11320 SW AMBIANCE PLACE ! I
N
W
N
O
Ln
n
3
m
♦f / Z
n �
i
11320 SW AMBIANCE PLACE
A
i
I
1
City of Tigard Mechanical Permit
New Installation 0 Replace Ej Relocation FAddition � Alteration
n GATE:
HFAT?NG
CJNTRAL'rOR _ r _ OWNER
ADDRESS-- -_-----___---- — JOB ADDRESS----
PHONE
DDRESS_ --PHONE ----- __-- APPLICANT-----,------
Heat
PPLICANT ----.____Heat Input RaVngiBTU per Hour) _ ___—_-- Vent Size Flue
FUEL OIL L] GAS 0 ELECT U OTHER - ----_ _`
- _ ITEM ------- J_ NO. FEE ITEM NO. FEE—
or Issuance of Permit _ SEE BELOW Each Air Handling Unit or Duct System _ 7.50
New-up to & incl. 100,000 BYLl 8.00 Commercial Hood System _ 7.50 E
New 100,000 BUT's& over 1.50 Other Equipment • Each 4.50 `
Woodburning Stove _ 4.50 1 Trip Insoection 4.50 _
Wall-Floor- Suspended 6.00 Air Condition Compressor - up to&incl.3 H.P. 6.00
Vent System w/Fan— 4.50 Air Condition Compressor-3.1 to 15.H.P.Incl. 11.00_
3epair-Heat Cooling —�_— 6.00
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTFIACTORS ! I
PERMIT ISSUANCE10.00 � Comments:
FEES _ _
SUBTOTAL
— % STATE _ Y lauad By — r.T*•~""
2 -%-PLAN CHECK 1
' OTAL __�__— _ RI?C.# —— Signature of Applicant
CITY OF TIGARD
P.O. Sox 23397
12420 S.W. Main
r,Bard,Oregon 97223
October IB, 1979
The Oregon Bank:
REFERENCE: Construction of single-family residence in Genesis Subdivision
on 115th Avenue in Tigard. (Genesis II, Lot 20) .
To Whom It May Concern:
Builder has informed me that footings have been poured approximately
one foot into, over a common utility easement. I hereby acknowledge this
error on his part and agree to allow this encroachment.
However, I want it clearly un:terstood that, should this City need to
perform any work in the future in this area, it may be necessary to disrupt
the normal routine of persons residing in this dwelling. The granting of
an easement insures our right to do this. Obviously, we will perform our
work, if it is nr.cessary, in a judicious manner.
If you need clarification or have questions, please advise.
Yours truly,
4011
Aldie Howard
Planning Director
AHvmc
CC: R.I.chmond, Bopp and Knox Company
Frank Currie, Public Works - Tigard
Ed Walden, Building Official - Tigard `-.
BUILDING PERMIT APPLICATION COFY TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATEL BUILDER PHONE-_ � y
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHQNF
LOT NO. —_
OWNER JOB ADDRESS 'l �mt,ialil HOhi:ADDRESS _
ARCHITECT
Cz fltlk3 0810 SSI Pacer Ur, t.iV'I n ENGINEER
BUILDER ADDRESS DESIGNER r�
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR []RENEWAL ❑ --11
FIRE DAMAGE `JDEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE (:1STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING QCONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS v^-�
OCCUPANCY- -LAND USE ZONE ~1 i, BLDG.TYPE,..-- FIRE ZONE— PLAN CHECK BY L HEAT
�-ingls t'sma.ly i1wolli.ng 4o,/a><Ctnchad garage., 3 ballroom 2 cath.
liewwi. Permit
7 w n.i 4
All ►7 1 2416 :i GIG 90(j.
QC.�A..(.QAD FLU,Q�LQAD y,FJO�_,___ _ NO,S70RIES—,—,-�E1 NO.BEDRg9MS
BUILDING DEPARTMENT SET BACKS FROIIT 23 REAR 7 LEFT SIDE 3�. RIGHT SIDE
Permit r '.I.
THIS PERMIT IS ISSUE') SUBJECT TO THE REGULATIONS CONTAINEr, IN THE 3UILDING CODE, ZONli-;
Plan Check 1n.(ILI REGULATIONS AND AL'. APPLICABLE CODES AND ORDINANCES, ANL, IT IS HF.REBY AGREED THAT THE
—' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANV SPFCIFICA'rl')NS AND IN COMPLIANCE WITH
Sub-total 1131.00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANLIS OF TH!b PFRI•IIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOr; AND SUB CONTRAL;'c11S TO HA\ ;: CURRENT CITY BUSINESS
State Tax �.Uri LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEAT'NG.
Total ,u - 4fjuouu
By r;,1 $101.00
�a 1. _
---- APPLICANT OP AGENT `---
Approved I Recell,, No �j
li
�1
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
«r' v k U pl u rw l 01C Permit No. 6r /D—/'
Rough-in
Fixture
Final
HEATING
Contractor q
Permit No. 16 I S.Og /O yS�74 /
Gas or Oil ,
Rough-in
Final ---_—
SEWER
Final /—>-:d6-?�
DRIVEWAY
Final
3tonh Drainage
(Rein Drein)Final
Sidewelk
Curb&Street Final
_ Approach
BLE'.. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
I