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CITY OF TIGARD BLDG. DEPT.
12410 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
Oate:__�=_ _ 6 Permit No.
Inspector _ -
CALL FOR REINSPECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHC N' 639.4171
CONTRACTOR:
Pursuant to Section(s) o,' the Uniform Building (erode, the
following item(s) require correctin
00
Date:_ -- Permit No. _
Inspect
CALL FOR REINSPECTION
-dl►t
. _._.. -. .. :'�'g'�'�'•>I'.r.+az.+s_+wel�'. L'fi►. .a:_..�.:•i•_.:-w ni:..• - '7�.A+i ,c'^�=e_:
' �^ i f if��t��1t�1iICt�I f'tr`illf �To Permit ,_33.00_ _
l } ,/-lard 1 Fee _ 5'�
New Installation ', Re:►lace ❑ Relocation ❑ Addition ❑ Ah; rasion 3440,State_�22-..�
-TOTAL
CONTRACTOR
COTRACTOR 1�L5 At�_Ls.}.1 1T��'rJ� c LCe Ot4r.cR
N
• ADORESS 129OS V��G_�ld� - -_ WORK ADDRESS l Sf S'W' �c�I uS-L
x.
PHONE �.8-r g/ APPLICANT e2S {R_�AJt]KI� C' .
Heat Input Rating (BTU Per Hour) �p�( Vent Size _ Sri Flue Size G
FUEL Olt- U GAS ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FE
For Issuance of Permit Air Condition Compressor 15 to 30 }'p 10.0
5.
- -100,000- 00 Air Handling 10,000 CFM 3.0
New Under BTU I _
New 100_,000 BTU &over -_� _ 5.00 •_Air Handling Over 10,000 CFM 5.0
Floor Furnace - - __ --^ _ _ 4.00 ~_Evaporative Cooler 3.0
Wall - Floor -Suspended
4.00 _Range Vent Fan 2.0
�^ _ _
Install Vents Only - _7._00 _ Ven:System_- �-_ 3.0
Heat & Coolin 4.00 Hood Commercial_-�! — - 3 0
Repair_ _ 9
Air Condition Compressor Under 3 HP Commercial Duct System_ _ 10
_ - _--- -
air Condition Comf►r!rssar 3 t 1., HP _ 7.50 -
INSPECTOR'S
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY � ____ DATE .__---_-_—. ISSUED BY-...---------BY-...--------- DATE
BUILDING-PERMIT APPLICATION 1ITy TIGAR® DATE--.- 19 79
0 F-
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 13IJ I LDER PHONE.--L=-'L—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. 0WNERPHqN
17
LOT NO. —
OWNER 1]iLQhaffl--StQ0fdWQ11JOS ADDRESS 1334'1'3�,-W �Jililnillll*A* HOME ADDRESS
ARCHITECT
ENGINEER
!2UILDERADDRESS DESIGNER
STRUCTURE Q NEW 0 RUMODEL []ADDITION OREPAIR OFIENEWAL (:]FIRE DAMAGE ODEMOLITION
[:I RESIDENCE OCOMM CIEDUCATIONAL 0GOV-T [3Fk:LIGI0US0PATIO OCAR PORT OGARAGE [ISTORA,�EOSLAEI [IFENCE
OBOND OMOVING []CONDITIONAL USE CIDESIGN REVIEW ElcoUNCIL APPROVED OSIGNS
QCCUPANCY--L--7.�L LAND USE ZONE—R-10 BLDG.TYPE FIRE ZONE-- "PLAN,HECK BY ETU HEAT---'4—a*
�I� trust sin�ie femily dwellin W/attschud getage, 4 ijudrom 3 Beth*
-jetwe of PerMit 2420
_ewsz (3, vait ;jk!1870 - 47115o 00
4 $580700.
40 20 ..A9 A !RNIQ-111DRQOMS -VA.Lw..
OCC,LOAD _Q._5_T ES. E
BUILDING DEPARTMENT SET BACKS FnC.I!T REAR ----7. 1 171 1 SIDE RIGHT SIDE 9
Permit i211 00 THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONI-yG
Plan Check 102*"A REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK"ALL BE DONE IN ACCORDANCE WITH THE PLANS ANO SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 307o -,-0 ALL APPLICABLE CODES AND ORDINANCES. THE ISf.V.'.NCE OF THIS PERMIT DOES NOT WAIVE
RE' i RICTIVE COVENANTS. CUNTRACTOR AND sus CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4-- LICENSE. SEPARATE PERMITS RECUIRED FOR SEWER, PLUMBING AND HEATING.
Total 4400,00
POC 04 1106000
By P1
APPLICANT OR, AG-`—Nt
Approved Appt f4cp Receipt No. .57C�7e?
aft-
aa■
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
7/O-7C _ Contractor
Permit No,
z -,r Ew ,,L , O/Y, Rough-in
1_21As 7_ �1V'�./� Fixture
to-er 27 P/4..i,41/gag 0 Final `--
1 0_^���`' ^�A` � / HEATING
�. T7i�IIAL AppnO✓P ri Contractor
_ Permit No. i
Gat or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
Bl._M DEPT.FINAL TEMPORARY CERTIFICATE OCCLIPA Y
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
K.