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CITY OF TIGARD C1,
OREGON
Owner:_.. . . Permit No.. .... .13.J f.-._.
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Building Address...11695.."SW..•113th . P1. I '
......... ........
Certificate is hereby given this....14th._day of...N4.vQm.b.P.r............ 19.77..
that said building may be occupied and
that it complies with all requirements of
~�� I the Building Code for the City of Tigard, ,
as approved by the Tigard City Council. 9' +
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Building Inspector ..
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< . OREGON
Owner:_..-...-...rlo,ri-ss.ett.s....... ..................... .... . ......Pet mit No..._..... 1317
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Building Address. 1-16.55,..W.. 113th Pl., ..-. _• -_-_,.......
Certificate is hereby given this-..14th....day of....N y.t rT der , ly._7.1.-.
that said building may be occupied and
that it complies with all requirements of
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the Building Code for the City of Tigard,
as approved by the Tigard city Council.
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Building Inspector
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Address / / �" � Permit No.
�. Permit charge c� "g
Connection fee 7�
Owner
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Type of building Date connected
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!Service . ate / 5/ Inspection fee �S
Contractor Paid by Date
Size of connection Assessment paid
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City of Tigard
i INSPECTION REQUEST
for
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INSPECTION TIME : _ PERMIT NO. :
DATE: S /G 1 ZZ DATE ISSUED:--I-L--
OWNERS
SSUED:_ I-LOWNERS NAME : /196It s 7f"t
ADDRESS : /Z( E s�✓ /'/ee4 "
CONTRACTOR : -- €
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TEST*. Air O, Water ❑ , Visual , Laboratory o
RESULT: Approved , Disapproved ❑ Pending ❑
SKETCH:
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INSPECTOR DATE
NNOTE : Attach supplemental teat data horst]
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UNIFILD SEWERAGE AGENCY NO. ___1_1667 - _-
WA:�H I NG .EON COUNTY DATE -__ 2:23=77�-_ -------
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CITY OF_. Tgard -- - _ -- - ---
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a APPLICATION FOR SEWER CUNNI CTION PERMIT ,
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OWNER: .--- _
__ Herb riiorissette
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OWNER'S ADDRESS: _ --
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BUILDING SITE: I.OT __ -_--__ BLOCK ___ ADDITION
TAX LOT NO. _ _ TYPE OF OCCUPANCY residence I.
11695 5W 113 th P1.-
ADDRESS _ _
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DWELLING UNITS _ 1 -- ------ ----- ---.- -__ -- FIX JURE UNITS ---_---.- _
SURCHARGE IF APPLICABLE
575. 25.
PERMIT FEE --- _____ __-- __ INSPrCTION FEE _-_ — TOTAL DEPOSITED 6DU.-
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a F_W) (EXISTING) BUILDING -wFR SY.;ILM _ - Fanno Creek
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The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
AFFI_IC;ANT .._
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SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LIME SIZE - -- INSTALLER —_-- - - _-- _-
------ -------------
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RECEIVED BY- —; !._
(AGENCY OFA TS AGENT) -r!? ✓
' COMMENTS: _ _ Bldg. I
;!11315 Paid to _Laron H_ei�hte.___�150.00
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This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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BUILDING PERMIT APPLICATION C1TYOF TIGARD DATE 2-73-77
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE ` r•
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPEICIFICATIONS. OWNERPHONE—
LOT NO. 1
OWNER Harb MOrissuttc JOB AUDRESS.1(_-i 5 SW 114th Pi" HOME ADDRESS ;-
ARCHITECT
ENGINEER
BUILDGR same
ADDRESS DESIGNER I
1STRUCT-U-RE NEW ❑REMOD-L ----❑PDDITIUN ❑-REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION 1
-
I RESIDENCE OCOMM ❑EDUCATIONAL ❑C,OV'T ❑RFLIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.APPROVED ❑SIGNS
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OCCUPANCY l LAND USE ZONE BLDG TYPE— FIRE ZONEPLAN CHECK BY, ..—..__ HEAT_ _
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OCC. LOA( F_WQR.LOAD_______ ___HEIGHT 1 NO STORIES 1 AREA U..4 NO•BEDROOMS :5,__-/ALUE„�iJ.t�❑(
BUILDING DEPARTMENT20 42103E 21 LS ACKS FRONT REAR LEFT SIDE RIGHT SIDE
� Permit 130,00 _ —�—
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10,00 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
Subtotal 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 I'll LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLLMBING AND HEATING.
' Total 144.20
By AP. CANT OR AGENT
fApprove` L Receipt No. —
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DATE INSP. TYPE INSPECTION _ REMARKS _ PLUMBING
DATE
-- — Contractor _ E
Permit No. Y S�3 -� 7 — 7
Rough-in
Fixture
Final
` HEATING
_ Contractor _
Permit No.
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Gas or Oil
---
Rough-in -----
Final —_
SEWER
i Final
DRIVEWAY
- 3
_
Final
Storm Drainage
— (Rain Drain) Fi.ia1 _
Sidewalk T
Curb&Street Final
A roach-- _ -- r— S G' 77
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY —
Landscaping
Zoning Final
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City Of Tigard Mechanical Permit �; .� ; Permit _ 53.00
' -� Fee
New Installation [�':`'iiepia� ❑ Relocation ❑ Addit'snn ❑ Alteration ❑ -� ---
TOTAL -
CONTRACTOR7 . 21 a
rirr: itt:n•rj OWNER it�R�: r.tlt�i: �•r��;�l'r���•�"t'�r(
ADDRESS WORK ADDRESS�l�� f 45
PHONE7o1- 227() APPLICANT ;aii{� I.nurr T :J�ir, i III
Heat Input Rating (BTU Per Hour) };,; _(lit()I t U Vent Size -_ Flue Size �! I
FUEL OIL ❑ '�S\0'X ELECT ❑ OTHER_ t
ITEM NO. FEE ITEM NO. FEE
For issuance of Permit s.0i� Boilers Over 50 HP r
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New- Under 100,000 9TU NO. FEE
4y00 Air Handling 101Ct00 CFM
Newr_Over 1Q0,000 BTU 5.00 _ Air Handling Qver 10,000 CFM_ 5 0C
Floor Furnace 4.00 Evaporative Cooler 3.0C
Wall - Floor - Suss s�endcd 4.00 Vent Fan _2..-QC
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Install Vents 2.00 Vent S-Xstem 3 OC
Re air - Heat & Cnoling _ 4.00 Hood 3.0
Boilers Under 3 14" 4.00 Demrstir Incinerator S�C
Boilers 3 to 1Ci IIP _ 7.50_ Comm Incinerator20.0C t
Boi;eis 15 to 30 HP 10.00 Other Not Listed 3.Uf
Boilers 30 to 50 HP 15.00 r
—_
INSPECTOR'S COMMENTS• �`
CITY BUSINESS LICENSE REQUIRED FOR•ALI, CONTRACTORS OR S'J8-CONTRACTORS
APPROVED BY DATE ISSUED BY DATE '
RECEIPT NO. eZLSfUnature
774 of plicent
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