11040 SW GAARDE STREET 11040 SW GAARDE STREET
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ADDRESS PERMIT NO. i
PERMIT CHARGE .� none
A CONNECTION FEE
0w%,ER
/ PAID 8Y _� -��
TrPE OF BUILDING
DATE COr�':ECTED
SERVICE RATE ��d• "-JoDL) INSPECTION FEE a 51 erg
CQ%TRACTOR
PAW 8Y DATE ---
ASSESSMENT PAID
SIZE 0F CONr:ECTION _ _______ —
1300 $& 4( rr: PLUMBIN13 PER'IV!IT lei f�
Peninsula PlumbingCo holder of a valid W nbiny contractors licens,. is hereby
a�.�thorize'I to cause plumbing work; as herein note;; to be installed in acrordance wirh the plumbing cocle of
Tig-_rd. Such installations require inspection by the city inspector whr. shall be notified not less than four ¢�
(4) hours prior t0 the time the in-itallations are ready for inspection. City of Tigard Business License required ?
for all contractors and sub-contractors. t
Ilo�
Owner Robert Rallda��,ScQ '; 'W Q 'dg :it.-" _
_ _ Addres.._.__ _ �.s —__.��g,,A
- NUfd98R OF TOTAL y PERh11T HO:S
TYPE OF PERMIT ITEMS FEE ON FACH�j'gMOUNT (OFrice Use Only)
..
F.
S I D_UYJI
C' Sin31i Family-1 ba,,N-aach _�-�— 2500 12 •00 ____
OVOI?.i—Each I bdtl unit - 25.00
Addi;ictntl b34:hroumt-each - 10.00 _ _ �0
Mobil3 Horae spice-each 15.09
INDIVIDUAL FIXTURE .FEES_^
I to 50 Fixture+ in 1 buildingeach -- 3.00_ ---"-
51 w 100 Fixtjret m 1 btildir;-each 2.50 S
1; 101 !u 290 Fixtures in 1 b-illjir, -. ch
-_-._._r _b ._ _ 2.00
201 qr - _ ---
mors Fix:�rtin 1 builrli2-each 1.Su T
d.1ISr.ELI NEOuS
3uildin;Sir.er-13t So f!`
sewer-each
t0A0
r•!»'idonal 100 ft. -- -- -------- - �._
_ ,- - 10.00 - 1
6Jarsr 5rvic 1
_e to bvilt;inR ' 5.00 �
Priva��!'_t�.:Sv;:tms-each 100 It. 10.00
1 Oth-• t
owner
P£�Py 1T 125.00 For Po' r0inrf in;,c. +r PhKi 639.4i71 eine
44;Stat (/�
5!� Plumbing Contrzmwr By 1 W r,reei( `h I. �
TOT 41. 130.00 f(ECcI?7 NO. Is ?ci By ---
131umbing Division 11/17/7$
City of Tignrd
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Job: Robert Randall Co.
11003 S.W. (;garde
Add one bathroom ii10.00
.4o
u10.4o
I BUILDING DEPARVAENT. TIGARD 1�0
= PLUP;t?,.i`J3 PERMIT r
l Peninsula Plumbing Com_.—_—_ �___, holder of a valid plumti;ng contractors license is hereby
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euthorized to cause plumbing vrork as herein noted to be installed in zccordanre with the plumbing code oP
Tigard. Such irstallatiuns 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 contractors and sub-contractors.
Ito.-%-o
Ov-mer Robert Randall Co:_ Address .4d. C+�iarde St.-HIdg Date 11 14J2
- NUAARFR OF TOTAL PERMIT NO.'S
_•t TYPE OF PEHMIT _ ITEMS FEE ON EACH AMOUNT (Office Use Only)
t
R.FS I r E-N�1 A,,.__�,._- ---- -- I -5-- — -- -.._---
Sincle FArrity-1 ba!h••s_seh _- _ 10 �� --25.00
Oua'exxE.u_h t Kett+ unit _ _-- -- -- -�- 2500 — -- ----- ------- {
4d4itional bathm�rn7-each -- �___ 10.00
1 -— - --- __ - 15�Ot)
' hlobilt Horne Spe^,--each - _ .---�•--- ____—.�...__._ .-...-----.----..
t
1 I N O I V I O U A L FIX T U R F F_E E
1 to SO Fixturat in 1 buile;ng--Pnrh — _�__ 3_00_.-._ -� ----- ----
2.550
51 to 100 Fia;urei in _�..-
101 to 200 Fixtures in 1 building =,r.,:h, _ _ .-_._____.,___ 2 n0_ ---
_- 201 or more Fixtures in 1
M ISC F.L L A N r O U 5 1U.hO ---
-1st 50
S•',•, anal 100 f�_- -�-__ r _ _.._-._10.00
—
w.r• . to tiuildir� -- _.____ --- -_- -- --5.00
P systems•-such 1_0.0 It.
i
Sewer--stor _sewer water d raindrains owner*_
j -P; , .' ------------ ror Plumbing fn:r 'Gn P:;rr 63J -
10,00 — Plurntting Cunu 3,,tor E.;
T(1(�;l_ �O�d6 FIVcEIPT NO. lastt.,c{ By
BUILDING PERMIT APPLICATION CIT Y TIGARDBATC 19 ITT
coy
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICA,fED 13UI LDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIF ICA-1 IONS OWNER PHONE-
11040 LOT NO.
OWNER (.�j.JOA ACIDRE.St:t=rtj SLT G$rlMrQQ Y.t. HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESSDESIGNER
STRUCTURE ONEW C1 Rumr)DEL El ADDITION OREPAIR DnENEWAL CIFIRE DAMAGE []DEMOLITION
CIRESIDENCE CICOMM 0EDUCATinNAL OV'T 0 RELIGIOUS DPATIO [ICARPORT CIGARAGE OSTIFI,,GE OSLAB [AFVNC[-
DBOND [:1 MOVING OCONDITIONAL USE CIDESIGN REVIEW OCOUNCIL APPROVED OSIGNS
OCCUPANCY=:j,_–: LAND USE.ZONE---J'4 PLAN CHECK BY =_ HEAT__�;
;t�___BLDG.TYPE_11�', FIRE ZON6— ETI
n _!u 42,lux goartment all ur.r pl"n as prepared ky
—Pal* Be
21-liad"mL - 10 Bathrooms,
L QB 1 oAr)--All
BUILDING PARTK.ENT SETBACKS FRON!qe& Pjjjfl_REAR LEFT SIDE RIGHT SIDE
Permit t,LlD
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE. BUILDING CODE, ZONING
Plan Check ii., 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 COMPLIANCE WITH
Lib-total 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 LICENSE. SEPARATE PERMITS RFOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
Pot #I
0APPLICANT N
F6R AGE_ vp_p I.,ed Receipt No.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
._T
Contractnr_
Permit No14
/� -
Fixture
Final
HEATING
Contractor
Permit No.
13 �� — Gas or Oil
Rough4n
Final
SEW('R
Final
^— - DRIVEWAY
----- `_ Final - --
Stom Drainage
(Rain Drain)Final
------ Sidewalk
Cirb d Street Final
Approach
BLDG. DEPT.FINAL. TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY ---
/ Landvraping
Zoning Final
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