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INSPECTION NOTICE
City of Tigard Bu !ding Department
12420 S.V . Main St.
Tigard, Oregon 27223
Phone V9-4171
Address_..__ _ - ' �/ ---_—_- _— Permit #
Type of Inspection _____ =___�_.__-____-_-__ —• —
The following Building Code deficiencies are required to be correci:d:
Presented to -- -- --- --- ---- __ !nspector
;gate
CALL FOR REMISPFGTION
[] YES ❑ No
! W1 WX 11111111` Wjuw � � i13
BUILDING DEPARTMIENT, TIGARD �T
PLUMBING PERMIT 1V
holder of a valid plur,bing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than fo!jr
14) hours prior to the time the installations are ready for inspectior- City of Tigard Business License required
for all contractors and sub-contractors.
(�O'wner L. ,.�t=�.,�_C t, -T-�_-�_ Address / V �6 3 -S'-,A) Date
i NUMBER OF �— TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT loffico Use Only)
—
Single Family_1 hath—each _ 2500
L_ OupN-%_Each I bath unit —� 25.00
Add:tional bathrooms—each 10.00
Mobile Nome Spac=each _ 15.00
INDIVIDUAL FIXTURE FEES —
! Ito_5o rixrures in 1 building each — 3.00
I' 51 to 100 Fixtures in 1 building—each 2.50
101 ;o 200 Fixtures in I bedding—each 2.00
1 201 or more Fixtures in 1 building—each — 1.50 �—
MISCF !L-A NE0US
k_
Building Sewar-1st 50 h. 10.00
�Snwer—each a_dditionnl 100 ft. _— 10.00 —
I -Waver Servi:e to build_in _ 5.00
_
h'�''Prh�e— te N/at�r�rSystems—each 100 ft. -- 10.00 '
I Oth,, fSpIcIIJI
1
PERMIT For P/umbing Inspection Phone 6394171
Plumbing Contractor By Q
1'O rAL - RECEIPT NO. Issued By
BUILDING PERMIT APPLICATION TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FORA PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _.._.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICAT;ONS. OWNEP PHONE
LOT NO.17-Ij alitL l i., O;
OWNER 1-t Constr., Inc.JOB ADDRESS 14665 SW 83rd Avenue ^AR__
CHITECT
ENGINEER
BUILDER ;;3r10 ADDRESSRt.4-BOX 31 7A,Sherwood DESIGNER Pigrcy=8arr:1i }
STRUCTURE n NEW D REMODEL D ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
EX PESIDENCE ❑ COMM ❑ EDUCATIJNAL ❑ GOV'T ❑ RELIGIOUS [] PATIO ❑ CARPORT ❑ GARAGE F1 STORAGE ❑ SLAB FENCE
OCCUPANCY _LAND USE ZONE R-7 BLDG.TYPE -'^—FIRE ZONE_—_PLAN CHECK BY duh HEAT
Construct einole familyduelling—�, c"ittached garage. 4 Hadi 3cirr,s :i —
SEE CORREETION SHEET ATTACHED.
SEWER PERMIT# 175Q.Cl0 _ �ar{j _ �[]❑ oc;�f t•—_ ___
OCC.LOAD FLOOR LOAD 4_ 0 HEIGHT 22' NO.STORIES 2 AREA t 45/ i4a BEDROOMS VALUE
BUILDING DEPARTMENT` SETBACKS_ FRONT l REAR .ii LEFT SIDE RIGHT SIDE
Permit _ Z 47.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODIcS AND ORDINANCES, AND IT IS HERELY AGREED THAT THE
Plan Check 123.50 WORK WILL BE DONE IN ACCORDANCE W TH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. 'HE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal_ 370. 50 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLOMBING AND HEATING,
Stato Tax9.0 b
--- - SDC- 4LlJ.i!1.)
Total — _ U0 3 PDC# 11 $100.011A L�ICANTORAGENTrBy p 1
Recelpt No.
Approved duh ADDREISS �� �i PHONE /
DATE INSP. TYPE INSPECTION REMARKS PLUMBING A. DATE
Permit No.
-s-y�"/ —----- - Rough-in
_
Fixture
Final40 k --- •- --
O A jA")FEI/*qje __,_—�__-_---- ----- HEATING —
�L _--� �• � Contractor
%/S/� Ur It_�ir,.,• ----- Permit No. a 3�� ��•Zd ( �l
T
L Gas or Oil -- —
11-16'- b Q JL Q011 eats -- Rough-in
Final
SEWER
---- --- -- — -- ------ Final y^.?e � --
DRIVEWAY
-- - - ----_�� _- Final '_--
Storm Drainage
—�— (Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATEOCCTANCV Final
CERTIFICATE OCCUPANCY
1 �YLandscaping
Zoning Final
BUILDING PERMIT APPLICATION Tr
IGAR� oATE re_�/ . . ,
'THE LINDERSIGNED HEREBY APPLIcS FOR A PERMIT FOR ThEViORK HEREIN INDICATED BUILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOh'PANYING PLANS AND SPECIFICATIONS. OwNEP PL;or:>=
1'N G• � , LOT a7._..�7�rt— '---_
y JOEioODRESS
c1r t
ARCHITECT
()1 ENGINEER
UIL:JER — -- - AnDRESSIC^�.4 �11r0 DESIGNER
TRUCTURE: NEW _ ClREMOOE'. G AOiJI_T!ON C REPAIR Cl RENEWAL ❑ FIRE IJ,M.4GE J L3E►r10�:iION 1
-'SIDENCE C CCNIM 0 EDUCATICNAL C GOVT C RELIGIOUS L: PATIO C CARPORT C GARAGE C STORAGE C 'Ll+En FENL.'
:u.urANCY yLAND USE ZONE 9=Y-BLDG.TYPE FIRE ZONE- 'AN CHECK BY
toe,It ma
iE1LVER PERMIT it _ Gott" e 18o ,
',CC LOAD FLOOR LOAD p H'I T 2Z NO.STORIES AREA ,24- 7 NO.BED'ODMS VA.1 U;-7 300
BUILCIN,i DEPARTMENT $('1 BACKS FRONT REAR LEFT BICE qq c
�- hL RIGHT SIU .
^_rmit _ (1.t?`� THIS PERMIT IS ISSUED SUBJECT TO THE REGUL•AT INS CONTAINED IN THE EUILDING CGilc., ZGiI'`4•,
REGULATIONS :NO ALL APPLICABLE CODES AND ORDINANCES, AND IT 15 HERE3Y AGREt"J THA.' iY,E
'Ian Cheek r S� !WORK WILL BF DONE IN ACCORCANCE WITH THE PLANS AND SP-eLIFICATIONS AND IN CO'.iPLIA:lC
37015-0-
'�"--"� WITH ALL APPLICABLE COMES AND ORDINANCES. THE ISSUANCE OF THIS PER,.t1T DOES NOT WAIVE
,7
Sub-total 70 sQ- RESTRICTIVE COVENANTS. CONTRAC T'IR AND SUB CONTPA(,TC R3 TO HAVE CURRENT CITE EJB'?'t SS
q. LICENSE_`5FPARATE PENMITS RECIUIP-0 FOR SF'NFR,PLUM31NG AND HEATING_
Stan Tax • ( 8_.,�
SOC— O
Total S T
ppGv APPLICANT OR AGENT -
by _
Receipt No.
Approved ADDRESS Fitt]NE
i
LC
�1 I
C - S 1L I /00
WER CONNECTION S I�4,
_WEn INSPECTION
EWER SURCHARGE
Li/ V V• �S
UL
_
V.....-..
i 3 2.7 s 4 40�s3
' .7
Lim
7 goo
Citi. of Tigard Mechanical Permit No.
New Installati Replace E] Relocation❑ Addition Alteration Ej OA'rE:
TING ,
CONOrJTRACTQ;c� �{ � OWNER
ADORES i 3� JQB ADDRESS N U5
PHON _ AFPI_IGANT
Heat Input Rating(BTU per Hour) Vo 000 Vent Size Flue Size
FUEL OIL Q G S_DQ FLF,T ff OTHER _
_ t'rL VI �NO_ FEE ITEM NO.j FEE
For Issuance of Permit SEEBELOW Each Air Handling Unit or Duct System x7,50_
Newer to & incl. 100,066 9TU 6.00_ Commercial Nood System_ 7.50
New 1106,000 66T's & over y7.50 Other E t0 mrnnt - Each_ 4.50
Wood burn ina_Stove— 4.50 1 Trip Inspection 4.50
Wall-Floor- Suspended 6.00 Air Condition Compressor up to& incl.3 H,P. 8.00
Vent a sty em w/Fan i 4.50_ Air Condition Compressor-3.1 to_15. H, .incl. 11.00
Repair-Heat Cooling 6.00
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! I
PERMIT ISSUANCE 10.00 Comments:
FEES
% STATE _ Issued By _
25%PLAN CHECK