9837 SW KIMBERLY DRIVE-1 98:37 SW KIMBERLY DRIVE
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ADDRESS / , r''a u. .tX.v A�.,�rev: PERMIT N0. L1 �.5 T
r�
r PERMIT CHARGE none
OUNER 1 . �/f /�✓1 C0"Jf;FrTirJ14 FELE
PAID BY
TYPE OF BUILDING ��/ _ DATE CONNECTED
Sc:PVICE HAT �. INSPFCTIOPJ FEE
CONTRACTOR PAID BY [)ATF
SIZE OF f'ONW" CTION ASSESSMENT PAID
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
COWRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
oil
ez
')ate:
Permit No.-
Inspector
plkt�-IEOR'AEl N
at e■I e>i � e� eli eeii
I
BUILDING DEPARTMENT, TIGARD NO
PLUMBING PERMIT �
�-C/r" holder of a valid plumbing contractors Iicen ' hereby
g se Is herby
auth-,;ized to cause plumbing work as her?'-noted to Le 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) hc,:-:- -nor to the time the installations are ready for inspectio,,. City of Tigard Business LicEnse required
for all conxrectors and sub-contractors. (� l
(�0wnel`�-'tf-' Add ress e ZZ_
I NUMBER OF TOTAL' PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
[RESIP_ENT AL
Single Family-1 bath each 25.00
_Duplex—Each 1 bath unit 25.00
Additional bathrooms—each —� 10.00
Moblle Home Space—each — 1500 —
INDIVIDUAL FIXTURE FEES _
1 to 50 Fixtures in 1 buildin -each 3.n0
_5_1 to 100 Fixtures in 1 build_in —each _ 2.60
101 to 200 Fixtures in 1 building—each 2.00
201 or more Fixtures in 1 building—each 1.50
MISCELLANEOUS —
Building Sewar-1st 50 ft. 10.00
Sewer—each additional 100 ft. 10.00 �—
Water Service to buildfn 5,00 �1
_Private Water Systems—each 100 ft. 1000
Other (Specify);
PMs-
T
TIe 00 For Plumbing Inspection Phone 639-4191
te G' Plumbing Contractor By
'TOTAL L' RECEIPT NO. Issued By
BUILDING PER Aff APPLICATION CITY tTIGARD LATE 19
OF THE UNDER' -IEREBY APPLIES FOR APERMIT FC;R THE WORK HEREIN INDICATED 91JILnERPHONF X—
OR AS SHG N APPROVED IN THE ACCOMPAN`. ING PLANS AND SPECIFICATIONS. OWNERPHONE__-_
IAT NO.
OWNER r l`rJ.J f i JOB ADDRESS ,' }r fi,Lfi)y ; HOM_C ADDRESS
ir,,:'-IITECT
BUILDERADbRESS cNGiNEER
- f-1 nESIGNF..R r-t
STRUCTURE _ ^^❑,NEW lJ RT MODEL ❑ADDITION ❑RE?AIR _❑RENFWAL_ _❑_FIRRE DAMAGE�ODEMOLITION
❑ RESIDENCE IJCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO []CAR PORT ❑GARAGE D STCAAGF❑SLAB ❑FENCE
_ OBOND ❑MOVING^_ ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _
OCCUPANCY____,_LAND " r USE ZONE IiBLDG.TYPE FIRE ZONE—:--' PLAN CHECK BY 1 Xy' UL NEAT
"i'lLi_t1uLL-ain 11 Family QUIiL LLrTU te.01Q0 {iilTooly Q 8edltum 3 uatLt._�
quay PoKmit 17:,7-4 - $625.00 —"
- --- f+i�-�►go-441
U� lQLaI�____ ____E145?C3_lS?Al2A
40 H�L(� d•J NO•.,�L2R .$.__d AF;EA_i4tJd NO,BEDROOMS '� '_ r4046k•
BUILDING DEPARTMENT _ SET BACKS FRONT 26 REAR ul LEFT SIDE LCI ] `HIGHT SIDE I
Permit
" - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check `!%�. "=,[1 REGULATIONS AND All OPPLtCABLE CODES AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
WORK 011t BF DONE IN ACCORDANCI WITH THE PtANS,AND SPECIFICAV IONS AND IN COMPLIANCE W'TH
Sub-total 21; .+130 ALL APPI_ICARLE CODES AND ORLANANCFS. THE ISSUANCE OF THIS PE,1MIT DOCS NOT WAIVE
RESTRICTIVF COVENANTS. CONTRACTOR AND SUTI CONTRACTORS TO HAVE CURR'chT CITY BUSINESS
State Taxi LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMPING AND HEATING.
Total y03* 8
"�l• - .�y>.a. ,
LAY p1
APhLfCAN7 UR laGFtJ f �----- .- —
Approved I Receil,t No
DATE INSP. TYPE INSPECT'.N REMARKS PLUMBING DATE
-may Contractor
< ��•` Permit No. 79 �4/
3- 2-
Rough-in �?
3-2 _
Fixture
Final
—_ —4—
HEATING
Contractor— � ContfaCtor
_— Permit No.
Gas or Oil
Final }
----- ----- -- - --__— SEWER -- ------
�.v
Final
�— — `-- ----DRIVEWAY
Final
Stoll Drainage
(Rain Drain)Final
Sidewalk
Curb A Street Final
Approach
8LDCI.DEPT.FINAL T$MPORARv CERTIFICATE OCCUPANCY
CERTIFICATE CCCL,"ANCY Final
Landscaping
Zoning Final J
(JIL.DI�� CITY
'G PERMIT APPLICATION v,: ADDATE
t HSIG'JFD HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED L3uu.alRF''40NF6�i 9 / _
;;R .A5 SHOWN AND APPROVED IN THE ACCOMPANYING PIANS ANS AND SPECIF ICAI IONS. OWNER PHONE
LOT 140.
-�-�
q f..Q // (i JOB ADDRESS1__ =li '>asrjc%� �E ADDRE!i5 _.
G ARCH1-EC
T
��p ENGINEER
kR ADDRkS 9Q,1�.I�s —':— --_--'__-----C1E_IGNER -------- —
_
URE [RNEW _OREMODEL OADDITION QR .PAIR - -C�RENEWAL (Jr IRE DAMAGE ❑DEMOL1710N
1C,'-NCF ❑C.OMM ❑EDLICATIONAL ❑GOV'T FlI'II ,G10USOPAT10 ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB QFENCE
1GOND 0MOV ING _❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
�'UPANCY,r 4_ LAND USE ZONE -VC� BLDG TYPE"' .N +FIRE ZONf 3 PLAN CHECK BY - HLAT—._._ —�
-. __�-.... ._--..F _-_�. , ��__"�..IS��T.- %�-.��`----_.NQ�.STS291�„$_._!�__ARES[.J��-�9.,..B.E.1<9.gO.b1;4_1.___VAL.LLFu�y�?'�•c".
II BUILDING DEPA'ATMENT SET BACKS FRONT REAR- r� L"FT SIDE,eo RIGHT SIDE rP (,
THIS PERMIT IS ISSUED SUBJECT TO THE RECULATIO4'S CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS.NNL;SPECIFICATIONS ANn IN COMPLIANCE WITH
�uh•,otal ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
cihte Ta>�� f--d LICENSE. SEPARATI: PERMITS RFOUIRED FOR SEWER, PLUMBING AND HEATING.
Total .3o-3
By APPI ICANI QR AC;r NT
Appioved__ Receipt No ----- - -
-- -- ------ ADORFSS `_�HOIVF
/''_sly ,� c:7 J ✓u �`�
+� � wt sw rw e►� �. av a.
" " z . �- 1 T() Per snitCIL- N/ of T ion.-� r d r4 c ham cal Permit � .
1
tVc'��• ln5;r,lia'iPn gC;i.ece LJ Relocation ❑ Addition s� A!tLration *state .
Ad-
r OTA r
CC%TRACTOR
ADDRESS r. @ -� NO"(K ADDRESS
Ap7 ,
___
P�4nNC _ �! APPLICANJF
Heat Input Raving (BTU Per Hour)_ Vent Site ^-- _ Flue e_!
FUEL O1l_ J GAS ❑ ELECT U OTHERra.�,:
ITEM NO. FEE ITEM NO. FE
For Issvance_of ?ermit _ -� 3.00
Air Co!idition Compressor 1b to 30 HP
New- UnJer 100,OD0 6'fU _-f � 4.U0 Air candling 10,000 CFM 3.
Npw• 10U,OD0 BTU & over `-!- -� _, 5.0_0_ _Air Handling Over 10,000 CFM —�1 5.
Floo- Furnace 4.00 Evap:,•ative Cooler- - _- 3
Wall-_Floor-Suspended _ _ -4.00 _Range Vtnt Fan
Z•00- ��Vent System
Repair _ Heat E Cooling^ _- _ �_ 4.00 Hood Comt,,ercial _ _ 3 C
It Condition Compressor Under 3 HP 4.00 Commercia! Duc: System
•%ir Con-lition Comprrssor 3 to 15 HP E 7.50
INSPECTOR'S
CIT`.' BUSINESS LICENSF REOUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
novur,� �n av DATE ISSUED BY DATE