10705 SW BLACK DIAMOND WAY I
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10705 SW BLACK DIAMOND WAY
INSPECTION NOVCE
City of Tigard Building De,v ment
12420 S.W. Main S1.
Tigard, Oregon 97223
Phone 639-4171
Addre*% Permit
Type of Inspection
'The following Building Code deficiencies are required to be corrected:
Presented to Inspectur
Date
C4L.L FOR REIAGPE-MON
0 YES 0 No
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iCity of Tigard Mechanical Permit Permit r.OQ
Fee
New Installation IJ Replace U Relocation, ❑ Addition ❑ Alteration [_1 3%State
TUTAL _
CONTRACTOR OWNER
ADDRESS__TWORK ADDRESS__
PHONE _ _ APPLICANT___
Heat Input Rating (BTU Per Hour)—_ Vent Size — `Flue Size _
FUEL OIL LI GAS ❑ 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 BTU 4.00 _Air Handling 10,000 CFM 3.00
New- 100,000 BTU&over 5.00 Air Handling Over 10,000 CFM_ 5.00
Flo-- Furnace 4,00 Evaporative'.00ler _— 3.00
Wall - Floor-Suspended 4.00 Range Vent Fan - 2,00
Install Vents Only _ 2.00 Vent System
Repair- Heat&Cooling 4.00 Hood Commercial � 3,00
_Air Condition Compressor Under 3 HP 4.00 Commercial Duct System 10.00
Air Condition Compressor 3 to 15 HP 1.50
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY _ DA)E ___ ISSUED BY �_— DATE —
RECEIPT wO.
771 Signature of Applicant
LAddreo,3 Ld 0�
" 4tp� Permit
Permit charge -�
C o n ri e c` ion fee — Y
Paid by
l Date r.onnertFd
In,pection fae u2-S ,
�ntr. act-r Paid by d;A
r.3 of Assessment Paid
SEWER PERMIT NY 15905
Unified Sewerage Agency
of Washington County CITY OF Tigard . DATE 5-12-7A
OWNER: (`Monogram Homes PHONE :
OWNER 'S ADDRESS:
TYPE OF INSTALLATION:
Qy$UILDING SEWER ❑ BUILDING SEWER AND :TIDE: SEWER
TYPE OF OCCUPANCY:
x❑ NES ❑ `SINGLE FAMILY ❑ COMMERCIAL
❑ EX IST. (PRIUR 'TO 7- 1-70 ) 'j.MOLT. RES. [:1 INDUSTRIAL
FIXTURE UNITS;_, DWELLING UNITS 1
ADDRESS OF STRG�;TURE : 10705 SW Black Diamond Wim _
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALL-ING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS, THE AMOUNT PAID WILT_ BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT rEE $ 25.
CONNECTION ;HARGE 600.
SIDE SEWEP INSTALLATION B. Greene
OTHER ISSUED BY
DOTAL s 625.
APPL [CANT DATE
leo
SEWER PERMIT N? 15905
ADDRESS OF STRUCTURE 10705 SLI Black Diamond Way
TAX MAP TAX LJT SYSTEM �ar�r"i0 creek
LOT ---Z-3—BLOCK OF
L,,,L1a 1 d e n
APPROVED BY DATE TSSUED BY � DATE
U. U. " S REMARKS h1 ..n. J Opp_-_
fir• � war,-...-s. ,, .• __-^ ._
BUILDING PERMIT APPLICATION " Y TIGARD DATE -i-i2 7b ,g
2018
r U1
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONI?
��1y LOT NO.
OWNER -__ JOB ADDRESS ,14705 Sot v , HOME AdDRESS -'
ARCHITECT
BUILDER ADDRESS ENGINEER
f--1 _ DESIGNER
STRUCTURE _ONEW —❑RFMODEL ❑ADDITION ElREPAIR ❑RENEWP,L [:]FIRE DAMAGE []DEMOLITION
❑ RESIDENCE El Comm []EDUCATIONAL ❑GOV'T ORE LIGIOLIS❑PATIO ❑CAR PORT ❑GARAGE [J STORAGE❑SLAP [:]FENCE
❑BOND -❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPHOVED ❑SIGNS —
OCCUPANCY—nr,,�L_LAND USE ZONE _._BLDG TYPE�L' FIRE ZONE PLAN CHECK BY --_-HEAT
gym- -
i • rbr i� f M-LIu OWE41112 , #,Attayched parnalL- -1 hardraanm ��Lth
gar,.
I t'- Ij Q[ -6t L flt i t 0 ,90
-- ----
OCC_:._LQAp FI49E LOAD '!i) HEIGHT' �IL NQ.STQR�S ARE�.LIL» NQ.@uAOOMS •1 YALII� ySd
BUILDING DEPT RTMENT SET BACKS FRONT Z! REAR 1, LEFT SIDE RIGHT SIDE
Permit i .i a . l . -- ------ -- -- ---- --_-- -_-- - -
-" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Che--k �J s :%C' REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREHY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal - ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT r,OES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONT'RACTO^S TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REGUIRED FOR SEWER, PLUMBING 10 HEATING.
Total i (,:. . a.•Ub.
I By poosce #2
L60-W
APPLICANTOR AGENT ---
Approved Receipt No.
i
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DATE INSP. TY E INSPECtiION REMARKS PLUMBING DATE
S-77–_737
Contractor
S ` Permit No. 11oAlt S
__ Rough-in
Fixture
Final
f/O J•(J. r HEATING
Contractor
'Y Permit No.
s or Oil
gh in
Final
j SEWER
Final —
� DRIVEWAY
-Z / AMr 1 Final
c•
Stonii Drainage
(Rain Drain)Final.
Sidewalk
_F
Curb&Street Final
Approach
BLDG.DEPT.FINAL 'TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUP.�NCY
Landscaping
' Zoning Final
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