12160 SW 123RD COURT-1 12160 SW 123RD COURT
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INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23391
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection �� � �f�'`��!�/l.�/✓
Date Requested__ 2 Jam-- f) n. Time_ A.M. P.M.
�r -3 cii� _ "armit # �1
Addrass 2 '
Owner_ __ _ Lot #
Builder — -- ---
The following Building Code deficiencies are required to be corrected:
Presented toez" ['"Approved
ImpWor � L] Disapproved
Date
CALL FOR REINSPECTION
❑ YES I7 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection =` �P �r�ZZ'.. � — -
Date Requested Ti me� A M. P.M.
Address �� __' '� �� �'�, `-- _ Permit
Owner,- �.i,��a�-�p L _ Lot #-- ---- ----
Builder
The following Building Code -leficiencies are required to be corrected:
Would like .`irst thing in the morning inspection.
Please call tefore leaving - he will be waiting.
17
Presented to -- -- _ __-------_-------_—--__ -- -_ Approved
Inspector --..c=\+:.iL---- - - --- --- --- Disapproved
Date
CALL FOR REINSPECTION
EJ YES 0 NO
CITY OF TIFA MECHANICAL PERMIT
RD PERMIT NO. : r1E892887
emre0eteu
COMMUNITY DEVELOPMENT DEPARTMENT �"" TE ISSUED: 10/ 6/89
13125 S.W.Holl Blvd.,P.O.Box 23397,Tigard,Oregon 97223,(503)639-4175 — — PF I M.PMT.N0. 892887
JOB ADDRESS: 12160 SW 123RD CT
TAX MAP/LOT SUB: LT: BK:
LAND USE: t
LOT SIZE:
ITEM: N0: N0:
WORK CLASS: ALTERATION FURNACE (100K AIR HANDL.R t (O
USE TYPE: ACCESSORY BLDG. FURNACE 100K+ AIR HANDLR IRK G
CONST.TYP-c: FLOOR FURNACE EVAP.0001_ER '
OCCUP.GRP. : HEATER 1 VENT FAN
VENT VENT.SYSTEM
BLR/COMP (3HP HOOD
NO.STORIES: BLR/COMP 3-15HP INCINERATOR(DOM
DWEI.L.UNITS: ALR/COMP 15-30HP INCINERATOR(COM
FUEL TYPE BLR/COMP 30•-50HP REPAIR UNITS
i.
MAX. INPUT BLR/COMP 50+HP OTHER
FIRE DMPRS? GAS PIPING OUTLETS
HIGH PRESS''
LOW PRESS?
REMARKS:
Suspended heater in greenhouse.
FEESs
W Beck. Lynn PERMIT 00
N 12160 SW 123rd Ct. PLAIJ REVIEW
E Tigard OR 97223 FIXTURES $6.00
R
(503) STATE TAX $.64
OTHER
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RECEIPT NO.
This permit Is Issued suhlect to the regulations contained in Title 14
of the TMC. !jute of 0,!,gon Specialty Codes, zoning requlatlons fiELIUIRED INSPECTIONS
and all other applicable codes and ordinancer and it is hereby FINAL
agreed that the work will be done in accordance with the plans and
specihcatrcns and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and sohcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not started within 190 days.or If work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Penmilt..• Signature
Issued Ry rat I Eck-INWrrjtGN L-2 -44;1%
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
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,t'¢? �,�..,.,yr dM., rh�� AYI r' .a' $i• .;dli � r1 7a•1 s7Q� NI �,,,� .'>rl" � dry' ,,y .,,4, UP pi.
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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) reggire correcting:
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late:-- _.__ _ Permit No. —
Inspect-0!!t --
CALL FOR REINSPECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 6.19.4171
CONTRACTOR:
Pursuant to 'ection(s) of the Uniform Building Code, the
following item(s) require correcting:
T L Iae —- ---- --
Date: !!.. -:�-�-7
_ -- Permit No._.__
Inspector'_40 _ —.-
CALL FOR REINSPECTION
� 0
gx`;r.�WuY74.r.:�;�FA:.aw.diw+�i,�5�>�M�'J f7"""°'id•+f�'a e'er" t.. ,�f�,�„ ,. �,..',�-�f�e. i �
. i'}•"...+. • i!� r 1.... � tl .^Ql tll�:Y41�R' I" ~rY� -.- .`7 ..i.9h':y V Y
1l� 1Y IA �
BUILDING PERMIT APPLICATION 1 FY TIGARD DAT. C')
I9 >_ 43 • ?j •<-r
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WOHK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANft SPECIFICATIONS. OWNERPWONE_
LOT NO. +
OWNER :; . 1::1 j l JOBADDRESS i ,.. ..l] JW 1!JTd L, HOME ADDRESS
ARCHITECT
t 1 f t, 1 ENGINEER r y iGl
BUILDER E"iIrl ADDRESS h�3.� Jt.; cho.lus I orri ;>CSIGNER fie_ ,.y,. nrclay
STRUCTURE ❑NEW ❑R1'MODEL ❑ADDITION ❑REPAIR ❑RENEWAL [:)FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑(- )MM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND LJ MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY –''LAND USE ZONE.— ' �7 BLDG.TYPE ___._TIRE ZO
�' NE—� PLAN CHECK BY L'Wtt HEAT L 1kI°-=
-- f`onatrurt aingAn Family T1Welli(Ig W/rattnChCd egi+. 4 c3. droohm -the. ``
-- _ '')EF' CORRECT ION SHEFT %TTA:Hr U. I
Sowor Permit 29386 29386 -r �70:r.00
OCC,1,Q.g,QFLQOR_LOAD 40 HEIC�hIT__-_ 2 NO.STOIS__-. A2laQ _B _L_ r _ JI'•
BUILDING DEPARTMENT CET BACKS FRONT 16 REAR ke LEFT SIDF +I HIGHT SIDE
Permit :a X01.1)1.) -_�CL ' rl , 'TTI"T-m�" �77,T—ITHIS PERMIT IS ISSUED SUBJECT TO THE REGUTAIIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1(7p. Ill REGULATIONS AND ALL APPI-ICA13LE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT 1 HE
--_ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANE)IN COMPLIANCE WIIH
Sub-total 301. ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS !'ERNIIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY RUSINFSS
State Tax 8-()4 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total " 30 3. :•,4 5V V41IO.00
ev P1 PUC ,wl $100.Utz
APPLICANT OR AC3EN1
Approved t:LIH Receipt No
--- H() E • -
6
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
/O-/7'7� �► �'V O —_--_ Permit No.
Rough-in
/1'1L-��! / • K Fixture
Final
HEATING
/,j'?L• !/ 0/liw�M/t� Contractor n /
Permit No.
Gas or Oil
-- ---- Rough-in
^— Final
SEWER
Final If
DRIVEWAY
Final
St. Drainage
(Rain Dnin)Final
Sidewalk
Curb&Street Final
- Approach
BLDG- DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY i 1 Final _
•n—` Landscaping
�f Zoning Fhial
77,...w711senw�r�swwrsrwry
I GtI�fN � H;�1:ia;, ' '��� til• i't., .�Vf >f'�N"V.4 ,. ;Jiu� -�1 n� .r'♦�r�,t• t Jkl�. .
i
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_. CITY TIGARD ELATE C �. Q ,�9�_ N
BUILDING PERMIT A �,1 I CATION OF
THE UNDERSIUNi D H-PFE0 �(' 'l IES FUR APERMIT FOR THE WORK HE.RFIN INi,w i ED salt otR15,401,16V-74.34,
OR A1S SHOWN AND A' !.'VEO IN THE ACCOMPANYING
PIANS AND SPFCIFICA(I,.}NS.
OWNER Au—i N i P� (: ADDRESS Iz�(►t7 310 LZ-34&,4-.
A 70
STRUCTURE NEW F11MI)PEL (]ADDITION LIHEPAIR RENEWAL ❑! ' t tIi
RESWENCC CI(.OMM C]EDu!.A-IJIVAE_ ❑GOV'T ❑RELIGIOUS LIPAT10 AGAR PORT ❑C; I STORAGE❑SL:8 ��F c N:
R.7 01OG_ T1•PE %+N FIRE ,' 1413- . P(Ar. HECKR �17 HES"
ePeiaa74;f
SEWER PERMIT `'' �o�ra.�e. (p(07
(?CC -()LD A/V HLIGNT EA 2/.2` 16,900
i BACKS� �`RUl:i 28 LER ; :-(-Et
f�I� . 00 -
5 PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE POILDINC• CODE.
(Plan C;-SCh, It 4F1ONS AND ALL APPLICARLE CUDFS AND ORDINANCES AND IT IS HEULE?Y AGY EC' Tint
WILL BE DONE IN ACLORUANCE WITH THE PLANS AND SPEC'IFICATION', ANC.IN CC!I- ' F
L APPLIC'"FILE CODES AND UNDINANCES THE ISSUANCE. OF THIS :EF?MIT DOLS ".UT
STRICTIVE COVENANTS CONTAAr.10k AND SUB CONTRACTORS TO HAVE CUFPENT (,Ii•
�r _!p TaK �� $� e) FNSE SEPARATE PERMITS REOU;RED ►OR SEWER, PLUMBING AND HEALING
Total 30?. J 4 )C
� E
_ 4P0L i( ANT i.1H u(,E N'
I,r No
SDC_
PDC _ -__ �... - -.. /oo
`,I !Jl R. _0NNI (- T 1IlN S & &0
5EWER INSPECTION S ? 2
5F'WER SURCHARGE 1 /!'� L.&vv-. ILL .
Comments: ____ �-- _ Rfi j JO 'l"79
S\U (,Z3 C4. lof'*�y3 .
Well'" r-(mcr„- w-&w s -G ffi 9
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3.YI x 2?-G 1 v .33
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212.- 14G, 3g3
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City of Tigard
13125 S.W. Hall Blvd. MECHANICAL PERMITP.O. Box BOX 23397 Permit tv
Tigard, OR 97223 Descrip°o^ -
Tahle JA MehYunical Code OTY PRICE AMT
639-4175 _ -
1) Permit Fee -0- -0- 10.00
Name of oe1°4opf1Bf" y� 2) Supplemental Permit 3.00
Furnace to 100,000 BTU
Job Address Adtlrhm 1 (o v C,,/ 1 7 3-.,9 (°I( _1 ind.duds&vents 6.00
TaxLW04 Map No. 2) Furnace 100,000 BTU + 750
ind.ducts&vents
Lot Block SuWvWon ---- --
Name((x name d busaheas) 3) Floor Furnace 6.00
ind.vent
MarTxgAddreu 4) Suspended heater,wall heater
Owner or floor mpunled boater _ 6'00
Gtyisl�le-jj,'o S�' r ap 5) Vent not ind.in 3.00
appliance permit
9 z j Repair of beating, -
Name P� ng,retrig.,
y�9 �,P� 6) cooling,absorption unit -- ti.00
Address K pf� Boiler or comp to 3 HP -
I a- I (r 0 SI,� � Z 3,v C7 se � absorp.L:ut to 100,000 BTU_ 6.00
Occupant /stale Boilerorcompto3HP-15HP
p �P 8) 11'00
absorp.unit to 500,000 BTU
�- i Sa,r C �7 kZ 3 __— -- -
- _—--- Name Boiler or comp 15 15.00
30 HP Y-
y� 01 ���c�! 9) absorp.unit lk-1 million --
t tas,hg Ad ,amu Phone Boiler or comp to 30-50 HP
.z I G S i a 3 y„( 10) absorp.unit 1-1.75 million - - 22'50
Contractor Cr1/statap Boiler or comp to 50 HP 31.50
m r v� i 11) absorp.unit 1,750,000 BTU -
State rieglstratinn No. Cry Bus Tax No. 121 Air handling unit to 4.50
10,000 CFM
(hereby adrnowledge that I have read this a :r«x,Mat the..In<,tt.uoo Oven Is 13) Air handling unit ------ -
7.50
jconea�ihu I am the owner or autthodred per"a the owner,shat Mans wtntitted aro in 10,000 CFM + J-- -- — –_-
cornpGarna w h State laws.that I am regisle wl with the State nuuders'Board,that the 14 Non portable
numtrer given is uorred-(it eaempl from State registration please give reason below) ) evaporate Cooler 4.50
Vent tan connee
1 df to a single dud 3.00
-- ) Ventilation system not --
16 4.50
included in appliance permit
Hood served by
17) mechanical exhaust 4.50
svwb"( or WstM) -Date 18) Domestic type 7.50
Describe work ❑ addition (I alteration O repair p incin^ralm —
to be done residential ❑ non-residential ❑ 19) commercial or industrial
----- type incinerator
30.00
Existing use of --------.-_ - -
building or properly_ -- 20) hOther,i.e..woodstovIi,water solar,clothes dryers,etc. 4.50
Proposed use of -- —__
building or property_. _ 21) Gas piping one to four outtQts 2.00
L_ Typo of fuel- oil I7 natural qas 1-1 LPG ❑ electric ❑ -`-
22) More than 4-per outlet
"OTIC[ - SUB-TOTAL /d
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- —
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5% SURCHARGE d`✓
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUBTOTAL
ABANDGNED FOR A PEPIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL t3
Special Conditions_
(_j � �� �� fi l�� t'c: h'4tcf���r�icc�l t'trrnit _ fit ��c::n,t__.._.5,
RC:i!acv 0 Relocation ❑ A ijltlon *4
IOTAL,
'-.._^tkrTOR -J__ z� ✓rte -- e,.,:i �; �r►� z_
AD7P,ccSS--.2Q ; �,(,� Lr►LyA- �/�- WORK AAIDDRESSJrZ�'L/O • S'• u1. Jam? Qj 4
PHONE �S� " �— ---
APPLICAP:T t.-y. /7Lrt�[E,r
He,-; Input Ratin7 (BTU Per Hour)_--4 u U Vent Size _ Flue Size`
FUEL OIL ❑ GAS ❑ ELECT GD-` OTHER
ITEM NO. FEE ITEM NO. FES
For Issuance of Permit ) / 3.00 Air Candido►Compressor 15 to 30 HP 10.
New- UnJe: 10J,O03 BTU � � 4.00 Air Handling 10,00_0 CFM 3.
New- 100,000 BTU S over 5.00 *'Air Handling Over 10,000 CFM
Floor Fu nace J- 4.00 Evaporative Cooler 3.
Wall - Floor -Suspended 4.00 Range Vent Fan T.
Ins;all Vents Only 2.00_ Vent Sys-em _ _ 3.
Repair - Heat E Cooling -_4.00_ HOOD Commercial _ —� 3.
Air Condition CumprN,s07 Under 3 HP - 4.00 Commercial Duct Duct system -_ 10.
r Condition Compressor 3 to 15 HP 7.50
`i
INSPECTOR'S COMWENTS_ _ ---� - - —• - -
CITY BUS114ESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUR CONTRACTORS
APPROVED DATE ^_ ISSUED BY v_ DATE
RECEIPT NO. _ _,_. _ - --� --_ �---�- -
774 Signature of Applicant
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