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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following items) require correcting:
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R.
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./N /fit cL,/A"&,.f r' L-4 A.�
Wil 0,0^1
Date: �y�_ .<_ 9 Permit No.
Inspector
CALL FOR REINSPECTION
r114 OW-V no" -w-��-� ^"►Fv' _ .. .. ��
BUILDING PERMIT APF-(CATION 11 Y TIG A,RD DAIE19 79 , 'X1 M
6791
THE UNDERSIGNED HEREV APPLIES F00 APERMIT FOR THE WORK HEREIN INDICATED BUILDER"HON.
OR AS SHOWN AND APPPOVED IN THE AC(.,_)MPANYING PLANS AND SPECIFICATIONS OWNERPHGINE�
LAT NO.
OWNER 2 1 M hills _ JOB ADDRESS 1-128') BIW Qualls Lt. HOME:ADDRESS
--—— �` ARCHITECT
tENGINEER r,riarcy tsarcissy
BUILDER, 1AfJf1ir. tiamo ADDRESS 11 f iso SW 114th Pte _DESIGNER
STRUCTURE NEW 0 REMODEL _[]ADDITION OIIEPAIR 124NEWAL ❑FIRE DAMAGE ❑DEMOLITION
Itzi
C) RESIDENCE OCOMM OEDUCATIONAL OGOV'T OREL.IGIOUS[]PATIO OCAR PORT OGARAGE 0 STORAGE DSLAB []FENCE
❑BONDOMOV NG ❑CONDITIONAL USE ODESIGN REVIEW 000UNCIL.APPROVED OSIGNS
--- i:IWH y�ae
OCCCUPANCY.Ir-3 LAND USE ZONE__� (J _BLDG. TYPE_ .( FIRE ZONE_ PLAN CHECK SY HEAT -
(Unstruct sint'Ln feamii.y nuell.inij w/attached goings. 4 tiacJrOOMS
6t�-Iaaua nt' ttr�>`�Iit ti2:a E� (964.1 SW KiMbOtly Lite )
_. Sawal Permit s20339 — %70 .00
_ a.
OA
2,2 :4 4 ,�S7,Ob3.
S?QQJ.48L?__— _
__.11.4Q.131�AiL� .__ FLLGFIL_ 26 SSQf31fS._2—_AAEA _JQ M-5-
VALIcE_
BUILDING DEPARTMENT SET BACKS FRONT _ 21) REAR _48 LEFT SIDE 46 RIGHT SIDE_ 0
Permit 3.04 - -
-- THIS PFRMII IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10.(110 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND It IS HEREBY AGREED THAT THE
— --- WORK WILL BE DONE IN ACCORDANCE WITH. THE PIANS AND SPECIrICATIONS AND IN COMPLIANCE WITH
Sub total 213.On ALL APPLICARLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax H.i r LICENSE. SEPARATE PERMITS REOUIRED FOR ;EWER, PLUMBING AND HEATING
Total 5V221.1i�
t1y P1 ---— ---- - - -
APPI.;c'ANI OR AGENT
,approved 0111 l Receipt No.
DATE INSPP, TYPE INSP[.CTIOI! REMARKS PLUMBING DATE
Contractor K'P/1f00c
Permit No.
Rough-in �✓ i..-_v -�y
Fixture
.Aim' i
n, r_
Final
HEATING
' Contractor
— – Permit No.
Oas or 011
—� Rough-in
Final
SEWER
Final 9-X7_71
DRIVEWAY
Final
StorMt Drainage
(Rein Drain)Final
Sidewalk
�— I'urb&Street Final
Approach
BLDG.DEPT.FINAL M
TI PORARY CERTIFICATE OC Y
CERTIFICATE OCCUPANCY Final `
Landscaping
Zoning Final i
CITY TIGARD DATE _, 19 M
BUILDING PERMIT APPLICATION of G3 -b7
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN I' /ICAIED BUILOLR P.-I-- 9 I/
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICA1IONStav;Ner. +37
�,�� 0
O
pYJNER �• t Ih-
p 78 A �D.RES
— �--p .._C�.. � —._.
-490
n
0
[]REPAIR CIRENEWAL - — OF IHt L'.:;.�A'' LJ
J RUCTUnE _ NEW._ ��FIE M, .;E.L - - --0_ADDIT10N
RESILIENCE ❑COMM CIEDUCATIONALT OGOV'T OR!LlGiqysUPATio L_JCARPORT ❑GARAGE —[]SIORAGE05LA6 ALJ:
._ r
r ::�dCY 1f,�l\ oNOIISF 7c ���Q'_..,.LIIDG TYPE — i-fac ;I ' r 3- P' %CHECK BY_ -._.-__ HES ' V
crIA7021 15
SEWE.R__ GER_MI7 A --- - __ ._...._ ._..._.._.. _ _.
.f b
cC_IOPP_._..__.. . Kt*�n!� L�O ►IEIGIa.t._.d��__._NQ. ST'�flIE3._Z� -- P_REAt=401
gull DIN,DEF'ARtMENT ; .c r BACKS FRONT REAR LEF I SIC,
O
----- --- 0 iIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINFO IN THF. BUII.DIN(i COIF., ION
Plpm Check /0.� GULATIONS AND ALL APPLICABLE CODES AND onDINANCES. AND IT IS HEP.EBY b(iRFEll THAT
RK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANDSPECIFICATIONS AND IN COM'1,Irr,f
Su')•total /3 ,Or to APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT OflrS NOT
'E.STRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE L.URPkNT C: ry 8(
Sate Tax _ R Z_ 'rrNSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING
Tutal2 , L uC# Q
____.. __.... _ 17 `R1.
eipt No
AripruvPd PHO N�€
5DC
F,D C
Sf WER CONNECTION
; OER INSPECTION $ _ 26
SEWCP SURCHARGE
pea
Comments: _ _._.__._ _. . .
Tai-!�f
P
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Cit of 1 --13 ) U lrltt.r1arlica E �i1)��t- 9 - Permit
y --
;;----�� d', ?�`y Fee Som
I�?w Ir f!al:�liOn Rto b:e ❑ Reloca:ion ❑ Addition 110 Alt*r&6an
3'-State 3z•
TOTAI. --. .
CONTRACTOR 4�,(At- — skY ��� ,• OWNER 8 vt—
ADnRsm�� Nl�u�-31 q. -}j II �(o Y WORK ADDRESS ILZ J ,S
PHONE (u�(�(ISSI APPLICANT HdC I h�S •
Heat Input Rating (BTU Per Hour)_.___ _-- Vent SizeF Le
FUEL OIL ❑ GASO ELECT ❑ OTHER
� ITEM �NO. FEE ITEM NO. F£.
i-or Issuanc`t_o' Permit —__ --1� T 3.Q0T� Air Condition Compressor 15 to 30 HP
�._.� .
2
New - Un:jsr 100,000 ET'U __ i __ � _4.00_ Air Handling 10,000 C Fti��
New ' 100.OrJ0 3TU E. c� er r ,�_��—+� 5.00 Air Handling Over 10,(100 CFM `"--
_Floor F_urne_t•a - _ � � 4.00 Evaporative Cooler �
Wall - Flno,- Su,;,een!ied � 4.00 —Range Vent Fan
vanes 0_ni,� _ 2._00 ---_ _.— M� 2.C.
1 —Vent Syftem
3 C
Rt�.ai' • 1i•;ai^E' CODliitg —~ ry~-I- -- _ 1
- 4_.00Hood Commercial
AC^mprUn-ter3HP _ ~�- _. . _1=3
.00 Comrmsrcial Duc Crsiem
.fir Coni-.ion Comtn_,:or 3 to 15 FI? I I '_-7.50
t�22 f:_r:'1'�i':L i._'-. �.!^���.��' ,.'. ...._ '' _Y_`�9iT:'Si'.L:!'_-1.T.'S�•Ilil .:SS3��� ___...._
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e Iris. eCrOFt•5 COt„l,;,.NTS�..�`..__,__.__�
CITY RUSINFSS LICENSF REOUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS �~ �-
1 APPROVED P.Y DATE _-„ ___ ISSUED BY DATE