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INSPECTION NLTirr=
City of Tigard Building Dei artment
12420 S.W. Main St
Tigard,Oregon 97223
Phone: 639.4171
1
Type of In3pection
Date Requested Ivil Ti me A A.M. _P.M.
Address ---j.0\ 54) "' __ Permit # 3��.5
Owner_ _ _ Lot # 3 _
The fallowing Building Code deficiencies are required to be corrected:
_. u�� �►� =
------ -
00
Presented to __ ❑ Approved
Inspector Disapproved
Date
CA U FOR REINSPECTION
YEI M NO
JAW
E]UILDING DEPARTMENT, TIGARD
`1 ' PLU'IRING PERMIT N?
holder of a valid plumbing contractors license is hereby
Guth rizedlto cause ,lumh�n work a,�iarein noted .o bf! installed in accordance with the plumbing coda of
F' 9 P 9
Tigard, Such installations require inspection by the City Inspe;tor who sh,ill be notified not less than four
(;) hours prior to the time the installations are rea.iy for inspection. City of Tigard Business License required
for all cop actors and sub-contractors.
Jnb
Owner ;I
__(, . . (rr, .% _ 4 �� Adress_ �. : ��� S� rte • `Dat
NuMnaR all _ y TorAL
TYP1. OF PE:3h11T+ _ ITENIS _FEF ON EACH
ISina+a Family-1 hat.-esch _ T_^ _ 25.00
25.00 J
1
Add itiomalbtthroom-;-vch _1000
_ _ _
I %1obtle higme°pace-each 15.00-_~
LINDIVIOUAI r1XT_URE9rrCQrgI'1IE.RCIAI -~ - _Y
ta_,0 Fixtures :n 1 buildir --each �._� ----- --- —��OQ _ •;
51 to 1011 Fixtures in 1 building-each- - -- _ -2.50—
I 101 to 200 --ixtures in 1 �uildir each 2.00 i
—701 o, lore Fixtures in 1 buiiC;t --each_ _ __ _ �- 1.50
If.tISCELL "E0U3 �!
Sswv-each additional 100 ft ` _-Y �^ - 10.00
Watsr Service to building _ 5.00
l_°ERMIT j,' r� For Pltfmbinq lnspcction Phorre 639 4!7!
4°S State / Plumbiny Contractor By /-Y' -r•.-�
T
I _TOTALRtt;E1PT NO. Issued By
I�1 � � t �► !� !�I ! ff
13UILLINC— PERMIT APPLICATION TIGARG DATE Js._`
THE'.JNDERSIGNEO HEREBY APPLIES FOR A PERMIT FOR THE WOR,:HEREIN INDICATEn BUILDER PHONE 20-4769
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING, PLANS AND SPECIFICATIONS. OWNER PHONE ��, _
�����
OWNER ;Ot39 1;0f7fJt; JOB ADDRESS- 1_:iO:iO SJI ..,,Lli r's�,�JIlULOT N 0._�d= Gta'tes _ —
ARCHITECT
ENGINEER
BUILDER 8C'I 61C ADDRESS Rt..4.BOx 294,T Sheiwouj)ESIGNER
STRUCTURE _U NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE i ❑ DEMOLITION
C1 RESIDENCE 0 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE_ ❑ STORAGE ❑ SLAB❑ FENCE
OCCUP'" ;Y _-LAND USEZONE _R"?BLDG.TYPE A—FIRE ZONE _PLAN CHECK BY f''I"' HEAT
I.J';t. t mile fwdily dwell.', , w/att1Ghei.- aQG* 5 t:•i i.!xr1rJ(ri5 -- --
- )RRECTION SH(TT C)' TACH109
SEWERPERMITN - 0(] 0
_ ..6_ -� cry------ ST
OCC.LOAD FLOOR LOAD 40 HEIGHT 1', NO.STORIES 1 AREA 1 NO.BEDROOMS VALUE SS I1 400
BUILDING DEPARTMENT SET BACKS FRONT REAR " t FFT SIDE 7 RIGHT SIDE 1 _
Permit ��� +ri THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan CheckIs 50 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS Ai;O IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE IS+MANCE OF THIS PERMIT DUES NOTWAIVE
Subtotal _-� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONT'iACTORS TO HAVE CURRENT CITY BUSINESS
State Tex LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
--- —
SDC--
Total —_— --
PDC# TI—SIOn- l' APPLICANTORACENT,
By
Receipt No.
Appy oved �DRESB PHONE:
DATE LNSP. TYPE INSPECTION REMARKS PLUMBING PATE
5=22-}.at �,( ,=• —. �� _��_ ------ .
Contractor —
�r^��"�O L Q¢ - P1yWlwd b*wN VA113 PermitNo. /S� ��.(,J t%i=l>_Sb_
Rough-in
Fixture — - -�-----
"2
1i 1� t �.�� Final
r✓T4P Yr1L�9Jsj ;� .{��G1QCJc�i� HEATING
I ,2-z� �r �G �/ -- meq/ —�—� Contractor
—
Permit Nn. q- !q
! y�-
i M-�'�� JQLOIO+jful�l ()CS� f1 HG•t amu" (G`Et C(L�frci Gm or Oil
Rough4n
----- Final ---- --------
SEWER
---- ----- - `---`---- ' Final 7-
DRIVEWAY
-- .—_.__ --. ------ Final
Storm Drainage
(Rain Drain)Final
Sidewelk
Curb&Street Final
Approach
`I3.DG. DEPT.FINAL_ TEMPORARY V CERTIFICATE OCCUP Y Final
CERTIFICATE OCCUPANCY / `
+� Landscaping
Zoning Finnl _
x U
Bail. UNG PERMIT APPLICATIONDATE
THE UNDEHSIGNED HERESY ',PPLIES FOR APERMIT FOR THE WORK HEREIN INDI ATED BUILDERPHON440
OR AS SHOWN AND APPR`O.VED IN THE ACCLLOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE__.._.....
ID
OWNER ��� ` 08 ADORE55 IJ O Av Q. L07 NO t*_
.l1 (��^ w t A C HITECT
�UILOEIZ_.._�GO LQ ADDRE55 R`_.a_!1 , `I � ew"v 1ESIIGNER
T
r
R
TIrURE EW u Rt Mn n
_ . ._ _._�N_ _ DEL �ADDITICN L.JREPAIR UNENEWAL _ ❑FIRE D,1-6;F
iESIDENCE CICOMM ❑EDUCATIONAL f,1GOV'T 0RELIGIOUS0PAT10_OCAR PORT EIGARAGE [] r C
CCUPaNCY_75 . I aC� -`- _.
�____ BLDG TYPE A)-FIRE ZONE I" 'Hf CK HY
?tied
� :4L
f N
`,EWER
RE 8 M I T I
;C t_naD FLOOR LOAD 4#0 HEIGHT NO $1091ES .. ARE %Q, g OF( ;r•.1-S SS)irrJO
RACK5 FRONT �Q REAR i ' :: DE OiVI, SIUI. /
M 00 -
1.4IS PERMIT IS ISSLSD SUBJECT TO THE REGULATIONS CONTAINED IN tHE BUILDING :1--
PI�n Check3"0 IIFCULATION„ AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS RE6\' AGAE_o -04-AT TI+@
9��4- - w'-1RN HEWILL BE DONE IN ACCORDANJE W1TH THE PL ANS AND SPECIFICATIONS AND IN COMWfLIAN! E Tr
Sub total - Q yb ALL APPLILARLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOEe NOf VWV1
! ! h1 SIRICTIVE COVENANTS, CONTPACTOR AND SUB CONiRA(:TORS TO HAVE CURRENT CIiY
S'�l!. Tax I I IC W
F'VSE SEPARATE PERMITS REQUIRED FOR SEER PLUMBING ANO HEATING.
`�0C
I - Y
ACOLrCAN
Applovpd Receipt No
SDC
POC
SEDER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE 0
dow
_ 1e �
Comments : `� 1fJ� �•Z �r:�I �� �/�a►i P ..�
�nc_ I -e eo
rrll .
Ply
.2 /- 8 x 27 g�
Fp
//It 31
�OL-r z
S7
oy 670_
rr�j Q
.mss 4o0
3
of 1 igard Mechanical PPi "'t �Tfl Permit $3.00
r �/ ° Fee S',t7 r� _
Wvi Installation J� Replace ❑ Relocation ❑ Addition L_1 AltcraN,-in ❑ j*4%State`3A
HEATING TOTAL
CONTRACTOR �''L%�,G, ,t'c': �"",�'�: . OWNER
ADDRESF, G- / t_>_`jy Sc �✓?y�"• j'�-„QT �9��c WORK ADDRESS TO
PHONE (--I I`.a ? .,C> APPLICANT (--I ? .� �".y.,r L< r
hle3t Input Rating (BTU Per Hour)Vic?Ucav Vent Site_ �S`'' _ Flue^Size
FUEL OIL ❑ GAS ,W ELECT ❑ OTHERY,
i
ITEM NO. FEE ITEM NO. FEE i
For Issuance of Permit SEE ABOVE _ A;r Condition Compressor 15 to 30 HP 10.00
IVe_v-up to & 4ne1.100 000 $TU 4.00 Air Handling 10,000 CFM 30�
�
��e'N-100 001 _$TU S & over 5.00 Air Handling Over 10 000 CFM
__ 5.00
Fir-or Fur naco_ 4.00 Evaporative Cooler 3.00 �.+ba
Wall . Floor -Suspended _ — -- —
_ 4.00_ Range Vent Fan 2.00
Install Vents Only 2.00 - Vent System _ 3.00
Repair•He�i& Cooling 4.00 Hood Commercial _ 3.00
Air Condition Compressor Under 3 HP 4.00- Commercial Duct System 10.00
Air Condition Compressor 3 to 15 HP 1.50
INSPEC'TOR'S COMMENTS I `
CITY BUSINESS LICENSE REOUIRED 06P ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BYDATE ISSUED BY----- , DATE
RECEIPT NO. ��rr
71+ Signature of Aopl':ant