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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
AddressPermit
__–__..---------_-__ —
Type of inspection
The fclioviing Building Code tieficiencies are requ'r A to be corrected-
L1
r
Presented to Inspector
Dale. -----------_.- ._.---
CALL FOR REI NSPECTION
0 YES NO
KJILI.1 NG DEPARTMIEN I TIGARD ly n
..� PLUMBING PERMIT 1�
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
"i igard. 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
i for all contractors and sub-contractors. ;
Job
Add ess-/!rjf s�+� �v�s�i► .%�C'date_1����''yc�
NUMBER OF TOTAL
TYPE OF PEnPAlT ITEMS FEE ON EACH AMOUNT
Sin2Lo Family-I bath--each
buplex--Each 1 bath unit
25.00 _ _ ;��••�°:
Additi .. !;athrooms-each
1NDlVIDi �.. r MX I LIR iC111
1, to�50 Fixture- In 1 huilding-oarh 3.00
51 to 100 Fixti.ires in 1 buildin each
-- 9�: _�_ 2.50
101 tn_200 Fixtures in 1 building-•each
201 or more rixtures in I buildin -each
-�- �•� •------�-
-sewer•-each additional 10G ftp 1040 -
_water Service to building`
Othrr-LStFclf V
PERMIT _�1� For Plumping lnsp?ctiun Phone 639.4171
4ca 5tatr. Plurnbiniy Contractor By lti
TOTAL s-a,470 _ RECEIPT NO. Issued By
AW wow =I
City of Tigard Mechanical Pormit NO. a _
New Installations Repllaa'ce ❑ 'Relocation❑ Addition ❑ Alteration DDATE:
HEAJING
CONTRACTOR ,C�`���L � /7 1 �' —_ OWNER_ / .LN-_,,e,Oa _ -
ADDRESS - -./I�.C1 L ii ,� .IOB ADDRESS/inHS 'WAYri"'I"
PHONE ��
Heat Input Rating(BTU per Hour) _.Zo �� . Vent Size Flue Size___._
FUEL OIL❑ GASJ4 ELECT ❑ OTHER
- -� — ITEM �j NO. FEE �— ITEM NO. _FEE
For Issuance of Permit E BELOW Each Air Handling Unit or Duct System 7.50
New-up to & incl. 100,000 BTU 6.00 Commercial Hood System 7._50_
New 100,000 BUT's & over __— ✓ 7.50 Other Equipment - Each 4.50_
Woodburning_Stove 4.50 1 Trip Inspection _4.50_
Wall-Floor- Suspended -_ 6.00 Air Condition Compressor - up to& incl.3 H.P. 6.00
Vent System w/Fan _ 4.50 Air_Conditio__n Compressorr3.1 to 15.H.P.incl. 11.00
Repair-Heat Conling _-_ 6.00
CITY BUSINESS LICEN51' REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! I
PERMIT ISSUANCE 10.00 Comments:
FEES
---- — --- ----- ------
SUB-TOTAL
% STATE Issued By—..--
25%
y ..--.25%PLAN CHECKruaE_�
BUILDING PERMIT APPLICATION TIGARD DATE -__: - _. tg._ 80 3444
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED QUI',DER PHONE _ 620-6080
OR AS SHOWN AND APPROVED IN..THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNLR P NE —_
ams
T t'k ! ,ti JOB ADDRESS 12✓j8 7 SW Glacier Lily Circle LUT NO.---.""- —k..-
OWNER , c Sualm�rlake
ARCHITECT
ENGINEER
BUILDER 3111110 ADDRESS 7.05 SW SandbuIg a!� DESIGNER P8_Cit`iC Structure�Irz
STRUCTURE P NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL L] FIRE DAMAGE ❑ DEMOLITION
.13 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
_ ----•--_-_ ..� .-ate_ --�2 8=
OCCUPANCY P`3_—_LAND USE ZONE 7_(aD BLDG.TYPE 5N _ FIRE ZONE`-PLAN CHECK BY _ HEAT
vConstruct single family .wollj,ng w/af.J lched g+,r e!_3 t3,eorooms 3 bathe.
-- SEE CORRECTrlN SHEET AT !:HED.
SEWER PERMIT_# 27070
OCC.LOAD _ FLOOP LOAD 40 HEIGHT 20__N_O.STORIES_ 2 AREA 2.352 NO.BEDROOMS 3 - VALUE$73,601.
_ BUILDING DEPARTMENT—� SET BACKS FPON'T so REAR i 78_ LEFT SIDE —d RIGHT SIDE '7
Permit 3.)•00 I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _117, a0 WORK WILL. BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANU IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 3 %x• '0 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-----' LICENSE.SEPARATE PERMITSM9 I�EU F i�WER,PLUMBING AND HEAT'I{(
State Tax 4 ., 4.40 111`1 "i t
SDC— ; �41!U.+%l"• .
----
- PDC# 1 $101).00 APPLICANT OR AGENT
BY
duh Receipt No. ADDRESS
Approved _
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
�> Permit No.
Rough-in
Fixture
f LA Final
HEATING
---- -� — --
Contractor
j�
-- ----- --- Permit No,
Gat or Oil
— Rough-in
---------- -- Final ---•---
- -- SEWER -- -- —
---...— Final
DRIVEWAY --_Final
Storm Drainage
(Rain Drain)Final
Sidawelk
Cush&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OC A - F,41
CERTIFICATE OCCUPANCY �- �- C�
o Land.aping
Zoning Final
K,