10395 SW HILLVIEW STREET 10395 SW HILL VIEW STREET
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CI'T'Y OP TIG ARD
1 2�A E C Z 0155 S.W.ASH
P.O. [lox 23397
Tigard, Oregon 97223
DATE:
• PEC E I PT 4
LICENSE4: _
AMOUNT:
FWJ�INESS FAME:
BUSINESS TELEPHONE NUMBER:
BUSINESS T-I)DRESS• /0-3 --- -----
TYPF. OF BUSINESS: --•---- --
ADDITIONAL INFO.: I of employdea, N o= company vehicles, M Of CUStOiner ASits per day, operatim
hours, sq. ft, bldg.: _ .i ��.�.�- s/L_a �r /� --C tss V6-v.&
S 1 L y o`__ �=�'- /I G►T1��_._�s `S � --¢-�"
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MAILING .,'iDRESS (IF DIFFERENT THAN ABOVE) : = — ---
'1'AK MAPA-, TAX LOT
NAME & TITLE OF APPLICAV-:
SIGNATURE:
TELEPHONE NUMBER OF APPLICANT: le-2
N r,ME(S) OF OWNER(S) :
IF CONTRACTOR, STATE NUMBER:
NOTE: SOLICITATION OR SALES "DOOR TO DOOR" ARE :CdIBITED WITHIN THE GtNMUNITY. BUSINESS
LICENSES WILL NOT BE ISSUED FOR SUCH ACTIO4.
ACTION TAKEN: APPROVED BY: _ ——e — DATE: _ZZ
DENIED BY -- DATE:
REASON:
r� CONDITIONS:
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Fin's: OCCUPATIaQN PERMIT APPLICATIOQ\ ;
ORDIMMCE: r 791-X7-2
PISSED is/'-�/•� •\�J.-._ -
APPLICANT /? i
B US I►MESS NA,bIElt
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II(WE TMHONE NU1T:3ER BUSINESS TELEPHONE RAMER��
TAX MAP # TAX UST �
ZONE DFSIMATION
NX11 RE OF THIS UST . . . BE S P E C I F I C . . . . . . . . . . . . . . . . . . ..
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This application shall be submitted to the Planning Director for review. Certain
conditions may be added to the apptx)vat of this permit.
Prior to commencement of business, you will obtain a Business License.
LICLYSE NUMER
S I(34:1TU T DATE;
10/22/79%mc
CITY OF TIGARD BLDG. DEPT.
12420 S.W MAIN STREET
TIGARD, OREGON 97223
PH')NE 639.4:71
CONTRACTOR
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
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Date: --- PermitNo.
Inspector '`
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 Building Code, the
following item(s) require correcting:
Date: Permit No.—
Inspector
CALL FOR REINSPECTION
- t. ,�. ...,»�r�r � ....,e•�,��Yr4ranw�N�t'+WJR"'�.AIS?' "°"MM�4Wl�RVt�'h►'v'1�'W�"�'�M"'M* """' A'1�►9M�1r""�y/''�T.`�., .�� ���r'1y�F•w"�yp�-•1r10,'�_,:yn.�+.,.
BUILDING PERMIT APPLICATION CITY TIC� RDDATE1/ s/ is79 X? 2638
of t
639-1 bbO
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUIL DER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHO r6ipliY1.SPk@4S,*
LOT NO—
GWNER t,4 JOB ADDRESS ' � tI�KA DDRESS
t ' r(. :,{�_C_ ARCHITECT
""A 1711, 140911 5161 C01,011Y Gr- � ENGINEER
BUILDER PODRESS DESIGNER
STRUCTURE ❑NEW 081-MODEL ❑ADDITION [-]REPAIR ❑RENEWAL _❑FIRE DAMAGE ❑DEMOLITION
C� RESIIIFNCE [:]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS OPATIO [:]CARPORT nGARAGE OSTORAGE[:ISLAB ❑FENCE
❑SONO OMOVING— ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED [-]SIGNS
OCCUPANCY '11 LAND USE ZON �c t _ BLDG.TYPE �A_ FIRE ZONE PLAN CHECK BY FL - _ HEAT �-
*r`I sintjlw feei.ly dwelling w/attar;had Warage w 86d>L0*00
AL CORPECTION '�IFEET ATTACHED.
Sewer Permit. U0 7[a - %625-U0popfir, �.
SIU 1+ 7 swiii.nno.
OCC I QAR._ flQ�bl Q$44M$____._.._,CA1SlF_
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit �1�+�.�.l�i -----____. =' ------=--- ----- --------- -=_-=—
THIS PERMIT 1, ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan CheckREGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL SE DONE_ IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 27EJafi, ALL APPLICABLE ConES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— ------ RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State,Tax '"? 410ENSE., EPA p%Tlk!j ITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total U 3 toBy
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_ APPI._ICAN7 OR AGENT
Approved _- Receipt No.
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING _DATE
Contractor
Permit No. �,; 41,q0
e �• Rough-In
Fixture _
Final
Byb��
O` HEATING
�S •1L ^ Contractor ' 1
Perm+t No. 15/3
Gas or OII
Rough-In
Final
SEWER
Final
DRIVEWAY
Final
Storni Drainer.
(Rain Drain)Final.
M----- _, — Si&wwtlk
Cwb R Street Final _
Approach
IJLDti.DEPT.FINAL T/CMPORARY CERTIFICATE OC( IPA
Final
TIF LATE OCCUPANCY
:ERr— —�
i
Landscaping a
Zoning Final
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Of -1-ir-13rd Mt'charlical Permit N:0 Fee
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f 1 '� ;�C�:e:P ___1 r.CL�:a;�On �1 =.]'3i'��n J t•�t�fati�r 'J 31'ns'�t! _
n T Fi ^-� �- 'L( c�� c• Y"_Aj-� _ Otitir4ER �L 4.-
^� C— RAG O ' - - —
AV
AD�RESS .U..L.Z....L�.=L _: r WORK AODRESS/U 3�1 �5 ✓5� s - ".�•
G� -
i _ S / w
1 PHnN` � yr � APPLICANT , � >`•� �.
--�- Vent Size Flue Sit*.______
_Heat Inpu; Rating (BTU Per hour)
FUEL OIL rJ GAS ❑ ELECT OTHER --
ITEM NO. FEE 'TEM NO. FE
,Op Air Condition Compressor 15 to 30 HP 10.0
For Iss.jance o' Pen-nit 3.0
New •• Utljsr 16,55,000 BTU T�� 4.00 Air Handling 10,000 CFM
-----'-- --' I - g 00 'Air Flandting Over 10,000 CFM 5.0
h•w • 10:x.000 BTU & ovar _ _ _ ----� n,native Cooler _ 3.0
_ 4.00 Eva►=
4.00 Rangy Vent Fan
lti'all • Floor S��st, _��_,________ 3 L
II Vents
only �_ 2.00 Ven:System
Instat Cooling, _ __I_._...__. ^4.00 _Hood Commercial _ �T 3 C
Ftpar, r�,ior Under 3 HP�j ��++_ _ 4.0Commercia! Duct System 10.0
Air Condition C_omp __.._.__.. . ----__._�_.. — _
.i, ndr,ion Comtrressor 3t 15 HP� I 7.5(11
Ir CO _ rrri.....tss••..r+••.:.a rr�_ •' .ns.aa=-•�� _nr_•-.y--'�.:ss
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INSPECTOWS COc,arr•EN(S�_� — - -- ----- �-- _.___ — —_ �_.__
° CITY BLISIr;GSS LICENSE REOUIREO FOR ALL CONTRACTORS ORSUB-CONTRACTORS .
pA7E ISSUED BY DATE