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NNSPECf]:UN_N ICE n
city of Tigard Building DOParteent
Tigard, Orecon 97223
13125 SM nalBlvd. r
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Inspection Line (Rec-c�-Phone)t 639-4175 Business Phone: F'9-4171
Inspection:—
Fooring 11bg. ::nderslab Mech. Rough-in Appr/Sdwlk
.r 7 Line
♦ Found. Plbg. Top Out
San. Sewer Framing g
_8
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F,.L/Beam Struct.
Post/Boom Mach. Rain. Drain
Insulation -plumb.
Water Line Gyp. Bd.
-Koch. t
Plbg
. Underfloor N
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Times hK
DAte Requested: _
emit I
Addressr r�
Builders_ —
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•rHE FOLLOWING CORRECTIONS ARE REQUIRED:
'A fir
711
-` Inspectors_ ' /�ltmt.eI—
APPROVED D79%PPROVED --- APPROM) sUBJNM TO ABM
Call For Rei.nsp. '
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BUILDING F'E.RMIT
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a1YCXT1QARD
i W.M IT 4t• . . . . . . F3►J1'")1
1tZ�'J
CfiY !!YARD
COMIMUNRY DEVELOPMENT DERARTMEW i cn;00a SIA'rE ISSUED: 03/12/91 s
131268Yr AWI BINd.P.O.Box 23W,TlPW,OrWn q1 (603)6304175
;I.J'A0.IVISILJN. . . . : YL.--0,_DE WINDMILL ZONING: R-4. 5
. _ . . . . . . . . I_OT. . . . . . . . . . . .f
RE=ISSUE a FLOOR AR(Acl -____.__._.__.r..__ EXTERIOR WALL CONSTRUCTION
L:LAS5 OF WORK. :NEW F I RS'f. . . . :225 S f N- S: E:.: W. �
TYPE OF USE. . . :ACS SE(,OlgD. . . : S PROTECT OPEN I
TYPE OF wi\,s-r. :5N TH I FD. . . . : 5f N: S: E: W1
OCUJ",ANCY GRP. :M1 TCJT(-iL .-- - ----_.: i <3 t- ROOF CONST : FIRE
UC'CUVIANCY LVAD: BASEMENT. : Sf AREA SEP. RATED: �
;TOR. : 1 HT. : 11 ft UAR(16 . » . : f" OCCU SEP. R' .ED:
BsMT"': MEZZ? : REUD SETBACKS--------- REQUIRED- -_- ---~---- -_._..____._.
r`L_OOR L-OAD. . . . 140 pg t LEFT:5 f t RCHT-23 f•t FIR 'W-VL.: C'IOK DET. .
DWELLING UNITS: F'RNT: ft REAR:5 ft FIR AL.RM: HNDICP ACC : �
9EDR11S. E'f�VHS: IMF' SURFACE-. PRO CLTRR: PARKING:
)ALUL.. $ ; 1000
R,emar,i4s : rl��r^rien hc ,a
FEES
TIMOTHY TATE tyF)e amol.lnt date rersrri
1,2'305 SW KATHERINE ST F'RMT E 17. 50
PLCK t 11. :x,13 / f
YI GARD _�R 97223•-O000 3PCT 0. 63 / ✓
Phone! #a `iO3-6419- ?:,E34 PAYM 6 29. 76 PL.1_ 03/12/91
PAYM Iil. 0Ih JL_FI 0;'/].c::✓�31
CONTRACTOR r\IO'r ON F TL.E
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;.'From. #: _.._......__.�_..__....29. 76w1'0TA1_
4
fleay H. . : {
-- - -- --_ REQUIRED INSPECTIONS
4..
This pereit is issued subject to the regulations contained in tha Fr••aminfl Tnsf)
tigard Municipa. State of Ore, Speciaity Lodes and aii other 113 sce. inspection _
applicable laws, Al, rk. will he done it accordance with Final Inapectibn
approved plans. This Pers.: will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
9
Per'mit.tep
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i a pec By : �.........- .._. l
L;all for, inlapection — 6:351-4175
1
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LNCK RECT #
131 P
255W tlall Illvd. /
OF TIG.A�RRD 110 Box 23397 PERMIT #
Ti
rd,crosofi 97223
COT.4MUNI-ITM)I,;VI:LOPMllN,rDEPAR'IMENTgaSo� Ore,,-ft9t DATE ISSUED
i
OB ADDRESS: r 3�''JrN�i ^�f TAX MAP/LOT Z i'p
LOT: LAND USE: — — ■
SUB:
VALUATION: �
SPECIAL NOTLS
OWNER
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REISSUE OF:
NAME:" ---
% LAST RE I S: --- -
ADDRESS: Z
Z _ FLOOD PLAIN/
PHONE: /' Z3 Yom--- --- SENSITIVE LAND: _--
CONTRACTOR APPROVALS RE(�UIrWED
__ �;i�✓ Nfer-
NAME: PLANNING:
_ -
ADDRESS: ENGINEERING:
FIRE DEPT: _ ----
PHONE: OTHER:
CONTR. BOARD #: _ EXP DATE:
NEMS RFQ'u i KE
SUBCONTRACTORS: PLUMB: _ ____ LIST/SUBCONTRACTORS:
MECH: --- —__-- BUS TAX: _---_.—_-
1ARCCH ENGINEER CALCULATIONS:
NAME: -- _—�__----_---- _ TRUSS DETAILS: _--__—__--
ADDRESS: _ _ —_ OTHER: -
PHONE: -
PROPOSED BLDG. USECI
COMMENTS:
APPLI T 'GNATURE
a Received By: '�`' —_ — Date Received:
41
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PERMIT # ACCT # DESCR,':PTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees , .5 0 . — 4
10-43, 00 Plumbing Permit Fees
1
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)
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A
Building 8Y
Plumbing
Mechanical
■
10-433 00 Plans Check Fee -Hi=-- /4 JOY �? j
Building 3 f!
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Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees _ —
25-448-06 Institutional TIF Fees
2.5-448-03 Office TIF Fees
25-448-01 Residenti. Traffic Fees
. -
25-448-05 Mass Transit TIF Fees
s 52-449 00 Parks System Dev Charge (PDC) _ _-
31-450 00 Storm Drainage Syst Dov Chug
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 slater Quantity (Fee ire lieu of)
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CHECK AMOUNT a 29. 76
NAME NW CUSTOM BU I L.I)k R CASH AMOUNT x 0. 00
ADDRESS P. O. BOX 23,236 DAYMENT DATES II Q�3/1r.'J�i
SUBP I V I O I ON
'i IGARD, OR 972L:fi•-- 1:305- iSW KATHE'RINEc
PURPOSE;. OF PAYMENT YME"NT AMC UNT Pil 1 ll PURPOSE OF PAYME.14T AMOUNT PA I U
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Y OF TIC�ARD BLDG. DEPT. �
12420 S.W. MAIN STREET
TIGARD, OREGON 97223 I
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, =she
following/item(s) require correcting:
■
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'Date:--=!-- G- ,�-� - -- Permit No.
InspeODr�_
X�p(
CALL FOR REINSPECTION
a TlS�F��A ul EE.�Y
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223 4
PHONE 639.4171
' I
CONTRACTOR.
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting: '
c D'EiC 7
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—_ .---- V yy ,aha«,
Date:
Permit
----- -----
Inspector �� �
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Ppf
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CALL FOR REINSPECTION
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223 n
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following items) require correcting:
r
late: Permit No.
Inspector-'" '
CALL FOR REINSPECTION
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�.1 "I 1063
BUILDING PERMIT APPLICATION cOF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILVERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHUNF A
LOT NO. iCl li
OWNER lamas Pnnimi JOB ADDRESS 23UJ ,w— HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ; i}::._ ADDRESS' U ^} SL: ;iL.;t I DESIGNER l.lyfr' U1'y !�. f7.�(i1DSi 1
. t
STRUCTURE ❑NEW _❑RF'MnDEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
Cl RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE (I STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑)ESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY-----.-.LAND USE ZONE -7 BLDG.TYPE. _FIRE ZONE_._. PLAN CHECK BY UL't4
_ ".6!.LU'-.ti 51"',,aIU f"mil)I4w+.� .L�il1 411L1tLi Li i. :y.. ' rl�k►• :r Iak3; laJUll1::1 1. ,,aat1114•
i
SILL L;likACT2'.Ir ali CT ATToiOIE ,
UC(:, LOAD ._._------- FLOOR ALD HEICzHT '.1 N�:._SS.QRL�S.__.�__�H�_ 1►fJi.NO.BE1��01l15 �.1/ALUEJQ6► ,;CU
BUILDING DEPARTMENT SET BACKS FRONT 10 REAR LEFT SIDE 7 RIGHT SIDE D'
Permit 17u.00 -n1 ( / =—Ht—N Iii '. 011
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check t1Tal.U�, 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
Sub-total c.67 alt) ALL APPLILABLE CODES AND ORDINANCES THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
I RESTRICTIVE COVENANTS. CONTRACTOR AND SOB CONTRACTORS TO HAVE CURRENT CITY BUSINES;,
Slate Tax 7.12 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ' 74.Id, `AL1(. (i I) L�!'
f
BY - PL WDC tax 6100.
----- ----- — APPLICANT OR AGENT
Approved Receipt No,
d x� �+ •ui
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� �WI�YIA.. 1sn+++.w'.�w�rnw�nw+we,.w..wen�n-wa�ewuMW'Mn.'KrvMa?xewtiaMawur,M+r+..aa..rwe,.v,rw•.,.,+«�s.�a..n.uwvw,��arwaw e,nwr. . M �...w..«,+ ....�.gv,.w+rw�Yr?M�+Is,
YPE INSPECTION REMARKS PLUMBING I — DATE I
DATE INSP. T _
Contractor
Permit No.
Rough-in
410f, f7/< Fixture
Final __-
�, -
NC e
HEATING
Contractor �
I Permit No. r y 1 1
��_�; Gee or Oil
M1 JQ_ rJ Rough-in
.3 - 7-%0
Final
..__.SEWER
1 _
— - — Final. a/_]��'
I DRIVEWAY 1
— Final
Storm Drainage
(Rain Drain) Final
Sidewalk
h Curb&Street Final _
Approach
BLDG. DEPT. FINA1. TCMPORARY CERTIFICATE OCCUPANCY Final
F CERTIFICATE OCCUPANCY - —
'�'� l and caping
Zoning Final
I. , ,��",v�#t.'ld�;.,�;., ,;, r;Arur,.,,rw:,��N�R�x�•
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BUILDING PERMIT APPLICATION "y TIGARD DATE _ _ ,� 7 — o2�(�3
THE UNDERSIUNi O HERE6V APPLIES f Oil APERMIT FOR THF WO ?K NI REIN INr)ICATFD BUILDERPHONF`4'- a■
OR AS SHOWN AND AFPRCVIO IN THE ACCOMPANYING PI-ANS AND SPFCIT ICATIONS. C.'.'NEFT PHGrIE__-- Q
LOT NO fitl_�efPLjK���
a DDRESS a 3Qe +Q w KAO"he gi•
FJU�LDCR _ _ AD_O_F_tE��5••�f5 r-1 � DESIGNER_ � ,
STRUCTURE NEW— OFlFMfrDEL L-JADOITION UAEPAIR RENEWAL OFIRE DAMAGE DEMOLIIQ
_ . _ Q
RESIDENCE EJCOMM DEDUCATIONAL QGOV'T ORELIGIOUSQP.IT10 QCARPORT ❑GARAGE ❑STOPAGEOSLAS ❑FEN- �
TUI"4Nw LANP - Q`7 of DG
�MTrPE.�#.._ FIRE ?CNF PLAN__CH
ECK By HEAT
__-_ -_ i -- _
`!/Q� _F&* y7b pNl_ —
a
SFlJEF .PERX111
OCC Lr?QD ~ r 'TV HEIGHT.-13 NO STURIE.S � ARJEAN'l. NO BFJPUJMc � �/ Oj'
—VALUE l�Is .
5V1) '1v; Cir _ I SACKS FRONt
_ ..,,2V I;.E
4R LEFT SIpE 7 _ RIGHT WIDE '1
( ,IS PERMIT IS ISSUFD SUBJFCT TO THE REGULATIONS CONTAINED IN THE PUILDINC CODE, -70'.,•
I plan Chrek Q'_ GULATIONS AND ALL APPLICABLE CUDFS AND ORDINANCES, AND IT IS HEpEBV AGREED THAT TI
)RK WILL FF DONE IN ACLURDANCE WITH THE PLANS AND SPECIFICATIC)NS AND IN COWIPLIL.,W.E Wl
S").T.otar 4 •O L APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES %OT VVAP TR
SICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CI i V BUSINI.
°hate Tax �Y, .ENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Tonal. __ Z.�T•_�Z• ��#
-
AaPL.ICANT pp AGENT
I A: pruvr•d -w NU
SDC_ - �pp
P D C---
I WE R ONNt f. T 1 ON
SFWER INSPECTION ,`Z J%
SEWER SURCHARGE $ !O La4e1t #4s I
Comments :
-- 1 QY ( PIA- no4 `R o4 . Q•1.) ,'C aj.A./.7?
____ ____��-1� ►►�-� �sac� off.• ,
75
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VA �N�
�o . Q . 74 I
cp di, gf. lob
28 x 12 3 3
j 24
7s
F P Z r• 6v
a 224.3 3 9, ao $
40mv 20 x /Jr 300
$mo
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BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT
holder of a valid plumbing contractors license is hereby I
authorized to cause Oumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. 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
�.L,,me-s IXl�Lt ¢ 1 AddressL23n. r Date
■
Owner �•_
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
Sin le Family-I bath—each 25A0__— Z 5•• `ry <
Du lax—Each 1 bath unit V� 25.00
Additional bathrooms each
Mobile Home Space—each _INDIVIDUAL FIXTURES FIXTURES COIYiMERCIA
1 to 50 Fixtures in 1 building—each 3.00 _
51 to 100 Fixtures in 1 building-each 2.50 — --
101 to 200 Fixtures in 1 building—each _. 2.00 _—
201 or more Fixtures in 1 building—each _ 1,50_
--- I r
MISCELLANEOUS
Sewer—each additional 100 ft. _ 10.00
'Plater Servier! to building___ � 5,00
Other S eciF ):
PERMIT `>!LI. (� For Plumbing Inspection Phone 639.4171
4 o State 60 Plur.bing Contractor By
TOTAL.,___ RECEIPT NO,
tl �,1
4
III'
j C7� Tigard Mechanical Permit Nn Permit X00
'IJ g Fee
/J ❑ Addition ❑ Alteration ❑ 47.State
New Installation Replace ❑ Relocation TOTAL--
HEATING
OTAL HEATING
Or
r
�2 / %Itis WNER
CONTRACTOR ----
ES; /6 WORK AObRESS S Ste ./
A..DR
APPLICANT Vent Size Flue Sze
PHONE S^ s
Heat Input Rating (BTU Per Hour) d
�-
FUEL OIL ❑ GAS K ELECT ❑ OTHER_
NO. N0. FEE
FEE ITEM
IDEM '
For Iss}.lanre of Permit EE ABOVE Air Condition Compressor 15 to 30 HP _ 10.00
_ 3.00
New-up to & inc1.100,000 BTU 4.00 Air Handling 10,000 CFM
5.00 _Air Handling Over 10 000 CFM 5.00 .,x
Pdo,v.100,00 BB U1 TT 's d over_ _ - - 3.00
Floor Furnar:o 4.00 _Erative Cooler
vapoY __ _-
4.00 Range Vent Fan 1.00 �;�
_Wall• Floor •Suspended _ _ - - -- - 3.00
install Vents Only V - r 2.00 V Vent System .�;
4.00_ Hood Commercial _ 3.00 ,5
Repair - Heat u Cooling _ _. - -- — 10.00 `
Air Condition Compressor Under 3 HPT 4.00 Commercial r7uct System —
Air Condition Compressor 3 to 15 HP 7.50
INSPECTOR'S COM,'vlENTS
Ci fY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB CON TRACTORS
4'•PPROVED BY`_.__. DATE _� ISSUED BY_�— DATE _
t
RECEIPT NO. ---
,ra Sig-ature of Applicant
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