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INSPECTION NOTICE
City of 1"igard Building Department
P O. Box 23397
J Tigard, Oregon 97223
Phone: 639-4175
l/y
Type of Inspection "-
Date Requested__- 01 Z7 Time A.M.-� P.M.
Address i_ 1 J—(:—S - --)w �Z`i - r�Q---- Permit #_L(C
---- ----------
Builder --- - — - ------ -------
The following Building Code deticienci-rs are required to be corrected:
Presented to Approved
Inspector LI Disapproved
Date,
CALL FOR REINSPECTION
❑ YES L7 NO
l�
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223 � 7
Phone: 639-41 , '
Type of Inspection
Date l4rnuested .�_—�5_1L
__— Time--A.M._�/_P.M.
Address �5—
1 f��. _ Permit #(Q
� _
Owner z Lot #
Builder
The following Building Code deficiencies are required to be corrected:
c
Presented to
Inspector _er � [� Disapproved
Date
CALL FOR REINSPECTION
❑ YES [_�] NO
CITY OF TIGARD PLUMBING ���23 "�-
Applicants mus'. hold Oregon Registration to conduct a plumbing PERMIT 639-4175
business or must be property owner/operator not hiring wside help.
Nww of Dewhprnent -- _ Piumbrntt Permit No.S Z 3 3
Iddrear y �� �, 1�vxipUon
ORS 014-21-010 OLIAN, PRICE AH1T
Job Tax Lot Map.No.
Address _ FIXTURES
Lot - SubdMelon Sink _ - -- - 7.50__ 7
--]Awns(or name srness Lavatory ----- - 7.50
Tut,x TubtShower Comb- 7.51) '7
Shower Or11y - �- -/ 7.50
Water Cbsol _._ 7.50 EA-5
Owner city/stale zip 7,� 7_
OWmasher 1- -—
f'tnone— Garbage Disposal- _V - 7.50 _7�
_� --
Name Washing Machine - 7.50 7•-
flax Oram__ _ 7.50
-
Mailing ress Phone Water Heater -- — - 750 7�
_� _ Laundry Room T.ay __ _� 150 - - -
Occupant Cyy/$tale Urinal
Other Fixtures(Speafy) 7.50
Na -
ass 7'50
--- -- - - 7.50
Contractor CKy/;'este - ZIP -- -
MISCELLANEOUS _
_ gw Tax No geww 1 all tar 3000
Sewer♦a.Addil 100 15.00 -
tate - xF-iar�iTo - - late s s o - 29.00
JL (Residential) Water Servfos 1st 100_ _
-'"- -
I herotnr ack,owledge that I hew read Itis app%cation.Curt C»inlamnarlcx+ Water Service u.Addit.ZV 1500
even is oorted,that I am rrgiviered with Ow Stale Burgers 13card.and also Storm a Rain Drain 1 at.100' 90.00
Leve a Stale PkpTk"boerwe Crat this numbers given are oonred,that all Storm a Pyn Orairn AddM 100' fA
pkxrnbwV work wir Se done in woordw»with appscwAo pr°�iOre ns of O ---LS
gon Revised SUAfts Chaplers 447 and 693 and appacabis oodes ar' ,a1 AAoI>Me Honor Spam --- 25 00
no hep will be employed un ia,"*wood under ORS W3 (If exempt ox- Bede Flow Pnrwnbon
State reglWatio n,pW"*"reason beiaw) Back For PremombMiort Oev10a 7 50 - -
HOMEOWNERS -1 hereby OarWy gust I am Cie ownw of Cie property de -
sors»d above,at whidr beatlon I propose to nM"t r+wnbbV wwd&§Gbm kx Any Trp or Waste Not
my ori use emi this property is rmt bakq cwtanxaed for age.lease or rent Con iscled to•
Catch Bach ?A0
----- ---�---- — --- iMP.
of Erdal.PIumb np _ 40.00 Per hfi-
- - fah RegU11etad 10.00 Per�tt
Alter-of Pkrtlbing Will d, I LOO_
an EA"
Bldg.or Build.AddNkxr - 1100 ftw+
New
lAK3NATURE - {f F {
fatal _ -
Deecr6a worts M wo twMilk)n[ 1 ww*tkrm❑ pair[7 d.lellirg
_ _ 15.W
reeiasn ial CLt, non-
Esdatlrlp use of .,
bL"v or propertyP U46,
CA 1x�� �0
-
TOM wr
Tf tM pefrrt[I bnootnsa aur and rai01 trartc a ownM voaon arAwetaed b not con+
tltsltOaA wM1Y "C da(I W r tnsn/rudbn ar er0446 slugs VW Of ebertdornad kfr
a www of 100"I d atw fto now work M ot"Itie nOed /
erae� a- ..
� !R
INSPECTION NOTICE
� City of Tigard Building Department
P O Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of !nspection YT --
Date Requested Jam-`1 Time A.M._ �"'� P.M.
r n
Address r �-� 1��SL -- _—_- Permit
Owner QQ - ---._---- Lot #
Builder - -----The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspectur �_ - _- Disapprove .
Date
CALL FOR REINSPECTION
Cl YEd ❑ NO
CITY OF TIGARD 639.4171 DATE _T9
6695
_� -�►'_I � ��
BUILDING PERMIT -�— ---
TAX MAP w-.^A_LOT N0. 44 -SUBDIVISION, F `_�•�
OWNER KCV41uY D. Zt7C' — --- JOBADDRE3S �11?J�' bd 124t.1'BUILDER
STATE STATE REG.NO. __EXP,DATE
BUILDER'S PHONE 620-41,W
ARCHITECT _ PHONE _?Afr'�0��_ OTHER
STRUCTURE ,; NEW REMODEL 1 ADDITION REPAIR MOVE OTHER DEMOLITIOPi
L_ RESIDENCE I COMM EDUCATION 1 IND I RELIGIOUS ACCESSORY GARAGE OTHER FENCE
OCCUPANCY —LAND USE ZONE �BLDG.TYPE _i:A_FIRE ZONE PLAN CHECK BY HEA"f
C'.c¢'t ta:'.Ict single tit' A`C`T" i0R`iT, :)ih'J"l'.r`:'i to (31
SILIbjC*r:t: tO T,Cn)n IMS. x)50 -rK1 n..0!
'2'st uzn C�C�4l�7 ss c-i�s�.�i.i'✓fi71� r'if'�iTfT•f'i �.T.i�iiiilf a!• _—.—_----_ _ __ _
SEWER PERMIT M
'1;41
OCC.LOAD FLOOR LOAD 4(',HEIGHT "`'' NO STORIES AREA :' •+`.' NO.BEDROOMS VALUE
—BUILDINl3 DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 3'�?ef�D _ THIS PERMIT 13 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES ANJ ORDINANCES, AND IT IS HEREBY AGRECD THAT THE
Plan Check 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
PI.Ck.Fire _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Tj`X PERMITS.SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
State'six ��•�$
Total APPLICANT OR AGENT
PDC'r
re 100.00 1.110.00
--— — -
Receipt No.�f '� ADDRESS PHONE
Bal.Due
Issued By__—. Aonroved By
DATE INSP. TYPEINSPECTION REM -.IKS PLUMBING DATE
4'-2/ ) C- Contractor
��� •r J�Q�." �,c Q�„� rL Permit No. —
=/
Rough-in
Fixtu
G / Final - —
C ;'`,' ecru-_ otr�_.Pr• c -� HEATING
Contractor
Permit No.
6 _ '• GasorOil
A. ��7 .n �L- Rough-in
/ •� h /� �/ t I . i / l,, c" t Final
I - —
y- SEWER
Final ��-
�Y DRIVEWAY
— ---- Final
iStorm Drainage
(gain Drain)Final
Sidewalk
Curb A Street Final -
_ Approach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTFICATE OCCUPANCY --- -
Landscaping
Zoning Final
Nld+kW Iai+NPN1bf dfll
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f'ormit NAff /hb
Cascriptlor
Takla 3A Machanlcal Coda CITY PRIG! AMT
City of Tigard -- - _ - -- -
13125 S.W. Hall Blvd. 1) Permit Fee -0- 0 10.00
P.O. Box 23397 _�-
Tigard, OR 97223 2) Supplemental Permit 3,00
539-4175 Furnace to 100,000 BTU
1) incl,ducts&vents 6.00 (�
Furnace 100,000 BTU f
2) incl.ducts&vents 7.50
Name of Development -� Floor Furnace
3) incl.vent 6.00
Job Addie s �JJ s,- )4 Suspended heater,wall heater 6.00
Address � - �,.�y / or floor mounted heater
Tax lot Map No Vent not incl.in
Lot / Block Subs visf 5) appliance permit 3.00
Nam (o of bus " sl Repair of heating,refri
6) cooling,absorption unit 6'0
Mailing Address - -- Boller or comp to 3 HP
Owner 7) absorp.unit to 100,000 BTU 6
city state Zip - Boller or comp to 3 HP-15 HP y
8) absorp.unit to 500,000 BTU 11'00
Name 9) Boiler or comp 15-30 HP 15.00
absorp.unit 1/2-1 million
Mailing Address �— phone Boiler or comp to 30.50 HP
10) absorp,unit 1•1.75 million 22.50
FContractor Zip Boller or comp to 50 HP
Ciry'S1ale
11) absorp.unit 1,750,000 BTU 31.50
State Registration No. City Bus.Tax No 12 Air handling unit to
10,000 CFM 1.50
edge that I have read this application tliat the information given is 13) Alr handling unit750
, he owner or authorized agent of the owner,that plans submitted are in 0,000 CFM +
compliance with State laws,that I am registered with the State Builders Board,that the 11 Non portable
number given is correct (it exempt from State registration please give reason below) ) evaporate cooler 4.50
15) Vent fan connected Y r
to a single duct 3
--- -- Ventilation system not
18) included in appliance permit 4.,t
i0
!
Ho,:d served by 4 so
17) mechanical exhaust -7
;ABip 14111 (owner or apart) Dab
Domestic type
19) Incinerator 7.50
Describe work
❑ addition n alteration Cl repair O
to be done residents non-residential 11 om
rCmercial or industrial 3000
Existing use of 19) type Incinerator _- -
building or property _ I _ _ heater,solar,clothes Other I e.,woodstove,water-
Proposed use of
20)) dryers,etc 4 50
� ry
building or property, — _— 21) Gas piping one to lour outlets— ' -_ 2.00 �'—
Type of fuel- oil ❑ natural gas LPG O electric r]
1 1 22) More than 1-per outlet
NQT=
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUIS-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUS-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -- �' -
WORK IS COMMENCED TOTAL
Spacial CwWltlons
Dabs Isrued �,< by
a� � ■ er
CITY OF TIGARD BUILDING DEPARTMENT PLAN CHECK NO. :
PLAN CHECK APPLICATION DATE RECEIVED:
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID: /�7c
This is to certify that the attached sets of plana hav,_ been submitted !c>r plan
check pursuant to the Oregon Structural Code and Fire 6 Life Safety Cod_, edition.
PROPERTY OWNER: f-I c; OWNER'S ADDRESS:
CONTRACTOR: 'e '�'` TELEPHONE: / '��^ `7�/ y
JOB ADDRESS: 12 6� X, �� LUT NO. 6 MAP:
DESCRIPTION OF WORK: Z� LG� ::�
Approvals Required SPECIAL NOTES
OPlanning Dept. O Reissue
UEngineering Dept . O Flood Plain/Sensitive Lands
UFire District O Sewer Availability
UOther Other
Items Required
UList of subcontractors
Business Tax
., Calculation.:
OTru9s Details
O Parking Plan
OLandscape Plan
OOther
COMMENTS:
City of Tigard Building Department
BY: r .
�
ma !• � � � //
C,vvrkshee-yPLAN CHECK NO. `7
for inspections call 639-41.75
PERMIT NO.� �(!�
CITY OF TIGARD 639.4171 DATE ---1°-- --
BUILDING PERMIT
P.O. Box 23397, Tigard OR 97223 TAX MAP LOT NO. __SVUDIVIS!tjN./jA-r
, lCc' __ JOG ADDRESS _lL�s
OWNER .0 .�: /j'YL/
!�
BUILDER �C. �! �LC'C' lL"/�c�� - _ STATEREG.NO. y 7� EXP.OATE C/��/ �
BUILDER'S PHONE
ARCHITECT Z.Ar. h�G/it/�Cl� PHONE r 30 2 OTHER
STRUCTURE NEW C] REMODEL ❑ ADDITION - C] REPAIR
C) MOVE O OTHER O DEMOLITION
RESIDENCE 0 COMM O EDUCATION ❑ IND Q RELI�`US. ❑-ACCESSORY Q GARAGES U,OTHER O FENCE
OCCUPANCY +�,3 LAND USE ZONE - BLDG. 'YPE .�11 FIRS.ZONE- I PLAN CHECK BYz4,.C_HfAT
Construct single family dwelling w/a CLQAr-9t all 1)P'1" =+ nrn� aA nl�.ii
-- �'y - -
SEWER PERMIT# - '(ldu) baths, /l trigs aardoe //[[,,�� �' ---/
OCC.LOAD FLOOR LOAD �U HEIGHT 2** No.STORIES 'OZ" AREA/X& NO.BEDROOMS VALUE D
BUILDING DEPARTMENT SETBACKS FRONT 9t/ REAR LEFT SIOE S- PIGH T S DE :j- 0
Permll S Z THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN T►:E BUILDING CODE, ZONING
J
� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE
Plan Chock .2 [ U WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. T14E ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PI.TA L Fki RESTP.ICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
(' TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEINER,rI.UMBINO AND HEATING,
Slate Tru C)& 5500
Total APPLICANT OR AGENT
PO(./
Pr Pd. d `. } s.L. �r
�/26QHf7�r
-'� Retelpl No f AAODDPFSS
@al,due r
iued By ---Approved By
I�
SSDC
SOC — -- _�—_ y G —
/ 5-0
tJ RECEIPT
PDC - .•y _�_ —
qDATE PD.
SEWER CONNECT ION 5 _/ -7 _ ? �. AMOUNT P0._- � Qa
5EWER INSPECTION S
5EWER SURCHARGE
F
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