14440 SW HAZELHILL DRIVE 14440 SW HAZEL HILL DRIVE
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639 4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
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Date: Pe Permit No.__
Inspector -.
CALL. FOR REINSPECTION
AJL,;{ESS_LL4-4k
PERMIT CHARGE none
dW N E R ._ _.....__. . CONNECTION r"E E ( ---
PAID BY
TYPE" 0f F3UILDING �p.�� UATE CONNECTED
S:.PVICF HATE ...�._. /.`_�� _ r.�-- ..�„, INSPECTION FEE
CON TFFIA( IOR _ ._.._.�_.. PAID BY � DATE
SIZE OF CONNECTION q- --- ASSESSMENT PAID _
i
BUILDING DEPARTMENT, TIGARD
i �
��� +J PLUMBING PERMIT
P','� C,.ta .�4t'. !'S - ^' G 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. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection, City of Tigard Business License required
for all contractors and sub-contractors. /7////Da
/
Owner ! o Q Add ess_L._� (J :al-� �/ fDate._.L2_L
NUMBER OF TUTAL
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
R.E_�tOP-C-N LA is_�._____
—Single Fain illy-1 bath—Path 25,00 S"o"Lt
_Duplex—Each 1 bath unit 25.00
Additional bathrooms—each _. 10.0o
Mobile Nome Space—each _ 15.04
INDIVIDUAL FIX_T_UREB GOMMERCIAt
1 to 50 Fixtures In 1 Ljildirig—each 3.00
51 to 100 Fixtures in 1 buildin -each `_ __ 2.50
101 to 200 Fixtures in 1 building—each _ _2.00
201 or more Fixtures in 1 building—each 1.50
MISCELLANEOUS
Sewer—each additional 100!t. _ 10.00
Water Service to buildin__ / 5.00 'TI _
Othgr (Specify): —
PERMIT For Plumbing Inspection Phone 639.4171
4%state Plumbing Contractor By _
I TOTAL RECEIPT NO. Issuarl RV
.,,;y..,.„:u„r,: .,,�„ ,aJP',4.��a �.tSG:a:.�.s�6�.lofy�lC"ro'Ltit� mywr�an:nayw`anrrav^*1AY•w,}'1'.a�+vRl'r Y.
'�'81 ^A�+!��s4�;.; nA�y;n.Y.."Te+",�,�'•NIr`�''wY�`
"BUILDING PERMIT A CITY TIGARD DATE____�'_'1`� " ,9 o � 0�"
PPLIGATION of .
THE UtiDERSIGNFD HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED EUILDERPHONE—.—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE•-- _-
LOT NO.
OWNER .108 ADDRESS 14440 SW Hazelhi11 0!7(7VIEADDRESS 11th, r
ARCHITECT —�
BOA 71! Ore. r R� DESIGNER
BUILDER i a L ADDRESS '1.'T p
ENGINEER
STRUCTURE ❑NEW tt--J❑RtMODEL ❑ADDITION ❑REPAIR ❑RENEWAL _ ❑FIRE DAMAGE ❑DEMOLITION
❑RESIDENCE ❑COMM LE_DUCATIONAL ❑GOV'T ❑R5LIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STUHAGE❑SLAB []FENCE
` ❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COINCILAPPROVED� ❑SIGNS
U_CUPANCY_` LAND USE ZONE—'1_30 BLDG.TYPE N FIRE ZONE CHECK BY_._—_:___, HEAT '
- ---- a�t8trus, n Is family Itwe13 ir>`y w vttechtc:i ysraUe — 3 k cath J i1rtm — :3
_.. se was permit 187«.0 $625000
M 1
SLCS<. -,^11 F.L4Q91JQJZjffiGH1. 26 _NZ i�Al�� 35�1���_�NO.BEDROOIAS `7' VALUE1"
BUILDING DEPARTMENT JSET BACKS FRONT 24th REAR Irl LEFT SIDE 7 6 RIGHT SIDE 1.
Permit $280. 5 --
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING C)DE, ZONING
Plan Check 14fir r REGI.ILATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS HEREB/ AGREED THAT THE
WOFIK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND-nF(IFICATIONS AND IN COMPLIANCE WITH
Subtotal 432,7,.., ALL APK ICA.BLF CODES AND ORDINANCES. THE ISSUAFICF_ OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTOR; TO HAVE CURRENT CITY BUSINESS
State Tax LICE4SE. SEPARATE PERMITS RFOUIPED FOR SEWER, PLUMBING AND HEATING.
Total 1444 a 29
By Fs
APPLI(ANT OR AGENT —.-- ___ ---------------
�Appro�ed � �' Receipt No.
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DA'rE INSP TYPE INSPECTION REMARKS PLUMBING DATE
Contractor p
Gv- nAi� di-SAM old-.cl IPA $ ._. —_ -- Permit No.
yr
7_-11-7/ Rough-in
Fixture
4-717 Final
10 -1.2-7 nmp 51A HEATING -�—
3-�0k
Contractor
Permit No. /J���) �� / ��._ ]�j'_ 7 rT .
Gas or Oil
— Rough-hi
Final `
SEWER
i Final
DRIVEWAY
Final
Storm Drainage
lRain Drain)Final
Sidevalk
— Curb&Street Final - -
- __ Approach — — —
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Q Final
Landscaping
Zoning Final
Permit_ SMO of Tigard Mechanical Permit
New Installation K Replace C1 Relocation ❑ Addition ❑ Alteration ❑ "- 4 % State_
HEATING , TOTAL
CONTRACTOF �ujjsvr K)O L (' h l OWNER--�' IL1 1 �ZLA&
ADDRESS2 � �t �� �Ol.t1kLL1_✓d. WORK ADDRESS
PHONE Z. q �(o( ( _ APPLICAN-T 4 d( � ogA?r f
Heat Input Rating (3TU PP- 'Jmur) ODS? Vent Size Flue Sizei
FUEL OIL ❑ GAS ELECT X, OTHER__I kj), T Ej10
ITEP/I NO. FEE ITEf11 NO. FEE
mor Issuance of Permit SEE ABOV Air Condition Compre.ror 15 to 30 HP _ 10.00
N-V-up to & inc1. 100L000___•B'1' 4.00 Air Handling 10,000 CFM^_ i� 3.00
N^'.v- 100.001 BTU's & ov��r �S.OU Ah Handling Over 10,000 CFM 5.00
Ficor Furnace _ 4.00 Evaporative Cooler 3.00
Wall • Floo. _Suspended ~_ r_ 4.00 Range Vent Fan 2.00
Ins tall Vents Only _ 2.00 Vent System 3.00
Rej._air• Heat& Coming ___ _4A0 Hood Commercial _ 3.00
Air Condition Coj,.pressor Under 3_H? 4.00 Commercial Duct System 10.00
Air Co.-,dition Compressor 3 to 15 HP�Y 7.50
INS"ECTOR'S COMMENTS
CITY BUSINESS i_ICENS AEQUIFIED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
'%PPROVED BY--_ _ __ UATE ISSUED BY / DATE___
Sig,-.a*urof Applicant
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