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S! MING DERPRTMENT, TIGAr NO
�y PLUMBING PERMIT
CAN!► ��� __�e!' . holder of a valid plumbing contractors license is hereby
authori27d to cause pl� work as herein noted to be installed in acrordarlce with the plumbing code of
Tigard. Such inEtallations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of T Igaro Business License required
for all contractors and sub-contractors. fob ST
� _�, Addresi._11.�7 �1� 4� –_ Date 9� .3•Sr'/
Owner 't
NU7TE61 OF TtTAL
IOUN ;i
TYPE QF PEpti111' ITEMS FL-F. 0�! eA(:FI A?,10UPlT
fSmala :amliv-1 bath-each _ ,�_ - 25,00
�_Du-gl'tx=P�ch 1 h±th unit _�__r• _--25.01)
Additimal bathrooms-each -_— ,_ 10.00 _-
I MobOe Hume Space-Rech _ 15,00 1
INOIVIOUAL FIXTURESCOMMERCIAL
50 Fixtures in 1 building-oath __ 3.00 --.
!_S1 to IOU Fixtures in 1 building-each 2.50 _--
101 to '400 Fixtures in 1 building-each - 2.00
701 or more Fixtures in 1 building.-tach- _ M_ 1.50
1MISCELLANE0US � _ --------
Sewer-each additional 100 ft. W-.��-•_ _-10.00
Water Service to building _-_.• 5,00
(PERMIT For Plumbing Inspection Plrone 639.4171
1 49;State _A"V Plumbing Contractor By �Zt'x1R2.�
1 TOTAL — RECEIPT NO. ht--d By _-- _
w NEWS
BUILDING PERMIT APPi.ICA-KION TIGARD DATE—__—.".
'rHE UNDERSIGNED HEREBY APPLIES FOR A PERMH I-OR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. of, OWNER PHONE
OW JER J09ADDRESB, 11475 C?,; S1 LOT NO.
-------- --- -- ---
ARCHITECT
ENGINEER
BVILDEFh AIaye Constr. ADDRESS 12. f,D DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL L$ADDITION ❑ REPAIN ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS O PA fl0 n CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE_
OCCUPANCY _-i_-:-, LAND USEZONE _12-7--7 BLDG.TYPE =IRE ZGNE PLAN CHECK E17'tIr HEAT W
.?^tacwt ac'dikion to single falril.y norvj 2m.] floor.
SEWERPERMITN
OCC.LC, D FLOOR LOAD HEIGHT Nn.STC aIES AREA NO.BEDROOMS ? VALUE
_BUING DEPARTMENT SCT BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit (H] THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CL MING
-� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED ... F THE
Plan Check T:, WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICA11ONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State lax 3.S4 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC--
Total
- ---
PDCM APPLICANT OR AGENT -
By _ f
k?C,1" Receipt No.
Approved �� _____�
ADDRESS PHONE
DATE :MSP. TYPE INSPECTION
��� RLMARK8 PL.0gIMCs ! DATE
Contractor /
0'r _ PPrn+'t No, r
p
`�D_(�(r y�,� d►. c��'1�.t� � Rough-in
f d �CJ>•l( t�t� Fina:
1_ �++ HEATING
3-31-� 71 g(`, 04 jgj$K 1 i CQ�L i Contractor
64
41 t` 13140p, ?gmiAA! ,4n L V77n aIIl 5Z4d i
Pe .it No.
t t �AAtI , t tTN� Yl iltc h10 i lltJ I�( C4��• Gat or Oil _-
- Rough-in
Final
.� SEWER ------�.
Final
DRIVEWAY
Final
Storm C ainage
(Rain Drain)Final
` Sidewalk
Curb&Street Floal
Approach
BLDri.DEPT.FINAL, t TEMPORARY CERTIFICATE OCCUPANCY l _—
CERTIFICATE OCCUPANCY I t-mai
` - Landscaping
�
Zoning Final
BUILDING PERMIT APPLICATION TIGAii:) DATE_�'.'���1`�' .19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILCG%"NONE
OR AS SHOW,!hNO APPROVED IN THE ACCGNIPANYING PLANS AND SPECIFICATIONS. 0YJNER PHO,,mw/�4Y6 ��S
_'••:r:-Rzx,108 ADDRESS
ARCHITECT
ENGINEER
SUILCER ADDRESS1,�.�7[7 r DESIGNER
�,r"1:_ �rrcr--u'�,..L.L.2 47
STRUCTURE C NBV Cl REMODEL AOOIT:ON ❑ REPAIR (] RENEWAL ❑ FiRE DAMAGE ❑ DEMIOLI?ION
_..
''�ESIDENCZ C CCM!N C EDUCATIONAL ❑ GOV'T Cl RELIGIOUS G PATIO C CARPORT 0 GARAGE C STORAGE ❑ SLABC FENCE
:u.iir•ANCY Z_:_5 _,LAND USEZONE Y % BLDG.TYPE �a _1�FIRE ZONE----�PLAN CHECK BY AD_HEAT
/
00 r
�`•-s_••�"�ific•-Z7 _ -.. _. :sem.j"moi. �. .,-1_t Q_-...-[ �Y.i�..i
.11 FL
`.EWER PERMIT K
CC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA- �Y "NO.BEDROOMS ,� V4.LUE�� t^ c
-- f2
BUILDING DEPARTMENT SETBACKS FRONT REAR I.EFTSICE RIGHT SIDra
�
�'^mit HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE EUILDIN CODE,ZOWNG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, A�JO IT t5 HERc?Y AGREE) TY,Ai TY,E
'Ian Check ~�i WORK 'WILL BE DONE IN ACCORCANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO'i:PUANCE
I WITH ALL APPLICABLE CODES ANO ORDINANCES. THE ISSUANCE GF THIS PSRMIT DOES NOT WAIVE
Subtotal ESTRICTIVE COVE` A,*4 rs. CO`!i SAC T OR AND SUS CONTRACTORS TO HAVE CURRENT CITY fiu,SIhtSS
I L .FNSE.SEPARATE PER7,11TS REQUIRED FOR SEEWER,PLUMBING AND HEATING.
/ �
stits Tax 'a
lural _
POCS APPUCANT OR AGENT
BY
Receipt No.
Approved 1 ADDRESS /"ONE
CC •
EWER NNECTI
F WER INS P TION 9 ���� .
EWER S hCHARG.. S
nmmoOfc • ' /l �� � � �_
! ! ! ! ! ! ! !
I
CITY OF TIGARD—12420 S.W.MAIN—TIGARD,OREGON 97223
RECEIPT
DATE: ��a� " �' AMOUNT: $_=L� 6
I
c'"i. !. ,� ��1�1 ` _�---1 �r—D6LLARS
NAME; CASH:
ADDRESS:_ i 7��� ,y:t �K-P 12 ,i`- 1 9' CHECK- _
M.O.
! OF
FOR: ACCT_! PERMITS _SURCHARGE AMOUNT `
SEWER BILLINGS 40-364 _T $
BUSINESS LICENSE 05-331 _ — --
PLUMBING PERMIT 05-332
MECHANICAL PERMIT 05-332 --
ABUILDING PERMIT 05-333
SEWER CONNECTION 40-363 _ ------
SEWER INSPECTION 40-365
SYSTEM DEV.CHARGE 25-366
PARK DEV.CHARGE #1 30-367 _
PARK DEV.CHARGE #2 30-368 --
ZONING ADJUSTMENTS 05.362
r� TOTALS $ '
RECEIVED BY
PtRMIT NUMBERS A#IONlD:
Numbrr Amount Number Amount _Number Amount
s ,W _ _ S - $
RECEIPT #
�.�.......ryl..».tr.wwh�r_...._...+Y._ ._.-......-._.�.-�.w•,.W'.•wv..-.�.»r..,.:..i. .�..-.e._._._....._.�,...A.w.�.�.��.,a�_..rvw..+•.wv^Rr^�.._....__......._.-....._.....�
NO 27107
I
BUILDING PERMIT APPLICATION) 11TY TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BIJILDERPHONE� _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_.—
LOT NO. - __.--
OWNER ;uhn 5andbo JOB ADDRESS 1��7"'1 ''fv �'I'St- HOME ADDRESS -- _
-- ARCHITECT
ENGINEER
BUILDER ADDRESS0
S ^^ DESIGNF9
STRUCTURE _❑NEW ❑Ri-mnDEL _ nADDITION REPAIR _09ENEWAL []FIRE DAMAGE ❑DEMOI_IT_ON
❑ RESIDENCE ❑COMM ❑ DUCATIONAL -❑GOV'T ❑RELIGIOUS❑PA- u:AR PORT ❑GARAGE [:]STORAGE❑SLAP [:]FENCE
❑BOND IJMOVING ❑CONDIT+ONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCU'ANCY- LAND USE ZONE _7 -BLDG,TYPE----- --FIRE ZONE j PLAN CHECK BY_._F '-•' HEAT_-._
9,lalad Strdvq (Pro-fab
- -----—
Irletallati,Jn
Q-C,LQAQ „__FLQOR LOAD_ _-.- AREA
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT S.')E RIGHT SIDE
Permit
THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Pla ,Check REGULATIONS AND ALL APPLWABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- -- _ WORK WILL BE DONE IN ACCORDANCF WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPL ICAHL.E CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State TA LICENSE, SEPARATE PERMITS REQUIRED FOR SEW'R PLUMBING AND ::EATING.
Total •2f)
By P
AOPLICANT DR AC3ENt
Approved f.•i.!Ei t'1en Receipt No
DATE INSP. TYPE INSPECTION - u REMARKS PLUMBING DATE
Contractor
iax.�.• ----- - Permit No. -^ - —
Rough-ir.
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
-- -- - ----
Rough-in --
-� •— ---- --- -- - Final
- - - ----- ------ _.�—_ - SEWER
------ --__ _----------- -- final
-- -- ^-- DRIVEWAY
----- ---.-- --------------- Final
— _ _------- Storm Drainage �-
--- _--- �---—` (Rain Drain)Final
- -� -.-^ -�- Sidewalk
Curb&Strew Final
- --- - _.- -- Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -
Landscaping
Zoning Final
Wt ■'►
City of 1 igord
INSPECTION R&EQUE
Sr
for
INSPECTION T'ME: �7 PERMIT NO. :.�
DAT E: -_D AT E ;S S u E D :
OWNER'S NAME :
ADDRESS.* F/
!/
CONTRACTOR :
TEST : Ai- L , 'Acte- "
Viauo: � , �.�Lo-afo�v C
RESULT: AparcVG DiaaPp,oved Pendin7
S KETCH:
i
I
I
ECTOR DATE
L NOTE : A•to,�lr �u�^;omental t 1 rJnta I
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rM+r-rr.�:Ku,.t.,wars.,Wlwgt}'yps.�e.., .. ...-... .. ...,�u�aw�•..wur.,. .r
CITY OF
BUILDING PERMIT APPLICATION IG,ARD DATE_ ���$ ,9 N` ��
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPE,pCIFICATIONS. OWNER PHONE—_.--,
OWNER ADDRESS JI.1Q?5 SoUl• / BUILDER PHONE
ENGINEER
Fil!1LiLEH__ ARCHITECT _ DESIGNER
STRUCTURE (:]NEW ❑REMODEL _ ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
El RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PONT ❑GARAGE [3 51-ORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING -]CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPP.G IED ❑SIGNS
6C.
OCCUPANCY_ LAND USE ZONE.— BLDG.TYPE ._._FIRE ZONE._ PLAN CHECK BY._—_ HEAT...
c;oT1atrul;t ;:U A 23 addit wn in reaa., dwel tir►g with Usi th
acroruing to approved plants
anchor baits E' u.c. — tempered Blasts in sliding door
H-14 insulation in KAX coiling r-LL in walla R-5 in foundation
OCC. LOAD FLOOR LOAD _ HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR L EFT SIDE Y RIGHT SIDE
Permit _— — --
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS .'ONTAINED IN THE BUILDING CODE, ZONING
Plan Chet k REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THI,
--� WORK WILL RE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WI i H
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT ';VAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
196 State 32 LICENSE.. SEPARATE PERMITS REQUIRED FOR SEWER, Pt UMBING AND HEATING.
Tot II 32*3 .
By
-- -
APP.-ICANf OR AGENT - -
Approved Receipt No.
AODRES5 rliiini( ----
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _l,"_�rd'�-
:��r
c' - lOr9iZ iii/Fin/t 0.0 _ Permit Noir
1J.-J�- L_' V—�L(cQs��'�i - , /, 1 b 6 l•/4•�5• Rough in _
Fixture
Final— — ----
HEATING
Contractor _
Permit No.
- _- -- J Gas or Oil
Rough-in
Final —
SEWER
---—— -- —
DRIVEWAY
Final
— — — Storm Drainage
(Rain Drain) Final _
Sidewalk
Curb&Street Final
BLDG DEPT. FINAL _ TEMPORARY CERTIFICATE OCCUPANCY I"final
CERTIFICATE OCCUPANCY --
Landscaping
Zoning Final
i!t ! w I!►
City of Tigard
INSPECTION REQUEST
for
:NSPECTION TIME : /'m , PERMIT NO. : —.-
DATE:
O. :DATE: Z>AdJ6 DATE ISSUED:_.,_. L
OWNERS NAME :
ADDRESS :
CONTRACTOR '-
TEST'.
ONTRACTOR :-TEST' Air El, Water p , Visual G , Laboratory p
RESULT: Approved , Disapproved r_ Peadinq p
SKETCH:
UH.-Ot�'k'i ��cvN Cy /5 Fi �Ix�r'1
Lj v a
� ew,
�:;pS
INSPECTOR DATE
NNOTA Attach supplementol test data hetet]
�1.
Andressf�-/ �J �� Qir� Permit No.
Name of Occupant__ Permit charge _
cWb� lf
------ ---- Paid by
Date connected
T 7pe of Building �� �y!?n ,/ Inspe0ion fee,
;t J
Service Rate_ ..._,'- ' y —�--- Paid by _- _
..__..__Date
Contractor. __ Assessment -Paid
Size of connection _ __..
�,Liul,t 1ti^.A✓ d
�4,