15635 SW OLD ORCHARD PLACE ■
15635 SW OLD ORCHARD PLACE
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City of Tigard
INSPECTION REQUES I
for
INSPECTION TAME: - PERMIT NO. : —
DATE:
O. :DATE: �' DATE I S S IJ E CI :_.1.1--
OWNERS NAME :
ADDRESS:
C0NTRACTOR
TEST : Air ❑, Water[] Visunl p , Laboratory 0
REQULT: Approved D , Disopprcved Pending p
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I SPECT0R DATE
�N01E Attach supPlementol test data beret
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City of Tigard
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INSPECTION REQUEST
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for
INSPECTION TIME: " _ PERMIT NO. :- I
DATE: ,3 DATE ISSUED :__1_ --
OWNERS NAME
ADDRESS:CONTRACTOR :
TIE ST : Air 0, Water 0 , W seal Cl , Laboratory p I
RESULT. Approved 0 , Disapproved El , Pending [] —
SKETCH:
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INSPECTOR DATE
GNOIE: Attach Iupplemental test data beret?
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City of Tigard
INSPECTION REQUEST
f or
IINSPECTION TIME * ��. DATE PERMIT SSUED:----�--�--
DATE
OWNERS NAME — —
A D DR E S S : -JG� - —� �--- ---— — _
I TEST. Ai► D, Wafer D , visual D , Laboratory D
e RESULT: Approved � , Disapproved D Pending D
� SKETCH:
I
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! PECTOR DATE
[NOTE ; Attach supplemental tRst date hs►ef]
5
CITY OF TIGARD MECHANICAL PERMIT
DATE PERMIT N0. � � M FECEIPT N0.
BY U //C-� 7'✓,�/ G `�_ .___�___ FEE
1. Permit shall be obtained prior to commencement of .injtallation.
2. Permit shall be obtained for all appliances which are to become
a fixture to the building.
3. Relocation, replacements, alterations, or changes to burners and
duct work require permits.
4. All work to be concealed must be inspected before cover up.
New Installat'on [A ,qiReplace ❑ Relocation ❑ Addition ❑ Alteration ❑
CONTR. _; /} ,i J ,tea ��� . I- � � OWNER -
�_
ADDRESS a on ` '
., /��-- ��.(�Jrnrn �� �,. WORK ADDRESS r� L41--/1
_ /.!. APPLICANT �t�,",��., � .
TELEPHONE NO.
FURNACE MANUFACTURER �> ��, _`s-r�>',►(-r TELEPHONE NO.
HEAT Input rating (Btu Per
r-Hour) �In ,yn,-, _ Vent Size � Flue Size --- -
:7JEL OIL LI GAS El ELECT LJ OTHER
TOTAL SO. FT. Top Floor Main Floor /� �1�% �� Basement
GENERAL
(�-- ITEM N0. FEE _
ITEM NO. FEE
i
For, Issuance of Permit �:_ x.00 Boilers Over
New - Under 100,000 Btu 4.00~_ Air Handling10,00 CFM
New Over 100,000 Btu -Air Viand in�_Over 10'000 CFM
Floor Furnace . Evaporat ve Cooler
Wall -moor •-• Suspended j .0 vent Fan ----
Instal Vents �'YUU- Vend_Seem `--- 0
Repair - Heat & Cooli.nE0- _Hood -�
Boilers Under 3 H 4.00 5omes ie ric nerator _ 0
Boilers to 1 H _ 7.5U ~�F5i Inc- _nera or 20.0
Boilers to 30 Iip 10.00 ��i�ei• oi STs e�-`--
B o i 1 e r s 30 to 50 Hp - - ------ -_
INSPECTOR 'S COMMENTS
APPROVED BY DATE _ ISSUED BY DATE
Signaturg of Applicant �v�-
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City of Tigard E
NSPECTJON RtQUE,ST I
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3; PERMIT
DATENO. : ----
INSPECTlC�N TIME.: -7 DATE ISSUED :_.---1-
t-� %�
OWNERS NAME :
ADDRESS: T /
CONTRACTOR : '
TEST : Air D, water(] , visualX, LabcratorY 0
RESULT: Approved , Dis�oved 11�' pondino ❑
SKETCH. I
A
INSPECTOR DATE
f
FNOTg: Attach svPP1emertal tett data bereta7
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: ' 3 PERMIT NO. '. _ATE ISSUED :--L2--
DATE: 7 D ._—l-1--
OWNERS NAME ; ._ _ L
A DD R E S S oaW. 1111lie
10-12 11
CONTRACTOR
T
EST : Air ❑, Watera Visual/ Loboratory ❑
ZDisapproved ❑ , Pending L]
RESULT' Appruved _
SKETCH;
INSPECTOR DATE
Mpts: Altoch Supplemental test data herf"Gi
city of Tigard
INSPECTION REQUEST
for
INSPECTION TIME -
DATE:
OME . ��' PERMIT NO.: ---
DATE: �`� S� DATE ISSUED:_._L—L.--
OWNERS NAME :ADDRESS :
CONTRACTOR :_ — - - "
TEST' Air [7, Water Q , Visual 0 , Laboratory 0
RESULT: Apr
,oved 0 , Disapproved U , pending F1
SKETCH: C
1APECTOR DATE
CIOTE: Atto:!, supplementol fell dots herel�
PLUMBING PERMIT APPLICATION
Jui,isdictiori of
�No. Type of Fixture Fee Permit No.
I Permit fee
Water Closets ilets) '
ToPermit Issued�`� :
^ Bath Tubs Approved by -/
Lavator}r_ash-Basin _� Building Permi�i
;'hower - Receipt No. in��a
Sinks' Dis' qahin --
1 Sinks I::_ hen
Sinks, Ord3.nai,V_ —� _ Location of Building
_Sinksi Bar_____ _--_.--- ---- -- �`� -v_ /� t c << _ . r r' %._,.el
— ____---
- Sinks, SlU_ -
_ AutomWE c Dis er_- ------
— - uDioral
-ry - Name & Address of Owner,
Laund �'irays__�_-•-- -__--_
-_— _Drains,
Drains, Area
D_rraains.L_ fi gsratsr --
+Rain Drains r`-
Autumatic Washer Nome & Address of Plambe:
7ounTains�ri:nc�`i - '' '' •/�, �—_.'_-
-
Fountainss Soda -
Ho t Water Tank -
`,ater Service Si7_e _
Urinals _ Buil�d-.ging (Old or N_e-w��41tF�r , Repair or
mit^h= a`sin's --�Ya%c3M� _
L,aw=rinkler_ -
_ -'Swimming Fool _—____..- ----•- Other ------- — ---_____-----
Sprinkler System____—_—. .__-___ _ __ ------- ------------
This permit becomes null and void if work or construction authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 12.0 days at any time after work is cormnenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bon
I hereby certify that I have read and examined this application and know the sa
to be true and correct. A1.1 provisions of laws and ordinances gov-:rning this t
of work will be complied with whether specified herein or not, the granting of
permit does not presume to give authority to violate or cancel the provisions
.- .of any other state or local law regulating construction or the performance of
construction.
Signatrzre,' of Applicant
V �
CITY OF TIGARD
17420 S. W. M+m StrMt
TIGARD, OREGON 97227
APPLICATION POR BUILDING PERMIT
New Construction Demolish ❑ Addition ❑ Remodel ❑ Hove ❑
ZONING P-h _ DATE ISSUED 11UILDING PERMIT
DATE: RECEIVED BUILDING FEE $Y�DNo.
BY PLAN CHECK S/0• e0 P4r-13sue fw Zy-
OTHER S y.vD 1)0#n &ArwA 7+-' VALUATION $,7 31 _
, & I sioTr RECEIPT No.
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT s`y42MAP I__ CENSUS TRACT —`� JOB 1
Architect or Engineer
Address %,cS.3e�r. Phoney�:�'� .�
Owner
Address --Phone--
Builder—
Address
honeAddress Phone
BUILDING USE Single Rea. Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP_ No. of Stories_ Total Height_ Area of Lot.—
Type
.ot—Type of Construction V E loon Area B--
Set
i ---Set Backs: Front__Xy--z'_ Backy+� L.Side v `_ R.Side��
Private Sewer Pipe Size_.IS -_� 5ewer'�h%- �C�•4tleptic Tank ❑
.rater Service Pipe Size_� Storm Sewer Ditch ❑ Drywe11❑
� a Q�-"at..f r+r. �y �i.��e►�4►. v•.'►�r.�. L�
Street and Curb Requirements_'� �
Driveway Width No. of Psrkinq Opaces
SEPARATE PERMITS REOUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED
FIELD C11rCF: flY PATE
PERMIT APPROVED BY
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon And the City of Tiqard, Oregon, and that the building will
not be occupied until a Certificate of ()c7upancy has been ivsued by the City of
Tigard building Inapertof..
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13572
EXH13IT "A"
CITY OF TIGARO
Roaidontiol Structure Occupcny Rostriction
KNOW ALL MEN QY THESE PRESENTS, that occupancy of rocidontiol
at.ucturo (a) on the following deacribod lands prior to the rsco:dine,
of nn occupancy pornit releasing the rsatriction. in the Dead Rocorda
of Wanhington County, Oregon, is prohibited by the ordinance of
the City of Tigord, Oregon: (Tho City will losuo o release
as soon as a final inspection daterninos that the construction
is satisfactorily conplotod)
DESCRIPTION OF PROPERTY:
ADDRESS OF PrOPEfiTY:
NAME OF O41NER:
ADDRESS OF OW"dER: w�S .c. ,w ���� `
IN WITNESS WHEREOF, the undersigned huo c:ausod this
restriction to be executed this_ 1
day of ,4
9 �•
OWN ERi
4fP10
APPROVED: T.itlo Af
'Building Ufficial
City of Tigard
STA'E OF OREGON
County of Wsahington as. January 19 _;.:
Personally oppocred bofore no the above nLraod
Roy Brenn and acknoul.adgod the foregoing
instrument to be his voluntary act and deed.
~
Notary Pualic for Oregon
� y Commiooion Expires: 1!16175
WXUP r)40MRRrry, A M
Drw*.v e1 _.
«'add/ LMrnn�
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1372
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1
EXHIZIT ^A"
C;TY OF TiuARO
Ruoidontiol Structure Occupcny Routriction
KNCW ALL MEN 9Y THESE PRESENTS, that uccupanc;! of rocidor,tial
otructure (o) on tho following deacribod Tondo prior to the roco:cinc,
of an occupancy pornit raloaoing ti,u roctriction, in the Daad Rocordo
of Wonhington County, Orogon, io prohibitod by tro ordinance of
the City of Tigard, Orogon: (Tho City will i3auo o :olaaaa
as 000n as o , , ,,cl inopoction dotorninoa that tho conatruct;:on
is ootiofoctorily complotod)
DESCRI_PTIO,'` OF PRC?CRTY:
..�..-.-4, ',! ,%t-\
�'a ��M_l_t.r d�C7 \r`. =+vc.`c. '�'L►� C'o c�y.. `��\ NI
`'L L.C�e�v c\i,-.+ V54 W+a 'a�•n�,�u� C.4v.."�l\\ Li��t'1e,�
AODRESS OF PROPERTY:
;AnE CF O'IJN'LR
ADDRESS OF OVNEN
I:r W:TNESS WNERCOF, .ha ung;care, d ',ra cauaod Chia
restriction be oxecutad this ,mow_ day of _, 19+,
DWNER:
APPROVED: �itlo
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City of Tigard
STATE OF OREGON
County of 'daohington S on. January 19 19 74
Parnonally oppocrod bofore mo t'na cbovu ncaod
Roy Arcrwn and acknouiodgod tho forogoing
inecrument to oe his voluntary act and dood.
Notary Puol.c forgo
r���6�7s
�,7 COL3:AiaJion Expirue;