12207 SW MILLVIEW COURT 12207 SW MILL�IEW COURT
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CITY 01' TIGARD PLUMBING L3125 sw HaU lgvj.
Applicants must hold Oregon Reg;siration to conduct a plumbing F R M IT6399-4175R 97223
business or must be property ownerloperator roll hiring outside help.
Name of Dev»lopmenl � /}-
Address,_ y�--- DescriptionPlumbing Permit No. .__
o�U Z J (jj _/_t 1� ee OAS 914.21-370 OUAN, PRICE AMT
Job Tax Lot Map.No. �—-
Address FIXTURES
LD1---C3lod* Sutxfivlslon ,
Sink �- -- - -� --- 7.50 7 ,
Nam or ness Lavatory � - 7.50.,
rt ric_�_ Tuh or Tub/Shower Comb- I 7.50 J�
(,(_) ^ K 1 -- Shower Only ( 7.50 S?
Owner /State J ZIpT Water ---- -3 7.50
(%g �r JOO Diahw+shar 7.50 S
Phone Garbage D*spo"I _ ! 7.50 �Sa
Nems WashingMachrna - - - -- R -- 7.50
Floor Drain 7.50
Mailing A&Iress Phone Water Heater - -- � •'.50. `7 -
Occupant - Tip -- Laundry Room Tray -- 7.50
cn
y7statA -- ------ —
Urinal7.50
Np" e Other Fixtures(Specify) --- - 7.50 _
Maftv
— � 5 _Y _--
Contractor lStite ZIP. 7.50
���r-e-4 Y- 9 2 MISCELLANEOUS
----- CAy Bus Tax No Sewer tet 100' 30.00
Sawa-ca.Add►t.100' 15.00
lR •� '��(10 3c/ Vq . _water ser0ca 1 st 100 --W -- --1 - 20.00_ 4°
I hersby rkr*owMdpe eh x I, reed v*appkaflon,OW tw iniormation water Service sat.Addit.[ ' — 15.00
elven is coned that I am regh+wed with two 899 Bu7does Bowd,and also Storrr 6 Rain Drain 1 st.100• 30.00 -
have a State PknnbMq lioww that the nurrrbws plvwr are coned.0*0 all
Ourrb*V work*0 be done In woo denoe wKh app4ca61e provkkxvs al Ore- Stone 6 P.yn Drain MO.100' --15.00
gon Revised Sestutes Chapters L,7 and 03 and applicable codes and that Moblin tomb SPS 2500
no help will be employed w4ess Iloonsed under ORS 90.1 (11 exempt fnxsa ---- --- -
State repleirstlom please gbe rosson bsbw). Bad*Flow Prevershon
HOMEt71hNERS_.I hereby oerllfy IhM I am the owns of the property de- 'Device or Anil-PostttionDevice 7.50 --
sorbed above,M which locator*1 propose to make a pkwft p kWONSO n I- Any Trap or Waste Net _
my own use and trill property le not bekp ouvWticrid for saie.Itaa 1 a r*M Comseolud to a Park" ,J--- 7.50
1~Caduh Basin 7.50 —
of
Exig.-.Pkryt 40.00 Per Hr.
_ "d hwea _ -- 40.00 Per Mr
q Wu
Aller,or Plumbing wtMaln
an F_dMkV Bldg 15.00 min
AUT IZEO Tl1RE New".or Build.Ad~ _ -_+ 25.00 min _
11-44L ' r v --- - �' a Pain Voiri,ie_`
Descries work newsiaddition n altonsooh ce
E] repetlr( 1 ll' 15.00 /
R!dedne residential f twn-r»Idential -
Exh t V use of
hMAR appope►a---- __ _____._.________.___.__ --- VnTM �
Nomcx
"stI pM11M ba00rnaa nus and void Iwo**a with ted 4 not ow,
rrtatosd tat',Mn tB0 eiaryRytr M serattruallon a sloAtlsMlspM+aded a sbsndor+sa kx
at In to IIIc aye M MWOM ow work At oorllmlMlaad
fMalCIAL QONOPT WO __ _ --
Dase Issued 3i ? lir
CITY OF TIGARD MECHANICAL PERMIT Hecelpt A
Permit
Description
Tel?Is 7A Mechanical Cods CITY PRICE AMT
City of Tigard i) Perrri,Fee -0- -0- 10.00
13125 S.W. Hall Blvd. — — —
P.O. Box 23397 2) Supplemental r rmit 3.00
Tigard, OR 97223 ---
639-4175 1) Furnace to 100,V11 BTU j 600
incl.ducts&vents
(� 2) Furnace 100,000 BTU + ---^— 7.50
incl.ducts&vents
Name of Development 3) Floor Furnace 6.00
incl,vent
Job Address 4) Suspended heater,wall heater 600
Address / or floor mounted heater _
,2�O� ��✓ / — —
Tax Lot Map No. 5) Vent not incl.in 300
appliance permit
Lot Bla:k SutwJivlsan —�- —
Name(or name of fwsineas) 6) Repair of heating,ref r ig., 6.00
cooling,absorption unit
Mailing Address Phone 7) Boiler or comp to 3 HP 600
Owner absorp.unit to 100,000 BTU
CRY/stale —1-- - —-- —Z p - - 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
---••----
Name ) Boiler or comp 15-30 HP 15.00
9 absorp.unit 1/2-i million
MeIIMtg Address Phone 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million _
Conti ac tr cry�stae -- zip — - 11) l3oiler or comp to 50 HP 31.50
absorp.
_ unit 1,750,000 BTU
Slate Neglstratlon No. ^':y Baa Tax No. 12) Air handling unit to 4.5U
10,000 CFM
Air har0ing unit - 7
I h oreby acknowMBdge that I have read tlds application that the intomiation given Is 13) 10,000 CFM 4 _
50
oonscl,that I am the ownsr or autfwrited agent of the owrwrr,the'plans submitted are In ----
o wnpliance v*h Stay laws,rhat I am regWored with the State Buildam'Brwrd,that ttw± 14) Pion portable 4.50
monbet given 1s co"fro (II exam w from State registration pleas"give mason hxkm) evaporate cooler J _�
15) Vent fen w,inected 3.00
to a single duct
Ventilation s}.Item not 4.50
16) included in appliance pet mit
17 Hood served by 4.50
_mechanical exhaust
S:gnalure(owner«agent) _,_ -- _-T Dat" 18) Domestic type 7.50
Describe work addition alteration repair [J incinerator
/V El
to be done residential 7� _non-resl('Iential C1 -` 19) Commercial or Industrial 30.00
type incinerator
Existing use of
building or properly— _—.—-__ __ ._._ 20) Othe,i.e.,woodstove,water 4.60 y J"'
heater,solar,clothes dryers,etc.
Proposed use of _
building or property — 21) Gas piping one to four outlets / 2.00 ;Z
Type of fuel- oil ❑ natural gtas0'J LPG ❑ electric ❑ —
22) More than 4-per outlet
N2T� SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- - -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 s%pW 4068UHCHARQE b '
DAYS, O't IF CONSTRUCTION 01 WORK IS SUSPF NDED OR PLAN REVIEW 25%OF SUB-TOTAL a
ABANDONED F05 A PERIOD OF 160 DAYS AT ANY TIME AFTER -
WORK IS COMMENCED. TOTAL Wo
Special Conditions_-_-------_ -_- ._ .------ _ _- /
r
__- Data Issued o by �' --
■
DATE �_ -- 19 49*x9
BUILDING PERMIT APPLICATIC M 642.,7849
THE UNDERSIGNED HEREBY AF'-)LIES FOR A PF..nMIT FOR,THE WORK HEREIN INGi SATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFIC'^,T„JN5, OWNER P Hi /TlE il —
l +wi
OWNIER W': . Larson HC?iTlejIDBADDRESS ---
AHCHITECT_
ENGINEER
`3f1;' ►#
ADDRESS DESIGNER
BUILDER-_ _ -- -
STRUCTURE_ � F� NEW ❑ REMODEL ❑ ADDITIrN ❑ REPAIR ❑ RENEWAL _❑ FIRE DAMAGE ❑ DEMOLITION
C RESIDENCE [I COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS
_J PATIO El CARPORT ❑ GARAGE r_1 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ R- LAND USE ZONE �4��BLDG.TYPE .�L—_FIRE ZONE._ .PLAN CHECK BY - F3['TttEAT_._ #f---
—
Subject tc) 85 code. Amnrt $160 sewlWisurcharge. —
SEWERPERM17k '.4062( Idu) 3 bet_hs, _ 14trttps T c�arace: are 4D.1�_,,,___ --
OCC.LOAD FLOOR LOAD 4 0197 HEIGHT 201 NO.STORIES * AREA V 8 5NO.BEDROOMS 4 �VALU E���Q
-- _-- 7
BUILDING DEPARTMENT SETBACKS FRONT--- - REAR ' LEFT SIDE 7 .IGHT SIDE
- _
Permit 3�'1 ' )n THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONIAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, FIND IT IS HEREBY AGREED THAT THF..
258.05 Plan Check - WORK WILL. BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-totalJ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE. CURRENT CITY BUSINESS
LICEIjf.SEP4111 ,p RMITS RflQU HEU FOR SEWER,PLUMBING AND HEATING.
State Tax SDC— f6iQ>�l0..00
Total
:_:):
i.1.,�[7 � t
PDCN APPLI NT GENT
—` 574 .90 Receipt No. If� ADDRESS PHONE
proved tE37T
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Permit No. C L t -
Fixture
Final
HEATING
A" _ Contractor e 1—' y6
d f( ------- __ Permit No. A/919
Gas or 011
RoughJn
` -----��—L�—--– F i nal –
�` SEWER
n++A�' _ Final~ __
DRIVEWAY
Final
T
Storm Drainage
(Rain Drain)Final
--- Sidewalk eV
Curb&Street Final y� /-
Approtch --
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
,1
,1
ff - W W
CITY OF TIGARD BUILDING DEPARTMENT PLAN CHECK NO. : �
-LAN CHECK APPLICATIOt. DATE RECEIVED:
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID:
This is to certify that the attac'ied sets of plans have been submitted for plan
check pursuant to the Oregon Structural Code and Fire & Life Safety Code, edi.tion.
PROPERTY OWNER: �' V(_� y r! OWNER'S ADDhFSS: �bq 7 So) I)A"�-
CONThACTOR: TELEPHONE: 4 2 !
JOB ADDRESS: 2- Z v�l �U-� M i v� w�G LOT NO. , MAP: L 0/11 I 1 Vl )
DESCRIPTION OF WORK: J)f to ,� )
Approvals Required SPECIAL !VOTES
0 Planning Dept . U Reissue
Oengineering Dept. 0 Flood Plain/Sensitive LandF
OFire District 0 Sewer Availability
Other 0 Other
Items Required
List of subcontractors
Business Tax
Calculations
OTruss Details
0 Parking Plan
0 Landscape Plan
0 Other
COMMENTS: S" EL)
City ofTigardBuiV111g Depertm,
BY: 6
for ins1)ecT ionti ca11 6'19-4175
CITY OF TIGARD 639-4171 PcRM S T N0.
BUILDING PERMIT DATE
P.O. Box 23397, Tigard OR 97223 TAX MAP '-S/-yj/ LOT NO. I SUBDIVISIONf�It/l}Ifr w)
OWNER_ _ _ JOB ADDRESS ' Z Z� 1 S�il-� I V�C.w `l,
:UNLIDER L-CYVJ ,_� 1 � STATE REG.N0. 5■_ E.XP.OA EUILOE'VS PHONE
PHONE OTHER
STRUCTURE t NEW _❑ REMWEL O AOOITION U REPAIR O MOVEU OTHER 0 OEMOI.ITION
19 RESIDENCE Cl COmm ❑ EDUCATION O INO Cl RELIGIOUS. O ACCESSORY _ ❑ GARAGE U OTHER ❑ FENCE
OCCUPANCY s—LANGV- VE %tom Y SLOG.TYPE FIRE Z0NE_—PLAN CHECK BY �,I-i' MEAT
Construct single fai. dwei l iing WfaLtached yar��al perA �iveel pl ,jj
Seer _.to 85 cUde• _ --- -- -- --__
SEWER PERMIT/,3y06 -� '(�du)_ baths,!ytrar� —.9sTLs�, a a na
OCC.LOAD FLOOr LOAD HEIGHT NO.!iTORIr_S AREA NO.BEDROOMS VALUE r '?
BUILDING DE!'AHTMENT — SETBACKS FRONT REAR LEFT SIDE y RIGHT SIDE
Perml� THIS PERMIT IS ISSUED SUSJE:T TO THE REGULATIONS CONTAINED IN THE DUILDING COOS, ZONING
Chock S REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HERESY AGREED THAT THE
Pts
S WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE"
!h G Fkn iRESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT C4TT BUSINESS
O TAX PERMIT'S.SEPARATE PERMITS REQUIRED FOR SEINER,PLUMBINO AND HEATING.
LPr@Pd
ac / cj rJ�" Ssrx,-
q SOC–
/ �� APPLIGANTORR AGENT I,� -nit
/ p v � � J SQ nK ALOO 0"_- q 0077'
Rocelpt No ADnRESS P►i(111�
s � Y• 91�
Issued By__,_ _ -----APProvsd BT
S.� )C
S 0 C
r RECEIPT #
DATE PD.
SLLIER CONNECTION S //� c AMOUNT
SCUER INSPECTION S
SEWER SURCHARGE ` S ,"
:ommente: