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BUILDING DEPARTMENT, TIGARD N0
PLUMBING PERMIT 6
Wder of a valid plumbing contractors license is hereby
�.�. -
author� cause plurrihing ork as herein note) 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 ccnt�actors and sub-contractors. Job
NUMBER OP TOTAL
7YPE OF PERMIT ITEMS TEF. OV EACH AMOUNT
I_�qL51Q E N 1!A
Smile Familv-1 path—each------- 25 00
Duol,riExa'
h 1 bh unit L 25.00
A?d tionat bath,ooms—each 110.00 ------.---._ J
Ntob+'e Home Spic —each r 15.00
INDIVIDUAL FIXTUR•
-s COMMERCIAL _
_ 1_to 50 Fixtures In 1 building—each _ 3.00�
5to 100 Fixtures g
in 1 buildineach 2^50.
4_�_1
__._� es _ _.�. .. .._.
101 to 200 Fixtures in 1 building—each 2.00_
� 201 or mars Fixtures in 1 building—each 1.50
MISr_FLLAN EOUS
fS•w!r—oarh additional 100 ft. _ 10.00
Water Ser,ica to building _5.00_
Other (Soecifvl
PERMIT �– For Plumbing Inspection Phone 639-4171
I _4I;
I L
Nev. Pj RrI:)ca6on E) Aijonon X-Stat-
'Ile IIOTAI
CTOR J1,4j Dce7
46T29fAft
- I w
r
wORK ADDRESS
PHONE APPLICAN-1
Heat input Rating (BTU PerHour)- 3 5 200 Vent Size Flue Size
FU=L OIL 1 G"S ❑ F LECT OTHER!
ITEM NO. FEE ITEM NO. FE
For Issuance of ermit 3.00 Air Condition Compressor 15 to 30 HP
Air Handling 10,000 CFM 31
Nevy- Under 103.030 000 BTU
--New- 10p,fJ00 BTU & over 5.00 Air Handling,Ove. 10.000 CFM, 5.(
Floor Furnace4.00 Evaporative Cooler 3.(
4.00 Range Vent Fan 2S
all - Floor -Suspended
Insall 'Vents Only 2.00 Vent System
- Heat & cooitng____ 4.00 Hood Comrnercial----
Repair
Air Condition CompressorCompressor'
Under 3 HP_i 4.00 Commercial Duct Systemm
Air Condition Compressor3 to 15 HP 50
INSPECTOR'S C0r,0,1ENTS__---.----
-------------
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY DATE ISSUED BY DATE
RECEIPT NO.
I A Sionaltire of Applicant
0/6
BUILDING PERMIT APPLICATION of CITY TIGARD DATE____ /
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13U I LDER PHCNE 777—'.aG��'*�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE__:OO
LOT NO.._ r
OWNER `Ink Hiil Ynyoist.fibBADDRESS111680 561 (;i' &-d0l') PA1'{. IIfaMEADDRESS
ARCHITECT
BUILDER }c.moriri(gi ENGINEER
CI
ADDRESS DESIGNER
STRUCTURE CINEW — ❑RI MODEL ❑ADDITION ❑REPAIR QRENEWAL_ ❑FIRE_UAMAGE ❑DEMOLITION
❑ RRESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ElSTORAGE❑SLAB []FENCE_DEICIND_ ❑MOV INC, ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS—
OCCUPANCY_ L_LAN[?USE SONE r,. BLDG. TYPE FIRE ZONE PLAN CHECK BY !tit HEAL
L.0"Otr"uc t *ArI$;19 f Mily awt. , .09 w/e ttachnd Warage, i i.ec;room I Jelthl. ^---TY PC "A" Fig—Issue. 1-►hour f'iryurall at come on Property link.
Sower Perrin t �" 0307 •• > 7A;:.L'f1 —_
UCG�.I.QACL___ .�FJ"44L14L1fa-_. HEIGI1 _NSL�I4HI AR��---- -.'N4 @ LIE42M$__._ VA1 UE$2A1 17006
BUILDING DEPARTMENT' 20 1! +
--. SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Penult «� r � Il -- – -----• — --
THIS PERMIT IS ISSUE) SUBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20NING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCI' WITH
Sub-total _ L. a 00 ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
� G RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFSS
.
State Tax '0 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total �1r?b.�E :lr�1� R"` ', .$409AW&I UK—pl
By P
+SOC t1 61U0000
3�.LT APPLICANt OP AGENT
Approved Receipt --- --_ --- ------ --
No.
DATE INSRI TYPE INSPECTION — _— REMARKS PLUMS NG DATE
I
Contractor
Permit No.
Rough-in
Fixture
„QAC_ Final
1 HEATING
L.aal- —l=�i^s.oL..cL r•.in�:T .-.labs. -- --
Contractor n
� — Permit No.
— Gac or Oil
--- ---' — — Flough-in
— -- — — Final
--— SEWER -
---— --- Final_
-- DRIVEWAY
�— — Final
--- — Stom Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
-- �__—. --------.__ _ Approach
BLDG.DEQ T.FINAL TEMPORARY -CERTIFICATE OCCUPANCY
Final
CERTIFICATE OCCUPANCY ---
Landscaping
Zoning Final