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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address ''% .,�.. .SF'°%' 'a L+ r,,' Permit # __
Type of Inspection
The following Building Code deficiencies we required to be corrected: � �- :—_� �'` �✓�'
'''7_sl--' ci��.r� �-•.e�,.o •�.�'^w _,.r_Ll�..�.. i„Z�� _.[�� �', r-?__ '1..,-_'�L�,�y..rk. �G.� ly-f:.'C.[:_�:
Presented to
Inspector ~
Date
C'4L.L FOR RE•IWECIION
❑ VES NO
CITY OF VGARD BLDG. DEPT.
12420S.W. MAIN STREET
TIGARD, OPEGON 97223
PHONE 639.4171
CONTRACTOR:
PL zivant to Section(s) of the Uniform Building Code, the
foilo,oving iiern(s) require correcting:
A L
Date: 7i Permit
Inspector
CALL FOR REINSPECTION
w tsswr s � etw tew tri � eev t�
BUILDING DEPARTMENT, TIGARD 1 Tn
PLUMBING PERh11T 1. .
-- -- -- �� _-., holder of a valid plumbing contractors license is hereby
z athorized to cause plumbing workTs herein noted to be installed in accordancei h
w t the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be Notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tirard Busir ess License required
for all contractors and sub-contractors.
�� ) 1 1 - 17 �
Owner_— n'L1l f __,_ Address �`�'~ � �L�
-- `�'�`�' - -- --- ,�ClJ Cjz� Date_,-��,
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT `— ITEMS FEE: ON EACH AMOUNT (Office Use Only)
Sine F0mj!Y7 1 bath-each 25,00
Qu�InR_Each i Lath unit -25.00
Additiunal b�-hrooms-eaco V _ 10.00
Mobile Home Space- each _ _ 15.00 e
IINDIVIDUAL FIXT%2RE FEES"J50 Fixtures in_1 buildwi-each 3._00
L201
1 tom100Fixtures in t building_•each 2.5001 to 200 Fixtures in 1 buildin -•each 2.00
or ore Fixtures in 1 building-each 1,50SCELLANEO_US --- —
Building Sewer-lot 50 ft, 10.00
Sewer-each additional 100 ft. 10,00
Water Service to building— 5.00
Private W tr S,ystems--each 100 It. 10.00
Other -- If_y) -- I ---- "`
PE RN- _ For Plumbing Inspection Phone 6394171
3"6Sta+. Plumbing Contractor By
TOTAL RECEIPT N0. Issued By
"wJL -AWIA-mw ams ww
CITY OF TIGARD FLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, ORFrON 97223
PHONE 639.V71
CONTRACTOR:
Pursuant to Section(s) Of the Uniform Building Code, the
following item(s) require correcting:
Sit
Date: -- Permit No.n s pec t a�r�'��-- ---- .FOR REINSPECTION
� •-"�'*'r !�9'A"".w,�„"_.,,t-,...�..,,�..,.,�,�„-_.ems-� .. �,,..-vwre►«.aw�*„•+r�r.r +w*r ,
7jM 1,?
BUILDING PERMIT APPLICATION coF TIGARD DATE.____,_:_ , r _.—• 19 7
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN IN BUILDER PHONF _____
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
LOT NO,
OWNER •C.m A. Idd9 11 iar JOB ADDRESS 11305 % tIOVS "U”' HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER F _^-1-- i 1"� ADDRESS r� S��I T +r _DESIGNER
STRUCTURE ❑NEW REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL —❑FIRE DAMAGE ❑DEMOOrION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SL.AB ❑FENCF
❑BUND [3 MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED [:]SIGNS
UC---CUPANC L LAND USE ZONE
— Y1 BLDG.TYPEFIRE ZONE_ PLAN CHECK BY_____.______�
— TYPE—FIRE 51MILM femity dwoollinii LJ mt'tarhk,,.,
— 1HF UT t17V !iME:c'7 ,I.xtAcHf:o. ._i_ --- — -----------
Cn % atlgi.'uu,
UCS4J.4912.------- EL49J3 LOAD _AEIS�FIL_ _ NS?�SJJ�FLI APJz9 _`1U_._1�_UB_QQM.$___.__YAQi. —
_ BUILDING DEPAP FMENT
SE r BACKS FRONT REAR LEFT Si 7E RIGHT SIDE T♦
Permit _ _��- • fY1i`1 —.�— _—_,.
THIS .FRMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COLE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— WORK WILL BE DONL IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE. OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE CGVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Stati!Tax LICENSE SEPARATE PERMITS nEQUIRED FOR SEWER, PLUMBING AND HEATING.
Total PUL rel y►1ll�:l�uf3
By
I AnP1 rr ANT OR AGENT
Approved Rerei Tt No
Tom::..... ..,..... .... ... _. , .. .. ..�......W _ .—_
i
r?
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor --p--/'— �
Permit No�b k7
r a
Rough-in
-
Fixture —
a 7�_- _13V7�Sc� •/� — Final i'
HEATING
��'�'�� K 4" a♦2' 7 Contractor
1 PermitU 3Y q—t—� 7 J p
Gas or Oilit
--_--- �-- Rough-in -- - -
---- --- ---- -- Final --
-- SEWER ---- --- --- --
--_ —---__ _—�— — --- — FinalDRIVEWAY
Final----- — --- Final
Storrh Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CEPTIFICATE OCCUPANCY -� Final --
n
7- r
Landscaping
Zoning Final
BUlLDINu PERMIT APPLICATION CSF TIGARD DATE . 19 • �+ 1,9
-44
THE U SOERe)IGNEO HEREBY APPLIES FOR APE RMIT FOH THE%';ORK HEREIN INDICATED eUILOERPHar•,
,Z6r
�
OR AS SHO':;N ANO APPROVFO IN THE ACCOMPAiNYING PLANS ANO SPECIFICATIONS. a%'n+CF'PNOrI
A � �t /14g� Lor No.�.�klQ
. lJ` 1oc. '� JOS A00R�s3 ' SW /V00� ~~
71-1
ARCHITECT
1- ENGINEER
eUlf.OER AOOR S: �`-i7u 1c 1 OESICN_Rryry _
S.RIdCTI;,RE dKEW ClF1E'000EL QADDIr10N ❑AZPAIn CIFI IEV;AL CIFIRE OA-MACE ❑OEMOUTIJN
E510:NCE ~ —`
l_.ILv'."•t ❑EDUCATIONAL ❑GOV'T ❑RELIGIUUSCIPAr10 L1CAR PORT ❑GARAGE Cl STORAGE❑SLAB L..IFENCE
�r I:UPAfJ•CY, ''LANp,E W" ,� bLOG�TYPE _ FIFE ZONE!� PLA14 CWECK BY H£aT
01
SEWE4 PERMIT
FL00_13�2r" 1•I I(Lhl'I��� -__�� fir. RI —?R�?6eIlJ6!_IVUs� � .`YALUF_���QD
I---- SUILOING OcPARrw.4i, �
___ SE f BACKS FROM C .20 R20
EAR 23 LER'SIDE RIGHT SIDE
i�— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUH.OING CODE, ZONING
Plan Check. �� �� REGULATIONS AND ALL APPLICABLE COOES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
IhJ.IK WILL BE GONG IN ACCORDANCE WITH THE PLANS ANO SPECIFICATIONS AND its COMPLIANCE Y:ITF+.
5u0•total 3 7� ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CO`ITRACTOR ANO SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Ida I O 0 LICEP:Sc. SEPARATE PERMITS RaQUIRED FOR SEWER, PLUMBING AND HEATING.
! Tyr! 0 SOC -
•--- PDC
' APPLICANT OF �r
i Approves II Receipt No.
A%1n4fi5 _ y M NE
SDC -
P O C - SDa
SEWEP. CQ1,1NECTION $ (200 ,
SEWER INSPECTION S
SEWER SURCHARGE $
�.
Comments .
ew �w �. �r � nor ■w � s
F(oor 1 30 X 175-
y_z X 3.9 34
t7)
4 q 3G
/4 x /o
qfr.,. Floes Zv-G x ��. 328
/2- G x ?_44-
/0 k s
k 0� 0 �(o
� (p 907.
ed 2 S
._3et!rt
Pat mit_____S3.0U__
City of Ticicard I'milit NT
0 Fee__ 5--0-
r4e-%% ins.allation X Ren!ace C1 Relocation "Addilion ❑ Al-ti_,'raiion —3.2
TO T A L—_AL'-
Cr,%TRACT0 OWN,E R
ADr)RESS WORK ADDRESS
PHONE: APPLICANT
Heat Input Rating (BTU Per Hour) la X ee- a Vent Size Flue Size
FUEL OIL CI GASI ELECT ED OTHER
ITEM No. FEE ITEM NO. FEE
For Issuance of Permit 3.00 Air Condition Compressor 15 to 30 HP
JNew- Gnd 156,000 BTU 4.00 Air Handling 100,000 CFM
' Air H;��idling Over 10,000 CFM
New- I OU,000 BTU &over 5.01,
Floor 4.00 Evipcorative Cooler 3.00
Wall - Floor- Suspended 4.00 Range Vent Fan 2.00
Install Vents Only
i.00 ;nl, System 3.011
Repair 9oling
- Co _—_Hood Commercial
3 0-1:
Air Condition Garnpres.%or Under 3HP 4.00 Commercial Duct System 11'.
:'lir Condition Compressor 7.50
INSPECTOR'S COMM
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTUREOR 508 CONTRACTORS
DATE ISSUED By
APPROVED DATE