12145 SW MERESTONE COURT r,
1-145 SW MLRESTONE COURT
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MECHANICAL PE.-11141-1-
I:"EP-M'TT N(7. : ME08.1.803
CITY OF TIGA RD
CITY AND
COMMUNITY DEVELOPMENT DEPARTMENT ISS111241): 9/ 8/se
13 125 S W Hall Olvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 Ppxm . iom'r .NO. 91318 03
J(R.-) AOUPIEI S : 1,p-1.A1,5 1.1w
IAX MAP/L.01' SUB: Ll BK :
I ANO
1 01 STZE :
:E TEM: NO: ND
W 0[1 K Cl ASS ; Al.-'1'EAAT:1:(:*iN FURNACE <100K A- 11P HANDI.-P <10
USE TY1'-1rr.: : S:CNGI-EL FAMILY F'UPNACE 100V+ AIP HANDI-P 1.OK
CONS'Tr'l-Oap F--I.IPNACE CVAP .C00L..EP
HEA*T*EA VENT F'AN
VEN'T' VENT . SYS11:11"i
BL.11/COMP <:31-IP II-11000
NO . STOPIAKS : Dl.-P/COMP 13--1.11511-4p INC I NEPATOW(UOM
DWELL .UNTI'S : BI-14/COMP 1-5-30H0 I NCINEPPYTOR(COM
I fplli.: WOOD ULPICOMP 710-15011'.1p R>.-:PAIR UNII'S
MAX . ININ-11 SLR/COMP' '504-1-AP OTHER
FIRF:. UMPIRS.? GAS PIPING' 01LITLETS
VII(A-4 FIRESS?
LOW PPr-'.:SS'?
1:3EMAPKII ;
WOOD STOVE
FEE..S :
O KOHN JOHN PFJIM11, $11-0 . 00
W 121,15 Kiw mEnr--:,,-rnNf.:- ri- PL.AN IIE:V:I:F:.W
N
E I DIP 97PP3 F. I X 1,0 Rl::.5 $4. 50
R 1:'11HONK, (503) dl'i.10---OP-6(2 STATF* TAX '73
011,11EP
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N ANDPON FIPEP11. ACE SHOP
T
R 1:11.955SW PACIFIC HWY
A tirjarcl 9,22 3
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T PHONE.', (,".103) Ar.10 0 2 6 P
0 NO 433'26 P.3
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P r No
This permit is issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes,zoning regulations PRQUIPErr.) INSPIEUTIONS
and all other applice6le codes and ordinances, and It Is hereby NAL
agreed that the work will be done in eocordance with the pians And
specifications and In compliance with all Applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void If work is not started within 180 days.or it work is suspended or
abandoned for a per,d of 180 days any time after work has
commenced It shall bo the responsibility of the permittee to assure
all required ifispectionh art requested and Approved
Permittee Sign t'..
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
IWE!.Ew 1111111111 li rNw
Address
Permit Noo
Permit charge
Own.ar Conn.-ict'.on foe 'n 0
Paid by
Typo of building Date conn3cted
Service rate Inspec,-ion feF�
Contactor paid by Date
Size of connection Assessment paid
2 10J I
Y
ADDRESS PFHMIT NO. A (3
PF RMT CHARGE none
OWNER CONNECTION FEE cit,
P 0 ay
TYPE OF BUILDING DATE CO 4/ECTED
SE RV I C'E R A T E V'SPVCTION FEE XK
17nNTRACTOR PAID BY DATE
SIZE OF CONNECT ION ASSESSMENT PAID
BUILDING PERMIT APPLICATION 1OF
1T TIGAR® DATE__
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN IND!C,ATED BUILDER PHONE___.�_.�..�.
OR AS SHOWN AND APPPOVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE-
LOT LOT NO
OWNER ,1.I1in A. LaI wer JOB ADDRESS 1214 ? j1J ;HbME. ADDRESS
ARCHITECT
BUILDER _ a ADDRESS ENGINEER
'
--- __ r)E-SIGNER
STRUCTURE __❑fftW ❑RSMOOEL ❑ADDITION ❑REPAIR _ ❑RENEWAL OF IRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM DEDUC:ATIONAL ❑GOV'T ❑RELIGIOUS❑PArLU ❑CARPORT ❑GARAGE ❑STORAGE❑;iLAB [fFENCE
_DBOND — ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED - ❑SIGN'';
(fir CUPANCY___-_.___LAND USE ZONE` __PLDG.TYPE-..------FIRE ZONE PLAN CHECK BY_____._
- — -- —
I.t l r i• t',�I til 1. 'y' i i 1nI l: A 1.G i l l kJ j t L 1,L1'_ 'Y€ ..J t�w'I A C�[� (i r I Q U ITI a1 R 1
__. 'wfi r permit L3916 sawn r cortrl, ��` ��?. :�ewr�r 1rlep. i►2a,
M—C LQ,AL) ----E.1.��R1�AJ� HEIGH"L_. _--____ NO,STORIES_ 1 AREA L�Ei�?NQ_@.E12HSZQM�_.__�YALSlE -14s.vuu+
BlJll_OING DEPARTMENT .2 3 1 I c
SET BACKS_ FRONT _ REAR LEFT SIDE RIGHT SIDE
Permit 163.00 — --
THIS PERMIT IS ISSUED SUBJECT TO TIIE REGULATIONS CONTAINED IN THE BUILDING CODs, ZONING
Plan Check X1,50 REGULATIONS AND ALL APPL "ABLE CODES AND ORDINANCES, AND IT IS HERE11Y AGREED THAT THE
WORK WILL BE DONE IN ACCCIt.DANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCEWITH
Sub-total 244.0 ` t ALL APPLICI.BLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICFNSE.,SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HFATING.
Total _—. — -- 110i i-1#j0L0 »111 ,i►, UU6
By
APPLicANT OR AGENT `—.. . ..._..
Approved —� Receipt No. ¢'-
UATE INSP. TYPE INSPECTION REMARKS PLUMBING QATE
Contractor
Y
Permit No.
Rough-in
Y�--l�—Ae' —_lope, Fixture --- —
3/-7B _— Final
-3 7�+ HEATING
Contractor ---
f
Permit No. L Z W-2
Gas or Oil
Rou h-in
Final _
SEWER -
- Final —'— —
DRIVEWAY
Final
—� — Storm Drainage_____ _
(Rain Drain) Final
Sidewalk
— Curb&Street Final
BLDG Of "T,FIN TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
i �.. Zoning Final
4SEWER PERMIT N? 1.3916
UUnified Sewerage Agency T i Oa r d 2_.22-';g
of Washington County CITY OF_ DATE
OWN'-R: John A. Loewer PHONE :
OWNER 'S ADCrtESS: _,•
TYPE OF INSTALLATION:
❑XBUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
W fEXSINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1 _ _
PERMIT CONDITIONSt THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR
INSPECTION, PLEnSE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEESt
PERMIT FEE $ 251—
CONNECTION
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL $ 625.
APPLICANT DATE
bc:ni.;a. Z���.�. lJiw�i1 s �� ,:► SEWER PERMIT' 1 ;391fi
ADDRESS OF STRUCTURE 12145 SW Merestone Ct.
TAX MAP TAX LOT SYSTEM fanno creek
LOT BLOCK OF .
APPROVED BY DATE or ISSVeD BY DAT
REMARKS bldg. #1897 Paid to Leron Heights X150. 00__- _ y_
CITY OF TIGARD
ORDINANCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE
G c•
DATE : / -�� /IY ESTIMATED SALES PRICE
AIPI_ICANT NAME , --Z_. �.�,ra� -=- - TELFPHONE
JOB ADDRESS 1 .,�/ - - J,��; ;, %`. r�� BLDG. PERMIT /X 7
AMOUN ,' OF FEE FOR P. D. C. ioy-
DESCRI;"TICN OF IMPROVEMENT
EXEMPTIONS - PER ORDINANCE #77-71
FEE RATES:
A. Single Family dwelling unit under $40,001.----------- !T5.Q�
0. Single family dwJlling unit over $40,000-------------- Jj,0_Q.2
C. Mobile Home Cotirt Space (New Development)----------- $ 50.00
D. Multi-Fancily dwellings--per unit---r-------------------$ 60•.00
CONSTRUCTION IS LOCATED ON S.E. —/ . SIDE OF S.W. PACIFIC
HIGHWAY. N.W . i� Park District #I. S. is Park District #II.
CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE:_ �>� A Y _ ESTIMATED SALES PRICE
APPLICANT NAf1E_,-)r"/," ,' ,„ TELEPHONE
JOB ADDRESS ;;z-_ `zr� .z�._�. �,t LrBLDG. PERMIT
AMOUNT OF FEE F9R 5 , D. C.
DESCRIPTION OF IMPROVEMENT_
EXEMPTIONS -PER ORDINANCE 7777-26
FEE RATES$*
A. Single family &,elling unit under $60,000.--------- n0.00
B. Singly, fnrni.ly dwelling unit aver Ser0,000.--------•- $,400.00
C. Mobile Humo Court apace (New Development)---------- $150.00
D. Multi-Femily Owellings--per unit-----------------..- $240.00
E. Commel.'cial, Industrial & Instituticnal(Park. Space) $ 50.00 each
F. Single family unit under $40, 000. ----------------- $250. 00
3UILDING PERMIT APPLICATION CITY
TG . RDDATE ►. . _._._. ,9.��. tip 1977
�i*F UNDE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONk 3k
UP AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
FP ,I�,�bL.../4� IN� Og ADDRESS r Z�I�� �I.�+E.p�_—�_!—HOME ADDRESS �Z f S� K1.clYU�•7 U 44C'^-
ARCHITECT
[� u ENGINEER
P_.af�rC ___e� _— ADDRESS _ DESIGNER
qE vEW �OREMOOEL ❑ADDITION OREPAIR _ ORENEWAL OFIRE DAMAGE ❑DEMOLITION
(NCE (ICOMM DE'DUCATIONAL OGOV'T ORFLIGIOUSDPATIO DCARPORT ❑GARAGE O570RAGEOSLAS [:]FENCE
POND El MOVING _DCO_NDITIONAL USE DDLSIGN REVIEW _ ❑COUNCIL APPROVED DSIGNS
Ll'FANCY L AMUSE ZONE"`_- --BLDG TYPE ___.�_..FIRF ZON .__PLAN CHECK BY,_ _.— — HEA
LA- 49 — -- --
�Aa�.--- FLQo � nT_— _ N� pl55 I_._A �y �,�M�-3._VALUE
_BUILDING DEPARTMENT SET BACKS -FRONT RE AR Z LEFT SIDE / RIvHI SIDFrtmit
THIS PERMIT IS I.;SUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
'Ian Check — G� REGULATIONS AWD ALL APPLICABLE CODES AND ORDINANCES, AND 1'f 19 HEREBY AGREED THAT THE
_a WORK WILL BE DONE IN ACCORDANCE ;VITH THE PLANS AND SPECIrICAT10NS AND IN COMPLIANCE WITH
5uh total_ _ tea ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RL5TRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
iatf Tex S Z LICENSE SEPARATE PERMITS REOUIRED FON SE.WEn, PL UMBING AND HEATING.
Total - 0p,
By
_ _ _ Cl rCANI OR AGENT
!approved Receipt No. i 3 �' � �i Y,
----- - Ai)nRE55
r ,
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yJ
CITY OF TIGARD MECHANICAL PERMIT r�ecoipt*
Perrnit k
Description --
Table 3A Mechanical Code
City of Tigard � CITY PRICE AMT--
13125 S.W. Hall Blvd. 1) PnnnitFee -0- -0- 10.00
P.O. Box 23397 - -_ _
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 - _
1) Furnace to�i 00,000 BTU
Incl.ducts&vents 6.00
2) Furnace 100,000 B'rU +
incl.ducts&vents 7.50
~ Name of t�evelolxnent Floor Furnace --
3) incl.vent 6.00
,lobAddress Suspended heater,wall heater
Address S.M)o07 a 4) or floor mounted heater 6.00
Tax Lot Map No. `- Vent not incl.in -
_ -- Lot '` Block subdivision 5) appliance permit 3.00
Name(or Hama of twsfne^ ss) Repair of heating,roar ig., -
c //IV /t_11h/N 6) cooling,absorption unit 600
Owner Mailing Address Ft�ne Boilet or comp to 3 HP
wtr-hr57w4e cT, lr�G-��s 7) absorp.unit to 100,000 BTU 6.00
city/State - ZI
, 8 Boiler or comp to 3 HP-15 HP -
-7-16^ f-d 1 p r e . 5,77-2 3 ) absorp.unit to soc..000 BTU 11.00
Name Boiler or comp 15-30 HP -
7-4e /HC. C7-0h? 8/5yOp 9) absorp.Knit 112-1 million 15.00
Melling Addrsw
Phone 10) Boller or comp to 30-50 HP --
Contractor �7�J S` w. p�fC/,-"cN w f! L zcv 0x absorp.urdt 1-1.75 million 22.50
city/state ZIP
11 Boiler or comp to ti0 HP
T�Ginc�� FT'P, cj"7��3 ) absorp.unit 1,750, 31.50
000 BTU
State Registration No. coy Sus.rex No. Air handling unit to _ --
Z/3 3 -7 12) 10,000CFM 4.50
I her"scknowiedge that I haveread this applMetlorr that the Information given is 13)
Air handling unit
oorreci,that I am the owner or auffarized agani of the owner,that plans submitted are in 10,000 CFM + 7.50
compliance with State laws,that I am registered with the State Builders'Bovw,that the Non portable
number given is r"rer:t.(It exempl hom State registration please give reason .below
) 14) evaporate cooler 4.50
15) en,fan connected
---
i� to a single duct 3.00
-- 16) Ventilation system not
--- -- Included in appliance permit 4.50
Hood served by
t 7
) mechanical exhaust 4.50
_T re(owner or agent) --'�-- bale -- - -
18) Domestic type
Describe work ❑ addition ❑ alteration. repair ❑ incinerator 7.50
to be done residentiAt
—non-residential ❑ -
Commercial or industrial
Existing use of _ 19) type incinerator 30.00
building or properly Other i.e.,woodstove,water
Proposed use of ,-- �- 20) heater,solar,clothes dryers,etc. / 4.50
building or property _
-- 21) Gas piping one to four outlets 2.00
Type of fuel- oil C7 natural gas 0 LPG ❑ electric l_J -
22) More than 4-per outlet
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CO�1- SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S%O 41116 SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER PLAN REVIEW 25%OF SUB-TOTAL
WORK IS COMMENCED. - - -
Special Cnnditions TOTAL
�_ _ Date issued�_�_ by _- -