15905 SW OAK MEADOW LANE-1 15905 SW OAK MEADOW LANE
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ADDRESS �
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pER,"1IT CHARGE none
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� C,1 I O N FEE
OLI„ _ �7-- _�- -- ---- ,?
PAID 5Y _ --
TYPE OF suILU?NG �
DATE CONNECTED
/rte Ir,sPECTION FEE _
SEiVl'CE HATE _..`. .` cr
PAID BY GATE
_----------_” ----- -—
CONTRACTOR - --------- ASSE SSM'NT PAID
SIZE OF CO,,piECTION
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BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT
holder of a valid plumb ng contractors li;;ense is hereb�-
authorized to cause plumbing work Qa herein noted to be installed in accordal,ce wit:7 the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall bo notified not less than four
(4) hours prior to the time the installations are rsady for inspection. City of Tit,ard Business License required
for all contractors and sub-contractors.
Owner____._.._ __-- Address_____— --
NUMBER OF TOTAL PERMIT Nn.,s
TYPE OF PERC.:!T ITEMS FEE ON EACV I AMOUNT (Office Use Only)
Sr. is Ft rally- b,-.n-each _ ___26.00
Duplex--=ach 1 bath unit�- _s _- 25.00
Additione bathrooms--each 10.00W-Y-
Mobile Ho.ne Soco-each
_ 15.00
INDIVIDUAL FIXTURE FEES �-
1 to 50 Fixtures In 1 building-each ��- _ —3.00
51 to 100 Fixturns in 1 b-iilding-each - _ _ 2.50 —
__701_to 200 Fixtures in 1 building--each _ — 200
__ 201 or more Fixtures in 1 building-each - � 1.60 _
MISCELLANEOUS_
Building Sewer_1st 50 ft, i _10.40 -�
Sewer -each additional 100 ft.
Water Service to_building _ _5.00 _
_Privet e water S s�temsAeach 100 ft _ _ i 10.00 -
PERM) _ For Plumbing Inspection Phone 639-4.171 —�
-_3%State_ � ` Plumbing Contractor By
TOTAL. RECEIPT NO. Issued By
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I City 01 1 193 FG Mechanical re nt[
Neva : lrw,I:atlon ge:rlace [] Relocation 0 Addinon D A!ieration 7:1 401111b�slat
illbli�S 70TAL_�•3�._~
CQ::TRACTOR s��tq+y� r,��.�•e �� _ O�';r:Er, -���.�'_z� _ ,t.��� ,
ADDRE� 3 LA3��.�AM+ WORK ADDRESS
PHONE 6'C`te_ — �^_?�"�G -- APPLIC.ANT_�. ,£. Qom-
~' (BTU Per Hour)
Heat Input Rating ( T tag.___� Vent Size
.' -__�— _..'Z_ ine .Mize
FUEL OIL ❑ GAS ❑ ELECT ❑ OTHER -----�—
ITEM NO. FEE ITEM
NO. FE
r�• .
For Issuance of Permit _� -�3.00 Air Condition Compressor 15 to 30 HP
x New• Under 100.000 BTU 5,00 Air Handling 10,000 CFM 3.(
New. 1 Or1,000 BTU &over 5.00 •'Air Handling Over 10,000 CF M
Floor Furnace 4.00 Evaporative Cooler
Wall- Floor •Suspended r 4.00 Ranye Vent Fan
install Vents Only 2.00 Vent System 3
Repair Heat & Cooling --� 4�0.0 Hood Commercial
'•ex Air Condition Compressor Under 3 HP I 4.00 Commercial Duci Systern —�
Air Condition Cornpressor 3 to 15 HP 7,50
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACZORS OR SUB•CO14TRACTORS
_ _
-�-. APPROVr.D BY bA`fE 1SwUED BY' DATE
RECEIPT NO.
z7rSignature of plit s
. ..,...., •+-•.«ter w�«�..._-., -
A
CITY 1o/ /, ""� dry, ti
BUILDING PERMIT APPLICATION o f TIGARD DATE - 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF-_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWN!LkPHONE
LRinla LOT NO._..r-
OWNEfi " R t m l-i n L){�rl., C O- JOB ADDRESS 1�J 1+ ' SU '..4k '. el pi tiow HOME ApDREss
ARCHITECT
BUILDERERda'tt1
ADDRESS ENGINEER
n DESIGNER
i ❑
"TTRUCTURE _UNEW D REMODEL ❑ADDITION — REPAIR ❑RENEWAL ❑FIRE DAMAGE CIDEMOLITION
D RESIDENCE ❑COMM DEDUCATIONAL DGOV'T DRE!IGIOUSOPATIO_❑CAR PORT DGARAGE ❑STORAGEC_�SL.AB L^IFENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY._ -LAND USE ZONEIX. BLDG.TYPE rfd FIRE ZONE�� PLAN CHECK BY CE. —_ HEAT
Re—i6sue Raise at 51,41 Suinctierf iold 4..rtanw.
— ;-ramv dwwlling w/ettachisd garage, 3 8adVium — 3 6)sLhw, ^_ ---
;r wwr 1'Jf+rmit 14`1745.2' — R:a 621 .1]U40 ---- —
QS�S<<LQAD---- FLQ-QBJ LQ - _--KEfQ T ' e --1 Q—JTQBIE, AR '2_6�Iry��..IyS1�FJEDR00M�`t—�/ 59 �A.C�L','
BUILDING DEPARTMENT SET BACKS rgONT REAR
---- LEFT SIDE RIGHT SIDE.
Permit
—� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check LU*UO REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 1,99*(1101 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE Oc THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tana 7, '_.6 y8TNSE. SCPARATFCTTkRrk >;REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total POE
-- r APPLICANT CIA A C E N T —`—�-- -'�"--"----'"—�"
Approved a ' fit? Receipt No
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DATE INSP, TYPE INSPECTION REMARK= PLUMBING _ DATE
Contractor
W-7.1 No.
eem
Rouph-in
/ /' Fixture —
JIL
- - Final -
G HEATING
O Contrartor
Permit No.
Gas or Oil
Rough-in
Final
-' - SEWER
- —_�- - Final
-- - DRIVEWAY
-J� Final
Storth Drainape
—T - --- (Rain Drain)Final
Sk*mlk
Curb&Street Final
Approach
ILDG DEPT.FINAL TEMPORARY CERTIFICATE O�.CLrANCY Final _
CERTIFICATE OCCUPANCY —
_ Landtcapinp
Zoning Final
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