16104 SW 93RD AVENUE 16104 SW 93RD AVENUE
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CH Y GE TIGARD PLUMBING IJUZ -% "&U 11,x.
Applka* email )load ori pn 1t4soMWn W,WrWW a plumbtrls Uc
PERMIT d CR WW
busM►tn or mum be per
ow aloalomoi,M
r rMS outside hcl . 6D-917'5"
ftbmmOde c,aralol>,+tara
PlumbrnM Ptermll No
dmtut
09111cr m
.10b !`9 ORS 814.21.610 OUAN. PRICE AMT
Tax Lol mala,No.
Address
FIXTURES _
l.ol BlockSubdivlskm -- ----- -- -- —
Sink
«norm.61 business) _ L 7.50 Del
/.�' ����✓ E Tub of Tuh/Sknvor Comb _ _ ?so '41
-WWIQ
Ow ��: .I� % Shower Only --- — _. 7 50
1s zip Wolof Clow
Dishwasher __- / - &0
Phone_44 Gatbpe Disposal - �- - SO -
Name Washing Machine A / 7 50
Fb«Dram_ 7_50 ,r?
ilii,fl r —_�— Vflane - Water Hester -- 750
Occupant CMy�Sute Zip - — Laundry Room Tray 7 i0
_
Urinal _ 7 50
y� . 01tw Futures(Specify)
750 -
7.50---
Pfibno
750
"Coir
ZIP 7 so
1 1 2I1�e MISCELLANEOUS
kY Am Tax No Sower lot IOO' 3000
ley -- - - - -- .
Sewer-e&Addll 100 _ 1500
Water Sv*m tat to0 _1 y ?0 00 Q(�
I homby adtnm%dge that 1 haw rrard thea appicatxu,MW Mss Infoneal on Waller Sarvios ea Addi12V 15.00
elven it pwrom dual I am replabrad%*h fhb Beall&*$W-s Beard.and dso _ _--
ham a 84115 Pkallblq nowise that the fxurrbwv plvwe am 0oncL OW me
Sbmn S Rain Orako t m.100 ---JO 00 _.
P41m1AIrq Is art will be dons h somni mos wkh appaoabls prov%kwm of qrs- Slam i fayre Oram Adds 1-00'-..... 1500.
flan Aim 'tilaauba CUOM 447 and cal arta WpaeysWs oedes an That Mob%Nom1e Spun- - ,- - - 2s 00
na hv0 wB la amtpbyW i,x"p Amwd urWw ORS eti2 (11 sxsn"aom
State^s*Wukf1.PlMee plve mason below'. Bade Flow Pnimmon ion
WA4EOVA*-RS-I hereby wryly sw I am the ova w of the pmpwty ds- Devlos« Dev%c,r _ 7 SO
aalbad abort,M whId location 1 peopoes to male a pfemtiiq Imstaltoom l r Any Trp or Waste Not
MY awn um and V*-oparly Is mol bdrq oonsl'1+tasd br sale.Nass of rent Mrrlwclsd to a 1ixtun 7.50
CttM BOGIM
ktap.of Faded.Plaribiq - _ - W 00 Per 1�*
9ppecia�N RoRoque~onagwlkx's 40.00 Per H!
_—_-- Misr of Ptu tV wfthtn
�r�•>i�l�/1 �� - an E Btdq_ 15.00 man
JCtlTflpRiZE-�== D SIOWTURF Deb flaw of Sued.Ad0111on MAO man
----
DoWdIle worts nivwjaaf� allaratbn[] 1,01:14161 [.l then ISM
las.a ---_--.----------- ._ __
a
�xw�fA�arwt _
TOT"
va«I wilt Mawo s no am"mown*w mram bre salrlorlaad M mol cone
A M� etA►ti asrlrnr+bt+lr 1noAtla a11t#/arrtlse a at- an ad to
Mfr Ase Mn work IS eert1 11 ad,
SAL QOIMfT10 0 �J
_ Oak Issued _.�����/� f-- by
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PeNecel
CITY OF TIGA,RD MECHANICAL PERMIT celpl ptrmit
Dsacrlptlon
Table aA k4chanicel coda OTY PFOCE AW
City of Tigard t) Psimii Fee -0 -0 1090
13125 S W. Hall Blvd.
P.O. Box 23397 -�_--_--�— – ---
Tigard, OR 97223 -�) SLpplemental"ermh 3.00
639-4175 ] %, ' 7 Furnace to 100,000 BTU
t l incl.ducts&vents 6.013 r
Furnace 100,000 BTU r
2) incl.ducts&vents 7.50
Name a t rarewpnent 3) Fluor Furnace
2 incl.vent - --- — -6.00
Job Address -` Suspended heater,wall heater
Address d '' _4) or floor mounted heater -- _— 6'00
Tax Lot y Map No. Vent not incl.in
.00
Lot Bleck Subdivbfon 5)-appliance permit
m 3
Name(or nae of business) A 6) Rupair of heating,refrig.,
,� - ell,11/4,/,A.�,_ cooling,absorption unit 600
Mail Address Phone - Boiler or comp to 3 HP
Owner �) absorp.unit to 100,000 B1 U 6'�'
City/State Zip - 8) Boiler or comp to 3 HP-15 HP - - - 11.00
_absofp.Unit to 500,000 BTU
Name Sl Boiler or comp 15-30 HP 15.00
absorp.unit'h-1 million
Boll9r to 30-50 FIFv�
argAddr� rrfrorra 10) a cet1absM.un 1-1.75 million 22'50
CoMraclor chy/Stab 1 t_.) Bo ller or comp to 50 HP ------ - - --
ZIP 31.50
abs.imtt 1,750,000 BTU i
Stab nsgbtration No. Cly Bus.Tax No. Air handling unit to 450
12) 10,000 CFM
heresy acknowledge I hevr+rend tris Air handling unit
I he
apphratbn that are ke nation given is 13) 00
10,0CFM + 7.50
,
cxmr* that I am ars owner or wAxKited agent of aro owner,that plana*Aar ted are in --
oc+npllanos with State laws,tial I am registered with the Slate Milldam Roani,that the ) Non portable 4.50
number ghron M corrao (N exempt from State nxiistration plan"give reawmi bebwl 14 evaporate cooler
) Vent fan connected
to a single duct 1-- OU
Ventilation system not
- 16) included in applia=ennit 4.50
Hood served by - -
17) menlCel exhaust / 4''0
c,�fra
we(owner or ) Date ) Domestic type
-Descnlbe work ❑ addition 0 alteration CJ repair n 19 Incinerator 7.50 -- -
to be dom residential EF- ❑ Commercial or IndustrialExisting use of
19) type incinerator 30.00
txii;,'aq or properly--_ Other Le.,woodstove,water
treater,solar,clothes dryers,etc. 4.50Proposed use of -- -
building or property - -- - 21) Gas piping one to four outlets / «:.00 2
Type of fuel- oil p natural gas P9' LPG U electric ❑ -
22) More than 4-per outlM
N4TIGL SUB-TOTAL
THIS PERMIT BECOMES NUL!_ AND VOID IF WORK OR CON. -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 190 .5-- -4%SURCHARGE y Z
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN MVWW 29%Or SUB-TOTAL 7 !2
ABANDONED F'OR A PERIOD OF 180 DAYS AT ANY TIME AFTER - —
WORK IS COMMENCED TOTAL
Special Conditia,s
Date issued _ _�by l
BUILDING PERMIT APPLICATION 1 DATE-__ Ju]y ,g4' 679
TH( UNDE F;SIGNED H'c:REB'i APPLIES FOR A PERM' FOR I HE WORK HEREIN INDICATED BUILDER PHONF. fiG
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNE9 PHQ
1 � _—
OWNER D.U. Anderson JOB ADDRESS 16104 SW 93rd SOT NOo.L'
-- � -- - ----- -- .� ARCHITECT
same ENGINEER bldr.
BUILDER V ADDRESS DESIGNER
STRUCTURE QCNEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
IN RESIDENCE ❑ COMM ❑ EDUCATIONAL 17 GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT L7 GARAGE 11 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY —LAND USE ZONE �
— '�TYPE N FIRE ZONE—�PLAN CHECK BY (IS HEAT 135 s
Cctnatruct single, frtslai].v dwrel].inc- w/raLt lchc:d ril axjC, a11 per saL7pr C!d plans
_Subiect to 85 cc-dot REI I OI'6518,
Vii' utility easement-south P/1--flrel)lace nro-lact,ion not encroach on casaamcrit__
SEWER PERMIT 0 34024(ldu) 2 baths, 8 traps garage ;area 3CO
OCC.LOADFLOOR LOAD 4 0 HEIGHT 20NO.STORIES _ AREA ;"0.BEDROOMS 4 VALUE G6000
BUILDING DEPARTMENT_ SET BACKS FRONT 20 REAR 5 min• LEFT SIDE �l RIGHT SID0'
Permit 534.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
40.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 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 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
16.70 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
State Tax `: _ < .i;
Total 390.7u SDC- GQQ.on `/
By
40.00 PDCq APPI_ICAN OR AG JT - _�—�-- ---�"�`-"--
150.00
.'TZT---� Receipt No.
Approved ADDRESS - - — - -�- �� PHONE
k
i
F
DATE INSP. TYPE INSPECTION REMARKS G PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final...
HEAVING
Contractor 32 2,20-62
Perm!!No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm DrairW
(Rain Drain Final
Sidewalk
Curb IN Street Final
Approach
r I INAL TEMPORARY CERTIFICATE OCCUPANCY
CERITiFr[CATECCPANCY Final
Landscaping
Zoning Final
V " FLAN 11th NU.
for inspections call 639•-4175
PERMIT NO
CITY OF TIGARO 639.4171 DATE 01 if
is� _
BUILDIFIO PERMIT /�� ,��.�•
P.O. Box 23397, Tigard OR 9722131 TAX MAP _. / /_ LOT NO. VIDIVI ION
DwNEA� C Y f/UL�I�LN '� -- ®fl ADDRESS LJELL S •C.0 . 3Y , _
BUILDER N STATE REG.NO. EXP.DATE
ARCHITECT
PHONE —OTHER
STRUCTURE NEW E2 gEMOOEL ❑ ADDITION ❑ REPAIR ❑ MOVE 0 OTHER Q DEMOLITION
CKRESIDENCE ❑ OOMM _ 0 EDUCATION ❑ INO - ❑ REURIOtM ❑'ACCESWRY u GARAGE ❑OTHER C3 FENCE
SEZONZ^ FIRE ZDNF PLANCHECKBY
OCCUPANCY --LAND ._HEAT
Constrict single family dwells -aAi -P1ar
_SnhjPrt to 85 code.
SEWEAPERWT�, /r,�'? �� �dU� blths, traps 7 4(3aaraoe area —
�1 a NO.9MR1ES ? ARW1 /�/"/ ' O.BEDROOMS VALUE-
OCC,
AWE
OCO.LOAD FLOORLOAO �� HEIGHT
8URDING DEPARTMENT_ 1 `
—1 JET BACKS FRONT �� REAR LEFT SIDE RIGHT SIDE
Po"Iml j THIS PERMIT IS ISSUED SIIBJEI:T TO THE REGULATIONS CONTAINED IN THE 6II1lDIHt] CODE,ZONING
dtEGULATIOMS AND ALL APPLICABLE CODES AND ORDINANCES.AND IT 93 HERItOV AGREED THAT THF
PIanC beck � WOT4K WILL BE DOME IH ACCORDANCE WTTH THE PLAMS AND SPECIFICATIONS AND IN COMPLIANGI
II IM ALL APPLICABLE CODES AND ORDINANCES. THE ISSUAHCE Of THIS pfRMR DOES NOT WAM
Pt Ck Fri R�,STlt#,CTNg COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAV!Ct111R[NT CITY #USINEss
TAX PERMUTE.SEPARATE PERMITS REOW.,R,IFo FOR SEWER.PLUMBIN AND HEATING.
Stile Tax Ss or /i/+'Q. .5 oAJ �l/c
SOS'.— --
Total -)• APPLICANT OR AGENT
Pr9pd. '
RaCslpl No ADDRESS LT ONI
'• �
Bal.Cw
I,.u.d AY—----_-Approved Br—
SSDC - $
SDC -
"� RECE;P1- #
noc -�^ —
�-- DATE PD.
SEWER CONNECTION 5
AMOUNT PD. -
SEWER INSPECTION
SEWER SURCHARGE _ S
ommente; s- --- - -
;-.• -- -------
__ _ - _........ .