11950 SW SPRINGWOOD DRIVE 11950 SW SPRINGADOD D1IIVE
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` ......Permit No... 3
11950 SW Spri.n.4.wood-..Dry................. . )' •r
�.- Building Address. ............................... . ........ . .
Certificate is h-reby given this.....1. ........flay of... ,.Ap.r4............... 19_77.... k
tr at said building may be occupied and
4C` that it complies with all requirements of i
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
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BUILDING DEPAR T MERfT, TIC:ARD
NO.
PLUMBING Pc:Pr,IT
Tualatin Valley Flumbing & Heating Inc. holder of a valid p!,-Imbing contrac,ors iicense is hereby
authorized to cause p!urnbin3 work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the :Ly inspector who s )jil be notified not less than four
(4) hours prior tr, the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Tigard
Owner Wayne Helli ckson Addresi L930 ll Ser ingiynod-D-r_ Date h-21-76
NUMBER OF ! TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Oniv)
� RESiDENTIA
Single Famiiv-1 bsth—east: I 1 25.0025. 00
Dui3lex—Each 1 bath uni; 25.00
Additiona! bath rooTs—escti 1 10,00 � 10. 00 l
l Moaile Home Space—each 15.00
INDIVIDUAL FIXTURE FEES
1 to 5C Fixtures in 1 e uildi —each 3.00
51 to 100 Fixtures in 1 budding—each 2.50
101 to 200 Fixtures in t building—each 2,00
2C1 cr more Fixtures in 1 buildia —each ! 1.50
MISCELLANEOUS
Buiidino Sewer—%t 50 t. 10.00
�--Se—w.--each 3dditiunal 100 ft. 10.00
I.—Wale,r Service to bui!dpN 5.00 I
Private Via P,S stens—each 10C ft. 10.00
Other i5 i. I:
PE R W T 35. 00 For Plumbing in-gwt7on Phone 6.39-4191
'% State 1. 0 5 1 Plumbing Contractor By( �G' ✓�
[_TOTAL 36- 05 ! RECEIPT NO. Issued Py
WuW"c^'ra •ww.aw�wrsiw�R
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE june rs ---- » '� H° 0873
TNF UNDERSIGNED HEREBY APPLIES FOR APFRMIT FOR THE WORK HEREIN INDICATED OWNEFJPHONb 640-7566
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIQNbr
OWNER v.ueyns HIiIlLckmun ADDNESS :;i.)2 N*E:o itith ft1118LIurc BUILDERPHONE____
ENGINEER I
.)on Alexander DESIGNER
911H—
SameQfY18 AR;HITECT�11.QF. tt
STRUCTURE Lrr��!!JNEW _ ❑REMODFI_ 0ADDII'ON ,^OREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCE UCOMM OEDUCATIONAL ❑GOV'T ❑RE:IGIOUSOPATIO_OCARPORT ❑GARAGE ❑SIORAGEL.ISLAB ❑FENCE
eBOND []MOVING ❑CONDITIONAL USE DESIGN REVIEW []COUNCIL APPROVED ❑SIGNS r
—�- I I
OCCUPANCY I LAND USE ZONE � BLDG.TYPE-. __FIRE ZONE� PLAN CHECK BY ET HEAT
,;unutruri x•`J"!l uq. ' frame 1;Jt,e1-1.1IIE,j w/ ettaeohed garage No tIga emilnt
t1e�-1�ssu�r I bedraumax
1571
OCC. LOAD 5 FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT2n1-0 36,M 12*939 _ fig--0
_SET BACKS FRONT REAR LFFT SIDE RIGHT SIDE
Permit 133,00 -_--
- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10,0111 F:EGULA'rIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
WORK WILL BL DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State 3199 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
. Total 146.99
BY ---------- - __
•,Y_ n!'� 'ANT OR AGENT
Approved Receipt No.
AnUnrEss —��-- HON:
R`�MARKS PLUMBING DATE
DATE INSP. TYPE INSPECTION — — —� -
Contractor
7/z 17
Permit No.
Fixture �—
Final _ _ __--.---
HEATING
ootractor 2 �! j74
yf Permit No. �
' � Gas or Oil
Rough-in ---
Final
SEWER a7 ;
Final_
- DRIVEWAY
Final _ --
Storm Drainage
(Rain Drain) Final
Sidewalk
Ctna
b&Street Final
h_ _
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY _
CERTIFICATE OCCUPANCY —ing
(� inal C
I
TIN
CITY OF
BUILDING PEWIT APPLICATION TIGARD DATE,
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYINGEIFIC S. OWNER PHONE
OFN_VER�_�/✓W_!�J J /C�ADDRESS .3 e�/��E_�sT/� N/�a. UIL.DCR PHONE
D ENGINEER _
;tiJll J?ER -����' ------___--------A�1ET
TE
,�STTRRULrUHE _ !_JNEW OREMODEL -OADDITION OREPAIR ORENEWAL FIRE DAMAGE ❑DEMOLITION
hJRESIDENCE [COMM OEDUCATIONAL�OGOV'T ORELIGIOUSC1PAr10 OCARPORT OGARAGE OSTORAGE OSLAS OFENC5
_QBOND , _-DMOVING ❑rorwITIONAL USE ❑DESIGN REVIEW— ❑COUNCIL APPROVED _ CISIGNS-
OCCUPANCY----Ir_LANG LSF e-ONE.�_� .--_._BLDG.TYPE� _ FIRE ZONE PLAN CHECK BY HEAT—
A.
Q_QC,LFl,OOR.LOAD �1 HEIGHT + � NO,STORIES AREA ?I VALU 'J_
BUILDING D T1Al10}'^ SET BA_CK5 _FRONT /� HEAR Q� — V LEFT SIDEy� RIGHT SIDE
Permit �� -
-- - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE DUIL7ING CODE, ZONING
Plan Check r1 C1!J REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recordin-, ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONT %A,;TOR AND SUB CON'rRACTO.46 TO HAVE CURRI.NT CITY BUSINESS
State G9 LICENSE.SEPARATE PERMITS W ktUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
APPL.ICAN?OR AOFNT
Approved r Receipt No.
ADDRESS ^P-NO'VE
`ll�
ONY �S7l
P.
6 A A' ?I., rNs
COV.P�lve
S.w
1-�S*
V. %-V,le,Ye
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7 s
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City of Tigard Mechanical Permit ��I° C��J' Permit $3.00
s;as
New Installation Replace n Relocation ❑ Addition ❑ Alteration U Fee
TOTAL 3
J
CONTRACTOR _ �1 OWNER_Is���/�'tC-�T�%l'�ic -Y c_)P,
ADDRESSeO WORK ADDRESS /L�7 �—L' S./_.I S.•�/'t1`' DUU1 �12,
PHONE <<`� — I�5 APPLICANT
Heat !nowt Rating (BTU Per Hour) Ven:Size s Flue Size
FUEL OIL _1 GAS 2' ELECT G OTHER_
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit 3.00 k Boilers Over 50 HP 25 0
New - Under 100,000 BTi 1 4.00 Air Handling 1G,000 CFM 3.00
New - Over 100,000 BTU 5.00 I Air Handiing Over 10,000 CFM 5.00
Floor Furnace 4.00 Evaporative Cooler 3.00
Wa I - F'oor - Suspended 1 4.00 Vent Fan 2.00
install Vents 2.00 Vent System ' 3.00
Repair - Heat & Cooling 4.v0 Hood 3.00
Boilers Under 3 HP 4.00 11 Domestic Incinerator 5,00_
Bailers 3 to 15 HP 7.50 Comm. incinerator A 20.00
Boilers 15 to 30 H.P 10.00 Other Not Listed _ 3-00
Boilers 30 to 50 HP It 15.00
!NSPECTOR'S COMMENTS
CITU BUSINESS LICENSE REQUIRED FORALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY DATE ISSUED BY DATE
RECEIPT NO. /1
"' Signature of Applicant L
�4
C7
PERMIT
• ov
UUNF:R .T� --��,� ,� C0NNEC7ION FEE -
PAID BY
TYPE OF BUILD114G DATE CONNECTED
SERVICE RATE �/S;l�_�_____
INSPECTION FEE
CONTRACTOR
PAID BY DATE
_ _� __ __ _�.___._
SI1_E OF CONNECTION _..
ASSESSMENT - PAID
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