10640 SW GARDEN PARK PLACE 10640 SW GARDEN PARK PLACE
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BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT '• -
� +-'r� holder of a valid plumbing contractors license is hereby
authoriz to ause plumbing w6rk as herein noted to he 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 1 igard Business License required
for all contractors and sub-contr;.ctors,
Owneri • s, ,d.'_- Addresst�Q�S' Yp'�c�► r Date J-j_ r' 7y_
--
NUMBER OF TOTAL PERMIT NO.'S
T1/PE OF PERMIT wr ITEMS FEE ON EACH AMOUNT (Office Use Only)
Sin'Ile Family 1 beth-each 25.00 s`
Uuplex-Each 1 bath unit _ 25.00
%dditional bethr"rnliach
Mobile Home Space-each `� _ _ 15.00
INDIVIDUAL FIXTURE FEES
1 to-50 Fixtures in 1 building-each 3.00
51 to 100 fixtures in 1 building-each _ 2,50 -"--
101 to 200 Fixtures in 1 building--each � - 2.00
201 or more Fixtures in t buildm each ,00
MISCELLANEOUS
_Building Sewer-1st 50 ft, 10.00
Sswer-each additional 100 ft. - ^^ 10.00_ -r-^
Water Service to build ng— - - -_� 5.00_
_Private Water Systems-each 100 ft. _��- _ _ 10.00 -
Other fS ecif 4: MY
--
PERMIT ForPlumbiny lnsPection Phorfe 639-4171 805 N.E. 'QU
3"o State /`` Ct Plumbing Contractor By �' � OR 97013
TOTAL :31(- C RECEIPT NO. issued By
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(iJ ' Fte
N' I ;Cot on nC-0,0:-c i=.Cl oczflon L _J -•,i-i,t;On 1 Alitr-lion �- __
IOTAi
o;, :Er;
n / ' AC)13:
IVORY, A DEtESS Ia.L qo 1
_ PFlnr: ��
Neat Input Rating (BTU Per Hour'- � Vent Size ---- - —
Flue Size
-
FUEL OIL r_i GAS U E,ECFJ OTHER — -�-- —� —�
ITEM NO, FEE ITEM NO. F
For Issuance of Permit i� 3.00 Air Condition Compressor 15 to 30 HP
r. N.,,,r . Un is;v j pj p�0 ETU 4.00 Air Handling 10,00'J CFM 3,
Neap• 106,000 BTU & over 5.00 •'Air Handling Over 10,000 CF Wr -- -F
Floor Furnace -�--~ 4.00 _ Evaporative Cooler 3
-s Wall • Floor -Suspended 4.00 "38nge Vent Fen 2
Install Vents Only _~- 2.00 Vent System — 3
' _ �... _
�,. Repair - Heat &_Cooling 4.00 Hood Commercial 3
Air Condition Compressor Under 3 HP x.00Commercial Duct System 10.
Air Conditian Compresser 3 to 15 HP�� -- 7.54 --- --�-- ----_--_ -_
INSPECTOR'S Cor',,V[NTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB•CONTP,ACTORS
r+e APPROVED BY DATE - - ISSUED BY DATE
REChIPT NO.
1'-: n. Signature of Apraiirant
-'sa or,.if'IV�!ti•�rW"�44'w"'�7w MrY�"w''"'rVn"'"rCb�i7MR"�"+'"''A,�"'^n`"'!+""�t�1+t�Mr^)",/ -•.�7�'t�1V/11wFi `�""' - ..�
CITY �w /� 79
BUILDING PERMIT APPLICATION of TIGARD DATE____ 19
11AE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE--_--
LOT
HONE- —_--_LOT NO.----
OWNER .ICJS ADDRESS ]W 64:2 L u ori Palo,HOME ADDRESS -
ARCHITECT
9931 .,91E 80thE diPtl . ENGINEER
BUILDER ADDRESS _�— DESIGNER
STRUCTURE ❑NEW ❑RI M11DEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIR--+E DAMAGE (:]DEMOLITION
[:1 ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSCI-TIO ❑CAR PONTT ❑GARAGE FJ STORAGE SLAB CIFENCE
❑BONG ❑MOVING ❑CONDITIONAL USE 0DESIGN HEVIEW DCOUNCIL APPROVED [:]SIGNSCPA
_
OCCUPANC _.A.AND USE ZONE _BLDG TYPE FIRE ZONE- PLAN CHECK BY 1
�_ HEAT.______
�.on :: c ruc :inglae i`efally dusAi 11lig W/ QttraCh6L g4I1>!'U 6s, 2 Hedt amm �• �
i o 1 10Gl 6
G
LOAD j_____HfjQjHT N4ASS-S7B1J AREANO,8U59QM$..,.--VALDE_ _ ---
BUILDING DEPARTMENT 20 � "T
-_-_. SET HACKS FRONT REAR LEFT SIDE RIGHT SIDE
Petmit
THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan CNecic in,i 1 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-' WWORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICA'T'IONS AND IN COMPLIANCE WITH
Subtotal 37.• ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-'-'- R`fSTRICTIVE COVENANTS, CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax -�' I-Ir.ENSE SE`PA- RRAATrPERMITS REOUIRED FON SEWER, PLUMBING AND HEATING.
Total �1 a�•�� ��
By -
Y
3A LICAN7 Op AOENt � �� _`T
l `
Approved Receipt No
DA-E INSP. TYPE INSPECTION REMARKS — PLUMBING
_--DATE
.� Contractor
Permit No. / � 6• -7-��—1/
E--/�.79 (� — 9ough•in
--
Fixture _
Final -
HEATING
1" ---
-- -- Contractor j n
___-- Permit No, /h 7 7, �'60'
---�- --- ------- -- Gas or Oil
Final
SEWER
--_--- --- ------ _. Final
W— — DRIVEWAY
IFinal
Storm Drainage
(Rein Draln)Final
— — Sidewalk
— Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final —
CERTIFICATEOCCJPANCY -- ---�
Landsrnping
Zoning Final
i