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13850 SW 115TH AVENUE-1 13,450 SW 115TH AVENUE � I rn k EA H V ~ rd J `+� ✓ !11 C4 1 /n CO 04 EL4 s, D m A N r2 04 w \V q �4 81 to R r4 � 4 CITY OF WILDING PERMIT i' APPLICATION TIGARD GATE 7 '18 7' N_ 0389 THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORN. HEREIN INDICATED OWNER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. _�---.—._-- Ua+lr_d L. H611'riGh OWNER _ ADDRESS � GUILDER PHONE ENGINEER =LDER r- Ofwl'lkll _ ARCHITECT ''.ESIGNER STRUCTURE ❑NEW ❑_ REMODEL ❑ADDI i ION _ C3 REPAIR ❑RENEWAL _❑FIRE DAMAGE EIDEMOLITION ❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO [:]CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE ❑BOND C1 MOVING ❑CONDITIONAL-USE ❑DESIGN REVIEW ^COUNCIL APPROVED ❑SIGNS OCCUPANCY_ LAND USE ZONE r? a—BLDG.TYPE .I FIRE ZONE-- PLAN CHECK HEAT ___ JfiS. I.TL� E: 20 dk_-,, ;c !i a floor �- --- 4 x lu bvefflin6 ANX A x post w raiiing - - OCC LOAD FLOOR LOAD HEIGHT _ NO.STORIES. __ AREA VALUE 3 RC1 BUILDING DEPARTMENT $ET'IACKS FRONT REAR LEFT SIDE _ RIGHT SIDE Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COLe ZONING Plan Check REGULATIONS AND ALL APPLWARLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THA. ----- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPEk'IFICATIONS AND IN COMPLIANCE WITH Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVr +:OVENANTS. CONTRACTOR AND SUB CONTRACTORS TO NAVE CURRENT C1 fY BUSINESS I%State LICENSE. SEI',.RATE P'.AMITS REGUIR£D FOR SEWER, PLUMBING AND HEATING- Total By o APPLICANT OR AGENT Appioved Receipt No. "DRESS VI a rNf PLUMBING DATE DATE INSP. TYPE II:SPECTION REMARKS Contractor Permit No. Rou h-in — Fixture _ _ Final - HEATING — Contractor —�— - - — Permit No. _ —� Gas or Oil Rou h-in _— Final — ---"— SEWER - - -- Final — - - DRIVEWAY --- —_ Final Storm Drainage _-__ _ - --- — -�.—i--_`—� -- (Rain Drain) Final . Sidewalk _ _- Curb &SFinal _ __ _ A roach SLOG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final _ — CERTIFICATE OCCUPANCY Landscaping Zoning Final ��L City of Tigan d INSPECTION REQUEST for INSPECTION TIME : PERMIT DATE : .'-_/ DATE ISSUED :__!_!._ OWNERS NAME ' womalaq ilsgnm!% — ADDRESS: C0N'rRA(,T0R : ---EST : pair JL, WN-,ter p , V._uai !J , I-aboratory �j RESULT: Ap •roved ❑ , )!suppr3�ej , eridwrl [] SKETCH.' a)/Val) W1478-1k /09* r e PAA/ W#~ C,#s#4v*Ttt s ►Wr, ''�t R&-.- e.4r M> V4- p SlrLr- &*SeX I SPEC OR DATE NOTE : Attach supplemental teat data beret) CITY OF TIGM0 1110 -'2Z PERMIT 110. Y r +` riat shall ;oe obtNined prior ^ COFMO came of inetallat on. 1. Portit shall be obtained for all appliances which are to hacOm • ! R to the building, r changes to burners and deet 3. Relocation, replacement, altetal�0*v- require permits . 4. All work t be concealed must be .++ter. ��d before cover up. Installation Replace a i f� ❑ Relocation ❑ Addition Q- Alteration �J OWNER >H�. �� ._ WORK ADDRESS LRBSS _?� APPLICANT 1/N/+J�j^"• `J�"'i'�l - -Il TELEPHONE NO. rURNACF. - MANUFACTURER TELEPHC'4E NO. �r HEAT It put.r-rating (Btu Per Hour ) 1->3._ ryr. Vent Size S 1 0 Flue Size I'UEL OIL 0 GAS X ELECT � OTHER?MAL SO.SO. FT. Top Floor 2.O r_ Main Floor Basement r,ENERAL ITEM NO. FEE AM'T ITEM NO. FEE Ax* Z21 Issuance of Permit _ 3.0Boilers over 50 Hp Meer - Under 100,000 Btu 4.0 Ai_r Handling 10,O00 CFM __— 3s0 AMrr - Over 100,000 Btu _ 5.0 Air Handling Over .10,000 CPM 5.00 44r furnace_-_ _ 4,0 Eva rative Cooler a _ �} - floor - Suspended 4.0 Vent Fan •0 jnsta 1 Vgnts _ 2. yAntwa_tam —_- -_- 3.0 Haat b Coolin 4.0 Hood 3.0 10v:0 Under 3 H -- 4.0 DomesticsIncinerator 510 ilers 3 •o 15 Hp _ 7. _ Comm, Incinerator 0.0 iters 15 to 30 Hp y — 0.0 Other Not Listed 0 lers 30 to =') Ham5.0 INSPEC-rOR'S COMMENTS --- APPROVED BY __ DATE - ISSUED BY _ _ DATE _ Signature of Applic nt I r �L City of Tigard INSPECTION REQUEST for INSPECTION TIME : 16).- PERMIT NO. : 47a� DATE: '' 13117-1- DATE ISSUED:QF- OWNERS NAME : ADDRESS : CONTRA,:, rOR :— TEST. Air ❑, Water [1 , Visual B; Laboratory ❑ RESULT: Approved 0 , Disapproved ❑ , Pending L] SKETCH: INSPECTOR DATE COTE : Attach supplemental feet data heret] i I I Address 13850 S.W. ll�th Ave. Permit No. 4725 Permit charge Owner Dave Helfrich Connection fee 425 Paid by Columbia Custom Homes Type of building Residence Date connected 10-31-72 Service rate 3.00 per month Inspection fee 25.00 Contractur Columbia Custom Homes Paid by same Date Size of connection 4" Assessment Paid Says - g � IP+ertnit issued_ arry OF TIGARD, ORl�OON Permit No._z0-_y'-y',J-0 City Hai# Application Approved 1 uikl* Dopa Milt Coat of Installation.._ __.....,...` ; Fee for Permfi_'��_ 7� Applicant shall fill in cast of fi:stallation only, Date - 2 above this double line. street sewer Permit__ Application is hereby made to m- Umbing Pipes or Fixturer, according to plana and specifications a_,d install description as given below: Location of building—Number and Street-..___-/ Lot-------_—`-- _ Bloc Addition— Name dditionName and Address of Own Name and Address of Plumber Building (Old or New)— �it�u height in Stories- Occupied aa_ SCHEDULE OF WORK I NUMBSJt NUMBER - FIXTURES--- New Move IR'pl'ce FD[TtJR>g3New (Move B'pl'ee T I- � 1y g-_-- — I Water Cloeeta.�._ —.�_ _. Fountains, Drinking- Bath Shower_-_-- _� —lid —_ Fountains, Yard Bath Tub __ _ Fountains, Basins �`_ - (� Hot Water Tank Sinks, Or � ._��—_—y _ Sinks, Bar '-inks, Dishwashing __ _ _ I�_�_ Sinda, Slop Automatic Dishwasher J- Drp.jm gel Laundry Trays I I_ _ Drains, Ice Box _- Drains, Floor L �1_ _ Urinals I I ( - Drains, Area I _ Catch-Basins, Yard v Rain DrainsI — Catrh Nasins, Garage Automatic Washer f �I, _ Catch-Basins Sub 3011 Water Permit No Bldg. Permit REMARKS: - I r IMPORTANr I-- Plumbing shall not be Installed In any buildlill (either now, altered,or repal►od), except as shown or designated on the corresponding buildinglens as filed Mlafh r or required by, the Building Department In accordance with the provislons of the Building Cn a and Ordinanas 67.19 of the City of Tigard, r• r i a;re` toC a plumbing dsystem according to this description, clans and specificati s and the ylumbing lode of the install Plumbing Firm Supervisor r ; UNIFIED SEWERAGE AGENCY fvo. --47a5 a ' WASHINOTON COUNTY DATE CITY OF k APPLICATION FOR SEWER CONNECTION PERMIT r OWNER: -Nbon - ------ —_----��._- -.__ __ _ OWNER'S ADDRESS: ET------ CA TY NATE- -' 71• BUILDING SITE: LOT_ J*--.- BLOCK ADDITION Yom% _ TAX LOT NO TYPE OF OCCUPANCY _ __.____� • ______. ADORESS __- _ - �•Y•u' _ _.__ - . DWELLING UNITS .__ __ __1___ FIXTURE UNITS SURCHARGE IF APPLICABLE PERMIT FEE _—__ S! INSPECTION FEE TOTAL DEPOSITED 500M (NEW) (EXISTING) BUILDING SEWER SYSTEM ._____.____..jA' The Applicant 9grees to comply with all rules and regulations of the Unified Sewerage Agency. APPLICANT.--. h SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE SIZE _,_. INSTALLER ______ Malt PrloM___ RECEIVED BY__ IA07.r"=Y OR ITC AGENTI COMMENTS: Th;s Application and permit expires in ninety (90) days. The amount paid will be forfeited should expiration occur. (/ 4 i 7,3 BUILDER VALUE :;�: z+T" FEE `' DATE 1 LOCATION UWIvER JO e # MAY #.;)Sl O`1' f') TYPE PERMIT EE , SEWER PERMIT FEE MCHANICAL PERMIT � DATE BY DATE :9Y EXCAVATION FILL AIR CONDITIONING FOOTINGS FOUNDATION VENTILATION FORMS SPRINKLER SYSTEM J SLABS MASONRY FLUES REINFORCING STEEL FIRE DOORS EXITS STRUCTURAL STEEL GARAGE FLOOR PLUMBING R. I . DRIVEWAY _ ROOF/FLASHING _ 3r SEWER,_ FKAMF S"'')RM DRAIN LATH WALLBOARD .PARKING HEATING _ FENCE/SCREEN WATER HEATER FINAL CITY OF TIGARD 12420 S. W. Mrin Mit YIGARD, 06t6GpN I= APPLICATION FOR BUILDING PERMIT Addition ❑ ❑ Move New Conatruct,on x Demolish EliRemodel _ DATE ISSU'EDJ=9�-R BUILDING PERMIT ONING R-7 No. ATE: RECEIVc.D ��-72_- BUILDING FEE PLAN CHECK ,y BE VALUATION S_ + •� OTHER S te_- RECEIPT No. LL( L _ TOTAL $ 136-so k' S i Z TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION 1p CENSUS TRAC-i w-19 _ JOB R ,OT �_�_. MAP II�7� i��_____- ►rchitect or Engineer`_�umbla_Cunte� kddress 9 Kt. Jefferson Terr&w 1"4 06VOOP -- Phone hwner r,+1 �nb .l'1i8 acme■ __--- ------ Phone - _ _ kddress D,,!�--yeftwrann r'9CG l.' 3uilder Phone kddress _ --- - 3UILDING USE Single Red. Multi Res. F1 Comm. ❑ Industrial 3CCUPANCY GROUP I No. Of Stories— Z— Total Height +___ Area of LotT� rype of ConstructionIX70CkpOL V Floor Area B Set. Packs:: Front ;� Aack_ XE8�3- L.Side 1'7 _ R.Side Ll Private Private Sewer Pipe Size_ 4" �. Sewer U.8-A- TILVAleptic Tank j/4" Storm Sewer 0. Ditch ❑ Dryweil❑ Wa_er Service Pipe Size__,__ Street and Curb Requirements k:xirti �.w.--___�No. of Parkinq Spaces__ Driveway ----- SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED _— _____— —I�l -g' - -'--T DATE _ b�24-32 FIELD CHECK BY_---------_ ----.- --- ----- _ ___ ' PERMIT APPROVED BYsz:� k / It is understood that all work will conform with applicable nodes and ordinances of the State of Oregon and the City of Tigard, Oregon, and that the building will not be occupied until a Certificate of Occupancy has been issued by the City of Tigard Building Inspector. ` [� +, _---- S gna o Applicant