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INSPECTION NOTICE
City of Tigard Building Derjartment
12420 S.W. Main St.
Tigard, Oregon 97k2l
Phone 639-4171
Addrea. _.__ -�L_ 7 "� _..�' •" Permit #
Type of Inspection
The following Building Code deficiencies are required to be corrected.~.,,=L_,.Z'�
Presented to_. _ Inspector
Date
CALL FOR REIA4FECIION
D YES NO
BUILDING DEPARTMENT, TIGARD V_1)
I PLUMBING PERMIT Y •
holder of a valid plumbing contractors licens- 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 De not'fied not less °han four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub/-contractors.
Own.:r l ��j /ii,G Address C sG�_ S".j r/�l
�.,�_— L= Date i,C -% L i"�5 (.
NUMBER OF TOTALPERMIT NO.'S
TYPE OF PERMIT T ITEMS TFEE ON EACH AMOUNT (Office Use Only)
-RESIP ENT IAL
Sin le Family-1 bath-each �J 25.00_
Duplex— ,,:h 1 bath unit 25.0.)
_!o,;iuonal bathrooms-aach 1000-1—
Mobile
000Mobile Horne Space-each 15.00 _ V �—
INOIVIOUAL FIXTURE FEES
_
— to 50 Fixtures in 1 building--each 3.00
51.110 100 Fixt+-res in 1 building-each 2.50
101 to 200 Fixtures in I building-each 2.0_0 _
201 or more Fixtures in 1 building-each
MISCELLANEOUS
Building Sewer-1st 50 It,� 10.00 -A
Sewer-each „+d;;goal 100 ft. - 10.00_
Water Service to buildinq-_ 5.00
Private Water Systems-each_100 ft. - -- `10_.00
Other IS ecif ):
PERMIT For Plumbing Inspection Phone 629.4171 ,(
3°�State /6 Plumbirg Contractor By r ., J`Qi►�r3c4c a tai
TOTAL �y/ E RECEIPT NO. Issued By ��
t ilk Iul w IN
BUILDING PERMIT APPLICATION TiGARD DATE_ dL 3422
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN IVO.-CA7E1) BUILDER PHONE U-39-.L J�JU
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANL)SPECIFICATIONG. OWNER PHONE Zi-b-—a Tum �`1illei LOT NCI •f3-„Zi- C ,ark
__. _ JOB ADDRESS 147EiC1 `.a,,; u.il'U iiVbf1�36
ARCHITECT
ENGINEER
BUILDER Fame ADDRESS14800 S' 92nd Av[ DESIGNER Stevens Desitin Sarvice
STRUCTURE t NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAn1AGE ❑ DEMOLITION_
13 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO O CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY .R-3 LAND USE ZONE . I3-7 BLDG.TYPE _ -1 -FIRE ZONEPLAN CHECK BY dwh HEAT gas_ _ _
"unstruct single family owtt lliny 6,jai ,ed OX 4 8edr.Dome 2 ot!it
RL-ISSUE OF PERMIT rt i1��9 9830
SEWE9PERMIT# 22056 ,'�7'.30•00 �1U 4J6 sgo.t.�
OCC.LOAD _ FLOOR LOAD 40 HEIGHT 1J NO.STORIES 1 AREA 1603
NO.BEDROOMS 4 VALUE_ _ . /CIU.
BUILDING DEPARTMENT
SETBACKS FRONT A® 20REAR Y: LEFT SIDE 6. ', RIGHT SIDE
Permit x'413.00 __ THiS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED �
ONTA NE:1 IN THS BUI_DINt3 CODE. ZONING
Plan Check 10.00 REGULATIONS AND V-L APPLICABLE CODES AND ORDINANCF7,. AND I I IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN JOMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUAN",E OF THIS PERMIT DO'-'S NOT WAIVE
Sub-total 13.0D RESTRICTIVE COVENANTS,. CONTRACTOR AND SUB CONTNACTOAS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERVI:•S REQUIRED FOR SEWER,PLUMBING AND HEATING.
state Tax Q, J i
Toto, 2.31. :,� sac- : 40U,00
T
To - 1 PDC# J I 10 n•a In APPLICANT OR AGENT
By
-- - --
Approves] ot.lh Receipt No. --
�_ PHONE
I
I
I
t
- DATE INSP. TYPE INSPECTION ---` REMA'tK3 - PLUMBING T DATE
Contractor ,/
` A7*
Permit No, 60�'7
Rough-in -�`- -- _-- ' A
�- .,,- �p .. Ou\ ���SA _ VQANc N►T -Low-� Fixture
-3 41,
.�cC / ,'-final -
�1i3-�O HEATING --- -
11-/4-Lt� - A� / �•_�k Contractor
Perm'•
Cas or Oil
------- Rough-in - - -
- Final -
- --.._.-. — _----- - 3EWER
- _-.--- - -------- -- ... --- Final J6 !7 Y ay{
--I..
---- - --------- -- -- - -- DR[ WAY
__.-- --------- ---- -- Final v -
r ---- Storm Drainage i
Y- - - -- - - - -- - ---- -- (Rain Drain)Final
- - —-- -- --- --- - - ------ Sidewalk
- -- Curb&Street Final -
BLG. DEPT. FINAL TEMPORARY 1 CErtTIFICATE OCC
DUP --
CERTIFICATE OCCUPANCY I sinal
Landu'aping
Zoning Final ^�
1 ..
n�
v
13UILDING PERMIT APPLICA T ION '�
TIGAr�3 oArE_ _.
THE UNDERSIGNED HER-6Y APPLIc'S FORA PERMIT FOR THE WORK HEREIN li^JOICA rEc) BUILDER PHONE 7 /-
nq AS SHOWN AND APPROVFD I1"I THE ACCO� PA^YING PLANS AND SPECIFICATIONS. nV NER PHONE --- --
_
-7 /�fff,/" JOB ADORE :;Sf=�1� E. LOT NO./7/g1ya11t�j- r�
/�
BUILI'ER
_� � ADDRESS O V I \Y AK.Aic DESIICNER
STRUCTUPE NEW ❑ REMODEL ❑ AODI_TION _] REPAIR 0 RENEWA. ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCe C CGM11 ❑ EDUCATIONAL- -0 GOV-'-T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORA E ❑ SLAB❑ FENCE
GiirANCY //_ ' _ LANG USE 2GYE ICip/ -_BLDG.TYPE FIRE ZONE_-PLAN CFO ECK BY HEAT_
Ilk
SEWER PERMIT a _._ - _ -
OCC.LOAD FLOOR LOAD � `HEIGHT � NO.STORIES AREA/603_ NO.BEDROL =S VALUE(O -7yp
BUILDINGDEPARTh1ENT SETBACKS FRONT 20 REAR '� IEFTSICE S•S
_ RIGHT SIDE
Permit Z��• gyp_ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS COYTl,1NED IN T}I=
X.
REGULATIONS AN'J ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HE9d3YlAGnEr_D NG T�r:AT'tTHE
FAlanCheck _ _ �- b0 WORK WILL BE DUNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
�S
WITH ALL APPLICABLE CODES AND OROINHNCES. THE ISSUANCE OF THIS PERIMiT DOES NOT WAIV27�iZ.3• RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY t3USItirS,;
LICENSE,SEPARATE PE9V11TS REQUIRED FOR SEWER,PLUMBING AN.- HEATING.
- --- ___ 23 1 •j,Z soc—
Total
'— PDG# AP*UCA.NT QR AriENT -
Approved i Flecelpt No.
ADDRESS PMONE
13DC
a U Val l��.
.EWER CONNECTION S 72.5 �1p03
33 s3, sy
�.WER INSPECTION S
-,EWER SURCHARGE S _ G Z� 113
--- --
(02, ?o 0
" .i y-y of Tigard Mechanical Permit N? Permit ,00
Fee_ D'tJ
Nesv Iristallarion ai—Replace ❑ Relocation ❑ Addition ❑ Alteration ❑ 4%State '
HEATINGTCTAL
CONTRACTOR 1j1y„Q//�� OWNER1
ADDRES°, �ijS�jp/6 WORK ADDRESS -
PHONE_( APPLICANT/T10
Heat Input Rating (BTU Per 1:�our' --/OsVent Size Flue Size
FUEL OIL ❑ GAS - ELECT ❑ OTHER
ITEM N(s. FEE
_ ITEM NO. FEE
For Issualice of Permit _ EE AF}OVET4.00Evaporative
Condition Compressor 15 to 3U HP _ 10.00 t
_New-up to & incl. 00,000 BTU Handling 10,000 CFM 3.00 �I}x
Pie'nr-1.00,001 BTU's & over Handling Over 10_000 CFM �f
5.00 '
Floor Furnace: Cooler3.00
Floor Suspanded nge Vent_Fan 2 0o
Install Vents Only 2.OG Vent System �� 3.00 :
_Repair •Hn3t&Cooling _ 4.00 Hood Commercial
A r Condition Compressor Under —' - -- 3.00 _
00 Commercial Durt System 10.00 ”}
Air Condition Compressor 3 to 15 HP 7.50
INSPECTOR'S COMMENTS
I;ITY BUSINESS LICF..NSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS y
APPROVED BY DATE ISSUED BY__ _ DATE
RECEIPT NO.
ignature of plicant