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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 638-4171
Address /C.;V '-,-, ,_ ,"�-_r�r -,,``
ype of Inslection
The following building Code deficiencies are required to be c3rrected:
s
Presented to Inspector
Vite _
CALL FOR RE=/WECT/ON
YES CJ NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregor, 97223
Phone 639-4171
Address Permit
Type of Inspectler
The following 3uilding Code deficiencies are required to be corrected: 4:z"/
Presentad to Inspector
Date
CALL FOR REIWE-MON
YES NO
City- ®f Tigard Mechanical Permit NO. ,,j2 CC �c_
Kew Ir.rsl!atlQn El Replace ❑ Hvlocation Q Addition 0 Alteration C] DATE:
HEAT!NG /
..7mf RAfTORi ' � OWNER_l1.cGI t .rsr_c T
ADDRESS. JOB ADDP ""_r264; C✓. ..; �.+r
r' i ice YC A` l/ /�./ � y i'e7_7�Fcr(
/
" PHONE ,�� // z / __.__ APPLICANT - -��----
Neat Input Rating(BTU per Hour) --. Vent Size sr' _ Flue Size_. •__ •,,_
FUEL OIL Cj GAS Q ELECT f3 OTHER
ITEM 1110. FEE ITEM NO. FEE
For Issuance of Permit SEE BELOW Each Air Handling Unit or Ducta std em 7,50
New-up to & incl. 100,000 BTU 6.00 Commercial Hood Svstem 7.S0
New 1001000 BUT's & over _ _ 7.50 Other_Equipment . Cach 4,50_
Woodburr,ing Stave _ 4.50 1 Tr`.p Inspection _4.50
Wcll-Floor- Suspended i_ i _ 6.00 Air Condition Compressc, • up to&incl.3 H.P. 8.00
Ven Eystem w/Fan __ _ 4.50 Air Condition Comdr essor•3.1 to 15.H.P.incl. 11.00_
Repair Heat Cooling 6.00
CITY BUSINESS LICENSE REgLIIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! I
PERMIT ISSUANCE 10.00 Comments:
FEES d'),I,
Issued By--,-
25%
y —._25% PLAN CHECK
c
TOTAL y—, G REC.40 — --- Signature of-.kppilcant
BUILDING pFPARTMENT, TIGARD �7
MILE"dAUKIE PL-VI ;;, , PLUMBING PERMIT :fin
authorized ick w— -, hoiden of a valid plumbing contractors licfnsz is hereby
I igard. Such installations require kn sn ct(on by the City Ir spe.cas herein noted tO be led tor In accordance with vvho shall be notified he plumbing code r
(4) hours prier to the time the installations are re d not less than four
for all contract ready for inspection, City of Tigard,Business License required
or; and sub-contractors. �f
� � .l n b��`sti'��..-.fix.�%,.t,�v.•,,, "
Address-
-__TYPE O PERMIT NUMBER C;!t
B
ITO7 A L
FEE ON H€s!P_E_Nslp�� TEPAS EACH AMOUNT I
x-Each 1 bath unit
Additi1nal bathrooms- "--- 25A0
Mobil,-1Home
If•IDIVIDUAt RIXTUREB CCII�(_ I.A --
1 to 50 Fixtures In 1 buildin each
6f to 100 Fixtures in Ibuildin`g,_each -
_ �-
tOt to Z00 Fixturys in 1 buildin - 2.50
- .1 earh_- �`
Q1 or morn Fixtures i�-1 building-Bach - '" •----- �
A1 1 S L I.A
iV E 0 U 1.50
N -----------r_ ----1-
—Sswer-04ch additional 100 ft,
5.
0_
Other (` eclf
PrRMlr _ O•�U For Plumbing Inspection Phone 39.4171`
4 o State 6
Jam`
�rnrnt "" '�" per CIpT Gln Plumbing Contractor By
lea inrl p„
BUILDING PERMIT APPLICATION TIGARD DATE 3462
THE UNDERS�GNED HEREBY APPLIES FOR A PEkMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING 'FLANS AND SPECIFICATIONS. OWNER PHONE
LOTNO..54-Picks Landing,
OWNER-L:161Varly Cunsta . 00iiIADD-RESS 10060 SLI Kent Place
HaUbard ARCHITECT
ENGINEER
BUILDER sems ADDRESS 11903 Gruadacr!�>3, E _DESIGNER . Pi.arcy f3ai clay
STRUCTURE VX NEW 0 REMODEL El ADDITION El REPAIR 0 RENEWAL LA FIRE DAMAGE El DEMOLITION
OAESIDENCE 0 COMM 0 EDUCATIONAL 0 GOV'T 0 RELIGIOUS El PATIO El CARPORT D GARAGE 0 STORAGE 0 SLA130 FENCE
OCCUPANCY .-L=1 -LANDUSEZONE L"71—PO BLDG.TYPE —F-4 __� h FIRE ZONE-7 7PLAN CHECK BY �_-HEAT-1—,011—
a
W/attk''
____L,q_qstrui.t_ single family diisiling 4 Btadrooms :3 Dathu,
SEE UIRRECTION SHEET ATTACHED,
SEWER PERMIT#
OCC.LOAD FLOOR LOAD 40 HEIGHT J) NO.STORIES 2 AREA ii322 NO,BEOROOMS 4 VALL1167.19 :501).
BUILDING DEPARTMENT SETBACKS FRONT i2 REAR :3 LEFT SIDE 7»a RIGHT SIDE .1
Permit THIS PERMIT IG ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES ANP CRnINANCES, AND 11 IS HEREI1Y AGPEIED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH TIIE PLANS AND SPECIFICATIONi AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 3461 :J0 RESTRIC11VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE XRRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATIAG.
State Tax 4/,11 9,24. "', . . I'll
Total 3"):,),7 4•
HOC# I I S100-Off -A-pp—uCAp476mAGEN7
By P1
Approved Rece,pt No. ADDREStl PHONE
I11iff W W_ elril asl sl w aq w w
PLUMBING DATE —
REMARKS
DATE INSP. TYPE INSPECTION —r Contractor
\O_31_5co GS o-r� -- Permit No.
040 4u�-*.,- —.-- Fixture — _—_—
/Y -- r Final
HEAT 1 N G Flu- -
1
�,br-s�•� ��,(i --''! �L!`�"� Contractor 303_ _
Permit No—. �1.-/��D a(l�
/�� Jx.[•'F'c'�P: --���.--_--_— -- -- Gas or Oil _ ----
_—� ---- — -- �— -- Final -
------ — — - SEWER
-- — -- - —.-- -- ----- .—. Final V
�^ —~ DRIVEWAY
___-- — Final ----
--`i-- --- — - ----- Storm Drainage
_------------•-'-- � (Rain Drain)Final —_----------
-------.__-- ---- Sidewelk -
------ Curb&Street Final
-----_ Approach ----- —
- TEM?ORARY
IC
CERTIFICAT pOE C� Find --�
IjLD(i. DEPT.FINAL— E IFICATF OCCUPANCY - 3 `p / -
Landscaping
I7oning Final
i
�i
BUILDING PERMIT APPLICATION ;IGS;`;" DATE /�
THE UNDERSIGNED HEHEBY AI'PLIcS FOR A PER?AIT FOR Ti WORK HEREIN INDICATED BUILDER
PHOT E _
OR AS SHOWN AND APPROVED IN THE:,CCOt,4PANYING PLANS AND SPECIFICATIONS. � -----
rZ���� LOT NO.
i,.;":ER +y•[i� •LOJ013 ADDRESS I OOH Q0ARCHITECT
Fr/�V' Pl _ -
- ENGINEER •(�
c.�� ADORESS 1 .3
DESIGNER-- `�
13UILGEP �t�-
STRUCTURE _ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR _❑_RENEWAL ❑ FIREDAMAGE ❑ DEMOLITION
RESIDENCE i7 COMM. ❑ EDUCATIONAL-❑ GOV'T C1 RELIGIOUS G PATIO_ (_.i CARPORT C GARAGE C STORAGE E3SLAB❑ FENCE
-` J A - L� !, HEAT �,
: �
CriC6UFANCY 3 LAND USE ZONE —BLOG.TYPE S- .. FIREZONF Pt AN— CHECK 8Y —
CAP C,
SEWER PERMIT --_--
OC:C.LOAC FLOOR LOAD HEIGHT XV NO.STORIES P. AREA .ZU Z ZNO.BEDROOMS VAL UEA 30C
.— -- LEFT SIDE ?� RIGHT'SIDE �j f
BUILDING DEPARTMENT SET BACKS FRONT Z� REAR _--__ --- _
Permit —��3 I•o THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUiLDENG CODE,7.ONIN^u
- REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGPEED THAT THE
IpIinCheck WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COtAPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PEA"AIT DOES NOT WAIV'c
Sub-total 3 , 5'P RESTRICTIVE COVENANTS, CONTRACTOR AND SUE CONTRACTORS TO HAVE CURRENT CITY BUSINESS
r`-'- -- -- LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State im: Q• ��
- 1401may__ — __ _ _—----- ---- --
Total — — • �� PDG# APPLICANT OP jqNT
- --- Receipt No. PHONE
ADDRESS
Approved
SDC -
DDC -
SEWER CONNECTION
SEWER INSPECTION $
SEWER SURCHARGE S _7`��--
104 f�o
SO IZQ4 P("0 .
kso- 14 eo,,+ cjm� A-me,
//1a k (loan
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x
ego Z I.90 2
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