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iNSPECTION NOTICE
City of Tigard Building Department
12420 S.'N. Main St.
Tigard, Oregon 9722?
Phone 639-4171
r '
Address '�- �' _� •� �' Permit #.
C
Type of Inapertion r. •-�'
The following Bedding Code defic;encies are required to be rorrecteo.�
Presented to -._. -_--- -_ --_ ._..__..__._..-_ -.-_ -----.._ _ Inspectdi
Date ---
(ALL FOR RE-HO"("TION
❑ YES ' NO
I Did L.u'1PLIIMBING' 1PERMITt luf�n!j N 00
holder of a valid plurnbin
y contractors license is hereby
tagAthorized to cause p,--m`liag w rk as herein noted to be installed in accordance with; the plumbing code of
igard, Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prier to the time the installations are ready for inspecti-)n. City of Tigard Business License required
for all contractors and sub-contractors.
Address._Z�'_l' r Oates
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT - ITEMF FEF ON EACH AMOUNT
-- (Cffice Use Only)
R 1:S I P_E1L TJ8 L
Sin le Femil�l bath each 25.00 c;
Du x-Each 1 bath unit 25.00
Additional bathrooms-each _ 10.00
Mobile dome Space-each _ 15.00
INDIVIDUAL FIXTURE FEES - -M -- - --
-- Ito 50 Fixtures in 1 building-each 3.00 —
51 to 100 Fixtures in 1 buHdin -each 2.50
101 to 200 Fixtures in 1 building-each _ 2.00
,nnro Fixtures in 1 buildin _ - --
_ g-each
MISCELLANEOUS
Building Sewer-As 50 It, 10.00 _
Seer-each additional 100 ft. 10.00
Water Service to / rildin9 -� 5.00
I,
Private Water Sytems-each 100 It. 10.00 -
Other (Specify):
PERMIT 31," , For Plumbing Inspection Phone 6351.4171
u9f;State Plumbing Contractor B '
y4lLa1 �� J�^a c lrc_
TOTAL '1 C� RECEIPT NO, Issued By
WIF
BUILDING PERMIT APPLICATION TIGARD DATE__�.�� ' 1s_ _. 3696
THE UNDERSIGNED HERE 3Y APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED �iUILDER PIHIoNE _b47';,nlill
OR A,i SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT NO._4_8 — C�1®CICTi9
OWNER (InLUH41M&S, icic.JOBADDRESS 1506a SW ti,.th Ayenuu_-- ---_ _ Park_ Estatea
ARCHITECT
ENGINEER
BUILDER salyle ADDRESS Pt.3 " liox 448,hillabCOUIGNER Dan Klover
STRUCTURE CA NEW ❑ REMODEL ❑ ADDITION C7 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE CJ DEMOLITION
M RESIDENCE ❑ COMM ❑ EDUCATIONAL 0 GOVT ❑ RELIGIOUS ❑ PATIO 1-I CARPCRT ❑ GARAGE ❑ STORAGE D SLAB❑ FENCE
OCCUPANCY . R'3 LAND USE ZONE _ff 1 BLDG.TYPE _ FIRE ZONE---- PLAN CHECK BY _dash H EaT` _a8
Construct single _famil ry dw,sillin(4 w/ottached gai age. 3 Bedrucims 1 Both.
RF_'--TSSOF Of PERflIT #3659 (11960 SW 122nd Court)
SEWERPERMITk 2331Q — 875r,," garags 395 sq. ft.
OCC.LOAD FLOOR LOAD 40 HEIGHT 13 NO,STORIES 1 AREA 1017 NO.BEDROOMS 3 VALUi642}a00.
BUILDING DEPARTMENT SETBACKS FRONT 20 REAR 4C _ LEFT SIDE 6 RIGH; SIDE 9 _
Permit $1fiC• 00
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZONING
REGULAVIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check lO.OU WORK WILL. BE DONE IN ACCORDANCE WITH THE FLANS AND SPECIFICATIONS AND IV COMPLIANCC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT 'NAIVE
Subtotal 176.00 RESTRICTIVil COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
St_a_'e Tax4% b+fay LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
_
_ SDC— 6400.00
Tutal $182.b4 _ 7/}
PDCM II $100.00 APPLICAN?OR AGENT
BY P1
Approved duh ADDRESS
No. -------- - - _..--
ADDRESS _ PHONE
DATE INSP.I TYPE INSPECTION REMARKS PLUMBING DATE
lContractors Permit No. =&�.
7/
Rough-in
Fixture
Final
HEATING
C-49_-J. .04,00, 1091:11"w"r-hLA
Contractor
Permit No.
Gas or Oil :03 ev- 4-
Rough-in
Final
SEWER
Final
JDRIVEWAY
Final
Storm.Drainage
(Rain Drain)Final
SidetA 'k
Curb&Street Final
Approa-h
BLDG.DEPT.riWAC TEMIORARY CERTIFICATE OCCUPANCY
CERTIFIC.a rr OCCUPANCY Final
Landscaping
i Toning Final
BUILDING PERMIT APPLICATION -riGA-17 DArE a 3 19-A5—(
THE UNDEHSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYiINGG PLANS ARZ), CIFICATIONS. OWNER PH 'E _
C.A.INER `:J��t Q �OB ADDRESS ' y,0f-) 7�V LAve-
LOT NO.
ARCHITECT
U. 3-190 449 kr,'I�5-dO«V DESIGNER��
ENGINLEA
BUILDER 7Lt � /DDRE°S X ^
STRUCTURE_'W NE'N ❑ REMODEL ❑ ADDITION _❑_ REPAIR ClRENEWAL ❑ FIRE['AMAGE ❑ DEMOLITION
RESIDENCE C COMA ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO Cl CARPORT ❑ GARAGE C STO AGE Cl SLAB❑ FENCE
Ste- c-- - _ _ -- - - -
OCCUPANCY 1 �" __.LAND USE ZONE RQ7 _BLDG.TYPE u_FIRE ZOt E PLAN CHECK BY 2f
���Pei-It 104
1"� ..J t:tx�t t/ �Et-�iR'�!�uta'^hp►A Q .
SEWER PERMIT k14.00C.LOAD FLOOR LOAD 40 HEIGHT/3 NO.ST7RIES AREA IDI NO.BEDROOMS -3 VALUEgfaO
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 40 LEFT SIDE RIGHT SID!
Permit 11.0 tO•oD THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZON'NG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IS HEREBY AGREED TeAT TPE
Plan Check t� WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN C0,10PLIANCE
r7 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVS
Su�tatai (D�� REjTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TU HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
[FRI
ate Tax fp T
tSOC �Td / 0. dAPP UCANT�AGE_
Receipt No. _
L Approved ' ADDRESS PHONE
0C
EWER CONNECTION
EWER INSPECTION $
r
r-WER SURCHIRGE $
! � ro
'nmTnrlf'C • 1 . 4•Z+01 GSASA g'rt P'_ ..�__.
New-M.^.allation ® Replace n Relocation[] Addition C] Alteration 0 DATE:
HEATING Tmperia.l Mech. C'inco Homes
CONTPACTOR —�___ _— OWNER
ADDRESS PO Box 06327/97206 JOB ADDRESS 15085 SW Rath P1 .PHONE 777-3801 APPLICANT Imperial---M•echh..
Feat Input Rating(BTU per Hour) 15. 5 RU Vent Size / 4 Rue Size
FUEL OIL[] GASE] ELECT E]x OTHER
—I—ITEM TO. FFE — —� ITEM NO. FEE_
For Issuance of Permit SEE BELOW Each Air Handling Unit or Duct System^ 7.50
_New up to & incl. 100000 BTU _ 6.00 commercial Hood System _ _7.50
New 100,000 BUT's & over r _ i.�0 Otf er Equipment • Each v 4.EO�
Woodburnin ZStove 4,50 1 Trip Inspection 4.50
Wall-Floor. Suspended 6.00 Air Condition Compressor • up to& incl. 3 H.P. 6.00
Vent System wlFan 4.50 Air Condition Com iessor•3.1 to 15.H.P. incl. 11.00
_6.n0
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUR-CONTRACTORS ! !
PERMIT ISSUANCE 110.00 Comments:
FEES ^` O,i
SUBTOTAL �rOCI —•______._._ � —�--.---._..__ __.— __ i
% STATE _ � o)T Issued By_�
25^o PLAN CHECK
TOTAL __-- — REC. ---_._--
Signature of Aool;cant