14915 SW 103RD AVENUE-2 1.4915 sw 10 ,RD AVENUE
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INSPECTION NOTICE
City of Tigard Building Department
P.U. Box 23397
Tigard, Oregon 97223
Phonic: 639-4175
`\ T
Type of Inspection
Lim,! Requested �i— T� _��'A.M.___—._P.M.
Address �.� ��/C� Permit #_-
Owner.--__._-- -- --__-- Lot #_
Builder — --— --—-- -------- ----The following Building Code deficiencies are required to be corrected:
Presented to —_�--_ _ T � Approved
Inspector I Disapproved
Date
CALL FOR REINSPEC?'ION
0 YES ONO
CITY OF TIGARD MECHANICAL PERMIT Receipt#
Permit#
Deecrip�7on
City of Tigard
Tsblc,.A Mechanical Code QTY PRICE AMT
- —
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0 110.00
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
6:19-4175t) Furnace to 100,000 BTU 6.u0
incl.ducts&vents
Furnace 100,000 BTO i -
2) incl.ducts&vents 7.50
Name of Development - 3 Floor Furnace
incl.vent 6.U0
Job Address Suspended heater,wall heater
Address 4) or floor mounted_heater 6.00
Tax Lot Map No. Vent not incl.In -
Lot Block Subdivision 5) appliance permit — 3.00
Name(or name of business) Repair of heating,retr ig.,
6) 6.00
- j T cooling,absorption unit
Mailing Address Phone Boiler or comp to 3 H P
Owner I ) absorp.unit to 100,000 BTU 6.00
City/State Zip 8) Boiler or comp to 3 HP-15 HP 11.00
-1})l� '.y, I - absorp,unit to 500,000 BTU -
Name 9) Boiler Or comp 15-30 HP
absorp.unit'/z 1 million 15.00
Melling Address -Th—one - 10) Boiler or comp to 30-50 HP
absorp.unit 1 -1.75 million 22.50
Contractor City State - Zip — -Boiler or comp to 50 HP
11) absorp,unit 1,750,000 BTU 31.50
stet, rgglstren12)
on No city eus.rax No. Air handling unit to
10,000 CFM 4.50
I hereby acknowledge that I have read this application that the Information given is 13) Air handling unit 7.50
correct,that I am the owner or authorized agent of the owner,that plans submitted are In 10,000 CFM i
compliance with State Inws,that I am royiatered with tha State Builders'Board,that the Non portable
number given is correct (it exempt Lom Slate registration please give reason below) 14) evaporate cooler 4.50
15) Vent tan connr,cted
--_ to a single duct 3 00
_-- -- _ Ventilation system not
16) included in appliance permit 4.50
- Hood served by
a !'u 17) mechanical exhaust t.b0
Signature(owner or agent) Date -Domestic type — — —
Describe work 171 addition C1 alteration 11 repair r l 18) incinerator 7.50
to be done residential [-I non-residential IJ Commercial or industrial
Existing use of — 19) type incinerator 30.00
building or properly _ Other i.e.,woodstove,water
Proposed use of 20) heater,solar,clothes dryers,etc. 4.50
building or property _—_ -. 21) Gas piping one to four outlets 2.00
Type of fuel- oil I natural gas 1-1 LPG II electric [ I --�- -
NOTI -
22) More than 4-per oidlet
CE -- --L--- ----
SUB-TOTAI'.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON — --. —
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - ---- --WORK IS IS COMMENCED. TOTAL
Special Conditions
AC )21E
Date issued.. by
INSPECTION NOTICE
City of Tigaro ouilding Department
P.O Box 23:397
Tigard. Oregon 97223
_ Phone: 639-4175
Type of Inspection � �� —_ - __-_-_--
Date Requested Time A.M.
Address _.�. 15- �. P Permit # _
Owner_ -- -- - --- - -- Lot #
Builder ----------..__ _� -- ____ ---- _
The following Building Code deficiencies are required to be cor,ected:
Presented to IA Approved
Inspector �,� -- -- I I Disapproved
Date
CALL FOR REINSPECTION
0 YE8 1..] NO
i
I
I
CITY OF TIGARD 639.4171 6_20 66
6290
BUILDING PERMIT DATE �__�_--- 9 _
TAXMAP —_.__LOTNO. -SUBDIVISION
OWNER Thomas J. S Lean& M. Mart JOBAODRESS 14915 SW 103rd Ave.
_. .—... _.___�.. _.
s auris
BUILDER STATE REG.NO. EXP.DATE
BUILDER'S PHONE 620-0109 y_
ARCHITECT - PHONE _ _.______ OTHER
STRUCTURE �J NEW REMODEL ; ADDITION I , REPAIR J MOVE Ll OTHER CJ DEMOLITION
RESIDENCE U COMM I-] EDUCATION ❑ ;ND I RELIGIOUS kJACCESSORY f I GARAGE OTHER FENCE
OCCUPANCY LAND USE ZONE BLDG.TYPE I' FIRE ZONE PLAN CHECK RY ►I'L HEAT
i.:vnatruct cover for hot tub
SEWER PERMIT N M
OCC.LOAD _FLOOR LOAD HEIGHT NO.STORIES AREAA Z NO,BEDROOMS VALUE)OQQ
_
BUILDING DEPARTMENT _1 SET BACKS FRONT REAR :1l _ LEFT SIDE i(i RIGHT SIDE lt3
Permit 17.50. THIS PERwr IS ISSUED SUBJECT TO THE REG0LArIONS CONTAINED IN THE BUILDING CODE. ZONING
_^I 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
PI.Ck.Fire RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.'EPARATE PERMITS REQUIRED FOR SEWSP'.P"LLUUMBING AND HEATING.
State Tax .70soC—
Total 29 58 _ j --- —
• APPLICANT OR GEN.
-- PDCN
Prepd.
Bal.Due
Receipt No, ( t DDDRUS — PHOONE�''---
w�l
Issued By . _ _. _-_—---Approved By----..,..1.
.. ..•.wiRru:,u+...rr.u.c.rmdMawY.... ..f.:.a�5,«a.:a-...:..:;r-;.:..wt.�.eiWwv+.ti.a.a.......u.i4k..w�ulers,.,.ww.. ,ei«..._.., vw:.:..x,
i ■f � � � S � t
DATE INSP. TYPEINSPECTION REMARKS PLUMBING DATE
. ,..i( e►�C ^ — — � .tu.ls' p.�.f� l' Contractor - —
Permit No.
He igh-in
Fixture
Final
-- -- ---- �..._— -- - -- — HEATING
Contractor
Permit No.
GasorOil
Rough-in
^-- _ _ � .� _—�_�_�'~y'A ^,�•_ _ Final _
SEWER
/A-'10 r,.CA e 1 .Iu.w�K. � Final ---
---� DRIVEWAY
Final
Storm Drainage
— (Rain Drain)Final
Sidewalk
Curb A Street Final
Approach
BLDG.DEPT.FINAL CERTFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final
l andscaping
Zoning Final
Lor inspections call 639•-4175
CITY Of TIGARO 639.1171 DATE
f%1L0jNG P 1MIT
• ox Tigard OR 97223 TAX MAP LOT NO. SUEI0IVISION
OWNE;Iti + 1 ho r- s v -2md �_ bi1 zz A I. 46 / .IOB ADORiAv `7 / l Lti.- %L r d Z, ,-
` -
SUILDER v 14 44a STATE REG.NO. _EXP.DATE
SUILDER-S PHONE G 1 C t C rl
ARCHITECT .Sr4 b4c,_ PHONE _—OTHER
STRUCTURE Q NEW ❑ REMODEL (aAlDITION REPAIR ❑ MOVE U OTHERQ DEMOLITION
RESME14CC O COMM ❑ EDUCATION ❑ I.vO ❑ HEL.I:Umps 'ACCESSORY Q GARAGE —_ ER- -❑ FENCE
�s .�..r.
OCCUPANCY __LAND USE ZONE BLGz TYPE �.:-;NE ZONE PLAN CHECK BY ' •HEAT
SEINER PERMIT f
GOC.LOAD FLOUR LOAD HEIGHT NO.ST,;RIES AREA /1f Z-- NO.BEDROOMS VALUE
SUILDINO DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT:IDE
i.
Pwaalt THIS PERMIT IS ISSUED SUBJECT TO THE RFOULATIONS CONTAINED IN THE BUILDING COO*,ZONING
REGULAnONS AND ALL APPLl�AB1 F CODES,AND ORDINANCES,AND IT IS HEREBY AGREED THhT 1 HE
P1 chwk WORK WILL B& ,X)NE IN AGCORt1ANCE WITH THE►LAMS AND SPECIFICATIONS Attu IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THts PERMR DOES NOT WAIVE
PL Ck FW ��. REETRICTIIIE COVENANT& CQNTRAt;TOP AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-' TAX PERMIT&SE PARATL•PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING
State Tax r
Taal Z'•x' SDC -
APPLICANT C H AGENT ---_- .- -
RrOd PDCI
SOL ow 2�T' Rooelpt No. AUDAESS -
t
Issued By _---APP'S By
SDC
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INSPECTION NOTICE
� City ut Tigaid Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
C� _ Time A.M. P.M.
Date Requested
I Address
Permit # 3C��-
Owner-_ �„ �Je�'t Lot #
i Builder
The following Building Code deficiencies are required to be corrected:
OK— i=130
t
Presented to _ _ � --- ----- ---•-- 14� Approved --
Inspector _ _- ❑ Diwpproved 1
DALe it
CALL FOR REINSPECTION
YES LTi NO
aw W WJUWtJLWmwJpqrAINEMAIs mmI
f — INSPECTION NOTICE ,
City of Tigard Building Department a/.c 0
12420 S.W. Main St. I
Tigard,Oregon 97223
Phone: 639-4171 j
Type of Inspection a
i
I `M L, 1
Date Requested rime N.M. P.M.
Address � ��'1��� s � 0 3 d _ Permit
Owner Lot #_
Builder —
' I
The following Building Code deficiencies are required to be corrected:
�1_... ),-I Q/*•1,T -1' I pit
X%V- /-Zk-j5"T7 A!Ly, —
__ i3
i
i
Presented to -.-__ Approved
Inspector -----._. .1;-.,��=�-=- -- L] Disapproved
Date
CALL FOR REINSPECTION
❑ YES �2 NO
BUILDING PERMIT APPLICATION TIGAR0 DAr
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED OwLLA H0NE< ct
OR AS SHOWN ANO APPROVED IN THE ACC.OIAPANYING PLANS AND SPECIFICATIONS. LOT NO.
ONNER 1 ;• c .' J00 ADDRESS I rECT
ENGINEER
DESIGNER
tlutl�ER X ADDRESS
STRUCTURE ❑ NEW ❑ REMOOEL_�A�a��N ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DE�Aa
RT ❑ GARAGE G STORAGE Cl RESIDENCE ❑ COMM ❑ EOUCATIONAL ❑ GOV'T ❑ RELIGIOt1S ❑ PATIO ❑ CARPO HEATLAg❑ �
BIAG.TYPE __FIRE ZONE_PLAN CHECK BY
OCC;jTANCY LAND EZONE
SEWER PERMIT 1 S AWc
./ �I'r'— NO.STORIIES Z- ARE/ �7 C} No.BEOROOM�
OOMLOAD FLOORLOAD T V HEIGHT? , LEFT SIDE L/ "f' RIGHTSIDE/2.•
BUILDING DEPARTMENT SET BACKS FRONT "r 'v REAR
Pbrtnfl _ THIS PERI T1Arr IS 0NS ANSD ALL APPI.ICAI�LE CODES AREGULATIONS
D O WNAfICM AND IT IS NEltE1r AGREED TH
REGUu
Ms vCtwck 9 WORK WILL/E DONE IN ACCORDANCE WITH THE PLANS AND SPEGACATIONS AND IN COMA
PER.MIT DOES
NOI
ALL APPLICABLE CODES
NSU OF
WITH CTOR ACJNTRACTOns O HAVE CURRENT CI OU
SuSdotal RESTRICTIVE COENANCONTRA
CL
LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER.PLUTA41tIG AND NEA N
Stir.Tax ` T
SOI:—
Total POG ArpUMIT OR AGENT
AY _,.�----- rt1oNE
R�csipt No AOURESS
Appmv
—w � �►�l I�L�.NNJ '1 �p �
s 0_C
v
SEWER CONNECTION S
SEWER INSPECTION $ /
SEWER SURCHARGE S
-- ----
BUILDING PERMIT APPLICATION TIGARD DATE__AUZ 16 ty_____ 5481
THE UNDERSIGNED 14EREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 6247.0104
LOT NO.
OWNER i. �r6 s _ JOBADDRESS 1491`3 SW 103r4 Ayc; u-:
ARCHITECT
ENGINEER
BUILDER 'Same _ADDRESS DESIGNER
STRUCTURE _ 11 NEW_! ❑ REMODEL CTIADDITION_ ❑ REPAIR _ U RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE---PLAN CHECK BY _ !jW —HEAT----
Addition
HEAT----Addition to Single f milt' dwell!•ag alt p*tr aper rad _
Plans and Cocks 1tec uireass. —.-- –_--
add 1 Bath
SEWERPERMITN_ Septic Sys C.'m
UCC.LOAD FLOOR LOAD 4 U HEIGHT 204 NO.STORIES 2 AREA 640 NO.BEDROOMS VALUE r''.flj
BUILDING DEPARTMENT SET BACKS FRONT 0 REAR 5u LEFT SIDE 3U♦ RIGHT SIDE ( '.
Permit _ 14t',.5U THIS PERMIT 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 91.33 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-total 231.83 RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 5.62
Total SDC--
' l3i.45 1�'G,r1T..,_•t .+ �'�'�
- - PDC# A_P LICART_OR AnEPI
By _ Gl, _- - '
Receipt No. —�
Approved ww ADDRE3��— PHONE
ff W-PRAK
DATE INSP. TYPE INSPIECTION REMARKS PLUMBING DATE
Contractor
I-Q
T Tip Rough-in Fixture
HEATING
Contractor
goof, Permit No.
Got or Oil
7;2 W A Rough-In
Final
SEWER
Final
V atwx
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Fine
Al)rrr,.ch
-- -f-imcA
cLoG.DEPT. riNAL Tr 0 RA I�jY TEER Tor OCCUPANCYFinal CERTIFICATE OCCI'PANCY i
IIL.-ndpctit.
Zon-nQ Final
T BUILDING Kt..CEIPT
NAME: DATE
ACCT. N DESCRIPTION AMNINT
10-432 Building Permit Fees
10-431-600 Plumbing Permit. Fees
10-431-601 Mechanical Permit Fees s _
10-230-501 State BL+ilding Tax
10-433 Plans Check Fee
30-443 Sewer Connection (20X) S
30-202 Sewer Connection (80X) s
30-444 Sewer Inspection
51-448 Street System Dew. Charga (SDC) f
52-449-610 Parks I System Dew. Charge (PDC)
52-449-620 Parks II System Dew. Charge (PDG) _
31--450 Storm Drainage System Dew. Chrg (SSDC)
10-230-505 TRFD (95X) s
10-470 TRFD (5X) s
10--230-506 Washington County Fir* 01 (95x) Z
10-478 Washington County Fire N1 (5X) f
10-220 Amart/Wedgewood
TOTAL �—
(bs/1214P)
MRwrlIF
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested— Time A.M.—P.M.
Address 14415- 5a) A-;V s Permit
I-T-
Owner j Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector Disapproved
CALL FOR REINSPECTION
Lj YES Zl' NO
City of Tigard Mechanical Permit 3 3 a
New Installanow n Rep,ace L-1 Relocation C( Add-ttor. j Alteration IDATE
HEATING
CONTRACTOR __ F4 --- OWNER - -- --- -
ADDRESS - - - - __ --- _ JO8 ADDRESS
PHONE APPLICANT - - - - - - - --
-ear Input RatonglBTU per Hour, _ _ _ _-- ger=t S,:t --- -- Fiuf. Sirr_ - ---
5"'EL OILy GAS F� ELECT C OTHER -
-- - - ITEM NO. FEE - A. ITEM - - - TNO. I --FEE
For Issuance of Permit SEE BELOW I Each Air Handling Unit or Duct System -� r 7.50
New-up to & incl. T00,000 BTU _ 6.00 Commeraa! Hood System _ ) 7.50
Yew 700,000 BUT's Pt over __ ' X7.50 Other Equipment - Each - 450
Noodburning Stove 4.50 ! t Trip Inspection 4.50
YYalt-Floor Suspended _r 6.00 Air Condition Compressor up to& incl 3 HR 6.00
`Dent System w.'Fan _- 4.50 Air Condition Compressor 3.1 to 15.H.P. incl. ; + 11.00
Repair-Heat Cooling i 6.00 --
�/ Y-
ztj4rr Z, -F— -- - - - - r - -
{
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT E10 Comm m":
FEES _
SUBTOTAL ---- �r - - - - - - - - -
.-% STATE �l r
-rt-=_�---� ts�ed By
25%PLAN CHECK
TOTAL REC.r t
Signature of Appticant