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BUILDING DEPARTMENT, TIGARD
PLUNIRING PERMIT N {
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein nock. I to be installed in accordance with the plumbing code of
Tigard. Such ;:istallations.require inspection by the City Inspector who shall he notified not less than four
(4) hours prior to the time -t.he installations are ready for inspection. City of Tigard Business License required
for all c ntractors -.id sub-contractors. Job J h
K � Adriress./ — ��LGl� Date j
Owner 1' _
f -- NU!v19cA OF �- TOTAL
Il- TYPE GF PERMIT ITEMS - FEE Wil EACH AMOUM
L Sin01e Family-1 bath-each - __ 75.00
I _Duplax-C-xh bath unit - ^-TL _ 25.00
�--Additionai battorooms-edch 10,00 1'
I &13bile Home Spice-each �— 15.00
INDIVIDUAL FIXTURES_ CgMMERCIAI
1 to 50 Fixtures in 1 building-oath 3.00 _-
51 to 100 Fixtures in 1 building-each 2.50 =�
101 tr 200 Fix ire% in 1 buildin -g each -� _ 2.00
I_7.01 or mo-d Fixtures in 1 buildir -each _ _- - � 1.50
f.1 15 C E L L A N E O U S
_Sewer-each additionas 100 ft._ _10.00
Water Serjice to building — +M�5.00
Othnr (Snmr.ify):
PERMIT [j�� for Plumbing Inspection Phone, 639 41;1 — –
I 4-; ;tatet��) Plumbing Cont,arjor By
( TUTAL -5�a. Q(j RECEIPT N0. Issued By
,. ....�.�.na. v,,.p. 7buti.:�/'4'✓"P�rr,�ir12>M<,i'"+'.i�'�kA%'$u':6'!fR 9^'y"�",�,�• rtC�Tl�'h'il�d,yfa;,�iMretr�yrYw 'b9�i'�K'i � .,.. .-. �Sd►'W F,", ' �,
BUILDING PERMIT APPLICATION 1OF
1T TiGA,RD OATS - 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUII_DERPHONE.—..
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE —
LOT NO. E! i. ..
OWNER JOB ADDRESS Vi., (j J.L11 4 .,= HOME ADDRESS —__• _
` ARCHITECT
ENGINEER
BUILDER ADDRESS '* 4 C�1,1 Mus"U '1Ck — DESIGNER _
STRUCTURE ❑NEW [)RFMODEL DADDITION ❑REPAIR GNENEWAL ❑FIRE DAMAGE CJSLAB
❑ RESIDENCE _❑_COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS[)PATIO [:]CAP PORT ❑GARAGE ❑STORAGE CJSLAB OFENCE
[)BOND ❑MOVING DCONOITIONAL USE — ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS �—
ii--'
OCCUPANCY.—._.___NJAND USE ZONE _ —BLD[:.TYPE REZONE— PLAN CHECK BY._._____-____ NEAT_ —.
II,�, rUC c.:jpjux and (J0A;6Gh1% rare• —�"!•-s3aitiLt3am�T � t Ci+r�tt:�, ------ _—
i f rAl ' C.':C T A'T T fi r..
U�
LOAD F_1,.4Q.E�LS2AD
VALUE—
HEIGHT X10 $TORIE$��__ARIIA:_-�1_UERBOOMS YL',LUE `_ �I1•
BUILDINGDEPARTMENT _ SET BACKS FRONT `�" REAR ' LEFTSIDE � RIGHT SIDE
Permit
---' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check y, REGULATIONS AND ALL APPLICABLE COD' 3 AND ORDINANCES, AND IT IS HERFBY AGREED THAT THE
--- u.JR1' '41LL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal f ALL APPLICABLE CODES AND ORD!NANCFS, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOVI AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEr 44 TE PERMIT'S R@OUIRED FOR SEWER, PLUMBING AND HEATING.
Total t 4:00 00
BY
A LICANT OR AGENT
Approved R.cei It No.
IwwMwwX1w-Lw-Lw-AMf
DATE INSP.I TYPE I 4SPIEC 710M REMARKS PLUMOIN(,; DATE
Contra:tor
Permi-.NO. &.0 17
- gh
IOU n
(SARAVir FLepit Fixture
Final
ma HEATIPIG
Contractor
Perrniv No.
Gas or Oil
Rough4n
Final
SEWER
Final
DR!VEWAY
Firal
SIOM Drainage
(Rain Drain)Final
Sidemlk
C4.rb&Street Final
Approach
BLDG-DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Lan&.caping
Zoning Final
77'1
j
BUILDING FERMIT APPLICATION SOF TIGA RD DATE. ��.f_ ,g �D .27sr3
THE UNDERSIGNED FtER'c8Y APPLIES FOR APER vIIT FC ? rHE `10FIK HEREIN INDICATED BUILOERP;-IQr4,AR-4m._..
OR AS SHOV:N AND APPROVED IN THE ACCONIPANYIf�G PLANS AND SPECIFICATIONS. ChVN=PP;i13r; __
AA
/.1121S�p " � LorNo�4�
JOB ADDRESS / ��I Yj� Ql .
49CHITECT
"Y
8u1�_OC� e. AOOREi, OESIENGINEER
E
STgUCTUrRF NE'N ❑FlkVf10EL L„1A001`I01 DRENEY.AL ❑FIREO,•.MAGE QOEl.IOLITION
PcSIUErlCE �COti1t1 ❑EDUCATIONAL 0rOV'T C�P?LIr10[;c OPArin OCAR PORT' Clrr--,,
_ _ ❑GARAGE L15TORAGELJSLA3 []FENCE
hrCUPAf.t•�Y Q_J LANO USC 204,J= 8-.pG«[YPE�„5.— _.EIRE ZONE PLAN CHECK SY yE
--- - S�_�crKar.�'�poy- '�� _ a-^ • _ gam!*x ,��___
SEWER PERMIT
CLODft 4 I•IEIGF•I1•
-- -- 1y�TN�_ TURIES / AREA� TNO gE R tiia �p0
SUILOIN-•OEPAPTMI NT ScI*BACKS FRONT 2a REAR 3
! LBF; SIDE �Q RIGHT SIDE A?
• 00
-
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINELI IN THE B:IILDING SODE, 7GNIN^.
Plan C+eck V RECULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANG I T IS HEREBY
nuFEc_D THAT THE
l7 —1- MILL BE DONS: IN ACCORDANCE WITH THE PLANS AND SPECIFICATIC^iS AND IN CGhIPLIAN.F WITH
Su7•t0[81 9 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PEhMIT DOES NGT 'NAIVE ,
I) _ ��• S RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CIT E
Sate Tax ( 7 7,Z LICENSE. SEPARATE PERMITS RCQUIRED FOR SEWER, 'LUMaING AND HEATING. Y BUSINESS
Z L SDC -
�-- POCK
" APPLI ANT OP 4 r �-
AplJrov� Receipt No
AnnREi5 —�h10�1K_ ---
SDC
POC
SEWER CONNECTION /.2.c)0
SEWER INSPECTION $ 3J-
SEWER SURCHARGE
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• .i y t ,4 t�',�I3
Comments . IV pieit0
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