15040 SW 92ND AVENUE v
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ADDRESS -
PERMIT CHARG`, r none
CONNECTIODJ FEE
PAID BY ilzz&-
.�� DATE CONNECTED
TYPE OF BUILDING
SERVICE RATE � /�_ ____._-----
INSPECTION FEE
PAID 8Y DATE
C 0 N T R A r T O R _..____..
ASSESSMENT FAIU
SIZE OF C O.J�J E G T I 0 h
T- , -79
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
Date: Permit Nr,.__
Inspect
CALL FOR REINSPECTION
City of Tigard Mechanical Permit l Permit
� Fee_
New Instailatiun E-f Replace ❑ Relocation ❑ Addition ❑ Alteration ❑ 4 % State_ IL 1w
HEATING TOTAL l _ - -"•
CONTRACTORa„ rn_,��r� I 1�, it ^ ,{i_l��t OWiNER_�. 3_�.1 � _Jr_.__
ADDAESS'pU 2. , rn'a�-5 (7 ���r!.rrA ('?re- 'F`C�z. WORK ADORESS___1�?� u
PHONE, ^c?-” 3 syL t;_, 7!!t w"�APPLICAN7
Haat Input Rating (STU °er Hour) .�) Vent Size —� Flua Size_—
=UEL OII_ ❑ GAS ❑ ELECT 0-r4R iNks 111
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _ SEE ABOVE_ _ Air Condition Compressor 15 to 30 HP —� 10.00
—up to & incl. 1001000 AT_ �_ 4.00 Air Handling 10,000 CFM 3.00
100,001 BTU's & over 5.00 Air Handiing Over 10,000 CFM 5.00
Floor Furnace 4.00 Evaporative Cooler
Wall -Floor-Suspended _ 4.00 Range Vent Fan z.�p
Install Vents Only 2.00 Vent System
Repair -Hcat& Cooling _ _ _ 4.00 _ Hood Commercial _
_ 3.00
a,ir Condition Compressor Under 3 HP '— 4.00_ Commercial Duct System _ — 10.00
,air Condition Compressor 3 to 15 HP 7.50
NSPECTOR'S COMMENTS I
:ITY BUS!NESS LI - 4" RgQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
f FFtUVED EY :.r` DATE �'T6SUED RY__ DATE
sECEiPT NO.
of Applicant
BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT NO.
J .
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as her ' noted to be ins'a,,ed in accordance with the plumbing 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 installations are ready inspection. City of Tigard Business License required
for ail c ntractors and sub-contractors.
Gwr�eAddrer�1� .6 _lam—�tG?G aa.e�i�0 ' 79
1/7 NUMBER OF TO !u PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT ;Offica Use Dn:yi
111 S LIN T IA I
-110 Family-1 both—ench ��
a
Du x—Larch 1 bath urit 25.00 _
Rr;u,,:onal bathrooms—each 10,00 ZzL
V.ob ,e Nomn 5 ace—eoch 15.00
1VDIViDUAI FIXTURE FEES
1 to ;0 Fixtures in 1 building—each- 3.00
,i1 to 'CO Fixtures in 1 buildin —ench 2,50
101 'o 200 Fixtures in 1 building—each 2,00
20' or more Fixtures in 1 buildin —each 1,50
PG ;3CEI.i.ANE0US
i;uilui�n_Sower-1st 50 ft. �IO.00
rw�i`cnch additional 100 it. _ 10,00
W ,-•service to building
.a Water Systems—oath .00 't,
10.00
a
For Plurnbin;i inspection Phone 639-4191
Piumbinr, Contractor uy _
"G"'A,. RECEIPT NO. Issued 3y
M,f
CITY OF TIGARD BLDG, DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Sec;ion(s) o. the Uniform Building Code, the
following item(s) require correcting:
J'
7ate:.,�_—,00' —Permit No.^_
Inspecto
CALL FOR REINSPECTION
t
BUILDING PERMIT APPLICATION Coy TIGARD DAIE-�--'" ___ . 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUiLDERPHONE— -
OR "S SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE_
LOT NO. —
e^i
OWNER JOB ADDRESS L ' 1• a h __ HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRI' > _J DESIGNER —
STRUCTURE ❑NEW (�_�❑RiMODEL LJADDITION ❑REPAIR_ ❑RENEWAL ❑FIRE DAMAGE— ❑DEMOLITION
[:] RESIDENCE ❑COMM IJEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SI-AB [:]FENCE_
❑BCND ❑MOVING ❑CONDITIONAL USE [—]DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY--LAND USE ZONE_. BLDG.TYPE_ _FIRE ZONE __ PLAN CHECK
-- instruct. C!iiL�1w fanny �iwtl bdi6rsff u 0 t;UOrUGtt.1 LiAwiI, ---
> Nwrml , i4721 — '%622.00
OCC. LQA_Q� -FJ.QQB LOAD () HEIGHT tQ �Q R �_f__AREA i,, a �1Q, QBSZti2�S�_._.YALUJI' `��ulI
BUILDING DEPARTMENT SET BACKS FRONT 12L1 REAR r"'' LEFT SIDE " " P.IGHT SIDE 4.4
PermitTHIS PERMIT IS ISSUED SUBJECT TO THE RFGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICN9LE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
MORK WILL BF DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REOJIRED FOR SEWER. PLUMBING AND HEATING.
Total _ — tit 7f� �' :✓wt., t; L q LL.I
By P
APPLICANT OR AGENI
Approved IJwII Receipt Nf,
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w wfilllmllil,
A
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
.3—2CL7 -�� «/ Contractor
Permit No. /'a
Roughen 17 1
yZ?7 Fixture
Final
+_ HEATING
Contractor
Parmit No. Y� 7-F
Gas or Oil
Rough-in
— --- Final
SEWER
Final Final ' ---f
DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final.
_ Sidewelk
Curb&Street Final
_ Approach
13LDG DEPT.FINAL TCMPORARY CERTIFICATE OCCUPANCY final
CERTIFICATE OCCUPANCY
/ Landscaping
�/� y G• y Zoning Final
Him
_ilL DING PERMIT APPLICATION rOF ('I RDDATE odd 19 7-.1 N°�
-
"--,E �1NDEk, 'vED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE&26 .0 SS -
q a�, SHCWN AND APPROVED IN THE ACCOMPANYI PLANS-AND SPECIFICATIONS. ��TNRPHo
Gf�„�� y LOT NO t-1 f
�
R ( IIT r JOH ✓ADDRESS O
HOME ADDRESS 5�`
ARCHITECT
ER_ C^ r_ — ADDRESS� O �i_LKSL�LLCs - DESIIGNER alt IJ J
'RI �f._W ❑REM_ODEL OADUITIO_N_ OREPAIR OR N—EWA—L— ❑FI-R-
E0AMAGE ODEMOLITION
! iOkNCE OCOMM
❑EDUCATIONAL--DGOV-T ORELIGIOUSOPATIO`OCAR PORT�OGARAGE OSTORAGE OSLAB ❑FENCE
Nr, OMOVING -- ❑CONDITIONAL USET� ODESIGN REVIEW �OCOUNCIL APPROVED (:]SIGNS
"vI D USE ZONE. __ ___ _BLDG TYPE._ - — FIRE ZONE_ -PLAN CHECK r3Y_ _-._ HEAT
�.
()AQ -- • _ _ F-L.9QR I O A D_ �__ HEI d T,_ —- �P –�- -8� ,' �_ �4�.B E LIH�S2M zI KCAL v4�
LEFT SIDE RIGHT SIDE
HUILOINf OEPART MENt SET BACKS FRONT REAR _—
i
- THIS PERMIT IS ISS%IED SUBJECT TO THE RFGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Ptan Check 1 � RFGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
--- - WOPK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL
I
IANCE WITH
Sub-local ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
`- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Sime Tax LICENSE. SEPARATE PERMITS REOUIRF.D FOR SEWER, PLUMBING AND HEATING.
-Total
BY
Appy oved~ Receipl No --
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