10720 SW HIGHLAND DRIVE 10720 SW HIGMAND DRIVE
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JUNK E. REIIi�.Ijlt PIS i!';NC, i@ii,BUILDING DEPARTMENT, TIGARD
F. 11. EPX Ijo PLUMBING PERMIT N0. �
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. Stich installations require inspection by the City Inspector who shall be notified not less than fuur
(4) hours prior tri the time thE. installations are ready for inspection. City of Tigard Business Licence required
for all contr-lctrn s and sub-contractors.
Owner IIZ4, 914hV. A0 C%o - — - AddresslQY '
NUMBER OF TOTAL PERMIT NO.'S
TYPI OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Single Fa 11 —1 beth—each
Duplex—Each 1 beth unit _ _ 25.00 _
Additional bathrooms—each �/ 10.00 X61 UC i
Mobile Home Space—,ich _ _ 15.00 _
INDIVIDUAL FIXTURE FEES _
1 to 50 Fixtures 1 building—each 3.00 _
51 to 100 Fixtures in 1 building—ench 2.50
101 to 200 Fixtures In 1.building—each 2.00
201 or more Fixtures In 1 building—each 1.50
MISCEQ_t.ANEOIIS
6u Idin S_wer-•1st 50 ft. 10.00
Sew..r—each additional 100 ft.' 10.00 f
star Service to building_ __6.00 "`•'
Private Water systems—each 000 ft. 10,00
tht.t S f
P►.iMIITotic) For Plumbing Inspection Phone 6394191
9(. State (/ Plumbing Contractor By
TOTAL RECEIPT NO. Issued By
4
c- ty 01 1 10- arLI M cfianical rerma Z: ►r: r111 _�s_��
• �/�FI!:J!a^-f � nehC.atiOrh � AC1Ci,'idn � �+!I!-rat'An I_J
N,s•: Ins:jI;a,• on _ - :S:atlr.. •��._ —
` -yam • TOTAL_.�..�.` i _
•rr1a '���TQ �Y"� ��\��it�.Yl � _� Lii iCf1 _._I•7Ai1T.J ' ►-_L,__.��Z+�—.-..
Apl^nC WORK ADDRESS0•� �.q k4� Ft_S+tSkN2.1e�t�b
PH(IN _. _.-_-OM:ILL- APPLICANT___- • JE__��'�t,����4-n
Heat Inp.'*. hcting (8111 Per Hour) _ � CX,� Ven; Size � �' '' Fiue Size- _
FUEL OIL ❑ GAS ar ELECT l__) OTHER
ITEM NO. FEE ITEM NO. FE
Issuance of Per, - —� _5-�- 3 O� r Condition Compressor 15 to 30 HP
New - Un i 1UtT,000 ETU 4._00 ) Air Handling 10,040 CFP J 3
_ _ _ �_
New- 100,000 BTU &over ~- I 5.110 1 'Air Handling tr '10,000 CFIV, �~� 5 t
L_.__ ---- — L_.
Floor Furnace _ _ 4.C;1 Evaporative C_oolei
Valt Floor SuspenJed Range Vent Fan Y 2.(
Install Vem._n^•!'r —_ ^:)00 _ _Vent System
Repair • Heat & Cooling4.00_ Hood Commercial _— ( ` � 3(
Air Condition Compressor Under HP ' 4.00 Commercial nuc', System ___.air Conditin Com,')rc-ssor 3 to 15 IIP -- 410.;,
447-!. INSPECTOR'S COAfMENTS__ _.
e,
7: GI TY f3U51hE55 I_I(:ED:SF RFQLIIREIO FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY OATE ISSUED r3Y DATE
RECEIPT NO. 1
r,
,,� �„ 5iunature of Ap rcant�` '�_�
CITY " 4
BUILDING PE MIT APPLICATION of
HEREBYTIGARD DATE
THE UNDERSIGNS HEREBY APPLIE; FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN A� D APPROVED IN THE ACCJAAPANYING PLANS AND SPECIFICATIONS OWNERPHONE
r
LOT NO.�
OWNER i,.0 i i y8 JrJB ADI, 'ESS i 1)I L1 C H� t, Aitis: 1.*HOME ADDRESS
_.ar.
AhCHITECT
! ENGINEER
BUILDER s pj�in I _ ADUREsS _ DESIGNER
STRUCTURE ao'W ❑RLMr1DE1. [,'ADDITION 0.RkPAIR �- ❑RENEWAAL. [-]FIRE DAMAGE []DEMOLITION
❑ RESIDENCE [11c0MM ❑EDUI-ITIONAL El(;cv"T ❑RELIGIOUSOPATIO ❑CARPORT L_IGARAIE. ❑STORAGECILLA13 ❑FENCF
❑BOND ❑MOVING ❑CONDITIONAL_USE OULSIGN REVIEW ❑COUNCIL APPF OVED ❑SIGNS
CCLIPANCN.__.__::_.LAND USE ZONETYPE- FIRE ZONE PLAN CHECK BY___� _ .____ HEAT ,
��--I>��+FJk1
AREA 14 1._N4,,BE[2RQOM _ Y9L� t -•
_ BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Pe r nu t � ;*lel(� .. _-•-�—•------ —�.—.�__-
—'— —"- THIS PERMIT I� ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check i0o00 PEGULATIONS A,ND ALL APFL—BLE CODES AND .,nDINANCES, ANC IT IS HEREBY AGREED THAT THF--
WILL
HFWILL BL' rvONE IN ACCORDANCE VATH THE PLANS AND SPECIFIC AI IONS AND IN COMPLIANCE WITH
SUI)-total ALL APPLICABLE C11DES AND ORDINANCES THE ISSUANCE OF 1HIS PERMIT DOES NOT WAIVE
— RESTRICTIVE f;OVFNl�ITS. CON'iRACTOP AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6*64 LICENSE, SEPAIIA'E PEFMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ZF� sfJ<I 511. 9R'1lrijoco
PDC 02 611)0.1In
FA�urovftcl
APPt i(.ANT OR AGENT
Receipt No.
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3+�a,��.toy>i$i ���� ���?�44 l���?!.��4?.' ;•+ '�:.3•'t}' h 2�3>l�i�p;:
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DATE INSP. TYPE INSPECTION REMARKStContractor
,UMI31 G DATE r
_-- -- ���
`NOI —hlq�� I V
Fixture
'3-.27-79 �.ar..•c�r-.c,gF�,�.�� _.— ,_�.�
Final
1-71 t-,-rpL AT1�/( -- HEATING
Contractor
Permit No. �S� � ,3:Z 7-31
Gas or Oil
— — Final -- .--!
.SEWER -- -- - ----
_ —_ — .—_. — ---- Final -------- -
DRIVEWAY
- _ -- — --- — Flnal�
Storm Drainage
(Rein Drain)Final.
Sidevwtlk
Curb&Street Final
Approach
— 13L X3.DEPT,FINAL TrMPORINPY CERTIFtC,TE OCCUPA Fri' Final
CERTIFICATE OL'.'UPANCY
Landscaping
Zrning Final
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