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INSPECTION NOTICE
City of Tigard B Aiding Department
12420 S.W. Plain St.
Tigard, Oregon 9%223
Phone 639-4171
Address —___—. �' c._ ' _ �� ,�. ,•.,. _?" Permit Ik_
Type of Inspection �,-ray-�7-..;, sl Ss.
J""" tea-
"i he following B.iili��ng Code deficiencies are required to be corrected: ..,, -
r
Presen.ed to �— _._____. Inspector
Date u — -----.
(:.4/_l_ FOR REiWECTION
❑ YF..S 0 NG
1
=.a—
BUILDING pl:PARTNIEV TIGARD O
,LLV,131NG PERMIT 1� ' r
holder of a valid plumbing contractors license is hereby
authorized to cause olurnhi;.g work as herein noted to be installed in accordance with the plumbing code of
Tigard. Su,`: installations require inspeCd011 I7y the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations a-e ready for inspection. City of Tigard Business License required
for all contractors and Scb-contractors. dnb S? l
Owner-'&,"t, _ .� Addres_r .1�LC�'�L1y �� s Date_ ,�6 J ll
NU`.t3cR or- TOTAL
TYPE OF PERMIT ITEMS FLE OV EACH AMOUNT
s
,SM D E N T I A L �
Sinate Family-1 h7rh-each _ _.� 15.00 _
Du I?x—Each 1 bath unit �— _ 0000_ 0000 25.00
Additional bathrooms—each 10.00 _
_Mobtla Hame Space—each "— 15.00
INDIVIDUAL FIXTURF.9 CQf ERC N1. _ 0000
1 tc 50 Fixtures in 1 building—each _ ,z _ _ 0_3.00 ^�
51 '.o 1000 Fixtures in 1 building—each _ _ ,_-2.50 �` J
101 to 700 Fixtur?s in 1 buildng—each 2.00
� 701 or more Fixriras in 1 building—eich 1.550 _
h1_1SCELLANE0US
Sewer—each additional 100 ft. 10.00
Ware,Service to buildin 5.00
1_ 12er ISv Fyf:
1 PERMIT For Plumbing Inspection Phone 6394171 1 0
,°;State Plumbing Contractor By
TOTAL RECEIPT NO. Issued By
Cs t y of Ti and >'�!,`�c��a¢�ical �crri�)tT Permit
Fee _
New Installation Q2Rep13Ce ❑ Relocation ❑ Addition ❑ Alteration _] 4%State
HEATING TOTAL�_ ,��
CONTRACTOR ( �,�lts?� t` -_ 1 �, OWNERA.1�lRr.� �tr21�
IaDDRESS�,� - �� WORI&ADDRESS
PHONE "�;t; _� �� APPLICANT _¢� -�IVc,
Heat Input Rating (BTU Pe- Hour)•__LVent Size "
��7_�----- ------� Flue Size •-------.
FUEL OIL C�l GAS (� ELECT C' OTHER
ITEM NO. FEE ITEM NO. FEE
For Issu ince of Permit ~� EE ABOVE Air Condition Compressor 15 to 30 HP 10.00
New-up to h inc1.100'000BTU _ 4.00 Air Handling 10,000 rFM_�� r 3.00 �I
Plew-10_0,001 BT s & over 5.00 Air Handling Over 10 00_0';FM 5.00
Floor Fui nacu__ 4.00 Evaporative Cooler
3.00
_Wall • Floor •Suspended _ _4.00 —Range Vent Fan _ — _2.00 „
1nst311 Vents_O_niy Vent System 3.00
RWpair• Heat& Coottng_ _ �- _4,00 _ Hood Commercial__ 3.00 '
_ u�
4ir Cond;ri�n Compressor Under 3 HP 4.00 Commercial Duct System 10.00
Air Condition Compressor 3 to 15 HP
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS i
A1'F'ROVED By _i DATE ISSUED BY _ DATE _
RECEIPT NO. -
74 Signature of Ap cant(-.,?' .•, ��
BUILDING PERMIT APPLICATION TIGARD DATE— � �'_/ tg G 3303
THE LINDEHSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 639-4069
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _A
r, — __— LOTNO. 1b-1��CiCB LEin[�_ l 1
aat� R
OWNER GOttmr CQfTsBtJpgADDRE8810p40 54! I�icka� Court .—
ARCHITECT
ENGINEER
BUILDER 93mH ADDRESS 17635 SW F?saP Bund P(J.DESIGNER
STRUCTURE _F'_NEW ❑ REMODEL ❑ ADDITION El REPAIR ❑ RENEWAL ❑ FIRE DAMAGE_ ❑ DEMOLITION_ i
"RESIDENCE ❑ COMM ❑ EDUCATIO_NAL_❑ (--�sV'T ❑ t•'ELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE (J STORAGE ❑ BLASE FENCE I
OCCUPANCY _It"3 LAND USE ZONE R7720_BLDG.TT fPE�—�M FIRE ZONE__3 PLAN CHECK BY dwh HEAT g�8
Construct singlra, Family dual naW/attachad Ua g_ a,__ A L'�.drooms
SEE CORRECTION SHEET AT?ALVEU.
SEWER PERMIT# '1981 — 17:30.00
OCC.LOAD FLOOR LOAD 40 HEIGHT 13 NO STORIES J. AREA 2042 NO.BEDROOMS 4 VALU$7El 100.
BUILDING DEPARTMENT SETBACKS FRONT REAR !''I LEFT SIDE RIGHTSI6t 7
Permit 2245•O J THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
?2• r10 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT !S HEREBY AGREED THAT THE
Plan Chock _ WORK WILL BE DONE IN ACCC'iDANCE WITH THE PLf,NS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMI) DOES NOT WAIVE
Sub-total 367. JO RESTRICTIVE COVENANTS. CONTRACTOR AND 3UB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PI.UMBING AND HEATING.
State Tax �a' 9.180 X400•017
SDC—
Total _ _$377. 30 PQC# II S100401 APPLICANT OR AGENT_ _.1�r'=
—`—`—
By P1
dWh Receipt No. ,
Approved ADDRESS PHONE
F
P
i
DATE INSP. TYPE INSPECTION REMARK$ PLUMBING; DATE
Contractor
5::2��S0 s i �w.�w..r Permit No. ti yc// - 6,, $�Y7-F?D
2.2 -`;gyp o/"O u 7 Pfu ow Rough-in
q' 2s R 949 ell" 10i (J/f—C' 7_s r Fixture
ai P -3u 92AOKA4 'rSd _ dot= C/ _2 Final
I-]7-LV bee :2; s a O-k HEATING —'
Permit No.
Gas or Oil
Rough-in -
Final —
SEWER
Final g-'Rtir"SO A
i DRIVEWAY
Final
Storm Drainaga
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE 6&:.ii CY Final
CERTIFICATE OCCUPANCI' / ED
Landscaping
Zoning Final
f
r.
BUILDING PERMIT APPLICATION TIGARO cATE_ —J.� 19 /�
THE UNDERSIGNED HCP[BY APPLIES FOFi A PERMIT FOR THE WORK H,-REIN INCIICATED BUILDER PHONE -"6
C1R E^c,yr.INN AND APPjP,ROVCD IN THE ACC,0rs'P/A„NYIN11G,PLANS AND SPECIFICATIONS. OWNER PHONE
__�►�L�4�t a 408 ADDRESS Iyok W 1'id C' � LOT NO.
ARCHITECTENGINEER -
BUILDEP Su-m ADDRESS �.Z(0�,} S� y�P $1�1�iC�. DESIGNER
STRUCTURE NEW ❑ REMODEL C]_ADDITION _❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEfAOLiTICN
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO C CARPORT ❑ GARAGE C STORAGE ❑ SLA
B10 FENCE
OCCUPANCY _ __ _. LAND USE ZOO E Q' _ _BLDG.TYPEs2�4/ FIRE ZQNEPLAN CHECK BY HEAT __
--___.___ mo o ►,° Z ! 1
SEWER PERMIT
OCC_LOAD FLOOR LOAD HEIGHT /3 Y N0.STORIES AREA 7 NO.BEDROOMS
REAR 17 �IyALUE /
r9U1_-LDIN(;pEPARTMENT SET BACKS FRONT 3c' 14 LEFT SIC
_ z/i�� m0 / RIGHT SIDE
ann -_ -
11t THIS PERMIT iF ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE, ZON'NG
I -fl—I REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT THE
�PIinGheck d�Z.Z. W RK WILL 8E DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO3MPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
SYEYtQtal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BU 5INESS
Stvte Tax
LICEASE.SEPARATE PERMITS REQUIRED FOR SEWER,PI '7M8ING AND HEATING.
•
Total �A '�2.. SDC---
1 L PDC# APPLICANT OR AGEN'i -----
By
Approved - -- Rerelpt No. ADDRESS
------- PHQNE
IDC
PDC #_/L' -
SEWER CONNECTION
SEWER INSPECTION S
SEWER SURCHARGE $
commerts : /,z
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2 aC 37' q��A
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3,410
l o ;z 30