12280 SW 124TH AVENUE ■
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BUILDING PERMIT APPLICATION TIGW D DATE 3.489
THE UNDLRSIGNED HEREBY APPLIES FOR A PERMIT FOR t IE WOlK HEREIN INDICATED 3U!LncR PHONE 439-6791
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE __620-711-2
LOT NO.
OW .ER ban Davis JOBADDRESS 12760 5W 124th Avenue _
- -- — ARCHITECT
ENGINEER
BUILDERC11slaSiC HOMO ImproyeoADDI;ESS 12335 SW Ann Court DESIGNER i3lOors
STRUCTURE ❑ NEW ❑ REMODEL ADDITION ❑ REPAIR LJ RENEWAL _0 FIRE DAMAGE ❑ DEMOLITION
IN RESIDENCE ❑ COMM ❑ EDUCATIONAL Cl GOV'T ❑ RELIGIOUS_D PATIO ❑ CARPORT LA GARAGE C1 STORAGE C.] SLAB❑ FENCE
OCCUPANCY —L"L".�__.LAND USE ZONE _ 0"?_BLDG.T"PE FIRE ZONE_ PLAN CHECK BY
Gon!struL:t 116v_addition to existing garage (residential)
SEWER PERMITM
OCC.LOAD FLOOR LOAD slab HEIGHT 11 N0.STORIES AREA 126 NO.BEDROOMS VALUES t A(11n.
BUILDINGDEPART;:itNT REAR rSIDE + RIGHTSIDE
SET BACKS FROG ' 2I1 "'— �'' �—
Pei nit 124.00 THIS PERMIT IS ISF•j r..) SUt;ECT TO THE RE.11,1 1,i IONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AN' ".. APPLICABLF_ C0DFl- AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
Plan Check 12.00 WORK WILL Pf f 4 ACCORDANCE V:ITH THE PI-PAC AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICA o. CODES AND ORDINAVCES TH ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ 36,00 RESTRICTIVE COVENANTS. CONTRACIOR AND SUB CO V1 RACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REOUIRF_D FOR SEWER,"!.UMBING AND HEATING.
State Tax 4 i •96 a
— SDC— lr, �r ,.M • ,; �..
Total $36.96 c._�---= - ---- -
- PDCM_ APPLICANT OF ApENT
ty _ pl
Receipt eCelpt No. ' -ADDRE95---- ---------- — PHONE--�
Approve: _
�r ® r IWARAW-
DATKK INSP. TYPE INSPE"ION REMARKS PLUMBING DATE
Contractor — — —
/ Permit No.
f Rough-in
` Fixture
Final
HEATING
—�---------- -- Contractor
Permit No.
Gas or Oil
Rough4n
Final —�
----
SEWER
Final-- �_—
DRIVEWAY
Final
Storm Drainape
(Rain Drain)Final
5idawslk
Curb&Straat Final
------ Approach
BLDG.DEPT.FINAL i'EMPORARY CERTIFICATE OCCUPANCY in.l
CERTIFICATE OCCUPANCY
1_iinAscaping
Zoning Final
-777
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BUILDING PERMIT APPLICATION TIGA--:) DATE &s7&W 19� / J
THE UNDERSIGNED HER EDY APPLIES FOR A PER?AIT FOR Tf iE'VVORK HEREIN INDICATED BUILDER PHONEl2�'OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND,SPECIFICATIONS. OWNER PHONE 62o_?�2��
o �
_J'.•1"!ER �6ZY (°f ^-- JOB ADDRESS I2.2 SO 30 12, 4±5:Av e-. -
AnCHITECT
ENGINEER
BUILCEP—LGQ1,t Y�t�Q� DOF�ESS DESIGNER -
STRUCTURE ❑ NEW ❑ REMODEL _ADDITION _❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMIOLI T ION
❑ RESIDENCE COMM ❑ EDUCATIONAL 'J G_OV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT GARAGE G STORAGE ❑ SIAB❑ FENCE
OCCUPANCY ��Y LAND USE ZONEtom-- BLDG.TYPE -� I FIRE7.ONE__ =PIAN CHECK BY -AL-HEAT.
SFWER PERMIT#
OGC.LOAD FLOOR LOAD HEIGHT J f_ -NO.STORIES - AREA iZ(p NO.BEDROOMS
-� BUILDING DEPARTMENT_ SET BACKS FRONT REAR — LEFT SIDE .S- } RIGHT SIDE
P4rTIt OO THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILD= CODE, 70P."N3
REGULATIONS AND ALL APFLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT I XE
�PIAnCheck ��. �� WORK WILL BE DON": IN ACCOP.CANCE WITH THE PLANS AND SPECIFICATIONS AILD IN COMPLIANCE
p WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
SulYtOtal (p RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTAACTOn3 TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERWTS REQUIRED FOR SEWER,PLUMB:NG AND HEATING.
State Tax +
Total SDC-�-- PbCtt ------------ ----
APPLICANT OR AGENT
By
Receipt No.
`Appfr,YM ADDRESS _— --- -- ---- PHONE.
5DC
P_D C
SEWER CONNECTION
;EW-R INSPECTION a (o x. 2ti-'$I)-=,236
FEWER SURCHARGE
'?4 oD
r„moron} : • - '
IMUM
A00RESS o2grJ t& PERMIT NO.
PERMIT CHARGE none
CONNECTION FEE _6o-o ,
PAID BY 1&4
TYPE OF BUILDING /t�ev DATE COQ:":ECTED
C�
SERVICE RATE l� C- INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF COJNECTION 5SESSMENT PAID
6-17 So
�► !f AI !4 1i It!
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 �tem(s) require correcting:
'date: —S l Permit No._- _--
ir.specto
CALL FOR REINSPECTION
i
j bUILUINILi Ut'N.:`; INICi`Ji, I IUB AML/
PLUNIBING PER-MIT N�
1 , holder of a valid Plumbing contractors license is hereby t
authorized to cause plumbing work as her.,• noted to be installed in accordance with the plumbing code of �
Tigard. Such installations require inspecti n by the City Inspector who shall be notified not less than four �
(4) hours prior to the timo the installation, are ready for inspection. City of Tig rd,$usiness L.icensa required
for all contractors and subcontractors. / r��Q/l
Owrer. j _ Addre�;/,7_�AV 0— r _ _ Date- I
NUM3ER OF TOTAL PERMIT NO.'S
t!; TYPS OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
kYy
Sinal+ Family-1 bath-,tach 25.00
Onola:a-Each 1 bd:h unit - --� _ 25.00
Additional bathroumrc
s-ah_ 10.00 _
Mobils Home Spica-each 15_.00
INOIVIOUAL FIXTURE FEES
s 1 to 50 Fixt•jrat in 1 building-each 3._00
51 to 100 Fixture] in 1 buildir -each 250
tUt to ?UU Fixtures in 1 buiidin;::94.r 71.00 -�
a01 or mors Fir`�es in 1 buitrlin9 •each—__� 1 5r1 !
hl 15 C E L L D,N c O U 5
6�ift+ir,Saner-11t SO ft. _ 10.00
Fo't'hnr
wer-arch e1.d�itional 100 ft. 10.00
ater 5ervica to building ' _ 0.00
ivets 6':ater Svaterns-each 100 It._ _ 10.00_-
(SoYr•If•I; _
PERS 11T For Murthrnr P,hon?63,4.44171
a Stag_ _ Plumbing Contractor By
i _T01'�L ___ _ RECEIPT NO. Ise;ed By
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BUILDING PERMIT APPLICATION c0F TIC-BARD L�A�E_ 12/ Ig
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BULDERPHONF
OR AS SHOWN AND APPROVED IN THE C YING PLANS AND SPECIFICATIONS OWNER PHON�{��
LOT MOS 1
T
OWNER. ".UJ JOB ADDRESS t� '`J 124th HOME ADDRESS
�- ARCHITECT
�q}� ENGINEER
BUILDER t'alll7llW' ADDRE�jSL 465"' -'L' !33 L'u,T.,.""'1'a DESIGNER
STRUCTURE DiEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL [-]FIRE DAMAGE [:]DEMOLITION
❑_RESIDENCE ❑C—OMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
iL..iDOND ❑1,AOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY `•'t" LAND USE ZONE BLDG.TYPE-.`_�1__FIRE ZONE -AN CHECK BY f HEAT �8 Q
--- L.Orlstrurt eirl��jg 1,8mi1X dwullln� u/sttachuc1 gsrs ,jo 4 Lisidruom — 3 oath.
fie—Iasuo at L.-2289
e 7071 gal
Q",_LQAD _! FLOOR LOAR___40.__._ HEIGHT 14 N.4 SS�Fil.6�_�----AR�A1t11Q NO.BEDROOMIL__—YALUE
BUILDING DEPARTMENT SET BACKS FRONT Rr _REAR _113_ LEFT SIDt' � RIGHT SIDE
Permit sl ' .00
A. THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED .N THE BUILDING CODE, ZONING
Plan heck REGULATIONS AND ALL APPLICABLE .ODE:: AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WOR16 WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPEC,FICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CON'rRACTOR AND SUB CONTRACTORS T) HAVE CURRENT CITY BUSINESS
State Tax 7. :11.' LICENSE. SEPARATE PERMITS nE_OUIRED FOR SEWER, PLUMBING AND HEATINC-
��:�. .. %400.00
Total ;�►J ODIL #2 $1130,011
APPLICANT OR AGENT
Approved K v, Receipt No 16 --- ---
..-.._..-.._.._...•....... .. �......w�.........��....r....�......u..�.��..»...-........_.. n-i..noGcc_.._...__.,.�....�........,..._.............._� _....�-__ tNriNL
DATE INFP. Type INSPECTION REMARKS PLUMBING_ DATE
Contractor `
•—,
Rough-in
2_ �! Fixtum — --
Final ---
� HEATING
Contractor
— -- Permit No.
Gas or Oil TT
-- --- --- -- Rougher.— —
Final
SEWER , }
F inel
ir11� DRIVEWAY
ark Final
Stoll Drainape
(Rain Orme.)Final
Sidewalk
Curb&Street Final
Approach
KLDO.DEPT.lrINAL TEMPORARY CERTIFICATE DCCtPANZY Final
CERTIFICATE OCCUPANCY I
Landscaping
Zoning final_--- - _-- - --
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4'44
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3!JILDING PEW111, i APPLICATION FY
"-1E UNDFRSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF
-,R AS SHCWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
R � /1 �d JOB ADDRE5S T .SGf/ /�� HOME ADDRESS
9 7Z Z ARCHITECT
ENGINEER
LR�----1�--- -- ADDRES`; �. 3.,�c�—G,.�.. '• _�AvL DESIGNER
URE CRIJEW ❑REMODEL DADUITION ❑REPAIR — DRENEWAL - ❑';IREDAMAGE — ❑DEMOLITION
Svo IDE-NCE -E)Co MM DEDLICATIONAL DGOV T DRELIGIOUSDPATIO ❑CAR PORT ❑GARAGE ❑STORAGE DSLAB ❑FENCE
'lROND El MOVING ❑CONDITIONAL USE QDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
^uP4N/C�Y 3�L.A,Nb USE ZONE RLDG_TYPE .,�rrhFIRRE ZZONE.-3 PLAN CHECK
a t'T2-1i
�`�yti%Z`'�r
_.NQ.�zQR1J-5 �±13E� /��.9�QE.49��.�aLu OS R
—�.. BUILDING DEPARTMENT SET BACKS I HONT 30 REAR- //-7 LEFT SIDE Z- RIGHT SIDE --
.�._. ._._.�--. -
?ermrt THIS PFRMIT t5 ISSUED SU5.1FC7 TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check RFGU1 ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE. IN ACCORDANCE WITH THF PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUh•10tal fr ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- ----�---- - RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
F,lete Tax LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Tool
By ---- --- ____ ». — --- --- — —
APPI ICAN1 0-_ AGENT
AVP,Ted Receipt No
�1� yd O
II
City o 1 iga (i IF'Itl'I�t�nical �rertnil NSI Pe:cnit__-._.�jJ4.UJ....
t�_�t IhS•al o:ion t RCCr e�C L—'1
Relocation ❑ .'.dd;rion ❑ �IiL'f21ipf1 ❑ 0 Statr- ._—_
TOTAL._
C'".i i=.nC'T O R @l '� !_.__�.._ O��N c R �--•u?��-�------ -�-�_..�
r 1VO;iK ADDRESS�O
ArJ- •-r--f- --_.— _ --
DPLICANT
Heat Input Rating (BTU Per r) Ven; Size Fi a Size_,,_
FUEL OIL ❑ GAS ELECT OTHER_ _
ITEM NO. FEE ITEM NO. FE
Fo Issuance of ?er_mri' 3.00 Air Condition Compressor 15 to 30 HP --L---L1-0.[
New• U ;ie: 10J•000 BTU 4.00 Air Handling 10,OJ0 CFM L 3.
n
y New- 10U,000 BTU & over 5.00 _Air Handling Ove: 10.000 CFM, 5.
Floor Furnace 4.00 Evapora;iveCooler 3.(
Nall • Floor ---SL 4.00 Range Vent Fan 2_(
Invall Vents Only 2.00 Vent_System _ 3
C-9 ( 4.00 _Hood Commercial _ J
Repair - Heat & oolin _ _
Air Condition Compressor Under 3 HP _ 4.00_ Conimerci'r ^ Systrm _ 10.(
Air Condition Compresso• 3 to 15 HP —� -7.50
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY--_— — DATE ISSUED BY--- DATE
ft RECEIPT N O.__________
Signature of Applicant '
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