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3UILDING DEPARTMENT, TIGARD
PLUMBING PERMIT NO
ladder of a valid plumbing contractors license is hereby
authorized to ause plumbing wor as herein noted to be installed in accordan:e with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall he notified not less than four
(4) hours prior to ttte time the installations are ready for inspection. City cif Tigard Business License required
for all corttraa-ct--ors and sub-contractors. fob
0wmer _sL�__.Ql_ttc Address./22 71 .
1111;jat,i OF TOTAL
l TYPE OF PERMIT ITEh1S FEF' ON EACH *MOUNT yx„
A_!_$I Q P N T I A L
Single Family-1 bath-•each _ 25.00
Du 1?.-E1ch 1 bath unit / -25.000_-_ _ p ��)<� J '
Additional bathrooms-eachL10.00 1 sit s
M11-)b0e Fiume Space-tach _ 15.00
INDIVIDUAL. FIXTURES C0MMERCIAl
_I to 50 Fixtures in 1 building-each _ _ 3.00_
51 to 100 Fixtures in 1 building-each _ _ -_ _ _ - 2.50
101 to 200 Fixtures in 1 buildin --each _ _ �r - 2.00
( 201 or more Fixtures in 1 buildfng-eL-h 1.80
I R1 I S C E L l A N E 0 U S
I. .�
Sewer-each additional 100 ft. -�✓_ `- _10.00
Water Service to building -� M- �~ - 8.00 _T_^
4. Other ISper_ityl.
I PERMIT Foy Phimbing Inspection Phone 6394171
i 4%State /,y C Plumbing Contractor By _
1 —TOTAL 34 RECEIPT N0. Issued By
i
City Of TIOL-1- rd Mechanical Per.mii ,T? Permit..-___
----
Nev, -
:--�� Fee
��� In;;alia?ion � R::,;��e 17r;location � Addition a A!i-Lration ❑ v•
3ic$i8te_ �-�
CO TRACTOR � L�L�i-- 011EF, _�LQNE I U AL
Qy�'' �cT.2
WTIDT
PHnR �-s1_L ��-sem__.G .tLL/ Ily boeo 1 0RK AD ESS /aj -
PHnNE lC /� - APPLICANT
Heat Input Roiinj (BTU Per Hour)___ f-� d Vent Size 4 - Flue Size` T `-
FUEL OIL ❑ GAS ❑ ELECT Nr OTHER
ITEM NO. FEE ITEM
NO. FE
For Issuance of Air Condition Compressor 15 to 30 HP
New- Under 100.000 BTU I -- - 10.
L__� ti.00 Air Ha_nd!;r.s O,OOD_CFM 3
New• 10U,000 BTU& over -_ 5.00 ••A_ir Handling Over '10000 CFM
_Floor Furnace _ - -' --- L5•
4.00_ �Evap orative Cooler 3
Wall - Flnor - Suspended _ 4.00 _ 3ange V_ent Fan � -
Install Vents Only _ y� _ ?,_00 Ven• i.
s
_ _ Sy tem
Repair_• Heat & Cooling - _ -- —__ 3
4.00 Ho_ad Commercial _
Air Condition Compressor Under 3 HP - _ 4.00- - Commercial Duc; - 3
Air Condition Compressor 3 to 15 HP -- -___._51'siem -� 10
_ _ 7,50
- ..__-�_.��•�E-���Li._:.�����•—2..-�'L.'^_L_ _.21^�.-_.� L-X5::_1.=. ._�L�'S_-ftt.:C�-.�.�."_
"'�SeaE'L'L-'k�.1•=t•a SSS'_._.. .. _-�_-
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY DATE
ISSUED BY
—- —. - DATE
-21V 14SU7 ii
110
BUILDING PERMIT APPLICATION CITY TIGARD DATE J/ 19 7q
OF 777-56731
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 PHONE
LOT NO.—�
OWNER Iak Hill IrIVust. lr7BADDRESS' J� JI. Nur'' N! ; ADDRESS —`
ARCHITECT
931 SC 30th Pt:.1d ENGINEER
BUILDER t•:Irll. , ADDRESSr _ DESIGNER
STRUCTURE []NEW 0 Rl MnDEL ❑ADDITION ❑REPAIR ❑RENEWAL [:]FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE U STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDI-,IONAL USE ❑DESIGN REVIEW _❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY — LAND USE ZONE_ _BLDG.TYPE FIRE ZONE____ PLAN CHECK BY_ HEAr...
instruc
_ _--
inexcuc t si,lcalo for Ayclwylling w/st~tached gmraye. 2 Hbdroam 2 teeth.
TYPIF I'D" - Rii-leaut+ - Lut 33. 1-Hour f"! rowan at r,,- Tm))n pr3 arty linty.
",user hermit 1120301 — 570'.x.00 -
20
H€LGHS._.___.__ N9 i1'SZ9!E �_ �A--___.__LN9s@E.RR4.4M5--_..-_YALUE —
BUILDING DEPARTMENT SET BACKS FRONT REAR I f I T SIDE FIGHT SIDE
Permit 141,1-1.or-
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE RUILDING CODE, ZONING
Plan Ckeck J.00 i..GULATIONS AND ALL APPLICA14LF CODES AND ORDINANCES, AND 11 IS HE1EBY AGREED THAT THE
WORK WILL B c DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS f,ND IN COMPLIANCE WITH
Sub-total 17 1,00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— — RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax .0R LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING
Total _ %42.0U X), XX 1R s OK-PI
By
APPLICANT OR AGFNI
Approved Receipt No.
•e
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATEE
Contractor q
Fermi!No. r 7379
_ _ Rough-in
Fixture
9 Final
-r
HEATING
/hAL --
Comractor
Parmit No. / m—e-71
J l
Gas or Oil
Roughdn
Final
SEWER
Final
DRIVEWAY
Final
Stom Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OC Fine;
CERTIFICATE OCCUPANCY /— —
Landscaping
Zoning Finol
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