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DRAWING IS LESS CLEAR THAN
THIS NOTICfe;--11' IS DUE TO
THE QUALITY OF THE ORIGINAL
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►' 0«�Ier:... .�'...'"..:%...' .Permit Nu
Building Address../. .. ,. .( . . 4 �.....�... ............ f
Certificate is hereby g;.-en' this. ........... .dad• of.. .. .. .. ... ............. .,
that said building may be occupied and '
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that it coplies with all requirements of } �;
the Building Code for the City of Tigard, %
as approved by the Tigard City Council.
9
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Building Inspector
P.
V�,1 eY..y ,.} M."si 1 i 4:t"� E T'e:>� ;�ws� ` r 1 ^�''M"� �.i e'*°' ♦ 1 ��v
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City of Tigard
INSPECTION REQUEST
/) for i
INSPECTION TIME : PERMIT NO.: —�
DATE: 7 /,-7417(g DATE ISSUED:
OWNERS NAME : T 1)- (�'— - _
ADDRESS ' —
DDRESS : .� y ���yc�f� ,�>�cam,
CONTRACTOR :
TEST:Ai►❑, Water 0 , Visual LoUoratory p
RESULT: Approved fid , Disapproved p , Pending p
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SKETCH:
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INSPECTOR DATE
COTE: Attach supplemental toot data heret]
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IONN E. REINNARDI PLUMBING,I�UtLUtNC; DEPARTMENT, TIGARD
P. 0. BOX 129 PLUMBING PERMIT NO.
NEWBERG, OREGON 91132 holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contra tors. /d/J'3, hof �9 i
Own � �•_.�_____ Addrest:f� _
NUMBER OF e N TOTAL PERMIT NO.'S I
TYPE OF PERMIT _ ITEMS FEE ON EACH AMOUNT (Office Use Only)
RESIDENTIAL
Single Family--1 bath-each 25,00 �d
Duplex-Each 1 bath unit __ 25.00_
Addltlonal bathrooms-each ✓ 1_0_00 O. 0C)
Mobile Home Space-each
INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 building--each 3.00 _
51 to 100 Fixtures in 1 building-eech _ 2.50
101 to 200 Fixtures in 1 building-each 2.00
201 or more Fixtures in 1 buildin -each 1.50
MISCELLANEOUS
Building Sewer-1st 50 ft. 10.00
Sewer-each additional 100 ft. __- 10.00
Water Service to bulldln 5.00
Private Water Syttems-each 100 ft. 10.00
Other IS ecif
PERMIT &T- 00 For Plumbing hispection Phone 639-4191
% State Q. Piumbing Contractor By Z,I:
TOTAL •3lv•D RELEIPT NO. Issued Ey
I .
7
City of Tigard
Bob
I N Ce T 10 N REQUES ".
for
INS FSE CT"ON TIME' .-------- P E R V I T [40.
DATE : DATE ISSUED
OWNERS NAME : ---,T-
ADDRESS'
CONTRACTOR
rF 13)T ' Air [1, Watel�<,- , Visuc
"E^IJLT' ApprovedA Disapproved
S KETC H: Pe-V-v,
911
IN PF DATE
A
CITY OP ;., W 0831
BUILDING PERMIT APPLICATION TIGARD DATE /9
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS
A 194
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ADDRESS 101bb #1406 Hifjt'11wi It. C• BUILDER PI_I4NE —
�.►r:r3 -
ENGINEER DESIGNER
%..AM*: ARCHITECT -
ALII LDER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION _ ❑REPAIR ❑R— ENEWAL [:]FIRE DAMAGE DEMOLITION
❑_RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FES
[3BOND ❑MOVING []CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED LISIGN5
U FIRE ZONE PLAN CHECK BY HEAT
OCCUPANCY LAND USE ZONE . _BLDG.TYPE
t;:�ilsstLwc:t 130) ryT . t't. Fzamu dwo,1,1i.ng With ett:,�t naa�i t�[Ira�e
c► batacasm>al�t. Atxutdirtg tw appr'wQd P1611m.
---— —�
NO.STORIES AREA VALUE, .•
FLOOR LOAD HEIGHT -----
QgC.IOAD f
REAR LEFT SIDE RIGHT SIDE
BUILDING DEPARTMENT SET BACKS FRONT --
Permit
THIS PERMIT IS ISSUED SUBJECT 1'O THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
t" REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check YVORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIIVEpCOVENAENTS. CONTRACTEO�IRFAOR SEWER, PLUMBING AND HEATINGTRACTORS TO HAVE .
CITY BUSINESS
State L10ENtSE.yIEPIRtIfXF� 1 R4OVlf.L`3fa
Total
BYAPPLICANT OR AGENT
Approved _ Receipt No. rloN€
ADDRESS E55 ------
DATE INSP. TYPE 1 SPEC710N
REMARKS PLUMBING DATE
S -1 � � _ �-� � /?p,..-... E-�i� -�,�.-✓ ,�, Contractor
Permit No. d�
/
Rough-in —
�►^r_
C[/ Fixture
�- Final -
HEATING
Contractor S
Permit No. �'� •1 ��Z//7�
Gas or Oil --
Rou h-in —
Final _
SEWER (e-.7•76
---' Final
-- — DRIVEWAY 7 ��
Final _.
Storm Draina
(Rain Drain) Final
_ Sidewalk
--- _ Curb&Street Final
-- ----
Approach 4,c -7 L
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Q L Landscaping
Zoning Final
1