9705 SW FREWING STREET-1 9705 sw EREWING STe.-ET
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AODRFSS D ( PERN[ r NO .
QFRMI1 CHARGE none
OU-NE = L./ �C.QA•a�� C(NN"CTION FEE S
PAID B Y
TYPE OF' BUILDING uaTE CONNECTED
SCP,VICC RATE .INSPtrTION FEE r,
COh;RAC7OR PAID HY .__._ DATE _
SIZE OF CONNECIION ASSESSMENT PATO
CITY OF TIGARD BLDG. DEPT,
12420 SW MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
P;,,;ut,,nt to Section(s) of the Uniform Building Code, the
,ollowiiig item(s) require correcting:
Ile
olate-_ --'��- -%` -- Permit No.
Inspector` ' -5---- ---
CALL FOR REINSPECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform B---;Iding Code, the
following items require correcting:,
v
Date:.__ Per►nit No.
Inspector _--�
CALL FOR REINSPECTION
. ....�-..h.,.,•w*Mpr'w"K"�"r1Y"p'""`^""-�r.....�—,,...,+.-..--.+...av*.---.___...-•-_, _..-__.._--_.,,,"�,,,,,_..,...r........-.--�-,.—....--.__..._..,_-�-�_.�.....,.,......-•-"•--•---_.. .........._,.,........-.--- >rr^�-,..
BUILDING PERMIT APPLICATION 11T TIGARD OATS ✓l�'_!�_.__._ 79
OF
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE—__.._.�_
OR AS SHOWN AND A?PROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. UWNER PHONE —
LOT NO.___ —
a4kirT r.?'ax'1�1on '4 Su r rewisi } St. HOME ADDRESS
OWNER Y JOB ADDRESS
ARCHII'F_C'r
ENGINEER
BUIL.UEh K'1f1,�tun Constr. /ADDRESS _ DESIGNER _
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR_ ❑RENEWAL r3FIRE DAMAGE l_1DEMOLITION
❑ RESIDENCE OCOMM ❑EDUCATIONAL ❑GOV'1 ❑REL.IGIOUS❑PATIO ❑CARPORT ❑GARAGE GSTORAGECISLAB [:]FENCE
❑BOND C1 MOVING ❑CONDITIONAL USE Cl DESIGN REVIEW ❑COUNCIL APPROVED —,CISIGNS
OCCUPANCY_._LAND USF ZONE_- _BI 3.TYPE----FIRE ZONE.. PLAN CHECK BY - _HEAT_ —
+,amtJl.� t3i1 uxistj(16 ajtructuro down to floor level, _
Secure building permit Uieforu st4rt of building
Q",.LOAQr_1D 2.8._L4.AD_.__ F B _�_.NQ.I�E.f�HS24MS—__�A...L��—.__ -_
BUILDING DEPAF MENT SET E'ACKS FRONT REAR LEFT SIDE _ r� RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABL.r- CODES AND ORDINANCES, AND IT IS HEREBY AGREED 1HAT THE
-- — --- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICPRLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tait. •40 LICENSE. SEPARATE PERMITS REOUIRED TOR SEWER, PI_11MBING AND HEATING.
Total
By p p
2079 APPL IC.ANT OR AGENT
Approver!
DAVE IIN.3It TYPE INSPECTION REMARKS s PLUMBING DATE
s - - Contractor
Permit No. � --- —
vtL - -- - - Rough-in
Fixture
Final _-- --_
HEATING
Cootroctor
Permit No. �V
Ges or Oil
r� �— Rough-in
Final '-
SEWER
Final -
DRIVEWAY
Final
Storm Drainage T
(Rain Drain)Final
Sidewalk
Curb 6 Street Final
_ Approach
OLOOL DEPT.FINAL _TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE 0C:C1J"ANCY final
L ndlcapii.'7
Zoning Final
'i
I
BUILDING PERMIT APPLICATION 1OF
1TTIGARD DATE t
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED SUILDERPHONF �1-r�,p01
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF,.,.
eil1. N4.
i i,� t��it . .J +.,. �
OWNER �- JOB ADDRESS_ w+ !— HOME ADDRESS
- ARCHITECT
ENGINEER
BUILDER ADDRESS _DESIGNER
STRUCTURE ❑NEW_ ❑REMODEL ❑ADDITION—��❑RE.PAIR 01,ENEWAL_— [:]FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO [:]CARPORT ❑GARAGE ❑STORAGE❑SLAP ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPkOVED ❑SIGNS
OCCUPANCY__ I.ANU
�
USE ZONE_ —7 �11a}��BLDG. 1 YPE—..—_—FIRE ZONE.— PLAN CHECK BY HEAT_.
ingla f'ramily dwelling w/attenhad gaxago - 3 PeLrooms w births„
C CONNECTION SHCUT ATTAW �_ y
too rmit , 18760 - !' 62;.01.1
47,00U.
MC,LOAD F1S).�fi LOAD ---__.--.—t!E1StN_7-- NQ�IQFiI.� .--AREA- ------NS?H1[2Fj99MS VAI. _
BUILDING DEPARTMENT SET BACKS FRONT r 7 REAR LEFT SIDE RIGHT SIDE
Permit ?�,j,�y �t f,U �._._...._
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check yr�r " REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL BE DONE IN ACCORDA'JCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 271. ALL APPLICABLE CODES AND ORDINANCE— THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PFSTRICTIVF COVENANTS. CONTRACTOR AND SUS CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax - _ T^ LICENSE SEPARATE PERMI rS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total — . 14
By
--• APPI ICANI OR AGENT
Approved Recelnt No
.....,..................,.....w....m.W....«.................,.,...,,sem..«...-...._....... ,.w ........._......__ . .an�urac .. --,. F._� .. _.
DATE INSP.I TYPE INSPECTIONREMARKS PLUI4aING DATE
—
NSP, Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Cootractor
I'llf it�O -1 7-9 4$
Gas or Oil
Rough-in
n
Final SEWER
Final
DRIVEWAY
Yv Final
Story Drainap
Main Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT. FINAL —.tMPOF'ARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY 5' - - 7
Landscaping
Zoning Final
CITY OF TIGARD MECHANICAL PERMIT
PERMIT N0. RECEIPT N0.
ATE - `' :
• FEE --
Y
Permit shall be obtained prior to commencement of installation.
1. Perm appliances which are to become
Permit shall be obtained for .all
a fixture to the building,
elocation# replacements, alterations, or changes to burn
duct workers and
3. R require permits.
4. All work to be concealed must be inspected before cover uP•
�at'o Replace Relocation Addition �eration [�lew lns a � OWNER
/(�
ONTR
S
WORK ADDRESS
ADDRESS
APPLICANT ,
TELEPHONE NO. l.•�� -7rS`7
FURNACE MANUFACTURER Ccs�'� TELEPHONE NO..
� .L 'J4( � Vent S i 2.e --. Flue Size
---------
AT rating (Btu Per Hour) `_____�
FUEL OIL ❑ GAS ELECT OTHER
Flour Main Floor //�� _ Basement LA _
TOTAL SQ, FT, Top -----�-
--- -�- GENERAL
-------_,---`_ _____- t . • ITEM NC. FEE
ITEM N0. FEE
For Issuance of Permit .00 Boilers Over 50 HP
NeW - Under 100000 Btu 4.00 Air Nandl ,000 CFM
Air H`andling Over 0 0a--0 M - '
NeW Over 100 000 B u •00 E poratiye Cooler
H�loor Furnace -- 00 Ven Fan
Wall - Floor __ Suspen_e Vend S a m �O
_-
fte air - Neat Cool n .00 Hood _
4.00 Domesa Inc nera or ��
Bo ers�Jnder 3 1� 50 Comm. I-n�inera`£orl_O.00
Borers 3 to HQ - -�-- --pier No is e�
Boilers to _3o Hp 10.00
Bo
INSPECTOR t S COMMENTS - ��"�� •^V -�
DATE ISSUED BY DATE ,
APPROVED BY __.________.-__..- _ -- /4/��i✓y ' `�'/�✓ ��
St i ture of pplicant