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INSPECTION NOTIGE
City if Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639 4171
.Address .�.� y'� 5' -1'� ..�:�-.��''�.=:;..�,,� Permit +M�
Type of Inspection
The following Building Gude deficiercies are vequired to be corrected: :,, . �� f-- . 2_ Ar' ..tet ,, L.�..•.
-.._ ,eK: L -AY-e'�- i .-___�_.... ....r.:... 4::-.�_ _ —w�-1.� _--+M4�i•`. �" -`►-'�—..._.J'r _ ..Q� .✓. .,•
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_. ._� --'d Com' �1 "�';��_._ �"'� _)"w ••� 1�
Presented to._ _ Inspector
Date d
CALL FOR POFINSPEC.T/ON
4 VES Cl NU
f
BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT Nn
molder of a valid plumbing contractors license is hereby
authorized to cause plumbing wort• 4s herein rioted to be installed in accordance with the plumbing code of
7igarcl. Such insta',ations require inspection by tha City Inspector who shall be notificj not less than `our
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business '-icense required
for >.'I contractors and sub-contractors. Job !
Address-_��
44 -,
M NUMBER OF _- TOTAL T
TYPE OF PERMIT 1TEh95 FEF: ON EACH AMGUNT
!E S 11211 T I A L
l Sir3!e Famitl--1 bath-each � 2500
1 O_UIPl±�t--Each 1 bath un4 - ^- 25.00
F Additional bathrooms-each _ y— 10.00
_Mobile
INDIVIDUAL FIXTURES C,MMERCIA
_1_to 50 Fi-Awres In 1 building-each 3_0) tt="
i 51 to 100 ri;.tures in 1 !wilding-each _ - — 2.50 ,5'!
_1.0I to_200 Fixtures in 1 buildiry-each _ .2.00 — _ -_
.01 or n;=re rirlures in 1 Lpuiiu y-1.50
MISCELLANEOUS
Sewer•-each_ aWltional 100 It. — _ 10.00 -
YVater Service to building- 5.00
Other l5 eeiY l �.� -- _ L _ _ — I
PERMIT '710 00 For Plumbing Inspection Phone. 6394171
n•L'State_ , G O__ r lambing Contractor 8W Cot
-- -- --
BUILDING PERMIT APPLICATION TIGARD DATE__ 4�%' �_—,�e_ Eil 3720
THE UNDERSIGNED HEREBY APPLIES FOR A PFRMIT FOR THE WORK 11FRE!N INDICATED BUILDERPHONE (32.0-8081)
OR AS SHOWN HND APPROVED IN THE ACCOMPANYING PLANS AND SPECIE ICA TIONS. OWNER PHONE
LOT NO.--9-4__-. Amen
OWNERTrad_bwark Homes JOBADDRESS 1299`a SW Hawke Uea.rd Street Summer Lake
ARCHITECT
ENGINEER
BLLDER 8GIn + _-_ ADDRESS 715= SW Sandburq St. gDESIGNER Trademark _
STRUC'fuRE IA NEW ❑ REMODEL El ADDITION O REPAIR -❑ RENEWAL _❑ FIRE DAMAGE ❑ DEMOLITION
I)SRESIDENCE CI COMM C_1 EDUCATIONAL ❑ GOV'f FJ RELIGIOUS ❑ PATIO U CARPORT I_.J GARAGE ❑ STORAGE ❑ S!AB C7 FENCE
OCCUPANCY —2f_3_. LAND USE ZONF _R7 PD BLDG.TYPE _J._-FIRE;!ONE-------'PLAN CHECK BY _d4h HEAT
-- Construct 'mingle fjmi_y dwellinrl. . u/attached _�` e•-- 3 Bedroom* 2 Bathb.__�
SEE CORRECTION SHEET ATTACHED. — - -- -- -- - -__-_--
SEWER PERMIT#233 JR - 1750,00 —
OCC.LOAD FLUOR LOAD4020 HEIGHT 40_ NO.STORIES 2 AREA 1737 NO.BEDROOMS _ 3 VALU$61�SOU•
-- --- ----- -- -
- BUILDING DEPARTME14T SET BACKS FRONT 24 REAR 1 H LEFT SIDE__20 RIGHT SIDE 11
Permit X0(7 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTPIhJED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 1 1015. 1-0 WORK Wlll BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES Ncir WAIVE
Subtotal 11 .• 10 _ RESTRICTIVE COVENANTS. CONTRACTOR AAD SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4 8. 64 ALSO is f)6WG00 SE. +CHARY OF 62MJ.00
SDC'--
400.Cl1 __._..-.__y..
Total $324, 94 •� �', L- - - ----..._.�--
__ PDC# $l OO.o rrk WLICAw 049 AG
By ---- p1
Receipt No. / _
Approved _ duh � ADDREl3£ - --- PHONE-
DATE INSP. TYPE INSPECTION REMARKS PLUPPING DATE
Contractor
Permit in
Rough-
Fixture
�/� .Ot►®aT Final
�- Z sir' s:<u.s.CG .� HEATING
fig it d.
�r Contractor
Permit No.
Gea or 011
_---`—
Rough-in `-
- - -----
Final
SEWER —
V� Final
-- DRIVEWAY
Final
Storm Drainage
_ — (Rain Drain)Final
Sidawelk
Curb&Street Final
Approach
—BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPA Final
CERTIFICATE CCCUPANCY /67
Landscaping
_ 7oni io Final
-�m�-
City, of Tigard Mechanical Permit NO. ---
New IA is allation6o Replace ❑ RelocationE] Addition j Alteration- DATE: _
HEATING
CONTRACTOR z'�'4�'7/ r' OWNER
ADDRESS T...�2�i� -cS7t- — 'J,OB ADDRESS �J1Jc�1f ��.�•� �,
PHONE �11.;`L1 r.1�__.__—_ APPLICANT ✓( e—E
Heat Input Rating(BTU per Hour) Vent Sire_'' Flue Sipe_ _6
___= _
FUEL 0+1_ GA� ELFCT OTHER
ITEM ��-- NO. FEE -- ITEM NO. FEE
For Issuance of Permit SEE BELOW Each Air Handling Unit or Duct—System
Now-up !q.A incl. 100,000 STU _—i— x.00_ Commercial Hood System 7.50___,
New 100,00_0 BUT's & over 7.50 Other Equipment - Each _ 4.50
Woodburning Stove _ ._4.50 1 Trip Inspartion 4.510
Wall-Floor- Suspended_ 4_Ii.0r1 Air Condition Compressor - up to_&_incl.a H.P. 6.00
Vent System wi Fan — _4'.E0 Air Condition Compressor-3.1 to 15. H.P.incl. 11.00
!e a
Rir Heat Caolin g U �
e —._ - -5-- --
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! I
PERMIT ISSUANCE 10.00 Comments:
' FEES -- ------ --
SUB-TOTAL
% STATEC ` Issued By..—.__._-_—
�5%PLAN CHECK _ �t<�ivaF ` Z42. --+