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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-q.171
Address _------r�_ _ _ - _ _—_ _ -----.___--- _--_-- Permit
Type of Inspection --•-- ------- --•__-- __ _�_---_-._ _ _�—
The following Building Code deficlem,iea are required to he corrected:
Presented to _—. Inspector
Date
t,.;�' FOR RFIMPECTION
/ I /
BUILDING PERMIT APPLICATION TIGARD DATE___ '1' _,ta t; '
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 31-1ILUER PHONE
OR AS SHOWN AND APPROVED IN THE.ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE------
LOT
_.._LOT NO.16"1,Jsysrl:( Megu.
OWNER i—f-ilt. CUflStI.. l..JJOBADDRFS'i 1A1�:j W 00th Lourt
— -- ----- _ —�_— �Ai4"1r.,6T —_
EMOINQ�'�Ax
BUILDER some _ ADDRESS5203 SE 28thyPt1d. DE&ONEo R. Jenne Der.iVint3_—
STRUCTURE N NEW F1 REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE E DEMOLITION
12 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS_❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE 0 SLAB❑ FENCE
OCCUPANCY [t--3 LAND USE ZONE R-7PDBLDG.TYPE 5n � FIREZIJNE3 PLAN CHECK BY d-Wh HEAT,A�8`` _
Construct single Pemi?.y dwelling u/attechred garage (zero lot line)
SEC CORRECTION SHEEP PTTwBHED. 2 Bedrooms 2 Baths,
SEWER PERMIT# 21997 - S750*00 —,_-- garaus b46 sg t f ts_
OCC.LOAD FLOOR LOAD 4J HEIGHT 21 NO.STORIES 2 AREA 1.199 NO.BEDROOMS 2 _VALUES b l r 0()0
BUILDING DEPARTMENT SET BACKS FRONT 1 8 REAR Vic+ LEFT SIDE 1. RIGHT SIDE
Permit $201.00 THIS PERMIT IS ISSUED SUB IECT TO THE REGULATIONS CONTAINED IN THE BUILDING COVE, ZONING
140. JQ` 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 APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
St o-total 301•;ala RESTRICTIVE COVENANTS. CONTRACTOR ,AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tex 0.01
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLU.18ING AND HEATING.
�� c•JC— �Qf3I1.Ulf
Total 1309.be"t
By P1 PDC# I I $100.00 APPLICANT OR AGENT
Receipt No.duh Receipt ---------- -
Approved ADOREEB ___.----__.._. ._ _PHONE
DATE - INSM TYPE INSPECTION
REMARKS PLUMBING
—_-----.-- ---- _J�ontrii
DATE
/2- yo _ i+ io ctorPermit No. 2i`�--- �-�
Rough in - - -- j (vc'
\<t�Y♦r0 �A1_�Y.� l-,xture --— -- -- -
F}nal
-- HEATR,:G —
_ -- -- Contractor p
t> —�— — -- -- — ---- Permit No. 200�' ?.�p `3
Gas or Oil
— --- - — —_-_ Rough-in -- —
1• — ----- Final
+i —_ ---- -- - —_----------- SEWER
Final faty -
- — DRIVEWAY Ki'`Y Fit —
Final
-- ---- _ __ Storm Drainage -----
(Rain Orsini Final
Sidewalk
---- _—_ Curb&Street Final
Approwh
BLDti DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY - -
,
CERTIFICATE OCCUPANCY Final
LarMcaping
__ --- - ---- Ii 7_oning Final
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14 M, ,v `5'.Ly.-: - 'K+V:.• �h.4 i, .'117 .�, 3. _
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r
W I� v N IN
BUILDING PERMIT APPLIGP,T ION TIGARD DATE
THE UN0E-RSIGtiED HEPE'BY APPLIES FCn A PEMAIT F09 ThE WORK HZ ZEIN INUI SATED BUILDCR PHONE 2--�—=��
(D�;AS SP.OVVi J ACID APPROVED IN TY.=- A.C-1 C)tMPAt•lY!NC PLANS ANO spEC:FICATIC!NS. 0.lN_?.P,10,s _
-LV1� oclnA ao J013 ADDRESS ��• 3'� � � �D —_---•-�.�.���L_
6T
�MtEGi�
81"L.QEA aw1eaoDREsss' 3 �2$Y QEStGNER Q.,1egM: I�pAr{�,wA-
STRI u`TiIPI- NEW ❑ REMODEL !3 AODI i JN— REPAIR _� RENEWAL L-1 FIRE OAMAGE ❑c=pE+AOLfi IrJN
RESIDENCE C CC ❑ ErUCATICNAL ] GOA'T C rREUGiOUS C-� PATIO a Cr1A,-ORT r" GARAGE ❑ STORAGE G SLAS❑ FENCE
:ti iiirANCY-_ _2.-_"SAND 1, iE:'>>OVc B`LL`G.TYPE _ FIaErZON PLAN CHECK 6Y 1-5�11 AT`
SEWER PERMIT#
00C.LOAD FLOCR LOAD / 0NO.STORIES AR_E_.1_�.}fy __NO.BEDROOMS VF.LUc
ppd
BUILCI—NG b_P.ARTt ENT gFT BACKti FRON� --
_ REAR 3 8 LEFTSICE 11- RIGHT SIDE
P^rrrmit~- �l. �� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CZ-1-AINT[i IN THE c 1LDi?IG CODE.,
r 7 REGULATIONS ANJ ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HrFIZEY AGREED THAT THE
Y?lanCheck - �. sK WILL BE DONE IN ACCOPCANCE WITH THE PLANS AND SPECIFICATICN5 AND IN CO.YPLIAINOM
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NCT 'NAIVE
Sub-total _ _ 3U I- „�� ' RESTRICTIVE COVENANTS. CONTRACTOR ANO SUS CONTRACTO�13 TO HAVE CURRENT CIT-f 5' S1NES-S
Ll CEN 5e-SEPARATE PE iMl i 5 R°QUIRED FOA SEINER,PLUM 01NG MLI)HEATING.
Stats Tax SDC -
Total �_' '?��•_�
POCS APPLICANT OR AGENT _ -'------ •—
By _
No.
Approvers ReceiptADDRESS - PHONE —
DC — '410O
D C -• S 100
.
EWER CQNN"CTION
EWER iNSPECTIRN S
EWER SURCHARGE S _1
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J ry 1 tcr� BUILDING DEPARTMENT, TIGARD
No i
"QUITE F0::31 TNTHEFINESTPLUMBING PERMIT �
19415 F E MaIOUOUGNLIN BLVD..
GIADSTON6 OREGON oaosr— ^,____..__, holder of a valid plumbing contractors IicEnse is t,ereby
authorized to cause plumbing work cm herein noted to be installed in accordance with the plumbing code of
1 igard. Such installations require inspection by the City Inspector who shall be notified not less than four `
(4) h-jurs prior to the time the installations are ready for inspection. City of Tigard Buriness License required
for a'I con acto..rs,.a�ndd su"ontrartors.
O�.vner =-� !_L_,_i�i1 . -- Add Dat
Address Cy
_
_ T NWASER OF TOTAL ...,_
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
R E 1 Q E N T IAL
Single Frmily-1 bath-•each25.00 25.00
Du lex—Each 1 bath unit —
_ rt,tt
'C
Additional bathrooms—each _ 10.00 _
Mobile Home Space—each 15.00 _
INDIVIDUAL F1XTURES(C0MMERCIA ) "
—each 1 to 50 Fixtures in 1 buildin 3.00
fit to 100 Fixtures in 1 building—each 2.50
101 to 200 Fixtures in 1 buildin�e,1 1:h 2,00
201 or more Fixtures in 1 buildirnl—each 1.50
P,1ISCELLANE0US
Sewer—each additional 100 ft. ^— 10,00
'Nater Service to building 5.00
_Other 1^a ecir ►:
PERMI i For Plumbing Inspection Phone 639.4171 Y
4 State r Plumbing Contractor 6y
TnTAI acrseloT nen 1"i,nrf u„
City of Ttoa�'d Mechanical Perrraii Permit
\aw Installation Vneplice ❑ Relocation I-] Addition Alteration n 47.State_
HEATING TOS-AL—
CONTRACT 08 qtr �' — OWNER
WORK ADORESZO C
PHONE_ �� APPLICAi r _
Feat Input Ruing (BTU Per Hour) fjin Veit S re _ _ _ _ Flue Size _
UEL OIL r J GAS C ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. FEE
.-or Issuance of Parmit EE ABOV Air Condition Compressor 15 to 30 HP 10.00
.-i
�New-up to & inc1.100s000 BI'rJ 4.00 Air Handling 10,000 CFM _ 3.00
New-100,001 BTU's over _ _ —^5.00 +Air hlandling Over 10,000 CFM 5.00
Flccr Furnace �~ 4.00 Evaporativa Cooler _ 3.�0-
ihall - Floor - Suspended __ 4.00 Range Vent Fan 2.G0
Install Vents Only _— 2.00 Ver,,System _ 3.00
Raoair • Hear& Cooling 4.00 Hood Commercial 3.00
Air Condition Comprassor Under 3 HP _4.00_ Commercial Duct System iG.GO
Ai; Condition, Compressor 3 to 15 HP 7.50 -�
IN:PECTOR'S ''OMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
r-.11PROVED BY DATE ISSUED BY DATE
RECEIPT N0.
»+ Signature of Applicant