14615 SW HAZELTREE TERRACE-1 P
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BU;LDING PERMIT APPLICATION TIGARD DATE 19 i-
TNE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDIG'A i[_D iUILDEN PHONE - n,Ir�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIE-IGATION", ?WNER PHONE _
LOT NO.
OWNER ".,.rc,ju Carlson JOB ADDRESS 14615 :;�i --!A..Ze1 Trf'-f% `1'orrav - _
— '— - ARCHITECT
ENGINEER
'`c» h x'luhr
BUILDER A-DDRESS �-- DESIGNER
STRUCTURE 0 NEW M REMODEL U ADDITION ❑ REPAI9 ❑ RENEWAL O FIRE DAMAGE ❑ DEMOLITION
Q'RESIDENCE ❑ COMM O EDUCATIONAL O GOVT ❑ RELIGIOUS ❑ PATIO_❑ CARPORT L1 GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY X„-3 LAND USE ZONE BLDG.TYPE _ —FIRE ZONE=_-PLAN CHECK BY ^ttnr ._HEAT _
A,,`xrii mimmo- to residfncS& ill_ ncr pl �- and code ttirrment.4 —
dOiti3OnnI plans recIttirk-6.
SEWER PERMIT#
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES _ ARTA NO.BEDROOMS VALUiR 1,J, j P 7,
BUILDING DEPARTMENT SET TACKS FRONT RE 4R I.EFT SIDE RIGHT SIDE
Permlt 4_C6 THIS PERMIT IS ISSUEU SUBJECT TO THE REGULATIONS CONTAINED IN THs BL:LDINO CODE, ZONING
REGULATIONS AND +Li APPLICABLE CODES AND ORDINANCES, AND IT IG HEREB.' AGREED THAT THE
Plan Check 32s00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPI ICARLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub•totai 0600 RESTRICT.VE u,,VENANTS. :r)NTRACT("R AND SUB CONTRACTORS TO HAVE f LF1r4ENT CITY nUSINESS
LICENSE.SEPARATE PER":
DATE INSP. TYPE INSPECVON -- �—REMARKS PLUMBING DATE
Contractor
Permit No. --- --_---
Roughdn
o—.7k Fixture
Final - — - ----
HEATING
---•� "— T-- -- Contractor —
_ Permit No. --
i Gas or Ulf
Final
SEWER
—�—�—_�-- — Final '
---- ------ DRIVEWAY
Final
Finds ..—
Storm Drainage
_— ---�--_
(Rein Drain)Final
Sidevualk
Curb&Street Final
Approach
BLDG DEPT.FINAL TEMPORARY l'ERTIFICATE OCCUPANCY
C _
F'F rIFICATE OCCUPANCY
—� — Landscaping
Zoning Final
f
4
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAINI STREET
TIGARD, OREGON 97223
PHONE 639-4171
CONTRACTOR:
Pursuant to Sectior(s) of the Uniform Building Code, the
following item(s) revulre correcting:
lj
Permit No.,
—
Inspector
CALL. FOR REINSPECTION
�e
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARII, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following itern(s) require correcting;
Date:`_-g!"Zf --- Permit No. --__
Inspector
CALL r--OR REINSPECTION
�E
r.a
INSPECTION NOTICE .�
City of Tigard Building Department
P.O. Box 23397
111 Tigard, Oregon 97223
Phone: 639-4175
type of Inspection
Date Requested, Time A.M. �_P.M.
���y�
L 1l_i� ~ �/ �C�
Address
ermit #
Owner _ _-_ 7 Lot #
Builder_ -- � �4�•1/ �jbLC✓ � �—._
i he following Building Code deficiencies are required to I— corrected:
ri1V12I�1._ �
Presented to /6Approved
Inspector -� ❑ Disapproved
Date
CALL FOR REINSPECTION
DYES ONO
CfTY OF TIGARD BLDG. DEPT.
12420 S.W, MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Sertion(s) of the uniform Bu ding Code, the
following item(s� require correcting:
Permit
Inspect �^
CALL FOR REINSPECTION
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,-,) require correcting:
r 7l�
giltal� 11111111!
t
Date: ' Permit No.
Inspector'19�/'
CALL FOR REINSPECT,DN
_MK=I-, _,,
=JL
ME'CH(4NICP)L.
CITYOFTIVARD P E 1*11,M IT
C17Y OF TWIRD P E R M IT N. . . . . . . : M E C 1:)0 0058
COMMUKiTY DEVELOPMENT DEPARTMENT F",E'R 1111 1 M F:'C 9 0-0 0 115-P)
13 125 SW H&J1 Blvd P.O.Box 23307,Tigiud,Oregon 97M 003)f"176 DPTE 113GUED: 03/26/90
SITE: C41)DREGS. . . .- SW HOZELIRE"E' TF.'RR PARCE'L.- 2S110E4C--00(-',0W
9USDIVI'.;TON. . . . . AM116' ORCHARD ZONING: R--J.
D I OCK. . . . . . . . . . .. I_.01' . . . . . . . . . . . .. . . .3
..........
CLASS', Of WORK. . :ALT F LOOR I-URN. . . . EVAN' COOLERS
FYPE OF' U(,E,. . . . I SF' U N I T H L'A TE R S. . VEN'T F'ANS. . .
OCCUPANCY GRP. . :R3 Vr-'.NT,[:l VJ/O ()PPL. vi---'N'r SYSTE-1111.,
'3TORTES. . . . . . . . r, PUILERS/COMPRESE)ORS HOODS. . . . . . . .
11:11 E.I TY PE S 0- 3 Hf-''. . DOMES./GAS/ INC—[N.-
-
. .7 3 15 HP. . COMML. INCIN:
tll()X INPUTP BTU 15-30 HP.. . . » : R Er'()I R Ll N IT E)
F'IRE. DF)MPLRS?. 30 50 HF'' , . . . . WOODSTOVES. .
rips r:,RP3SURE. . . "304. liP . . . . CI...0 DRYERS). .
1,10. (*.)1;:' AIR HPNDLIqG UNITS OTHER UNITS.
FURN < 1.00K BTU: <-.- 10000 cfni.- I. G(I G 0U 11.ET S I
TURN >T:J.OP)K PIU: 1. l.0 0(a 0 c tni
R e III a-r k S:
(Jwrle-r: F'EEr
HOROI 1) CARLSON type AMOMA by (late r e e r)t
407 P0 N A Y (I V E F,p Y M $ 25. 20 JI-14 013/2 ,/90
1'.131 E. (IF: CAPRI PRIIT $ 24. 00
HAPLE'S F1. 33962 5 P Cl 41 1. 20
Corit-ractc)-r:
() A B H E AT I N(3
DIP1- ONE ()CE HOLDING
141.31.5 SW 72ND
TIGPRD OR 97224
141(,)Ile 503-684-3355 $ 25. 20 TOTAL
31339
REOUIRED !NSPECTIONS
This permit is issued subject to the requlations contained in the Final Ivisf)ectiati
I igard huniripal Code, State of Ore. Specialty
y Codes and all other ........ ------ —------
applicable laws. All work will be done in accorcance with
approved plans. This permit will expire if work s not started
within 1H days of issuance, or if work is suspended for mf,•
than 189 days.
.................I............ ..........
.._...w..__..... ..................---
I vi u e d D y .........................
Call foo inspectiori 639-4.1.75
CITY OF TIGARD RECEIPT OF PAVIZENT PEC Nu. 06110HIJI.
CHE4 AMOUNT i -.W. IT)
40 4
NAME: A & 8 HEATING CASH AMOUNT .(10
ADDRESS; 14915 SW 7'21`40 AVE F'AfMENT VATS 0--- ' 6-90
TIGA,',,D, OR 97224 EAL.00, NO/APM.-
14t-E.5 Stl HAZELTRIP.-f-, TERF
PURPOSE OF' PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT
MCCHANICAL PERM (90-005%) 2'4.00 SLATE' BOIL PVF(Mll IiAX (5*.1
7".7TAL AMOUNT pAIL)
ADOR--SS S PERMIT NO.
PERMIT CHARGE none
OW";ER CONNECTION FEE
PAID BY
-TYPE OF BUILOING DATE CON11:ECTED
SE°VICE RATE INSPECTION FEE
CONTRACTOR Pry ID BY GATE
SIZE OF CON14EC' ION ASSESSMENT PAID
.wr`..q"'�i. �....�,..,.�.err-...-'-9+�•.c•aw..-.e,,,.,'fiP,....�.n..r...r�'w►Ai�'�^...-.R.........,...,..-
BUILDING PERMIT APPLICATION cOF TIGARD DATE
THE UNDERSIGNED HERFBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONEY,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONf
i ( LOT NO.___
O_,VNER, i L[y L�lj �,BLdl JOB ADDRE <;
IL1 r, <. l w HOME AD RESS
RCHITECT '—
BUILDLIR 1: „� (1�� ; ADDRESSENGINEER
DESIGNER-r,, _
STRUCTURE C1.JEW ❑FI'Mr.DEL�p❑ADDITION_ ❑REPAIR CJHENEWAL— EIFIREDAMAGE ❑DEM�-O�TLITION
J
❑ RESIDENCE CCMM ❑EDUCT 'ONAL ❑GOVT ❑RFLIGIOUS❑PATIO ❑CAR PORT�OGARAGE LJ SfOHAGE❑SLAB ❑FENCE
❑BOND ❑MOVING —'❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY .max —LAN p USE ZONE__�_Z—_BLDG TYPE - `- _FIRE ZONEA- PLAN CHECK
4 �tt:a. .`--
r33WrE)r Part,,ll,t 17420 0l;r
gercis 792 loo/ft.,
OCA. F 1,S?S2Ei LOAD 411 _ _-ji ( �r —.�J51,_SIQRI Afl A.32-9-1 No'.aEv-8-Qoms yALljlffu 40G. 0
BUILDING DEPARTMENT SET SACKS FRONT �) REAR 47 LEFT GIDE 160 RIGHT SIDE
Permit BUILDING
THIS PERMIT IS ISSUED SUBJECT TO THE REGULAIIONS CONTAINED IN THE BUILDING (:ODE, ZONING
Plan Checkwa a .-C REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
YORK WILL FE DONE IN ACCORDANCE WITH THE PLANS AND SPFCIFICATICNS AND IN COMPI.IANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. I ONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State'fax LICENSE. SEPARATE
C.i,PF�Rel(S REQUIRED FOR SEWER, PLUMBING AND HFATING.
— y �•'a,.. .. C 4144!!
Total . 3(.� PUC $jU0.00
BY pl
. A• .i a nNi Kira nclr.T
Apploved �rl n I Recei t
No.
a�
<2.31
DATE INSP. TYPE INSPECTION REMARKS I PLUMBING Df.TE
//a _;V221 Contractor
Permit7;_'.6
iFinal ough-inl !xture
rl HEATING
Contractor
3 ,� Permit No, 3r� / 9-7 6 7
rl tP7 It �� rs % O,E .sem a Oil
Rou an
--rt1_':c-w Final
r SEWER
Final —
DRIVEWAY
Final
Stanh Drainage
(Rain grain)Final
Sidewalk
[Approach
Street Final
__
tS.fN3. DEPT.FINAL IrniC CCUCERTIFICATECERTIFICATE OCCUPANCY / G� sp�ng
Finei
i
83 00
Cit � ioard Mechanical Permit y_ Perrnit
Y of � - � Fee
New Installation ❑ Replace Cl Relocation L1 Addition ❑ Alteration l_� 4_% S
TOTAL.
HEATING
CONTRACTOR.. , OWNER ,�/ ' �IL.�- --
ADDRESStd �„�� (dc4_�✓t WORK ~•DRESS_L_L (' j x �.
_ APPLICANT
PHONE_ S 7[f— � ��i�. ._ --- -
Haat Input Rating (STU Per Hour) -,�-_'� i l� Vent Size _ Flue Site_
FUEL OIL ❑ GAS ❑ ELECT OTHERL��o �.�e,�,�,�(,k� - --
ITEM NO. FEE ITEM N0. FEE
F_or Issuance of Permit _ SEE ABOV'. Air Condition Compressor 15 to 30 HP 10.00
(79w-up to & inc 1.1001000 BT _ 4.00 Air Handling 10,000 CFM 3.00
, 5.00- Air Handling Over 10,000 CFM Soo
Nwv:
100.001 BTU s & ov r_ Evaporative Cooler 3.00
Floar Furnace 4.00 - -
4.00 Range Vent Fan 2.00
Wall-Floor •Suspended 3.00
Install Vents Only 2.00 Vent System
R,pair-Heat&Coo Ii1.9 _ 4.00 Hood Commercial 3.00
4ir Condition Compressor Under 3 HP _4.00 -Commercial Duct System 10.00.
Air Condition Compressor 3 to 15 HP 1 7.50
INSPECTOR'S COMMENTS -----
i
,:ITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
,%PPROVED BY DATE_ - ISSUED BY _ DATE
r1ECEIPT NO.
y� Si�r.a'ur3 of Applicant
CITY OF TIGARC MECHANICAL PERMIT Receipt#
Permit#�C__ - �_,,�CJ/J
Description
Table SA Mechanical Code
City of Tigard ---� QTY PRICE AMT
----
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.0 Box 23397 --- — _ _
Tigard, OR 97223 2) Supplemental Permit 300 -
639 4175 Fumacetot00,OWBTU
--
1) incl.ducts&vents 6.00
-2) Furnace 100,000 131 U c __-
incl ducts_&vents 7•� S c_t
Name or Dewbp,,,er" - 3) FloorFurnace --- -- --- - -
incl.vent 6.00
Job AdOr"s _ Suspend3d heater welleate
hr
Addressl S /7/i Z Ez�n.eC� 4) or floor mounted heater 6.00
Tax Lot Map No 5) Vent riot incl.in
Lot MIX* SubtitvesK n _- appliance per_tit 300
j Name(or rwrr Of businew) - Repair of heating,raft tg.�- -- --- -
I 11
UL 0 �J�Q(S n ) cooling,absorption unit 6.00 -
Owner ling PhD7) Boiler or comp to 3 HP
07 11 4Y I W- jsF 0i CV�'�', absorp.unit to 100,00_0 BTU 6.00 -
CM1t4tate Zip 8) Boiler or comp to 3 HP-15 HP _ -
_- W LE S >tL 3 3 Z - absorp00
_unit trr 5 ,000 BTU 11.00
Name Boiler or comp 15-30 HP - -- -
A - (3 C.. ai absorp unit'h-t million_ 15.00
I Pilo -- 1 C) Boiler or conip to 30.50 HP - -
(� absorp.unit 1 -1.75 million 22.50
ZIP 11) Boiler of oomp to 50 HP
_absorp unit_11,750,000 BTU 31.50
State gwglsrratlon No City Bus Tax NoAir ha-udiinq unit to —s--
y 1`) 10,000 CFM 1 4.50
/ j
1 h"tylf mcknowk+dge that I have road this a VIlc.atron that the information given is I 13) Air handling unit
am act.owl!am the owner fir authorized ayerrt of the owr or,thaf plans s -mined pre in _ _10.000 CFM + 7.50
oo"4ianc*with state laws that I am rmvsferatl with the State Buikfyr. Board,that the Non portable �-
1 nur'rtief M 18 oorrOct.(If exempt from Stale tegiaLMron please give reason beinw) 4) evaporpte cooler 4.50
Brent!an connected
to a single duct 3.00
- Ventilation system not
16) included in appliance perm_ it 4.50
17) Hood served by
_mechanic:al exheust 1 4 Sn
k:,wner or agent)- - -- Dale a- Domestic type -
Describe work -- - 18) Incinerator 7.50
❑ addition ❑ alteration � repair [] _to be done _ residentlel 21_ non-residential ❑ Commercial or industrial — y
Existing use of 18) type Incinerator 30.00
building or properly--u�E'� --
20) Other i.e.,woodstove,water
Proposed use of -- - - heater,solar,clothes dryers,e;c 4.50
bullding or prop'arty — _ -----_-•--.-___ -_
_ _-___-•-- 21) Gas piping one to four outlets ----- l 2.00 .J c
Type of Fuel- oil ❑ natural gas LPG C I electric F1 I __
- 22) More than 4-per outlet
NOTICE
THIS PERMIT BECOMES NOLi AND VOID IF WORK OR CON- __.___._ SUB-TOTAL Ck'
STHUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5�0 406SURCHARnE 2,-,DAYS. Oq IF CONSTRUCTIO►I OR WORK I5 SUSPENDED on � - - --
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER --_PLAN nEAEW 25%OF SUB-TOTAL
WORK IS COMMENCED. --�^- -� TOTAL- - �S
Special Conditions
_ �_ ----- Date issued -by