12720 SW 111TH DRIVE A w v w
12720 1W 111TH DRIVE
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BUILDING PERMIT APPLICATION TIGARD DATE _ 7/6/_,19-01 3803
THF UNDERSIGNED HEREBY APPLILS FOR A PERMIT FOR i HE WORK HEREIN INDICATED BUILDER PHONE 771-06137
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE__ __—
OWNER Bruno Gallian0 JOBADDRESS 12720 SW 111th Avenue LOTNO. 3-Uildernee-p—
Portland ARCHITECT
ENGINEER - —�—
BUILDER Delmer Mahler ADDRESS d6i5 SE 1-1019ate Blvd. DESIGNER D. Nehler
STRUCTURE ❑ NEW 1 REMODEL ❑ "ADDITION ❑ REPAIR L_'j RENEWAL F] FIRE DAMAGE I:I DEMOLITION
OVESIDENCE ❑ COMM ❑ EDUCATIONAL 11GOV'T 11RELIGIOUS ❑ PATIO C] CARPORT ❑ GARAGE USTORAGE SLAB' FENCE
OCCUPANCY �"l _LAND USEZONE —-171-BLDG.TYPE! 5N�.FIRE ZONE_--PLAN CHECK BY dWh` HEAT yam
Construct storage accessary building per plans and code.
SEWER PERMIT M
OCC.LOAD FLOOR LOAD Slab HEIGHT 9 NO.STORIES 1 ARFA 2Fi tl NO,BEDROONIS VALUd 4,000-
BUILDING
,000.BUILDING DEPARTMENT SET BACKS FRONT 3 REAR LEFT SIDE In RIGHT SIDE
Permit SP 8.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
1!t REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND i IS HEREBY AGREED THAT THE
Plan Check
00 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
Subtotal 42•nO RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
state Tax 1.1
SDC--
Total $43,1 _
-- PDCtt AFwi-iCnrvi OR n(,t Nr
By P1
--- Receipt Nn
Approved duh ADDRESS ----
--- -- PHONE
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
f, Rough-in
Fixture
Final
HEATING
��— Contractor
Permit No.
Gas or Oil
- .-------
Rough-in
Final
SEWER
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
`— Sidewalk
Curb&Street Final
Approach
BLDM DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIMCATE OCCUPANCY
Landscaping
Zoning Final
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A p � '0
BU!LD1NG PERMIT APPLICATION �0FY TIGAID DATE _Y. Is �' •
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDIC D BUILDER P;HOfJnl 0 0
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANAND SPECIFICA IONS OvnvEPP .0
/� `,gyp► LOT NO
74VfJEP_ �'/AN(/
JOB ADDRESS
� (�1� y /o U1
ARCHITECT
U140 9c - C I F ENGINEER r
!U1�_O.'2 ' AODRESS V �J D/.J^�'- r DESIGNL-R �N
STRUCTURE _ NEw ❑RI MnOEL ❑ADDITION _ ❑RcPAIFI ❑RENE1NAL ❑FIRE OArAAGE �f
�-f _ rr--tt _ rr--tt __r�--fI ❑D_v10 L I T I J
U nESIDENCE CJCOMM ❑EO.CATIONAL DGOV'T URELIGIpU5 LJPATIU LJCaR PORT ❑GARAGE STORAGE❑SLAB ❑FENC
ll,,--II
0r1,UPANCY.Q—..LAND USE 7.ONE �L_____OLOG. TYPE�_FIRE ZONE---- - PLAN CHECK BY'- HEAT
SEWER PERMIT
9-C,; _
-LOAp FLOO�l�O
. AO �`� HEIGHT `N0.ST RIE _J AR E_aNQ�E�R00M5 _� �j,VALUE ?DOD
BUIL^IN G DEPARTMENT SETBACKS FRONTREAR 3 LEF"T SIDE Q RIGHT SIDE
P'l m I t - —- - --
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, tONIN
I I':an Check /�J V v REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TH
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CONIPLIANCE WIT
ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES
`,:a[? Tax �, �Z LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total _ SDC -
- PDC#By
I o
APPLICANr OR :IGF rir
Approved Receipt No
AnnRFti4 _ -T - PHONE
SDC -
PDC -
SEWER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE
Comments :
ADDRESS I�%' "! '��� � '[) L � .�_ PERMIT NO.
PERMIT CHARGE pane
OWNER CONNECTION FEE God,
PAID BY
TYPE OF BUILOING Ag-J DATE CON;":ECTEO
SERVICE RATE / o{L INSPECTION FEE _
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSML-NT PAID
�► �r ® WIs
PLOmBING PERMIT _
C 6 hoider of a valid plumbing contractors license is hereoy
ajthorized to ce.'Ise plurrlbin,, Ark as herein noted to be insta..ed in accordance with the plumbing coda Of.
Tigard. Such installations require inspection by the City Inspector who sha;l be notified not less than fou.-
,W)
ou.;4i hours prior to the time the installations are ready for inspection. City of Tigard Business License requ;red
for ail contractors and sub-contractors.
Vv:rC y NU:t',r':r OF TO"A� I PERMIT NWG
Typ E OF PZAMIT I ITP1.5 Fac 0`' cAtaA tiT I (011fice Use :.n_/)-
_1LF I 52500
- _5 -nln =nr ii�1 ba'ti-each
Oup'nx-Earp 1-bath-unit - 25.00 t
Acd;,:on) hathrooms-each _._.._._._.._! 1000 f U o _.. f
Vr:bi;e Homo Soece-each I 15.00 � L
',NOIVICUAL F_IXTURE FEES
1 to 30 Fixturat in 1 building-eechI--
51 to 'moo Fixtures in 1 building-enrh I 7•50 �-- --
101 to 200 Fixtures in 1 building-ac 2.n0 L _
2.11 or more Fixtures in 1 huildi=each I 1.50
M ;3CELLANE0US --
3w'ld°„q Sewar-1st 50 ft- _,_ 10.00 L
Snwnr-each mH1001,31 100 ft, 10,00 ,_—
Wa;ar Service to building - _.. -. ��
5.00 1 -j
°riv(te Water Systems-eech 100 ft. __—_,, ," 10.00
I
Q•trr ;sprCjy):
— For Plumbin1 it;::pjc:iort Phone 633.4131
1 PlumbinZ Contractor ay
RZCEiPi' NO. Issued 3y �_�
G y of I l��f Cl r1.1tCIt MCL7! rtr;n)r Yr::nrt ssuu _._.
Ere---- _
�,�•; Ir,S;;lialion '� Re,dace ❑ Relocation ED ,,,Idi:ion Alteration !: 4;6 Stale .'57-
TOTAL
t-ut��tA-f-9.—_ - OWN cR2�Gntay_
IVORY, ADDRESS 111-n �.L►_), Illi
AD7R`-ES_ APPLICANT
�.._
PHONE — --—
Heat Input Rating (BTU Per Hour) Vent Size _srFlue rza
FUEL OIL ❑ GAS 0ELECT ❑ OTHER
�.:-.
ITEM NO. FEE ITEM NO. FE
For Issuance of ?ermit � 3.l)0- Air Condition Compressor 15 to 30 HP 10.[
' 5.00
New• Under 100,000 BTU Air Handling 10,000 CFM 3.(
New• 100,000 BTU & over 5.00 '•Air Handling Over 10,000 CFM 5.(
Floor Furnace --4.0-0
Evaporative Cooler 3.(
_ _
rs
4_00 7.(• 14'.11 • Floor •Suspended Range Vent Fan
_ __- - -- -----
2.00 Vent System 3•t
?'. Install Ven!%Only _
Repair.• Heat & Cooling 4.00 Hood Commercial —_ 3.(
.j.�• -- �._�_
-
Air Condition Compresso! r Ude► 3 HP 4.00 Conimerrial !)ut:,wSystein
-;ressor 3 to 15 HP -+� - 7.50 _
.` air Condition Comp
INSPECTOR'S COMXENTS ._�_ _ _� _._...
�V
CITY BUSINESS LICENSE REOUIRED FOR ALL B
CONTRACTORS OR SUBCONTRACTORS
u4. APPROVED BY DATE ISSUED BY DATE _
RECEIPT NO.
rr, »a Signature of A41i ?l I4XIIw�,_
3 "� ,• '
BUILDING PERMIT APPLICATION 11T TIGARD DATEOF
___
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT cOR TFT- WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PL , IS AND SPECIFICATIONS OWNER PHONE
LOT NO. —
OWN ,$111 IaQtty.' J013 ADDRESS 1.2720 SW 111th P!IN(.( HOME ADDRESS
ARCHITECT
A ENGINEER
BUILDER } f'r ADDRESS ►L W J :? L1e8r «�ll,,.!_ DESIGNER y ----
� _--
STRUCTURE ❑NEW G H' M_nDEI_ ❑_ADDITION ❑REPAIR [:]RENEWAL ❑FIRE DAMAGE UDEMOLITION
® F,ESIDFNCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS UPATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
_❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COL'NCII.APPROVED [:]SIGNS
OCCUPANCYC7-3 LAND USE ZONE R-7 _._BLDG,TYPE. 5N _FIRE ZONE PLAN CHECK BY E'TiJ HEAT__
.Iwrla�tcLSI t ai .+I le feMily dwelling w etterheo ger,agw. 1.3;adrraur;► j
Sewoz Permit 662540
LOAD FLo g LOAD 40 HEIGHT 16 STORIES_1 ._AF L> _4t�' NO BEDRQQ�IN�u VALUE _
BUILDING DEPARTMENT SET BACKS FRONT 63 REAR LEFT SIDE G RIGHT SIDE
Permit �19g.(�(�
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20NING
Plan Check 99*50 REGUI ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT ;S HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal �� ��Q ALL APPLICARLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 171�,U LIgEISE. SI.EPARATE ff',F TS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 2.:504.46 PDL 1 — 11101.0(1
Bv P1—1_ APPLICANT OR AGENT
Approved r . +I,%i clop► Receipt No
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
....f_, Contractor
�iC 7_ OS✓ J ..��+:.` _ ---- Permit No.
Rough-in J
�l�y �• _ Fixture
/_ U Final
HEATING
Contractor
,. Permit No. /3
_!
c� — P3Y
a
Gas or Oil
Rough-in
/O Final —
p(- SEWEP ---- ---
cpeFinal --
/y� DRIVEWAY
Final
00
Storm Drainage — ---
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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. , n PLWAIT PLf ATIGN ��TY Tf�,`.RD DATE � ' [.__.�, le2$_ �a "Zy4 v,
3 JIL DI JG PE AIT AP C OF
Hc,I(,NED NEK
HEBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNLR PHONE
y�i!_
SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. LOTN 'HaNF
LOT NO Fd-5
R , ` }'I C, _ JGI1 ADDRESS j 2_2jC �.I)" •
HOME ADDRESS
ARCHITECT
IS S LJLrL�7^L ..-._
DESIGNER -
��--II NEW (3REMODELD
_ _UAUIIIION O
-_— REPAIR IJRENEWAAL_ ❑FIRE DAMAGE [:]DEMOLITION
IDF.NCF LJCOMM ❑EDUCATIONAL ❑GOV'T OREI -GIOUSOPATIO ❑GAR PORT IJGARAGE ❑STORAGE OSLAB []FENCE
I'BOND MOVING [3CONDITIONAL USE _❑DESIGN REVIEW []COUNCIL APPROVED _❑SIGNS
uF LNCv — -ND USE ZONE It`� _Bl DG TYPE �✓^f IRF ZONE PLAN� CHECK BY_ HEAT i�.
l � ,liVLt
c1�:G LQAF' _ F 4Q.QR LQ.AQ_ -�!E!�H �� --- NO.HI9A!F� �- A8€� '_► _9EpROOMS�{ _�(g �n d.
El 1111 PING DEPAHT6IENT— SL BACKS I RONT ��� _ REAR- �_;� -� LEFT SIDE �,— RIGHT 51DE /D
THIS PERM11 IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Cheek - / C S� RFGULAT100`,b AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
J�— 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
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
,,Ie Tax L/ '7/i LICENSE. SEPARATE PERMITS REOUIREO FOR SEWER, PLUMBING AND HEATING.
--�-�-
BY A-1
APPi ICAN1 OR AUENT i
AClri ov,.d J Receipl No r /' / 6 y- 6 C'
AUURES6 H
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