13020 SW 107TH COURT _ 13020 SW 107TH COURT _
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ADDRESS / c,,�a _ �� ,C� +�� �c- PERMIT NO,
PE, ^IT CHARGE
OWNER fr t {� �- v CONNECTION FEE ____�� •"
--
PAID BY .,cc.tt: nev
TYPE Or' BUILDING DATE CONNECTED
SERVICE RATE INSPFCTION FEE
' ONTRACTOR _ __—Y PAID BY . ,N DATE
SIZE OF CONNECTION AS -ESSPIENT PAID
i
EMAM
ciry of
BUILDING PERMIT APPLICATION TIGARD DATE_ ��� 19_ N° 0270
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS ShOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE___—
„c,. - ---- ---- 107th Lt,
- —
OWNER ADDRESS BUILDER PHONE
ENGINEER
=1 DEH ARCH, ITE, 'T DESIGNER
STRUCTURE ❑NEW ❑REMODEL OADDITION Cl REPAIR 1 ❑RENEWAL. ❑FIRE DAMAGE ❑DEMOLITION
0 RESIDENCE ❑COMM OEDUCATI'INAL CIGOV'T 0RELIGIOUS OPATIO OCAR PORT ❑GARAGE: O STORAGE OSLAB [--]FENCE
OBONO OMOVING ChONDITIONAL USE ODESIGN REVIEW OCOUNCIL APPROVED OSIGNS –
OCCUPANCY—_.._–_LAND USE ZONE--.....---BI_UG.TYPE --_F1FIE ZONE-___ PLAN CHECK BY _ HEAT
t trlr�r� 40 feat barn 7 feet high — ------�— —�
Q1CC LOAU FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT —� SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit ;40ou — -- — — _— -----_ -
-� -- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THF
– — WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING-
Total
By
APPLICANI OH ANENT — - -- _���----- "----
Approv,,d Receipt No.
AUC)AE!;5 HU
DATE INSP. TYPE INSPECTION�► REMARKS PLUMBING GATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
_ Contractor _
Permit No.
Gas or Oil
Rou h it
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
A roach
BLDG.DEPT. FINAL 1 EMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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I City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME : PERMIT NO .
I DATE: DATE ISSUED. Z I
OWNERS NAME :
IA D D R E:i S : Z. ,,'2C 'SZGt.i/07 c jt_
CONTRACTOR : -5,O&M66 __..
TEST: Air CJ, WWer p Visua�r Laboratory p
RESULT: Ayprov�,d Disapproved p Pending
I SKETCH: 0"
7 h
1 INSPECTOR DATE
[OTE : Attach supplemental fast data horst]
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City of Tigord
INSPECTION RE® UEST
for
art. p ✓
INSPECTION TIME : /., 4)0 PERMIT NO. : .
DATE: 'L74 DATE ISSUED:.
0WNERS NAME : �`'LI �'`� _ v,;2u _
ADDRESS :
CONTRACTOR : L_L.
TEST: Air p, Water ❑ Visual O , Laboratory p
RESULT: Approved , Disapproved C , Pending (]
SKETCH:
INSPECTOR DATE
[NOTE : Attach supplemental test d ata here,]
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City of Tigard
INSPECTION RE V�
Ql ,S T
for I
INSPECTION TIME: PERMIT RO. :
DATE: -3 ZIL17Y DATE ISSUED :- I L_ I
OWNERS NAME : o � vYa
ADDRESS: ��U7ti ��►,rf� _ �, '
CONTRACTOR :
TEST : Air p, WoterjK Visual ❑ , Laboratory p
RESULT: Approved , Disapproved ❑ , Pending []
SKETCH: _ I
30 � 0
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NSPECTOR DATE
NOTEAttach supplemental toff dL
%to beret] I
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. : _
DATE: 3 /1,2/7�1 DATE ISSUED :-- Z
OWNERS NAME :
ADDRESS: /3041e)
CONTRACTOR : --A _R"wel
TEST : Air p, Woter Visual ❑ , Laboratory p
RESULT: Approved , Disapproved ❑ , Pending ❑
SKETCH.
INSPECTOR DATE
500E Attach supplemantal Sast data beret]
PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No. -
y,rd Permit fee _ a
Water Closets (Toilets) Permit Issuad
Bath Tubs �A C"!- Approved by —
Lavatory Wash Babin, Building Permit---
Shower _ _ v Receipt No.
n s, 5i.shwashing
SS nks,_ Kitchen _ ��SinksOrdina Location of building
-91MRs Bar {,Z j --- --
Sinks Slop _ --r��► r7'`'
Automatic ishwasher- �s
--------------------
74
Laundr Trays _ Name & Address of Owner
Drains. Floor
�rains, Area -'-----_--
Drains, Re rigerator --- -' '-
Rain Drains "i -0= -"�----`�
Automatic Washer ts: Name & Address of Plumber • •,
Fountains, r n n
FountainsSoda .,�
Hot Water Tank
Water ;sviceerSize 1 , r C -'- f- ----
Urinals — .-Buildin (Old or New Alter Repair or
Catch-Basins a—rcT-- ) nsta-= --__. _ �.
Lawn Sprinkler Systom
--
Swimming Poo Sprinkler
V
This permit becomes null and void if work or construction authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond.
I hereby certify that I have read and examined this application and know the same
to be true and correct. All provisions of laws and ordinances governing this typc
of work will be complied with whether specified herein or not, the granting of a
permit does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
Signatupe of ApPicant
CITY OF TIGARD MECHANICAL PERMIT r
DATE - f - ' PERMIT NO. �; 93 RECEIPT N0.
BY FEE --. SRXRR XroaX 9.09 -
1. Permit shall be obtained prior to cc:,mmencement of installation.
2. Permit shall be obtained for all appliances which are to become
a fixture to the building.
3. Relocation, replacements, alterations, or changes to burners and
duct work require permits.
4. All work to be concealed must be inspected before cover up.
New Installation xx Replace ❑ Relocation ❑ Addition ❑ Alteration ❑
CONTR.
Mickey Bowen _ ._._ _..� OWNER Mickey Bowen
KXK68 13175 SW Ash Drive Togard 1-�e SW 107th Ct
ADDF::.ss WORK ADDRESS —
APPLICANT imperial P I b G & Htq, Inc
Lennox
TELEPHONE NO. 777 3801
���
FURNACE - MANUFACTURER TELEPHONE NO. — I-
HEAT Input rating ((Btu Per Hour) 110,000 Vent Size _ 5910 Flue Size 6''0
FUEL OIL ❑ GAS [a ELECT ❑ OTHER
TOTAL SQ. FT. Top Floor Main Floor 1614 Basement
GENERAL
ITEM N0. ITEM NO. FEE
For Issuance of Permit _ _ _x_00_1" , Boilers Over 50 Hp __
New - Under 100,000 Btu 4.00_ _ Air Handling_l0r_1000 CFM _
New - Over 00,000 Btu_ sxx -Tir Han�dli-ng 2yer 1O,OOCC_FM
Floor Furnace _ = Eva oorr_a_tive Cooler
I
W`=---71-o-`®
- uspen e---- �.�i -_dent Fan ..�---------�
Install en s U- -went-9V-s:E?m 0
R�eTair - Heat &_Conlin -4-
_00_ ____Hood
01
Boilers Under 3� .__ 4 ,00 _ mes�_ic nc�nerator0
Boil ars �o 15 H��_� _7_•50 comm. nc�nera orw_-- __ _ _ 20.O
CJ
T3oilers -S. to 30 H� 10.00 —'a�Fei�`�fo�_L_"isted----------- — •
B i'lers 0 to 55 rip— _5 00--
INSPECTOR'S
0-INSPECTOR'S COMMENTS —_, ��_�;_•___ �.��___ - -- _______—_—_.._ __
----
- A,
APPROVED BY _ DATE ISSUED BY _ DATE
Imperial Plumbing & HeotIng, InE,
Signature of Applicant Htg Supv.
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City of Tigard
I
INSPECTION REQUEST
for
INSPECTION TIME :.,,� � S PERMIT NO. .-
DATE:
O. :DATE: �I /�. .I DATE ISSUED:
OWNERS NAME :
I ADDRESS :
I CONTRACTOR
ITEST: A r 3, Water ❑ , Visual Loh ,rotary [i
RESULT. Approved , Disapproved J , Pending [i
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SKETCH:
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INSPECTOR DATE
I [NOTE : Attach supplemental feet data heretd
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p 37
UNIFIED SEWERAGE AGENCY NO. - 4914 _
WASHINGTON COUNTY DATE 11-13-73
CITY OF--- --- ... ---- - - 1igiird
i APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: __ _ -_Dickey Bo►1en _h_LW].la DiElacco
I -- —
OWNER'S ADDRE2,1Z175. .5,W.-fah Drive --
STREET
_ Tigard - _ - —__—� Oregon
ITV STATE ZIP
BUILDING SITE: LOT-31 BLOCK — _ ADDITION --P.-a-thf-iDdar -_ _.
{
I TAX LOT NO. .__ .____ _ TYPE OF OCCUPANCY _ Residen .e
ADDRESS
I DWELLING UNITS -.-1__. __ __ ___ ._-_ FIXTURE UNITS
t
SURCHARGE IF APPLICABLE 50-_ ta_IIax�ry Dell
PERMIT FEE 4513 ____ INSPECTION FEE __25 TOTAL DEPOSITED
(NEWT (EXISTING) BUILDING SEWER SYSTEM ___ Tigard
it —
The Applicant agrees to comply with all rules and regulations of tele Unified Sewerage Agency.
�� J A4
APPLICANT L�L_� � �-�-'��__ _
( SEWER PERMIT
,
I THIS PERMIT AUTHORIZES CONNECT) ' HE SEWER SYSTEM.
i
iLINE SIZE 41t INSTALLER
ti RECEIVED BY.
IA CV OR ITS AGENT)
( COMMENTS -7 3-
This
-This Application and permit expires in ninety (90; days. The amount paid will be forfeited
should expiration occur.
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CITY OF TIGARD
1742) 1 w M., 51,we
•IGA 11D OWfb^.N *7723
APPLICATION F,,h ifu L: I:,.. ;1i.:01IT
New Construction, a I)emoIISh ❑ Addition ❑ Remodel ❑ Move ❑
20NING_ � y_ DATE ISSUED---kL713-?3 BUILDING PERMIT'
DATF. RECEIVED
HUILDING FEE S _4AAn1i _ Nr
PLAN CHECK S 47.00 ---2an2- -.---' —
BY_^�_ --- ----- r)TItF:P $� 4 stela VALUATION ; 16,146.00
*.00 RECEIPT RECEIPT No.t �
TOTAL f...,.n_nn fir sign
91,.94
TWO SETS OF PLANS AND PLOT PLANS MUST t)F: FURNISHEC AITH APPLICATION
LOT / --�L_-- MAP / %Sl ton ____ CENSUS TRACT _y�-� JOB 1
Architect or Enqineer M—kalt Unuon ____—_
Address 13175 5.W. Adh Ur. -- -----Phone6-71313
Owner M J Ck ey dowel l a Willa 01Hscco
Address_ 13175 S.U. Ash or. , Tigard, Crayon —Phone__`
Builder Mickey Hownp a Willa O1Bacco
Address 13175 5.W. Ash Dr.
BUILDING. USE Sin•lle Res. ❑ Multi Res. ❑ Comm. ❑� Industrial ❑
OCCUPANCY GROUP! No. of Stories_— Total Flelyht - Area of Lot
Tyne of C. nstructiorl xIoXJZXX%ZIXXSVX V Floor Area
:1' 27' ti'
Set Hacks: Front_Xar%, Back_ t,.Side___ R.Side
Private Sewer Pipe I.1ze4sry Sewers_Isdf'eptir. lank ❑
water Service Pipe Size_^ _ Storm Sewer �J Ditch ❑ Drywe•ll ❑
Street and Curb Requirements_ _exIeti
Driveway Width_ 180 _. _ �_.__�yO. of Parkinq Spaces-- 1
SLPAPATE PFPMITS REUUIREO FOR SEWER AND PLUMHING
SPECIAL IuroPMATinN
7 71
ADDRESS ASSIG`IED.—. lUdfiU S.W.—"WA" !
F.ELU CHECK 4Y_4* ._DAT'r.
PERMIT APPP'IVED HY �! iu.,,
It is understood that all work will conform with applicable codes and ordinances
of the State of oreeon and the City of Tiqard, Oregon, and that the huildinq will,
not be occupied until a Certificate of cupancy has been issued by the City of
9igard Huildi•ul Inspector,
qna are oT App c nt