11790 SW 92ND AVENUE-1 11790 SW 92ND AVENUE -_
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BUILDING DEPARTMENT, TIGARD
BE01ION & HELLUM5 PLB(i., INC. PLUMBING PERMIT � 'a
3321 S. E. HAViWTHORNE BLVD., 231 88PS i
holder of a valid plumbing contractors license Is hereby
authorized to cause plumbing work as harein noted to be installed in accordance with the phi nbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
W hours p`or tv the time the installations areregdy for inspection. City of Tigard Business License required
for all conti jct r; and sub-contractors, -(0_1')�pb Wil) I Q
Ownef�.H�.n°, cUtON_) �. Address-kUn ��Q � Date I17 8j
NUMBER OF TOTAL
TYPE OF PERMIT ITENIS FEE ON EAC11 AMOUNT
_REStOENTIA( .,._
Sin le F mll —1 bath—each j 25.00 .�
Ovtslex—Foch 1 bath un t 25.00
Additional bathrooms—each _ _ 10.00_
_Mobile Home_Space—each T^ _ _ 15.� T °j
INDIVIDUAL FIXTURE) CMm1F C Ht _
_ 1 to 50Fixtures in 1 building—each _ 3.00 _ di
51 to 100 Flxturei In 1 build rq each _ �^ _ __ 2.50__ _ - �_� 1
101 to 200 Fixturos in 1 bulldlnn—each 2.00
_101 or more Fixtures in 1 buildin2each 1.50
MIS-ELLANEOUS
SL —each additional 100 ft. 10,00 _
water Service to building
Other (Specify)-
PERMIT et fir Plumbing lnspectlon Phone 639-4171
A :State >G� Plumbing Contractor By
TOTgL _ y/. (rj(1._ --.. RECEIPT NO. lavurl Rv - � ---
I
BUiLUING PERMIT APPLICATION TIGARD DATE
1 HE UNDERSIGNED HEnEBY APPLIES FOR A PERM I-1` FOR THE WOE IN FIEREIN INDICATED BUILDER PHONE
OR AS SHOVJN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE T
e Ct.
GWNER__ /tiI.1LIt0n co. _ JOB LOT NC 4 -Barbe
ADDRESS 11790 SW 92nd Avenue _
I /G , ._t„t_. It , 6 ,• �l(L�-1 � ENGINEER ARCHITECT
BUILDER same ADDRESS_ aGZ.Q..QyLq•—..,L.Jn. I DESIGNER Piercy barcle ry
STRUCTURE El NEW ❑ REMODEL O ADDITION ❑ REPAIR ❑_RENEWAL ❑ FIRE DAMAGE 0 DEMOLITION
9kRESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO n CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAR❑ FENCE
OCCUPA!ICY R`3 LAND USE ZONE R=S BLDG.TYPE 5N FIRE 20NE �" PLAN CHECK BY dwh HEAT----V!g
Construct single family dwelling w atteched
T � garage. 3 Bedrooms 2 Ba t;'Is. _
SEE CORRECTION SHEET ATTACHED. PLAN #1098A
SFWERPERMIT# 23373 — WggM �gQQQQ {Q�
OCC.LOAD FLOOR LOAD 4O_'IEIQHT 13 NO.STORIES 1 AREA 1099 NO.BEDROOMS 3 VALU649,60(3•
BUILDING DEPARTMENT SET BACKS FRONT 15 REAR 21 LEFT SIDE 5.5 RIGHT SIDE 1 r
Permit187.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
f REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 1 93.5 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
Sub•tofel zHO.50 RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 7,4a LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER.PLUMBING AND HEATING.
Total $287.98 SDG . 4400.00 f ..
PDC# I X100.00 APPit.ICA RAQENT
By
Approved dyh Receipt No.
__ rr�,, PHONE
IVA xl��I
DATE INSP. TYPE INSPECTION REMARKS --
-_- PL MBrNG DATE
Contracto
Permit No. a-753 / /� - -�/
p%ZO-0/ vu — --- Rough-in L
Zv ' --�
Fixture . ?
i
Final --
HEATINC
Contractor
Permit Nu.
--- Gas or Oil
Rnugh-in -
- Final --
_ SIEWER -----
--- Final
DRIVEWAY
Final
- - Storm Drainage
-- — (Rain Drain)Final
-' -- -- Sidewalk M-
-"— - --------- - Curb&Street Final
BLDG. DEPT. PINAL -T Approach
TEMPORARY CERTIFICATE CICCLPA.�y
CERTIFICATE OCCUPANCY 1 / Final -
Landscaping
Zoning Final
EVEMMUR
77
SUI!DING PERMITAPPLICATION TIGAz:) OATE � `�_•�s �_ �� f
THE UNOERSIW^ ED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER P,yC;aE6?,i-63G
OR AS SHOWN AND APPROVED IN THE ACCO!'PANYING PLA""S AND)PECIFICATIONS. O'rlrl_=^o:to.;S
TIG1ZON �Q. JOB ADDRESS 117 h LOFtt0. 0.�' eE.
U . -`. _�� l�_ _--mac.•
ARCHITECT
2 7 nv_e 1 ,0 Q ENGINEER,
51.ILCEA O►,W1`Q ADDRESS L 7 703 DESIGNER• 1
STRUCTURE NEW Cl REMODEL ❑ ADDITION ❑ REPAIR ❑ PENEWAL Cl FIREDAMAGE ❑ D=t,IOLITI
R'75IDENCE ❑ CCkim ❑ EDUCATICNAL ❑ GOVT ❑ RELIGiO1U'S��❑ PATIO ❑ CAR PORT ❑ GARAGE C S i ORAGE ❑ SI�;F�= FEN
�L-ZUPANCY _-C _ LAND USE ZONE �_�-aLDG.TYPE I!R._._FIREZONE_._�PLAN CHECK BY ` HEAT____
-. �o►�''s �v1C��� Paw.1_�t���uQ��N_ tt1 Q 1'70.C.lfiQC.�I,]Gl�!-GLCj�+, -----_--
-- ------ -------------- �a�l Dom_ a, �a_�-�_—
SEWER PERMIT ___ _ V G f✓ 5,20
OCC.LOAD FLOOR LOAD O HEIGHT 13 NO.STORIES c
�_ _ I AREA I OQQ N0.8_DPCO,!S 3 VALUE
( BUILCINuDEPARTMENi SETBACKS FRONT REAS Zr LEFTSICE RIGHTSIDE
.j.'� RIGH. SIDE
i?emit -,� �' v THIS PERMIT IS ISSUED SUBJECT TO TY.E REGULATIONS CONTAINED IN THE EUILDINC; COD-T ZOK;,
'=13n Chec v REGULATIONS AND ALL APPLICAAI,E CODES AND ORDINANCES, AtiD IT IS HrFtc-3Y AGR£E'J 2 aPAT T
ORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO'.iPLIAN
TH ALL APPLICABLE CODES AND ORDINANCES. THE MLIANCE OF THIS PER`,t17 ODES �;OT VYAI
u total _ �� �•�y
RE tRICTIVE COVENANTS. CONTRACTOR ANO SU3 CONTRACTOA3 TO HtiVE CURReNT Cii f E SI11e
wp p UC, ISE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUNIaltJG AND HEATING.
^_C7C8 ia7c • I vv
Total q8 SDS �IOG L.1�T'J toM6 �ctt�, RowlaPhe •�k '}`.
PDC# APPLICANT ORAGENT - ------___
BY
t Receipt No Lice#_1 2 oz
i Approved ADDRESS PMONE
3nC - S 4tAO
::nC - S Z _lob
=EWER CCtiUECTION' S __ zJ _ l �i�•�
=WER INSPECTION
�EWEA SURCHARGE S � �w
tit 37. q8
1
�i. 1018 A
T (2° ,-4 14me. I g s l
l l '7 4 c 4su 1 a.'d- AIme. 13.4. C..4
/4-, * (a�
F'100�- 'fah : 6x 13 76
s� x
23 It$
�.� x *3 7�
i
City. of Tigard Mechanical Permit NO. ._
`.en.tn,.allation 12x Replace Relocation [_j Addition Alteration r_ DATE:
HEATING Imperial Mech. Tiburon
CONTRACTOR __ OWNER _._
^1,a).gESS PO Box 06327/Ptld. 97206 JOB ADDRESS 11790 SW 92nd Ave. (lot- 4)
PHONE __i 1Z 801 APPLICANT_
Heat Input Rarng(BTU per Hour) Vent Size—__ Flue Size
FUEL OIL[j GAS & ELECT OTHER
v ITEM 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 u 6.00 Commercial Hood System _ 7.50__
New 100,000 BUT's & over _ 7.50 Other Equipment - Each _ 4.50
W_oodbu_rning Stove — _ 4.50_ 1 Trip Inspection ^ _ _ 4.50
Wall-Floor- Suspended _^_ _ 6.00 Air Condition Compressor - up to& incl. 3 H.P. _ �6.00
Vent System �
Vt w/Fan _ _ 4.50 Air Condition Compressor-3.1 to 15. H.P. incl. 11.00
FlcatCc'!!r,r� .— _ 600 — ----- ----- — }--__
CITY BUSINESS LICENSE REQUIRED B" ALL CONTRACTCRS OR SUB-CONTRACTOR'; ! !
PERMIT ISSUANCE 10.00 Comments:
FEES V 6,00
SUBTOTAL 16. 00
_—_% STATE Issued 12y
$16.64