14165 SW 80TH COURT EWIWIW
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BOILDING OPEPARTMENT, TIGARD
PLJMBING PERMIT N?
holder of a valid plumbing contractors !icense is Hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified riot less than four
(4) hours prior to the time the installations are ready for inspection. City of Tarch Business License required '
for all contractors and sub-contractors. Job s"' U)
04vner_ = �; :% �==— _ AddressDat
IVUM9cR OF -- TO UN
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
°in2!e Family-1 bath-each / _ _ 25.00 _ -7 L7U • ;
- --
Cu lep x--Each 1 bath unit T — 25.00
Additional bathrooms-each 10.00 ~"
_tiHome Space-each _ _ 4` _�-15.00
INOIVIVIDUAL FIXTURES(COMMERCZA � -- ---------•-__._... _ _
1 to 50 Fixtures IS i building-each 3.00_ A
5112 100 Fixtures in 1 building-each _ 2.50
101 to 200 Fixtures in 1 building-each 2.00
201 or more Fixtures in 1 wilding-each _ 1.50 F _
MISCELLANEOUS
Sewer--each additional 100 It,
`Nater Service to buRdin� 5.00
....-Other (Spacif ) ---- —t
PERMIT For Ph.mbing Inspection Phone 639.4171
4fstate OPlumbing Contractor By
TOTAL y RFr'FIPT n1n lecnnri RV i
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BUILDING PERMIT APPLICATION TIGARD DATE_ 61-1,87-19' ____ 3243
THE UNDER"iGNED HEREBY APPLIES FOR A PERNU I FOR THE WORK HEREIN INDICATED 81JI1-DER PHO VE 732-417:,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO, l t�—Wayeriy. &L t,
OWNER J-E;, nnstZ.Co. JOBADDRESS14165 SWBrith CO Jrt
e 1SPIt21-Itl�� -
�1Jc31 N�q;<
BUILDER s...me - ADDRESS`=
DA—Z INSP. TYPE INSPECTION REMARKS PLUMEIN'- E
Contractor
p it No..
F Flough4n
S-Ir ze" Fixture,
jfj�-vv Act j,"i's to Firms Final
HEATING
II Contractor
Permit No.
Gas or Oil
Rouph4n
Fi,lel
SEWER
Final .1,t
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLEMa DEPI.ir TEMPORARY CERTIFICATE OCCUPANCY
CIZITTIF11CAT9 OCCUPANCY Final
1-andscaprig 4—
Zoning Final
ilk
7.
'JIF100.1.4
yl "q
A
' 1
BIJ!LDING PERMIT APPLICATION TIG,ARD DATE!!!"--- .19_A0
THE UN9EPSIGNED HLPEDY AFPL ES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUIL,);-:R PHONE
OR AS SHOWN b ND APPROV D IN THE ACCOMPANYING PLAI AND SPECIFICATIONS. OWNER P;1ONE
�,yy nn �+y I LOT NO.LS WaLuer�
OVVNERJ-F—hf 1:04 ao. JOBADDRESSAl�p.�_ 5 1{/W'~ �._.---- �- JACQdt�M�S
hA+eFMf't'!'T
Q p, PiilIC.+NE n
BUILDER .�O►w1Q. ADCRESS 0,LS E�2T)!�'}�C}• DESIGNER 1 r.,jear►s-1)e si4ti
STRUCTURE _KNEWi ❑ REMODEL- _❑ ADDITION _❑ REPAIR —❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE CC COMM ❑ EDUCATIONAL_❑ GOVT ❑ RELIGIOUS ❑ PATIO ❑_CARPORT ❑ GARAGE ❑_ST�OjRAGE C3SLAB❑ FENCE
V.7-PTX_
OCCUPANCY 1S' LAND USE ZONE _ BLDG.TYPE _ _9_FIRE EZZONNELr�,1�, _PLAN CHECK BY yGE .
� HEAT
— l'.�►+�'I���'�a. Faw�i l �+�e ll iP�w .�.#���.-,�-� a --- --- -
f
,7
SEW ERPER Iv1ITM --
OCC.LOAC FLO_0_R LOAD#0 HEIGHT C7Q NO.STORIES_ ti AREE'L,? NO.BEDROOMS VALUE-Q.
BUILCING DEPAPTMENT SETBACKS FPONT_!4► �~REAR ��f LEFT SICE 7-'&"' RIGHT SIDE
s-
P^rrnIt _� p0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOwNG
n p p I REGULATIONS AND ALL APPLICABLE CODES AND ORDI.NANCES. AND IT IS HEREBY AGREED THAT THE
Plan Check v WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CUT,'PLIANCE
WI1H ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE 01: THIS PERMIT DOES NOT WAIVE
Sub-total _ Q_� ��_ RESTRVr TIVE COVENANTS. CONTRACTOR AND SUS CONTRACTOR3 TJ HAVE CURRENT CITY BUSINESS
�, 4� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,FLUNI3ING AND HEATING.
State Tax •
SD
C -
Total _ G ,(off --
PDC# APPUCANT OR AGENT
By
'-� - Receipt Na
Approved ADDRESS — —-- PHONE
SDC - q00
PDC_
SEWER CC JNECTION
SEINER IN7P=CTIQN— S 2?•-
SEWER SURCHARGE_ $
/Zos'
Comments . _Qe.IL'_ CsIts() _ —
i
I
y lei ! r"d Mechanical Permit
No'v Installation Replace 0 Relocation Q Addition ❑ Alteration '^I 4%State ..Z
TOTAL____.2r 2,k
HEATING _
CGNTRACTOR�E_ _ 14 l�n/MC c£ _ OWNER�[--��LT� sT
Al')DR13S .3 _ WORK ADDRFSS4,<'-
PHONE
,<_PHONE 'j� 2�2 —_----.---- APPLICANT 6:6-10:4.4-
Input
En./0:4.dInput Rating tSTU Per Hour)_,,_g Vent Size _ ���� F''jP SirE
r UEL 0 1 L 'ED GAS Wr ELECT ❑ OTHER�T_
ITEM NO. FEE ITEM NO. FEE
fir Issuance of Permit SEE AJ30VE __ _ Air Condition Compressor 15 to 30 HP 10.00
i
`J:i,v-up Co & inG1.100,000 BTU 4.00 Air Handling 10,000 CFM — 3.00
_New.100 00 RTU 5& over 5.00_ Air Handling Over 10,000 CFM 5.00
=:ccr Furnace 4.00 Evaporativa^_L.iler 340
,113!1 - Floor •Suspended _ 4.00 Range Vent Fan 2.00
Install Vents Only ~2.00 Vent S_wern
F'cpjir • Heat E; Cooling 4.00 Hood Gummercial _ 3.00
Air Condition Compressor Under 3 HP 4.00 Cornmeriial Duct System 10.00
Air Condition Compressor 3 to 15 HP 7.50
!NbPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTt;)RS OR SUB-CONTRACTORS
i•PP90VED BY DATE ISSUED BYDATE _
r1FCE-IPT NO.
��+ Signature of Applicant