12010 SW SPRINGWOOD DRIVE lam
12010 SW SPRINGWOOD DRIVE
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INSPECTION NOTICE
City of Tigard Building Department
1242G S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
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Type of Inspection f
114
Date Requested _ lime 4.M. �_P.M.
Address �' �U �—�`�'�y �l P....—
Owner
ermOwner .. .. - -- - - -- Lot # _
Builder ---- _ �-----_._--- __
The following Building Code deficiencies are recuired to be corrected:
of
_ 1
Presented to -_ - Vj Approved
Inspector _ L_, Disapproved
Date
CALL FOR REINSPECTION
C_l YES jZJ NO
INSPECTION NOTICE
City of Tig&rd Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
P h o n PZ, 4171
Type of Inspection �—
Date Requested----- �� -«. _ Time A.M. -----P.M.
Address _-Cc22 .Permit #.
Owner Lot # _
Builier
The following Building Code deficiencies are required to bo corrected:
• 7 l
---'ry-'�-sem---- — - -----
Presented to - ❑ Approved
Inspector _.- g Disapproved
Date _- 7' !' =
CALL FOR REINSPECT ION
YE8 0 ;4O
1 ' .bM.�'� .'CJr�_��I11i✓�Sri _ '
CONNECTION EEEUWNER
_._ PAID BY �
TYPE OF BUILDING _� ycl DATE CONNECTED
SERVICE RATE _ INSPECTION EEE
r.nNTRACTOR _ PAID BY DATE
SIZE OF CONNECTION) ASSESSMENT PAID ____
BUILDING DEPARTMENT, TIGARL
PLUMBING PERMIT
Tualatin Valley Plumbing & Htg. Inc . holder of a valid plumbing contractors license i$
hereby authorized to cause plumbing work a$ herein noted to be installed in accordance with
the plumbing code of Tigard_ Such irStallation require inspectionby the City InSpector who
Shall be notified not ieSS than four hour prior to the time the in-Aallationf are ready for inspection.
City of Tigard Bu;;inef6 License required f,-:r all contractor:, and Sub-coniractora
Owner - Dori Hellic1Qon Addrej6 12010 SN& Springwood Dr Dace 9-6--76
Reyidentia' # of Item_ Fee on each -Total Amount Permit No
Single Family - 1 bath - each 1 $ 25. 00 $25. 00
Additiona: Bathroom - Each 1 $ 10. 00 $ 10 00
Permit $35 00
3% 1. Plumbing Contractor by ' ?
Total 3 5 Receipt No. I.,;ued by
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1NSPECTION REGUES"t
.for
iNSPEDT10N "'IME47RMi'f
DATE: ATE SJED:_._r
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CITY OP J4nw 1:' r N2 088?
3UILDING PERMIT APPLICATION TIGARD DATE__ iA.
JHE UNDERSIGNED HEREBY APPLIES EOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN QND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_— -
}Uri 'i a ADDRESS SW Sprinquuo4�LUa�J.i sILDER PHONE EtliiYlb
OWNER
jXXX2161 AP'.>,ll1111161HA RK E_NGIN_EFR Jaynoi Iiellic:kson
�EF, �jome ARCHI7 CT FF--JDESIGNER
STRUCTURE L_JNEW ❑REMOPkL OADDITION [ REPAIR ❑RENEWAL - ❑FIRE DAMAGE []DEMOLITION{,,.J REcinENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS CIPATIO ❑CAR PORT ❑GARP.GE ❑STORAGE rOSLAB ❑_ENCS
DBOND C?MOVING CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.'-PROVED LJSIGNS
HEAT—. ---.
O CUPANCV LAND USE ZONE BLDG.TYPE___ _FIRE ZONE_ PLAN CHECK BY---=r.
On8trLlct Ono ttingl• family dwslliny Lbz)i 64. ft.
sq. ft* gArfigs
-'1AqSk�eciJr'+aa�t 4both —
lb
OCC.LOAD FLOOR LOAD HEIGHT — N0.STORIES ARES — VALUE
77—
BUILDING DEPARTMENT SET BACKS FRONT — REAR — — LEFT SIDE RIGHT SIDE --
Permit
— -- — THIS PERMIT IS ISSUED SUBJECT TO THF REGULATIONS CONTAINED IN THE RUILDiNG CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED ';:AT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMITDOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUPAF.NT CITY BUSINESS
j%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Totol
By
A --- - __
Pr ANI OR AGENT — - _
Approved Receipt No
�__ ADD ES5 -- -- NO
DATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HQATING
Contractor
Permit No.
Gas or Clif
Rough-in
Final
SEWER
...............................
Final DRIVE
WAY
Final
Storm D.air igp
(Rain Drain) Final
Sidewalk
idewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY -Final
Landscaping
Zoning Final
CITY OF
BUILDING PLRMIT APPLICATION TIGA RD DATE-.--�'� t�Z� N°
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED //,, O Z
` OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND PE (CATIONS. OWNER PHONE_"� ._
AL DRESS -�w�le ERPH2NE(OZ�.��
ENGINEER
DESIGNER __
STRUCTURE NE�Y ❑REMODEL ADD
PION_ []REPAIR _❑RENEWAL ❑FIRE DAMAGE []DEMOLITION
SIDENCE [:]COMMM rJEDUCAYIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CAR PORT ❑GARAGE ❑Sl'OHAGE❑SLAB []FENCE
RE
rr--�� ('�
❑BOND El ❑CONDITIONAL USE DDESIGN REVIEW 000UNCIL APPROVED []SIGNS11
_ _ _ _ —t------_ r___
�
OCCUPANCY_ __—LAND USE ZONES=� HLDG._TYPE=, —FINE'ZONE PLAN CHEK BY_ _ HEAT 7
C _
OCC�LOAO FLOORLOAD
HEIGHT �� NO.STORIES _AREA I '„r VALUE _ (pG�
BUIL_DSNG DEPARTMENTyY SET BACKS FRONT !i O L,.&^REAR jgt7�.' U LEFT SIDES f C/ RIGHT SIDEPermit 'TG -
--- PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILIJINC ':00@, ZONING
Plan Check '��'p REGUI ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS NO SPECIFICATIONS AND IN COMPLIANC"WITH
Recordina ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- -- -- ---- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State` Q7 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND F&ATING.
Total -77 34 2 s
By _._--
�— APPL '::ANT OR AGENT
Approved > Receipt No.
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t'
UNIFIED SEWERAGE AGENCY NO. 9572
WASHINGTON COUNTY DATE June 17, 1976 _
CITY OF1 . jd -- - ---
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: -- --.- - - -_ -_ nocLMail o(son
OWNER'S ADDRESS: _
2780 SE Hol.lyhock Ct.
STREET
__Hillsboro OR _ 9712
CITY STATE ZIP
BUILDING SITE: 122BLOCK _ ADDITION
W__
x 1,p1S1-348
TAX LOT ��. __.. _________�. TYPE OF OCCUPANCY
ADDRESS _______ ._-------_____.12010 5IJ Springwood
DWELLING UNITS- _.. _ 1 FIXTURE UNITS
SURCHARGE IF APPLICABLE
PLFiMIT FEE _ -_ 550. 00 25.00 575. 00
INSPECTION FEE ___ .__ TOTAL DE70SITED ._
(NEW_ (EXIII-ING) BUILDING SEWER SYSTEM ___ Farlqn �reBk__
The Applicant agrees to comply with ali rules and regulations of the Unified Sewerage Agency.
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE ___ _ _ INSTALLER
RECEIVED BY. -
IAGENCY OR ITS AGENT)
COMMENTS: BJ.dc�. ;y' 0882
This Application and permit expires in ninet%;., (90) c'ays. The amount paid will he forfeited
should expiration occur.
-rases
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City of Tigard ►Mechanical Permit —��`1
ermit OC
Fee c,
New installation Replace ❑ Relocation Q Addition ❑ Alteration ❑
TOTAL
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CONTRACTOR r,`�/C/ l: S /���fJl1 OWNER
ADDRESS �� ~j, �i G/<< WORK A DRESS `) ' f vUtX �•
ry
PHONE { —/� `> �!- APPLICANT
Heat Input Rating (BTU 'er Hour) Vent Size, Flue Size
FUEL OIL ❑ GAS ET ELECT OTHER
ITEM NO. FEE ITEM NO. FEE
For issuance of Permit 3.00 i, Boilers Over 50 Ho ' 25.00
New - Under 100.0(`) BTU I 4.00 Air Handling 10,000 CFM 3.00
New - Over 100,030 BTU 5.00 Air i fandlhnq Over 10,000 CFM 5.00
Floor Furnace 4.00 Evaporative Cooler _1 i 3.00
Wail - Floor - Suspended 4.00 Vent Fan k 2.00
Install Vents 2.00 Vent. Syster, 3,00
Repair - Heat & Couiing 4.00 Hood 3.00
Boilers Under :1 HP 4.1%C ji Domestic Incinerator
Boilers 3 to 15 HP 750 Comm. Incinerator �^0
Boilers 15 to 30 HP 10.00 Other Not Listed 3.00
Boilers 30 to 50 HP 15.00
INSPECTOR'S COMMENTS
CIT'! BUSINESS LICENSE REQUIRED FOP. ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY DATE ISSUED BY ATE
RECEIP 40.
"` Signature of Applicant
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