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City of hg and �
INSPECTION REQUEST
f o r f
IN,�PECTIC►N TIME: PERMIT
DATE: DATE. ISSUE?,D :_�L�1___
OWNERS
N�A.MI E :.�_....5'J v.ci a►ti: r.2 I _------
ADDRE
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TEST : Air p, Watery , Visua� E}-,T_abnratory )
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RESULT: Approved L 1 Disapproved ❑ , Pending []
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INSPECTOR DAT'-
;NOTE: Attach supplemental teat data Aerefid
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An Azik%
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City of Tigard �
INSRE"CRold REQUEST
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for
INSPEc'milW TIME: .����''. PERMIT NO. :.
DATE: DATE II SUE D
OWNERS
C ON'f R A C T C R ' .____.__ --- ---------- - - I
TES-r : Air C.I , Water[] , Visual M, Laborotoo Fj
_RESl1Uj" Approved Ll Disapprove" (7� , Pending ❑
S ll..'"TC I-1: I
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INSPECTOR DATE
LNOtE . Attach supplemental test data beret]
MOLML
13785 S.W.-Fairview Ct. Permit No,. 4774
Address
Permit ebar ;e
Connection fees 425
Paid by
Dat1! collneC'ted 2-23-73
T a of baildiag � �ience -----
Service rste _.3�SJ_h'�r, n,.�r�Lli _ s Inspection Vte
25
Paid by came �_ Date:
contractor �11�1c1LErt1L_Si"r _„�,.__._�__...__ ,—.....–.,..--._--�-
:size of cowieetion 4" ��__ Assessment, .�,.. i'a4•'j —
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1541,Ia 1,tt�L-b 0-1190" !, 07-
City, of Tigard
1\1S:P*:OTlON REQUEST
far
4N SPECTION TIME : 4'02 PERMIT NO. :J2'LZ
DATE : .-,2—j;9 1'3 DATE ISSUED :
OW14ERS NAME .' —_---
ADDRESS: .
'T'E'ST : Air [_J , Water❑ � Visual B', Laboratory 1'] I
RESULT'. Approved Pj Disapproved O Pending (.]
'SKETCH: I
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INSPECTOR — DA'T'E I
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L_40tE At?,;ch -s pp emeiI,,l tvsI doIa heMe�.;�l
�tr�rri•����.� ISIC"�!lI�N WIU�8'1r)•1�
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CitTigardI
y of
INSPEC-nON REQUEST I
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for
INSPECTION - - �
S ECTION TIME . s: PERMIT N4. . 7 -0S r I
DATE . _) /1-3/? (SATE ISSUED : I I
C)WNERS NAME :_ ` ---
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CONTRACTOR '.
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TEST : Air 0, WoterL7 , Visual p , Laboratory U I
RESULT: Approved P , Disapproved L- Pending
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INSPECTOR �,,N�'E
k.NOTV Attach suppif-menta teat data Lore t]
�rN�►���r�rmlr�3x�aj,>i�siY>�ruir�:��;�I�r�n��r�lydul���wut�rrr�,�;r,��::�:.;�,�n►��i�rr��u.��um.��.�u9
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C:T`i OY TIGIIED I(119:A IMG PERKIT 3
ATB pct_- PiUtM1T NO. I1BCE;LFT NO.
— FEE
1. Permit shall be obtained '^►ar to rrn'm,'tcameri :rf inet.alaeit <in,
2. Permit shall be obtained fnr ail. aF:)Itanc•es which are, to become a fixturrs
to the building
3- Relocation, replacement: a' "c-t:etE,a+trey. c chaarlworks to bxrner.j and duct work
require permits .
4 All uor)r I— he concealed ,mu;tt be ,.,,N.... before cover un,, ,,
New Installatsorn Calk heplace m Rolo•.ation 11Addit:en 11 Alteral�ion rru
CONTR. QUANIANT CORP ._.r _ Ci►NER _ QIIAORAMr CbEP _
�i ADDREGS __ I750 SM SKYLINE BLVD --_ WORM ADDRESS �I3785 SW FPJRVI[W LANE
PORTLAO, OREG011 _ APPL:CA r IMPERIAL PLUhI[•.,r% & NEATIN(+,INC.
^ELEPHONE NO. •_ ,1,77 3801
FURNACE - MANUPACTURFk GENERAL ELECTRIC _ _ TELEPHONE NO..
HEAT It put rat,no (Bt,t Per^Hour )8010100 - � Vent Size 4 Inch -_ Flue Size 4 Inch
FUEL OIL ❑ GA: )W ELECT ❑ _ OTHER _
TOTAL SO. FT, Top Floor ..._. Main Floor: — I1S5 Basement - ---
GENERAL
ITEM NO. FEE AM'T ITEM NO, FEE AM'T
For Ieauanc•_e oi. Per.-nit } n
_! 4 _ Hot. ta over 50 Hp__ _ � Iis 0
�lew - Under lUO,QG- . 9tv XX 4-0 �P - 11,ndl inq_,0.Oc:p LF" 3,.01; _--
New -_Ovei i00_,G(;O b',, 1 5.0 --Y Alt1►rq CVer lU U00 CF S 0
Floor Fur_r�acE 4 t r _ce t.n _pr _ — 3..00
Wall F104-t - a 4 Edea ..4_.0 _ Vey r. - -_ 2.00
_
Install Verta 2-0 VQn asci 3 00
e stir -_Heat 6 Cooling 4 0 Hood - —� - 3,00
BOA lera Uttdez•_l Hk _,. —_ .est t c :r;ci r,era t or _— 5, 00 _
�ioile.r.e . «.• 13 FIL._ __ '. 5 _ CoP __. r ;}e.ator.. ._._.-___ 0.00�—
Doi Tera 15 to 30' H —
0 0 ptlter --- listed 3.0
Boil,s!rs 30 to 50 Hp . 15 C
INS'PECTOR'S COMMENT.
APPROVED BY 1� _- .,. CA':E LJ ?3._ ISSUED B ;_ _ TE
MPEPI PLU -r TI NC.
e c: Art.�tca:lt
y
4M III I I
PLUM Bli.0,; PERM11 APP11CAL7' ON
Ju.rlcdiction of
No. ( °.yT)e of Fixt,,ire Fee Permit No.
Permit f ee
2 Writer Closets (Toilets
Permit IsSLed
bs Approved by,
Building_.,.,avatory LwLah Bas
S;-iower Receipt No. _A/.2 I_-
Sinks, Kitchen
Sinks , Ordinary Location of Building
Sinks. Bar I-Amc
Sinks, I'll o V
I Automa tJc DishwasF_eT___
Disposal
Launder 'frays Name & Address of Ownpr
Drains. Floor
D:,ains. Area
--Drains, R or
-n Drains
Autom=—Vasher Nnnif, Address of Plumber
Fountains Drinking
k -- I —
Fountains. Soda
H
Water ,.an ot -------- _j!MdjMjj,_Qr0Unn 97206 ------
Water Sf.-rvice (31ze3A'
U`11,11sBiuilding (Old or (dew) (Alter. Repair, or
sash assns Yard TTl-s7=
Lawn '�T)rinkler tem
limming Pool Mer
fpr-Inkler SysTem
This permit becomes null and void. if work or construction authorized is not
commenced within 60 days, or if construction or work Is suspended or abandoned
for a period of 1420 days at any time after work 13 cc:inmenced,
All plumbing firms must be licensed by the City of Tigard and pnst a $19000 bvAt.
I hereby certify that I have read and examined this application and know the VAW,�
to be true and correct. All provisions of laws and ordinances governing this
of work will be complied with whether specified herein or not, the g-ranting of
permit does not presume to give authority to violiate or cancel the provisions
of any other state or local law regulating construction or the perfomence of
construction.
WPEPIA1 M11
PLUS A IAEA?INS
"S . aturp of ApT)Iicant S 4"
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II 7V JV
UNIFIED SEWERAGE AGENCY NO. 4774 ....�
WASHINGTON COUNTY DATE __:11-29--72
--------... ._ .
C I T Y O F_�_ Ti�►rd
APPLICATIONS FOR SEWER CONNECTION PERMIT
Qued.re►nt Corporation
OWNER:
OWNER'S ADDRESS: - s•w• skyline suite 20
- _
STREET
aDn --- .._.-. -
CITY SY ZIP
BUILDING SITE: LOT--I4---- BLOCKADDITION -------
'TAX LOT N0. TYPE OF OCCUPANCY
ADDRESS . 3_r]-11ILLrTL4w C31
l _�_ __ __�____ FIXTURE UNITS
I DWELLING UNITS---- - ----- _- -- -- -----_—
SURCHARGE IF APPLICABLE - 50.00 50.00 Derry Dell
PERMIT FEE INSPECTION FEE .__gi__ TOTAL DEPOSITED
Tigard
(NEW (EXISTING) BUILDING SEWER SYSTEM ------ ___- _-
I
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT��� ._ �`... -----
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
41f (Joy+:: sa=wn
LINE SIZE --------------- ---- INSTALLER -
RECEIVED BY.___ f - Ana cv o-�Oks ----Ao' T~-- _ _. _ ___ _ _ _ _ _ _- _. ___.__._._
COMMENTS: .
This Application and permit expires in ninety (210) days. The amount paid will be forfeited
should expiration occur.
-.
L ,2�/S I?UJ.LDERL'4�...
LOCATION _.��� �5.._.�������c�t�� wUWIIFIi -
JODVIAL ii;. 3/ ?CSL te`'._ ..1t7.._�.
PLUK3,FTi
ECE 47z Y. _�-_ .._- FHR KEa';: _ MrCt'A JL(A1< <A EiJ ��.b!1. ,- _? _...
DATE� ._�_...__.._.,. ._.�.,.._. By _.. tA'i'F __. ..__�.�._._......_ ...
Ex ZON F _ rH ONDIT IO NIzG r._. .» _..r�.... .
sIA.P5 _..._.. 0.- -_ ZSFI�lR-YFFLUF,'.5
REINFORCIM, STF.I'L
iT"'C'1,JPAL S`1�LL_. FLOOR ,.. .. __... ..._ .,. _...
PLUM LG R.I._ _ _ _ ',RIV'k-,WA;Y
OARD
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CITY OF TIGARD
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ISW, s. W. '.Acle ftvo
TIOAIW,00AW N 1ilq
APPLICATION FOR RTITLDING PERMIT
Maw Construction I-XI Demolish [, Ad.+i.tion ElRemodel ❑ MovN1'
SOMING_R-7 DATE ISSUED_11-29=j? BUILDING PERMIT
Dl►�L RECEIVED 12-22-72 BUILDING FEE $ —T' No. '"24.5
ec.
PLAN CHECK 41;
_
67. bH --_� OTHER :ice- 10.00 VALUATION $-2Rtc
TOTAL :; `87.00 RECEIPT No. 7131
1Z-,ja2=•7
TWO SETS OF :PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICAT- ,N
LOT N 14 MAP # 2al _ CENSUS TRACT W-ly -- JOB #_ _
Architect or Engineer `.Tack Woodman dLAnsoclaias_,
Address---- Bellvue Washington — -�� Phone--
Owner
hone --_Owner 4�wirant OorP•
Address—line Blvd., Portland_ ----_--- _ ___ hone
Builder—_p rint_Co
Addrear same !� ,- Phone
BUILDING USE Single Res. n Multi Res. ❑ Comm. ❑ Industrial
OCCUPANCI GROUP I No. of Stories_ 1 Total Height--16_ Area of Lot
1
Type of Construction V Floor Area B-- --_ 1 2 35S
Set Backs: Front 20 _ Back 15- L.SidA_�___ R.Side__5_
Private Sewer Pipe S+ze 4"_-- sewer U.g.A._TJ4ar6eptic Tank ❑
r
Water Service Pipe Size— 3/4��� ,storm Sewer � Ditch ❑ Drywall
Street and Curb Requirements_ EXiAtiog
t,
Driveway Width____ 17 No. of Parking Spaces
SEPARATE PERMITS REQUIRED FOR SEWEn AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED Q.Y. b111da11 LlL.
FIELD CHECK BYBE __ - ------ -- DATE
PFRMIT APPROVED BY
It is understood that all work will conform with applicable codes and ordinan
of the State of Oregon and the City of Tigard, Oregon, and that the building Wi
not be occupied until a Certificate of Occupancy as been issued by the City Of
:'Pigtrd Building Inspector.
Signature of App cad- of —
�,a