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BUILDING PERMIT APPLICATION TIGAPD DATE ___.__.19 I 3412
THE UNDERSIGNED HEREBY APPLIES FORA PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE f)'4' 8%'1762
ORAS SHOWN AND AF:"P0 ; J THE ACCONSPANYING PLANS AND SPECIFICATIONS. ;:WNER PHONE_
.11480 SU a iru :+vanub LOTNO. XX'Hklm aG I . i ' s
OWNER 1 & F Cori etr. InLJOBADDRESS A��+�,� - -
ARCHITFCT
ENGINEER
BUIL'3ER t163 ADDRESS uteY4 — Box 317A,ShrI ASIGNER Piercy %arclay -_
STRUt,rURE UNEW ❑ REMODEL CJ ADDITION ❑ REPAii ❑ RENEWAL O FIREDAMAGE ❑ DEMOLITION
M RESIDENCE D COMM ❑ EDUCATIONAL ❑ '30V'T ❑ RELIGIOUS ❑ PATIO L7 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY --f--3—LAND USE ZONE 41--7 BLDG.TYPE aN __FIRE ZONE PLAN CHECK BY dwh HEAT
'tstruct single family dwelling w/atteched garage. 3 Gedrooms ? i:ath-n.
SEC CORRECTION SHEET ATTACHED),
SEWER PERMiTq�' aG =.i_7:i�tQQ-- __ a ic-p.Q.0_._`�
OCC.LOAD FLOOR LOAD ? HEIGHT .13 N0.STORIES 1 AREA 1Jg1 NO.BEDROOMS 3 VALL1460#401.1
BUILDING DEPARTMENT SET BACKS FRONT 1 REAR 24 LEFT SIDE i a RIGHT SIDE 13
Permit_ $209.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERF1Y AGREED THAT THE
Plan Check 1QA• U 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
Subtotal 313.50 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRA CTORS TO HAVE "URRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
� State lax �_ a.lei _
SDC
Total X321,66`_
By P1
PDCM APPL'TCJIFIT 60i-Ad—ENT
Approved dwh Receipt No. 'ACDRESS — --- ---- PPHOO E-
w w w w w
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
� 430- _ Contractor
q,;T 4 Permit No. 1,60
w Rough4n - ---
-,R_ Fixture
��•1-CC _� Final —
\� HEATING
Contractor
Permit No.
Gas or Oil �,� 8�3} /6-/7-�j pe
Rough-in
Final
SEWER
Final 1Q_4 �� /l �� di
DRIVEWAY
Final_- —_— - Final ---
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUP CY Final
CERTIIICATE OCCUPANCY
Landscaping
Zoning Final
A
BUIL')ING PERMIT APPLICATION �Ci�,�� '� DAT �•2 ,;9 '80
T}iE UNDERSIGNED HEREBY APPLIES FOR A FENlIT FOR Tn-ZW0-R EREI 1,JDICATED BJILOER PHONE( .Z •/ � _
oc
t'R AS SNOL^JN AND APPROVED IN THE rCCkj#4�Q1 a r,�;I!li�C Ov"I4-nr-P; O;;E _
✓ tft� LOi ;;O
—� Z _ JOB AOORESS
SUILCER ` �� ADDRESS R.�� ll"X4�IfA/I.(I IG'��tR_�eYGV _V I"t, /
-- ----�-----W-
STRllr-7U?E (�NEW v Cl REMODELV J AODIT!JN ❑ REPAIR ❑ RENEWAL _❑ FIRE D,"IMAGE ❑ DEMIOIATION
RESIDENCE C CCI. m C EDUCATIONAL :: GOV'T r RiELIGiOUS C PATIO C CAR PORT F-1 GAHAGE ❑' STORAGE ❑ SLABf i FENCE
ti CUrAN� r LAND USE ZONE9L.0TYPE E
_�_ -r.IV-FIRE�Z�ONE_/.'_,PLAN CHECK BY NEAT—jq „
SEVVF-R PERMI T p '--
UCC.LOAD FLOOR LOAD_ _ HEIGHT NO.STORIES.- AREA/5-6// N0.BEDROOMS_ Vd LU"�Q
�BUILCINGDC2ARTMFNT SETBASKS FRONT e?_1EAR RLEFT Z
_ _ � �� RIGHT 510EA _
P--rTTIIt '20!' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZOWNC
REGULATIONS AND ALL APPLICABLE CODES AND ORCINANCES, AND IT IS HER-�BY AGREED THAT TPE
Plan CheCk ION-SO WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC-TIONS ANC IN COLIPLIANCE
WITH ALL APPLICABLE COL'ES AND ORD!NANCES. THE ISSUANCE JF Tylc FER,*AIT DOES Now WAIV:
Sub-total 3• RESTRICTIVE COVENANTS. CONTRACTOR AND SUE CONTRACTORS TO HAVE CUR?ENT CI T r BJSINi:55
3(oUCENSE.SEPARATE "ERN1i 13 REQUIRED FOR SEWER,PLUAI3IAJG AND HEATING_
Stata Tax
Total
sDc— �.J_I
A �. Q> Toyn_�_.
POCO APPUCANTQFtAGcNT `BY
ApprOy,td -�— Receipt No. ADDRESS
y_ PI10NE
oc - D
Oc - S loo
CUR CONNECTTON S 72
=WER INSPEECTION S
FWER SURCHARGE S
xv
/ 60 ` .. -
2,3
23-10 )c /3 - 6'
ta-•►,TQ- 22 x 23- <o C /�• Sa
f \ 9
I r�
I
I
l b Q Tigard MeChariica{ Permit NT{'7 Pormit_—��3,Qp _
Fee_ `y-
New Installation Replace ❑ Relocation ❑ Addition 71Alteration ❑ 49.State c�
-E�
HEATING TOTAL
CONTRACTOR 1Aj, ' �`f-/� OWNER-Z;?� A-' L1'01VNZ
A:%DRELs> r WORK ADDRESS Q
PHONE.Zro,, APPLICANT_G_72
Heat input Rating (BTU Per Hour)_//7_S, Vent Size Flue Site
FUEL OIL ❑ GAS ELECT ❑ OTHER
ITEM NO. FEE ITEM NO FEE
For Issuarrcz of Permit EE ABOVE _ _ Air Condition Campressor 15 to 30 HP _ 10.00
Nei.^ -up to & itucl. 00,000 BTU 4.00 Air Handling 10,000 CFM _3.00 tf"
Plev-100,001 BTU's & over 5.00 Air Handling Over 10 000 CFM 5.00 ;
Floor Furnac_o_ — "
_ _ 4.00_ _Evaporative Cooler _ _ _ _ 3.00 g�1
_Wall • Floor Suspended_ 4.00 Range Vent Fan - r 2.00 :,
Install Vents Oriiy2.00 Vent System _ 300
Repair • Heat&Cooling_ 4.00 Hood Commercial 3.00 t
A r CondFm*on Compressor Under 3 HP 4.00 Commercial Duct System — 10,00
Air Condition Comprsisor 3 to 15 HP 7.50 —
INSPECTOR'S rOMMENTS -
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY_ _ _ DATE ISISUED BY DATE
RECEIPT N0.7 r4 _ —_ �_ W—
Signature of App' ant