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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregrn 97223
Phone 6:9-41'71
Permit
Type of Inspection
The following Building Code deficiencies ars required to be corrected:
Presented to Inspector
Date
CALL FOR REIWECT7CW
YES NO
City of Tigard Mechanical Permit NO.
New Installation n Replace C] Relocation C] Addition ❑ Alteration ElaATE:
HEA'ING ri 1 /G Tns OWNER
Grayson Construction
CON';RACTOR McCollister . eat; nrz � _
ADDRESS
L20 W' Baseline lid, Beaverton JOB ADDRESS 9360 SW Millen Drive -
- '
PHONE 64.9--9956 APPLICANT --
Heat Input Rati.ng(BTU per Hour) 75. 000 _ Vent Size Flue
FUEL OIL C] GAS ELECT ❑ OTHER
ITEM �NO.r FEE ITEM — NO. FEE
For Issuance of Permit SEE BELOW Each Air Handling or Duct System 7.50
New-u2 to & inc1. 100,000 BTU6.00 Commercial Hood System �— _ 7.50
New 100,000 BUT°s & over 7.50 Other Equipment^Each — 4.50 _
lWoodburning Stove 4.50 ~1 Trip Inspection — - 4.50
Wall-Floor- Suspended6.00 Air Condition Compressor - up to&incl.3 H.P. 6.00
Vent System w/Fan _ 4.50 Air Condition Compressor-3.1 to 15.H.P.incl. 11.00
fair-Heat Cooi�nc
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comments:
FEES_ 6,00
•C0
SUN.TOTAL • 0
% STATE • Iswed By
_25 PLAN CHECK
TOTAL • i REC. #
-- Sionature of Aoolicant
DUILUItyU L)LrF1r1 I Ivirly I , I iuiNt1U ��
1 PLUMBIN3 PERMIT
Central P1 umbi ni Inc . of Oregon _ holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein no,ed to be installed in acco,dance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations arf- ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. Kneeland Estates Lot 33
0wner___5T_ son Construction Co - -_ Addressg360 S . W . Millen Dr . Date 4/13/81
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Rte_"QENTIAL _
_Single Femily-1 both-each 1 25.00 25 . 00
�Uuplex-.Each 1 bath unit 25.00
AggAT al bathrooms-each1 10.00 IT. oo
Mobile Home Space-each 15.00 -
INDIVIDUAL FIXTURE FEES
Ito 50 Fixtures in 1 building-each 0,00
51 to 100 Fixtures in 1 building-each— _ _ 2,50 -
101 to 200 Fixtures in 1 building-each 2.00
_2_01 or more Fixtures in 1 building--each 1.50 --
t,11SCEL ' ANEOUS
Building Sewer-1st 50 61, 10.00
Sewer-eacl additional 100 It. _ 10.00
:rater Servic tojGuilq____
din 5,00 5 , 00�M
-- -- - _� _e
Private Water ,Ysturns-each 100 ft. 10.00
Other IS eci11: � -
PERMIT For Plumbing Inspection Phone 6394171
tl State , 60 P'umbing Contractor By -
TOTAL 41 . 60 RECEIPT NO. Issued By
BUILDING PERMIT APPLICAI ION TIGARD UATE — 365
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FGH THE WORK HEREIN INDICATED 81111-DERPHONE 246-3324
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER A.Larry GrLyson JOBADDRESS 9360 S41 Millen Drive LOTNO.- 33—Kneeland
ARCHITECT
ENGINEER
BUILUE.';_Grsyson Censtro Co. ADDRESS_ 8946 _SSJA�q.§ fjlvd, DESIGNErl Gary Petty 635-4616
STRUCTURE I-N NEW Ll REMODEL 11 ADDITION F1 REPAIR 11 RENEWAL 0 FIRE DAMAGE 0 DEMOLITION
L-XRESIDE14CE F-1 COMM D EDUCATIONAL EI GOVT 1:1 RELIGIOUS 1:1 PATIO 0 CARPORT El GARAGE 0 STORAGE Lj SLABD FENCE
OCCUPANCY R-3 LAND USE ZONE BLDG,TYPE --Ilt—FIRE ZONE --PLANCHECKBYHEAT
Re-Issup of Permit JJ3640 (9?_�6SLq Millen
Construct -single family dutelling w/attached Qararjg, 3 Usdroums 2 6& ths.
SEE CORRECTION SHEET ATTACHED,
SEWERPERMIT# 23:;03 - 1750.OU t.
OCC.LOAD FLOOR LOAD 40 HEIGHT 12 NO.STORIES 1 APEA 1-105 NO.BEDROOMS 3 VALUVIII,2011 .
BUILDING DEPARTMENT SET BACKS FRONT 2n REAR Z of I FFT SIDE 6 RIGHT Slf'F
Permit %191.00 (HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS COtITAINED IN THE BUILDING CODE, ZONING
REGU!ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check Z.Q.00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPI Ii,,ABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVE' ANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State—Tax 41 7.64 LICENSE.SEPARATE PERMITS REQUIRED FOR SFWER,PLUMBING AND HEATING.
08,b4 SDC-- S400.On
Total S2
By P1 PDC# I I S I CID.0DXPPUcA f OR AGENT
Approved duh Recelpt NoAbDR._E'9$-.
PIMNIF
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
ContractorZIP-Al --- ---- — Permit No.
Rough-in _
o / Fixture
HEATING
Contractor
-- _ — Permit No.
i
— Gas or Oil
Rough-in
Final
--. --_ _— SEWER ._�.
Final
- —_ DRIVEWAY
--------- --
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
{ Approach
BLDG.DEPT i`!NAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY 0 Final i—
Landscaping
))
Zoning Final
r
BUILDING PERMIT APPLICATION •rIGAR:)
THE UNDERSIGNED HER-70Y APPLIES FOR A PERMIT FOR ThE WORK HEREIN INDICATED 'BUILDER PHONE2 6-3324
nR AS ;HOMN AND APPROVED IN TILE ACCO% PANYING PLANS AND S"ECIFICATIONS. Os'c4CP..PHONE __
LOT NO. 3 G1t{Q
F, A. Larry Grayson JOB ADORES ��/_ o►t +�'a��t'� Q(.�Yt�-L�.G•l .T
AFICHITECT Burton Engineering
Graysonc 4- �V dy06 S.W. Barbur Avd. ENG0vEER Gar Pett
'ILCEp ADDRESS DESIGNER y y
— -- -- -- —- P"1 a-nd—9M-177 219._
;UCTURE EW ❑ REMODEL ADDIT!ON ❑ REPAIR C RENEWAL EJ FIRE DAMAGE ❑ DEMOL
nESIDENCE ❑ 1.+.N ❑ EDUCATIONAL '❑ GOVT C RELIGIOUS G PATIO u CAR PERT G GARAGE ❑- STORAGE C SLAB F
ANCYLAND USE ZO"f . �• �—_ BLDG.TYPE fL _.__FIRE ZONE._-__.PLAN CHECK BY r
=-A
!� aE. 'vim.�G,-�"�� r c►�kzni 15�w
1
.YER PERMIT/
C LOAC FLOOR_LOP-U �(j HEIGHT NO.STORIES _AREA//Os NO.8EDROOMS 3 V6,LUF _
BUILCINGDcPARTr.+�EN� SETBACKS FRONT ZQ SiEAR LEFT BICE �RIGHTSWE If,.,
rr•,q THtS PERMIT IS ISSUED SUBJECT i0 THE REGULATIONS CONTAINED IN THE BUILDING CGDE.ZC
REGULATIONS AND ALL APPLICABLE CODES AND ORDINAIICE.S. AND IT IS HEREBY AGREED TKA
WORK WILL RE DONE. IN ACCOP.DAN'*E WITH THE PLANS AND SPECIFICATIGNS AND m COUIPLI
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUI.` CE OF THIS PCR-AIT DOES ►i)T 1
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CIT! BUS
i:"C,ENSE.SEPARATE PERMITS NEOUIRED FOR SEWER.PLUMBING A14D HEATING.
2ra$,1a9��
SDC--
AOCI+ APNUCANT OR AGENT
;�rov�4 1 Receipt No. ---- PMONF I
1 Ii CONNECTION
JE-r-% INSPECTION
E R SURCHARGE