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CHY OF' TIGARD PLUMBIN6
Applicants must hold Oregon I ;lgration to conduct a plumbingTigard CR Wn3
business or must be property owner/operator nethiring oulside help. PERMIT 63.4-4175
Nam of Deve4c-,menl Plumbing Permit No.
Description
ORS 814-21-610 DUAN. PRICI: AMT.
Job Tax Lot .No.
Address - FIXTURES
,aW_ -"—Bkxk 6&ujbdrM0s Sink 1.50
Nam name SS) Lavatory 7.50
Tub or TubfShow ef Comb. 7.50
M&Ang Address v Comb.
Shower Only 7.516
WaIfW Closet 7.50
Owner ZIP It
Dishwasher 7,50
Phone Garbage Disposal
L 7.50
Washing Machine 7.50 76-37
Name
Floor Drain 7.50
Wrter Hester 7,50
Occupant zii/�Iatlw La iindry Room'ray 7.50
Jrinm 7.50
&r Fhftes(Specify) 7.50
7.50
MWN Address 7.50
CoMraclor ZIP 7.50
__7*�.Toic MWELLMEOUS
$01werIN 110(y 30.00
stow WIN.Board state PiRribors Elus.Uc. Sftw-M Adck 100- I5.00
Wow Service I at 100' 20.00
I hereby ailtnowledge Via!I he"i9ail ftu application.that"inlotmallim 15-00
given is anrredi shel I am rogWaroe wool the Slate Bu*Ws Board.and ata* Storm&Amin Drain Ito.100' 3000
two*a stow"kmvftq low"9W the M"bers gh"we 001, ow AN
pko.** work vA be done in atinordanoe with appilooblo pmvw"afore- Norm&PPJn Drain Addll.100'
gon As vined SUdufts Chopwro 447 and 003 and jppk*bls cod"end OW Mobils Home -
Spew 25 OU
no help will be employed unless lkwvoed under ORS 03 (it exernO hum -
Stele rog****^plesse give reason bek—)- 8sjckFbwPrwvwWn
HOWOWNERS-1 hereby osift that I am"owner of Vw pn"#*y 0* Devloo or ArdllvoUion Device- 7.50
scribed above,alwoki bc"wlpmpoevo*make apkgnt*VkvAdg$dOnfm Arty Trap orwaste Nal
my owt%use and Mile pmp"is W b4V oansinxied kw Sale.14090 Of Wll. Cartes- In a Fbm" 7.50
C4k*Bain 7.50
*OP.40&W.nun 40.00 Per W
"M If W"ons 40.00 Per Fk
-k Aker.of Pkrnt*v w"
-7-7
on L_Xiy& 1&00 non.
mdg
Cate " or DuAd.""on N.00 min
QL&iriA#-.jle Polily
Describe work now s6lition repair
lv.§iAm residential V1
Exk"use d
bU"crprqmwjy T�)TAL
P 01 N%CHAFM
low= To
ft" Wlind by
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Receipt
;ITY OF TJGARD MECHANICat_ PERMIT Permit
Descelption
Table 3A Mechanical C odeOTY PRICE AMT
;ity of Tigard ---------- _ _-- ---
3125 S.W. Hall Blvd. 1) Permit Fee U -0 10.00
'.O. Box 23397 ---- — --- ---
-igard, Oq 97223 2) Suppiemental Permit - 3.00
39-4175 Furnace to 100,000 STU
1) incl.ducts&vents 6.00
Furnace 100,000 BTU
2) +incl.ducts 8 vents 7•.;U 7-3a
/-� Na,vre of nev pment 3) Floor FUmaC3 '- 6.00
[c� 1��_�`,- / incl.vent - -- - -
Job Address e I n Suspended heater,wall heater
Address / yq 2 D oV ' r�if 4) or flc or mounted heater 6'00
Tax Lot Map NoVent-;cm1 Incl.in
r�bck eubdivisior, 5) appliar ice permit 3.00
Lot [) — -- —.
6)
Repair ofheating,ref rig., 6.00
cooling,absorption unit _ _
�`-ZL:I2� a I'" Boiler or comp to3HP —
Mailing Address _ Phone p
Owner 7) absorp.unit to 100,000 BTU 5'�
cityfstatP Zip - 13) Boiler or comp to 3 HP-15 HP , 11,00
absorp.unit to 500,09U BTU 0 ' //_#"j/
Nameg) Boiler or comp 15-30 HF
J g absorp.unit' -1 million 15.00
h
Mailing Address �dl• pha>. - 10) Boiler or comp to 30-50 HP ?2.50
absorp,unit 1-1.75 million _
Contractor citytSlate Zip 11 I Boiler or comp to 50 HP 31.50
d)sorp.unit 1,750,000 BTU
State Regis+ration No �- Cihr Bus.Tax No L12) Ali handling unit to - 4.50
1 r,,000 CFM
Air handling unit -
hereby aduxrvviadge that I have read thin application that the information given is 1 j) 10,000 CFM + 7.50
correct,that I am the owner or nuthodzed agent of the owner,that plans submitted are in ---
complier"with 51ate Inds,that I am registered with the Slate Builders'Board,that theNon portable
number gf,e14n Is correct.(11 exempt horn State registration please give reason below). ) evaporate cooler 4.50
------ --- -- 15) Vent fan connected , 00
-- to a single duct `7 ?' /),Or.
16t Ventilation system riot 4.50
Included in appliance permit
__-._ ___--------------._---.__-- 171 Hood served by - ---- 4.50 I
mechanical exhaust
Slimture(owner aagent►_ - Date 19 Dumestic type 7.50 --
Describe work El addition El alteration ❑ repair ❑ ) incinerator to oe done residential b,d non-residential ❑ 19) Commercial or Industrial 30.00
Existing use of type incinerator
building or properly '�L,p � - - 20) OthBaer L .,stud clothes dryers,water,etc. 4.50 (} !U
Proposed use of -- ---
building or property _.- - 21) Gas piping one to four outlets 2.00 4�f
Typc of fuel- -)II ❑ natural gas V000, LPG ❑ electric ❑ - --
22) More than 4-pe-.r outlet
NOTICE SUB-TOTAL U
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- --- - - 7
STRUCTION AUTHORIZED IS rT COMMENCED WITHIN 1130 -_ --- 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS USPENDED OFj. - Pt AN,tai-VIEW 25%OF SUS-TOTAL
ABANDONED FOR A PERIOD OF 1130-OAY NYTIME
WORK IS COMMENCED. i TOTAL GO
Special Conditions
-- - - Date Issued�__ _by��� -_-
BUILDING PE=RMIT APPLICATION DATL .19 _
OP7 31
THE UNDEIiSIGNE0 KEREBY APPLIES F:01-i A PERMIT FOR THE V1'ORK HEREIN INDICATED BU'LDER PHONE 638-0718
OR AS SHOVVN AND AFPROVED IN THE ACCOMPANY.NG PLANS AND SPECIFICATIONS. OWNER PHONE_
LOT NO.20 j ArrLC 6 �( T. "5.—c_ 5—rd
OWNER I)OT)IIIiS Itr:�sesth JOBADDRESS " 2tY SWlia�*r�:!i; i ! E::: .. _
_ Jess A1way, Inn ---- 3843 P*ftrs r" iri RCHITECT —� 635-3731
BUILDER ! 39027 4 J /88 ADDRESS nNGINEER Coln 6 Mei
r9,ve,L. DESIGNER_ _
STRUCTURE ® NEW ❑ REMODEL —_❑ ADDITION ❑ REPAIR— ❑ RENEWAL ❑ FIRE DA6GE ❑ DEMOLITION
EY,RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T n RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB El FENCE
OCCUPANCY —"---LAND USE ZONE ---BLDG TYPE FIRE ZONE_--_PLAN CHECK BY — HEAT__..;__._____—
Con%truce si.))cgle fr mi j. • clwtal.l.fng`w/att> shed garage, all per approv0d, plans . — ---
Oubject to 85 C040,-
SEWER PERMIT# 334111 ( ldu) 3 broth, 14 traps gars-,fir 860
40 OCC.LOAD FLOOR LOAD HEIGHT �STORIES AREA NO,BEDROOMS 4 VALUE
BUILDING DEPARTMENT' SETBACKS FRONT'° REARS LEFT SIDE IGHT SIDE
5 �, .5170 --- _.-_- - -
Permit THIS PERMIT IS ISSUED SUBJECT I ) THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
531 .83 REGI.:'.ATIONS AND ALI P.PPLICABLE:CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORv, WILL BE DONE IN ACC07DANCIz WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE. OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACI OR AND SUB CONTRACTORS YO HAVE CURRENT CITY BUSINESS
20.42 L C NSE.S ATFRERMITS REOUIR-,)FOR SE ER, LUMBING AND HEATING.
State Tax t ``++
SDC—
Total 802.75
PDCM T 1 5G nQ APPLICANT
BY 100.00
Receipt No.
Approved - 762.75---] ADDRESS T PHONE
DATE INSP. TYPFE INSPECTION — _ REMARKS - -- PLUMBING DAYE
Contractor
{ Permit No.
Aqs
Rough-in ----- _
^7 ,
/'.3L• t-1 V�i� �� �� Fixture
final 1-t--
HEATING
F. -� Contracts 9JA
Permit No.
c. 7n ,cf �J Ga:or Oil —
�
t * `� Roul;lh-in
l P/ 5 -_ rP ,� '�f •� rr� �G71�G ��'� _�—
Final
SEWER
Final-
t LG,
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final - -
LApproach
BLDG. DEFT.FINAL — —TIEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY --. -------
Landscaping
Zonino Final
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