11785 SW 92ND AVENUE 1.1785 SW 92ND AVENUE --
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INSPECTION NOTICE
City of Tiga:d Building Department
12420 S.W. blain St.
Tigard,Oregon 97223
Phor,e: 639-4171
Type of Inspectio+i �1 . ZC!� -._
Date Requ,isted— I Z 2 _ Time d/) A.M. _P.M.
Address —l_ 29 - - 31v -L � k�.-r�--
—_ 9 I 2 � o Permit #_ _
Owner _ �' Lot #
"he following Building Code o ficiencies are required to be corrected:
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Presented A p oved
Impactor /z- %s�,. �_] Disapproved
Date — -----�.— --
CALI. FOR REINS�PEC-TION
❑ YES LT MO
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BUILDING DEPARTMENT, TIGARD
BEDLION & HELLUMS PLBG., INC. PLUMBING PERMIT
3321 S. E. HAWTHORNE BLVD., 231-&885 holder of a valid plumbing contractor license is hereby
authorized o cause pbm Ing w r c as herein noted to be installed in accordance with the , unibing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installatid ady for Inspection. City of Tigard Business License required
for all contractors and sub-contractors, Job '
^wneLAL� _ .�dl — —_ Addressl_/7ES I _ D,3 _ cg
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
Single Family 1 beth-each 25.00
Duple_x-Ench 1 bath unit 25.00
a �
Additional bathrooms_each -_- -� -.. —10.00
_ 1r �0
Mrbile Ilnrnn^pu•rr•earh _ _ -------- .r_ --...._.__ �___... ...r_.._.._.__ ____.._......
INDIVIr)UAl FIXTUNE3_ CQ!`1 .IZ(LI AI
1 to 50 F_Ixtures in 1 building-•tach
Y
p i
51 to 100 Fixtures In 1 buildir111_
250_-_ _- - ,E d-wi
1 1 to 700 F i ttuas lr 1 building-each
701 gr more Fixtures in 1 buildingeach^ 1.50
MISCF1_lANE0U5 T _� --
Sewer-each eddition_al 100 ft. _ _ 10.00
Plater Service to building- _- / 15.00
_ i
Other (Specify):
PERMIT of Plumbing ln,pection Phone 639-4 fit
PQ o State %. (00 Plumbing Contractor Ry
TQTAL ,(�l ( . ~ RECEIPT N0. Itcnnrl ta„ 'I
t ! ! ! ! ! !
BUILUNG PERMIT APPLICATION TIGARD DATE 6/ib • __,1s 61 3790
THE 1,1�41DERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOTNO. 3 -0arbeE Couft
OWNER Tiburdki+ JOBADDRESS 11785 SW 92nd AUellUt3_
ARCHITECT
ENGINEER
BUILDER same ADDRESS DESIGNER Piercy uarcley
STRUCTURE ENNEW O REMODEL ❑ ADDITION _ ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
® RESIDENCE (-1 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT L-1 GARAGE I J STORAGE ❑ SLAB❑ FENCE
OCCUPANCY 9-3 LANDUSEZONE R-25 BLDG.TYPE �N FIREZONE -- PLAN CHECK BY dwh HEAT--- gab
Construct single Family dwelling W/attached garagl3. _ 2 Bedrooms 2 Oaths. _
SEE CURRECTIOAJ SHEET ATTACHED„ PLAN XAANA 129E A
'SEWERPERMIT# 233`72 - hTtX25QQ IX l000.00 a _4t�Q _K,Q-ft_
OCC.LOAD FLOOR LOAD 40 HEIGHT 14 NO.STORIES 1 AREA 1311 NO.BEDROOMS - 2 VALUES 56,p 000•
BUILDING DEPARTMENTSET BACKS FRONT 7 REAR 26 LEFT SIDE �• S RIGHT SIDE -1,+ 5
Permit L199.00 THIPERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
((� 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 T141S PERMIT DOES NOT WAIVE
Sub-total 2 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4'1 7.96 ' -�
Total
11�06,46 SDC— 1400.00
f,•
PDC#I S 10 0.U O APL ANT OR„GENT
By 1
duh Receipt No. - --
Approved ..- ADDRESS PHONE—� —_
DATE INSP. TYPE INSPECTION — ,REMARKS _—P — DATE--
�"�`` �•-s Contractor 'x:r
—�--` — -�
" � t��,. L — Permit No.
..Z4^J p/1 c,7-/A/y�►t Ryn Rough-in
Fixture
Final
HEATING
Q Contractor
Permit No. /
g24�V- 7- �
Gas or Oil
- --- Rough-in
- —-- Final —'-
-- SEWER
--- — Final
--- -- _—
DRIVEWAY
Final
All
Storm Drainnge --
- (Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCIP CY
CERTIFICATE OCCUPANCY Final
-
Landscaping
Zoning Final
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BUILDING Pc?1�11TAPPLIC'ATlON TIGARD DAT tg oto
THE UNDERSIGN=D HEREBY APPLIES FORA PERMIT FOR THE WORK HEREIN II JDIC En BUILDcR PHONE63�'dSO
OR AS SHOWN AND APPROVED IN THE ACCO: � � o .c ,E
PAty!l.!G PL..1V5 A�Jp S. EC�FICAT �... OJ'J�IcR P:-IOC.E
ER Traun.oN Geo. JOBADORESS1' h Lort10. ee.
ARCHITECT
CltL. //�� s ENGINEER P
9 ^JEr~� AA�'1`e. ADDRESS26 /•1V
7 � e, L.Q. q70 3µDESIGNER•1 (P/�/.� Qy
STRUCTURE NEYJ Cl REMODEL G ADOIT!ON ❑ REPAIR Cl RENEWAL ❑ FI—RE=DAMAGE—�_
-- ❑ DE►.tOU T IC_
RESIDENCE C COMM L,. EDUCATIONAL ❑ GOVT C RELI3i0US ?AiiO ❑ CARP L-j
GHT [r' GARAGE G STGA Gr_ 0 SLA¢= FENC
—C-CUFANCY R_3 LAND USE ZONE A SLOG.TYPE . —FIRE ZONE "—/n� PLANtC`1ECK BY MEAT--4--,
O S � ` fAMn�� euP.l�l N W Gl�0.Giha 1. AWQ .
'P� �iow'O►C�1`ti'w Ski w.�L.O�K •� I3 di0
Moon l 2q8 A z BMA4 _
SEWER PERMIT x IV
�
OCC.LOAD FLOOR LOAD Q HrIGHT �� NO.STORIES I AREA NO.BEDROOh1S •2 VALUE
{ BUILCIN:SOePARTMENT SETBACKS FRONT Z' REAS 2(p LEFT -
- ,�• '� RIGHT SI DE
�a�rmit THIS PERMIT IS ISSUEED SUBJECT TO THE REGULATIONS CONTAI,IED IN THE BUILDINGr'.7-
21.3n REGULATIONS AND ALL APPLICABLE CODES ANO ORDINANCES, AND IT IS H_9c3Y AG9Ec^. TH» ' ih
Check WORK WILL BE DONE IN ACCOP.DANCE WITH THE PLANS AND SPECIFICA7,'OtIS AND IN CC.'•',PLIA!IC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERM11T DOES N" 'NAI%
3�b-total 2 ^cSTRICTIVE COVENANTS. CONTRACTCR AND SU3 CONTRACTORS TO HAVE CURnE!V7 CITY
ENSE.SEPARATE PE941ITS A=_OUIRED FCA SEWER,PLUMaING AND HEATRiG.
5:ac�rax
Total _moo�• �G S �e�Ll+ C,e � 1o.al Ro�,aPhe
PDC# APPUCANT CH AGENT
eY L iet..,.ee l'2 2 oZ
`Approved Receipt N —
ADDRESS PhtONE
.00
:,c - 3T. # loo -k I
9-EWER MNNECTION S 72r To P&..:A.J y9• S o `
=WEF INSPECTION S hc g9o9
E',IER SURCHARGE S ---
rn,Tmr�r�tel � rj -18 Pti G'.Zst � n jv�, _
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4m� A ems+ cam. .
30
q x 311 3s'f
x 23 lc•l
3S -30 ,278
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City. of Tigard Mechanical" Permit NO.
Ne't, fn_:allation Ej, Replace ❑ Relocatior.❑ Addition ❑ Alteration Ej DATE:
HEC..TING Imperial Mech. 'Tiburon
COr,,TRACTOR _ OWNER
ADDRESS PO Box 06327/Ptld. 97206 JOB ADDRESS 11705 SW 92nd (lot 3)
PHONE 777-3801 — APPLICANT_ ?nip ri al _Mr-c-
Heat Input Rating(BTU ner Hour) ._.._.T__.__..___ Vent Sire.___ _ Run Size_ _._.
FUEL OIL GAS D. ELECT n 01-HER --
_ ITEM T-- NO. FEE —~'_- - ITEM♦� � NO. FEE__
For Issuance of Permit _ SEE BELOW Each Air Handling Unit or Duct System 7.50
New-up to & incl. 100,000 BTU — �' 6.00 _Commercial Hood System _7.50 _
New 100,000 BUT's & over 7.50_ Other Equipment • Each 4.50
Woodburnin4 Stove __ 4.50 1 Trip Inspection _4.50_
Wall-Floor- Suspended — 6.00 Air Condition Compressor up to& incl. 3 H.P_ i 6_00
Vent System w1Fan 4.50 Air Cwdition Compressor• 3.1 to 15. H.P. incl. II 11.00
Cc!�Iing 600
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUBCONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comments:
FEES _ 6.00 -— ----- - --- ----------
SUB-TOTAL 16, 00
— % STATE Issued By_
$16.64