10670 SW DERRY DELL COURT-1 ADDRESS:
O&C'M
i Irecords\microflmVargets\building.6ic
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INSPECTION NOTICE ��
City of Tigard Building Department
13125 Bw Ba'1 Blvd. Tigard, Oregon 9.7213
InspecpD Line (kec-O-Phone)e 639-+175 Business Phone: 639-4171
Inspections
Footing Plbg. Underelat MOC11. Rough-in
Appr/sdMlk
Pound. Plbg. Toy Out G1.s Line FiR11L:
Poet/Beam Struct. Sen. Sevier Framing
Post/Beam Mach. Rain Drain Insulation
Plbq. Underfloor Nater. Line Gyp. Bd.
Date Requested: - c� (� =( f{ Timet An
Addreer: nk5
„ (Q�� T
Permit 1:��-
TUR FFOLLCNING CORRECTIONS ARE REQUIRED:
,
Inspectors/ `�' /� `/� Dator�' �?-
✓ APPkOVRD DISAPPR(Y'Bn APPROVED SUBJECT Til ABOVE
�/� Call For Reinsp.
N�-SP�GTION. N01°ICE
CitX Of Tigard Building Depart ftnt
13125 6W Rall Blvd. Tigard, OV"gon 97223
Inspection Line (Roc-O-Phones 639-4175 Business Ph-ine: 639-4;73
Inspections
Footing Plbg. UnOerslab Hoch. Rough-in Appr/Sdwlk
Pound. rlbg Top Out Gas Line
Post/deam 3tru;:t. San. Sewer Framing -Bldg,
Post/Ream Hoch. Rain Drain Insulation _plumb
Plbq. Underfloor Nater^Line Gyp. Bd. _Mach.
Data Requaateds �Z_`eL CO -l t, T�(iimle:� _AM _
Address: loco C7 1 )4e ( ✓L-1 I�-IJ CAj pdrma- /,
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Iuepectorr/ ' < -— - 7
Date:
l` APPROVED — DISAPPROVED -_ APPROVED SUBJECT To ABOVR
For Reinsp.
INSPECTION NOTICE
City of Tigard IAaildiog I?epartakent
13195 8N Ball Blvd. Tigard, Oregon 97223
Ineptr_tion Line (Rae-O-Phones 639-4175 Buninesn Phone: 639-4171
Inapection
Footing Plbg. Underalab Hoch. Rough-in AEpr/Sdwlk
Foiind. Plbg. Top Out Gas Line FINAL:
Poet/Been Strur_t. San. Sewer Framing -Bldg.
Pont/Beam Mech. Rain Draln Insulation -Plumb.
Plbg. Underfluur Natter Line C dyp. Ed. -Hach.
Date Requested:_ -V ��_� r_Time: AN __-PH
Address: 7gQ Permit _—
Builder:
THE FOLLOWMI/
CORRECTIONS ARE REQUIRED:
Inspector --- -- --- Dates_/
APPROVED DISAPPROVED APPROVED SUBJRCT To ADOVF.
- _Call For Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 Sol Ball Blvd. Tigard, Oregon 972.23
Inspection Line (Rec-o-Phone): 639-4175 Business Phone: 639-4171
Laspection:
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. !*lbg. Top Out gas Lire FINALE
Poet/h. m Struct. L.in. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater LineBd.� -Mach.
��
Date Requeeted:__ � _ Time: AM
Address: le7 c Permit.
i
e_llder:__ J,2j —__
'ME FOLLOWING OORRECTIONS ARE REQUIRED:
/
Inspector: ...,___. !/'� _ _ Date:.__
__APPROVRD DIS"PRMD A'-PNOVSD SUBJECT TO ABOVE
/,/,.all For Reinap.
INSP-ECTION NOTICE
City of Tigard Building Departasent
13125 SW (tall Blvd_ Tigard, Oregon 97223
lnspec on Line (Rec-O-Phcne): 639-4175 Business Phone: 639-4171
Inepectlons
Footing Plbq, Underslab Mech. Rough-i.n Appr/Sdwlk
Found. Plbg. Top Out Cas Line FINAL:
Poet/Boom Struct. Ban. Bower Framing .-Bldg.
Poet/Beam Mach. Rain Drain ( Insulation -Plumb.-Plumb.
Plbg. Underfln r N ter Line y`pyp, Bd. _Mach.
Date Requested: O ��� Time: AN PM
AddresesSr�
Permllt
Builder:
TNM P'OLL0WINO 01OKS ARE REQUIRED:
Inapectors O
Dates_ -/ y
APPROVED DISAPPROVED APPROVED nURJECT To ABOVE
Call For Reinsp.
INSPECTION NOTICE
City o. Tigard Building Department
13125 SM Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O--Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbq. Und_erel.ab Mach. Rough-in Appr/Sdwlk
Found. Plbg. Top putt Cas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor //Water Line Gyp. Bd. -M*ch.
Date Requeetedt !p
Addrases
Builder
HE
FOLWWZa CORRECTIO'AS ARE REQUIREDt
Inepactor:-��%7�---- i — — --— Date:
APPROVED DISAPPROVED APPROVED SUAJEC- TO ABOVE
call For Roinsp.
City of Tigac4� -, .lding Departaent �-
13.125 Sp Hall bisd. Tigard, O Ague 97223
Inspection Line (Rec--o--Phone)z 639-4175 Bustneae Fhonez 639--4171
Inspection:
Footing fl.bg. Uoderelab Meeh. Rough-in Appr/Siwli,
Found. Plbg. Top Out gas Line PINftI.z
Foot/Beam Struct. San. Bower Framing -Bldg.
Poet/Bt..,n Mach. Raindrain Insulation -Plumb.
Plbg. Underfloor. Nater Lino Gyp. Bd.
c -Mach.
Date Requestedl_ _J Tines �_AM _PM
Permit #iMX 2-7al5Z-
THE FOLIX)WING CORRECTIONS ARE REQUIRED!
i
�3
Inspector:-�C� ✓/ _ _ —�
- ------- _ Dotes
`APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
CITY OF TIGARD — RECEIPT OF PAYll,r-*!,JT RUCs IPT NO. 9`2-0127
CHECK ' lilt-)NT 0. 00
NAME v GUSTIN, TAMMY CASH AMOUNT '7. 88
ADDRESS v 106170 SW DERRY DELA, CT lgPAYMENT DATE a 06/01 /92
SUBDIVISION
TIGARD, OR 972;:7..3--
PURPUSES OF PAYMENT AMOUNT PAID PURPOSE OF PA'-'MENT AMOUNT PA I U
PERM 7. 50 ST. BUIIJ-) VIER 0. 38
)DD RAIN DRAIN FIXTURE TO MASTER r-T'RMIl.'
�OTAL. AMOUNT PAID 7. 88
LNSPECTION NOTICE
City of. Tigard Building Deparbsent
13125 BW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)e 639-4175 Business Phore: 639-4171
Tooting Plbq. Underslab Koch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Cas Line FTNALt
Post/Beam struat. San. Sewer Framing -Bldg.
Post/Beam Neon Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line uyp. ad. -Koch.
Date RegaestrdtZ ,�A `Tfeesx IL—AMPN
Addresei In-ow (Y'1 J�X�. Permit
Buildert 6 Z�L
'MN FOLIAkINO OORRBCTIONB Alts RMIRBDs
140,
Inspectors
APPROVED DI8APPROVED APPROVED SUBJECT To ABOVE
Call For Reinsp.
IN�+PECTIO}IsJO�'SOS
City of Tigard Bu.ildiog Oeptrtrent
13125 Sw Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Buoineae PhonR: 639-4171
Inspections,__
Footing Plbg. Underolab Moch. Rough-in Appr/Sdwlk
Found. Plbg. 'fop Out Can Line FTNALs
at/Beam Struptl. San. Sewer Framing -Bldg.
oat/Ream Me--h,) Rain Drain Insulation -Plumb.
Plbg. Underfloor pater Lino Gyp. Rd. -3ech,
Date Requestads I sem'-- _oT�ss AN PH
Addreess
Ve-- .5/ ..—_IG._�
•Holt �:
Huildars
THE FOLLZ ODPIMCTION' ARE REQUIRED:
Tnepertorsq J� Dates
,_APPROVED DISAPPROVED APPROVED SUBJRCT 7r -;PME
Call For Rei.nep.
INSPECTION NOTICE �/ti
city or Tigard Building Deparf-ment
13125 B11 Ball Blvd. Tigard, Oregon 07223
Inspection Line (Rec-O-Phone): 639-4175 Busine6 Phone: 539-4171
inspection:_____
:noting ` Plbv. UndMIA Mach. Rough-in Appr/Sdvlk
Found. Plbg. Top Out Gas Line FINAL:
Post!Beam Struet. San. Sewer Framing -Bldg.
Post/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underrloor Nater Line Gyp. Ed. -Neth.
Date Requested: �- -` �- _Time: ))AM __PM
Address: Permit ft-!y
Builder:
TNR FOLLOWTNG CTION9 ARE REQUIRED:
Inepecter natell
X APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_N _Call For R: insp.
i
INE;PSCTION NOTICE
City of Tigard Building Department
13125 SO Ball Blvd. Tigeud, Oregon 91223
Inspection Line (Roc-O-Phonal; 634-4175 Bunineae Phone: 63 -•4171
Inspection:—._
Footing Plbq. Under.elab Rough=-ilt, Appr/Sdwlk
Found - ,
Plbg. Top Out FINAL: ,
I
F
Post/Beam 9truct. San. Sewer Pram Q� -Bldg.
Post/Beam Noch. Rain "Irafn Insulation -Plumb,
Plbg. Underfloor Water Line / Gyp. Bd. -Koch.
Date Requested: In `Gj Tom= __An PX
r
Addre■.: �/ �ormit
Builder:__ ld�
TOE FOLLOWING RI-_-IONS ARE REQUIRED:
�1
I
Inspect r:_
Datrr:
DISAPPROVED APPROVED BUBJSC'T To AROVF.
1
J
`_—Call For Reinep. �
I
i
t
I
INSPECTION NOTICE
City of Tigard Building Departurmt
13125 SW Ball Nlvd. Tigard, Ocvgon 97223
Inspection Line (Rec-o--Phone): 639-4175 Business Phone: 639-4111
Inspection:Af�
Foo,.ing Plba. Underalab Mach. Rough-in Appr/Sdwlk
Found. Pllg. Top Out GaR Line FINAL:
Poet/Roam Struct. Sail. Sewer Framing -Bldg.
Poet/Ream Mech. Rain Drain Insulation --Plumb.
Plbg. Underfloor Nate Line Gyp. Bd. -Hoch.
Date Requesteda, J� f �1/ TTim.�e..s. AM PM
Address: 4irmlt
,
THE FOLLOWING CORRECTIONS ARE RF.QIIIRlq�/)
—
_
Inspectors_ Dates
11PPROVSp DIIIAPPROVED APPROVku SUBJECT To ABOVE
Call For Reinsp.
CITYOF TIFARD Cny
COMMUNITY DEVELOPMENT DEPARTMENT i� MASTERPERMIT
13125 8W HoR Blvd. P.O.Bowe M97.Tigmd,Oregon IF=(503)670.417s / i -E R M I T #. . . . . . .
CC*T-
DATE
ISSUED: 04102,190.:
SITE ADDRESS 10670 SIS DERRY DELL CT PARCEL: 2*5310'zDA-02900
SUBDIVISION. . . . : DERRY DELL PI._AT 2 ZONING% R-3. 5
BLOCK.. . . . . . . . . . : LOT. . . . . . . . . . . . . . .:1
__.__.----------___---_._.._____._,_____. BUILDING -----________--_-__--._._..___-_._______-___
REISSUE: DWELLING UNITS:O BASEMENT. . . . . . . . :0 sf
i1-ASS OF WORK. :ADD BE:DRMS:Q BATHS: 1 GARAGE. . . . . . . . . . :0 s f
TYPE OF USF_. . . :f3F FLOOR AREAS-- ---- REQUIRED SETBI�CK - --- --
'I-YPE OF CONST. r5 F=IRST. . . . :72'0 sf LFF'T. . :0 ft RIGHT. sO ft
OCCUPANCY GRF,. :RU SEG0NO. . . :0 f FRONT. ;0 ft RE AR. . :0 f0.
STORIE:S. . . . . . . sl THIRD. . . . ab SLf RC=QUI
HEIGHT. . . . . . . . : 14 fit TOTAL-------:720 sf SMOKE DEETECTORS.
FLC,')R LOAD. . . . :40 psf VALUE. . . . . $ : 3:120 PARKING SPACES. . :0
Remarks : addition of 720 sq ft
_________-____. PLUMBING
51 NK5. . . . . . . . . . ..0 FLOOR DRAINS.'. . . :b BACKFLOW PREVNTRS. ,. :N
I.AVP_10RIE:S. . . . . :2 WATER HEPTF`RS., . . :0 TRAPS. . . . . . . . . . . . . . :o
IUP/SHOWERS. . . . : 1 LAU14DRY TRAYS. . . :0 CATCH BASING. . . . .. . . -0
WATER CLOSETS. . : I SEWER LINE (ft ) . -.0 GREASE TRAPS. . . . . . . :o
DISHWASHERS. , . . :0 WATER LINE (ft ` . :0 OTHER FIXTURES. . . . . :rT
PARBAGF DISV,. . . :0 ROIN DRAIN (ft ) . :0
W0541 INC) MOCH. . . :0 SF RAIN DRAINS. . :0
MECHANICAL -__.____.__.__..__.__ __._._.__-.------__-•-- FEES
I UEL_ 7'YPE:S-----.-------• UNIT HTRS. . :0 type amol.tnt lav date recpt
/GAS/ / / VENTS . . . . . :3 BPRT * 211. 00 JL.H 04/Oc2/92 -
MAX INPUT:O STU VENT FANS. . - 1 BPLC $ 137. 15 JLH L71;3/30/92 210.„53!`))+
F'URN ( IC40K -0 HOODS. . . . . . :0 R5PC E 10. `iii JLH 04/02/92 --
FURN ) =100K . . :171 WOODSTL7VE:S. :0 MPRT $ 00 JLH 04/02/92
FLOOR F'URN. . . . :0 CLO DRYERS. : 0 MPl_C $ 6. 25 JLH 04/1712/92 -
tkOIL%CME' ( 3HP:Q1 OTHER UNITC:O M 5 PC $ 1. 25 J!J-1 04/02/92 -
GPS OUTLETS:0 VIPRT $ 30. 00 JL; ; 04/02/92 -
Uweer: - -._________.._._.___..______.._.._ _.____.._.___.____. V'SFC $ 1. 50 JLH 1714/02/92
HONALD L AND TAMMY G GUST1N
! 0670 SW DERRY DELL CT
IIUHRD OR 97223
Phone 4: 639-2027
Contractor: ____.____----•.__ .._..__ ._.__.__._..
CONTRAC COR NOT ON FILE_
Phone it:
Req
420.:. 70 TOTAL
This permit is issued subject to the regulations contained in the -- ----- REQUIRED INSPECTIONE3 -- -- --
Tigard Muricipal Code. State of Ore. Specialty Codes and all other Foot./found Insp Gyp Board Insp
applicable laws. All work will be done in accordance with approved Post/Beam Str^r_lc`t Rain drain Insp
plans. This permit will expire if work is not started within 180 Post/Beam MecF,an Mechanical Final
days of issuance, or if work i uspended Torr more than 18"ays. P 1 m/unci s;1 a b Insp PI Limb F i na 1
' . Meclianir.,al Insp Boilding F=inal
m:i tteN aign�lt�_r /'1L {� Pl.r.,mtt Top Ot(t F'r�nKion Conti o I.
Framing Insp Crawl Dr,pin
;.sSUed By: Al _._._ In .ki[at r.,..i Insp _
Caul for inspection - 6.10-417,11
CITY OF TTCARD RFCFIPT OF P14YMFNT RECEIPT NO.
C14ECR AMOUNT a 2(3S. 55
GUST IN, TAMMY CASH nivIOUNT s 0. 00
0I)RES15 s 10670 SW DERRY DELL. CT PAYMENT DAT' s 04/02/92
SUBDIVISION
TIGARO, OR 97223--
',URPOSE OF PAYMENT AMOUNT PAID PURPUE-W UP PAYMENT AMOUNT PA I D
211'. oel PLUMBING PERM _._-._.____..FSO.
0. 00
110]HONICAt- PF. 2S'. 00 ST. BUILD PER 13. 30
,I—AN CHECK FE. 6.
Tf I'f of
AMOUNT PAID 285. :55
IIAC70F _L ��C1�� �3izs sw l�,u n%t PLNCK/Rl CI #
PO Box 23397 PERMIT ,`y'. 2yy S
COMMUNITY DEVELOPz1ENT DEPARTMENT 'rprA Oregon 97M
ZZ
(503)630-4171 DATE ISSUED
JOB ADDRESS: L� ? :Ll � l L C 4 TAX MAP/LOT 0 3 04-
LOT: -- _ LAND USE: _-- -- —
VALUATION: / )� ,(w
���MAL I) L-- C-1V�� i +� SP C AL_NOTES
NAME:. 4 L I I ' REISSUE OF:
ADDRESS: I -�uj f-le.cu Df- �� C'� _ LAST REISSUE: _
k6 bot 10 _ FLOOD PLAIN/
PHONE: ��J SENSITIVE LAND: `_-
CONTRACTOR APPROVALS RE UIRED, _
NAME: _ Iil�Il-� �.� ------ PLANNING:
ADDRESS: _ _ ENGINEERING: _
FIRE DEPT:
PHONE: Y OTHER:
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED.
SUBCONTRACTORS: PLUMB: iJ� � _ LIST/SUBCONTRACTORS:
MECH: ';amu-1lUf- ___ BUS TAX: � -
ARO VENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: _ _ OTHER:
PHONE:
PROPOSED BLDG. Of (Op
COMMENTS:
LICANT GNAT E
Received By: _ Date Received:
7
PERMIT M ACCT # L�CSCRIPT ION AMOUN- AIICJNT PD. BAL. DUE
.ve-.5Z 10-432 00 Building Permit Fees �,�ll __ ��� •`'�
10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees ?��� .2r•""
10-230 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check. Fee jLu 0 � — �'Z,57 _
Building
Plumbing
Mechanical
10-230 06 F i re
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees __--
25-448-04 industrial TIF Fees .^
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees _
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) -
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) _
24. 445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
TOTAL --n
S.s
nm/3587P.WPF
i
CITY OF T (BART) - RECEIPT OF PAYMENT Rt,GF I P7 NO. t c►c.. :��;5 �
CHECK AMOUNT a 137. 15
NAME i GUST I N, TAMMY CASIA AMOUNT f1j. 00
ADDRrss a 106701 !;W DFPRY DFLA. CT PAYMENT DATE r, 03/,-0/9P
SUBDIVISION :
TIGARn, OR 97223-
PURPOSE
72c3-PUrPOSE OF PAYMENT AMOUNT PAID PURPOSE (IF PAYMENT PMOLJNT PAID
L.FiN CHECK FE _ ._. 137. 15 ......
TOT(IL AMOUNT POID - -) 137. 15
CIIYOFT167ARD PLAN CHECK APPLICATION
N CHECK
PERMIT LA1
COMMUNRY DEVELOPMENT DEPARTMENT ulY PLA /
uizsswiarawd v.o.n�z�ar,Tq�a,ovrn�16aa1s�or�n
DATE ISSUED
JOB ADnQ FSS• 4r p(p ,2.0 .S U� �rrr'Z O!/' c' ,/ TAX MAPAOT.1 }1 0 3 014 O
,
EJB: ��'rr �iP' 7 � _!AT: - -- -
VALUATION: () SETBACKS:� LAND USE:
F1tONT:,REAR: LEFT: RIGHT: -- -
WORK CLASS: �� HEIGHT: y TOTAL ARFA:
USE TYPF: FLOOR L0-kD: c -- IST:
CONSTR. I TPE: .S N HEAT TYPE: `,l u 5 2ND:
OCCOP GROUP: DWELL/UNITS: 3RD: _-
000UP LOAD: NO BEDROOMS: BASEMENT:
NO STORIES: ,L_ NO BATHS: GARAGE: -,
:IMP SURFACE:
APPROYIIS REQ_ 'D SPECIAI. NOTES ITEMS RE(JIBED
PLANNING: REISSUE OF: LIST SUBOOMIRACr0RS:_
ENGINEERING; - LAST REISSUE: BUS TAX: __—
FIRE DEPT.: -- FLOOD PLAIN/ ! CALCUTATIONS:
OTHER: SEN LND.: — TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN: —
PIAN CHECK BY: OTHFF
DESCRIPTION �f ^N1Ct1i`sT PD. BAL. DUE
n° f c-.0-S-L 10-432 00 Building Permit Fees 30 -- - •fes"
_ 10-431 00 Plumbing Permit Fees -
10--431 01 Mechanical Permit Fees _ax
10--230 01 State Building Tax,--(5%) _`-��•�_ x''30
Building
Plumbing - 7•J _
Mech
10-433 00 Plans Check Fee _ Caa
- -
Building .L -
Plumbing
Mech '
30--2.02 00 Sewer Connection ---
30-444 00 Sewer Inspection _ -- -----
51-446 00 Street System Uev Charge
52.--449 00 Parks System Oev Charge (PDC) - �— - --- ---
31-450 00 :term Drainage Syst Dev Chrg (S:UC) -.- --.----
10--230 09 TRI-D -
10.230 06' Washingtaoi counLy fire N1 (9')1) -- -- --_
10-220 00 Amari /Wedgewood -
luiAi �:� T3�r7S WS.SS-
ktr. /I -- __ - --
APPLICANT SIGNnTUIZU -- -
k v i ved Hy - H.0 i' i� • 1
cn/3S8/P/181'
M
Cay or r and PLUMBING PERM Irl-
PO Elim 2=7
lam.OR g7m
(SM 639-41-71
ORS 8144/410
„lots MIMES
Act
_- 7—
or
nlrlllJf — -� 'e
Wadving
MirlDvik
S.r..71 "' _
MCStion5y Ma— o I
�OCtQdlri
ODOM
Saw"i0e,id low
V 1>r!+WQ
tMirr S�rriao..� aa�s
fw6wr�taw�Mw is awet ire l war sa owsw orrAwrisd seemed -
sb wwwwti+IOnt�le.s srR,waM.A�r., M r, %- e- wif.sled.bait.om l a••a Rain Drain to toot aaoo
am warn/wa so tt w1ww*j*Ows.cftift saw*dow ow WAN&W Swm s RAW Doan AOA.WW tidr
ow"Is woa-R, A o w o um sten... nR 6, siw wuaon tAobls 4i~r spoon
DWA00 or Ani4%adm T>rri11;�i Tar or
on
— "�—'—
Oaen.cbd a•rvow
�'wit�f R or wPair
is e« rwiieanlul 0 p ----
Mmx of Pasct PMwbLV per%r
SpodAdy gwprt.saadpwiv
F 0+Aoo c� main S;4
WNW
Pnrn+ston
wool -
__ Ne
p-srnorMfoN�rio�s� � _.®
_ HOME *W4w%jmwm Fee S2SA0 SIM TAI-
ci
PEAWTS SE00W VOID IF WORK OR oOW.SMICTIM S%SURC"ARM L S U
AUTNCIRIZFD IS Wn OOMMEMCM WDM 100 OAVS.CM tr -
0OHS1rA1C1"OR WOW IS S_1SPMW D CA ARAM)*WD ;j l.N iiC-ViE1N 2S%OF StIMI Al
FOR A PERW OF t00(MYS AT ANY Till,AFTERWtXW IS
-- -�
i t..
COMMENCED. TOTAL
s�
Data Ktlo6d _
.0
ECHANICAL PERMIT Plarick/R 17
of Tigard Mt ec.
.3125 SW Haff Blvd. APPLICATION Permi
_�C, Sax 23397
i-i.-ard, OR 197223
(56.3) 639-4171
Table 2A k4eduv"Code OTY PRIC,E Alliff
Jot) 1) peraut Fee -0- -0 10.00
Addren ap
2) SuppWnenml Pmut 3.00
44-- Furnace 10 165,000 am
incl ducts&vents 6.00
Furnam 166,665 BTU
2) imi duo's a vents 74
3) inct vent 6-00
-----_—Tigatur."
4) or kyx rrzurapd heater 6.00
V en
1 701 Wit in
5) appli-xv M-4 300
_TWP_T-cot hea".re".
6) cooling.ahvxpkm unit 6.00
Boiler or comp.F�jxxnp.as cond
7) lo 3 HIP absorp unit ID 100K BTU
or comp.heat pump,ar
8) 3-15 HP absorp unit ID 50W BTU 11.00
C.on*�re=r Rilit ccv. W cond.
9j 15-30 HP absorp tsin 5-1 mi BTU 15.00
or—comp,hear pwV,air cond.
10) 3050 HP absorp use 1 1.75 ffd BTU 2250
iiiii tim applicabon.Val div WJer at cornp.how primp.air cond.
1.atton qmm is cxnKt Ow I am III*owner or wAt"tmu agent 11) >50 HIP absorp unit 1-75 mil SM 31.50
of tw owner OW pian vibmigod are in awnpiliance with ckm Aor hwx%V iout to
kren.tsar I an nVaured with Ove Construction Contrac!Ws Board, 12) 11).0(*CFM 4.150
..at tva nLr.*w VrAr is correct (W exempt kum Staft registration.
9w reason below.) 13) 10.0(0 CTM 7.50
Non pornble
14) evaporav cooler 4.50
Vent hLi cx inectoo
15) to a single dLKI 100
VenNwm system not
16) included r,appiarve permit 4.50
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:"mw ne. addoon aiwat-on 17, me-a-Lar-ra ekhaust A 53
Comrr*r-%W or ffKLsbial
30
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19) he".r,solar,dosses drtt".Pic
20� Cas prc:croe-tc ::.xotr!0ts 2 OC
:'Ading 7;W operty
21) More ttwi 4 per ixidel
7f:)*of t.0 -of 0 rtabAral W 0 LPG 0 slactric 0
NOTICE I
Mtnrrur- Fee $25 00 SUBTOTAL C;7 -
P=_:Z�". SECOW VOID IF WORK OR CONSTRUCTION
A'_'--<'A7ED!S NOT Ci) VIENCED WITHIN 190 DAYS.OR 5%SURCHARGE .2
OR WOM'S SUSPENDED OR
A=- =CR A PERM OF 1130 DAYS AT ANY TIME PLAN REVIEW 75%OF SUBTOTAL
TOTAL 2- -S
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