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BUILDING PERMIT APPLICATION DATE___ 19
THE U'NDERSIGNEJ HEREBY Af'PL!F8 FOR A PERMIT FOR!HE WORK HEREIN INDICATED BUILDER PHONE _..
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 9:A S..'t500 _
LOTN .14FJ,XL—
OWNER Iritan Pr(j! JOBADDRESS Z —_(aAl
- - - --- - .y/d -
- ---- `;u.i.to2014 Pt:".Ild 972,ATRC:AITECT
2700 my 184, DESIGNER
BUILDER C°��� _ ADDRESS y
STRUCTURE ❑ NEW El REMODEL ❑ ADDITION _ rJ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE CJ DEMOLITION
IJ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GICA"T ❑ RELIG;OUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY __-LAND USE ZONE BLDG.TYPE .---FIRE ZONE PLAN CHECK BY — HEAT—.i)omniisli single family dwollhg. All, dp-bris to 1-� zerR mOd from situ. Stroots
to be kopt free 10 rnu 0 Y S. ,�:I7 . K: n ' 15C Pllfapnd S rttled'
ino Cted loo city. _
SEWERPERMITM
' _OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS VALUE
_BUILDING DEPARTMENT SETBACKS FRONT__ REAR LEFT SIDE RIGHT SIDE
Permit 15.00 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 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANC- SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SI'B CONTRACIORS TO HAVE CURRENT CITY BUSINESS
'HiQ LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
SDC--
Total 1:1.1 N-- --— - ----
PDCM APPLICANT qR AGENT
By
—�- ---- --- Receipt No, ADDRESS -— - PHONE - ---
DATE INSP. TYPE INSPECTION _REMARKS PLUMBING DATE
Contractor
Permit No. -- - -,--_--
Rough-in --_ --- —
Final
—HEATING
Contractor —
Perrnit No.
Gat Oil
Rough-in
—_— Fioal
--- 3EWF;t `_-----
--^- -Final
01 DRIVEWAY
kFnal
Storm Drainage —
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach -- -
BLDG. DEPT.FINAL TEMPORARY C6RTIFW ATE OCCUPANCY
CERTIFICAT17 OCCUPANCY Final
i
Landsc:ping
Zon.ng Final
INSPECTION NOTICE
City of Tigard Building Department C�
P O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection ]}��
Date Requested t Time A.M. P.M. !
Address _c ..a bcg"ermit �k -
Owner Lqt
Builder
The f0lowing Building Code deficiencies +re required to be corrected:
Presented to _ ___ __ _ pprowed
Inspector -- _ _ _ J Disepproved
r",ate
CAL FOP REINSPECT(ON
DYES CJ NO
i
N'C!TY OF �'lC�IARD PLUMBING Tigard CR 97,23 '��
Applicant- must "hold Oregon Registration to conduct A plumbing PERMIT 639-4175
business or r gust be p.operty owner/operator not hiring outside he(p.
Name d.DevoloprMV caol RA r---L Gb t/Z Plurnbnng Pt....:.-n.. 7
j
s 1 ORS 614-21410 DUAN. PRICE AMT
Job ax Lot Map.No.
Address FiXTURF..S
Subdivision S --_ . 7.50 7-�_
7.50 i
ams or r sines, Lavatory ---- -ag
Tub or Tub/Shower Comb _ - 7.50 7
Shower Only T 7.50 i
"r,,gens _
Water C 0set --- - `---- 7.50 a 5 r
Owner jc#Y/SL to Zip -- ---- 7 50 7
' O� Dishwashrer -- �-
- phone Garbage Dosal --- ( ` 7.50
isp7
d
Washing Machine - 7.50 -
Name Floor Drain 7 M
Wale:Healer - - 750 7
Laundry Room Tray - --- __._ _ 7.50 - -
OccupantCityiStalb r'p Unial - 1.50
-- ne— Jthaf Fixtures(Specify) - -
(PAI _ 7.50 _
P" _- 750 _ --
r
104- Com, o --- -- ----- 7.50 _
Contractor /State ZIP -
�('�„r„ tom__ a( 7 Z 3 MISCELLANEOUS
Sl k4 �y Sue Tax No r^^w 1 at 100, __30 00
�� n - -r _ tate Sewet•�e.AddR 100 1500
ale ! Beard fro a-QC iii _ __ 20.E 0
(ResKlenhai) Waler Servtoo 1 a7 100 ---- -
Water Service ea.Add�t.2�' 15.00 - -
I hereby ecknowbdge that I have read Ihie appMoatlun,than the krlormew^
given is owed.that 1 am tsgts(ered with I»State Builders foanG,and also Storm a Win Drain 1 It 100 _ --------
haw a State Pknftp sosnee that"numbers g+Ven we ootrsd. 00
trwt an 15 A0
phnnbwV wale wit be done in soco"W"with app"A P d Ora slam i Pyn Drehn Adds.100 25 00
gon Revised CA&%ACN00m 447 and e93 and appaoabh ootfes and list
ef AAodb hlonle SP�os^ —-- -- -
no heo wet be employed woo"licensed under ORS W3.(11 exempt from fact Flow Prevention
Stab reglatratk .pl aw give reason tvtow) Device or Ar1s44oaMion Der-M ?so
NOMEOWNf Ra 1 hw*by owwdy#W1 om tM owner of wo properly de
sorbed above.at which beatbn t propose to maks a'Nun ft knamoadon for Arty Trap or Waft Not
7.50
my owuse Ilia properly is rxA bekng oonalrucsed b+sato,base a rant corrwded b a Rxk"
n ud -
C410119-AM 7 50
40.00 Per Hr
SpwAa*y PaqueNed inspeclOnG 40.00 Perm
-------------- AMI.of Pltar+O4ng whliY+ - --- -
----- _— —--- -- ------- --- - knp 1 S�QO.tial
an Exdel
New ftOp.or&Ad.Ad~ - M.00 sawn
—�E -- - DomL -- - _
to�, = /(o .--r
I . ale f�anu l y_
Describe wotk newladldition[-I a%MfOn❑ repffk U rj,euiiq
to k2 dOtle
Exle g use of MI0t01ltrt. 0
haft or prem -- -- -- --
PNpoaU"
bubft L
TIMI iMl"brAomeg vv.A area*a1A M wear'a aonatruMbn GIA110 "is nil core*
IWO"VAN n W drilla^+I oatl`11CftA or W&*M suepamm or abwldnrw 9d
d portae to il"i ware M ah eme Ittibt wmk to osrrtr Amovd.
SAL tJOM1101N___ ———
OItAe wind �L/G�'� _ b1► _.
INSPECTION NOTICE
t%/ of Tigard Building Department
P.O. Box 23597
Tigard, Orb-on 97223
PhonJ: L39-4175
Type of Inspection 6 -- Time
Date Requested A �/— M/
n0( ' -M 7�_;7PM;
Address V2,-) 0 '. A,?-4%A P Permit
Owner Lot
Builder
The following Building Code deficiencies are -quired to be corrected:
Presented to P40popo-roved
Inspector f Disapproved
Date
f.
CALL P RE
"R , NSPECTION
Y E 8 1:1, NO
AIFIW
VI 1 Y VP' 1 IlaANU IVIC%,1 AVa11,ML VLhi1V11 I Permit N
Dercrtphon
City of Tigard
Table 3A Mechanical Code OTV PRICE AMT
–� --- --- --- - - —
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 1000
P.O. Bo>,23397 ------------- ---- --- -- -_–_
Tigard. OR 97223 Z 2) Supplemental Permit 3.00
639-4175 i) Furnace to 1(x,,000 BTU 6
Incl.ducts 8 vents 00 6,
Furnace 100,000 BTU +
2) incl.ducts 8 vents 7.50
Name of Development Floor Furnace
3) 00
incl.vent 6
Job Address - --- Suspended heater,wall heater
Address /'o 4-/ 7 0 4) or floor mounted healerVent not incl.in
6 00
Tax Lot Map No 5) appliance permit 300
_ Lot Block Subdivision
Name lor name of business) 6) Repair of heating,refrig„ 600
cooling,absorption unit
Meiling Address Phone 7) Boller or Comp to 3 HP 6.00
Owner absorp.unit to 100,000 BTU
City/State Z,PBoiler or comp to 3 HP-15 HP
6) absorp,unit to 500,000 BTU 11.00
Boiler or Comp 15.30 HP
9) absorp.unit 14.1 million 1500
1Aalling Address phone 10) Boiler or comp to 30-50 H P --
absorp.unit 1-1.75 million 2.•50
Contractor city/state Zip 11) Boiler or comp to 50 HP 31 50 -
absorp.unit 1,750,000 BTU _
Slate Registration No City Bus Ta,No 12) Air handling unit to 450
10,000 CFM
I nereb• acknowledge13 Air handling unit
that I have read this application that the information given is ) 10,000 CFM + ' 50
coned,that I err,the owner or authorized agent of the owner,that plans submitted are in
compliance with State laws,that I am registered v.'th the State Bumers'Board,that the 14 Non portable
number given is co"acl (it exempt from State regist+non please give reason below) ) d evaporate cooler 50
Vent fan connected
- -15) to a single duct _Sy 300
Ventilation system not
18) included in appliance permit 4.50
17 Hood served by —__ 4.50
mechanical exhaust y J
Signature(owner or agent) -- ---—— --- Date
18 Domestic type 750
Describe work p addition U alteration ❑ repair I ' incinerator
to be done residential iAJ non-residentlal Llt 9) Commercial or ir4,•-trial
Existing use of type incinerator - 3000
building or properly— t�Ai�� 20) Other i e.,woodslove,water , s�
heater,soler,clothes dryers,etc
Proposed use of
building or property — — 21) Gas piping one to four outlets / :tx1
Type of fuel - oil ❑ natural gas Q LPG E 7 electric I I ---"
22) More than 4-pot outlet
NOTICE --- BUB-TOTAL �/•s;
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARat / 3
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR i PLAN REVIEW"%OF SU&TOTAL S �.
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - ---- - ~—
LS:p:ecial'Conditions
OMMENCED TOTAL
- Date issued .__ //i� by f r<c
CITY OF TIGARD 639.4171 c' 6 6 4 2
BUILDING PERMIT DATE - ` _�s_` �_.
TAX MAP ..- LOT NO SUBQIVISIO S.
OWNER_ 7 tFtri T'TC}�'l:].l_� .`; _ JOB ADDRESS t'���t•
BUILDER : _._ STATE REG.NO. • _____EXP.DATE
BUILDER'S PHONE
ARCHITECT Ia.'..y T!Ltft _ PHONE —OTHER
STRUCTURE_ [ NEW REMODEL ADDITION [ REPAIR MOVE ❑ OTHER L DEMOLITION
RESIDENCE COMM EDUCATION IND RELIGIOUS ❑ ACCESSORY GARAGE OTHER FENCE
OCCUPANCY _LAND USE ZONE`_,�L BLDG TYPE --FIRE ZONE _PLAN CHECK BY HEAT
SEWER PERMITM
OCC.LOAD FLOOR LOAD _ HEIGHT NO.STORIES AREA -! NO BEDROOMS VALUE
BUILDING DEPA14TMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 4 t•n(% THIS PERwI I, .)SUED SUB'ECj' TO THF iEGUi.ATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLI;,'ABLE COUES ANC ORDINANCES, AND IT IS HERE.-Y AGREER THAT THE
Plan Check •CJn WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
— WITH ALL APPLICABLE CODE.; AND ORDINANCES. THE ISSUANCE. OF THIS PERMIT DOES NOT WAIVE
Pl.Ck.Fire _ _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS,SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
SDC-- '
Total ;! ..9f
APPLICANT OOR Adt-T
--- - -- —-- PDC#- ,
Prepd.
Receipt No. ADDRESS PHONE
Bal.Due
-- — Issued By _Approved Approved
-....�.a.ir....diaYr,sluer.....r4ri .+... ...u�n..Yw,",".i..........._�... -. ........ .. ... .. �:..a......rr.....w.:....-.....-,._.::.......4a....w...a......+..+{Iw.....•4..
DATE INSP. TYP:!;NSPECTION REMARKS PLUMBING DATE
YContractor l4S Y/"/,LJ
Parmil No. 5 iI
Rough-in
Fixture
Final
-
��� HEATING
— contractor yys� Y-9 87
7 --- -- ----- -
1� Permit No, Lf 72�
v /, �1
� L—�`---
� - ---- Gas or oil
— �- - -.----- Rough-in --- -_
Final
/17,5 1;'�"/_ - L.— SEWER -
Final
DRIVEWAY
--- - --- - - Final _.
--- Storm Drainage
--- (Rain Drain)Final
A ---_------------------ ! Sidewalk - ----- ---
Curb&Street Final -
--� Approach -
Bl 0G.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Fina!
CERTFICATE OCCUPANCY –
Landscaping
Zoning Find
ns IIIaT
FLAN LHLLN NU.
for inspect ions call 439-4l;5
�
'r�1 � RM i T tJO
CITY OF TIGARO 699-4171 DAT� � to •"`-�•--
BUILDING PERMIT -_ � C�t N
P.O. Box 23397,E"/igard iOEZ 91223
TAX � � LOT NO. 0001 1410,
OWNER ,/l T/�l1 ? /k-(qp•
JU8 ADDRESS
BU11.DER _ � �/1 C.-�[ STATE ArG.NO. `� ~� —EXP.GATE'`, f
BUILDER'S PHONEnU
ARCHITECT ��-19. PHONE ..0 :HER - -
STRUCTURE NEW O REMODEL ❑ ADDITION O REPAIR 0 MOVE CJ OTHER 0 DEMOLITION
RV-IOEHCE ❑ COMM O EDUCATION ❑ INr O REUGIO-JS, ❑'ACCESSORY 0 GARAGE 0 LTI-IER O FENCE
OCXJPANCY
/`+,-, !.ANO USE ZONE%!;�_BLDG.1 YPE `'" FIRE ZONE-::" PLAN CHECK BY � � � F/EAT C'-
Construct single family dwellinq VZA-Lj q,,bad _garapp, all p,-r apprmVed plans -- ---
Slibiert Lj 85 code.
lc Q
1
SEWERPFRLUTa -(ldu) batt ;straps garage area-3 C71 r•. r -r�
OCC.LOAD FLOOR LOAD y 0 HEIGHT /'l NO.STORIES /-- AREK 6(J ) N0.96A_9OOMS-;� VALUE
BUILDING DEPARTMENT _ SETBACKS FRONT <' REAR SIDE -` RIGHT SIDE
f,7-
^ _ � J — THIS PERMIT IS ISSUED SUBJECT TO THE REUW ATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT RS HEREBY AGREED THAT THE
C7 WORK WILL !NE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFN:AIICN=ANO IN COMPLIANCE
WITH ALL AP•LICABLE CODES /.NO ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WkIVE
RESTRICTIVE LOVENANTS,WNTRACTOR AND SUB CONTRACTON3 TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS IkOUIRED FOR SEWER.PLUMBINQ AND HEATING,
` > )
3 SDC - �� �A N AGENT
Pr�C',qRecelpl No ADDItZSS I mow
laaued By____,-_-._---Approved Br
ssoc
S0CPOC C2
RECEIPT #
DATE PD.
SEWER CONNECTION S =y � _ AMOUNT PD.
5CUEH INSPECTION S
SEUER SURCHARGE S
I ,
:o mm e n t o: ���iE-1 /,U ZGGci-cam _
for inspections Call 639-4L75
CITY OFF TIGAAO 639•4171 PERMIT
oATE
BUILOgNO P�RMIT _ -
P.O. ox 2 397, Tigard OR 97223 TAX MAP A-—1- 1—LL SLOT NO. 'fl SUODIVIS10tr -
OWNEiL =.is ►�I ( I� i'I � 7 I FS JOB ADORESzr
BUILDER SI:-'`AEG.H '--so FYP fLTC /
BUILDER'S PHONE
ARCHITECT__ _ _ PHONE—.-- ,_ OTi1ER
STRUCTURE J VEW ❑ REMODEL ❑ ADDITION ❑ REPAIR 0 MOVE 0 CJTHER 4EMCLITION
O RESIDENCE ❑ COMM Q EDUCATION C7 IND • O RELIGIOUS. 0-ACCESSORY Q OARAGE O OTHER 0 FENCE
OCOJPANCY'�_I— LAnD USE ZONE �' BLDG.TYPE FIRE.ANE_.C"AN CHECK BY t AT
T
SEWER PERMt;/
OCC.LOAD FLOOR LO/.O HEIGHT NO.STORIES AREA NO.BEOROOMS VALUE
rPfa(P>d,
ING DEFARTMENT
ULMH
BACKS FRONT RETIA LEFT SIDE RIGHT SIDE
/ THtS PERMIT CS ISSUED SUBJECT TO THE REGULATIONS CONTAINEO IN THE 11UILIXNQ COOS,ZONING
REOULATIO tS AND ALL-APPLICABLE CODES AND OROINAN(IM AND IT IS HEREBY AGREED THAT THE
_ WOIgK WILL QE DONE IN ACCORUANCE WITH THE PLANS.AND SPECIFICATWNS AND IN COMPLIANCE
WTTH ALL APPL.CABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
_ J'� RESTR#=VE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITr BUSINESS
TAX PERMITS.SEPARATE PERMITS REOUIREO FOR SEWER.PLUMBIN i AND HEATINQ,
�� � 5500
SOC
__ —POC
APPI.ICAN fOR AGEr S �
Receipt No ADORES3
Issued 13y-__._—__—_--JhpfCved
0 C - -- --
: -� R E C E I PT0C
DATE PD.
CUf_P, CGNNC C T I ON S AMOUNT PD. v
CUCF INSPECTION S
CUED SURCHARGE S
immento;