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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: .�.—�� ., Date: •���7� Permit No, Inspector� �^^ CALL FOR REINSPECTION ADDRESS - /V ..'� I ,' `r PERMIT NO. PERMIT CHARGE none OUNER CONNECTION FEE cid. PAID BY ) TYPE OF OF BUILDING DATE CONNcrTEO SERVICE RATE ��' cf� INSPECTION FEE � � - '✓ CONTRACTOR PAID BY DATE SIZE OF CONNECTION _ ASSESSMENT PAID BU1LMNIG 3EPARTMENT, TIGARD PLUiIIBING PERMIT NO. hoider of a valid plumbinG contractors license ;s-ho, s hereby authorized to cause plumbing work as Herein noted xo be insta.;ed in accord ande'With the plumbin; code of Tigard. Such instailations require inspection by -the City Inspectcr who sha:i be notified not less than four .;4j hours prior to the time the instailations are raady for inspection. City of T, igard Business License required for a:i contractors a sub-contrdctorr;. ``�� / y_ a.e- -`.<<'LL NUMIN'S OF TO', A� PERMIT NO.'S TYPE OF Pc"RhlIT ITElHS�+! FU ON cACH AL. (Office Uso Cniy) F r n Si_-IJ10 a r+ily-1 bath-each Dup'ex—cath 1 bath unit 25_00_ 1 Ardit;on.t; bathrooms—each 2 10,00 Sp _0M 15.00 ;N DIVICUAL FIXTURC FEES ---�- 1 to 30 Fixtures in 1 bu!'din —each _ I 3.00 to 'CJ Fixtures in 1 huilding-es+ch _ 2.50_ to 200 Fixtures in 1 building—each _ 2C0 _ 201 or rr.ore Fixtures in 1 building—each 1.50 I .r..,. . 0,-JL211$ewcr_tst 50 It. 5awnr—each additional 100 ft. 10,00 Wats-service to building _-Aco _r;vcta W.Itrr_SYrtams—urch •;;u N I 10,00 For Plumbinj Inspec;lon Phone 639-4 19 1 Plumbing Contractor ay r / C, , ,I :e7A RECEIPT N0. Issued By `�K raL/,s� sT'�lYlp07JjI.y. tf.i Ii6�AjAil "Y- 11� .,y,) !.' f 'M' ' � :,•V " ...,...�,... 'SRV Y' e,mow. gIJO.,DING PERMIT APPLICATION "'F TIGARD DATE.V 1 � 19 _ THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF,�y�� OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE'_ 14L4r,SW LOT NO.� OWNER il�r. u h JOB ADDRESS ,: trl� HOME ADDRESS I I' J ilil?ti..w + — — ARr:HITEC"f ENGINEER BUILDER — ADDRESS DESIGNER STRUCTURE _—LONEW ❑_a_I M_nDEL_ f _❑ADDITION ❑REPAIR ❑RENEWAL J[]FIRE DAMAGE — ❑DEMOLITION Q RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE ❑BOND (:1 MOVING ❑CC ADITIONAL USE ❑DESIGN REVIEW [:]COUNCIL APPROVED (:]SIGNS OCCUPANCY_4,4,aLAND USE ZONE_!• l BLDG.TYPE .____FIRE ZONE -3 PLAN CHECK BY____LT:,t _ HEAT.: dudll". u!a - a !:V.L. 3 `.)1Bt t1. Sewer Permit #175L!4 162',.30 �_. 9 .1O9D FLOOL��AIL.� HEIGHT _�Q. .._�f Q,��TORIES 2 �r112 �oeET oohs .�j_YALSIIE` BUILDING DEPARTMENT SETBACKS FRONT J REAR 24 LEFT SIDE 6 RIGHT SIDE a Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUIL171ING CODE, ZONING P'an Check uL-,1171 _ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DONL IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WI TN Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF TMS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTFIACT09 AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS State Tax iA-rid LICENSE. SEPARATE PERMITS REQUIRED FOFI SFWFR, PLUMBING AND HEATING. Total 4.3_09.`4A CTL 1 100.00 — R' By D1 __– APPLICANT OR AGLNT------ Approved _--ApprovedReceipt No. DATE INSP.I TYPE INSPECTION REMARKS PLUMBING DATE --_` �—�� —------�-- - Contractor J— /�-i� - Urt� �' .rte.-- p fk---=��•+—_e Permit NoW, Rough-in 3�Si� J h5 x� pope Fixture Final HEATING Contractor Permit No. Gas or Coil -v.—.-- -- ----------- Rough-in -- �- —�.__--- Final - SEWER Final 3-5- ------ ------ -- DRIVEWAY Final -^� Ston"Drainage (Rain Drain)Final Sidewalk — --T -_—_---__-- -- Curb&Street Final Approach BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPA J Final CERTIFICATE OCCUPANCY 1 i ry — 1 Landscaping Zoning Final I I l 3 JIL DING PERMIT APPI_ICA 110 , ruFY ' �C,',,RD OATS -4 i1N 11_HSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF 45 SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE LOT NO ,j�� a JC'P ADO HOME ADDRESS 7 ENGINEER IT I I Irr •Jr�.. U PI ADDRESS _ _- DESIGNER ❑REMODEL DADUITION_ _- QREPAIR (RENEWAL ❑FIRE DAMAGE ❑DEMOLITION !ICINCF L.JCOMI'n ❑EDUCATIONAL Dc,)V'T ORFLIGIOUSDPATIO ❑CARPORT ❑GARAGE DSTORAGEDSLAB ❑FENCE I,ROND - C�MOVING DCONDITIONAt USE QOESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _ (� vPnNCV 7�� LAND USE ZONE_ r�-_ =_._..BLDG I VPF_. __Y' FIRE ZONE. PLAN�CHECK.B/Y_�' HEAT - C 3 ".c I.QAp . __. F_LS�UR LQAR_ CL._—HE-riLl tk----_ JQ_sTnRIFS _._.LR �v 8€❑ROOMS —yam �O IO Ca /� BUILDING DEPARTMENT SET BACKS I-VONT IL7 J 'f"' REAR --��—�_ LEFT SIDE RIGHT SIDE� -- -------- - TNI; PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING �'ian Check �� (/ J RFGULAT;_.Nt, AND ALL APPLICABLE COfrES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE W.TH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH t.Il Intel ALL APPLICABLE CODES AND ORDII.ANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE - -- — ---�/ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS rti,tr Tex 0 l LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. _o_el I.�V _- APPI (CANT 4R ,1GENl Appluved Receipt No E C ,1 ® a �■r ®r iwr ■r �r s me PM ° IN 13 colo/. /4,/24.5- Qv //`�``�' .3�J