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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Unify,m Building Code, the
following items) require correcting:
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Oates. �' Y- �'J Permit No.
Inspect ` - -
CALL FOR ;;s:OWSPECTION
BUILDING DEPARTMENT, TIGARDrD E
PLUMBING PERMIT
�a holder of a valid plumbing contractors license is hereby
e of
authorized to cause plumbing vvork as herein notad ,o bellnstectorlwh► shall lbe notified ce wilh Enot less than ng dfour
Tigard. Such installations require inspection by the City p
(4) hours prior to the time the installations are ready for inspection. City of Tigard 8usin as License required '
for all contractors and sub• ontractors. fob `\ _Q- I
Yin �'T"pate_._ _ f
-.''�---
0wner - rC i AL
l _, NU`r14cR OF _ r
P.E UPI EACH
A,S1DUNT t
TYPE OF PERMIT ITEMS
------ — '
t
finale Fatuity-1 bath—each 2500
Duplan—Each 1 bath unit
s—each 10.00
Add,lional bathroom `---
15.00
INDIVIDUALFIXTURES CCMplERCIAt
7.00
_t to 50 Fixtures in 1 buildi
to 100 Fixturesin 1 bufldinq_each_��� _ 2.50
2.00
101 to 200 Fixtures in 1 building_each
1.50
2012r more Fixtures in 1 bpildingeach _ -, --
MiSCELLANEOUS
10.00
ITOTAL
ice to building
�� � Fnr Phimhing Inspertinr,Pltona 60 4171
_____ Plumbing Contractur By�— RECEIPT NO. Issued By - --.-
(>.,i t y c) .,- i i r a i'aMechanical Permit �,jQ Per
mit.—
'.�-. Fee f
Nrve Installation 'fteGl•+c�' r+ Relocation [ J Addition E-1 Alte.'ration n 4%State,_
HEATING ,�A TOTAL—
Ct:rfJTR.4CTUF dlbs f _ OWNER_1✓
WORK Appfif:SS � l / GfSY O_
w
_-_�`-_
PiICONE _ o
APPLICANT ,
I-,eat Input Rating (a,rU Per Ho+,r) ._ . _._.� .. �h:nt Si/
n o-rl-I Fi R Flue Size -�—
d
UIL OIL Ell GAS J'- ELECT 0 -
ITEM NO. FEE '
ITEM
. or Issuance of Permit t,13 AEiO - Air Condition Compressor 15 to30HP O FF-r '
inc1.I00,000 BTU
_ �h.00 Air Handling 10,00_0 CFM__ 3._0_0
over -b.00)Y _ - •__. ______.-- -
_ - .__ — Air Flandling Over 10,000 CFN1 5,0,E
Flcor Furnace _ Evaporative Cooler —3.60-
v'lall- Floor -Suspended -__._4 ands Vent Fan�� 2.00
Install Vents _3.G0
rtenair -Heat.& Cooling =+ --- -�00 ... __ -_Hood Commercial - - -�' 3.00
Air Condition Compressor Under 3 HP� -- '- 4.00 Commercial Duct 5yst^m � 1U.GU-
Hir onditinn Can;rrNssor 3 to 15 HP7.50 _ -- - -- --_
----
IN;.•PECTOR'S CiJAAeVIENTS
CITY BUSINESSLICENSEREQUIRED FOR ALL. CONTRACTORS OR SUB-CJNTFIACI-ORSA�
r"F ROVED BY— _ DATE ISSUED BY
_...__._ ._._._—__.,_--____-- _ DATE
FtFCF IP r -
?ia
Signature of Applicant
I
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CIT _ 79BUILDING PERMIT APPLICATION of T! DDATE
19_ - ro �
� 4.,«tl/i-r1.
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR 1HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWN -'RPHONE_ ,1118 L L...�
LOT NO._
7-177,
11NER 1 rarju(tina* nC1mwe JOR ADDRESS (IoO :ji. a nicor y 1. L. HOME ADDRESS
7195 _'Tw ._N09.+'t Qn ARCHITECT
�lflli� �l I') ENGINEER
BUILDER _��--y__ ADDRESS DESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑-1REPAIR QRENEWAL 0.rIRE DAMAGE [-]DEMOLITION
❑ RESIDENCE OCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSQPATIO ❑CARPORT ❑GARAGE ❑STORAGFOSLA13 [:]FENCE
❑BOND LJMOVING DCONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
— � - R_ W-74�U :JN — I)LtH r�aae
OCCUPANCY_____.LAND USE ZONE BLDG.TYPE ". _fIRE ZONE PLAN CHECK BY HEAT
Unnt f Urt single family dwulling w/tettechedgerag e. 2 bedrooms - 1 flathm.
no-Issue of Permit 112912 (12L2' SW i:h.icory ; ourt)
--- - ---- - ri wp r Gwr mit 20364 - M-�).00
;it 19 1 — l,lGy 1 3E3 1a0.
9_L9A(Z_—_.--._S:J 9QH.191q�T—__— _-.HE1�IiT_---- N0.8T'Zgl �--_ ALE
�� A_—
BUILDING DEPARTMENT SET BACKS FRONT 30 RA_E_��R_ 2+' LEFT SIDE 1 RIGHT SIDE
Permit 'i. :)0 L.C I Tl T. JL U F1 I a 31. mat.. or 11 00" --_
THIS PERIVIT IS IS`;UED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10.00 REGULATIONS AN.I ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- — WORK WILL HE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICA71ONS AND IN COMPLIANCE WITH
Sub-total
l n0 ALL APPLICABLE AND ORDINANCES. THt ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRAOTCN AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 'I LICENSE. SEPARATE PERMITS REOU 'ED FOR SEWER, PLUMBING AND HEATING.
Total �• � ' t
-- PUL #1. ':,100.
B ►'
_�— APPLICANT OR AGENT
Approved Receipt No
DATE INSR TYPE INSPECTION REMARKS PLUMBING DATE
/J-�-,'9 t irS i_ Contractor
S a_e4rin Permit No. .20Y3 y H-1-71
i
I - — Rough-in
Fixture_
i tlj v(' cr Final
-IY'�U fA�,(P. F�-• 7/r - - HEATING
Contractor
Permit No. 16 F- .2 f 10-Z9_ -2 S
Gat or Oil
Rough-in
- .---- - Final - -
SEWER
— --
Final A�
DRIVEWAY
Final /" r/ C' • gr T
Stone Drainage
(Rain Drain)Final
Sidewalk
Curb&Street F;nal
Approach
PLI743- DEPT. FINAL �Tf MPORARv CERTIFICATE OCTNS'Y Final
CERTIFICATE OCCUPANCY \tJ
Landscaping
Zoning Final ----� --