10915 SW GARDEN PARK PLACE 9
1.0915 SW GARDEN PARK PLACE
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ADDRESS --
PERMIT CHARGE none
J1D4 t�A CONNECTIO"J FEE c? ego
PAID BY
TY PE OF BUILD I"JG . Lf-P-�'— -- DATE COr;':
BUILDING DEPARTMENT, TIGARD I
PLUMBING FERMIT
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��1�1 holder of a valid plumbing contractors license is hereby
authorized to cau.e plumbin work as herein noted to be installed in accordance %vith the plumbing code of
Tigard. Such installations require inspection by the Cir; Inspector who shall be notified not less than four
(4) hourF prior to the time the installations are ready for i'nspectio'n. City of Tiqard Business License required
for all :rntractors and sub-contractors.
-� :.�_ \ 1�'--:AJ.) �C_�C�ia+' ��_ Dat
Owner r,t 1L.� Address__
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NUMBER OF TOTALP�ERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT IOtfice Use Only)
I_R_S_1.0 N T IA 1.
Single 1`4mily-1 bath-each _ :5.00
Qu lax-Ea h 1 bath unit - 75.00 _ u
-
tvlobiie I`00INDIVIDUAL 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 + building-each 2.00
201 or more Fixtures In 1 buildin -each 1,50 —
MISCELLANEOUS
-Buildin Bawer^1st 50 ft. _ 10.00 _
+ Sewer_-each additional i00 ft. _10.00
water Service to buildingT 5.00
Pl!Vale Water Systems-each 100 ft. _ _ 10.00
Other (specify): - - E
a" For Plumhin Inspection Phone 679•!'171 + r
PERMIT �� 9 A•- GAT'�.1�Y, OR 9IO13
F.State ��6 Plumbing Contractor 13y
TOTAL RFCFIPT NO. Issued By _
Uty of Tigard Mechanical Permit I Permit
`� _ Fee_,
New Installation 0 Replace U Relocation ❑ Addition � ] Alteration �_) 3%State _
TOTAL :jL
CONTRACTOR - R rJ L OWNER -
ADDRES5Sk, W, WORKADDRESS 164/�_ g�j ,�� 1
PHONE _ - //� `) APPLICANT _
Heat Input Rating (BTU per Hour)____::�4 20C.- Y Vent Size _ Flue Size _
FUEL OIL ❑ GAS D ELECT , OTHER
ITEM NO. FEE ITEM NO. FEE
For Issuance of Perrnit _ -_ 3.00 Air Condition Compressor 15 to 30 HP - 10.00
New Under 1.00,000 BTU i 4.00 Air Handling 10,0_00_CFM - 3.00
New 10G,000 9TU &over - 5.00 Air.0Handling Over 10,000 CFM 5:Q0
Floor Furnace __ 40 5.66-
4.00 -�- 3.00
:gt
all • Flo_or Su_ipended -- 4.00 Range Vent F_an -V `- --'
_ _ 2.QU
Ir,tall Vents Only -_2.00 Vent System -� 3.00_
Repair - Heat_&_Cooling_ _ 4.00 - Hood Commercial
Air Condition Compressor Under 3 HP 4.00 Commercial Duct System 10.00.
Air Condition Compressor 3 to 15 HP 7.50 ---
INSPECTOR'S COMMENTS
CITY EUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CCNTRACTORS _
APPROVED BY--_`_- DATE ----`�__ ISSUED BY _---�- _ DATE _
RECEIPT NO.174
4
Signature of Applicant
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BUILDING PERMIT APPLICATION 1oF TIGARD DATE.._ �,�,m�L_, 19 7L
THE UNDERSIGNED HEREBY APPLIES FOR APERM IT FOR THE WORK HEREIN INDICATED 8I)1LOERPHONr
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF ..
I',I of. °i LOT NO.____.
OWNER _,, jiln-} K JOB ADDRESS; (�Q Z QRfl l'G SG HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER 4 Qd 111111-1k _ ADDRESS DESIGNER _
T_t UCTURE ONEW ❑RE MODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DNMAGE ❑UFMOI.ITION
l IESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE El DESIGN REVIEW CICOUNCIL APPROVED ❑SIGNS
UCCUPANCY BLAND USE ZONEH—___ BLDG.TYPE�� _FIRE ZONE PLAN CHECK BY- QU HEAT
-2truLA duWiii�—_I LLCI testi urgra we 4 i.._� uotn 4 filet h. -------
— TYPE "01, flipu-lutiye 2f__Lgt .�iq _
— — — uumbiou c;lr;trm"_fuw uired for uouseSower* _--
—srarju ago 0140 , I'a
? - _�L�.ssQal�� �,eA_.xll2_►v�e..�Qa'�Qrt��_._.v�; ' t ['�7.
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 1: LEFT SIDE i{ RIGHT SIDE �.C1
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1G.DQ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAI rw
_ WORK WILL BF DONE IN ACCORDANCE WI TH THE PLANI, AND SPECIFICATIONS AND IN COMPLIANCE WITH
SL+total 17�OD AV_ APPLICARLF CODES AND ORDINANCTIS. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-� RFSTRICTIVF COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SFPARATI PRMITS RE13UIRED FOR SFWFR, PLUMBING AND HEATING
W11 'u04 UQ
Total "22 j• id PDC ;i U20.00
ByP1 - - __ —-- -
--- - APPL If.ANT OR AGEM1
Approved ►.. W+etdefs R+!celpl No
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i
DATE INSP. TYPE IN:'PECTION REMARKS PLUMBING DATE
_ Contractor
-
✓ permit No. — 7.2
.,y Fixture
Final
0.
HEATING
Contractor
,/ -Permit No.
Gas or Oil
_ —__---------��—_ Rough-In _
- - ----._ - Final
— -----_ _�
SEWER
Final
Final
— � �--- — DRIVEWAY--
Final
Stonfi Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
&DO.DEPT.FINAL TE:AIPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE.OCCUPANCY _—
Landscaping
Zoning Final
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