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CITY OF TIGARD PLUMBINGHAUU`OO.
Applicants must hold Oregon Registration to conduct a plumbing PERMIT Tiqu175
d CR business or must be property owner/operator not hiring outside help,
Name of Dovoloprneni Plumbing Permit No.
Addreur - f ,(l� ) ORS614-21-610 tJUAN. PRICE AMT
Jnb Tax LAA Map.No. _
Addreu FIXTURES _ -
W Hioch Subdivision -FIXTURES - 1 T. 17.30
err moms1 a
a11 Lavatory _ --
L, 1'.J 1111 { S ---- Tub or Tt6V%ower Canb - I _7.54
u uip Addrets Shower Ontr - _ -7 W
Owner (�,ky-%gate- — -- - WaterCbneiV _ - 3 7.50 r
Oishwaaher 1 7.50 I• d?
Phone GarbageUsposal -_ / 7.50
--- Name Wasting Mactune - 7.50 17.,7 e
Fkxx Dram ?10
750
fess Phone Water Neater -
-.
Leundry Room Tray 7.5
Occupant7.y0
/Stats ZP -- --- -
Urinal
fqv" terrier Fish"t!(Spedty) - 750
_ -- 7.50
Melling s 7.54
Contractor / i� ZIP -- ` - 7,'y0___
(11)C D �) _ MISCELLANEOUS Bus.Tax ax SOWS(1111111W 30.00 _
3H "/d 3 Pd Sewer-*a.AMR,100' _ ---- 115.00
— —__
( ai) Wader sarvloe t$1100' /_ x0.00_. L_too
I hereby enlaxz*Mdge OW I twv road 10 4JCWon,OW One 1140nn8tion water Swvioe ea.Addit.2' t 111.00
9mon is coxred.OW I am regWAted wNw�h Ow 1iwHuIkWo Board,arsd oleo Storrs 1 Rain Orin t ad.100 � 30.00
havoc a Stele Pkurtbkr0 Noone she to nuw-,-•-e giver arc!carred.Out as
pkm"work will be done in Kw dwvo Wdh appoo"Pr'a'm■31 Ors Sorm A 13r1n train AddR.I Oo ----
pon Revise!StuUm Q,aplers 447 and 003 and appaa11bie oxxles and than Mobk Nome Spooe 25.00 _ -
no hep wN be employed uriien**4i d undw ORS 003.(O owm- fro- Bark -
Stew regbf1111 w%plea m give reason below). 7,10
NOMFOt -I hereby 0W*go 1 am Oso recur d One property de t)evioa►or fix+otic.
ecr6edab*%%*tvA4de1' 1 1111 1pmpoNbmakaeC*jht6gkWaNa0ontor MryTroporWoM HO
my own ure acid 96 paatsuly le no b*q aorstitrss dl I for otr"-wNa W MO Carrseolod to a Mme 7.30
C .d EidW.Pkartsksg— I _ 40r11'0 hie w
!jp
_.._- - � Mir. g hksntbltsg wNhkn
--- an 7 _ 1&00 min
AUT/HOfILLEt)AIONATURE OaM Now w& ^ 1000 nMn _—
a 1rBiLr3 --.
r>eecritw work now,&) oddl ion[7 46WSHW L7 repatr O d Uirg ) )SAD er
Exiefttp tae of
bts1*q or property
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i�IIYI�M����t»a�,Nile n�a
BUILDING PERMIT APPLICATION djjj� DATE---- - —.»-... 7 -3
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE ` '_�'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
Z9'Z- J.5 le 3 LOT NO. 2S
OWNER \,' ' t! ?Tr ;:,t:s? JOBADDRESS 3.3439 sw Scot' Age r,• , . 12.4 MoacillcJrl It3. .l
—� — — ARCHITECT
1350 S FFalcon173 ENGINEER came
.
BUILDER _ ADDRESS LESIQNER v
STRUCTURE _ l'�NEW ❑ REMODEL_ ❑ ADDITION ❑ REPAIR ❑ RE14EWAL ❑ FIRE DAMAGE ❑ DEMOLITION
!�RERIDENCE ❑ COMM ❑ EDUCATIL NAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY 3 LAND USE ZONE DG.TYPE — r' FIRE ZONE_—PLAN CHECK BY �:__'—HEATS
cnant:rtwt single fmni.ly &a7.3 :in.g Sr/attached garar^, all r,;.3r npipr�vs Tans .
—__ fzrL.;risT -,f 644
3342 i.( Idtt) 2 b .lrh, 9 f:�apr, .ji)rage .,i 60
SEWER PERMIT M _-- —-------
OCC.LOAD FLOOR LOAD 40 HEIGHT 20 NO_STORIES 2 AREA 2i1C:' NJ.BEDROOMS s VALUE
BUILDING DEPARTMENT SET BACKS FRONT 45 REAR `0 LEFT SIDE RIGHT SIDE �
Permit 3 5V ' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, t.1NING
REGULATIONS AND ALL APPLICABLE ZODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE FLANS AND SPECIFICATICNS AND IN COMPLIANCE.
WITH ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ RESTRICTIVE COVENANTS- CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT Cl'�Y BUSINESS
—� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 25. SDC Ou.00
_.
By X 40 00} PDCM APPLICANT OR AGENT
Receipt No.
Approved Ci E9 -- ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
- —. �— Contractor _ j 31)&J 6•.$'&'7
Z-97 ) Permit No.
Rough-in
7—,9 .3- Fixture
Final
HEATING
Contractor A
Permit No.
l "� l� r q F I •-- y �� —--- _. Gas or Oil
Q ----�`— Rough-In
Final
/01 et—
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Droin)Final
Sidewalk
Curb&Street Final
—•---- APPS usch
BLDG. DEPT.FINAL TEMPORARY---J—CERTIFICATE OCCUPAF4-y r
CERTIFICATE OCCIJPANCY Final
Landscaping
i_� _ Luning Final — ��
for inspeCLia',s call 639•-4175 PERMIT N0.
CITY OF TIGARD 69.4171 DATr.
BUILDING P�RMIT / suoavlstoN
P.U. box 2 397, Tigard OR 97223 TAX MAP LOT NO. -L1---
�. 7
C'S�G�Lam;C+r r� -�rf l y t E°� - IUe AooFiEss _
OWNEEL
BUILDER `"� ST^TF_7EG.NO.
'^ Z X!.DATE �- 5c ~`
r 1
BUILDER'S PHONE z Cr-2
JL: C'Q Crc :;Csc�iJ (,l M,til�..-�-- -- _ PHONE_.._�.— - OTHER_ ------
ARCHITECT', �
ST RE BREW ❑ REMODEL O ADDITION_ O REPAIEi C2 MOVE ❑_OTHER (.7 DEMOLITION
RESIDENCE ❑ Comm' ❑ EDUCATION C! IND • C) RELIGIOUS. LJ-ACCE SORY Q GARAGE CJ OTHER U FENCE
Oc"PANCY �►r;-3-LAND USE ZONE _�_FLOG•TYPES_ � FIRE 713HE +� PtJ�N GHE:K BY 1-!�-MEAT
C_costructt single family dwe11inU /attached aat,�r' --
uU�ert: to tis code, :�- 444 -
SE:WE;RPERMIT/,33(/2. 1 -(1 du) .2baths ra 5 garage--A
O,CC.LOAD _ FLOOR LOAQ QO HEIGHTNO STORIES "L- AREA 2"Z.• NO.BEDROOMS
_ BUILDING DEPARTMENT SET Bf CKS FRONT 1,4 y `w REAR LEFT SIDE& RIGHT
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS
CONTAINED IN THE REbYgUll.roIhC CODE, AT T14;
REGULATIONS AND AL1.APPLICABLE CODER.AND ORDINANCES.AND R<S NEREhY AGREED THAT THE
PIM Chock �,/� �" WOI1K WILL BE DONE IN ACCCROANCE WITH THE PLANS AND SPECIF'ICAT'10NS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES.THE ISSUANCE OF THIS PERMIT 'OES NOT WAIVE
P'L Ck,FYRESTRICTIVE COVENANTS.ppNTot/l%TOR AND$US CONTRACTORS TO HAVE CURRENT CITY BUSINESS
— TAX PERMITS SEPARATE PERMI REQUIRED FOR SEINER.PLUMBING AND HiEATING.
Stmte Tax �r sscc- _7 l/
SOC—
TOtal L h TORAG NT
---- pDC,
l Rsce+pt No AOORTSS
Bal.Due ,?^�
Usued By __ADDYOvad By
SSDC --- S
50C� _P� Go RECE I PT
Po c --- -:. SIJ DATE PD. ---
5MCR CONNECTION — / AMOUNT PD.—
SEWER INSPECTION S
SEWER SURCHARGE S
-ammento. �� ---
t,u�ulNl N _
U I V OF I IUAHU MECHANICAL PERMIT Permlt# 7:7 z _.
eescrlptlun
Table 3A Mechenical Code QTY PRICE AMT
City of Tigard -0- -0- 10.00
13125 S.W. Hall Blvd. 1) Permit Fee
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit — 3.00
639-4175 1) Furnace to 100,000 BTU 6.00
incl.ducts&vents
2) Furnace 100,000 BTU + 7.50
incl.ducts&vents _
Name of DevelopmentFloor Furnace 6.00
3) incl vent _
l0 �' Suspended heater,wall heater
Joh Address 4
) or floor mounted heater 6.00
Address 3 -
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,ref rig., 6.00
J i������ cooling,absorption unit
Mailing Address phone 7) Boiler or comp to 3 HP
Owner absorp.unit to 100,000 BTU 6.00
City/State zip 8) Boller or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name --- 9) Boiler or comp 15-30 HP 1500
-. absorp.unit 1/2 1 million
Mailing Address Plane .10) Boiler or Comp to 30-50 HP 22.50
_ absorp.unit 1-1.75 million -
Contractor C41State Zip -- 11) Boiler or comp to 50 HP 31.50
_ absorp.unit 1,750,000 BTU
State Registration No. City Bus.Tex No 12) Air handling unit to 4.50
10,000 CFM _
1 hereby edge acknowl Air handling unit 750
that I have read this application that the information given is 13) 10,000 CFM +
correct,that I am the owner or authorizud agent of the owner,that plans submitted are, — --
compliance with state laws,that I am registered with the State Builders'Board,that the f4) Non portable 4.50
number given Is correct (If exempt from State registration please give reason below). evaporate coo*
15) Vent fan connected Z 3.00
to a singe duct
-- ----- --:- - - 16) Ventilation system not 4.50
Included in appliance permit _
Hood served by 4.50
/ { �� 17) mechanical exhaust
aturb(owner or agent) Dale 19) Domestic type 7.50
vibe work O addition ❑ al.eration f..l repair ❑ Incinerator
to be done __residential-% non-residential U 19) Commercial or industrial 30.00
Existing use of �� %� type Incinerator _
building or properly__�G�� 7 _ 20) Other i.e.,woodstove,water 4.50
Proposed use of heater,solar,clothes dryers,etc.
building or property �.��_—._ - 21) Gas piping one to four outlets 2.00 2
Type of fuel- oil CI natural gas *- LPG l:1 electric O — �Y
22) More than 4-per outlet
NOTICE SUB-TOTAL W
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON �"—
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL 7,
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
TOTAL ,7
WORK IS COMMENCED.
Special Conditions
_-- __-- --,- __-- Date issued
,J