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BUILDING DEPABTNrliNT, TIGARD
�- PLUMBING PEOMIT -
' ho'der (,f a vali.l plumbing contractors license iti hereby
authorized to cZs—c plumbing work as h4rein noted to bt. ins ailed in -,=rdance with th plumbing code of
Tigard. Such installations require inspection by the City Irt_ot-ctor wl:o Shall be notifi,d 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.
Ownerl�fii�.5yoi✓�,('�o��'t AddressDate'-7
NUMBER OF TOTAL PERMIT NO.'S -
TYPE OF PERMIT _ ITFMS FEE ON tf
AMOUNT (Office Use Only)
A LSinge F25A0 Duplex-Each 1 bath unit25.00 ^- i
lddutionel hathrooms-each
__- -- - ------ ii
Mobile Nome Space, each 15.00
INDIVIDUAL FIXTURE FEES - !)r
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 1g-each
- ` �►
_ 2.00
201 or more Fixtures in 1 building-each --- 1.50
PA I S C E L L A N
ldinwr•-1st 50 fBu .
— ---
10.00
Sewir-each additional-100 It, 10.00 -
-- -
Water service to huflding - -_-_ 5.00 ��-
Private Water Systems-each 100 It 10.00 ---- - -- -_-�-
Other S ec)I
FERMIFor Plumbing ln.specrinn Phone 639.4171 8Q� N.
�j F�47'17VT1y�! IBJ 1►�
3"b State �, •� (, Plumbing Contractor By ___C,N BY OR g��l`.3
TOTAL 'C••/r. - RECEIPT NO. Issued By
I L
pill Fee -y—o'g
Relocat;an Ci J, C)n A!;-;rilon X'-, S.
11DTAL
C-:.TP.AC:TOR C),v-F.F,
14J WORK ADDRESSj
PHONE APPLIC:N'T____
-r
Hea; Input Rating (BTL! Per }lour)_ Ven. Size Flue Size
UEL OIL CA5 EJ ELECT OTHER
ITEM NO. FEE ITEM No. FE
-or Tss*--' -.w AiTCoTdition
Issuance o! Permit a to 30 IAP
New 10.1
Air Handling 10.000 CFM
f�ew- Unje, 155,603 BTU 4.0c)
31
New- 100,000 BTU & ever 5.00 Air Handling Over 10.000 CFMI
5.1
Floor Furnace 4.00 Evaporative Cooler
3.1
Wall •- Floor -Suspended 4.00 Rang?Vent Fan
2.1
Install Vents Only 2.00 Vent System 31
Repair- Heat & Coo.ling 4.00 Hood Commercial
Air Condition Compressor Under 3 PIP 4.Gr
_1 j Commercial Due; System
7.50
4X;r Condition Compressor 3 to 15 HP
INSPECTOR'S COMiMENTS
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY- DATE ---- ISSUED BY ---- DATE
RECEIPT NO.
774 Signature of ADplirani
'"'14a'il ry, ffio"pi'vwwwwo '_u.::`.' v��' '7� P7M1---v PRIM +p•.r-.� .1��' •7 p�',-..-.
l
1ITY �y
BUILDING PERMIT APPLICATION of T'IGARID DATE
THE UNDEHSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE-----
OR
HONf --_OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICAZ IONS. OWNER PHONE .----
+ 9R Hill L n /aA ' ���� �3Gordon Park Plock. LOT NO.
OWNER Jog ADDRESS HOME
ADDRESS _
�y
t ARCHITECT —
""tvnertd 8931 %L 90th. PIA' , ENGINEER
BUILDER ADDRESS r-� DE5,IGNFR
STRUCTURE InNEW DLM
RnDEL ❑ADDITION DREPAIR DRENEWAL ❑FIRE DAMAGE. ❑DEMOLITION
D 71E.SIDENCE DCOMM DEDUCATIONAI. DGOV'T 09ELIGIOUSCIPATIO [:]CARPORT ❑GARAGE D STORAGE El SLAB [:]FENCE
❑BOND ❑MOVING DCONDITIONAL USE DDESIGN REVIEW DCOUNCIL APPROVED DSIGNS
CU°ANCY LAND USE ZONE_ -BLDG TYPE _FIRE ZONE— PLAN CHECK BY HEAT
Construct singlca family dwelling wfaLtaohod gasatgo - 2 i.iktOrwams -- r: ,at.hn.
TYPE C p PE-155UE OF P "AIT #27255 (Lot 31) —
1 HOUR FIHC. I;IRLL RLQUIREO HfTWEEN :3UILDINGS.
SfUrP ;aEF<!'HIT �18"28 - 1.,625.1130
4QCs-Q r1__--__ELQQR_I.QAIL40 960—�NO,-@-EI�,Q.0-k��S_ YAI�€ _ ---
BUILDING DEPARTE '? f1C1 i :
MNT0
— — SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit. 4,1 .'1/w.
. -- __------ - --------- --__--_---------- — -
�' – THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS C-,ONrAINED IN THE BUILDING CODE, ZONING
Pleb Check' 10000 REGULATIONS AND ALO APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total I.Sd101 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
4R REST ICTIVE COVENANTS. CONTRACTOR AND SUB CO'JIRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE.. SEPARATE eEBMITWEOUIRED FOR SEWER, PLUMBING AND HEATING.
Total —r-- t 1 wer 41 0.00
-- ----------
APPLICANT OR AGENT
----------------------------
Approved R^reiht No -3137
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DATE IINSP. TYPE INSPECTION - REMARKS PLUMBING DATE
Contractor�_ n
Permit No. Iq Z 5-•
Q _ �---- ------ _ Rough-in —
51g� • �,mi� ek--IA,! Fixture —
f ! S% C�iwrtie�_�yu i�e.l
_ / D Final
HEATING
—--- �----- Contractor
-.-- — Permit No. /(p '1.'j$ /O - 77
Gas or Oil
-- -------- '— ----------- Final
--- ——--- --�.-. —
SEWER
-- --- ------ -- Final
DRIVEWAY
Final
Storpn Drainage
— ---- ----- --_ - � — i(Rain Drain)Final —
Sidewalk
-— — Curb&Street Final
Approach
BLDG.DEPT.FINAL TtMPORARY CERTIFICATE OCCUPANCfFinal
CERTIFICATE OCCUPANCY 7ndscaping
ning Final
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