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CITY OF TIGARD 639.4171
6655
BUILDING PERMIT DATE 'j� 1
TAX MAP�_���` LOT N0. 0—SLIBDIVISIQN _
OWNER —_._ JOB ADDRESS L� 7 �w / ::)•✓ '7
BUILDER _--- STATE REG.NO. +'' __ EXP.DATE
lt_ —
ARCHITECT PHONE __-.— __.OTHEF
STRUCTURE i NEW REMODEL ADDITION C7 REPAIR MOVE 0 OTHEP DEMOLITION
RESIDENCE COMM EDUCATION IND i1 RELIGIOUS F ' ACCESF:)RY ❑ GARAGE OTHER FENCE
OCCUPANCY _LANF1 USE ZONE BLDG,TYPE FIRE ZONE_ PLAN CHECK BY HEAT
})CICi�.0 S.'.., �.,f LMR' 1� t•: ''t:iX� �i --
co
SEWER
�'. ;171Z` R�7 C'.:CX '•
SEWER PERMIT M
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES _ nF+F A NO.BEDROOMS VALUE --
_BUILDING DEPARTMENT • SETBACKS FRONT MAR LEFT SIDE RIGHT SIDE
'_Permit 1 r' �_- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
AO �y�t RE'3ULATIONS AND ALL APPLICABLE CODES k.ND 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.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 111600 ('
SDC
Total '6.80 'KPPLICANT OR AGEN 1 -
-- - PDCiY ' ' 1 din x!11!
10
Receipt No, 'fADDRE88 PHONE
Bal.Due
- leaved By__,_ Approved fy--- ,
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DATE INSP. TYPE INSPECTION REMARKSPLUMBING -T---
q _ DATE
Contractor
_ Permit No. 53b8'
Rough-in
Flxturt
Final
7 lil—� — HEATING
7,2�p 7 ��cl'y�_tj� _ Contractor
Permit No.
S1 c_ o9 II
lGasor0if
Rough-in
Final
_ SEWER
Final /�'L �—�47
izo
DRIVEWAY
----- -—— - - --
Final
Storm Drainage -
--_._
(Rain Main)Final
Sidewalk -
- Curb&Street Final
—_--_ Approach — —
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY FinLl
CENTFICATE OCCUPANCY _.
Landscaping
Zoning Final
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Hecelpt
CITY OF TIGARD MECHANICAL PERMIT Permit M_ z
oescrip"" Qtr IMMC� AMT
Table 3A Medidif bMda
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City of Tigard t) permit Fee -0- -0- 1 10.00
13125 S.W. Hall B!vd.
P.O. Box 23397 2) Supplemeroal Penult 9.00
Tigard, OR 97223
639-4175 1 Fumace to 100,000 BTU 6.00 ;
Ind.ducts&vents
Furnace 100,000 BTU + 750
2) incl.ducts&vents
�— Name of[)svelofxnent 3) Roor Fumace 6.00
incl.vent
C
c, J -- — Suspended heater,wal!heater 600
Address Job Add Z,rou Ty 4) or floor mounted heater
Tex Lot Map N�. 5) Vent not incl.in 3,00
appliance permit
Lot Jj Block Subdivism 1�lc.1
Name(a nems d buainess) 6) Repair of hearing, i 600
_ cooling,absorptionu unit
�r'111' -_- Boiler or romp to 3 HP
Halling Addreu Phone 7) 6.00
Owner absorp unit to 100,000 BTU
CitySlate tip 8) Boiler or comp 103 HP-15 HP 1100
absorp.t ~tit to 500,000 BTU _
Boile or comp 15.30 HP 1500
Name 9 absorp.11.,it'/'2-1mt'Ilon
10)
rvlawirq Addrse. Pltwta Boiler or comp to 10-50 HP 22,50-
_ absorp,unit 1 -'.75 miltion
Contractor Ckylaw a -- -- ' LIP 11) Boiler or comp to 50 HPf 31.50
-- _ ( absorp.unit 1,750,000 BTL — ---__.
gyle q or No. City Bus.Tax No r12) Air handling unit to 50
10,000 CFM _
1 Air handling unit 7.50
1 hereby actorowterlge vw I tib"mail tis appicown"tthe information given is 131 10,000 CFM +
14
oonect,art I am go owr»r or suftdmd agwo d aw owner,that plana aWrnitw are in
corroia,r y wMh sum two,that I am regMMrnd with the state Puwdera'Board.that are Non portable 4.50
number given is wrrrct.(ff exempt from state rwistration please give reason below( evaporate evaporate cooler
- 15) Vent tan connected 3.00
to a single duct _
_-_------_ ___ --—_--..--- -- -- - 16) Ventilatlor',system not 4.50
Included In appliance permit
— - - - --- _.- 17) Hood served by 4.50 t� r
mechanical exhaust
DateDomestic type 7.50
18)
Describe work O wWftlon O aheratlun I..1 repair f I Incinerator _
to be done residential non-residential LJ 19) Commercial or Industrial 30.00
- - --"---- type incinerator
_
Existing use of ^/1 --
building or properly /� � 1 20) Other i e,woodetove,water 4.50
-- -- heater,solar,clothes dryws,etc.
Proposed use of -
building or property — 21) Gf,d pdng nue to four outlets 2.00
Type of fuel-- oil (:1 raboal pu,B-- LPG ❑ electric 17
22) More than 4-per outlet
NOTIC —_ -- - SUB-TOTAL _
THIS PERMIT BECOMES NULL AND VC-10 IF WORK OR CON- 4%WROHA1M
STRUCTION AUTWRVED IS NM COMMENCED WITHIN 160 - -
DAYS, OR IF GON ITRUCTION OR W04K IS SUSPENDED OR PLAN RavWw 21%OF#UB-MAL
ABANDONED FOR A PER=Of 100 DAYS AT ANY TIME AFTER
1MOI,K 19 CGMYIIi�D,
Dais Issued -_._ __ _._. _ by .