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Applicanb must hold Oregon Rcglstralion to condtxl a plumbing 1-igard CR 97223f'1JIZ IY1 I�
business or must be property owner/operator not hiring outside help. 609-4175
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.� "Pow �,},,, Plumbing Perrr111 NO. I ,•
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Job 14-21•eto- OUAN PRICE AMT
Tax La Map.No -
Address
---- ----- __ --- FIXTURES
Block Subdm0on -- - - -
Slri 1.50 •
T narne ss LAvalory 1.50 _ •V
✓ __ � ]� Tub or TubrShower Comb ?so
Shower Only 150 _
Owner =IP.. -- Water Closel - - 50 Q
Dishwasher 1_ r _ 72•ec?
fir"11e Garbage Disposal 1 750 ,t
-_- Name--- -
Washing Machine _ 150
Floor Drain 1 so
Water Healer - - - _ Iso •s
/Slate
Occupant 7Ki --- -- Laundry Room Tray r 50
P Cky - - - -- ---
Urinal 1.50_
! —� Other Fixtures(Specify)
�� a � ?SOcm*ockw _ .
ZIP ?so-
MISCELLANEOUS
CAy Bus Tax No Sewer to I00
30.00
,a 1- -i Bus o Swww♦e.Ad(M,100 --- -- _ _ 15.00
Water SeMw 1 at I OL' - 10.00 -
( Y aola+owledp0 seal 1 have real MMa al plicallon.1ha1 lite k*)nnatbon Water Service ea.A4d".X0' 15.00
Olin is 001 Mel l em nnoolered w111 Me S ata Builders Board,a xi also Storm&Rain Drain 1 st.100' - — 30.00
10"it 1912%Pllsrtft licena4 M+a the mwTtb"gwsn are oomia, ew an
pkw►tbkep work wA be done in tocordarwr wM appacabie provisions or(ke Skxm&Pdn Drain Add" 100' _ 1500
Ilpn ftvbed StMMe Cha item 441 and f.;=^d aorrikAty Oohs and Bui mob"Home SP� - 2500--
AO�7 Well ba elrillbyed unk u licensed under')n:;403. ("sxennx frc"n _ _ -_. _-
Ok"replateMon,please Ow reason below) Baca Flow P,w4nbon
1 hereby DW*MTa I am IM ov of 1t'.0 pmvwty de Devioe or Ana-PoaMion Dev4s r 90
40"d atDove,e1 whiafr loris:on I p vfms to make a v 1 7 +dn0 Ineraaaaon for Any Trep or Weels Not
awrl use end Mlle ProD«a Y not bekep mreeauctr "ur aW.leave«rw>t (.orrwc*d to a FUM" 1.90 _
-- _ .—__r---------- ---- - COW Basin - 1.50
hap.Of Exlat.PkanbUtq 40 00 f*er FM
8111111:111111111 pngLoob ktapeGNru 40;00 Per hM
_ - Aber of PWrrtbing wW*
A/� --��-}}
an emu _ _ 15.00 min _
AlITf40RIZED t3fOPr,i t1t1F r�7e v A l [)w New skip or Strad.AdMwn _ WOO nen
' sinde fatal �
Oeocrbe work r*w addfiKTn I —_ tkx1 1 1 repair F, X11 its_-- - - - 15.00
reekierltial _- -non•rtisk$entialf I
use of —�— u
a+ o or pror
6�i i _ tri
T%%PNft beM AW said and MW 9 taw*or owwVuoanx,a~red is not sem-
e MM SMO�ArMel+slAuiaOen�r.forM U tlUapeneee a'lbandrinM lo+ _--
f1111019 01 WN OM aMr ueerk le eewll A Mod
—-- -- Claw r«r.rt
CITY OF TIGARD 639.4171 oarE 'Z BUILDING PERMIT t9
j j
� TAX MAP __ LOTNO. _SUBDIVISION Cr
A
S JOWNER ffibr%,wj_�S A 11y ( JOB ADDRE',S 146 749 '9
BUILDER a STATE REG.NO. _ —I:XP.DATE ^_
BUILDER'S PHONE 244—q 2/el
ARCHITECT— PHONc OTHER
STRUCTIIRE NEW ❑ REM^nri_ ❑ ADDITION ❑ REPAIR l.] MOVE U OTHER ❑ DEMOLITION
ESIDENC•E ❑ COMM ❑ EDUCATION ❑ IND ❑ RELIGIOUS ❑7ACCE:SSORY El GARAGE ❑ OTHER ❑ FENCE
OCCUPANCY LAND USE ZONE J-17 BLDG.TYPE _FIRE ZONE '"-_PLAN CHECK BY ' �/_HEAT
r 2 d
SEWER!FERMI T N '� /�'7 1, ',� _ ZLLIy(�•/� I (-} C4(4 (J
OCC.LOAD FLOOR LOAD l'i1 HEIGH7 I�/?' NO.STORIES 1 AREA_-1NO.BEDROOMS VA
—_
r BUILDING DEPARTMENT
SETBACKS FRONT �/.,� REAR P�� LEFT SIDE J, (,, NIGHT SIDED
Permit 2 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COOS ZONING .
REGULATIONS AND ALL APPLICABLE CODES ANO ORDINANCES„AND IT IS HEREBY AGREED THAT THE
R'en Check WORK WILL BE DONE IN ACCORDANCE WITH TI!E PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND 09DINANCES. THE ISSUANCE OF THI:3 PERMIT DOES NOT WAIVE
PI.Ck-Fire _ RESTRICTIVE COVENANTS. CUNTRA�CjOR AND SUB CON-IMCTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS
Stale Tax e, O IEREO FOR SEWE4i,fLUMII'NG AND HEATING.
, '?
Total — / ov APPLICARtCA AGENT -
Prepd. �a PCGI
U'� Recelpt No. WiDRES.SPHONE
Bal.Due T ,
'— Issued By, `?'1_ Approved By
SSDC --- S Y v
110c •- _ op Q
PICC
SCUER CONNECTION _
SCWER INSPECTION S Z , 40 .
f
�)EWCR SURCHARGE
Cammente:
I.
ral
46,111 V Ut 1 lkxAMU IVItk.HAIVOVAL 1j►t1iW, I Permit%+ ._V2
Description
T"3A Msohonlcal Cods _ Ori PIACI AMT
City cf Tigard 1) Permit Fee -0- .0. 1000
1312 . S.W. Hall Blvd. �' --- ---- -- ---
P.O. Box 23397
Tigard, OR 97223 ') Supplements;rermit 3.00 -
639-4175 .) Furnace to 100,000 BTU 600
incl.ducts&vents
2) Furnace i 00,000 BTU + 7 5n
Incl.ducts&vents
Name of Dsvelopmsnt 3) Floor Funtace 600
Incl.vent
Job Addrf' / q) Suspended heater,wall heater t;0o
ea `7
address 1 or floor mounted heater --
P1 /
Tax Lot a Map No. 51Vent not incl,in t tk)
' appliance permit
,.of ♦;btk Subdivision -- _--
Name(or name of business) 6) R wpair of heating,refr ig 6(XI
l _ cooling,absorption unit -
7
Mailing Address Phone 7) Boiler or comp to 3 HP t;OKI
Owner absorp.unit to 100,000 BTU
City/State ZIP 8) Boiler or comp to 3 HP- 15 HP 111 U(1
absorp.unit to 500,000 BTU _
Name 9) Boiler or comp 15-30 HP 1500
absorp.unit Va-1 million
i
Melting A rasa Phone 10) Boiler or comp to 30-50 HP 22 5(1
absorp.unit 1 -1.75 million
Contractor coyistate ZIP - 11) Boller or comp to 50 HP 11 Sp
absorp.unit 1,750,000 BTU _-
Stela Registration No City BusTex No 12) Air handling unit to 450
10,000 CFM _
Air handling unit . tikt
I t,er iby acknowledge that I have read this application that the information given is 13) 10,000 CFM +
cor•sd,that I am the owner or authorized agent of the owner,that plana submMled are in -- ---
oorr okance with State laws,that I am registered with the State Builders'Board,that the Non portable 4 so
numkw given is coned (if exempt from State regisirstiun piesse owe reason below) 1 a) evaporate Cooler
151
Vent fan connected ,. .11�11
_ to a single duct -
-- --- --- --------- - - Ventilation system not 4 .010
16) includttd In appliance permit
_ --- - ------`� Hood served by
1�) 450
mechanical exhaust
Sq tiff"(owner or agent) ----- ��- - Oat* 18) Domestic"a l yn
Describe work D addition D alteration D repair D Incinerstor
to be done residential Gra non-residential U 19) GwmmerCial or Industrial 1\1
Existing use of »Incinerator ' -
buildingl or property------ !�-J... S F� _ 20) Other Le.,woodstove,water
heater,solar,clothes dryers,etc
Proposed use o1 — --
building or property -- 21) Oas,,Aping one to four outlets 2 Oh
Type of fuel- oil D natural gas 9 LPG ❑ electric f
22) More than 4-per outlet
- SU&TOTAL r
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 160 -� 4%SURCNAl10!
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDiiU OR PLAN REVIEW 25X OF BUG-TOTAL
ABANDONED FOR A PERIOD OF 11110 DAYS AT ANY TIME AFTER TOTAL k
WORK IS COMMENCED --
Spe"caXmilons
- ------ — — - Date Issued