15395 SW OAKTREE LANE S', OAKTREE: uANU,
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1:1'1'1' UI t'1UAk(U MECHANICAL i•L'KMii Permit tl-
I..iLy of 'rij;ara --- ---
I .1115 SW 11111 Blvd • DgeorlPton QTV ►RICE AMT
P.O. Box ?3 39 I Table 3A Meci-enkag C•>de —
I'igard OR .47223 1) Permit Fee 0 �0- 10.00
!,
11,-4175
N o 2) Supplemental Permit 3.00
Furnace to 100,000 BTU
'� Sk c 1) incl. ducts & vents 6.00
2) Furna,:e 100,000 BTU +
Name v; Development _ incl. Uucts & vents 7.50
.3) Floor Furnace
rN, incl. vew 6.00
Jju ! ;7C� <A1.1 4) S lspended heater, wall heater
Addrelis Tex Lei ^'"r'"" or floor mounted heater 6.00
Lot nlcx Scbdivislnn —
„�,_,.,,�_...�,�.._...--.--- • � 5) Vent not incl. in
_.-- �.•,, -• 3.00
Name ( or name of business, appliance: per
mailing Address worts 6) Repair of I eating, refrig.,
Owner I ��I?s- r`�1 �?+�p: iT�C•. (. cooling�absorptinn absorption-unit 6.00 _
;!p 7) Boiler or comp to 3FIP
l.Ityrst.t.. �`r.. `, r ;1_ c ! absorp, unit to 100,000 BTU 6.00 -__._
aaa Nems 8) Boiler or comp to 31-4P i 5HP
ab-orp. unit to 500,0001 BTU 11.00
fltll --
Malling Address or=- Phons _ _ 9)"-Bnilar :c mp 15-30 HP
l.r.c �, , , � absorp unit 4:-1 million 15.00
Contre, or 10) Boiler or comp 30-50 HP
clryisti.ts a� -► .� - _absor . unit 1-1.75 million 22_50
ct
State Reglatreflor, No. City Bus. tax No. 11) BOile or comp 50 Me
�. absorp. unit 1,750,00^ E3TU 31.50
I hereby Mknowledge that I have read this application that rite Information 12) Air handling unit to
glven Is correct, that I am the owner of outhoozed agent nt the owner, that 10,060 Cr'IA 4.50
III piano submitted we in compliance with State laws, that I ,rn registered with ----- — —
the State Builders' Board, that the --
number given la cerreet. (if exemp! 13) Air handling unit
wort, Stall regisirstlon piea9e give reason below). 10,000 CFIA + 7.50
14) Non portable
evaporate cooler -__ 4.50
15) Vent fan connected
to i single duct _ 3.00
16) Ventilation system not
included in appliance permit - 4.50
Siren+tore (ov+ner per!1 _ __ p81Q 17) H-.)od served by
Ue,crlbe work Cj addition❑ Alteration C, repair[] _mechanical exhaust _ � 4.50 —
to be done residential ❑ non.-resldo_itial ❑ 18) Domestic type
_ incinerator7.50
(Fxistiny use of <_
ouilding or property - --- -- 19) Commercial or industrial
Proposed use of _ type incinerator 30.00
bui lding or property+. =- -= =`•� 120) Other i.e., woodrtove, water
heater, solar, clothes dryers, etc. 4.50
1•ype of fuel — oiI[1 nwtiral das❑ LPG[) electri4 --- _ -
•---�- 21) Gas piping one to four )utlets 2.00
NOTICE. -- - --- --THIS PERMIT BECOMES NULL AND VOID IF WORK OR 22) More than 4-per outlet
CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN _ SUB-TOTAL
180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED - 4% SURCHARGE r
, _____ _ ___. _ i:._..•
OR ABANDONED '-OR A PERIOD OF 180 DAYS �T ANY -..�_
`�-� PLAN REVIEW_25%OF SUB-TOTAL
TIME AFTER WORK IS COMMENCED TOTAL i �•;
Special Conditions -- --
-------- _.-------�-..._ ________
by
(�AtA 11tl�Rli
C - ty of Ticloard mcLlmnical Perfflit
New Installation k1l"Re:flace ❑ Relocation Addl*ior- P, Stale,
r CO T R ACT 0 A
WORK AD[)RLSSjraL
9?,-
it
ADn Fi ESS J—CL MAW—
inNE p APPi-ICANT.
Heal Input Rating (BTU Per H!;tur)___ Pin Vent Flue Size
FUE� OIL, GAS [Er'l ELECT L3 / OTHER
ITEM NO. FEE I1'..M NO. FEE
i cz A-r C-,undiiion 'Iomptwor 15 to 30 HP 10.0c
For issuance of Permit
4.00 10,000 CFrM
Under 100,000 BTU Air Pand-ling— L 3.00
over E)00 ''Air H indling Over 10,000 CFIVI 5.00
Floor Furnace FvaLlorative Cooler- -- 3.00
\NalRange Fent-Fan 2.00
T or - S
Floor o t;s�iLnd�d 4.00
Instal! Vents Only 2.00 Vent System 360
Hood Commerci;F
Repair - Heal & Cooling 1100
Commev-41 11�-L:i S�-Slern
Aircom r-
7.50
-VII Condition 6on.pr e 0
INSPECTOR'S COMI NTS-
r-ONTRACIOR!� OR SUB-CONTRACTORS
CITY BUSINESS LICENSE REOUIRED FOR ALL
APPROVED By. DATE ISSUED B
RECEIPT NO.
Address Permit Nos
Permit charge
0uner
Connection fee
Paid by
i'yps of building Gate connected
Service rate Inspection fee
Contractor Paid by Date
Size of connection Assessment paid
tlli'A� r QUILDING DEPARTMENT, TIGARD i
IONn E. Rau,! I,!(1T Pt4lHBINu,I!rC, NO.
C t1. rM 179 PLUM3ING PERMIT
41132 holder of a valid plumbing contractors license is hereby
zutoorized to cau,,e plumbing work as herein noted to be Installerl in accordance with the plumbing code of
Ticflard, Such ins—hatiuns require inspection by the City Inspector who shall be notified not less than fo.r
(4) hours prior •to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. fJr�,iL ;TI/S � y�
0wnerJZUZd _ Address,
��NUMOER OF TQ 1 L PERMIT NO.-S
7YPF. C`i :'ERfWIT ITEMS _FrEE ON EACH 4M 01.1 icifrice Lisa onivI {
Single Femily-1 beth–each ____ f 7b 00 '� � -----"—"
Uuo_Iex—Each 1 both unit — Z'• ) -
Additionsl bethroorns–each_ {— �� _ tO.GU M•�9�
Mobile Tome Spaq–each -- I ,R 15500 _
INDIVIDUAL FIXTURE FEES
_1 to 60 Fixtwes in t bulldlnd_uach _ �_3.00
_51 to 100 Fixtures in 1 building–each _ _ ._.?•r0 _, — __ __–.
101 to 200 Fixtures In 1 building--each _ _ _2.00__
201 or more Fixtures in 1 buildlnl;–each _ �.__ __,ix I_ --
MISCELLANEOUS ___ _ --------- — –
Ouiiding Sawer-1st 50 ft
_Sewor–each additional 100 1t, —1A !0.00 _--
Water Service to building` _ __ _^ 5.00_
Private Water Syatelr,s-each 100 ft,
Other S Cif _I_ –.�.� -------�
_PERMIT CSL For Plumbing Inspection Phone 639.4191 _
Plumbing CoWrerwr By
Tn7AL _ O Rf IAWT N'J. IssuaJ By
(" BULDNIG PERMIT APPLICATION "ry TIGARD DATE_-_�w'�-7
., _� ._ _ 1716
)hF_ UNL,ERSIf;PIED HEREBY 4PPLIES FOR APERMIT FOR THE WORK HEREIN INi)ICa tD BUILD ERPHON
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFJCATIGNS. OWNEF PHON':-- -
LOT NO——
OWNER � " • _ JOB ADDRESS 191;, Slid Usktj7t r:' Lr
__ HOME ADDRE.:.is
ENGINES'.7
BUILDER V � ` ADDRESS DESiGNEI'-
STFIUCTURE ❑WEW _QREMODELtt--�t ❑ADDITION _ OREPAIR — ❑RENEW_AL QFIRE UAMAG=_— L.JDEMOLITION
1_JRESIpENCF. ❑COMM ❑EDUCATIO-�NAL LJGOV'T URELiGIOUSOPATIO ❑CARPORT C)GARAGE L-7 STORAGE OSLAB EjFENCE
�013OND_ ❑MOVING,, — ❑CONDITIONAL USE ODESIGN REVIEW �1JCOUNCIL APPROVED �L,ISICNS -
OCCUPANCY--!—LAND USE ZONE _ BLDG.TYPE '" —FIRE ZONE_ PLAN CHECK BY_—
Mo tl t G S.."11." I t."I. I j t. S: m u E48 1 0:. ,
i3X•1.,UI�1i:' ? .
r•mmo bld(j. townhutise, Ir.. wall W/0tta('!",Ij m
BUIL DING DEPARTMENT
SET BACKS FRONT REAR i.-. w Sil. Id a
-- 1 '� LEFT SIDE Ulr WGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE i IONS CONTAINED IN THE BUILD114G CODE, ZONING
Plan Check Lp�[jLi REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGRErD THAT TNF
W7RK WI: L BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal s, ALL APPtICABLF CODES AND ORDINANCES. TOF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUE CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING_
Total l R, 24
By
- y�---- APPi (CANT OR AGENT —� '•'—"'—
Approved I' yG ll Rereipt No. 1 j
UATE INSP. T\'PE INSPECTION REMARKS PLUMBING DATE
t
ntractor
rm t No. La j 12 /9
u h•in
a- --------- - - -- - -._——--- --
a xture -- -
nal - --
�(o`) HEATING __----
/l.d R � �- �� -� Contractor _
_ -- —. ----- Pe mit No
Gals or Oil
Final
-----------------------------
Final
DRIVEWAY
Final
Storm Da nnage
1"ide,,ovalk
Rain Drain) Final
Curb&Street Final
__ App
roach
-BLDG DEPT. FINAL TE14PORARY CERTIFICATE OCCUPANCY Final
CERTIFIw-nTE OCCUPANCY
(� Landscaping (�
`,, \ Zoning Final `•
it
SEWER PERMIT N? 137110
1
LJnifieU Sewer ge Agency DATE __ 9•-] 4-77T_
of Wash,ngton County
CITY pt ---_L1paTd
OWNER : ___T .0.C —,._-- - — - PHONE . 6
OWNER ' S ADDRESS:
TYPE OF IN:;,TALLATION:
X,UX BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XXWL
Ef XSINGLE FAMILY [ICOMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) LJ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS CWELLING UNITS .—.. --
PERMIT CONDITIONS, THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULAT .ONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE. REFER TO THE PERMIT NUMBER. THIS APPLICATION
FXPIRES IN ONE -HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL +
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLA' ION "- ISSUED BY -
OTHER
TOTAL s__-__ 025. -
JAPPL.ICANT DATE
NOTICE: e�d__OAYS OF TIDE
ABOVE BITE. SEWER SERVICE
CHARGE WILL BEGIN FOR T11:g `A�ER PERMIT T M 13790
PERMIT. VVYY 'Y'
ADDRESS OF STRUCTURE—L5-395___ ?•5395 !�a_kL1311 —.--.--.—
TAX MAP ____.._ TAX L 0 T -
SY`iTEM fanno _r�•n�lt _
LOT — 594 BLOCK -- OF —/
7-7
__- APPROVED BY �DATE !� I.5. EU BY DATE
REMARKS d Q.
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