15034 SW 91ST AVENUE 15034 SW 91ST AVIME _—
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P.U.8ox 23397
6 � 13125 SA [all Blvd.Tigmd CR 97M
CITY OF f1�1GARD PLUMBING NCa
A,ppolicant: m 'st holo C>egon Registration to conduct a plumbing PERMIT 6.39-475
business or must be property nwner/operalnr not hiring cxrlside help.
Name of Development
Plumbing Permit No. �Y/_C-_-
Address 11 - Description
ORS 814-21-013 QUAN. PRICE AMT.
job Tax Lot — Map.No.
Address S--� ---
Addaa FIXTURES
Lot E31oNc Subdivislon Sink 7.50__ 2S�
Name or name oThusiness Lavatory _ 7.50
/ _- 1� Tub aTub/Shower Comb '2_ 7.50
sig
V-4. 'Address
N
C)O I' W r°C Shower Only --_ - r - 7.50 -p
Owner / late ZIP Water Closet _- -- :1 7.50 Z 2
Z) 3 Dishwasher _ 7.50 7 st
Pho1e Garbage Disposal v- _ / 7.50 7.
Name Washing Machine - 7.50 "t7
Floor Drain 7.50
MaifingAddress - --Ptx7ne----- Water Heater ---� / _-` 7.50- S-Z)
Occupant ----- Laundry Room Tray--- - 7.50
Zip -
P City/Stale
Urinal 7.50
-- Name re- Other Fixtures(Specify) 7.50 --
7.50
PowkV Address �- 750
Cortrsctor CHy/Stete m 7 50 -
MISGELLANEOUS
City Bae Tax tJo Sewer 1 at 100' _ 90.00
Mate
s BoaRrN 3tetepiu r�ers DUST-: o Sewer-ea.Addit 100 _ -- 15.00 --
(Residential) Water Service 1st 100' / 20.00 1.0
I hereby V*nowledge that I have read IN*application.that the IMcrmatlon WL'Ar Service as.Addit2Mr --- Y 15.00_ _
given is correct,that I am repfslered with to State Brrillees Board.Ivid ale: Storm&Rain Drain t st.100' 30.00
he" a State Pkwnt*V boons@ that the nun tws given are oorred, 'I'.al all
pkKnbrng wah wig be done In socordanee with appticabte provieloVS or Ore Storm&Pyn Drain Addit,100' 15.00
gon Revised Statutes Chapters 447 and 993 and app>rkable codes and that Mobile Home Space 25.00
no help will be employed urMss Ikonsed undo ORS 963 (11 exempt fnxn Back Flow PreverMKxr -
State registration,please give reason below)
ffOMEOWNERS-I hereby certify eve I am the owner of the property de- Device of Anb4*oUion Oevivois 7.50
eorbed above,M wtMCh bcabon I propose to make a pkwrt*g hstaltabon kx Any Trap or Wash Not
n j own use"this properly M rat bokV cor%W.ded for 66e,Isaee of r•M CorwnCMd to a FixUue 7.50
Catch Basin -—- 750
it".d Ex*.Plumbh+p - 40.00 Per Hr
---- ---- -A�_-- ---
Spedialty Re4uMlfad itimpoodons - - 40.00 Per Hr
Aftw of Pksn1Ang*11116
- t an EAMIrV 15,D1 min
kk
AUTHORIZED SIONA E
New Bldg.fit Build.Addition
---- - ,-irule Gwil
Describe wrA newaddition afMration❑ repair( j d e11' --35.00 --�
to be done rtWiiL]dential 6k non-residMtial I l ---__._._ �._ _
Exis"use of
WkIllirtq or propertl _-- 7 r.t "� �� OUFTOTAIL lye '-
Piqpmed uos of 4%SURCHAME S
alb - -- - TO11Al
MoTk'! --� -__ -_----
ThM pa becomes ftA and void M work a oatetruarcin mWicinzed is not M, asap .r...�a••s
twit 1sArtYt ti0 dsyaar M owtrrt toMttn or wont r Nlafwdsd or sbo ohm Md fa
a period of 100 days id eny Mrtw IA1M work In aimmwwA
11111MCIAL OOIa(YIOno_ —__-. _.. r
Deft laaued 1,e.4 2_._ by .oto
�- Mt)"a Is OR.--
AD
�I
Building Permit No, -7 1-1 1
Location 15034 :,w qa,+ 11
`r,'Ao-rd, oR q-7aa�
Date -�
Statement of Exemption
From Bui�Te Bose- _---
Registration
s
J II--
1, _ 111 i Sherv�� �c�IY�Z.C►'� am personally exempt from registration
with the Builders Board for the following reason:,::
I am performing work on property I own, a residence that I reside in,
and/or a residence that I will reside in. I will be my own general
contractor and will hire subcontractors who are registered with the
Builders Board.
(Y) I own, reside in, and/or will reside in the completed dwelling. f
My general contractor is:
Name - NGIME.S /ypLw^) NIC-,
Builders Board Registration Number, 'AQ 41Q� 9 $ - j� ag* —
Registration f,xpiration Date
All subcontractors who work on this dwelling will be registered with
the Builders Board.
Signature
w Ix IF
BUILDING PERMIT APPLICATION DATE___ 19 749
THE LINOERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WJRK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _
LOT NO. 2 S 1-11AD__
OWNER Phil & Sherri JF. UMMDRESS 1504 rkV 91ot Ave. 27 Mallard T.-ik .z _
- (aI5 g • o j�24 ARCHITECT
NGINEER
BUILDER Ilc�"" ~� In � 7IS Rk4rrap Blvd,Suits 202• DESIGNER Tarry Taft #1500
STRUCTUREkINEW ❑ REMODEL L] ACJITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
[_RESIDENCE ❑ COMM E EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USE ZONE R4 --'T%LDG.TYPE all FIRE ZONE._PLAN CHECK BY .E_W__ HEAT__QA
family dwn 1 1 i nrj _&tj_&t_f n r-hns n_r_,-ni n, all-perSubject to 85 coda. no NoT >ar ArF rmtm:)ATIt1N ON rl1 t.--
SEWER PERMIT# 33442( 1du) -1 hath, 11 timprq;,r�zgn 449;
OCC.LOAD FLOOR LOAD 40 HEIGHT 20± NO.STORIES AREA AO.BEDROOMS 3 VALUE 699000
_BUILDING DEPARTMENT SETBACKS FRONT 20 RFAR 38 LEFT SIDE_ 6 RIGHT SIDE 6
Permit _14Q_GA _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
421 .00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRA(:TOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REGUIRED FOR SEWER,PLUMBING AND HEATING.
Stale Tax 13.60 ` : 250.00
Total - SDC— 600.00
.60
PDC# TT 250.00 .4PPLICANTORAGENT -- -By 190 1 00
Receipt No.
Approved 474-.60 - ✓,��'f� � ADDRESS P40NE ---
wNWIWA
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor 44 /yS6U
7_ y a� 3 _ Permit No. �l
O "" L �Pir✓.Qti _ ____— Rough-in
Fixture
Final --
,.•�/ HEATING
_ t L• i Iced ntractor
` —7 Permit No.
Gas or Oil -- -
Final
--- --I--- -- — SEWER — ---
_—,.--— --- ------ final
--- - - - — - --- — DRIVEWAY ----
---- - ----- --- -- - ---- Final v— --- -
Storm Drainage
(Rain Drain)Flnai
---.Sidewalk
Curb&Street Final
Approach - -----
BLDG.DEPT.rINAL TEMPORARY CERTIFICATE OCCUPANC' 11 Final
CERTIFICATE OCCUPANCY
Landscaping
T.oninp Final
MW
CITY OF TIGARD BUILDING DEPARTMENT PLAN CHECK NO. :
PLAN CHECK APPLICATION DATE RECEIVED:
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID: C)
This is to certify that the attached sets of plans have been submitted for plan
check pursuant to the Oregon Structural Code and Fire 6 Life Safety Code, S edition.
PROPERTY OWNER: C OWNER'S ADDRESS:
CONTRACTOR: !��' +7r,.c r� %�li�J.c� TELEPhONE: _
JOB ADDRESS: >' 24- I.0'I NO. 6 MAP;
DESCRIPTION OF WORK:
Approvals Required SPECIAL NOTES
OPlanning Dept. O Reissue
OEngineering Dept: . O Flood Plain/Sensitive Lands
OFire District 0 Sewer Availability
OOther Other
ILems Required
List of subcontractors
OBusiness Tax
L� Calculations
OTruss Details
O Parking Plan ' ^^
O Landscape Plan
r
O Other :SM11
H NES NOW, INC
;ror 111)
COMMENTS:
1225 NW Murray Blvd
rude, 102 --
Pprfl,� 27V
C F "PAT- O'BRIEN Or
City of Tigard Building Department. CDN VALK�'
i
BY: I eadirrg WiP way to
�---• ciffcxd��ble hcxrx�crwnersh��
No
0 uri
t
NLJN LhLLh NIJ. 5 9 ��-
tor inspections call 6:39•-4175 PERMIT NO. 4o 7
CITY OF TIGARD 699.4171 DATE I _ 1ST-- =jr
BUILDING P RMIT A 1"
P.O. nx 21397, Tigard OR 97233 p�� c TAXMAP LOTNO. _?�_.___50001w310N
OWNER V l l S i/1 y1 I--4.��1111��ii JOB ADDRESS LI
BUILDER � �b W_ �.-�-� S TATE REO.NO. V4, DATE IZ '
BUILDER'S PHONEy 2.6 - 2-45 --
OTHER
ARCHITECT L 7 TAFT PHONE LEJ-02G —
ST RE NEW ❑ REMODEL ❑ ADOITION O REPAIR O MOVE O OTHER l7 D(MOI.ITION
RESIDENCE ❑ COMM O EL)trATION ❑ INO • O RELIGIOUS, 0-ACCESSORY O GARAGE C)OTHER O FENCE
OCCUPANCY LAND USE PONE t i _.BLDG.TYPE FIP.c ZANE '"= PLAN CHECK BY �.1�a►�At � �
Construct single family dwei j hjq_W/e.Ltached OT aQp- ;%I ] per approved plaapri _
S ihiprr to 85 code _—�—�
SEWERPERMIT
I,�, �sy 'Odu) baths.// trans aaraae area ��J
T
!) C.LOAD FLOOR LOAD HEIGHT Ulf-NO.STORIES AREA ISO® NO.BEDROOMS I VALUE �?��
BUILDING DEPARTMENTSETBACKS FRONT LEFT REAR
PwnWl "" THIS PFRMIT r-RUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODt.ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND R 43 HURBY AGREED'rHA'f THE
Plan Ch4rk WORK WN.L Be DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI.IANCE
WITH ALL APPLICABLE CODES AND ORDINANCES.THE UWJMC!OP THIS PERMIT DOLS W)T WAIVE
Pl.Ck.Firs RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY IIJSINESS
i� L TAX PERMITS.SEPARATE PERMITS RFOUIRED FOR SFW..R,PLUMBING AND HIATINO.
State Tu Jr lb iJ SSOC
-- SDC
Total / APPLICANT ORAGENT
—� POLI
r FRecelpl No ADDRESS
1381.Due
Issued By-ipJ►PWw�f
SSDC -- $ .-A 3,.0
oUC I v l ' RECEIPT k
t— DATE PD.
.
SCWER CONNECTION � _ �� AMOUNT PD._ha
SLWER INSPECTIIN
SEWCP. SURCHARGE S
r
:omrnente:
- 0 CAI'
e..r r ti yr r iiiiimnu mr—%, Av4i%.P#ALL rmri1V11 1 Permit #
Description
Table 3A Mechanical Code OTY Pf11C[ AMT
City of Tigard 1) Permit Fee -0- -0- 10.00
13125 S.W. Hall Blvd,
RO. Cox 23397 -- -- — --
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 1) Furnace to 100,000 BTLI 6.00 ! -
incl ducts 8 vents to
rurnace 100,000 BTU +
2) incl ducts 8 vents 7 50
} Name of Deve.,pne + e n _ Floor Furnace
00
10 /�Q�•C, -^d L0..�L.Z� 3) incl.vent - -- - ��
Job AddressSuspended heater,wall heater 00
Address 50 3 L^1 q t 14-- 4) or floor mounted heater 6
Tvent not incl.in
ax lot Map No 5) 300
t.of Z 7 stork Subdivision appliance permit
Name( r name of business) 6) Repair of heating,refr ig., 600
cooling,absorption unit
Mailing re[p --- Phoma Boiler or comp to 3 HP -- _ -
Owner `U �) 6.00
absorp.unit to 100,000 BTU
citylstat• ZipBoilerorcompto3HP• 15HP
8) absorp.unit to 500,000 BTU
11.00
N„T,eBoiler or comp 15-30 HP
T� l / 9) Br cr unit t/7.1 million 15.00
�/t^J
t-vre,t absorp.
Ms6rtpAddren Phone 10) comp to 30-50 HP 22.50
absorp.unit 1 •1.75 million
Contractor yf Boiler or romp to 50 HP
11) absorp.unit 1,750,000 BTU 31.50
Illlaq Repleltrallon No. Crty Bus Tax No 12) Air handling unit to 450
10,000 CFM
I hwebv ack that I have read this Air handling unit 750
nowtedge appkcatrori that the x�fomiatron yuan iti 13) 111,000 CFM +
coned.+het I am the owner or authonred agent of the owner that plans submMod are in --- -
00""Ance with Stat@ laws,that I am-eplalered wMh the Stall Wkiers Board,that tt+eNon portable
number given is correct' (it exempt front State registration please give reason below14) ) evftporate cooler 450
Vent fan connected
-- t 5 to a single duct 3 /:z-
16)
) Ventilation system not 18 Included in appliance permit x.50
Hood served by ---— Sp
�( t 7 mechanical exhaust -� 4.50_a.par+tl DoleDomestic type 750
Describe work l_7 addition O al lmtbi r] repair I 1 1 e) Incinerator
to be done resklenfial {� tion-fralMenhal 0 Commerclal or Industrial
-'- � 19) Incinerator 3000
Existing use of �� � � � In
building or property ka4A) 1_Z!•� �) eater,solar, stov..water etc. 4 50
Proposed use of
building or property --_ -__..------__—_-- 21) Gas piping tate to bur outlets 200 Z -
Tyne of fuel - ol► C 1 natural gas Wj LPG O electric Ll i
22) More then 1-per outlet
HO= — -----_ ___SUB-TOTAL �/
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON. - --- -- - --
xv
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 'LAN RIVIEW W%OF W&TOTAL a?1,
ABANDONED Fon A PERIOD OF 180 DAYS AT ANY TIME AFTER --- -- --
WORK IS COMMENCED TOTAL yJ
Spedal C vxldlllon* r
Date Issued ___ by ---