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INSPECTION N01 ICE
(�C City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-41775��
Type of Inspectionr�
Date Pequested C:P ' ►��JU/ Time A.M. P.M.
Address 71�_�F�f Permit #_&2d
Owner -f- Lot 1.
Builder /a _ Lt-C t C
The following Building Code deficiencies are required to be corrected:
l Rey
//rr �Le- iii �u r 1,f, : . Cu•^./` __—_
3. (26 U Z'1 I'G n ►^ta Ir. ,PG S f-`G N ^�v-^ o� '� L'�� LI '
Presented to ���-7--"`- — ❑ Approved
Inspector G�,� _ _ approver!
Date
CALL FOR REINSPECTION
❑ Y18 ❑ No
CITY OF TIGARD PLUMBING 13125 qW H&U Blvd-
Apok&ft nwo Wd � R4W&tion to cumW a Owirlbft Tigm-1 CR 97"3
bu*wn or be rtop"pay owns not hWft Wsi&ttL, PERMIT &'O-C,75
Plumbing Pwimil No.
LNoc6p&)n
ORS814-21-41110 OUAN. AM7
Job Tax Lot Map.No.
Address FIXTURES
W —
;2 Wrick Sk1b(JM%1W sbr* 1.50 it
L"a 7.50 b —
Tub or TublShwer Cott
7.50 7-�'t
MaToV Aftess ShoWWOf* 750
Water Clow ?so
Owner
Dishwasher I'5o
Phorw Disposal 7.50
Name WAs"Mactvne
Floor Drain 750
7,=ij-;1GJd..—ss Water Healer ?so
Lai indry Room Tray r 50
OccLpani ?so
Zip
OqtW Frittwes(Speaty) 710
I'lo
mom
Convac-ftw okylstaile ZIP 1,so-
MISCELLANEOUS
Bus Tax No 30-00
S~-ea.AWN 100' 15.00
Ste"unp., lae
I hereby odmaoilodge WAN I tigiii*retail ihis appk*Wn.00 on IndorrimAlon Waller SWVWG ea.Addd.200'
giver,is oorram that I win r%q@Wzd nor the stem qLadeesElowd,and oleo SlOrM&PAW Drain 191.100' 301M
have a Steffe Pkm"losinito to the nwibm elven we Conrad.Ju"20
Owntiong workwN be done in&Woft;m-*%qM Wole"pvii lsione of Ore rAorm&P-in Drain AddN.100' 1500
eon Revised Star-tz-i Chapters 447 ano W3 and appic"oDdos and that L4otA@ Home Spam2500
no help w0l be employed unless loartood underORS W3.(11 exempt from
Stale reglallnialcm.plea ss gl"reason Neioiv) Back Flow Preivenbon
HOMEOWNERS-I hmtrf oo#Wy OW I am the owner of the prop"do- Dwvloe or Anll4lokiliion D*v"
750
scribed above.of w1dof locaft 1pmpo"iomaboapkxnbung kwkWA96mfor Any Trap or Wasas Not
r"own use mid MW pe vally in to beirviorivInKft'd Ow 4419,Leese Orr*14 Cvmnracied k)a F4xWm 7.50
Catch Been
IrW of Exist PUT6k!q 40.00P r t4f
40,00 PW
Aller.of Pkmr**V
15.0o men
an
AUTHOPAZED SIGNATURE ala Now or PAM.Addlkn -------- PLOD"M
Disecrtiewirw* owwrj itrAWitorill eftru"On C] repair n 'umoo
I jQ k2 ft!j_ --j
Exft wo(A
-
tato WOW
a pooled of W drp W&V Sm aisir wo&b owitsaitl Ked
WINCIAL CONOM000
Do" "jed d�.ZA Z by �_
I
BUILDING PERMIT APPLICATION SATE-
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT I OR THE WORK HEREIN INDICATED BUILDER PHONE 625-61(17,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. O)lffi'ER P1-11"Y 1 70 T
LOT 140
OWNER JOBADDRESS 12278 Mi.11>;.iew Ct. isI-q�
:>r 971tlp ARCHITECT
I ENGINEER
F MILDER ADDRESS lg72 N`)hra wo t b(Lk _DESIGNER L, ` a f t R 16 -4
STRUCTURE [-1 NFW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE 1:1 DEMOLITION
QtRESIDENCE 0 COMM 11 EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ P",710 ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB[..] FENCE
OCCUPANCY --R3—_.LAND USE ZONE .--RA.-5 BLDG.TYPE _-5X FIRE ZOP E PLAN CHECK BY --U!r HEAP_
Construct sirtciI.e family Vitra L].ing w/w��Lnched gtr +ga. X1.1 t_er Mprgyo. _ plans.
Subject to r`: cora. utiWict: to Amar^t $360 ---
SEWER PERMIT 0 14 04 G(Odu ) 3 k»Iths, 22't x_ apps gar-age area 416__-
in 20� 2 18
OCG.LOAD FLOOR LOAD HEIGHT N0.STORIES AREA BEDROOMS 9 82040 VALUE !_—
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE G RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COL., ZONING
`q R, 30 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
PI3n 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-total _ RESTRICTIVE COVENANTS. CoN TRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
—� —9. F LIC,ENS,,E.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING L ND HEATING.
State Tax
Total G49.40 SDC- 60U.0t+
1"
9.40 Fnca :C - 5 0.0 0 di i
By
3 004
AReceipt No. ADDRE8t3 —� — PHONE
pprmved
I
9
K.
a
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING 1;qTE
1 Contractor -
f
Permit No.
tt Rough-in
Fixture
Final — --
�d�fc '� HEATING g� y
Contractor �7�
Permit No. Lf
/.ice
0 ,( 1 , r� C� � a�-�� Gee or Oil
jI 0 K --�— Rough-in
Final
o� --- - - - _ SEWER
D Final
DRIVEWAY
u
Final
Storm Drainer
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL t� - POR
TEMARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
I��r inspecc .on , call 639-41.7', FERMIT NO
CITY OF TIGARD 639.4171 DATE ---2`7
BUILDING PERMITr' LpT NO. SUBDIVISION
P,01. Box 23391, Tigard OR 97221 TAX MAP .
iL Yl��A I�.i., JOB ADDRESS 1 ih vim; /rJll I UI c'w /
OWME -- — -
BUILDER
1,178 It SHE EXP.GATE
STATE REG.NO. _ `—
_ —�
BUILDER'S PNONE EH�IWGCiD.OR 01140 —�,
_ PhONE__._�---- _OTHER
ARC.JIII-ECT �/
STRUCTURE_ NEW FlEM_UUEL ® A_OD_ITION (- REPAIR O MOVE0 OTHER 0 OEMOUIIOf'
O RESIDENCE CJ 40M' O EDUCATION 0 IND O FIEUGIOUS O ACCESSORY Q GARAGE O OTHER ❑ FENC!
OCCUPANCY i , LAND USE ZONE-r-TMPE FIRE ZDNr _ PLAN CHf.CK BY (.5.��►1f ATS__—�-
_Construct singIe_famiI v-dwelling
SEWER PEAWT 0 -- C>C Y (I du) bath_.___-
--_ - -
NO.STORIES - AREA 4 NU.8EDROOM5 '% VALUE
LL
OCC.LOAD FLOOR LOAD i%f HEIGHT _'� -- `�
= -��--'-- LEFT SIDE RIGHT SIDE ,
BUILDING DEPt.RTMENT SET BACKS FRONT REAR- ..........•--.-.-�:.........�•
THIS PEt7M11 IS ISSUED SUBJECT TO THE REUUU,TIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES ANC ORDINANCES`AND IT M HERESY AGREED THAT THE
PURCh*CY_- f' WORK WILL BE DONE IN ACCORDANCE WITH THE PLAN' AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APP'LICJLBLE CODES AND ORDINANCES. THE ISSU..NCE OF Tl115 PERMIT DOES NOT WAIVE
PI. Fks RESTRICTIVE COVENANTS.CONTRACTOF1 AND SUB CONTRA.CTORS TO HAVE CURRENT CIT! BUSINESS
--- -- - G TAX PERMfM SEPARATE PERMIT R�:OUIRED FOR SL,A( PLUM YU A!/q HEATING
Stale TAR / U ssn-L / 'n
-- SOC
��,llG
J—
Sal.
Total _-- -s A
l PD
GP
No DURESS
� U
Due �.5 . ��pproved BY__ -
issued 13y------
SDC 4' �' —• RECEIPT b
PDC -���_..'--��-.�= DATE pp
/C ,.,
SE1�ER CONNECTION � AMOUNT PD.______
5EWE9 :NSPECTION_
SEWERSURCHARGE _ S �� ••�� I�,^5 tC�'' I
Qu
:ommente:
CITY 0'r- TIGARD MECHANICAL PERMIT permitN �
Descriphon
Table 3A Mechanical co 'e CITY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. t) Permit Fee 0- o_ 10w00
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223
639-4175 Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
2) Furnace 100,000 BTU + _ 7.50
incl.ducts&vents
Name of Development 3) Floor Furnace 6.00
C,
KIincl vent
Job Address _ — 4) Suspended heater,wall heater 6.00
Address 2-A 7 ' J w /�11'1121; or floor mounted heater
Tax Lot Map .� „ i5 I C 5) Vent not incl,in 3.00
Lot .7 B►xksubdlviston fy appliance permit
Name or name 0 buaki_., i 6) Repair of heating,ref rig., 6.00
` /1117 1� � � G,�y y ( � I cooling,absorption unit
Mailing Address phone 7 Boiler or comp to 3 HP 6.00
Owner ) absorp.unit to 100,000 FJTU
City/State 71p 8) Boiler or con Ip to 3 HF-15 HP 11.00
absorp.unit to 500,000 BTU
Name 9)Bo er or romp 15-30 HP 15.00
9) abtlorp.unit 1/z-1 million
Melli d esa Phone —V 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1 -1.75 million
Contractor .ystala -Zip -- t 1) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU
late Registration No City Bus Tax No. 12 Air handling unit to 4.50
10,000 CFM Air handling unit 7.50-
1 hereby acknowle+,lge that I have road this application Mat the information given is 13) 10,000 CFM +
owrect,that I am the owner or authonced agent of the owner,that plans submitted aro in
compliance with State laws,that I am registered with the Stale Builders'Board,that the 14) Non portable 4.50
number given is correct (II exempt from State regi3tration pleb.j give reason below) evaporate cooler
Vent fan connecteu 3.00
15 to a single duct .V
---- -- -- Ventilation system not 18) 4'
included in appliance permit
Jz- 17) Hood served by 4.50
_ mechanical exhaust H SJ
L UAA
tum(rnvner or g nt) _ Date 18) Domestic type
7.50
Describe work % L, additi n ❑ alteration ❑ rs►pair ❑ incinerator
to be done ---residential nonresidential U 19) Commercial or industrial 30.00
Existing use of type incinerator _W
building or properly�_-_. 20) Other i.e.,woodstove,water ) 4.50
Propm,ed use of heater,solar,clothes dryers,etc.
building or property _ _. 21) Gas piping ci to to four outlets 2.00 I
Type of fuel- oil ❑ naturb, gas A LPG ❑ electric 1-1
22) More than 4-per outlet
NOTICE: SUB-TOTAL f cr
THIS PERMIT BECOMES NULL AND VOID IF WORK Or' CON- 406
- -- e
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 56/,o SURCHARGE - yj
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF StIE-TOTAL y 7�
AHANr_IONED FOR A DERIOD OF 180 DAYS AT ANY TIME AFTER - TOTAL
WORK IS COMMENCED. Vo
Special Condi!ions�^
DatF is�,tled by