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INiSPC :TION NOTICE
City of Tigard Building Department
12420 S.W. Wain St.
Tigard, Oregon 97223
Phone 639-4171
Address Permit
Type of Nspection
The following Building Code deficiencies are required to be corrected:;
Presented to__----- ------ - inspectot
Date
G 4u- FOR REIAGPEcI70N r_
0 YEB C7 NO
ss� sssr .. s. �■[ .. ..� wt
—_--
City ®� �igard. Mechanical Permit NO. J
N,tw Inst Ilation Replace ❑ Relocation❑ Addition ❑ Alteration El
HEATING OWNER
C")NTACTOR C7�r7 �}
ADDRESS
��'�� � j• Li.: ��� - 1�''�l�D. JOB ADDRES;_.._JM /� �'G7VT- ew
PHONE �� :�- -- APPLICANT -
Meat Input Ratin,(3TI! per /ZodG Vent Size 25 �L Flue S71 to
FUEL OIL.❑ GAS 5t ELECT OTHER -- `�— —
ITEM NO. FEE ITEM a NO. FEE
or Issuance of Permit _ SEE BELOW Each Air Handling at Duct 5 stem_ _ 7.50
New•up to ea incl. 100,000 BTU — 6.00 Commercial Hood System _ 7.50
New 100LU� BUT's & e
7.5L;7.5' Other Egui;anenr _Each 4.50 _
Woodburnin� Steve 4.50 1 Trip !rispection _ _`_
Wall Floor- Suspended _ 6.00 ��-_A r Condition Corip.assor •up w&incl.3 N.P. 6.00
Vent System w/Fan �— 4.50 fir Condition Comr.ressor.3.1 to 1E.H.P.incl. 11.00
Repair-Heat Cooling_ __
_ CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISFOANrE . 10.00 Comments:
FEE.
SUB-YnTA L
"V" 9, STATE Issued By.--____. _
25%PLAN CHECK
BUILDING PERMIT APPL!6ATION TIG. .RD DATE-- 3509
19
THF UNDERSIGNED HEREBY AP;'LIE:S FOR A PERMIT FOR THE V�uPKHEREIN INDICATED BLI:LDERPHONE
OHASSHOW APPROVED IN THE ACCOMPANYING PLANE AND SPECIFICAT'ONS. OVVNER PHONE
LOT NC.
P� L - s Landing
JOBADURESS 9870 SW Kent Court k I
OWNER OaVld -Or ARCHITECT
ENGINFER
BUILDER Game ADDRESS P-()- Box 23773OTigard DESIGNCR pigrcy-Barclay
STRUCTURE EXNEW U REMODEL 0 ADDITION 0 REPAIR L7 RENEWAL 0 FIRE DAMAGE-_ 0 DEMOLITION
X RESIDENCE 11 COMM 0 EDUCATIONAL 0 GOV'T 0 RELIGIOUS 0 PATIO F-1 CARPORT L1 GARAGE 0 STORAGE 0 SLABO FE ZZ
'uh
R-3 R7PQ PLAN CHECK HEAT
OCCUPANCY LAND BLDG. 3; BY
3 Bathe
single family dwellkp_9 W a�
Construct _L �tached gar,a.go. 4 aedrao.i
AT, ACHED-
SEWER PERMIT#
OCC.LOAD FLOORLOAD 40 HEIGHT 22 NO.STORIES AREA 2747 N0.BEDROOMS 4 V I I
7
BUILDING DEPARTMENTSET BACKS FRONT 43 REAR I0 LEFT SI()E j RIGHT SIDE
Permit $275.00 THIS PERMIT IS ISSUED SUBJECT TO HE REGULATIONS CONYAINED IN THE BUILDING cooko, ZONING
7 H f
REGULATIONS AND ALL APPLICABLE COb:S AN ) ORDINANCES, AND IT IS 1,ERE13Y AGREED THAT T
P Tlr'g�6 h,a c WORK WILL BE DONE IN ACCORDANCE WITH Tri*F.,' PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS FEJAMIT DOES NOT WAIVE.
RESTRICTIVE COVENANTS. CONTRACTOR P,%ID SUB Cr)NTR,1114-,iORS 10 HAVF. CURRENT CI1Y BUSINESS
Subtotal lk�P 14EAT, G.
0'-�' LICENSE.SEPARATE PERMITS PEOUIRED F01,SEINER,PLVI INGAIIV
4
rStat'eT'a, 11.00 $400.00
SDC-
Total $623, A
By L1 P1 PDC# n n--APIkICAR-T-dk-A4-E?iT—
Receipt No. ADDRESS
dwh PHONE -
_.___
Approved
f
DATE INSP. TYPE INSPECTION
M_ - REMARKS PLUMBING DATE
--� L---1 pp ermi:No. -0/
s-rPd9 �3 1�1�►+ C�aa Cd• b Z/"OI Rough-in `
Fixture —
OttF'�� - Final
--
jai HEATING
ntractomit No. iL 561t or Oilugh-in
al
SEWER___ 1-1
DRIVEWAY
Fina'
Storm Drainage
(Rain Drain)Fin,l -
-_ Sidewalk
Curb&S .ret Final * —_4
Approach 4
SLOG DEPT.FINAL TEMPORARY t ERTIFICPTE OCCUPANCY -�-
CERTIrICATE OCCUPANCY Final
Landscaping
Zoning Final
I
CITY OF TIGARC-12.420 S.W.MAIN-TIGARD,OREGON 97223
RECEIPT
DATE: _-l�Z ' /�,.�s:�__•AMOUNT: $�
�._______
/ _ —r-j- --=DOLLARS
NAME: ._._ �� � �� cif �' � (,
CASH:
ADDRESS:— \ f' /
3775 `
_ CHECK: _
1
M.O.: ,
FOR: 0 OF - ....wF.
,_ _ ACCT. ♦ PERMITS -- -SURCNARGE-- AMOUNT
SEWER BILLINGS
i 40-364
BUSINESS LICENSE 05-331 _
' PLUMBING PERMIT �~� ---~---
05-3,32 _ S_-
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333
SEWER CONNECTION 40.363 _
SEWE:2 INSPECTION 40-365 -
SYSTEM DEV. CHARGE 25-366
PARK DEV. CHARGE #1 30-367
PARK LSV, CHARGE 02 30-368 -_ -- -
ZONING ADJI ISTMENTS 05-362
— TOTALS S �,
f��ECN`.�ED BY _-
s�-
PERMIT NUMBERS ASSIGNED:
Numbr► mount Number_ Amount I
^ m
Aount t i #'A
Number
RECEIPT
BUILDING PERMIT APPLICATION DATE 3)ec. 4 ,9 go Mo
TME UNDERSIGNED Hi F�LBY AFPi_IE i FOR A PERF�IT FOR TFit WORK HEREIN INDICATED BUILDER PHONE— !R
OR AS SHOWN AND APPRO`.LD IN THF ACCC�OM,,,►P�AwNYING PLANS AND,S�,P,ECIFICATIONS. OWNER PHONE
L::": E'?. J �I Ems' JOB ADDRESS _1_SCl�..! LOT MO.`fZl�__ fe_
ARCHITECT Lit
�7 ENGINEER (�
BUILDER '� � ADDRESS I-,Q ,_ 3M ~ DESIGNER `
STRUCTURE NEW 0 REMODEL ❑ ADDI i ION _❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE _C DEMOLITION
(RESIDENCE COMM ❑ EDUCATIONAL ',J GOVT Cl RELIGIOUS C~ PATIO Cl CARPORT ❑ GARAGE G STORAGE Cl SLAB❑ „NCE
1-urANCY ,-,LAND USE 7.ONE� PDBLOG.TYPE �S_ IIJFIREZONE_._—.-.__PLAN CHECK_jY HEAT_
5ce .4 ef 41100
3 �ct�
IT ER
SEWPERMIf � --�
7�
OCC.LOAD _ FLOOR LOAD HEIGHT .22 NO.STORIESAREA NO.BEDROOMS
SETBACKS FRONTVA.LU
__.__ BUILGiNG nEPARTMENT � 2
Z _ REAR T SI
/^ LEFCE 1„2 T SID _
o _-- � RIGH_
THIS PERMIT IS ISSUED SUBJECT TO THE RF,;,ULA.TIONS CONTAINED IN THE BUILDING CODE,ZDF;:N^
Iol�nGheck { `��'� �"� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORE; WILL BE DONE IV ACCOP.LANCE Y/1fH THE PLANS AND SPECIFICATIONS AND IN COMPLI,G,ucE
WITH ALL APPLICABLE CODES AND OPUINANCES. THE ISSUANCE OF THIS PER`AIT DOES NOT WAIVE
X`��/° FESTRICTIVE COVENANTS, CONTi7ACTOR AND SUS CON i RACTO iS TO HAVE CURRENT CITY FUSINESS
::;ats Tax
LICENSE.SEPARATE PER%flTS REOUI;iED FOR SEWER,PLUMBING AND HEATING.
� _ —,�1.. �
Total — TA ---- ---- ---------
PCICM PPLICuN'i OR AGENT
lay
Receipt Na.
Apptgv,,d ADDNESS PHONE
50c—
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0C S OS
3 41
- -.._._... _._ _-_...__Z
poc 41-- .
_EWER CONNECTION $ _ 7,?.dC_
EI,JER INSPECTION
SEWER SURCHARGE 5 �.,
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