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INSPECTION NOTICE 5
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Type of Inspection
The following Building Code deficiencies are required to be corrected:
;i
Presented to ._� —____.V____ _._–_.a—_-� Inspector
Date
CALL FOR REIWECTION
VES ❑ NO
INSPECTION NOTICE
City of Tigard Building Depirtment
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address
Type of Inspection
The following Building Code deficiencies are required to be ocm,*dW* 'tFe,
Ar
-le
Presented to Inspector
Date
CALL FOR REIAGPECTION
YES El NO
City of Tigard Mechanical Pi-.- ,nit Potmit+,__$3.00
Fee
New Installation D Rep:ace ❑ Relocation Addi+:_., L=1 Alteration L-i 3%State _TOTAL—__CONTRACTOR OWNER
ADDRESS _— WORK ADDRESS
PHOP:E_ — APPLICANT �- --- -- _—..
Heat Input Rating (BTU per Hour) _ —__ Vent Size _ Flue Size
FUEL OIL ❑ GAS L , ELECT ❑ OTHER �—
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _ 3.00 Air Condition Compressor 15 to 30 HP 10.00
New-Under 100,000 CTU 4.00 Air Handling 10,000 Cl-M 3.00_
New- 10U,000 BTU &e%,er 5.00 Air Hanclh.4 Over 10,000 CFM—.--- 5.00
Floor Furnace _4.00 Evaporative Cooler _ _ 3.00
Wall-Floor-Suspended 4.00 Range Vent Fen _ 2.00
Install Vents Only 2.00 Vent System _ 3.0_
Repair - Heat&Cooling _ _4.00 Hood Commercial —_ _ _3.00
Air Condition C,impress 3r Under 3 HP 4.00 Commercial Duct System
Air Conditior. Compressor 3 to 15 HP 7.50
INSPEC fOR'S COMMENTS._
CITY BUSINESP LICENSE i,'OUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY DATE ISSUED BY DATE_ ____,_
RECEIPT
774 Signature of Applicant
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CITY OF TIG ARDOREGON
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15440 SJ Alderbrook Circle Address. ........ ..... . ... . ..... .... .. . . Lot #44
1.........
Certificate is hereby given t.his......1 ?... ..cl.iy of ma r r h l9 ..7.A
that said building; way be occupied and l
that it coinplies with all requirements of
us approved ny tnrl Tigard ('it,y co':'61
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Buil,li.1:; Insptcttar � �'��
is
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urwf•n u.e a
address S �//U G C'iPermit No.
- Permit charge _ 2?D
iJWner. Connection fee "'�,f,o —
,.._ Paid by - � C
Type of huildinn Date connected
Service rate /`' Inspection fee
Contractor Paid by _ date
Size of connection Assessment ����_ paid ��
SEWER PERMIT M 13824
Uf4nfied Sewerage Agency T i i r d 10-4-77
of Washington County C I � Y �)E ----------—__� DATE _
OWNER : T_n_�_ PHONE :
EIWNER 'S ADDRESS: _-
TYPE OF INSTALLATION :
yQVUIL_DING SEWER ❑BUILDING SEWER AND SIDL SEWER
TYPE OF OCCUPANCY:
XDtEW BXS'�INGI_E FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) ❑ MUL_T . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWE.L.LING UNITS __ 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
ANO REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED /.ND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL_
BE FORFEITED SHOULD EXPIRATIOf. OCCUR .
FEES:
PERMIT FEE $_ 71;_
CONNECTION CHARGE
SIDE SEWER INSTALLATION _ __—
ISSUED BY
OTHER —.—•- _r___—�
TOTAL $
APPLICANT DATE
1 '
SEWER PERMIT N . LVSV l
ADDRESS OF STRUCTURE— 15440 SW Aldnrbrook Circle
TAX MAP TAX LOT r,_ _ SYSTEM fanno creek
LOT _ BLOCK __. �OF
APPROVED BY DATE % ISSUED , Y DATE
REMARKS bldg. 1,'1757
........ .«......,.».»..-...,,..,..........w.:r..r•n�...w+�«p.+..earn..»..,.�.,y,wrw.•...... ,+.plw.�++«rw- w.+a-,.w..r,
BUILDING PERMIT APPLICATION CITTi ARD DATE 10-A-77 ___, ,e 7
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR TH, WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONr
LOT NO. _
OWNER i JOB ADDRESS 30440 SU Nlderbrook Ind ADDRES
ARCHITECT
LNGINEER
BUILDER :1 ADDRESS DESIGNER _
STRUCTURE '' 'UAEW tt--��❑REMODEL ❑ADDITION ❑REPAIR_ ❑RENEWAL IrrjFIREDAMAGE ❑_DEM�-OL:TION
10 R�'SIDENCE ❑ L
COMM JE.DUCATIONAL 0GOV'T ❑ LI
REGIOUS❑PATIO ❑CAR PORT 0GARAGE [I STORAGE[:]SLAB [:]FENCE
❑BOND EMOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
QCCUPANCY L _LAND USE ZONE LL'__L _BLDG.TYPE J —FIRE ZONE -L PLAN CHECK BY_ H0W� HEATS d�'
Lot ,p441 reissus sa mw as ii)616 sw iummerf'isld Lane --- —
f'rese dWallint� i..!attecbbd garage 2 badroy;i%. 2 both
QGC.LOAD _FIQQLLOA__DIQF1L_ ____N�,SLQN_LES.____--- AR EA 1368__JYSi.._.@liI2t341� VHLUt �._..----
BUILDING DEPARTMENT _ 101 601 d i f
SET BACKS FRONT REAR LEFT SIDE RIGHT Slnt:
Permit 127,00THIS PERMIT IS ISFOED SUBJECT TO THE REGULATIONS CONTAIN.TD IN THE BUILDING CGDE TONING
Plan Check 10.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT :S HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 137*00 ALL APPLICABLE CODES AND ORDINANCES THE ISSUA'jCE OF THIS PERMIT DOES NO1WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTCRS TO HAVE CURRENT CITY BUSINESS
State Tax — 5.418 LWEyFE S.PI%AdbPERMITS RF..GUIRED FOR SEWER, PLUMBING AND HEATING.
Total 142•�+0 P.ff))'C• #2 $100.
By
APPLICANT OR AGENT ___- ----- ---------_-
Approved a Receipt No.
AIR INE
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UATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
10-10-11 Contractor
1 0 -11-' Permit No.
0-14-11 �U Rough-in
8- 1 \ ro t /� _ Fixture
(2 - - - cC42 Final
HEATING
end
_ Contractor
l -�.e.v e-1' R.yla�en Permit No.Aat
� Gas "r Oil _
01C -- Rough-in
--- ---- -
Final -- --- - —
2-(7- _ �K SEWER
--
tZ-2o-1' _ Final
15 AV-P4,C<-4" DRIVEWAY
�d c -. 1 ____ • � Final
41Stcrm Drainage
c
GLc-t (Rain Drain) Final
g
0K Sidewalk --
Curb&Street Final
Approach _
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final —�
Landscaping _
Zonir, inal
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