11440 SW LOMITA AVENUE 11.440 SW LOMlTA AVENUE
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CITYOFT11FARD F'111-:Pmll' N".) . : MI.A491A.P5
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COMMUNITY DEVELOPMENT DEPARTMENT 00100"
13125 S W.Hall Blvo-P.O.Box 23397,Tigird,Oregon 97223,(503)6394115 IN-YT E* 'I'SWEA): 3/113/89
14104 1"W111 4—;Q11. 619 gQab---
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108 ADUPEGS : 11,e4,4110 W ('I'. (IV L'
TAX MAP/L.01' SUH: LT: HK :
LAND USE :
I OT 4O,ZE :
X TEM- N11.1 NO:
WORK CLA55 : ALTEPAT10N FURNACE <100K 1 A'I:P HANDI-0 <1.0
t . . *TY I -IANDI
JISE -"E: 51INIGLE Y FUIPMACE 1.00K+ Fla'I1 I -.P IUI
CONST . TYPEK: 1:1-100A FURNOCAK E.VAI" .COOLER
OCCUI-1 . VE'NT F'AN
VF.:'N'Y* VEN'T' . 5Y51*F:M
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NU. L'1T0P1F;:S ! HI P/COMP '.r.NG.ENE:RA1*0P( DOM
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1,0171- TyPr-
G)A5 BI P/COMP 130 50FIP PEPAIJI UN11'S
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1:*)I--I(.)Nl::.* ((503) 639--50'3,v.) si'TA'TE 'TAX $1 1 0
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0 PHONV.' (503) EN:116-89-1-1
RI PEGv1S'TT4A11(]N NO. .520319 ro rAi.-: fpP3n.0
This permit is issued subject to the regulations contained in Title 14 PF:CE:1PT NO.
of the TMC. State of Oregon Specialty Codes.toning regulations
and all other applicable codes and ordinances, and it is hereby PF(AUT.REE)
agreed that the work will be done in accordance with the plans and G.A5 L'.I:Nrr-.
specifications and in compliance with all applicable codes and PO50, a PrEAM
ordinances. The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have curre,,i city NOLJG'I+--T.N
business tax permits This permit will expire and become null and FT NAI...
void if work is not F arted within 180 days,or if work is suspended )r
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inslinctions are requested and approved
--W1 .I 4k//
Permitt(a Signature
Issued By
I'Al.1 FOA .1.11NISPEU-T 1.0N 639 -11. 7,`3
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
MW ww se• r. w•
INSPECTION NOTICE
City of Tigard Building Department
P.G. Box 23397
Tigard, Oregon 97223
Phone 639-4175
s
Type of Inspection
Date Requested_ Z '-r "' g -7 _ __— Time__ A.M. P.M.
Address _ �l y't/b —� ,�—_..-`_--- Permit #
Owner ------ fit // ----- Lot # _
BuilderThe following Building Code deficiencies are required to be corrected:
i
Presented to
--�-- - --- --- �Y�Approved
Inspector —,�/� "� Disapproved
Date
CALL FOR REINSPECTION
❑ YEt ❑ No
�s ws isr saw w� a sr �
BUILDING PERMI" APPLICATION TIGARD DATE_ '."U_PCMI)Sr W_19 84 5016
THE UNDERSIGNED HF RE$Y APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE ►
OR AS SHOWN AND AfIPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
y LOT NO.
---
OWNER ,. � 1. roe nDDREss _!1440 SW Lomita f�11tJ _ mgt-33np
ARCHITECT — —�
dUIIDER Cl&aaf+` Pluuiuin3 ACJRESS 2ENGINEER a4 hilltop Dr. DESIGNER
STRUCTURE ❑ NEW - =R ❑ ADDITION El REPAIR D RENEW/,I_ I FIRE DAMAGE ❑ DEMOLITION
.kRESIDENCE El COMM I I EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 7 STORAGE Ll SLAB❑ FENCE
OCCUPANCY A-3 LAND USE ZONE R-4.5 BLDG_TYPE 5!!� —FIRE ZONE Y PLAN CHECK BY W""""" HEAT
Mwdel existing Bathroom (hou—sLruetural) V
SEWER PERMIT M
OCC.LOAD _FLOOR LOAD 40 HEIGHT_ NO..STORIES I AREA NO.BEDROOMS_ VALUE 5 t3fJU.
BUILDING DEPARTMENT
SETBACKS FRONT REAR _ LEFT';IDE RIGHT SIDE
Permit 56.au THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE Cr DES AND ORDINANCES. THE ISSUANCE OF THIS PERMI; DOES NOT WAIVE
Subtotal 56.5u RESTRICTIVE COVENAN'S. CONTRACTOR AND SUR CONTRACIORS TO HAVE CURRENT CITY BUSINESS
State Tax 2.26 !.ICENSE.SEPARATE PENMITS REQUIRED FON SEWER,PLUMBING AND HEATING.
Total 58.7ta SOC—
fOCN RLICANT O -- /�
LApproved --—.BC}2_— Receipt No. f A888
i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
C
Permit No.
Rough-in
[Fixture
7 Final
4djc,v e HEATING
Contractor
Permit No.
Got nr Uil
11 Rough.;,,
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rai"Drain)Final
Sidewalk
Curb&Street Final
Approach
Ba--DEPT.F I N,,t L— TEMPORARY
CERTIFICATE OCCUPANCY '-'kRTIFICATE OCCUPANCY Final
(Tc Landscaping
7oning rinal
BUILDING Di!"ARTMENT, 'TIGARD
PLUMBING PERMIT
holder of a valid plumbing contractors license is hereby '
authbri7ed to cause plumbing w as herein noted to by installed in accordance with OV2 Plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall ba notified not less than four
(4) hours prior to the time the installations are ready for inspectian. City of Tigard Business License required
for all cqnractors and sub-contractors.
Jib
Owner Address114N, .—`�/aJ� _ Date /4"A7 J
NW.'2211 4F TOTAL
TYPE OF PERMIT I,,-EMS FEE ON EACN AMOUNT
p0-WE11TIAL `_—
Single Family--1 beth--each ?5,00
D�ex—Each 1 beth unit -
-__�__ 25.000
Additional bathrooms--each ~~10.00 T �~
hicbile Nome S ace—each 15.00
INDIVIDUAL FIXTURE. CUM
r.] RCIAI --
1 to 50 Fixtures In 1 building—each 3.00
51 to 100 IrLI buildir_each 2.50
101 to 200 Fixtures in 1 building—each _ V— 2,00
201 or more Fix ores in 1 building—each
h11SCELLANEOUS
S8�7ar—ea6 additional 10011. 10no
Water Service t1p building
O11
sr (specify):
_P E R NU T For Plumbing In spew tion Phcne 639.4171
41 State Plumbing Contractor
FtFr.FIPT Nr)
ar► ar a.r AMR awn MIM
BUILDING DEPARTMENT, TIGARD ND 21 Q 2 I
PLUMBING PERMIT
/��J, k�'«�. Jf•� vii �• , holder of a vapid plumbing contractors license is hereby
authorized to cause plumbing work as hirein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business L_xense required
for all contractors and sub-contractors. o b 6,3 q— 3 5—
Owner__T_.`__�_ ; jL Address �° Dateda -,�•,.,
r--- NUMBER OF TOTAL
TYPE OF PERMIT i�� ITEMS FEE ON EACH AMO1INT
fl-"I D E 1.I lAl__—_--- — — — —-- —Single Femlly-1 beth each —� --_ _ 25.00
Duplex—Eech 1 bath unit 25.00 _
Additional bathrooms-each ,—_—_ — 10.00
Mobile Home Space each — 15.00
INDIVIDUAL FIXTURES cOMMERCIA
i so 50 Fixtures In 1 building—each _ 3.00
51 to 100 Fixtures_in 1 building-each _—_ 2.50 _
101 to 200 Fixtures In 1 building-_each �— 2.00_-- —.—
v201 or m_ore_Fix_turas in 1bulldiny_earh__ 1.50 —
MISCELLANEOUS
Sewer_each additional 100 ft. _— 10.00
—Water
— —_---
Water Service to building `-- —_ _ 5.00
Other (Specify): !U 1 IC -d X.�rt t - — D --
PERMIT
_ For Plumbing Inspection Phone 639-4171
4 State f> Piumbing Contractor By
_TOTAL RECEIPT PI c1 ?0 Issued By �__
iIPLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No. '7!Z-/ 32-
Permit fee /a go /e,
_ Water Closets (Toilets Permit Issued
Bath Tubs _ ___ __ Approved by _ (�
Lavat� Wash Basin w. Building Permt
i
Shower_ _ _ Receipt No. L�''� 7'_
mks, Di shwasYiin � --
Sinks 9_ Kitchen
-_ Sinks, Ordin'ar'y_____ -- Location of Building
in_ks� Bar__�_�_� -----__------
Sinks, S1 -
_ Automatic_Disfiwas jer _-.----------------.- -
Disposal
LaundryyTra s _ Name & Address of Owner
-Drains, Floor
Drains Area
-Drain sA Re�`ri�erator _ _ _ -%
Rain Drains
Automatic Washer Name & Address of. Plumber _
ountii ns, ri n in -__ �� 'a n�"
Fou ntains' Soda _—__ %l`�� 77
-Hot Water Tank 77 --
Water Service Size
Urinals �� _ Building Old or New Alters Repair or
Ca tri-Basins --TarT" _ n:sa� _
Lawn, Sp rinkler System
_ Sw_imming_Pool
Sprinkler SystemThis permit becomes null and void if work or construction authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $19000 bon
I hereby certify that I. have read and examined this application and know the s
to be true and correct. All provisions of laws and ordinances governing this 't
of work will be complied with whether specified herein or not, the granting of
permit does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
i `
Signature of Applicant
r
CITY OF TIGARD
t 14M 1 W wM $0,601
T 1GAIND 0*100" /1223
APPLICATION FUR RUILI)ING !'t:PM1T
Now Construction Demolish ❑ Addition ❑ Renv)da1 ❑ Move❑
7.C)FItwo tl 'r DATA: ISSUt;D BUILDtr+C PERMIT���
DATt: RECEIVED PLAN
FIVE 8�i�e No. �� ,��
PLAN CHECK S _._. i_._.. — -�-6
BY
OTHER 1 TO %site $ .414
VALUATION
TOTAL 5. 2 RECEIPT No._
TWO SETS OF PIANS AND PLOT PIANS MUST BE FURNISHED WIT11 APPLICATION
IAT IM_ MAP 1 CENSUS TRACT JOB 1_.___
Architect or Engineer
Addreso _ M� Phone_—
i-ne r _lGjjjr.
Address_ �I yL2._o1+(L�_Ld,�XX/LQ. r-Qil�_�_ Y —Phone
Builder
Addresf��____.
BUILDIW; USE ngle Res, ❑ Multi Res. El �aff" ❑ Industrial❑
OCCUPANCY GROUP--__ o. of<' n
eight -- Area of Lot —
Typt of Construction I a B� _ 11 j_i R 2 __
Set Backs, front—,—__— BacP.Side�!_((_�'"�11
Private Sewer Pipe SiteSeptic TankWater Service Pine S itch ❑ Drywe11❑
Street and Cur equirem#nts
Driveway dth _No. of Parking
SEPARATE PERMITS REQUIRED FOR SEWER AND PL1M11ING
SPECIAL INFORMATION
ADDRESS ASSIGNED1j�&10
FIGLU CHECV BY DATE
PERMIT APPRCIVF.D y ,4
It s understood that all work will conforwith applicable
m c
odes and ordinances
of the State of Oregon and the City of Tigard, Oregon, ano that the building will
not Im occupied until a Certifir,ate of 0cc.upancy has been issued by the City of
Tig6rd Buildinq Insp,,tor . a d
5lgndtlit�pp1 eili nt- �� ��
C
fAn^L
tA%e
CONSTRUCTION
crrr Or. tIUARD
7
ALL SPACFS MOST BE' ENbOR4Fp
PRIOR To
APPROVAL OF
push or,"
14.A M-pl, t 7
/�
i
Address --/��.�LO J AJ. elk/ll A�O'Permit No,
f
Name of Occupant iL/".9f M�k'lw Permit charge
A, e r
Connection fee,_—.. �'
Paid b e Z L h c
Date connected_
Type of Building �E S/DF,eI E _ Inspection fee
Service Aate Paid by c./C' Date 2 /1"'_ F
. oPaidContractor e AT � 0
r
Size of connection
i
E
wr
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 716 DATE
PBRMIT IS GIVEN TO
Y
OF --
.r'
TO CONNECT A
TO'FIIE SYSTEM OF TIGARD SANITARY DISTRICT
� 4
AT
THIS PERMIT MUST BE POSTED ON THE DE9CRIRED PREMISES UNTIL.CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
F I.ETED. +
PERMIT FEF. PAID 6...............................TIGARD SANITARY DISTRICT
By
e
CONNECTION INSPECTED AND APPROVED
ierititendent
Date
CITY OF TIGARD MECHANICAL PERMIT Receipt#
Permit N
Description
Table 3A Machanitat Code QTY PRICE AUT
City of Tigard 1) Permit Fee y -0- -0- 10.00
13125 SW Hall Blvd. _ _
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit _- 3.00
639-4175 1 Furnace to 100.000 BTU 600 / ov
incl.ducts R vents (^'
Furnace 100,000 BTU +
2 incl.ducts&vents 7
Name of De"lo(pmeol 3) Floor Furnace -- _ -- 6.00
V`\ 1
I � � \Y Z (� TA L,j 7 incl.vent -- --
Job Address 4) Suspended heater,wall heater 600
Address or floor mounted heater _
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,raft Ig., 600
cooling,absorption unit
Mailing Address i Phone �� Boiler or corm to 3 HP
t Ar 6.00
vner � ' [a ` (J Gv L C)V�I I � 6 `J `1�G absorp.unit to 100,000 BTU _
("ity/stale Zip --� 8 Boiler or comp to 3 HP-15 HP 11.(X1
absorp.unit to 500,000 BTU -
Name q Boiler or comp 15-30 HP 1500
C ) absorp.unit 1/2-1 million
Boiler or corn to 10-50 HP
Max0 f�Z.I.X, R.2 q'q'o Z c, 1 0) absorp.unit tp 1.t u million - - 22'50 -`
Contractor II bb g
f;nylst.a 7jp 11) Boiler or comp to 50 HP 31.50
absorp,unit 1,750,000 BTU_
State Registration No. Cit,?Bus,Tax No. 12) Air handling unit to -� 450
10,000 CFM
Air handling unit
I harebY sak,K,wfodge ftf I have read aws application that the information given is 13) 10,000 CFM + 7-�
oorred.Mint I am ere owner or aufhonzed agent of ific owner,that plans submitted are in —
comphanco with State laws,Mat I am registerw-Nin hie State Builders,Board,Rist it" 14) Non portable 450
number given Is corned (If exempt from Stare registra6 m please give reason below). evrporate cooter
Vent fan connected
15 to a single duct 3.00
--- --- --- ----- -- Ventilation system not
16) included in appliance permit 4.50
17) Hood served by _ _--4.50 - -
mechanical exhaust
So-h-(owns'of agrmf) _ Dale 18) Domestic type -�- 7.50 - -
Describe work O addition C1 alteration U repair I ) incinerator _ _ - _
to be done residential U _ non-residential ❑ 1 S) Commercial or industrial 30.00
Existing use of type incinerator
buildingor properly Other i.e.,woodstove,water
P P Y------ --- -- ___---- ------ -__--_ 20) 4.50
Proposeo use of
heater,solar,clothes dryers,etc.
-- - ----- --
building or property ------ , 21) Gas piping one to four outlets 2.00
Type of fuel- oil [ 1 natural gas f 1 LPG 1-1 electric I 1 _ "- ----- -
___ --- - 23) More than 4-per outlet
NOTICE SUB-TOTAL Z L
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION
ON- 5% SURCHARGE I I U
STRUCi ION AUTHORIZED IS NOT COMMENCED WITHIN 180
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DA'I'S AT ANY TIME AFTER ----
WORK IS COMMENCED. TOTAL Z 3 (]
Special Conditions __
a>. ■r t uas tl.11 .Ilr as �
THE UNOE.RSIGNED HEREBY APPLICS PUH APEHMI I EUH I►IL W014K HL11014 INLJIL,, LU uu1LULR:':Iv1�rlyrJ(- '�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN,: AND SPECIFICATIONS. OWNEltiP►A0(&r _
Lor No_ 6r —
J013 ADDRESS a c
ARCr11TECT ' `` 1�
1 >/ ENGINEER
U11_�,.?,•>f (" ��..<�f��_ -L.,'.�j�-!� ADD_RFS,i ,Zyt/�.-c- J'�y� l�C'. OESIG:yER
STRUCTURE _ r-IN �
EW _Rk'l1ll ❑
0EL AOOITIOY DnEP.:IR+ ❑RENEVIAL ❑FIREOAMAGE ❑OE:.10lrT
(�yRESIL�t"ICC ❑CO►LM ❑EDUCATIONAL CJGOv'T L 1REt.'�ICUS❑?ATIO ❑CAA PORT ❑GARAGE Q STORr.GECISLAB ❑FF
CCLtPAr,,Y x-3_LAND USS 2UNE OLOG, TYPE�N_ PLAN CHECK BY
-z---- — HEAT
W.
y -L A--.tl�_
— -eft PFTRUUM 444 6 HUM
.SEWER PERMIT � _ Gar��c —
Qs�-l.7j�-D FLOOR 1.0A0 t r J HEIGHT NO, TRIES l AREA NO BEnIinQjk_S_ VALUES�n
SIIILOING OEPARrmENT rT BACKS FRONT REAR LEFT SIDE RIGHT SIDE
I C1 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT
�- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICOJIONS AND IN CGh1PUANCE
J:Jti-tDfdl ,s' �S Su ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W
te
r_at+l Tax 2- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRVIT CITY BUST
I . I LICENSE. SEPARATE PERMITS REOUIRF.D FOR SEWER, PLUMBING AND HEATING.
TotalI SDC -
PDC#
a•,
APPLICANT OR AGENT
A;nrovr-r1 I � ' Receipt No �--- -�-+-
Ar1ngF%S
SVC (Storm
SDC -
PUC - !6
SEWER CONNECTION S
SEWER INSPECTION $
SEWER`SUR_SURCHARGE $_
Comments ;