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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR-
Pursua! '. to Section(s) of the Unitorm Building Code, the
following item(s) require correcting:
oar e--Ae
Date: a _ e _ _ Permit No
Inf,peCfar�.e� .
CAL! FOR REINSPECTION
MR
t y 0 i W*ej&4eal Permit N?
Fee—
N,7w Instillatiun ti4nw,jry ❑ neiocatiun n
Addition Alturation 4%State —'
HEATING TOTAL—
CONTRACTOR
OWNER
a'-31
J' WORK ADDRE'SS.
PI IONS jk
APPLICANT
---
heat Input Rating (BTU Per�Iour)__... Vent Sim .— Flue
i UEL OIL C3 CAS [17-1 ELECT tig. ."A
ITEM NO. FEE ITEM No. FEE
cor Issuance of Permit
Air Condition Compressor 15 to 30 HP 10.-00
to & inc1.100,000 KU v 4.00 Air Handling 10,000 CFM 'I
3,00
NPw
BTU S & over 0
Air a ing Over 10,000 CFM 5,40
Flcor Furnace
4.00~ Evaporative Cooler
I IC110
0jall - Floor -Suspended
ku
Install Vents Only Vont System3.00
Pon,lir -Heat& Cooling —4 Rango Vem Fan
HoodCommercial
Air Condition Compressor Uncle. 3 HP 4.00 C*O-(-I,I-11-10,(-C-i-I,l—o-"U-c,t-.%'y'-SteM--------
10,0U
Air Condition Compressor 3 to 15 HP
INSPECTOR'S ( C'MIVENTS
CITY BUSINESS LICENSE REQUIRED FOH ALL CONTRACTORS OR SUn-CONTRACTORS
i-PPROVED SY--- DATE ISSUED BY DATE
FIFCEIPT NO,
Signature of Applicant
WILDING DEPAIMOEN 1-, TIGARD NO
' PLUMBING PERMIT
holder c,f a valid plumbing contractors license is hereby
authorized to causo plumbing work as herein 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 License required
for all contractors and sub-contractors. Job
Or`��-•� `�-��s .�..E1d�iress_.lo���?
wne .�..—._...._ �.
- -__._ TOTAL
NUMSI:R OF
TYPE OF PERMIT "- ITEMS FEE ON EACH AMOUNT _
Sin a Farnil
1- Lath•
_ 25.00
+x--Each 1 bat,i Unit -
_
Additional bathrooris-each -
--
?�lUblie� FI,•,ii .,q. ]C., _C°1C11 _ _-__ _ __. .-�, _-..._.... _____-___....-�-.._ ._-.-.._.,.-----__ --- .�.-.-
15. .c1
Inlnivvl�ou_AL FIXTu
-it—tt 1-N1 LlCTFI ! —.- ----- - ��
1 to 60 Fixtures In t building-each _ __ 3.00_ _ ---
A
_51 to 100 Fixtures in 1 uilding-ea
bch _-___ - 2.50
tot to 200 Fixtures in 1 buildin -cach�,______ — ----x'00 -- "—
'
201 or more Fixturei In 1 building-each 1
_ _� _ _-- 50-
M I S.C E L L A,N E n U 8-_-� ---- -- -- ------ -..
Sewer-each additional 100 ft. � ___ --. ___r_ ^_ 10.00
Water Ser�ice�to bulging ___
PERMIT for Plumbing I mpoc cion Phone 039.4171
4%State_ Plumbing Contractor By
TOT•; RECEIPT NO. Issued By
- CITY
BUILDING PERMIT APPLICATION of TIGARD tIATE _mss_- 1 ,s 79
THE UNDERSIGNED HEREBY AP'LIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 4�°�� 'll
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER M-T
LOT NO. jL1''� 7%me x t _
OWNER .- i:, � _ ;;;QLt; .LOB ADDRESS .121320 SW Chicdlty L.gIJ$WE AUdRES5
ARCHITECT
BUILDER ADDRESS 13 JL` 6') 11 filvc�, �LiyLn DESIGNER
STRUCTURE []NEW ❑RE-MODEL ❑ADDITION - ❑REPAIR ❑RENEWAL _,FIRE DAMAGE []DEMOLITION
❑ RIESIDENCE'❑COMM ❑EDUCATIONAL_ ❑GOV'T DRELIGIOUSOPATIO ❑CAR PORT ❑GARAGE ❑STGRAGE❑SLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE `❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCYI,'--�.LANO USE ZONE_"" ;_ BLDG.TYPE. —' FIRE ZONE— PLAN CHECK BY uI''N HEAT J00
--3; L LIF:LGTILP�'ySHLt A(T(/T�►jGg 11Q�� _(��-- ----.
_ .
40 _-HEIGHT W.—C NO,JO.@€a _JADE.N_4k. ,i NQ BEDROOMS 3VALUE$4!'9000.
BUILDING DEPARTMENT SET BACKS FRONT REAR 31 LEFT SIDE RIGHT SIDE t
Permit W2.00 Atli(? t.E rangy - -1G!t 's 571,). �It„ 1 ,F (),nU s 7
THIS PI RMIT IS ISSUED SUBJECT TO THE REG ILATIONS CONTAINED IN THE BUIL�NG CODE, 2NING
Plan Check 660 On REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BL DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal 2.A.130 ALL APPLICABLE CODE6 AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NO' WAIVE
RESTRICTIVE COVENANTS. CON,dACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY B,ISINF58
State Tax 6.06 LICENSE, SEPARATE PERMITS REOUIRED FOR SEWER, PLUMB114G AND HEATING.
Total W64,rib
By K' _
"- - - ---- � APPLICANT OR AGENT - - -
Approved �',)F� Receipt No.
..._....«.... «.w,.w�r.w..w..r.......,.._ t.nn �1G,i,.:w .-.� HONE --
DATE INSP. TYPE INSPECTION REMARKS PLUMBINGDATE
Contractor
Permit No. ��, f e,
6 i4
Roe!gh-in
1- 2 Fixture
-71
Final
HEATING
-16- 7 ct �T� •+ _Y
Contractor
Permit No, b/ 71�
Ciao or Oil
Rough-In
Final
SEWER
-- Final
DRIVEWAY
Final
Stom Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final _
Approach
SLDO. DEPT.FINAL TEMPORARY CERTIFICATE OCCIP CY Final '
CERTIFICATE OCCUPANCY yf�,
JLendeceping
Zoning Final