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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 972.2.3
Phone: 639-4175
Type of Inspection
Z-3
Date Requested/ F V _ Time A.M._ r_P.M.
Address 1�-27� Permit
Owner------- LL/'l�✓L.l(�. —_ Lot
Builder -- --`-- ------�__��
The following Buildinq Code deficiencies are required to be corrected:
Presented to r _ Approved
Inspector —_�1 Disapproved
Date _ c�/�--
INSPECTION
❑ YES ❑ NO
l'.0.l i.ax 1_LU)l
C- ITY OF TIG RD PLUMBING 1317.5 3q Hall 111vd.
Applicants must hold Oregon Registration to conduct a plumbingPE�M �r� Tigar 75 97M
business oti must�VropMy owner/operator not hiring outside help.
Name oa t e"lolxnera -- z ) ��Y
Plumbing Permit No _ ---
Address Deserip'Jon
V'72-1 ORS 614- 141 ' (.x1AN PRK E AMT.
Job Tax tot Mnp.No.
Address -_ __-- FIXTURE;'
Sink 7•'�
ame Fix—Mw o-To .r�isiness Lavatory 7.50 _
tT1 Address Tub ox TubtShower Comb / - 7.50
M _s
ar rnq Shower Only 1 _ 750
_ -
Owner City/. tale Zip -Water Closet 7.50�.-.- .--.- - ------ -
Dishwasher 750
Phone Garbage Disposal - - _ 7,50.
-- ---- --
Na a - Washing Machine L 750
---
Floor Drain 7 50
Mailing Address Phone Water Heater - - 750
Occupant `_.-.._ Laundry Room Tray - 7.50
Uccu
P City/Stale Zip -- ----- ___.
UrinalISO
ro«,e_-_ Other Fixtures(Specify) -- _ - 750
(l{//•F�/S _ Y 7.50
rens Phone
c' 750
Contractor C-Ity/State Zip %'
50
MISCELLANEOUS
�- City Bus Tax No Sewer 1st!00' _ _ _ 90.00
-tate . 3.BoWU-ffo_---St le Pkjmtwsl3us I-IC-TToSewer-ea.Addh.100 15.00
—(Res+denhal) --6 VL- 3 c//./y Water ServYb st'100 _--� ,� . _.
I hereby"nowledge theft I have ft read s aPplication,that this etor
kmatlen Water Servioe e .Addit t- - 15.00
given is oared.that I ars registered with dw State Builder's Board.and also Storm b Rnin Drain 1 at.100' 90.00
have a Slate Pt m*"lkwnee that the numbers ghren are ocxrocf.Uwt NI - - - -- -
pkrmbing work will be done in wcordw"wtth apWAble prcwfslons of Ore Stam 6 P:F Drain Addd.100' --J 1500-
gon revised Statutes Chapters 447 and 643 and appNrable oodetr and tlist Moble Form Soave 2500
no help will be ernpbyrd unless ww*od under ORS Sell (M exempt frrxn
State reglstre".please give reason bebw). Back Flow Prevontion
HOMEOWNERS-I hereby owtify that I am 0* water of I*properly vie gevloe or Anti-Polk,tlon Dews �50 -
*abed above.st which location 1 propoeo to male a pk nsbkV k>tNakabon tot Arty Trap or Waste Not
my own us$wed ft propwty is rept bsktp pwwouOtid kx sats.lease rx WA Connected to a Fixture 7.50
Catch Basin ---- 750
-- - ---- ----
Insp.of 6det.Pkxn"_ - 40.00 Per I
Spedelly Re,vitiated 1s uapodlorss _ 40.00 Pw Hr
Aker o11 Pknntwq wMMn
/ an Exwwv sidg 15.00"Vi
Al,r t TURF Now Bldg.or Busd.AddMlon 96.00 min -
Ueecribe work newt7f addition Q lift etlon❑ repair(] 15.0)
b hr dcxte reakieintial f j-�/f rx+tt•rsrklentif!l
E isl&g use of
htAk*V of proxierh -- -_ SWIOTAt. /` , 7,
Pi�Ws of NN
4% IOM
bARt1R
INOTME
TTM*I'dil l M ba no MA wd void N work or oaterwilan isowlead is not ppm
w wtpad W*dre WO dwew M flw%*L dw or wart M aulpw%W a abrin vied IOr
a paHrsd of Ilio days all rtp Moo atter worts Is olwtiiw ad.
�G '
�, _-
Uatts Issued '
INSPECTION NOTICE —�
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
/
Phone:
639-4175
Type of Inspection
s� ��' '�i��•--- '' –�c�—
`�C `'
Date Requested T I" A. P.M
1 _•
Address r r V _ �tertfS(t #
Owner l�_ Lot
BuilderThe follow Building Code deficiencies are require. to be corrected:
I
Presected to Approved
InspectorXJ DisapproNed
Date � /
CALL FOR REIMPECTION
0 YES Cl NO
I�
BUILDING PERMIT APPLICATION nATF _ 19—" 4795
THE UNDEPSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONL684-7 41__
OR AS SH00N AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER P q►'
LOT 110._'..``ice--_--_
OWNER JOBADDRESS t)12`s SL, River Dr.
lav Mz s� ad.4A9
ARCHITECT
slime PO f3Ox 23291riq. ENGINEER &RAW
BUILDER ADDRESS ° DESIGNER
STRUCTURE C'�NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
N RESIDENCE ❑ COMM O EDUCATIONAL ❑ UOV'T ❑ RELIGIOUS ❑ PATIO 1-7 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _13,._LAND USE ZONE 2A,3 BLDG.TYPE __aN_FIRE ZONE _PLAN CHECK BY M___HEAT
Construct single family dwelling w/attached ytir.ige, all per approved pans.
'%ubjact to 85 code. REISSUE, of 6561.
SEWER PERMIT 4 33471 ( Irdi ll 3 With, 12 t rape (ja_ ? qc
4 10
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIFS AREA O.BEDROOMS VALU
BUILDING DEPARTMENT _ SETBACKS FRONT 20 REAR 36 LEFT SIDE RIGHT SIDE 5
Permit 307. 00TH:S PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
111111 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAITHE
Plan Check 40.(j( WCRK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECI7 ICAT!ONS AND IN COMPIJANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRI(:rIVE COVENANTS. CONTRACTOR Al"D SUE CONTRACTORS TO HAVE CURRENT CITY BUSINESS
— LICENSL:.SEPARATE PERMITS REQUIRED FOk SEWER,PLUMBING AND HEATING.
State Tax 14 .08 :.> T
00
Total 4._1. .IG8 SDC— 600. _ _
— PDCN APPLICANT OR AGENT , I
By --`fit+.(3n-- T_,
Receipt VO. ��,�n ADDRESS TFIONi
Approved _- 382.68-- .--
iV
P
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No. 'Z8
7 R.ugh-in
711
.72rCQFixture
Final
'— HEATING
Contractor
7 — _ Permit No. Lf Al/1
Gas or Oil
— Rough in
-- -� --
Final
J SEWER
Final �'Z.L
_ DRIVEWAY
Final
Storm Drainage
(Rain Drain?Final
-- S idewol k
Curb&Street Final
Approach
BLDG.DEPT.F1!1AL TEMPORARY CFRTIFICA: r OCCUPANCY
ICkRTIF1CATE JC GU PANCY final --
—� - -
Landscaping
Zoning Final
06
SEWER PERMIT 33470
Uf41
Unified Sew*rage Agency CITY CIF Tigard DATE _ _ /� - %/-
of Washington County
OWNER, �Iawt; 1 tom,- _ �_ _ PHONE : 684- 57 43
OWNER' S ADDRESS: PO Box 23291 Tigard
TYPE OF INSTALLATION:
D BUILDING SEWER l_J LINE TAP AND BUILDING SEWER ❑ LINE TAP
TYPE OF OCCUPANCY :
® NEW Ll EXISTING SINGLE FAMILY COMMERCIAL
C_1 MULT . RES . �_� INDUSTRIAL
FIXTURE UNITS — DWELLING UNITS t
ADDRESS OF STRUCTURE , 10729 Sipl.�ii .r�I2>`I�P
Permit Conditions: The applicant agrees to comply with all rules and regulations c,f the Unified
Sewerage Agency. When calliny for an inspe^t!on, please refer to the Permit Number. The Permit
expires one hundred twenty (120) days from the date of issuance. The total amount paid (permit
fee, connection charge, line tap fee and/or other charge) will be forfeited if the permit expires.
De Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer
is not located at the measurement given, the installer shall prospect three feet in all directions
f-om the distance given. If not so located, the installer shall purchase a "Tap and Side Sewer"
!Iermit at the current charge and the Agency will install a lateral.
FEES:
PERMIT FFf $ - 35_il(1_
CONNECTION CHARGE 975 -nn _
LINE TAP INSTALLATION SSUED BY
OTHER ( .�/_ 7
TOTAL 1 , 010 . 06 DATE OF ISSU NCE
� I �
DATE OF EXPIRATION
SEWER PERMIT
ADDRESS OF STRUCTURE 10729 SWRiver Dr. 97224
2S115ADQUARTER
TAX MAP TAX LOT SECTION - - - ---
LOT 36 BLOCK OF _, I1nynr I.aridj_ac} _
ETT46-10-S 7 ^
�PPP.OVED BY - DATE SUED BY DATE OF ISSUANCE
D . U. ' S 1— REMARKS ---
"SI1PC'� PLAN CHLCK NO.
for inspect icons call 039•-4175
G tG h1,�T NO. ��
CITY OF TIGARD 639.4171 DATE --to-----
BUILDING PERMIT
P.O. Box 23391, Tigard. OR 97223 T.OXMAP � LOT NO. .Z- SUBDIVISION
-
JIJDAODRFSS
OWNER_— I
A, I Y, C7 h L STIP TE REG.NO. _.�—__c.XP.DATE _ ---
BUILDER _— /
RUILOER'S PHONE l^ 11 75W �// /
�SCO`rS� __ PHONE_ - _._OTHER
ARCHITECT_, M
STRUCTURE NEW E) REMODEL E) ADDITION_ ❑ REPAIR ❑ MOVE
['1 n*!;meq O DEMOLITION
RESIDENCE ❑ Comm C] EDUCATION ❑ ONO (3RELIGIOUS, O ACCESSORY (j GARAGE ❑ OTHER CJ FENCE
OCCUPANCY U1NO USE ZONE
OLOG.TYPE FIRE LANE ,..,,.P,AN CHECK 0Y `°�BEAT _
Construct single family dwei l in w/at ter ned aaraIIH-_at 1�_rca►ced-;:1 a;4 ---- -
Sul) '-yt t(2 '9') Lo
L p s i F— IJS,I(--
SEWER PERruT/, (I du) baths 0"traps aaraae �reC�� --- -
NO.STORIES AREA414-?4- NO.REOROOMSy LUE
OCC.LOAD FLOOR LOAD 1 HEIGHT � _ �/ «". — (,..�
BUILOING DEPARTMENT SETBACKS FRONT µ . REAR; G LEFT SIDE RIGHT SIDE J��
Ptrrnll �""" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUI4-OING CODE, ZONING
REGl1LATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT TNF
Plan Check «•• WOVIK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. TH ISSUANCE OF THIS PERMIT DOES NOT WAIVE
11.CkF" RE.STRtCTIVE COVENANTS.CONT OR AND 5C RA,,-TORS TO NAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE►ERMITS R UIREFI�SEW PLUMBING AND HEATING.
e StateTaK �� `+SOI'_
SDR,'-
Total -� -y sl►, ApOPI QTS E- __-
Prepd. Y
a
s N
Due j
Receipt No. AODRESS pNON4
Issued Ry__ --.J•rFroved ey
SSDC - 5 .2
SOC RECEIPT #
P O C - �___J__3�— DATE PD.
_ "' PD. -t>�► /11 ''�T�
SEWER CONNECTION5 � � AMOUNT�
SEWER INSPECTION S
SEWER SURCHARGE S
ommenCe:
CZTT OF TU AR D ilUZUI t6 DIMARTMENT PTIANno /
CUCK Amicalow DATE RECEIVEDi G- 5- S7
P.O. Box 23397, Tioard OR 97223 P/C DEPOSIT PAID: 4
ta-
This is to certify that the attached sets of plans have been submitted for Man
check pursuant to the Oregon Structure Coe and Fire & Life Safety Code, edition.
PROPERTY OWNER: OWNER'S ADDRESS: _
CONTRACTOR: -- (/ TELEPHONE:
JOn ADDRESS: 2d! r i//O JZ y Cys LOT N0. 6 MAP:
DESCRIPTION OF WORK: '
APprovalls Re Mired SPECIAL NOTES
OPlanning Dept. a Reissue
0 Engineering Dept. 0 Blood Plain/Sensitive Lands
0 Fire District 0 Sewer Availability
0 Other O Other
Item Required
List of subcontractors
0 Business Tax
0 Calculations
OTruss Details
0 Parking Plan
OLandscape Plan
Q Other
COMMENTS:
city of 'ri&ard Buildiop Departsment
CITY OF TIGARD MECHANICAL. PERMIT -�--
Permlt 0
Description
Table 1A Mechanical Cods OIN t>Mttca AMT
City of Tigard 1) Permit Fee -0- -0- 10.00
13125 S.W. Hall Blvd. —
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223 p�
639-4175 1) Furnace to 100,000 BTU / 600
incl.ducts 6 vents _
rumace 100,000 BTU +
incl,ducts 3 vents 7.50
Name of Development _3)- Floor Fumace ---- --- 600 ----
StS�I2�� incl.vent - -
Suspended heater,wall heater
Job Address 1) 6
Address �b� q72-�'^-� or floor mounted heater -
Tax Lot Map No ) Vent not incl.In 3.00
Lot L Back Subdivision 5 appliance permit --
Name(or name of business) 6) Repair of heating,refr Ig., 600
cooling,absorption unit
Matti Address Phone 7) Boiler or comp to 3 HP 600
Owner absorp.unit to 100,000 BTU
City/Slate Zip 8) Boiler or oomp to 3 HP-15 HP
absorp.unit to 500,000 BTU 11'00
NameBoiler or comp 15.30 HP 15h 00
/ / 9) absorp.unit' -1 million
41 ----
Ma&p Address Phone 10) Boiler or comp to 30-50 HP 22.50
absorp,unit 1-1.75 million
Contractor City/state 11 Boiler or oomp to 50 HP _ 31.50
absorp.unit 1,750,000 BTU
Stats Registration No City Bus rax No. Air handling unit to
12) 10,000 CFM 1 S0
I t*19by a-ivlowiedW thatW.I havo road this a "hori that the ankXmatuxr greeAir handling unit n Is 13) 10,000 CFM 750
rxx"ed,that'sm th,.n owner or suthodred agent d the owner,that piens subrntttea are in ----- ---
compliance with SWe laws.that I sm registered with the State Buliders'&wd,that the Non portable
nwriber phren is oared (II exwr4A from State rwostraaon plems plea ressrr+beaw) 11) evaporate Cooler 1.50
15) Vent tan oDnnected LI 3.00
to a single duct
— 16) Ventilation system not --- 1.50 —
Included In appliance perm_I_t
- 17) Hoodmveeileby 1.50mecanic
4-0.
(owner or am") ----- t ata 18) Donlasfic type 7 511
ac
Der:oe work El addition O alteration El repair i _ incinerator
to be done residential a non-residential i-1 19) Commarolal or Industrial 30 00
Existing use of type Incinerstor
buckling or properly 20) Other I.e.,woodstove,water 150
Proposed use of �,� heater,solar,clothes dryers,slci
building or property. _-- - 21) Gas piping one to four outlets
Type of fuel- oil L) natural gas CK LPG L1 alaClrlo ❑
-- 22) More than 1-per outtot
— __- SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON -- — —;x BURClIARO!
6TRUCT11014 AUTHORIZED IS NOT COMMENCED WITHIN 180
D"S, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUS-TOTAL
ABANDONED FOR A PERIOD OF 190 DAYS AT ANY TIME AFTER
WORK 18 0MMENCE0. '
TOTAL
8pt11i i bot1i>oma ---
_ Date Issued by