11615 SW SPRINGWOOD DRIVE 11615 SW .,PRIN(-;WOOD DRIVL
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CONNECTIC.N FEE
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PAID BY
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r P C OF E':I i-DING ..__mac< -n,c_.•-
tRVICE RATE -- -- ___ _--- . _ Iti�PECTION FEf.
PAID BY _ DATE
CONTRACTOR
SIZE D, .u')NLCTION
ASSESSf'�ENT PAID
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: `2 PIERMIT NO. :----
DATE '
O. :_..__--..DATE : // 1 s/ DATE ISSUED . -_LL_
OWNERS N!'M E : _i__ ^' 74( -
ADDRESS: #-
CONTRACTOR - 6--e—` -14)"EST '. Air El, W4.er[] , Visual Laboratory [p
9ESULT : Aipproved DisapproveJ C Fending []
SKETCH.
INSPECTOR DATE
rMOtE : Attach suppiemental test data bereta�
I
i
City of Tigard
NSP'ECTION REQUEST
- ford
��— i'ION TIME: ='2_ PERMIT NO. : I Ir
INSPECTION
DATE: !2 l/,,n6 DATE ISSUED —_1_.!
OWNERS NAME : �f � — -- i C
ADDRESS:
CONTRACTOR : .
TEST : Air ❑, Water 0 , Visual;EY, Laboratory [3RESUL . Approved ❑ , DiaapproII s Peldinp []
SKETCH: �
6
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INSPECTOR DATE
CN079: A/tach eupnlereental test data hereto I
I
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: ._ - PERMIT NO. :--_.----
DAT E: DATE ISSUED . ......I---
OWNERS NAME . 4v7- 2-
_- --.
ADDRESS: S u.�. �,"� ,Jb?��1�-- -
CONTRA^TORTEST * Air CJ, Water g, ViRval �, Loboratory Cl
RESULT: Approved`I , Disapproved C , Pending ❑ _
SKETCH:
INSPECTOR DATE
1-OtI! : Attach supolementw test data be►tto]
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CITY OP
BUILDING PERMIT APPLICATION TIG►ARD q
DATE�___ ., 19 �� � �”
12
THE UNDERSIGNED HEREB'r APPLIES FOR APERMIT FO 1 THE WORK HEREIN INDICATED 297-4521
OR AS SHOWN AND APPROVED IN HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHHONF
,l t i_..t1. , r ;-Q. : i it�'.; ;i.i R aily�biOl/�+ �l r 'e-
OWNER _ ADDRESS BUILDER PHONE
ENGINEER Oel1ign Sarvice Portland
F1llLLf2FR r-1 -1 CIARCtIItECTV DESIGNER
O -_
STRUCTURE NEW ❑REMODEL_ ADDITIONY^_❑REPAIR ❑RENEWAL —_❑FIRE_DAMAGE ❑DEMOLITION
El �R'--EISIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PAI'10 ❑CARPORT OGARAGE ❑STORAGE❑SLAB ❑FENCE
LJHOND ❑MOVING L-ICONDITIONAL('SE ❑DESIGN REVIEW OCOUNCIL APPROVED ❑SIC NS _
OCCUPANCY-_ LAND USE ZONE. _BLDG.TYPE---FIRE ZONE__. PLAN CHECK BY HEAT_
Lorlatrul.t si.iVIe story lwsllltr., 14i / "q. ff.. rrci m4, f'L•,
gatage d bath 3 Qalad>r'lora —_—
OCC•LOAD 4_ FLOOR LOAD All lb HEIGHT NO.STORIES 1 ARRA 1776 VALI_ r 310220.
BUILDING DEPARTMENT SET BACKS FRONT dl�! REAR �I.� LEFT SIDE 13" 6II RIGHTSIDE ,'3- 6"
Pe�'mit 13:x.('ICi — ----._�_
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10100 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DUNE IN ACCORDANCE WIl N THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State 4#29 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. /
Total !.4 7. 29
By
AEG' qNT OR AGENT� �
Approved -_-�_, -- RNr,mlit No
ADDRESS - Prim.-
DATE iASP. TYPE INSPEC".'ION REMARKS PLUMBING DATE
Contractor
i ------ �—
/ 2o�A. - nit No. S/ _ 3G O. 712 /7,
7i Ruuc�h in — --
Q�� Fixture
Final _
HEATING
aM,t]— p- Contractor
L i � CA r it No.
�6�,1 _ C�•x J Gas or Oil -- —
Finalif 11 1 —
ay SEWERf-N 76 LZ,-t-'
Final
U/� __ _— DRIVEWAY All-
Final
�L 1 j
Final
-- ---- ---- -- ------- Storm Chain_ aye --- -
(Rain Drain) Final
Sidewalk
Curb&Street Final _
------ _----_. ra roami-
BLDG.DEPT. FINAL. TEMPORARY CERTIFICATE OCCUPANCY Final
6 CERTIFICATE OCCUPANCY _---
/� Landscaping
Zoning FinalRIP ow, w
--"------___---- ---
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Y
`:`;'��� "''� `; ,��:��r„ ,,:#t�ttti'' �hn�h� ia1'1!ria'yN�l � ., to h ;t��.L�'��5�� ••11c} IisI.��WIit!lMHM: . : ,
UNIFIED SEW1(ERAG' E AGENCY NO. 9586___
WASHINGTON COUNTY DATE July 129 1976
C,I T Y O F ._- T j.t; j r d - - - - -- -----
APPI ICA I-ION FOR SEWER ('.ONNECT!ON PERMIT
OWNER: _ --- A.rt I z__& Co._,_-_ _- -
OWNER'S ADDRESS: __
_ _ - ---__ ----- -- - — —
STREET
-------- CITY --- ------___.�______.-- STATE ----_..^------- - .'iP
BUILDING SITE: LOT_._ __. ___ BLOCK - ADDITION
TAX LOT NO. — --- - TYPE OF OCCUF ____ residence
ADDRESS 1165__5W Springwood Dr.- _
DWELLING UNITS . 1 .--.-----.-.-----.- - FIXTURE UNITS
SURCHARGE IF E.kPPLICABLE .----_
PERMIT FEEINSPECTION FEE 25-t.0- TOTAL DEPOSITED _ G00_JL00
(NEW)-- (EXISTING) BUILDING SEWER SYSTEM _._ - ._. .__Fanno Creek
The Applicant agrees to comply with all rules and ret"ulations o he Unified Sewerage Agency.
APPLICA _.. 16L
SEWER PE13N(II-T-
THIS PERMIT AUTHORIZES CONNECTION TO THE SEW' I SYSTEM.
LINE SIZE _. . - - - INSTALLER ----- - - ---- .. __ _
R E C E I V D BY _ . ZX4_11,1 ` 4,1
� `—-------
1AGENCY OR ITS AGENT)
COMMENTS: 01dg. # 0912
This Application and permit expires in ninety (90) days, The amount paid will be forfeited
should expiration occur.
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City of 3i�drd Mechanical Permit ��,; Permit $3.00
New 'nstallatien -Ir Replace ❑ Relocation ❑ Addition ❑ Alteration ❑ Fee— —
�'�+
�+ TOTAL ,
CONTRACTOR, samr grri P��WRING & HEAT,f\U OWNER -�-( .
ADDRESS 17005 N. VV. CORNNELL RD. WOK ADDRESS
BEA - r
PHONE ' APPLICANT ._ um])lrq eQ}jn?-,
Heat Input Rating (BTU Per Hour) ( Vent Size �' Fire Size <'11'
FUEL OIL C' OAS ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FEE_
For i-suance of Permit 3.00 Boilers Over 50 HP 5 nn
New - Under 100,000 BTU 1 4.00 M Air Handling 10,000 CFM 3.00
New - Over 100,000 BTU 5.00 Air Handling Over 10,000 CFM_ .5.00
Floor Furnace 4.00 Evaporative Cooler i 3.00
Wall - Floor - Suspended 4.00 Vent Fan i 2.00
Insta:'I Vents 2.00 Vent System 1 3.00
Repair - Heat & Cooling 4_^0 Hood I 3.00
Boilers Under 3 :AP 4.00 Domestic Incinerator _ 5.00
Boilers 3 to 15 HP 7.50 Comm. Incinerator I 20.00
Boilers 15 to 30 HP 1 10.00 Other Not Listed 3.00
i:-)ilers 3f to 50 HP 15.00
INSPECTOR'S COMMENTS_ _
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SL--CONTRACTO S
11
APPROVED BY DATE ISSUED BY DATE
RECENT NO.
"{ Si a Jre of Applicant
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