /L
Gas or Oil
Final
.---- — SEWER -- -- -
— Final —
DRIVEWAY
^ Final
:;torn Drainage
(Rain Drain)Final
Sidewal
Curb A Street Final
iI Approach
—BLDG. DEPT.FINAL �r- TEA�PORARY CERTIFICATE OCCUPANCY (anal
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final —
r
KWIWIN
BUILDING PERMIT APPLICATION TIGARD DATE-
THE.UNDERSIGNED HEREBY AFPLIES FOR A PERIAIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOWIPANYING PLANS AND SPECIFICATIONS. O.VNER PHONE
T LOT NO.
OVINER lje t, TW..JOB ADDRESS I (D6O sto 7 f-. Q -
ARCHITECT
/� d ENGINEER
BUILDER ��'�►7ADCRESS _S'UVG'�. rDESIGNER
STRUCTURE NEW ❑ REMODEL ❑ ADDITION -❑ REPAIR ❑ RENEWAL - ❑ FIRE DAMAGE ❑ DEMOLITION
U RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT GARAGE ❑ STORAGE ❑ S,LAB❑ FENCE
s
OCCUPANCY _LAND USE ZONE SLOG.TYPE _FIRE ZONE_.PLAN CHECK BY HEAT.—
-----.- Gvwi--�rCw� �+�o►•o e � soh �.�--�°1�___�'��"—'*�- Q •- --
SFWERPERMIT K --
OCC.LOAD '� FLOOP LOAD("o/VC. HEIGHT /-I-" NO.STORIEiS AREA NO.BEDROOMS p VALUE.'_
BUILDING DEPARTMENT SET BACKS FRONT -telREAR /.2 0 L-FT SIDE RIGHT SIDE
Ponntt THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZOWNG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TPE
PlanCheci WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIGAT'ONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total ,J .j RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTOPS TO HAVE CURRENT CITY BUSINESS
UCENSF_SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
SOC--
Total —. .--- -__—---------- -- -
PDCA APPLICANT OR AGENT
By
Receipt No.
Approved ADDRESS — PHONE �-
SDC =,
RDC -
SEWER CQNN CTION 5 r
SEWER JNSPECTION $
SEWf�A SUFCHAR>;E '$
C _Q• --------_--- -
So
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do,
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W R R ■ R R R R A?!
. ..------- -------------------------------------------------------------------------------------..
,St INGTON COUNTY DEVARTMENT OF PUBLIC HEALTH CR_I-)C/ c
Administration Building_
150 N. First Refer _
Hillsboro, Oregon 97123
Telephone 648-8688 Subject
Location
Health Department Memorandum
The subject noted above has been reviewed and the following decision is recorded:
No Yes
( ) ( ) . . . . . .Health Department requirements have been met in full.
No Yes
( ) ( ). . . . . .Additional requirements as follows must be met before Health Department
approval can bL given.
Comments
Date Public Health Sanitarian
7/72 WCDPH SE-4
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BUILDING PERMIT APPLICATION TIGAPO DATE--t—^! Z/
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON !; '.2y-AJ
OR AS SHOWN AND APPROVED IN Fh-ACCOMPANYING PLANS Nn SPECIFICATIONS. OWNER PHONE
l' ''rr ' ` ii 7 LOTNO.-/O S1• G
O'rlr�eFl ae` Ite [�0'dLs�Jh�l„ ';8 ADDRESS N(0190 SO A..•
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J ARCHITECT
ENGINEER
BUILDER �i ADDRESS (:* t40� Ib DESIGNER
STRUCTURE NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ F1RE DAMAGE ❑ DEMOLITION
RESIDENCE 0 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OGC,UPANCY LAND USE ZONE BLDG.TYPE � —FIRE ZONE__ PLAN CHECK BY �_HEAT
_ —QAZ4 7w c- T SfA/[iAE' -r7*Ae Hs-
SEWER PERMIT K _ - tAsi _�7 I A• 8 Fi Y. !��i s,f
OCC.LOAD �" FLOOR LOAD yW HEIGHT NO.STORIES j AREA/07J/ NO.BEDROOMS VALUtg jow
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT^,'".'E RIGHT SIDE_
Pormit 90l THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE.ZONING
Plan Check s a /S REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TKAT THE
--- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AN:, oPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sut lotai RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUS;NESS
• a/ LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Ta>�
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SOC— ._
Total
PDC# APPLICANT OR AGENT
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A roved Receipt No.
PP ADDRESS PHONN
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SEWER C04%K.GTION
SEWER INSPECT I0
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