10390 SW SERENA WAY 10390 SW SERENA WAY
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rid "ITY OF TIG
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=i Owner: Bob Samuels Permit No. 35��
( � Address: 8735 SW Lehman Street, Portland F�
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Building Address: 10350 SW Serena Way
(•"- Occui.ancy:R-3 Land Use Zone: H 720 Bldg.Type 5P+_Fire Zone:
C imments:
�Fa'�:�'s� �J"fit �A•
1 '.� `-• � �- '.,ems.•+
Cert cat;; is hereby given this ilth day of Clay ,19L
that said buildin may be occupied ied and t hat it �' ; j
complies with all requirements of the Build-
ing
�Code for the City of Tigard, as approved •R
by the Tigard City Council. �,, z
I ding Inspector
� 1
4 Building Official
, 1 Post Certificate in Conspicuous Place 1 9� )
iiz
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.4171
Permit #
Type of Inspection
The following Building Code ditfic:em ies are required to be corrected:
I
Presented to _�__.--_— _ __ Inspector _--- —�_—^--._--_---
Date _--------_—_-- ____----------_�___�
GAL: FOR RVAISPECTION
❑ y!S ❑ No
City of T1 igarC; AAechan;ca1 Permit NO. ---
New Installation ElReplace ❑ Relocation E] Addition0
Alteration I__J DATE: 2/19/81
HEATINGTlcC0111Bter geatint� & Air Coni' pWNER Bob Samuels _ T
CONTRACTOR �_ - W. Serena Way
ADDRESS
2194.0 W 3gse1_i RJ , . TAp a"r J013 ADDRESS 10390 a. -
PHONE
649-559 APPLICANT McCollister fieatinP- & Air Cond. Inc_. _
0 t7 00Vent Sita_. - Flue Size _.__ .—
Heat Input Rating(6TU per Hour) � _.'=---------
FUEL OIL ❑ GAS [] ELECT ❑ OTHER _____ _----
_.P -- ITEM NO. FEE ITEM NO. - `EE
For Issuance of Permit SEE BELOW __ Each Air Handling Unit Duct System 7.50
_New up to i*i incl. 100.000 BTU6.00 Commercial Hood_System 7.50
1 7.50 Other Equipment - Each 4.50._
New 100,000 BU'1's & over _ 4.50_
W_oudhurning Stove 4.50 1 Trip InspeLtion
1Nall Flr ar Suspended — 6.00 Air Condition Camoressor . up to&incl.3 H.P. 6.00--
Vent S •�m w/Fan _ �._ 4.5U Air Condition Cnmoressor -3.1 to 15.H.P.incl. 11.00
Ls
Re2ai Heat Cooling _ _ 8.00
CITY BUSINESS LICENSE REQUIRED 8Y ALL CONTRACTORS OR SUB—CONTRACTORS! 1
PEFMIT ISSUANCE 10.00 Comments: --------- ---- ----
�-- _
FEES . 0 ------------- ._ ---------- —__
SiI TOTAL
17
STATE Issued
PLAN CHECK
TOTAL _ _ 1 ;.20 REC. -_-- - Signature of ACalican' --�
NCD ARTMENT, TIGARD *T�
PL �',ING PERMIT J.� •
holder of a valid plumhing contractors license is hereby
au orized to cause plumbing work as herein n .ed to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection the City Inspector who shall be notified not less than four
(q) hour:, prior to the time the installations are ready for inspection. City of Tigard Business License requiled
for all contrael,or d s
' contractor�ctor
Address_,JL, 3 , Date_Owner r
_
-----
NUMBER OF i'OT L PERMIT NO.'S
TYPE OF PERMIT ITEM5 PEE ON EACH AMOUNT (Office Use Only)
R E NI1
Single Famit-1 bath-each _ 25.00
Ou lex-Each 1 bath unit 25.00
10.00
r.ddiaonai ::athr�ims-each � ----
Mobile Home Space-tech_ 15.00
INOIVIDU_AL FIXTURE FEE2
1 co_50 Fixtures in 1 building each r 3.00
51 to 100 Fixtures in 1 building-each _ 2.50
10' to 200 Fixtures in 1 buildina-each 2'00 -
201 or mnre Fixtu(ees in 1 buMin -each 1.50
MISCELLANEOUS -
BuildingSewer-1st 50 ft. __ 10.00
_Sewer--each additional 100 ft. G,00
Water service to buildin 5.00
P.:vate Water systems-each 100 ft. ___ _ 10.00
Other (soec'f ): �— -- --
PERMIT 1,V, i '� For Plumbing Inspection Phone 639.4171
Plumbing Cantractar By
BUILDING PERMIT APPLICATION TIGARD DAT .�Z ,s w
THEUNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONEZ%-0730
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING rL.ANS AND SPECIFICATIONS. OWNER PHONE
�) "W�j�� C�� r EC LOT N -X ---
N69-a ',� S1 J_OB ADDRE55�(�390Llll.)_,�wwl�/I'e! ;f A
IT
BUILDER
90'", AOORESS����� Le1MAN Cj+. P4. DESIENGGNEERNER 0
1�. 42
STRUCTURE NEW Cl REMOOEL C] ,'ADITION :1 REPAIR ❑ RENEWAL Cl FIRE DAMAGE ❑ DEMOLITION
,RESIDENCE- C--CaOONIM Cl EDU-C—AT—IONA�L ❑_ COV'T ❑ RELIGIOUS PATIO ❑ CARPORT_❑ GARAGE ❑ STOR 4GE 1:1SLAB❑ FENCE
('n:i�UF ��ANCY "s7 LAND USE ZONE C!d--"F_BLDG.TYPE ti.FIRE ZONI`_=PLAN CHECK BY
SEWER PERMIT N
OCC.LOAD FLOOR LOAD �Q HEICHT IJ NO.STORIES AREAI&/#NO.BEDROOMS 3 VALUEE644,2 d
BUILDING DEPARTMENT SET BACKS FRONT 2CO REAR ?J=" LEFT SICE 4f.jRIGHT SIDE .�..�
Pgrmit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZON:!43
Ian Check /Q'8, ,f'� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGaEED T IAT THE
Pinn WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CXPLIANCS
r WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS P£RPAIT DOES NOT WAIVE
S�ub-total _ , 7 .•SSD_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTOR3 TO HAVE CURRENT CITY 6JSINZSS
' �,, A LICENSE SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
��atBTax _ a (Q'�
SOC—
�TOtal ,g�,�$ _ PDC# APL FC—A—N f OR AGENT
By
Receipt No.
Approved ADDRESS----- __.__----- PttONE
30C — #20
0C -• s -- # /00
EWER CONNECTION 5 72f___
EWER INSPECTION S 2-
,EWER
'EWER SURCHARGE _ s
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LIzd
n m m c A l_C
21 a
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rr (10
147
01-1
14-C� x 4 „_"2 G
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BUILDING PERMIT APPLICATION TIGARD DATE_-- JADI,lary 21 ,19 1. 3561
11-4 UNDERSIGNED HERFf3Y APPLIES FOR A PERMIT FOR THE N ORK HEREIN INDICATED BUILDER PHONE L__4730
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN: AND SPECIFICATIONS. OWNER PHONE —
I OT NO.
OWNER Iob Szvuels 111dr. JOBADDRESS 10390 S17 S+ereila URY -
- i ARCHITECT
ENGINEER
BUILDER qac ADDRESS -13735 _LAlvan 5t._f'ticl DESIGNER plarC,yISAxC]8q _
STRUCTURE_ Q,NEW ❑ REMODEL LI ADDITION G REPAIR ❑ RENEWAL ❑ FIRE DAMAGE _❑ DEMOLITION
[311AESIDENCE ❑ COMM C7 EDUCATIONAL ❑ GOVT ] RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE Ll STORAGE ❑ SLAB FJ FENCE
OCCUPANCY _.--__LAND USE ZONE _ R7111) BLDG.TYPE __ " FIRE ZONE - PLAN CHECK BY _dVh - HEAT
----- ,;oristn)r_L >;:i�k�.l� ��-;ily +.t'w�tlli,:�; wiL�; �° +• �i Ido Vie. �------
ane rorrection sheet atLacbed• —� — 3 bedror)ris _-
---- 2 ha t1i s
SEWER PERMIT#_ 23255 �.. - — -- -- - ----- -._ - --
OCC.LOAD 4,0 FLOOR LOAD n OHEIGHT 15 NO—STORIES -1 AREA 1.614 NO.BEDROOMS VALUE (A,200
BUILDING DEPARTMENT SET BACKS FRONT17 REAR 35 LEFT SIDE h.5 RIGHT SIDE - 5.5 - _-
Permit _ 217.00 _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
--- REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERBY AGREED THAT THE
Plan Check _
100
PlanWILL BE DONE IN ACCORL,ANCE WITH THE. PLANS AND SPECIFICATIONS AND IN COMPLIANCE
ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subdutal 325•50 j RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
--- 4. •hft LICENSE.SEPARATE PERMITS REOUIIIED FOR SEWER,PLUMBING AND HEATING.
ate Tax
— soc— crclo*ut) .- f
Tote 334.1.
-
PDC# I I lO0•�� APPL CAN�`Oq AQENT---- _--�_ _._ _ - ---
--
By
Approved
-- - riM�tT Receipt No. �Y ADE 8-- --- - PHONE-- -_.
__
I
DATE INSP. TYPE INSP -TION REMARKS PLUNIPING DATE
/ — --. ----- —_� -- - -— Contracto-
Permit No.
12
D 1'e2
7— �� ✓ u� _ Fixture -
Final -
^� HEATING
-,_ -- Contracto :��� - �o ►//�
Permit No.
Get or Oil -- — —(/
r
Rough-in
— - --"-- -- — Final --- ------
------ -- SEWER --- -- ---------
-_— -- -- Final
— -- DRIVEWAY -- -----.._.�
-- Y-- — — �--� Final
Stor n Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCL/PANCY
CERTIFICATE OCCUPANCY y() Final
Landscaping
--I Zoning Final I —
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