15550 SW 109TH AVENUE M-
15550 SW 109TH AVENUE .�
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Cit` of Mec' hanical Permit
Permit
Nava 1r►;tallatisn Replace Fee__
P ❑ Relocation ❑ Addition ❑ Alteration ❑ -- --
HEATING 9. state
CONTRACTOR TOTAL
�- OWNER t
'4JORESS icA,k A,4;s WORK ADDRESS ISSN
-- fie_-- ��-G,
SHONE
-{e:,t Input Rating (BTU Per Fjvtir)_ �®�• Vent Size
..UEL OIL ❑ GAS W ELECT C1OTHER - � Flue Sita
ITEM NO. FEE ITEM
or Issuance of Permit t- NO. FEE
!� inc.
_ r___r SEE ABO Air Condition Compres3or 15 to 30 HP
_up
to & int 10 1,000 BTU �- 4.00 Air Handling 10,000 CFM 10,0
100,001 BTU & over 5.00 Air hfandling Over 10,000 CFPrI -3.00
=ioor Furnace,.,—.
urnace _ 4,00 Evap� orative Cooler 5'00
:sli •Floor -Suspendyd 4.00 Rar.�Q Vent Fan 3.00
nvall Vents Only - �- 2A0 �� 2•C:.
i�ojir•Heat& gaoling Vent System
4.00 Hood Commercial 3.00
Condi60n Compres;ar Under 3 HP 4.00_ - 3.0C
sir Condition Como es.or 3 to 15 HP Commercial Duct System
--=_-�- -5 1.50 10.0r,
ISPECTOR'S COMMENTS —
'TY BUSINESS LICENSE REQUIRED FOR A_,. CONTRACTORS OR SUBCONTRACTORS
-PROVED BY DATE ISSUED BY
.CEIPT N0. - DAVE `�' �j
JOHN E. PEIi;NAa01 Pi.l11B?1�, jgBUILDING DEPARTMENT, TIGARD X10
P. 0. COx 129 PLUMBING PERMIT
!iI t;SE�S, l:rl��J'1 X1131
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be irstalled in accordance w;th the piumbin�l code of
Tigard. Such installations require inspection by the City Insp.,ctor who shall bn notified not less than four
(4) hours prior to the time the installations are ready for inspaction. City of Tigard Business License requircd
for all contractors and sub-contractors.
Owner __-Address. S�W
NUMNEn OF TOTAL PERMIT Nn.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT. (Office Use Only)
SJ_P E N T 1A LSingle Family-' bath-rach _ _ 25.00
Pup L_x ch 1 bath uni; 25`00 _
Additional bathrooms-each --�� _ 10,00
Mobile HomeSpace-eech 16.00
INDIVIDUA! FIXTURE FEES --
1 to 50 Flr.(ures in 1 bulldinjL- ach » T-i 3,00
61 to 100 Fixtures in 1 b-Ilding-each - 2.50
101 to 200 Fixtures In 1 bul'ding-each 200
201 or more Fixtures in 1 building-each 1.50 ��—
MISCELLANEOUS
(3ullding Sewer-1 at 50 ft. 1000
Sew.r-eech additional 100 ft. 10.00
Water Service to building _ 5,00
_Privet•_Water Systems-each 100 R. 1_0.00
Other (Specify); -
PERMIT AO 16,;06; for Plumbing lnu)ection Phone 6394191
�9G Statege Plumbing Contractor By t- c
RECEIPT NO. Issued By
1.
N .."� $...�'w7l'r7/778iy�r •.: r.N.,r�'ll�,�.r{.�+�.:`�`.1�?j�k��� ,.,r:,«'f N; ;.yl..i?h.,.:., ..�,•,a.. .. � -
i
BUILDING PERMIT APPLICATION 1�Y TlGARL DATE 19_
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED EUILDERPHONF
DR r SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
�t M�
109th Lor No._
x.
OWNER J�i.��I 11_1 D&V. t.•tJ, JOB ADDRESSI )!-"JO OW HOME ADDRESS
— ARCHITECT
ENGINEER
BUILDER odf9t? ADDRESS 1`a'iIOQ 5W 116th DESIGNER_
STRUCTURE ❑NEW ❑HFMnDEL ❑ADDITION OREPAIR _❑_RE.NEWAL e LJFIRL DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV-1 ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE_❑STORAGE❑SLAB ❑FFNCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _[:]SIGNS
OCCUPAN.;Y__ =L 1ND U_E ZONE,'. —BLDG.TYPE—P—_FIRE ZONE, PLAN CHECK BY__ Duh _ HEAT
t.Onglti�uct siFtyis family dualling w/uttached 6 c6(je 3 Bvdruuras daths.
---
MARK NC-Ia&UE Sana as 1`)613 StJ SuMMsi t iuld Lanw.
Sauer Paimit ;:20323 - J70:,.00 a 478
9S�.l4AQ _ -F�QAHl<oAn A( HF.IQHT 21 -_��4 S14R1��_� AREA 1{- 70 -,BEDROOMS ___ALV5_----�---
BUILDING DEPARTMENT SET BACKS FRONT JAJ — REAR !� LEFT SIDE `RIGHT SIDE T_ f
Permit 1'j 9.no r
THIS PERMIT IS ISSUFO SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10100 REGULALIONS AND ALL APPLIC".BLE CODE,. AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
WORK WILL BE DONE IN ACCORDANCE WITH T 4E PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal 1Jn9.C1t ALL APPLICABLE CODES AND ORDINANCE) THE ISSUANCE OF THIS PERMIT DOES NOT WAIVF
RESTRICTIVE COVENANTS, CONTRACTOR AND .'UB CONTRACTORS 10 HAVE CURRENT CITY RIJSINE>S
State Tax 7. JG LICENSE. SEPARATE PE4MITS REOUIRED FOR SEVER, PLUMBING AND HEATING.
Total :iL3W ,4kJU,'•J..
POC 4,100.Ul,
By P l ///` — -
w�'/ APPLICANT (1R A 1EN1
Approved l� ' Receipt No. !J /
D—TE INSP. TYPE INSPECTION REMARKS I PLUMBING DATE
Permit No.
3,z,: �a��+ - — -
Toy-og 6�L. Fixture —
Final
HF.STING
7 "le 0 k` Contractor
Permit No. •t y q-13-�
Gas ur Oil '
Roughdn
Final
SEWER�i
._.�.--
OPIVEWA'+'
Final
Storm Drainage
(Rein Drain)Final
Sfdewelk
Curb&Street Final
PApproe.n
BLDG.DEPT.rINAL TEMPORARY CERTIFICATE IC.CV' incl
CERTIFICATE OCCUPANCY —
Landscaping
Zoninq Final
i
CITY .f� ,'�Rl� DAT •..2 -, ,93� N2
JILDING PERMIT APPLICATION OF _
aE .'N7EHSIG%ED HEREBY APPLIES FOR APE FOR THE WORK HEREIN INDICATED BUILDERPHON -
:,R AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS A:ID SFFCIFICAIIUNS or✓NLOT No�oNF 27L�
, GC�2'_J�
RE',S c� r HOA1E ADDRESS ✓����1��-
1 ARCHITECT
t ENGINEER
IGNER
S
� R 3dM Q. � _ADDRk�S� 30 J K•� I I(O � _. ..��DE.,
- - - -.� r-•�
RE OR"'MODEL )ADUITION-_ -OREPAIR-„^-QaENEWAL FIRE DAMAGE _ DEMOLITION
NCF ❑COMM OEOUCATION4L-DGOV-T OWFIIGIOUSWPATIO,OCARPO?T IJGARAGE ❑STORAGEOSLAB CIFENCE
- DU �.
❑SIGNS
1EUND _-❑MOVING T �OCONDITIONAI USE ❑DESIGN REVIEW ❑COUNCIL APPROVED -T
(F4NCv InND_USE7.ONE K-- PelnG TVPF J5.Q—FIRF ZONE_PLANCHECKSY, HEAT`_=
0w
(” Q LVAD' I�O_&L4FiIESCD.......L4.,?ENO
...
- ----- - - —"- ! EF1::IDE /J RIGHT SIDE q �,
BUILDING DEPARTMENT 5ET BACKS_ - REARJ —
�ermlt� CONTAINED IN THE BUILDING CODE, ZONING
-
THIS PERMIT IS ISSUED SIIbJEC1 TO THE REGULATIONS
�Q_tTL� REGULATIONS AND Al L APPI ICACLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check NCE WITH THE ACCORDAPLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
WORK WILL BE DONE t
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
I S RESTRICTIVE COVENANTS. CON7RACTOR AND SUB CONTRACTORS TO HAVE C(, TENT CITY BUSINESS
)�te Tax
r I c - LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tax �—
Tata,
By _ AVPs IcAni 0 MAKGF"N
App,„ rt Receipt No _
II
por In
Lu 10 rte