10965 SW MIRA COURT 10065 SW MIRA COURT
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BUILDING PERMIT APPLICATION TIGARD
DATE__. ��'r'7 . 19. 60 3a#a55
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOP,Thr—WORK yFF+EIN IHDICATED P_UILDER PHONE 6430`9417
OR AS SHOWN AND APPROVED IN THE ACCOM PAN/ING Pt-wIS;i ID Sr'_CIFiCATIONS. OWNER PHONE
tbX LOT NO. ir�a �" 1-30A
OWNERMadi nna E(It era ri314WADDRESS 109 « _t:W miry Court
--- ARCHITECT
ENGINEER
BUILDER same ADDRESS11090 Sly! Allen, 8Vtt1 _ DESIGNER _
STRUCTURE VNEW ❑ REMODEL ❑ ADDITION — ❑_REPAIR _ ❑ RENEWAL _ ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE '._.i COMM C1 EDUCATIONA'. O GOV'T ❑ RELIGIOUS 0 PATIO LJ CARPORT ❑ GARAGE ❑ STORAGE ❑ 3LAB❑ FENCE
OCCUPANCY -.1t7_3LAND USE ZONE _°_-1D BLDG.TYPE _ 5N
_FIRE ZONE PLAN CHECK BY ___dun HEATS —$aa
Construct ain9le _Penn ry _duellin w attechod garage. ___4 Bedrooms 2 Both**
RE-ISSUE of Permit #3333 12105 SW h:':'rri Court __ _
SEWER PERMIT# 22080 — jj'j alp _. — __,___--—OerE3>I� �� 8 t i`L —
OCC,LOAD FLOOR LOAD 40 HEIGHT 12 NO STORIES AREA 1539 NO.BEDROOMS Q VALL660 p 500•
_BUILDING DEPARTMENT SET BACKS FRONT ��REAR� >� LEFT SIDE RIGHT SIDE 13
Permit -_ $209.00 THIS PERMIT IS ISSUED SUBJECT rO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 70NING
_. lO•C1O REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND iT IS HEREBY AGREED THAT 7Ht
Plan Check, WORK WILL BE DONE IN ACCORDANCE WITH THE PLANT: AND SPECIFICATIONS AND IN COMPLIANCE
�1� p0 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
"_ LICENSE.SEPARATE PERMfTS REQUIRED FOR SEWER,PLUMBING AND HEATING,
State Tax " -- 8.16 SDC—
Total___ f 2 7. 36
—` PDC# I1fJQ•t7U APPLICANTORAGENT
By 41�--
dwh Receipt No. ! ADURE93 ---
PMf)N[
Approved : /
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
�2= E u+• —e �— �.__ Cuntractor ✓aJF_ FN G l/
Permit No.
Rough-in
Fixture
Final -
HEATING
95
- / ^_`
P j Contractor
Permit No.
Gas or Oil
—_-
Rough-in --
____ Final — —_
—� SEWER
_—_ -- _.—_------- - Final
DRIVEWAY
F mal
Storm Drainage —
(Rain Drain)Final
Sidewalk !-
-� Curb&Street Final w
__ Approach — ---
l'lpt;. pEPt.FINAL TEMPORARY CERTIFICATE OCC ANCY
CERTIFICATE OCCUPANCY Final
I Landscaping
Zoning Final
���Y ^ r Y-. 7• ..-.... ., wry• ... - ..... w .._ .. _
BUILDING PERMIT APPLICATION TIGA;-:) DATEsI i_-- 19 A
THE UNDERSIGNED HEREBY APPLIES FOR A PER?AIT FOR Tt E WORK HEREIN INDICATED BUILDER PHONE u r '��7`
OR AS SHOWN AND APPROVCD IN THE A"COM IPANYINGDtjg GAJ'�1�PgqLA NS AND SPECIFICATICNS. CW E PHONE
31-�
1�9' DORESS I/1&� -_.-
- .-
- _--, ARCIiITECT
ENGINEER
13UILCER �. �-! �T ADDRESSI15u-r—
STRUCTURE _ NEW ❑ REMODEL .� ADDITION_ ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ClDPAOLITION
.. --
RESIDENCE�t� COMM ❑ EDUCATION 4L. G GOVT (J RELIGIOUS i� PAT10 ❑ CAR?ORT C GARAGE G STORAGE C SLAB❑ FENCE.
�G%iirANCV �c e.LAND USEZONE� BLDG.TYNE �V FIRE ZONE. PLAN CHECK BY HEAT
123 'C",}� ��� y�►+b
2.
SEINER PERMIT
OCC.LOAC FLOOR LOAD HEIGHT �iZ. _NO.STORIES AREA NO.BEDROOMS VALUE S'00
-_ BUILDING DEPAR MENTSET BACKS FRONT Q REAR _f-g LEFT SICE _ RIGHT SIDE
IP�rmit THIS PERIUIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILD!' CGaE, ZONING
—'— / REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERE'Y AGF°ED THAT 1H£
!PInn Check — f Q• WORK WILL BE DONE IN ACCOP.CANCE WITH THE PLANS AND SPECIFICATIONS AND IN 00101-sANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
(Sub-total _ 7• RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRi NT CITY 6J31Na=S5.
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
btats Tax -
��-^�-]' '� SDG-
Total _ -- --�r7�-mac= ----- —
PDC1► AGAN7 nH AGENT /
BY - Receipt No. --- -- ------, 6a►�'�"'f9.__
Approved TJ � ADDRESS
S u C
p a G_
SEWER CONNECTION
SEWER INSPECTION $ 2�
SFWER SURCHARGE
Pr+mrnnrl}R• t / 3� /V'��'� ♦ -�� fQ t *AM
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City- of Tigard Mechanical Permit
New Installation Replace Relocation E] Addition [ Alteration C3 DATE: _—
HEATING
CONTRACTOR - OWNER
ADDRESS
1011 AD ESS
PHONE�'S 3 .y �' APPLICANT
Heat Input Rating(BTU per Hour) i ' !`'j Vent Size_ ___. Flue Size
FUEL. OIL [] GAS ELECT OTHER
T-K- ITEM _ O. FEE ITEM ,— N0. FEE
For Issuance o1 Permit SEE BELOW Each Air Handling Unit or Duct System 7 50
Ne`w-uP to & incl. 100,000 BTU v 6.00 Commercial Hoo_d_S_ystem_— 7.50
New 100„000 BUT's & over 7.50 Other Equipment Each 4.50 _
W_oodhurn;n9 Stove 4.50 _ 1 Trip Inspection 4.50
Wall-Flonr- SLIspended 6.00 i _Air Condition Compressor - up tc_& incl.3 H.P. 6.00
Vent System w/Fan 4.50 Air Condition Corn ressor- 3.1 to 15. H.P.incl. 11.00
Nepair-Heat Cooling E.00
_ CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comments --�—
FEES _ 14" —
SiUB-TOTAL °<
% STATE +4' Issued Bye__ .L_
25%PLAN CHECK
TOTAL _ REC. # ____��_-- <,,, -- _, A--I:---.
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