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CITY OF TIGARD BLDG. DEFT.
12420 S.W. MAM STRECT
TIGARD, OREGON 97223
PHONE 659-4171
CONTRACTOR:
Pursuant to Section's) of the Uniform Building Code, the
following item(s) require correcting:
L
Date:
Inspector_�, `%—
CALL r-09 REINSPEri ION
1T Y TIS ARD DATE
BUILDING PERMIT APPLICATION 1OF
THE UNDERSIGNED HEREBY APPLIES FOR APUMIT Fn9 THE WORK HEREIN INDICATEC FIIJ I L3t::R PHONE
OR AS SHOWN AND APPROVED IN THE ACCOi.iPANYING PLANS AND SPECIFICATIONS. OINNUR PHONE--
1.0T '0-—-
OWNER JOB ADDRESa "12'70 5IJ 80th Plnrr. HOME ADDRESS 412L
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
ST R UC T U R C ONEW 1:1 Rt MODEL 0 ADDITION OREPAIR []RENEWAL EIFIRE DAMAGE jDEMOLITI0 N
0 RESIDENCE 11comm EIEDUCAT,ONAL []GOV'T ORELICOUSOPATIO EICAR PORT OGARAGE EISTORAGE CISI.AB []FEN(-,,
EDUND OMOVING 000NDITIONAL USE DESIGN REVIEW DCOUNCIL APPROVED L3S,GNS
OCCUPANCY—-'!!--j LAND USE ZONE----- _BLDG.TYPE___r3—FIREZONE PLAN CHECK By--L-h---- HEAT---
I jr t, cull f am-5 ly ouellill.4 to/attact vu 3 UkArOu' '
;alvl- Imit lt3123 62b.OU
bessmant ?Fle ion, f 1- 11 T wTs---�+tk—Jkt�0
21 1
F I DDflLLQAE)-- ---WLnQRL9S 1 Ws-- NALVY-- '--—
BUILDING DEPARTMENT _ SETBACKS FRONT 2!:h REAR b4 LEFT SIDE U PILO-IT SIDE
Permit
THIS PERMIT H -SUED SUBJECT TO THE RUGLILATIONS CONTAINED IN TI-;r BUILDING ('ODE, ZONING
Plan Check 96.5 G
0 REULA+IONF' L
AND AL APPLICABLE CODES ANI` ORDINANCES, AND IT IS HEREBY AGR 40 THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANT AND SPECIFICATION3,AND IN COIV�'LIANCIE INITH
SUb-total V:1 . .9 ALL APP--!CARLF CODES ANr ORIINANCES. T14E, ISSUANCE OF THIS PERMIT DOEi NOT WAIVF
REST-AC717k COVENANTS. CONITHACTOR AND SUB CONTRACTORS TO HAV-' CLIPFIENT ;:TY P'USINESS
State Tail
LICENSE- SFP1%RAj6IjER"lTS REOU'RED FOR SEWEP, PI JMBING AND HLA I INC,
'12
.u 1�
Total 2q7.?2 IOU.0(�
By
A�PLICANT OR AGENT
Approved Rccviot Nn V3 _;, . i
N low lAw.w' a
I
DATE INSP. TYPE INSPECTION :MARKS PLUMBING DATE
Contractor
Rough-in
Permit No.
-c !L - ow�L 3--),Z
Fixture
Final
HEATING
Contractor
Permit No. 141 4'79
Gas or Oil
Rough-in
Fintil
SEWER
Final
—__ __";�f.
DRIVEWAY
'_um Drainage
lRain Dfsin)Final
-urt,&Street Find
Appr"ch
,z_D_GRp_i:,FINAL TLt"MPORARY---CgR—.,:,li7-f,�..'kTE OCCUPANCY
CERTIFICATE CICCUPANCV Fin3l
Landscaping
Zoning Final
-77
k*f
AAik-kf"0
f
► SDIMAW
�JJILDiNG PERMIT APPLICATION CITY TIGARD DATE. �-+,i�' tQ — —. N9
" + -,"ql i I .f(-,NE r) HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF'.i 1_Q'/"V
F Al. AND APPROVED IN THE ACCOMPMf YIN 4jN D SPECIF ICAI IONS. OWNLF. PHO F
U /SLOT NO. ._.._._.,_-----V
Kt_ /L/��y/QL C�'STJOd ACIDRESS ^���' H7N�ADGRF_55 r/ S
ENS NIEERT�'cJ.��c} �a WJ c:1J0
R _ AM' .ESS_ _ __ _ _Dk.SICNER
..qF LR E
' W Y —❑REMODEL _ ❑ADDITION (3 REPAIR ❑RENEWAL ClFiRE DAMAGE �LlUEMLI LITII
;',Nrr ❑•_f'.MM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOLKOPAT10 ❑CARPORT 13GARACIIE [IS707AGEQSLAS OFEF
..,
�- CJD ❑MOVING ❑CONDITIONAL USE LJDESIGN REVIEW ❑COUNCIL APPROVED
�. • NCV LANI?USE N !:"0 —BLDG.TYPE FIRE ZON EPLAN CHECK BYY__�� HEAT_
4U -- FIOS?EU.I?L ?_--- - Hs1S�NI _--NQ.HIQBIE4 _._ FRE A a �r.NO-BLE Mr.QM-Sf- :0
HUILDING DEPARTMENT
SET BACKS FRONT 2 _ REAR �'y�t— LFFT SIDE RIGHT SID
"� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, lONf
.+w Check �- �� S �/ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY -GREED THAI i
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANDJN COMPLIANCE W
,.I, total ALL AV!II ICABLE CODES AND ORDINANCES. THE M"'IIANCE OF THIS PEFIMIT DOES NOT VVA
AFS74ICTIVF COVENANTS CONT 9ACTOR AND SLIB CONTRACTORS 'T0 HAVE CURRENT CITY NUSIN
i,-!, TaxLf '*77 �, LICENSE SEPARATE PFRMITS REOUIRED FOR SEWER, PLUMBING AND HEATING;.
WAVERLY CONSTRUCTION CO.
ANS X50 BB D '� 97032 _
'•; a ,weri _ Receml No
-- — - - �•,4()NE
e9 c.
f
�IN��
ADDRESS P'-rP1IT NO.
NEHMI T CHARGE / nono
C! .:%F:P, CD.;":EC11I0,J FEE ="L�.
z_k
PAJO BY om,
TYPE OF BUILCI G DATE C0NNEC TE0
SERVICE RATE _ � INSPECTION FLE
CONTRACTOR PAID BY DA7E
SIZE" OF CONINECTION _ A55ES-OMC-NT _ PnID
tvv.
PLUMBING PSRMIT I
voider o`. a valia p;urnbing contractors license ;s here,.•/
authorized to cause Plumbing work as herein noted to be insta„ed in accordance with the plumbing code of
Tigard. Such installations require: inspection by the City Inspector who sha;l be notified not less than `our
A4 hours prior to the time the installations are ready for inspection. C;ty of ;igard Pusiness License required
for ail co *ractors and Mb-con
��L. t <''-���i?---) Add-esu Jae
Gwner _ I;
NU,YEMS OF TO"A. I PERMIT yG.-S
TYPE OF PFR?,1IT j ITc'"o 3c ON 2ACLi A:r,OUNT (Office Use Oniy) _
_A35_ d_�LN rlAL
bi,h—ych �_.._ 25.00 '
Ou :ax—Car.`t 1 beth unit 2`;.00 �--'-� -- _ y
Acd.t:omai bathrooms—each _ h 100^00 _l /lJ�_ _
ycb,e Home space—each JE
16.OU _ i
;NOWXUAL FIXTURE FEES
1 U ,i1 Fixturr.•, In 1 building—each 3.00 •_ wl
i' to 1C3 Fixtures in 1 building enc:h I M -2.50--
10
.50101 'n1.00 Fixturas in 1 building—each _I _ y 2,C3
201 c•r mora Pixtures in 1 building—cock i 1.60
84 .3 ZELLAINE0USr--
3ui,uir,g�3ewr -131 50 ft. 10.03 --
So,mr—cart additional 10G ft, I 10.00 I 1
vt.c' S.•rvieo to building 5,00
>+.•ta 14a1er SYStams—ucch 100 It. _—_ j - 1040
,5
P-? — For Plumbing Inspection Phom 6394191
-l-"~ :c Plurrbl% Contractor ay
`O.A_ �= -��_ RECEIPT NO. _ Issued By _ __
W WW;JM;JWJ�FffiU��
L-33 F M chmt Permit NY
Cl '[ �/ Of ic o Fee -91.00
New Ins,51: !Ion RvI)ca,;on CJ Adc* ion 'D A!z;--*ra*,!on D 4T, )K- stilt 32
TOTAL--
C.--NTRACTOR General Furnace, & A/C Ince Waverley Const.
A(J--)R`SS 15536 F-'- Oxe. WORK ADDRESS1at__ja,_t4220_§, W, 80th
pHotjc 656-0326 APPLICANT G. L. Bell
Hea" Inpj: Razing (BTU Per Hour) _ 100,000 . Vent Size Flue Size
—
FUEL OIL GAS CY ELECT OTHER
ITEM NO. FEE ITEM NO. FE
?error;�, —300—T Air Condition
A For Isi;--;3ncc of, Corepressor 15 to 30 AP
New - Under 10-3,003 BTU 4.00 Air Handling 10.00',)CFNI,
67* d-00 -BTU & over —LL
New - 1 5.00 'Air Pandling Over 10.000 CFIA 5 1
Floor Fur rice 4.00 Evanzirative Cooler 3.r
Wall - Floor - Su-�-,,-?nded 4.0c) Parige Vent Fan 2.(
Install V,:,-1!5 oni). 2.00 Ven'. Sys:em
n 3(
j7-- Tib 0 Co
- rnmercial
C at %,03 Ing
Air Co-,ti,jion Crimp,tiAor Under 3 HP 4.00 Commo.-rcial Duc: Sys;crn
..%ir Com-?s:ian Com,pt essor 3 to IS HP
mspEc rocrs C01'.1,M.ENTS---
CITY EUSI-NESS, LICENSE REQUIRED FOn ALL CONTRACTORS On SUB CONTRACTOR.r,
APP10VED BY DATE __ ISSUED BY
DATE