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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection ` -, _--
C
D *e Requested �_- L— _ - Time ) A.M. P.M.
Address _1 �i_� _ C.-LJ`---Y-' Permit #
Owner . _ Lot #
Builder - - --
i
The followiny Building Code deficiencies are required to be corrected:
Presented to �eApproved
;00
Inspector I I Disapproved
Cate -- - ---- ---�+��� � -
CALL FOR REINSPECTION
0 YES [21 No
CITY OF TIGARD MECHANICAL PERMIT Pe P
�wah.rYearCode _ .rY rom AMT
Qty of Tigard 1) Partnill Fee -0- -0- 10.00 k
13125 SW Hall Blvd. -- -- -
P.O. Box 23387 gy .90WWrWUI Pff"* &00
Tigard,OR 87223
639-4175 1) Furnaco to 100,000 BTU N.00
Ind.ducts&vents
2) Fumace 100,000 BTU + - 710
W.duds&vents
Hama d Oawlepnwnl -- 3) Floor Fumace J-- £.00
f 7 7 ' � 2 Incl.Vent ---
-�-- Suspended heater,wall heater
k'� � 4) or floor mounted heater 6.00
Addret.s _.- __.
Tax L01 map NO, _— tient not Ind.in 5) 3.00
` Z appliance permit -- - -
Name(or name d bup�) _ 6) Repair of heating,tett i6.00
:�i:c�-cam- cooling,absorption unit
Holler or comp to 3 HP ti
.00
Owner
RX" 7) absorp.unit to 100,000 BTU _ — -
city/sws ZIP 81 Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU -
�ONer or omW 116-30 HP 15.00
Ilkt + -1
sw. ttruu.{. /'. ,. ��• ytf,0o0 ur*b
IO~
I hwuby ddp-OW t t7 6(J
aorowbw foo 00 r 1111 soon OW ftr► r i1M hend"
4
ec+era�ew I wn rNr owrrw or afr011se erwasb aww lMtdiwr N.* .1tJp00 t� -+ —
oon0" ww,em mtm to 1 so"ONOw writ err 6*06OWWW 9, sw as 11411.44m porplb le 4.60
rab,dw yN.n�oor�ol p Nrnp tYom�,,.a,,,�,pane,!r„.r«r.on ta.raa+I. isNap?onoe cooler.__ __
15 Voo fan connected 9.00
to a
Vvift on cyst.m not 4M
by 44
7.50
DesAi
wortr ❑ addoon [1 Owatlon C
to bb done /nalderrMial txx►"sildeMlal EJLorrxr►.;�-I or IndusMa 90.00
1g) kadnerato�
COW Le.,woodeftNe.1111111111111111ir
Proposed„se of ) taster,solar,clothes _ _ ---
btAlding of property _ 21) Gas piping one to ftKW autlsb ( 2.00 2
Type of W- oll 1.1 natured gas Gt LO ❑ electric ❑ 1 -------
22) More than 4-per outlet
NOM SUWTOTAL
THIS PERMIT BECOMES NULL AND VOID IF WOW OR CON-
8T111/CTIQ" T �� IN 10Q 4�G � .ARi
DAYS, OR IF(X*4 `7N ON YW0��11�0 lel PLAN REVWW NMI 7 t7
work I�S3p-"*1 Cvt �r
+
Date Issued by
CITY OF TIGARD BUILDING DEP aTMENT PLAN CHECK NO. : 7 2
PLAN CHECK APPLICATION DATE RECEIVED:_ , 1 U' F 7
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID: 5'/-o
This is to certify chat the attached __ sets of plans have been submitted�r plan
check pursuant to the Oregon Structural Code and Fire & Life Safety Code, `-1 > edition.
PROPERTY OWNER:
OWNER'S ADDUESS:
- - � (�C�! � ...�
CONTRACTOR: _
TELEPHONE:
JOB ADDRESS: .Lam" ,Q��e-t LOT NO. & MAP: 3
DESCRIPTION OF WORK: �h��A/ -� ��D
Approvals Required SPECI L NOTES
OPlanning Dept. Reissue C� ? 3
0 Eagineering Dept. U Flood Plain/Sensitive Lands
O Fire District O Sewer Availability
OOther. 0 Other
Items Required
OList of subcontractors
Business Tax
Calculations
UTruss Details
O Parking Plan
OLandscape Plan
OOther
COMMENTS:
City of Tigard Building Department
BY
LtJOrkShPe¢ PLAN CHECK NO. -Z
for inspections call 639-4175
PERMIT NO. Z.
CITY OF TSGARD C39-x/171 DATEI�wPv .
BUILDING Box PERMI23397T 3 ` SUBDIVISION L�_ ,rte
P.O. Boz 2 397, Tigard OR 97223 TAX MAP � LOT NO.
OWNEa
JOB AOOR£S 'rT'�-r�_ S.1/t/• � I �'N,- �r
-P,r 1 I STATE REG.NO. <<' c� EXP.DATEBUILDFR
SUILDER'S PHONE �/l� 1-- --j
L m 3
_ � PHONE
__._OTHER
AnC•HITECf. _
STRUCTURE NEW ❑ REMODEL (] AnDITION ❑ REPAIR ❑ MOVE ❑ OTHER O DEMOLmot.
RESIDENCE ❑ COMM ❑ EDOCATIOI I ❑ IND ❑ RELIGIOUS, C)A(XESSORY U GARAGE 0 OTHER ❑ FENCE.
---
OCCUPANCY jt=L__LAND USE ZONE _ _BLDG.TYPE LL---Lti�' FIRE ZONE _ PLAN CHECK BY MEAT `
Construct sine le family dwei l ined garage. all Pip approued plapri
Pct
1)r t o 1i 5 rude i S S U j", /Q q -3
SEWER PERMJT a -(1 du) baths, t r p S 1Q 0a0atae_kEfB— ---
OCC.LOAD fLOOR LOAD {r HEIGHTNO.ST_O_RIES Z,.. kR_EA f NO.BEDROOMS VALUE
BUILDING DEPARTMENT FRONT REAR " _ LEFT SIDE RIGHT SIDE {G '
SETBACKS �--�--
Pwmll �— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES.AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPL!:ABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOFS NOT WAIVE
PI.CIL Fki "".....
~ RESTRICTIVE COYCHANTS,CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMrM SEPARATE PERMITS RECIUIRED R I ER,PLUMBING AND HEATING-
State Tax SSOC-
SDC
Total 9S-L,
POCS
Prapd, _� 0 - / !'✓� — l^751 '- '
Recelpl No ApDRESS P►+O►�(
Bal.Due ,0� (1IS _
Ixxued Ely______--__-_--APP(ovad Br—
SSDC $
SOC - `` RECEIPT #
POC - DATE PD._Y-� --
SCWER CONNECTION AMOUNT PD.
SCWER INSPECTION S �
SOWER SURCHARGE
.0mmento: ------
BUILDING PERM f APPLICATION DATE _ is
?HE UNDERSIGNED HEREBY APPLES FOR A PERMIT FORTH E WORK HEREIN INDICATED 3UILDER PHONE 6434_-754 3_.
OR AS SHOWN AND APPROVE=D IN,THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
Jay MillerJOB ADCRESS__ ' `=W River Drive j
LOT NO...- 4 Dover I
OWNER _
saw, AOCHITECT — - —
ENGINEER
BUILDER _— /%DDRESS CFSIGNER
STRUCTURE IX NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
IX RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO C] CARPORT ❑ GARAGE ❑ STORAGE El $LAB❑ FENCE
OCCUPANCY — R3 LAND USEZONE —__R4-.5BLDG.TYPE UL--FIREZONE— _PLAN CHECK BY HEAT_ $aa-
Construct ,sin lea family dwelling w/attachedc��a��c�, all per approved plrang . _
FEISSUE of 6793. Subject to 85 code.
SEWER PERMIT M 34507 ( Idu) 3 h7ths, 10 trnpa gnrageA area 525
_OCC.LOAD FLOOR LOAD 40 HEIGHT ' ` NO.STORIES 2 AREA 9C11N0,BEDROOMS 3 VALUE 9 5000
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE — —_+RIGHT SIDES
Permit
391 .00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 40,00 WORK WILL BE DONE IN ACCORDANCE WITH THZ PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUN CONTRACTORS TO HAI'E CURRENT CITY BUSINESS
(,!CENSE.5 PAQA'[,PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 19.55 ::RI,� , (.tl
SDG— 600.00
Total 450.55 11 150.00
"- FDCM AP�LI At�TOF,,(iE1�T��"
B .
By ,
Receipt No. m_PH��_---1--yY-----
Approved ADDRESS ONE
DATE INSP. TYPE INSPECTION REMARKS II PLUMBING DATE
1147 Q L3-W7
Permit No.
Rough-in
Fixture
Final
HEATING
-- Contractor
Permit No. � r
Ges or Oil _—
Rough-in
— _ Final
SEWER ---
Final
J -
DRIVEWAY
.f �' Final
Storm Drainage
— (Rain Drain)Final
_ Sidewalk
Curb&Street Final -
Approach
9.DG-DEPT.FINAL TEMPORAt'Y CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY ---^--
Landscaping
Zoning Final
i
P.O.13ooc1 �vd.
41 ' TY OF TIGARD PLUMBING ]aM EY [;11/Hl
C I Tig3rd CR 97273
Applicanh must hold Oregon Registration to corvdud a plumbi„g PERM IT &-0-4175
business cr must be properly owner/operator not hiring outsi ie help.
Narr►e of^Oevebprne-> (, /
-S Plumbing Permit hro✓�LI
Audreaa /n�-.1-� Description
c- <"( �- 1:G I: ODr\ ORS 814-21.610 DUAN. P(ME AMT
Job Tax Lot Map.No.
Address _FIXTURES
Lel ,.� Block Subdivision Sink
) 41
arrw or name or business) n Lavatory—__ _- -7.50 _-
, F\�' i� � Tub or Tub/Shower Comb-- ( 7.50
'Mailing Shower Only _ _ i1 7.50
Water Closet Wa7.50
Owner City/ tate 70 -- --
Dishwasher _ _ 7.50 _
-� - Phone - rFloor
age Disposal -- 7.50
— - --- ing Machine 7_50 -.
Name --- -Drain____ -,_ 7.50
a1 ing ress Phone r Heater _ - 7.50
Laundry Room Tray 7.50
Occupant City/State —��-� rip Urinal 7.50 _
Name
e Other Fixtures(Specify) 7.50
^r W
Tr ' 7.50 _
—-
��(� C-
ding Address Phone - 7.50
Contractor Gly/,Yate Zip 7.50
-- LL -
_ MISCELLANEOUS
— City Bus Tax No. Sewer lei 100' - 30 00
561 -7 Sewer-aa.Addit.100 -- - 15.00 ^
latesoar-d}To. tate s s. o.
(Residential)(Residential) �,•��7 t/ '�L /-/3 water Servkx 1st 100'-.- 20.00 -
fI hereby acknowledge that I have read this application,Mat the information Water Servioe on.Addit.2001 15.00
moron is corned,that 1 am regiallwed with the State Builder's Board,aM also Storm 6 Rain Drain 1 st.100' 30.00 -
haws a State PkxnbMq Now%o that the numbers given am oorred,"wl all Stonn 5 Prin Drain Addh.1(10' 15.00
plumbing work oAU be done M accordance with appNcabb provWms d Ore• - -
gw Revised Statutes Chapters 447 and 693 and appNrsable codes and that Mobile Home Spm 25.00
no help YA be Mrrployed untw;Ikmosed under ORS 883.(11 exempt from --�
State registration,please give reason t>abw) Davi Flow Prevention 7.50
HOMEOWNERS-1 txrreby oerWy ow I am the owner of the property do—
sorbed.hove,at which location I propose to mike a 1*xrg*V Installabon for Any Trap or Waste Not
my own i so and this property is not being 0mv0nxJed for sale,baso or reM Cerx»cled lo a Fixture _ 7.50
Catch Basler 7.50
leap.of Exist.Pkwmtrrrg----- -- 40.00 Par Hr _
-- -- -- malty
ted Inspections _ 40.00 Per Mr ---
- Aller.of Pkaftbkrg will III
an E15.00 min
E*" 15.00_
AUTHORIZED SIGNATUREto New".a Build.Ad~ 25 00 rrAn
� = �z- ' � e fa111i1
Describe work now A] sddltlon E] alteretlon L-16epair[I -1112iling - 15.00L to be cone roe IdenN nal re weent-&
Extorting use of
SU&TCTAIL
PfcCA)wd u"of C'O
wwft or may- .... ----------- -- ---__--- TOTAL Q 7 v o
Tula partmM be", nuN and Void#wale or oonatruotion acRhwlsod Is not am,
111M wMHln 1B0 deyater N 0entlNuotlon or srakia auapwded or abandoned kx
a period of VW days aA any Mrta Wilar,wok is aorwtinoed
MyC1AL --
Do% Issued —_._. by -----
IX;U 4aD it 1rR5 re.