12320 SW 128TH AVENUE 12320 SW '.28TH AVENUE
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Da!e Requested A.M. P.M.
Address
Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to !-'!—Approved
Inspector Disapproved
Data
CALL FOR REINSPECTION
YES ❑ No
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MEU-4ANTCAL. PF:--PM:I T'
C17YOFTIIFARD NO.
CITYOFTWARD
COMMUNI""Y DEVELOPMENT DEPARTMENT 011160N 7/29 He
13125 S.W.Hall Blvd.,r O.Box 23397.Tigard.Oregon 97223.(503)6394175
C P P.1.M P'M'T NU 111301.41041
'10F.3 ADDP+:.SS : [;--2320 !'.iW :12011-1 AVF'
_I AX
.I'AX MAID/1-01 ri I,I U HK
I. AND U!�I:;.
1LJr Sii:l:al': :
NO: NO
WOWK CLASS: Al-TERATTON FUIPINACE (1.00K AIR HANDI-1:4 (10
tisk:-* TYPE : SINGLE FAMILY FtJPNACI:-- J.00K+ AIA HANVI ..:4 1.0K
GONST . TYPE: IFLOOP FIJPNACE:. EVAP - LOOLI::-P
OCCUP.Gnp. 11-111T.ATEP VENT FAN
VENT . 5Y5*TI---:M
BLP/COMP (3HP HOOD
NO- STOPIES : ULP/Comp 3-1.51-11P
DWELL .UNITS SLPMOMP 15-301-41=- I NCJ1:Nl;::PAT0P(C-011
FUEL TYPE GAS BLP/COMP 30--50HP PEPA:[P UNITS
MAX . INPUT BILPMOMP 50+HP OTHEP
1"IPE Dmpnt"i'f GAS 01-1111ET5
HIGH 1:)PF-.-SS'?
I OW PRESS'? YES
AEMAPKS :
gii'm 1ine ftlr' dr,yer,
0 PeAh i In i r OLCI PERMIT 1111110 , 00
WN 1-V320 SW 128th Av*,, PLAN 11F.:VIEw
E IA.g n r,(J F:1XTLJAE5
R 92 0
STATE TAX $ . 60
OTHER
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IR I TO l"Al- $1e.60
r4Ii;JA,JP I- NO
This permit is issued subject to the regulations contained in Title 14 .............
of the TMC. State of Oregon Specialty Codes,zoning regulations
and ill other applicable codes and ordinances. and It Is hereby GA5 1. INI.::.
agreed that the work will be done in accordance with the plans and
specifications and In compliance with all applicable codes and
ordinances The Issuance of this oermit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become mull and
void If work Is not started within M days.or It work is suspended or
abandoned for a period of 440 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested a9d approved
Permittee Signature
Issued By: LUAI I- r-;'(3 A I IN rA Pr-V I T ON
J
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
f
CITY OF TIGARC MECHANICAL PERMIT Receipt#
Permit #
Description —
Table 3A Mechanical Code QTY AMT
City of Tigard - - -- -- PRICE
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU
1) incl,ducts&vents 6.00
2) Furnace 100,000 BTU 4-
incl.ducts&vents 7.5J
r- Name of Development 3) Floor Furnace
incl.vent 6.00
Job Address — Suspended heater,wall heater
Address 4) or floor mounted heater 6.00
Tax Lot Map No. 5) Vent not incl.In
Lot Block Subdivision appliance permit 3.00
Name(of name of business) 6) Repair of ht '1g,refrig.,
PJAbCA, P�^NIn1iZRfj cooling,absorption unit 6.00
Owner
Mailing Address Ph" 7) Boller or comp to 3 HP
I A 3 l o 5 w /It rl -1'r t j absorp.unit to 100,00013TU 6.00
city/State1 Zip 8) Boiler or comp to 3 HP-15 HP
T" 'A9-7 a L3 absorp.unit to 500,000 BTU 11.00
Name v 9) Boiler or comp 15-30 HP
absorp,unit 1/2-1 million 15.00
Mailing Address PhOfe 10) Boiler or comp to 30-50 HP -A
absorp.unit 1-1.75 million 22.50
Contractor Cny,Stale
Zip 11) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU
State 9egistmtion No. City Bus,Tax No 12) Air handling unit to
10,000 CFM 4.50
I hereby acknowledge that I have read this application that the information given is 13) Air handling unit
correct,that I am the owner or authorized agent of the owner,that plans submitted are in 10,000 CFJ1A + 7.50
compliance with Stale laws,that I am registered with the State Builders'Board,that thrt Non portable
number given is correct (11 exempt from State registration please give reason below) 14) evaporate cooler 4.50
- 15) Vent fan connected
to a single duct 3.00
!� --- - - - 16) Ventilation system not
included in appliance permit 4.50
17) Hood served by
mechanical exhaust 4.50
Signature iowner or agent} Date Domestic type
Describe work D addition alteration ❑ repair [1 18) incinerator 7.50
to be done residential W _ non-residential U _ Commercial or industrial -
Existing use of 19) typE incinerotor 30.00
building or properly Other i.e.,woodstove,water
Proposed use of
70) heater,solar,clothes dryers,etc. 4.50
building or property
21) Gas piping one to four outlets 2,00
Type of fuel- oil I_I natural gas D( LPG f I electric F I —
22) More than 4-per outlet
TI �
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- - SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 SaIC 4a SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORN' IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER PLAN REVIEW 25%OF SUB-TOTAL
WORK IS COMMENCED. TOTAL
Special Conditions
Date issued by —
I I
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection CU- Y ,
t 7
Date Requested �//k A -S- Time A.M. P.M.
Permit
Owner .•I_ _, i/ --- Lot # `_
Builder
The following Building Code deficiencies are required to be corrected: ✓��I
--_.,� �y�—.moi .c1��-�" "2�r�• r^�r. .
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Presented to Approved
Inspector
[� Disapproved
Data mss'
OR REINSPECTIO 1
YES f NO
i
i
INSPECTION NOTICE
City of Tigard Building Department �+ • 10
12420 S.W. Main St.
t Tigard,Oregon 97223 {,
Phone: 639.4171
i
Type of Inspection CLQ- (Vi LN-
Date Requested Time_ A.M. p.M
AddressI' S Uki I b _ Permit #
Owner _ Lot #���
Builder �G tjc
The following Building Code deficiencies are required to be corrected:
c
Presented to U Approved
Inspector __.._ -
-�- Disapproved
Date
CALL FOR REINSPECTION
1-1 YES f_tl NO
BUILDING PERMIT APPLICATION TIGARD DATE_
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED SUILUER PHONEOR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER emol.l Construct o-- JOB ADDRESS 1232c,
post =s .! 22 . ARCHI'T'ECT
fakmw 3,'33 1161:Rr i�r. . ENGINEER
BUILDER ADDRESS DESIGNER" _
STRUCTURE L'� NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM Ll EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ LAND USE ZONEr"�_BLDG.TYPE _ FIRE ZONE— —PLAN CHECK BY I TEAT
let ,;male Farlily Ow. 11in- w, Rttnche�u —
"ee (-orrention sheet stt,ar..hecf :; 'iFelrnn
I>,atlrs
SEWER PERMIT MI'^^'�I — ear.- 460 -
OCC.LOAD FLOOR LOAD HEIGHT ; NO STORIES AREA 4013 NO.BEDROOMS VALUE
--- — - --
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit __ ' s'',•':'}_�_ THIS PERMIT IS ISSUED SUB.rECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 70NING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS R1 ND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal Z1t. RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
11.30, LICENSE..SEPARATE PERMITS REQUIRED FOR SEWr:R,PLUMBING AND HEATING.
—
Total 564.46 SDC- � '.
By `ice j PDC#1 APPLIC ANT OR A G F N r •
Receipt No.
Approved -- AVOI111E9I3 ''ll Lj - –PHONE --
s � �
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
O w Contrctor ��sp P •�'/.-ltZ/�/
d- 7 �� �✓ - Permit No.
Fixture -
Final
HEATING —----
4-L�.r-�CNt
Permit No. ;223 16,6 la`�'Jj 3
^' Gas or Oil
—• ----^---
Rough-in
Final
--- ---------------•— SEWER
Fina-
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final_
Sidewalk
Curb&Street Final
,1pproach
BLDG.DEPT.PINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIMCATE OCCUPANCY -- -
Landscaping
Zoning Final
BUILDING PERMIT APPLICATION TIGA„:) DATE THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TI iE WORK HERD BUILDER PHONE2.___?' rOO2qt`.
ORAS SHOWN AND APP.ROVT
E )IN-THEACCOMPANYING PLANS AN SPECIFICATIONS. OWNER PHONE,/�- _
LOT NO.
B ADDRESS
O."1NER
� -��-_- - --- - p ,e-�^IZZ� ARCHITECT
ENGINEER
BUILDER /�}}
F YI Q ADDRESS3 -M ✓� lllo �� DESIGNER- g�4GflO
-- ------------ ---- ------
STRUCTURE NEW ❑ REMODEL CI ADDITION r) REPAIR Cl RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
C RESIDENCE ❑ COMM ❑ EDUCATIONAL-❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE Cl STORAGE ❑ SLAB❑ FENCE
h•COPANCY .LANO USE ZONE _lam•- —BLDG.TYPE___FINE ZONE�— PLAN CHECK BY HEAT-_
wr
-------- z
SEWER PERMIT M
OCC-LOAD FLOOR LOAC#O HEIGHT 4/ _N 0.STORIES AREA Q�NO.BEDROOMS VALUEQ000
r BUILDINGD _
_ EPARTMENT SETBACKS FRONT ,2.0 REAR _-.. LEFTSICE rJ'.a� RIGHT SIDE .23 _-
P±miit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZON:!.,;
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TPE
Plan Check �• �0 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
~� `� WITH ALL APPLICALLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV_
(Submetal S'l• IQ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 8US1``.ES'�
(� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
;State Tax - _
/� t1 sac—
Total
POGO APPLICANT OR AGENT
By
—�- Receipt Nu
Approved f ADDRESS— PHONE
sac - yc�v
PDC - S _—_ __��_.0
...wWM. r+• NOW ••.�
SEWER CONNECTION 8 '"2S =-
SEWER INSPECTION
SEWER SURCHARGE
Comments : ._.�E•�c •g3 ��� AS6 P - �I�O�►. �'�llo
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j W L2 Q' Ap.e-.=--_ Re fs t A e, zj,/0,5 - 1304 3.
32,x $- io z83
3O )e, ll- 41 340
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