13460 SW GENESIS LOOP-1 IRWA
13460 SW GENESIS LOOP
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ADDRESS PFR^1IT NO._ /7 �
PERMIT CHARGE none
OWNER
�-, CONNECTION FEE
PAID BY
TYPE OF BUILDING / -a.J• DATE CONNECTED
SERVICE RATE ^� SSC INSPECTION FEE
CONTRACTOR _ PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID ____
NJUMMIN
CITY OF TIGARD 1311-0G. DEPT.
12420 S.W. MAIN STRFF-r
TIGARD, OFEGON 97223
PHONL 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following items) require correcting:
")ate: Permit No.
Inspector
CALL FOR REINSPEC 1011
I- '
l BUILDING DEPARTMENT, T(_.4t=iD �T
PLUart':tNG PERMIT -
I
holdrr of a valid plumbing contractors license is hereby
authori:ed to causes plumbing viork as f iris noted to be insl iIled in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspe.-,'o(• who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspecIon. City of Tigard Business License required
for all contractors and sub-contractors.
Ownek _ , /I _ Address /, te.
1 NUNIMR OF TOTAL PERMIT NO.'S
i TYPE OF PERMITITEMS FEE 17A EACH AMOUNT (Office Uce Only) {
Single Farr.ily_1 bath—each _ ?5 0►J
_Duolex-Each_1 bath unit _ 11500
Additional bathrnom:-eech10.00' `—�—
fvubilzHorneS�•t_:e_aa:h +--..__. .____--- .._. .._.___.-.-----.•- 15.OJ_,— ._-- _.__.....__ _—.____-___�_.
INDIVID_UA_L FIXTURE FEES
_1 to 50 Fixture% in 1 builaing:-nttrh� _-
51 to 100 Fialurei in 1 buildln -
101 to 200 Fixtures in 1 buildintZ 9�,h 2.00
201 or more FixtUr=9 in 1 bu4,1:1:g-euch__—__—_ 1.50
i MISCELLANEOUS
BuIldinSrwyr 191 5Q f. t_O.0r1 �—
_S�wer`e�rh ar dliunal 100 ft --- - ---- -10.04+ - -------- �_------• i
_Water 59rri_ra to 5uildir,g___�— _ _ _5 r,0
Private Watt Sy7TCfT19—tlJCrl tOU }S. _ --— 1000
YPERNiIT-�r.) e7v ForPhim.hirig639J171
Plumnir.g Cants actor
_ TOTAL S -�—~ RECEIPT PID. Issuid By
c) f a r d Pe mit C 'LL L3 pvi"it
Addi'lon A!-,L.ration Fee_
3%State
TOTAL_
C—_NT R A C T70 R
ADORESS 4&1%'_ WORK 'Ar)DRESS
PHONE APPLICANT—,
a Hej*� lnpj-. Rating (BTU Per Hour) Vent Size Flue Size
_ZS_LL�
FUEL 01L ❑ CAS FLFCT OTHER
ITEM NO. FEE ITEM NO. F E
F ci r I S,;--;3 m cC O'?error,
300 Air Condition Cornpr essor 15 1
New - Umdtr 103,003 6TU o 30 HP 10.c
4.00 Air r indling 10,000 CFN?j 3.
W7! 1".T 6TO�6;TU C—r 5.00 'Air Handling Over I
Fb_06_cTIT_- I 5.i
Floor F u.n ii,a
4.00 EvAP-Wative Cooler
Wall - Floo.- - Suspended J__3C
_t4.00 RanV.geVentFan 2.0
I;I a I I.'s—6111-) 2.00 Ven: System
Rcp_,it - H�,at & Coniiing, Hood Coirri'm—erc—ial-
0
3(
Air Condotinn Comp,tn�ior Unzier 3 H 4.00 Com. rmircial Duc: Syslein
— 6 - -
7 50
.- — • ___ 1 c
W co�:sl:icin .0m,f V111.0t 3 to 15 HP
A%v
InS°e:C t-�'t:S CO;itY;ENTs,,,__�^.._____..—=y—=____..__-- --��..___ �_
CITY F, -SS 0CENSF REQUIRED FOP ALL CONTRACTORSon SUBCONTRACTORS
APPROVED F.Y DATE
ISSUED BY DATE
- . ._.. ..�._.,.,.,..,,�,•.�r�-gin; ._-,..-. _.
BUILDING PERMIT APPLICATION 11ITYoF TIGARD DATE o �� I4l19
THF I INDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.—
ARCHITECT
o._ _
OWNER 1�ltl -• (�4udL'ar-1JOBADDRESS134i,t) ;ringillis L.n1: OMEADDRESS
D� ARC ITECT
BUILDER �,lleYtl6 ADDRESS Jam► I qb ENGINEER
DESIGNER
SSTnTRUCTURE ❑NEW ❑AFMODEL ❑ADDITION ❑REPAIR ENEWAL ❑FIRE DAMAGE ❑DEMOLITION
u RESIDENCE ❑COMM ❑EDUCATIONAL L.UGO;"T_niiELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING_ _I-CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGN
OCCUPANCY N_-3 LAND USE ZONE_F1�7 BLDG. T'/PE 'J FIRE ZONE PLAN CHECK BV f"Tt'! HEAT '
C.unstruct singlb family dum: lim,i w/r,ttar;hmd ymrmc e. :a ..iudruom
3 w/saunm- A du th„
Sew-or hermit 1743.A - S625,nO
rks
QCC,LQAD_ _—_Ei4S?B LOAD _fiE1GHt 2� _;iT4f11�"---3- 36 __NO.BEDROOMa + VAL 'CIU.t.,(.
BUILDING DEPARTMENT SET BACKS FRONTS REAR l J mill• E '
, __�_ ___ _ LEFTSIDE ?IM"*RIGHT SIDE
Permit �'. ,1+or, -— — _ — —
Plan Check ?V, THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAIN-71) INTHE BUILDING CODE, ZONING
• qj() REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
S:i •otal
17 9. WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
State Taxb, 1r'.l2 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Li ff NSE. SEPMATi0EITIJC.�REQUIRED FOR SEWER, PLUMPING AND HEATING.
r � i...s
Total f+389.t�2 sl)f 100.00
By P1
APPLICANT
Annrnvrri I 1 1_-Itj (—)-1 Receim No /5-0-3 __�_.------ --
DATE IMSP. TYPE INSPECTION REMARKS PLUMBING DATE -
�� Contractor
lF -
• Permit No. C>
y Rough-in
/ Fixture
Final
HEATING
Contractor
-
PermitNo. - ,3
'- Gas or Oil
. — Rough-in
-- - Final
SEWER Jnr
Final
---v DRIVEWAY
Final —
Stu ni Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
— ---.-- -- T � Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPA CY Final
CERTIFICATE OCCUPANCY
7lSS Landscaping
Zoning Final
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