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15665 SW OLD ORCHARD PLACE
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/ C:TY OF TIGARD HEATING PERMIT
DATE _ �/ /��/�i''�_ PERMIT NO. ��/3-�xrn RECEIPT NO. b
BY /�--�.�L1. i �t�' FEEL_
le Permit shall be obtained priat to cc-mencement of installatio:
2. Permit shall be obtaiLod for all arpliarces which are to become a fixture
to the building
3.. Relocation,, replacement: a r changes to b .rr.ers and duct wor
require peMits.
4. T11 work tw�o be concealed must be before cover un,
New Installation V."j Replace Relocation U Addition ��.. Alteration ❑
i OWNER
ADDRESS ", _ ��Cl/__ii ^�-- _— __ WORK ADDRESS
----- --((�a ? 1 tll t%,J_ ___ A F P LI CANT
,i TELEPHONE 140.
FURNACE — MPMUF'AC.'URE:R /�� / s TELEPHONE NO.
HEAT Ir put rating (Btu 1'er. H6ur ) rL(y__, Vent Size _� —_ Flue Size ---�'
FUEL OIL ❑ GAS ELECT ❑ OTHER
TOTAL 3Q. FT, Top Floor _��� Diain Floo.: f�1 L r Basement -
GENERAL
ITEM NO. FEE AM'T ITEM NO. FEE AM'
For Issuance of Permit 3,001 Boilers over 50 Pip _ —125.00____
New -� Under 100,000 Btu 4-='0 _ Air HHandling_10,,000_CFM 3._00
New - Over 100.000 Btu _5�0 Air_ Handl i ng_C2ver 10.,._000 CFbi 5.00
Floor Furnace 4.0 EvaQorata�e Cooler 3�0
Wall - Floor��rA ! nded 4,.0 Vent Fan 2.00
:install Vents _ 2.0 _ Vent System _ _ 3.00
Repair . - Heat & Coalin 4�,U Hoad_ 3000
Boilers Under_3 HP _ 400 Domdstfc_ Incinerator _ 5000
Boilers 3 +-a 15 H _ "� 5 Comm: Incinerator M _ 0.Q0
Boilers 15 to 30 Hp Oro _ Other Not Listed 3.00
—
Boilers 30 to 50 Hp 500 -
--q7--
INSPECTOR' S COMMENTS
APPROVED-BY � DATE _----•_-. ISSUED BY -- _ DATE
Signature o -Applicant
A�
("llity of Tigard
INSK.-CTION REQUEST
for
INSPECTION TIME : ���, � PERMIT NO.:
DATE: 111421,1_ DATE I SSUED:..—l.__L_
OWNERS NAME .' _ i IAC_.__
ADDRESS ���1 ,
CONTRACTOR :
TEST: Air ❑ , Water p , Visual ❑ , laboratory ❑
RESULT: Approved Disapproved 0 , Pending L]
SKETCH'
INSPECTOR DATE
CNOTE : Attach IU;01emental test data horst] i
W wx wl luwl wx wl W fid
City of Tigard
INSPECTION REQUEST
for
!N$PECTION TIME* =��� PERMIT NO. :—
DAT : --� 7 DATE ISSUED :._.__L_1
OWNERS NAME :!__��'�r
ADDRESS: /Cc;?� zu,yj i u�—L _
C-C,NTRACTO R : _
TEST : Air 0, Water D , Vieval✓z, Laboratory ❑
RESULT. Approved Disapproved ❑ , Pending ❑
SKETCH.
AA �,�,
-
i4—
INSPECTOR DATE
CNOTB: Attach sdpplemental test data hereto]
City of Tigard
INSPECTION REQUEST
_ for
INSPECTION TIME: _AW PERMIT NO, :---
D ATE:
0. : __._.DATE: DATE ISSUED : I Z_—
OWNERS NAME '. .
A. DDRES S: mec `� o--1
CONTRACTOR : _ �U.m�D%_
i"EST : Air U , Water(] , Visual 0 , I_aboratoiy f:]
RESULT: Apnrovedx , Disapproved EJ t�endiig U
SKETCH.'
INSPECTOR DATE
C10TE .' Attach supplemental test data here t]
w w 11111FAWIFTIFIRF-1 ��U-Wkwfi
i .
City of Tigard
INSPECTION REQUEST
(f or
INSPECTION TIME : PERMIT NO. '
9 DATE : 411 'Z7t,4 DATE ISSUM.-i-j-,
OWNERS NAME : .-
ADDRESS :
CONTRACTOR :-
TEST' Air 0, Water o Visual La5crotoryo
RESULTApproved Disapproved [I Pending o
SKETCH'
INSPECTOR /DATFL
0
UNOTE Altach SuPPlamental test dato hireil
FYN
r
City of Tigard
INSPECTION REGUEs"r
/ for
.e.. i
NSPECT iON TIME : PERMIT NO. : _
DATE: L1' DATE ISSUED: ._
:OWNERS NAME : --
ADDRESS . ��7� �✓�t"� �_��_
O PI T R A C T O R :_._.-
rEST. Air Q, Water p , Visual p , Laboratory []
RESULT.'RESULT.' ApprovedA, Disapproved G, Pending L]
SKETCH'
DA
INSPECTOR TE
NOTE Attach supplemental test data heret:01
I
I
SCit of 'T i gcard
r City
INSPECTION REQUEST
I for
IY' PERMIT NO. . --
INSPECTION 'TIME :,r.�J---
DATE-. � DATE 'SSUED'-- '-L
OWNEZS NAME :
I
ADDRESS : --
I
CONTRACTOR :—"- C
+ TEST 4 r J , Water j , wiscol O , Lo" ,ratorj r
I RESULT . ^.prroved)e Disapproved 1 pNnding ;]
SKETCH.
i
I
/ NSPECTOR DATE
1 OTE : Attach supplemental test d aia beret-,,)
1
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PLUMBING PERMIT APPLICATION
Jurisdiction of
No. Type of Fixture Fee Permit No.
Permit fee
Water_C_lo_sets Toilets, �y Yerait Issued
Bath rubs Approved by _
LavatoryWash_ Aas , -in �? Building Permit --_
Shower — Receipt No. `s___
i, in sD�shWaShing___
Sinks Kitchen _
_S inks Ordinary -'-- _— _— Location of Building %��'
Sinks.
Sink s-L Slop
Automatic Di shwasher�
Di s-po s al ,
— Laundry_Trays_—_-__ _ Name & Address c Own r,
_Dra_ins. Floor
Drains , Area _ -- - _ " ;�, 7 • �� /6'%'1 —
_Drains._Refrigerator
Rain Drains
Automatic Washer '�c,' Name & Address of 4lumbe�
L 7r-inking
---,-Fountains, Soda
Water Tank _ -
Water Service Size''
L)ri.nals — Building Oi.dor 9ew) Alter, Repair or_____
Ca t:cF-Basins�4arJ �stL _ _ --- — ----
Lava Sprinkler_ystem ---- �_------- _ ' _-- __--_—_---
S)± mining Fool
- _Sprinkler S_ystein______—_
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 120 days at any time after work is c,)mmenced,
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond,
I hereby certify that I have read and examined this application and know the sarne
to be true and correct. All provisions of laws and ordinances governing this -type ,
of work will be complied with whether specified herein or not, the granting of a
permit does riot presume to give authority to violate or cancel the provisions
of any other slate or local law regulating; construction or the performance of
construction.
Signature of Applicant
135'73
EXH131T "A"
CITY OF TIGARO
Roo'.dontial Structure Occupony Rootrictl.on
KNOW ALL MEN BY Th,'SL PRESENTS, that occupancy of reoiointio:
otructure (s) on the following der .rlbod landu prior to the rocord: �y,
of an occupancy permit roloaoinc the roctrict:on in thu Dood Rocorda
of Washington County, Oragan, is prahibiLud by tt'o ordinance or
the City of Tigard, Oregon: (Tho City will loouo o rolucao
o:! 000n on a fiaol inopoction duterninou that trio conotructic-
is ootisfactorily conploted)
DESCRIPTION OF PRCPFRT'f_t
{aa•1 Vt�e...c..+� . al.ae..c�# �r-.. �w ebb �'�►� `'a�'��t„ `�iV,�vt\c�`
!. �f'L $y•�R VY•� 1.�1e. . F.��'C ati P•. Com.o.a.-.�'r�' �7 a- L•�eo r•�
C_as•
ADDRESS OF PROPZRTYt
IArE OF 0IJNCR: - Z er?s
ADDRESS OF 06?;ELR: ��5."1rdr, _mow ti��.�T� y,y c.
IN u:TNCSS WHEREOF, the undersigned hoo cauaod this
restriction to be executed this aC�= day o`
OWNER:
'ams
' y• , r � . r fi r
APPROVED:
i ding U r t, C a
City of Tigard
STATE OF OREGON
County of Jaahington °A' anuary L;+ ly ��
Personally appoared bofore To the abovo nonod
[toy Brown and ocknouledgod tho fornloing
instrument to be him voluntary act and dood.
Not ry uu ;c for Aragon
My Commission Exoiros: 1116115
N-41ml—d k-31
aoQB11?"oM6lLN. drew M ir:nd�A t
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135'73
fit
EXHI3IT "A"
CITY OF TIGARD
Residential Structure Occup&ny Ruatriction
KNOW ALL MEN 9Y THCSE PRESEti,S, that occupancy of residential
structure (a) on the following deocribod lands prior to the racording
of an occupancy pormit releasing the rsctriction. in the Deed Rocorda
of Washington County, Orugon, is prohibited by tho ordinance of
the City of Tigard, Orogon: (Tho City will laouo a :o:oaoj
as soon no a final inspection detoroinaa that tha conatruct_can
is satisfactorily complotod)
DESCRIPUCN OF PROPERTY:
�t���a.r�'bw b� W d'��'. r•� `f. � La.+..�v+'C v ���J � •�•�L'1
A,DDIESS Or P20Pr7TY: _via c.�,� r •. _ .��\ ,
1 A i'E 0 F 0.1 N w R= "C ..\ _ _ .y.��• �,�r�.aa�.3_.._;. {
ADDRESS OF OWNER:
IN WITNESS WHEREOF, the undersigned hoo caueod this
restriction to be executed this :�h�= day of �_, ly-
OWNER:
APPROVED: 7:tle
ui ding OfficialCity of Tigard
STATE OF OREGON
County of Washington ss' January t9 19 74
Personally appeared before mo the abovo nQaod _
Roy Brown and acknowledgad the foregoing -
instrument to be his voluntary act and dead.
Notary Publ..cfofor- ' : l16/7!
ny Cowmiozi.on Exp.
t
�,✓ CITY OF TIGARC3
1"* w. W. Ire shv"
TIOARO. ORNOON 7
APPLICATION FGR BUILDING PL;RMIT
New Construction Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING / ) I�� DATE ISSUED-/_ �. -- - IlUILDING PERMITy—'^—
DATL: RECEIVED BUILDING FEE $ 00 No.
UY PLAN CHECK $ /Ci, fid k't Is:w, ft
OTHER $ y' C)o_jk&r? A%,gxw)K-YAL.UATION $ ��L�`./
RECEIPT No. S��a,,�
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH I&PLICATION
LOT Iw ^�>�a� MAP / CENSUS TRACT � Zroa 1—
Arrh.tset or Engineer aa.s�. .r„ ._ +�_•s_�sa.>�ss��� __.�..e�� —s_—_
Adctrc+t3s—�c �''�. _.__7i`Jul �.y►s4�3waa„wz_;�h_Phone `.3`�.- '.tet_,• �--
Owner
Address Yhona
BuiIde
Address
BUILDING USE Single Res. LN� Multi Res ❑ Comm,y Ll1r dustrial Cf
OCCUPANCY GROUP_ No. of Stories lk,,_ Total Height Area of Lot
Type of Construction 11 &4&--LU- V Floor Area B_—
`ao`a C•
Set Backs: Front_ � Back�_'tea_ L.Side�%.,Sl� R.Side �14m' ��
Private - •wer Pipe Size_ `� _ Sewer*,,. ic Tank ❑
Water Service Pipe Sizey�.rl� Storm Sewer Ditch ❑ 1)rywe11❑
Street enc] Curb Requirements _ �-
1
Driveway Width`�� of Parkinq Spaces_ _=
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INQORM;,rION
ADDRESS ASSIGNED
FIELD CHECK F!Y DATE.
PFRa12T APPROVED E7Y
It is understood that all work will conform with applicAhie codes and ordinances
of the State of Oregon and the C°t.y of '.Agard, Oregon, and that the buiidinq will
not be occupied until a ciDrtificnto of ~upancy has been issued by the City of
Tigard Eluildinq inspe--tor.
tgna�ur P%Pplicant