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BUIL DING PERMIT APPLICATION TIGARD DATE___ Septeriber 23,ts__-1_ 3919
I HE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FO,*1 I HE WORK HEREIN INDICATED BUILDER PHONE: 245-0391
OR AS.':,HOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PyO E
LOT NO._ 5 � '-',@�1C�1Seil�f•
OWNER _ ,13-lr fl TZ. i`'>reGeliee JOB ADDRESS 14920 S.W. 83rd Avenue _ -- - ---
- ARCHITECT
ENGINEER
BUILDER 'a'''e-- ADDRESS 7135 S.W. Willnr�re 1)r. DESIGNER Studie 5
STRUCTURE NEW i O REMODEL -_ [J ADDITION_ — r7 REPAIR O RENEWAL ❑ FIRE DAMAGE El DEMOLITION
DMESIDENCE C] COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIVUS ❑ PATIO D_CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY __- !.AND USE ZONE 's.BLDG,TYPE SLr_FIRE ZONEv "' PLAN CHECK BY _ � _ HEAT Can
+'onstrt►ct single family dwelling With attached %ara�a. `---- __ --
correction sheet attached - 2 betdrr,
1 bath
SEWER PERMITM ---- — ----- (•.wra'd 615s-
QCC.LOAD FLOOR LOAD 40 HEIGHT T. NO.STORIES 1 AREA `; 3 NO.BEDROOMS 2 VALUE 40.
BUILDING DEPARTMENT SE1 9ACKS FRONT 2�' REAR 3('; _LEFT SIDE 7 RIGHT SIDE 1'7
Permit 1�• __ 'THIS PL9MIT IS ISSUED SUBJECT TO THE REGULATIONS CONOUNE) IN THE BUILDING CODE, ZONING
?•00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANO IT IS HEREBY AGREED THAT THE
Plan Check _ WORK WIL! r:r DONE IN ACCORDANCE WI1H THE PLANS AND SPEC'FICATIONS., P::O IN COMPLIANCE 2400OO �WITH ALI. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OY THIS PEPMIT DOES NOT WAIVE
Seib-total_ — RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO 4AVE CURRENT CITY BUSINESS
LICENSE.5 EPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HE;TINS,.
State Tax 1►,, 6.40 ,
Total 246,40SDC-- �i40.OU e
By PDCN tl. 100.00 APPI-NNTOR ENT -
Receipt No. --
Approved _11"b _- ADDRESS - PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE _-
/ Contractoi�/1n��/IV —
Permit NoAb
547
R(,ugh in
Fixture
Final
c H TING
Contractor6tK
—� — — — — Permit No.
Gas ar Oil
_ Rough in
--� ^— — Final
sEwEr
Final
DRIVEWAY --
--- - -- ------------ Forel
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb✓y Street Final
Approach
81..170.G4PT.FIIIAL TEMPORARY CERTIFICATE OCCUP NCV Final
CERTal ICAM OCCUPANCY --__ — ----
(Landscaping
Zoning Fi"al
BU!!DING PERMIT APPLICATION TIGA-:) DATE S—� z3 —1g
T14F:JNDERS1GNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDiCATED BUILDER PHONE2-YA 4 _ V
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLA- '1$,AND SPEC!FICATIO IS. OVVNEP,PHO.NE
' _�OT` O.
O:'NER . / AE5 JOB ADDRESS O 0 3
_d� I
�j �`t�1 P:ICHITECT n
BUILDER �Awlel _ ADDRESS/q,'tr5W N`! 01�T��1'- •SER 940( U s
L
STRUCTURENEW 0 REMODELI T I
G ADDON _❑_ REPAIR ❑ HE:NF Jgg
AL ❑ FIRE DAMAGE ❑ DEMOL!'010.
RESIDENCE Cl COMM ❑ EDUCATIONAL ❑ GOWT Cl RELIGiOL_JS G PATIO ❑ CARPORT ❑ GARAGE C STOR c_❑ SiABQ FE1JC
00CUPANCY LAND USE ZONE BLDG.TYPE —FIRE ZONE'`_PLAN CHECK BY HEAT •���
- —"As n ._ --- -- --- --- - !t3�
SEWERPERMIT q "� �_f2l~ -
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA 2193 NO.BEDROOMS VFL I d 'p
BUILDING DEPARTMENTSET BACKS FRONT REAR 34) LEFT SIC. �-`RIGHT SIDE
P^rmrt —_dTHIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CON IA:-AED IN THF SUILOING ..Or)F� � ,[GP1..J N ;
Plun Cheek , 00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS !IERc`3Y AG;tEED TKAT i H
WORK WILL BE DONE IN ACCORDANCE WITH THE PLA.,S AND SFECiFiUATIONS AND IN Co,"iPLIANC
v WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUAN,-E: OF THIS PSRi.11T JOES NOTW,11%,
Sub—tote) _ /2 � M_ I FESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTas TO HAVE CURP,EI':T CiTf ELIG1,N .^.
f- & .4o LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
•;t to Tax • I
�I SDC—
Total . 7 l! gat 9 t e
PDC# APPUCANT OR A ENT By
Receipt No.
Approved ADDRESS �– —� PHONE
X00 .._.
LIE" 1:ON cT10IN 5 773
>EWCFi INSPECTION
EWER SURCHARGE S
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PJtwfn;,.allatlnn ® r� r,Replace u Relocation LJ Addition Alteration 13 PATE:
H'eATING imperial V,--ch. OWNER James R. McGehee
CONTRACTOR __ 14920 SW 83rd Ave.
ADDRESS---20—PO Box 2(327/Ptl.d__ ""L—
PHONE
" -- JOB ADDRESS
PHONE 777-3801 _— — APPLICANTIs —_—_
►'eat Input Rating(BTU per Hour) _40 0 _
Vent Sire._— ^.--r=- F;;jP Size__._..�q„ _ ---
rUEL OIL CI GAS Q, ELECT OTHER
— _ —� N0. FEE ITEM NO. FEk:T
ITEM
Each Air Handling Unit or Duct a;.. 7.50
For Iswance of Permit ,;EE BELOW B 00 Commercial Hood System 7.50
New-up to &_incl. 100,000 BTU --- _ 450
New 100,000 BUT's & over 7.50 Other Equipment • Each 4.50_
Woodburnin(Lsteve —_ 4.50 1 Trip Inspecoon Wall-Floor- Suspended — 6.00 1 Air Condition Compressor • up to& incl. 3 H.P. 6.00
—
Vent S stem w/Fan 4.50 Air Conditiu,�Compressor•3.1 to 15.H.P. incl. 11 00
H-3,C
LITY BUSINESS UCENSE REQUIRED BY ALL CONT RACTCRS OR SUB-CONTRACTORS ! ! —
PERh11T ISSUANCF 10.00 Comments
FEES _ ----- --- ------ — -- _.._
SUB-TOTAL C'r'
11 STATE (c, Issued By —
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