12655 SW 111TH DRIVEwimutm
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12655 SW 111TH DRIVE ..-
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t`e , 10655 sw SII", place.
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cor, 1Oleic these mems k 3 �ccf (�,
Q S eci l l,er Perm JS ^'C
ine? Perm
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SCS-itil ,� L
-�ADDRESf� PFRmIT NO.
S "' � 5 � �1
PERMIT CHARGE none
�
OW 1 E R +r� CONNECTION FEE
��' --
PAID B Y
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE / INSPECTION FEE 1�zS .--
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSE55MENT PAID
W W W W W iwfun INWWM
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
-)ate: /— -/�' _. Permit No._
Inspector'
CALL FOR REINSPECTION
"ILiILDAIG DEPARTMENT. TIGARD
^, hOi;:er v' a vaiia plt,rt 7icjg COiltraCtOis itcenSL .s norex/
d he p' 'bin; code of
author,Zed to cause piumbing work is as hercin no...
d t0 be in3:a..ed in actor ancj'With i WrTt�
Tigard. Such instaiiations require inspee ion by the City inspector who shall be notified not less than rout
;4} hours prior :o the time the instaiiations are ready•for inspection. City Of Tigard Business License required
for all co tractors and sub-contractors. ,7 ti
Gwnar Address
NIUMGEF. OF TO"A� PERMIT N0:
TYPIC Or PEANUTITUAS '=E ON EACH AMOLN'T i Vfice Use Only)
n710 Fa'n'g-1 bath—each __ 25.00
„ g
O.i 'ax—Cath 1 bath unit
Acdit;ora, b_nthrooms—each10.00 7!� ' 1
_ �r.o-n1 S�i,'a—cacti 15.013 ,
i,xlaIVlak,IA . FIXTURE FEES
1 to 30 Fixtures In 1 buildinr—each 3.00
i
51 to 'C0 Fixtures in 1 buildin —enrh 2.50
'01 to 200 Fixtures in 1 buildincy—each 2.00
213? or more :ixtures In 1 u'ldin —each
ELt.ANEOUS
i I
;;�i;uirri,Se,•�cr-1st 50 it, i i 10.00
Seer—each additional 100 ft, i 1Q.03
_ w
S,3-vire to building _ 6'00
,,r•v •c w••c.Systems—e.:ch 1.:C ft.
-,•• .- for Plumbing Inspection Phone 6394191 '1
Plumbing Contractor 3y tiyt
A�y FicC'cIP7 tiO, Issued By _.
v � s I� sr I■r �
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 6394171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Buildii>�, Code, the
following item(s) require correcting:
Avl-41e,
A.' _
Date: Permit No.
Inspector
CALL FOR REINSPECTION
W 1W
4F
Jc 0
CILN/ of I 1 - rd Mechanical Pertnit NTY Permit S3.00
Fee
Ne,.%- Ins'al!ailon Re:)!ac:e 0 Relacmion 0 Addition Aher"aiion C1 4*.,L Stale. 3z
TOTAL—
ONTRACTOR OWNER
AAA
C
ADPI
nESS
WORK ADD;IESS u65ow
r
PHnNE � APPLICANT —P
-7-
7.!
Heat Input Rating (BTU Per Howl k 0c) 92= Vent Size Flue.Size
FUEL OIL CJ GAS UTELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FE
—on-j;- _7
For Is.uance ol Permit 3.00 Air Condition Compressor 15 to 30 HP10 t
New- Under 100,000 BTU 4.00 Air Handling 10,000 CFM 3
100,000 BTU &over 5.00 'Air Handling Over 10,000 CFM 51
Floor Furnaccb 4.00 Evaporative Cooler 3
Wall - Floor -Suspended4.00 Range Vent Pan 21
Install Vents Only 2.00 Vent System 21
4.00 Hood Commercial Repair- Heat & Cooling Commer
Air
P 4.00 Commercial Duc: System 101
Condition Compressor Under 3 HP
Air Condition Compressor 3 to 15 LIP 7.50
INSPECTOR'S COMMENTS_----
-
CITY BUSINESS LICENSE REOUIRED FOR ALL CONIRACTORS OR SUB-CONTRACTORS
ATE
APPROVED BY DATE ISSUED BY R
do
y
Z -
RECEIPT NO.- u, .12
BUILDING PERMIT APPLICATION 1OF
IT TIGARD v E.— 1u',( 19
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE___
LOTNO.—
OWNER , JOB ADDRESS' 111th HOMF ADDRESS
ARCHITECT
ENGINEER
BUILDER _��----IIr3s.m�� ADDRESS DESIGNER
STRUCTURE LJNEW ❑RUMODEL _ ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY —ZLAND USE ZONE_L_"� __BLDG.TYPE,. IN FIRE ZONE—! PLAN CHECK BY % HEAT``-JOS
rwstruf t !_uirik,jla fjamtl� ;2wttill.l.rju attached geraylg - 4 Bedroom - 2 Lath.
setr.x ptprmit , 1.7447
----- -------ga ra -__4 f3� sq.��. —
QG�-�OAI;L —��4QH_L_OA� AQ__..__t IS�HI�i�_— STORIES 404
9L_NO.BEDROQM$4 VALI ��L7C'� _
BUILDING DEPARTMENT SETBACKS FRONT 2_, REAR 2(j L-Fr r SIDE 1J RIGHT SIDE 21,)
Permit 9`� 00 --- ------ - :_�' ------ - --=
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 99. 14 0 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 2913. , 0 ALL APPLICABLE CODES AND ORDINANCES. THF ISSUANCE OF THIS PERHIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CU'ARENT CITY BUSINESS
State Ta)A 7. 06 LICENSE. SEPARATE M T REQUIRED FOR SEWER, PLUMBING AND HEATING.
5VIF - *46 .bt
Total :�U� , ,:jl, iJgr (f1 i 1t1fl.UU
By APPLICANT(M n,I r.i - --- ----"- W�
Approved ---r_- Receipt No. I::,
I
DATE INSP. TYPE INSPECTIONREMARKS _~- PLUMBING DATE
Contractor
Permit No, Y
7 �� 36,E lY-G- k
_ Rough-In
Fixture
/ a F1na1
HEATING
Contractor
i Permit No.
/2- �9 I3 �� GAS or 011--•L C`.��_____
L _ _
�G- 9 /�� p Rough-in
Final
SEWER
' Final -�
DRIVEWAY
Final _
StorNt Drainage
(Rain[train)Final,
Sidewalk
Curb S Street Final
Approach
811.0G. Dgp INAL ik p0RARY CERTIFICA-T OCCUPANCY
CERTIFICATE OCCUPANCY '� Final
Landscaping
__. Zoning Final
o �■► � ® air ut � �s
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
_ NPC 1 c�A)4PQS�S , aN
T'
CoQ i o G�,_q6jr7f= /1 i<F c�S. _� 1U
sr./'c J- Zg1A-, Ani't s
-)ate: __ Permit No.
Inspector
CALL FOR REINSPECTION