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BUILDING PE MIT APPLICATION coY TIGARD DATE_ '�.-_- _-, 19_�
THE UNDERSIGNS HEREBY' APPLIES FOR APERMI' F-4 THE WORK HEREIN INDICATED BUILDER PHONE_'�OWNERPNN_ ---•rr--�-
OR AS SHOWN AN APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS LOT NO.
OWNER �U� .� In '<�'safU• JOBAODREWM45 5U 1Iil,�hl lir FJC .HOMEADDRESS
ARCHITECT
ENGINEER
BUILDER G it —�� ADDRESS __ DESIGNER
SrRUCTURI ❑NEW 0RI's(_1D_EL _❑ADDITION , nREPAIR ❑RENEWAL. ❑FIRE DAMAGE ❑DFMOL.IIION
[RESIDENCE ❑COMM ❑EDUCATIONAL_ OGOV'T [JREIJr.!OUS❑PATIO OCAR PORT ❑GAP,AGE ❑STORAGE❑SLAB ❑FENCE
OBOND (3MOVING - ❑CONDI IICNAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _� [:]SIGNS
N C-
OCCUPANCY_ FI-_,J LAND USE ZONE—IL'I _7 .BLDG,TYPE_`Ja) _FIRE ZONE �� PLAN CHECK 8Y_ HEAT
I uneti uct vi ng)a fwtnily L�woning w/atteci�9: ga l:4ge• �ti c'c r (.)M
_F uotaine. 80 -Isas+a game ass IU23-, 54t G-rfienleaf Tlnrract o -----
Sewer poLinit 2C121 1?0 )IM)
-- ______ _._.._ --�,�3�- -tom-•— _g,, .
-- 4U 1a Iv4.zlQft 1 _AREEL_.� ����H.EL2R�4MY91��!€ 771t•
BUILDING DEPAR I MENT RACKS RON7+ ^_ �-- REAR - 13 LEFT SIDE - RIGHT SIDE
_ SET M F
Permit _ �197.QC
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check L Ja it) RFGIILATIONS AND ALL APPLICABLE CODES l,ND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL BE DONE IN ACCORDANCE WITH --HE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb-total r17.00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 7.68 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total „tiffs �'E
SOIL - yt1C�i�r�uO
_..._ _ PDC i bXLJC.t7(a
BY pj' APPI.ICANI CRAUENT -----_.� — --- -
Approved PIA Receipt No 3 JJ
. _.
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DATE INSN. :YPE INSPECrioNno
LUMBENG DATE
tor _
Illi_ ^' o._ I ? �an — —HEATINGtor -
---- - Permit No
�- --~- Gas or Oil -
Rough-in
'- Final
-- - --- SEWER
Final
- - -�- _ - - - Ds'IVEWAY
---- --- ---- Final
Stoevn Drainage
(Rein Drain)Final.
--- � - � Sidewalk
--�'~ Curb&Street Final
Approach _
BLDG.DEPT.FINAL i TlkMPORARY CERTIFICATE )C(UPANCY Final V _
CERTIFICATE OCCUPANCY - -`- -
4• Landscaping
Zoning Final
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CiLy of Tioalrd Mec' �LjTical Permit Permit_---_ .QQ______ - I
I'J.te•j
ermit-
N.!vj InstjIlation Replace 1-1 Relocation EJ Addition '---1 Alteration El % State_
(1EAT1','4G TOTAL_
OWN E R
D
-L&,r, Ats WORK ADDRESS t
–R
'HONE Is- a(" T
APPLN
ICAT
Input Rating 'BTU Per Vent Size FlueSiz-1—
UEL OIL E-1 GAS ID ELEcr 0 OTHER
ITEM NO, FEE ITEM NO., FEE
or lisuance of Permit SEE ABOVE Air Condition Compressor 15 to 30 HP 10.004
-",-- p to & -inc.100,000 BTU'S 4.00Air Handling 10,000 CFM
1.00
!_L%1_t_t00-,001 BTU & over 5.00
Air Handling over 10,000 CFrv1
lour Furnace 4.00 Evapori.tive Ccoler 3.00
-a—
1i -_Floor -Susrpnd-d 4.00 Range Vent Fan Z00
nstall Vents Only 2.00 Vent System
3.60
'e'0jir -Heat& Cooling 4.00 Hood Commercial 3 O
Condition Compressnr Under 3 HP 4.06 Commercial Duct System 10.0(
r Condition Compressor 3 to 15 HP 7.E0
ISPFCTOR'S COMMEN,rs
ry EUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS 08 SUB-CONTRACTORS
-PROVED BY GATE ISSUED BY DATE
::CEiPT NO,
Sionature of AenW n r (JI
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II) BUILDING DEPART,
TIGARD
lONii E. RE6 N�AD1 PI,1,�BINg,INC. N�'
F. Q. EQY lt9 PLUMBING PERMIT
HEWSP. Q 90Y,1,2 91132 ____ _� holder of a valid Plumbing contractors license is hereby
authurized to Cause plumbing work as herein noted `I be Ilnspelctoraledlwho shall be notified accordance with Pnolt�psbsl thang n four
ety
Tigard. Such installations require inspection by the for iris action. City of Tigard Business License required
(4) hours prior to the time the installations are ready P
for all contr-lctors and sub-contractors.
� �;�� jf� uL� Dat0_L
= �--
oWllef �`4 .�n�a —= Addresslc�' TOTAL
PE4MIT NO.'r
NUMBER OF
AMOUNT (Office use OnIV)
ITEMS FEE ON EACH
TYPE OF PERMIT -- H -
Ulip h ii T{�L-----___ .f-._r� �.- 25.00
Sl to FcmllY-1 beth etch_--- --
25.00
Du lax-Each 1 bath uni: 10,00
Additional bathrooms-each 1s 00
-1 a Nome S ace—each _ - _
-----
IlinlylnUAL FIXTURE FEE6 -�-
__- 3.00 _ ---
1 to 50 F-_. FIxturei in I build "; each — 2.50
51 to 100 Fixtures in '. builoinQ_each 2 "-
101 to 200 Fixtures in 1 building-each _ 1,60 -
201 or more Fixtures in llbullding-tach
MISCELLANEOUS _- ___ __-- -- �
10.00 -
Building Sewer-1st 50 ft. - `--
10.00
Sewer-each additional 100 it. ---------- `}t.
-- 5.00
Water Service to bulldln
S ld 10.00
f=rhnte Water Systems"-each 100 1t. __ - -
Other Sp0IffY)' -
PERMIT�;j '00 For Plumbing Impaction Phone 639.4191 `
f Plumbing Contractor By .µms
% State Issued by L /
TOTAL G RECEIPT NO. - ;