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12676 SW SORREL DOCK COURT-1 12676 SW Sorrell Dock Ct. I i �I 1 C'N®F T IIVA M[-e-C9 0--0 114 WY OF TWARD) F:MI T #. . . . . . .. G0M%:1JNrTY DEVELOPR' ,'NT DEPARTMENT oaEaww FIRIM. 'PERNI'T' 4. InE C90-01.1.4 13125 SW Ha Blvd. P.O.Box 21397.TV j Ore(pn 91223 16011 09-4175 D01E ISSUED-. f t.., W'.) oU;,0%L,L, J.,L,L-.. 1- i D SLJNMF'.RLi)KL-: ZONING', R....7 . . . . .. . . . . . M I CH . ............ ...... .......... C., 01:.4F�U(1.171 COOLERS". W U R K,, FLOOR FURII-, VE111' FANS. L OF USE. . . . ..S L)N I T H E F: k)EN'T' SYSI'EVIS". OCTUP(INCY %GRI',- VEHI'S) W/O OPPL.- Si FOR I ES.. L.Lt G/(`C-)VI PR ES 0['05 HOODC'. 0....3 IAF . .. DOMES. IrKllhk 15 HP. ("WIML. 1Ht"Thl." W-lx DIPL11' '" BI'U 1.r5-':30 HFI. R.E PO IR U 11 T T 13 ODS1*OvkG- 3 IRE DAMPLIRr W0 0 D D R Y R 8 GOG I:)RLS1,'-.)URL. . . I: 1,,10 C.)F U N I I'S A YN H F'1 N 1)L. (.044 ER UNITS. 1--'I.)Rlq ( 1-00K Ot! 10000 0 UTL E..T 6. F1IRN )!t-1@1WJK FI'T'(.): > t0000 c!filln F E K S 0 W rl(A? 1.)e fA III C)t A 11 t by &P.t V� 'VQC I 15. 2, JL.H 1,2676 6W SORRE".L. DLJLI'� 1.4.. 50 W. 73 T' I'GORD m 04:: BLL.I. HEW'ING INC., , ................. ul-('I(111-1�11(ls C)R 13q t,: 0". r'1 Ia W— 61 44 I�jjj T W U I RED INSPEC .1O Thi: permit is issued Subject to the regulations contained n the F :I.I I o J. T II':;I:)P C,-ti. ------- Tigard Municipal Code, State of Ore. Specialty Codes and all other appljzaJ;e lass. All work, ail: be June in accordance with ...... .................. ........ ...... appTuved I,(anF,. This pertit will expire if worI-, is not started ..........11............ ....... within 180 da,s of issuance. 9- ill work is suspended for more ... ..........I I.—I......... thar 188 days. ............. ........................ .......... ................ ................... 11c.-�vIIIj..ttPe ........ . ..... ....................................... ... ........ ....... .... ............... ,.W.._...................__...._.......... ............... .... Cal'I fo-r J,juptctian MENOMONEE wlwxmu ,I �—I TY (IF T T ARD F=::f `:E:"I F'7 OF PAYMENT RECEIPT NO. t 75.t CHECK AMOUNT a i r. 27t IVAME y SELL HEATING CASH AMOUNT t 0. i►�'� �yp!AETS a 15550 SE F`'T AZ is A AvE: PAYMENT DATE: SUBDIVISTON t CLACKAMAS. OR Y7 t)15- l2676 EDW SORREL DOCP. I F ;!RPCII�A' OF PAYMENT AMOUN1 PAID PURPOSE OF PAYME:I IT AMOUNT PAID i i I TOTAL. G•N`1(_IIJNT PAID I 1/�rs�ri 9 i CITY OF TIGARD � � ;¢� ■ OREGON ' • , `'I. Don Morissette Permit No. 89179 Owner: � � a address PC' Box 19524, Portland, OR 97219 yY Bulil:ing:'sddress: 2LIESw Sorrel mak Ct w - , Occupancy: R1 Land Use Zone: g�pn Bldg. Type �;^� f; `� ? _ - gComments: pq sF tl Certifir.ate is hereby given this_2cxd —day of 19 _ s a . that said building may be occupied and that it complies with all i; Building Col--e for the City of Tigard, as approved requirements of the ' . by the Tigard City Council. t vire Dept. _Building Inspector BuildingOfficial Post Certificate in Conspicuous Place .=' Ili N'02!! 6?' Y.� #�R ,•'':�•`''+. �,!.�.vE.@' t�: � `-y - � Z.- '. rwl .- , Ih. o ,,• ...,fir ��z{x-;�''�^' ��..> '..f".rf � w.d?;. ��.'"'y�`�`.C�l�a-a�>,;vPx �r �'�{ .x%'•�.�' �'r,'"yab��L�' "" y,',, ��.'' � `,$ �,7"_�'�G'v' :at•�a'''" `Fy:<. .r'' � Bey ��= ^.��.,��^�f��'_��\-/ `"a"'l�-= INSNXTION NOTICE C,ty of Tigard Building Department R.Q. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Fi..a 1 Date Requested 6/2/89 Time A.M. .- -.__-_P.M. Aidress 12676 SW Sorrel Dock Ccurt Permit # .._ 89-0179 Owner Don Morissette _ Lot # Builder The following Builr';na Code deficiencies are requires to he corrected: ------ Presented to u APP►aved_ Inspector — � _ -------__ ❑ Oisepproved Date CALL FOR REINSPECTION 0 YES ❑ NO w w w w w w w INSPECTION NOTICE City of l igard Building Department 1� P.0 Box 23397 Tigard, Oregon 97223 I Phone: 639-4175 Typa of Inspection __ `� J -� C____. Date Li Requested �—_—__'Gt Time A.M. P.M. Ad7dress _ G _. 2 Y / �� L I�— Permit fik C� z Owner --__ Lot #t Builder1 � —The following Building Code deficiencies are required to he corrected: Presenter) to ___- -_ _— �'I Approved Inspector _ n Disapproved Date `.��`" U— CALL FOR REINSPECTION YES 111 NO INSPECTION NOTICE City of Tigard Building Department ( ! P.U. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 r Type of Inspection T -- Date Requested) �� ' �" G, ,Time A.M. _ P.M. Address i �� )t!)y 1� i � Permit # u 70 Owner `_ __. Lot Builder � ly L - The following Building Code deficiencies are required to bo corrected: Presented to �_�. _ -_ 7' Appoved Inspector _ .� ❑ Disapproved Date S CALL FOR REINSPECTION ❑ YES ❑ NO INSPECTION NOTICE City of Tigard Building Department r �� 1/ ►Y� P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection �y�=-------- / `r Date Requested -) "U/ _. Tim _ (yam� A.M._ P.M. Address _:'� �_ l��rG Peamit #-c� Owner _ Lot # Builder ' The following Building Code deficiencies are required to be corrected: Presented to - -_ - - -- APA ed Inspector Disapproved Date CALL FO�INSPECTION YES ❑ NO INSPE'MON NOTICE City of Tigard Builaing 'Department P.O. Box 23397 l Tigard, Oregon 97223 Phon(: 639-4175 Tyre of Inspection Date Requested_—__ _ Time—�_ A.M. _ _P.M. Address 1 . k Permit -- Owner Lot # Builder --- The following Building lode deficiencic s are required to be corrected: Presented to __ _ Approved Inspector _JYt �'] u�sap' roved Date __— CALL FOR JUEINSPECTION YES C=7 NO FIRM INSPECTION NOTICE City of Tigard Building Department "" P O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 r Type of Inspection Alak fir //��_ /•'}�� J ��-(� Date Requested - `� ��C _____ Time A.M. P.M. 7 cc' r Address Y�tF� ��-,� ? _ �� - permit � � � 7 Builder ►�<;The following Building Code deficiencies are requited to be corrected: Presented to proved Inspertor ~ - Date CALL FOR REINSPEC71ON ❑ YES ❑ NO INSPECTION NOTICE City of Tigard Building Department .� P.Q Box 23397 Tigard, Oregon 97223 Phone: 639-4175 'Type of Inspection NC- l_ryLC_ Date Requested me A.M. P.M. GG1 Address � � h L.11)}'Y-Y I I « Permit # � Owner_ __ Lot # Builder l0L I L _t_ 1 1— _ _..____--- The following�Building Code Viciencies are required to be corrected: ate- J. C6yirlrcJ 4 - jIF u Presented to "^proved Inspector it1�A �� ❑ Disapproved IF Date CALL POR REINSPECTION s 0 NO -- - AM L. r i INSPECTION NOTICE City of Tigard Building Department /� �J•� P.O. Box 23397 Tigard, Oregon 97223 Phone: 639-4175 Type of Inspection Date Requested �r _ Time K A.-M._ P.M./ \ / �� 7� �[� -. _ Permit # A•fdress 1 Lot owner #_ Builder uCNl The following Building Code deficiencies are required to be corrected: Presented to _ Approved Inspector _ '��"'� �_� Disapproved Date CALL COR REINSPECTION ❑ YES C.1 NO INSPECTION NOTICE C : � City of Tigard Building Department IU� P.O. Box 23397 VV Tigard, Oregon 97223 Phone 639-4175 Type of Inspections 11+x•1' —_aX DAMP. Requested_ (�,a� a� Time ,�.�� A.M. P.M. Address / `� �� > QC.11� Permit At Owner._ LOt # Builder.5t�--�f � O The `.ollovving Building Code deficiencies gre required to he corrected: Presented to [Approved Inspector L-_L_______. ❑ Disapproved Date CALL FOR REINSPECTION CJ Yes 0 NA ssy I I INSPECTION NOTICE City of Tigard Building Department i P.O. Sox 23397 C TlgE•d, Oregon 97222 Phone: 6.39-4175 c Type of Inspection pate Requested I(C1'�5 I Time A.M. P.M. % Address Permit # Owner lot # �� Builder The following Building Code deficiencies are required to be corrected: Presented to C;-pproved Inspector ❑ Dlsepproved Date CALL, FOR REINSPECTION Cl YES ll NO i INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phona: 639-4175 Type of Inspection __ l� �r�-- —--- Date Requested Time N.M.v P.M. Address � �c? ePermit # Owner _-. —__� lot #— Builder Thn following Building Code deficiencies are required to he corrected: i Presented t i Approved Inspector —_. __ --___--� Disapproved Date &d FOR REINSPECTION E-1 YE! C7 NO CITY OF T'VARDIa(.la:l..l)a:N(:y PEPM.I. I Pl::'PMT*7 NO . B(JIL-1901.19 z C17YOFTWARD 4 OR COMMUNITY DIEVELOPMENT DEPARTMENT 13125 S.W.Hall Blvd.P.O I )x 23397,Tigard.Oregon 97223,(5031639-41'15 1:)A T E 5 5 I : 1 .M.:1.) —1--- \,:� I's I'J)DPFG!5 . 1.2676 W 15014'4 DOCK LT, IAX 11166IPLAYT, 1.51 XAI)D 1.M1100 !;;IIM11II;:J4l AKE Vol-A 1.6:1. 1 EAAG105 FAUN T ; 20 REAP; 1.0 : -T : NE.14 DWEIA... . UNT 1'!5 : J. LAH:F. NO . I EK X 1 4)A- I I LIONK-0 N"i I T VN NO. L'-.'A f*1-05 N E: W kJ."LIP . (.!!I, P N '10,1 A 1.. A 1:4 1;::A J.R-5 0 NO ':i 1111: 1 ,. 1A5 11' . (',X.)N5'r : C F':C PF. 1:4 1.:1, If.?0 N D . 1. *-.!7 0 A P E::A 5 li-;:V`1.)P I? PAT U,1). C)C(Aff". PATIED: L.OAD /10 l,60 F I RK b 1:,*,P It I P? Al APMI? 1:!I—Ow(UOPM) 0 r.Tl---:C."t"? Yl F i fill. Il.oill-k:1 Ili'l (.-.:Y. Ll OF' NO . 0 II W N 6N P,1:.1 1.1:W E I Ax 9 fill.0 00 C 0 1`101 I Yll: DON N q0 T 17(71! l"t I I I I ':I I I f 1'. 1.:1 I'l,1 R f C) I::;1 X I $6 0 0 0 A Ili 0 00 C 1: P E.,1-:1 AT 1") < 11.:1.00 . 00', T 1 0 y I tqj t111 F0,TAL. 4111. 1 67/1 70 This permit is issued subject to the regulations contained in Title 1,4 T N0 3 C) of the TMC. State of Oregon Specialty Codes, zoning regulations .............. and all other applicable codes and ordinances, and it is hereby agreed that the work will be done in accordance with the plans and 1 17(:11 1.N(•) 1AUE 1.4 specifications and in compliance with all applicable codes and I CJ N D 1.)11.0 N WALL. ordinances The issuance of this permit does not waive restrictive I rk [00'.Am covenants Contractor and subcontractors shall have rurrent city business tax permits This permit will expire and become null and I''1. 1:' I JNDI:A;4SI-Al;) I y o 1::, 1:4 C I-I I SW void it work is not started within 180 days,or it work Is suspended or !:)1 61." F'.I:N01- abandoned for a period of 180 days any time after work has 1:11 11 FOC-I(A.)T commenced It shall be the responsibility of the permittee to assure all required inspections are requested and approved Permittee iignatun� i 1:40AP11) Issued By 7T1F—T—Rri—ii , I 'FON 639—A1 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE PE.PM11, '1Y OF T'0A RD1�'fi:GaMa: NO cffyor D 1-0001 ) A*YE:* I*.1-)5kA::0 : CITYO� ID COMMUNITY DEVELOPMENT DEPARTMENT 1:11 M. VIM I NO (3901.79 .3125 S.W.Hall Blvd..P.O.Box 23397,Tigard.Oregon 91223.(503)6394175 GW S431:4,61, CIT 3,'3LA* : P9 HIK ! (.�L) 'I.Alt!) !'AJH P'l P 171 TW V, :I'W W(')Pi< GLA%5 : NEM liGE. TYPE". : 153:11SIL.-III-E r"AMIL.Y III- ill-ppiif ialit lacli,erp.-ill I'll witI'l (:).p Vic- Unified jell-1c.'y T'he poirinit, 1.20 (:jlILyl% -111-c)m -t.he daL-t,(--.q imllicled . T h 1I.-I Lu t a 3. 34' 01co! %iol-M viewe.41' I.aLtol-4-11s . I.I., the %ewer' i% 1tic.-altv')d 14.Lt Lhk� M"I I 'M fill 11"fillink'Hit 0.1ce 3 J (- ljjt,wt:j , .1cit If,(:) T , in. d:1.r laild £iide ill.rid t'1*1 ol A j a 11(-'Y W-L:1.1 m :1.ilk *.I r ni . L -rrTTT-rT71qF. TF:NANT :j:M1::,IAAJI::J#W::N'1 I ., TUPP.: UNITG . I.1W10-LA:NG IWIITT!5 LAW $315 . 00 0 0 . 00 �Nrql I I 10N $1. io N E R $360 . 00 DON 0 M(.)I.*" r4:)!:il::.f'l'l-*..,. RLI7:1..AAKA-445 i:i�l N T lac! BOX R A C 1:1.-IONFF. (!l$03) T NO 3!'5!l'33 011. ,(49!5 00 0 171 NO , /0'�C) 12- .................................. This permit is issued subject to the regulations contained in Title 14 of the TMC. state of Oregon Specialty Codes•zoning regulations it. ul.I I 1::1. 1) :1: K ON5 and all other applicable codes and ordinances. and it is hereby 111,1 I . ,IN agreed that the work wili be done in accordance with the plans and specifications and In compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive covenants. Contractor and subcontracto•s shall have current city business tax permits.This permit will expire and become null ani void if work is not started within 180 days,or if work is suspended or ,abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permittee to assurr, all required inspections are requested and approved Permittee Signature c '40 N ol-4 Issued By ;1 4—) I SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE CRY OF TIGA RD NO . : 11-1 090i.259 COMMUNITY DEVELOPMENT DEPARTMENT 13125 S.W.Hall Blvd..P.O.Box 23397,Tigutd.Oregon 97223,(503)6394175 I"A111M . PMT .NO . 13901.79 1.2676 1:1W 'AA-WI L. DOCK 3 V -l< LT :P-9 r-411.1 1$1 . "5AD lZI000 !A.JV! . 5UMME -ILO 1�:- NO : tJl WORK CL ASS : Nl:::W 1616TEA:4 CI OS 1:::T 3 T PAP 0:51::' 51W31 1;:: 1.:,(.)M:i LA, URAA611... E)KF:1 OW PPVNrP CONST . I VN A W.)PA'IORY 13 "16F, P*'P:I.MI!;J'4 P.3 I'LJO iii-K)WEA"I 3 G'oRr-:A!:iE TPAPS D.E.!ii IAWA!ii IAE.P I. N0 . !'5'T JPTE:'.S . P. W(11!:;I--I*I:ljq(*,-, MA('.'.IAXNE: J. DWEA.A.. . I.1N:1T!:i : 1. 1 AUNDPY VRA 1111 131 UG . I)PA1N (I)TA F:'1...(:0r1 UPATN 51NK 1. SEMEN-1 (FT) WATEP VIEWTIE'V4 .1. 0 1,10 1 GA: I I Li: IMP *1410 , 00 W I.)13 I*-A:)X N 1:)c)I-1hillicl C)I' E R TAX 1117 . 0 11 P C I.-IIAPOLD 0 1:'I-f01ii.M6KI`:.IV5 1:1 UMEA:W, N T 1:)c) IROX (.2!50 R ,4. A 9*70r?"'I C PI.-IONFE. (!-*5015) 6:'50-772.0 T 0 NO . '39P'r? Al 10 1,-17 0 o PEX.Aii: I'PT NO f-' ...................... ......................... ............... This permit is issued subject to the regulations rortaineo in 1 itle 14 of the TMC, State of Oregon Specialty Codes, zoning regulations 1:,'l 1 i 1 0 N!.i PlIEC1 J:0W."i and all other applicable codes and ordinances, and it is hereby U N L)E PS L.(.113 agreed that the Work will be done In accordance with the plans and I I) a 1:4E AM specifications and In compliance with all applicable nodes and WO)"11:3-1 1 1:Nl:;*. ordinances. The Issuance of this permit does nM waive restrictive covenants. Contractor and subcontractors shp,11 have current city business tax permits. This permit will expire and become null and PAJEN DPAJAS void it work is not started within 180 days,or if work Is suspended or FTNOI.. abandoned for a period of 180 days any time after work has commenced.It shall be the responsibility of the permittee to assure all required Inspections are requested and approved Permittee 6� *'4� Issued By )tl—1 FOP TN5I:-IFA:"'I :I.0N SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE PLAMIT PEAKET E89 NU. M0260 CITY OF TIGrARD CITY&'t'WARD C) Olga 7FC DN OATE: 1.4/09 COMMUNITY DEVELOPMENT DEPARTMENT / 11-"RTMJ)MT' .N0 . 8901,19 13125SW Hall Blvd,P.O Box 23397.T!gard,Oregon 97223.(503)639AI75 0.2676 !:M ISi. AMU) 1/1000 !Alti, !i)LJhfU-.VII.AKU' 21? UK : I AND I,FiE' 1.4 1 1-11 VA : NO : I- U P N A Crii. <I K .1. ATH VIANDL.P <10 f)1"1 1,0010- A- 11:4 1-40N17LA 10K V(,)I:A . U)OL E.34 I Y I,I!:. UN liA 001.4 r-;'t.JPN0 (', 1;;, Ali:f, VEN 11' 1: AN )T EK I Vl:::N't' Vl;::N'l . SYSTEM HOW) P/(,.;0MV, 3-1."I.WR) :I.N(A:NE::PA 1 LM( 1:)('.)M l)AJF*I I... . I)NTT IS : 1. 01 ((:(:)M 14J."A.I.14 UNJAS 131_1:4 COMI., 30.-!)0I--IP i"IX INI:)UT 131 F4 U101"IF, LYTFIVA III .I 'iC', M 0 DON PE441VIT'l, 101.0 . 00 0 W 1!)c) BOX :1 V"I AN r!r.:,V.IJ.:W N 1:)c)v t .x►.17c c1r it 1 '1 E TAX it,R 03 1:4 C 0 1AEATTNC; INC N T I 1:"!IAZZA AIJIF R A 4 ('4 TOTAL. : 6 e T 1,[A"I �)I VW1,11 11IN 1,10 . Z1117 0 R 1. EJ i:,I N 0 2 I Ws permit Is Issued subject to the regulations contained In Title 14 of the TMC. State of Oregon Specialty Codes zoning regulations and all other applicable codes and ordinances. and it is hereby GAS 1. 1..JI::, agreed that the work*,it be done in accordance with the plans and 1"'OS T a I I M specifications and in compliance with all applicable codes and IA WK-A I-J.N ordinances The issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city business tax permits This permit will expire and become null and void if work is not started within 180 days.or if work is suspended or abandoned for a period of 180 days any time after work has cornmencedr It shall be the responsibility of the permittee to assure all required Inspections are requested and approved Permittep. Signal irr, C-1 it 1 1:nP TNI;4:11:01—T TON 639 -1.1. Issued B" ;61,-<_ ----__.- SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE \ 1! CITY OF TIGA RD h ct PLAN CHECK APPLICATION � � PLAN CHECK fl COMMUNITY DEVELOPMENT DEPARTMENT «` PERM.1 N - 13125 SM Hell Blvd..P.O,Boz 23397,Tigard,Oregon 97223,(503)6394175 DATE ISSUED _ JOB ADDRESS: ! w �OVK4;1Ez._ Occ_ k C I_— -- 'i AX MAP/LOT` SUB: v n� l ✓� LOTLAND UC;E:: OWNER J SPECIAL MOTES NAME: U� 8 L' �L I'V c _ REISSUE OF: ABDRE.SS• , . , I, LAST RE.I.SSUE: C IZ 1 C� FLOOD PLAIN SENSITIVE LAND: --- -""'� APPROVALS REQ IREU CONTRACTOR PLANNING: _NAME: -- _..__ r, ENGINEERING: _—__-,- ADDRESS: FIRE DEPT — - OTHER: —.— PHONE= ITEMS REQUIR'r D L_IST/SUBCONTRACTORS: ARCH/E_N_GINEE_RBUS TAX: NAM[ : _ -- -- _ CALCULATIONS: ADDRESS: — —_ —____ TRUSS DEI'AILS: — �— PARKING PLAN: LANDSCAPE PLAN: F FIONE COMMENTS: PERMIT sN ACCT H DESCRIPTI:OIy AMOUNT AMOUNT PD. RAL , DUE: "l_? 10•-432 00 Building Permit Fens ,0_ W 10-.431 00 Plumbing Permit: Fecs _ 4 10•--431 01 Mechanical. Permit fees 1.0-230 01 State Eiui ]ding lax (5X) _a?j `d Building Plumbing Met.h ___._____._._...t�.�.,�_..,.. ..._ fir'• prI"7 10- 433 00 Plano Building Plumbing _....... Mcgc h .__._......._...._..._..._.!!�_...__ r f 30 207 C►C► Sewer Connection 1 0 _.1./✓° 30--444 00 s(aws!r• Enspoction E11-440 00 St.roet: System Dev Charge (SDC) 1:)2 -449 00 Parks Sy s hmn Dev Charge (PIN') 31. 41_1u 00 Storm Drainage Syst Dev Chrg (SSDC) _..... 10 /30 OG Washington County Fire H1 (9b%) _ __.-----._,�.... __. ..._.._.._..... 10 -22o 00 Alllolr't./Wodowood C TOTAL ..G lC1Q.: ..._ 3_, ...7_..G_►_3G lam- r I s;IMA I Ultl. fkrce.i.vec:l By : __..... bate Rok-o ved; _ ... .1....._......._......_._............ c cr1/3118113/1E1P t 4 I CITY OF TIOARD MECHANICAL PERMIT Receipt # -//_ Permit # ___.L. Description Table 3A Mechanical Code QTY__ PRICE AMT City of Tigard 13125 S.W. Hall Blvd. 1) Permit Fee V. 0 10.00 P.O. Box 2339"/ -- Tigard, OR 97223I S 1 J �-P 2) Supplemental Permit - .1.00 639-4175 i 11 Furnace -BTU incl.ductss&vents � 2) Furnace 100,000 BTU 1 7.50 incl.ducts&vents.- Name of Devcloprrant 3) Floor Furnace 6.00 Cl 1 / �_ ---- Incl.Vent — -_--- Job Address - „cJy I�iVq 4) Suspended heater,wall heater 6.00 Address _LLc_.I �� or floor mounted heater (� 5'�,� s a�rr - - Tax Lot Map No 5) Vent not incl.in 3.00 Lot Block subdivision _— appliance permit — Name(or name of business) 6) Repair of heating,refr ig., 6.00 A,_ A z7�j - cooling_absorption unii Mailing Address Phone 7) Boiler or comp to 3 HP 6.00 Owner �2(v t'v s � / ti J absorp.unit to 100,000 BTU ctry;stale lip _ 8) Boiler or comp to 3 HP-15 HP 11.00 &4/ ON absorp.unit to 500,000 BTU - -� Name Y 9) Boiler or comp 15-30 HP 15.00 absorp.unit 1.12-1 million Halling Address Phone 10Boiler or comp to 30-50 HP ) 22.50 - �5s3-') S by /`i 4 Z ZG• __ absorp.unit 1 1.75 million Contractor Citt — Zip 1 1) Boiler or comp to 50 HP i 1.50 ahsorp.unit 1,750,000 BTU Stato Registration No City Bus.Tax No 12 Air handling unit to 4.50 y'/7 W • Cth 7 y ) 10,000 CFM 3-r A HT,.. I hereby acknowledge that I have read this application Thal the information giver; Air handling unit is 13) 10,000 CFM � 7.50 correct,that I am the owner or authorized agent of the owner,that plans submitted are in --- ---- compliance with State laws.that I am registered with the State BuildersBoard,that the14 Non portable 4.50 riumber given Is correct (ll exempt from State registration please give reason below) ) evaporate cooler 15) Vent fan connected — to a sinale duct 3.00 --- ------- -- — 16 Ventilation system riot 4.50 included in appliance permit Hood served by 17) mechanical exhaust — - 4.50 - - Signature 4or—or agent) Date 18) Domestic type 7.50 Describe work ❑ addition [_1 alteration C3' repair ❑ incinerator_to be done residential ❑ -,-.-non-residential fl 101 commercial or industrial 30.00 Existing use of tyke incinerator --- - ------ building or properly__041 5Other i.e.,woods',, ve,water -� 2J) heater,solar,clothes dryers,etc. 4.50 Prorosed use of ---- --- — -- -- building or property - -- -- -__-_-- 21) Gas piping one to four outlets 2.00 i Type offuel- oil 1 7 natural gas k1 LPG 1-1 electric I l 22) More than 4-per outlet NOTICE SUB-TOTAL 51' THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON --------- - -- STRUCTION AUTHORIZED IS VOT COMMENCED WITHIN 180S&10 4_6 SURCHARGE 7 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR -�- PLAN REVIEW 25%OF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS.4T ANY TIME AFTER ------- - - - - -- - WORK IS COMMENCED. TOTAL. js2 3 Special Conditions --- --------- Date issued by