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:I,�He:,'�ce l� Reiocation ❑ Add,T,,,, -� Alteration Jai.Stat:
New Ins;al,at;on TOTAL. _
.."' O�tir�cR_l sig• . .... , ,� _
C^%ITRACTOR _
�}R�— 1YORM, ADDR
ESS
APPLICANT__
PHONE hent Size- der I FIue.Size
Heat Input Rating (BTI I Per Hour) �,Qj�? rt a= --- r -'` —'--
FUEL OIL 0 GAS Eg"" ELECT ❑ OTHER R.
NO. FEE ITEM NO. Fc
ITEM _ -
-� Air Canditbn Gorpressor l5 tc. 30 HP
For Issuance of Per, 1 00---�—_�W-_^�
4.Q0 Air Handling 10,000 CFM
New Under 100,000 BTU _ i --5 U0. Ai, Handling Over 10,000 CFM J 5 l
New•• 100,000 BTU& over _r._ � - - �-- ----L
--'r--- 4.00 Evaperative Cooler
_Floor Furnace I - j 2.i
"-- — 4.00 Pang Vent Fan
\Rlall - Floor - Suspended _ — -----
2.00 Ven; System __�_�� —_�-3-d
Ins.all Vents Only —1--..--- �_._ _
R ,pair • Heat & Gooiing� 4_00 Hood Commercial �T-�~ 3- I
Air Condition CompY!ssa_Under 3 NP I _ �4 C►0 Commercial Duc_System � i �__LL_ '
\ir Condition Cornp.7,ssor 3 to 1S HP 7.50
IASPECTOP'S COr,,WErd-fS__
r CITY BUSINESS LICENSE REOUIRED FOR ALL CONI`RACTORS OR SJR CONTRACTORS
DATE ISSUED BY .,o-DATE J1
;r ,%PPROVED 3Y------ i
y' RECFIPT NO.
e><r s
JJNN E. R[ihlM01 C,i BUILDING DEPARTMENT, TIGARD NO
PLUMBING PERMIT �
K�'r1'"►RS, �;i� 'i ��'32 holder of a valid plumbing contractors license is hereby _
authorized to cause plumbing work as herein noted to by installed in accordance with the plumbing cede of
' Tigard, Such installati;,ns require inspection by the City Inspector who shall �)e notified not less than four
(4) hours prior to the time the irstallations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors,
c
Owner luL'& 0 C'► . Addresses(% '� ) u' x�r a?i to-.-
NUMBER
o__NUMBER OF TOTAL PERMIT No:S
TYPE OF PERMIT ITEM% FEE ON EA(:N AMOUNT i0frics Ute Only)
� ;. 0ENTIAL
Sm IgaFamlly-1 beth—tech _ L`., 25.00
Duplex_Each 1 bath unit _ 25.00 �w
Additional bathrooms—each __ / 10,00
Mobile Horne Space-each _ 16.00
INDIVIDUAL I°IXTURE FEFS
1 to 50 Flxtwas In 1 budding-Lsch 3.00
51 to 100 Fixtures in 1 building—sech _ 2.50
101 to 200 F f_tures In 1 bullding—each _ 2,00
201 or mc,e Fixtures in 1 building—each _ _ 1.60
MISCELLANEOUS
Bulldin Sewer-1st 50 It,. --- 10.00 _Y _
Sewer--each additional 100 ft. 10000 + ;
Water Service to ballding _5.00
Private Water.Systems—each 100 ft. 10.00
Other S Ify):
PERMIT '" ;G'� For Plumbing Inspection Phone 639.4191
% State U Plumbing Contractor By
TATAL RECEIPT NO. Issued By
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TICEJCr H E ADI C
IALIBOARD
"tai., Card acrd Mint fi3-, iAnsplr���°�� ss y Posted, �'�rioq t1��
" Stce t 3",Datil c ,,v
.» on 711.i" as s11r
Mi
,,. CITY
BUILDING PERS"+T APP! (CATION OF TIGARJ DATE
THF_ UNDFRSIGNED HEHEBY APPLIES FOR APERI'AIT FOR THE WORK HEREIN INDICATED BUn_DERIIHONE_—_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. owNERP.ioN�,,. -- —_
LOT NO.
OWNER I'unlnt.kn E,fa1% "fl. !C,11 ADDRESS i rIm SW highland F•- r1UNIL AEIDRES.; �-
--- — ARCHII-rECT
c' ENGINEERBUILDER _ emi ADDRESS >>�C , l_J ! I4.+ DESIGNER
STRUCT(.)9E ONEW _❑_RFMODEL ❑ADDITION ❑R_E_PAIR CIRENEWAL ❑FIRE Di,MAGE ❑DEMOL'1'ION
EJ RESIDENCE ❑COMM O1:CUCATIONAL—CIGOV'T IT^`�REL.IGIOUSOPATIO ❑CAR PORT ❑GARA-c 0S1C'RAGEOSL413 ❑FENCE
❑BOND 0MOV ING_— ❑CONDITIONAL USE ❑DESIGN REVIEW 000UNCI1. APPROVED --- -❑SIGNS
OCCUPANCY--- 'LAND USE ZONE BLDG.TYPE_ FIRE ZONE _ PLAN CHECK BY _.._._. HCAT--�.�_�
tlly!..'. '41 t u�tay5 rramiiy t.1waa.j.tinq w/atLuchur'. 9b, ,.1�( .
-
-- 2, �——
40 1,2 ] 1"':eta {a42fP4i.
-QCs;.LO A-p ___F�4SeE�_LQAIL __kLC1HT — NO:31QBJLUAR.-A--�-_� --YAtt
BUILDING DEPARTMENT SET BACKS FRONT Its REAR 14 LEFT SIDE RIGHT SIDE 4
Permit L L,1,•tlQ
.l.tl•(,: THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONe rUNTA,NED IN THE BUILDING CODE, ZONING
Plan Check -REGULATIONS AND ALL APPLICABLE CODES AND ORDIN..ACES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDMNCE W!TH THE PIANS AND SPrCIFICATIONS AND IN COMPLIANCE WITH
SUb•total — 176.130 ALL APPLICABLE (ODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
"— RESTF11C7lVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State fax e� LIC,HNAE. SEPARATE flEff TS REDUIRED,FOR SEWER, PLUMP.NG ANIP }(EATING.
-- ----�� --- 11Uf, r-d �!71l�t�•
Total
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DATE INSP. TYPE INSPECTION F.EMARK$ PLUMBING DATE
�.—,. 'Dr iy -� t 5'/J.Qfi�w S1oU� – Contractor
Permit No. /9 / 3irr -10-T7 n
Rough-in
Fixture _
Final ---� ---� .— I
HEATING
Contractor — 9
Permit
(ias w Oil
Rough-in
--- __ ^�_--- --— Final �— -- ---
Eli]
Final
DRIVEWAY
— _ Final
Stoft Drainage
r (Rain Drain)Final.
Sidewalk
—'� Curb&Street Final
— —+ Approach
BLDG.DEPT.FINAL TtMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY I'^ Final --` -- —_
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Landscaping
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