16570 SW 93RD AVENUE wi
c,
it
16570 SW 9?RD (.MRT _
� vMIMWY �M� fi..�✓�.VFM��M'Minf!MViI�w�M;.1Mw+i..wW� w .�,.a�.,,w.�.w.r.....wr.«�. ..��.�.. ..,...,e.....�..�w.......-.
• �.wr.w..�s�@il.��'1 �S�
CITV OF TIGARD
Cr(V0FTWAPD '
commuirrY DVVELOPMENT DEPARTMEW or,10cm PL(JMVI'NG PERNIT
13126SWI*,d1Btvd. P.O.1 Om 23357, lIpM,Orpgjn WZ23 '603)834r-4175 R Ill].1 It P L 114)0 W I
1-77M 1 0. ss
63 9--4 1'/1. 110TE.-': ESSUED: 07/25/90
T E* A I`D R LS I G 5 7 0 9 3 W R D CT PORCEL: 2SI14-AC
, ,r . , . I
BIJBI)J'V I S J()N.
j"A F7F:
ZONINO: R 4. 5
B L 0 G! . . . . . . . . LOT. :2
CLASS CIF'
IF' WORK. . AIDD GARDAU.: DISPOSOLS. 11OBTLE" HOPIE SPACES.
TYPE OF USE
: .SF UNSHIN(i, MACH. BA(,Kr.*I-UW PREVISITRF..
OCCUPANCY GRP. -R 3 F*LCOR DRAINS. ., . . . » „ TRAPS., . . . . . . . . . . .
. . . . .. . . . W A'T E Q ti Em r E iz�s CATCH FIA,-')INS.
F'] XTU R I-:S LAUNDRY TRAYS. -;:)F' RAIN DRATN'S. .. . ..
STIAKS. URINALS. . . "I'RApS.
LAVOTORIk"S. .. . .. . OTH E*R F I X V U R E S.,
I'LID/SVIOWERS. . . Sf:*tJ[:-R LINEE ('rt)
wA*I-E::R CILOSE.-Y's. WATLIF.' LIME (f t)
DRATI-I t)
C)wi-ier:i E s
KASSON t y P,a, awount b date rerpt
16570 SW 93RD CT PAY11 15. 75 JI-11 07/25,190
WBW
�i
-ZITY OF TIGARD PECUPT OF PAYMENT PECETV-',T No. 9
CHECT..' AMOUNT
DIAL ONE NEW I)IIIENSONS CASH AMOUNT
ADDPESS TNC. PAYMENT DATE
SE 16-'2NL SUSD T VI Sl I ON
'.lF.TLAND, OR 9776,
16)5 7 1) S W '?'7RD" CT
Puj'-,rk--ig(717 F''AYMC.NI
AMOUNT PAIr, f"UPI"OSE Or- PAYMENT AMOUNT PAIr..,
PLUMPiNG F,E'F-,,t-I P L.,M;Is.l-C,I '2: 1-15
15 oc, ST., UMPJ) F,"EP
TOTAL �41,,Icfl.1trr pAjV 1,!;. 75
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WKSWEA
1
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4176
Type of Inspection
[)ate Requested _� Time A.M.��._P.M. /-//Address
�<,'�'� _ Permit !�'_L�L
f-6 -•---�—�-
Owner � — --
Lot # '"
The following B►'ilding Code defia[ehcies i— required to be corrected:
77 .00
�r
Presented to __�.M —._------ APprov!d
Inspect-)r — L� Du,-appy ;ved
i Date —
CALL F(7R REINSI'EC�'ION
❑ YEs ❑ No
P,
CITY OFTIGA BUILDT1,K3 :7_PM1*T RD 4 PEN4MIT NO.
areolrwkw
CCMMU',%IITY DEVELOPMENT DEPARTMENT DATE ISSUED: 6/23/89
13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard,Oregon 9727.3,(503)639-4175 PWIM. PM*T.NO.
JOB ADDRE'SS : 16370 SW 9*.fl:fl.) (.,'I
'VAX MAP/LOT SUB: ('AFFAI...S COPNEP. L OK :
LAND USE : plel . 5
I. ur SIZE : VALUATION : tk 79 , 190 SETBACKS
FRONT: F-4EAP.
WORK (;LASS : Nl--*W DWELL.UNITS : I LErr : RIGHT
USE: TYPE : SINGI-F FAM11-Y NO. EEDROOMS : 3 E.XT.WAL.L CUN5)T :
I'ONST .TYPE : VPI NO. HATHS: 3 N: S : E : W .
OCCUP.GRP. : P3 PAOT . 3PENING5 :
OC*r,UP.LOAD N: 5 : E. W :
TOTAL AREA: 2098
NO. STOW7ES 2 isT: ROOF CONST :
HEIGIA'; : 2ND: A A E:A S E P A R'?
HASE.MENT'? 3RD: OrC(JP. SEPAP"? 14A- Tr-El'.) :
MEZZANINE BASEM'T
FLOOR LOAD: '(10 A A A CA;: ZiOO FIRE SPRKI-147 ALARM'?
FLOW(GPM) DE I-EX-I"?
HEAT TYPE: HDCP.AC(-,E`.SS7 CORR?
I'-'I.-AN C.HECK BY: r I t
1411'EMAVIKS :
PE15SUE OF NO.
LAST PEKISSUE
FEES :
0RM I Y' $373.00
W 5EBAS1 IAN RANDY PE
N 20A13 WALUIEN ST. I PLAN ARV IEM AV-)
RE I",I
welts Iinn
51 ATE TAX $18. 6!5
OTHER
C DEVELOPMENT CHARGES :
0 15E%BAS7TAN RANDY SIXII(STORM) $250 .00
N
T PENAISSANGE DE'VEI (]PMI:..N I SDC(STAKTA $600 . 00
R LI0A43 Weil DEN !:0 PDC:114 *,e3o .00
A
C liest lif,11,11 err. PREPAID < 1111110C . 00)
r PHOt—, 11."103) 637-5739
0
PI-iEGISTPATION NO. 1499315 TOTAL : *1 ,634 10
RcPNO, 1411
EruT 316
This permit is issued subject to the regulations contained In Title 14 ............
of the 't'MC, State of Oregon Specialty Codes, zoning regulations PEQUIREA) NSPECTIONS
and all other applicable codes and ordinances. and it Is hereby .1:
agreed that the work will be done in accordance with the plans and FOOT 3'.N(; SIEWER
specifications and in compliance with all applicable codes and FOUNDATION WALL PAIN DRAINS
ordinances The issuance of this permit does not waive restrictive POST & DE:AM WATER L INC:
covenants. Contractor and subcontractors shall have current r:ity 13L 14 , UNDEPSLAB CITY APPAUI/SW
business tax permits This pt_,rrmt will expire and become null and
void If work Is nal started within 180 days rif work lssuspended or tiLAD F I NAL
abandoned for a period of 180 time after work has PLa. TOPOUT
31.yhe FRAM I N(.,'o
commenced It shall be the r bill , o pernuttee to assure
all required inspections nest and approved F I PEPLA(:A:.
GAS L I NE::
TN'-5UT' LAION
VYP . BOA"D
dlermittee Sig alu
Issued By 007+7_fi_.*to+-.. "41r,E ttl,*1*J.k.0N IM -niftT411
SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
WA
qlF.'Wf.;'P PERM11*
� r �
�� I:) :IiM1 'T NO . : S&61.;)1396
t,.-:i
COMMUNITY DEVELOPMENT DEPARTMENT DATL-:* 15SUED : 6/23/69
13126 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223,(503)639-4175 PRi.m . Pm,r .NO. 891396
7
JON ADO'llESS : 16370 514 93PI'.) (" BIH.Y' USA NUMW : 37551
'TAX MAP -1-01 ISUB: CAFFALS CORNEP L.'r :P- 01"' :
I AND USE' P14.3
l..CSTSiIZE : I
SECTION: I WI-1: PNG :
WORK NEW
UGE- TYI)r--': 15INGLAK F*AMI:L.Y
'Thea ar.q.)IJi.cm.rit wgreels tj:i comply with nll. r,t.ileli; iiLricl reiguIntiorim ni? the Uriifiod
liewrer-iag(.e algenc'y . 'Tho permit 120 (Jiayla from the date i9isi.le(J . lh(.i4 tntat].
imnot.trit j-.)nLd will 1:)fl fl:)I-Feiteilj if t1*ie,t pvar,init fAxj:):0,ro!:; . 'T'he! A(..Ien(-.-y cioeq.; not
w.litee ther isr.'xniiriac�y of tj-j(,H jo(--,atj.aI-j (,,,.P the iaide uiewei- liato'raj- . lf th*.- iiiewell Vi;
not locatte-d ni, three M(r)fiLV.;LII"eM"I'11t Ul-V011 , thP 1.11-11SULIA.Cll" MI-IRL11 3 foe-t irl
tall. directicisvii. from Mich diStlAr.C." giVell . *Xf riot iso loc^i&tecl , the instai.l.).(?r- %hall.
Uri(] 5ido thea Agp.I-IC^y w:J.1.1. J.1-1sitall a IiAtriAral .
IN51'ALL . I*YPE: IMPERVIOUS AREA:
F:A:X1'UPE:' LINT'TS: TENAN'T' IMPROVEMEN'T' : NO
DWEL.L.ING UNITS : I
NCI . OF 13LOGS . I
0 51::1DA5*1*1i.NN RANDY PEPM11* $35 . 00
W
N r.*-2 0 A 3 W(NL.I)F-*,N 51 C(INNF.*.C*T*T.ON CHARGE $1. 100 .
E
R wean I.:lrirl gar L.INI---. I*AP 1N5i'TAL-I- .
CYTHER
C
0 sF-.-r-i0s'iT0)N ilANOY
N '
T N1:;:NA1l5F,-sANCF.'. 1XVELC)I-."M1'c:N*T*
R P043 WALDIL-N 1,1' .
A
(-, wt,*%t 1 -1.n n mr, 9*7068
T PHCIINIE. 1,50'311 6-57-5739
0 $1 1�v--5 0
PEGISTPAIJUN NO . -119,051.1
This permit Is issupdRiblect to the regulatir,ns contained in Title 14 P11710EIPI* NC).
of the TMC, Slat" of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances. and it Is hereby
agreed that the Wolk will be cone in accordance with the plans and P()LIGH I N
specifications and :n comp)once with all applicable codes and
ordinances The issuance of his permit does riot waive restrictive
II
rovpnnnls Contractor and 3t ticontractors !-hall have current city
business tax permits. This peimit will expire and become null and
void if work is not started withlo 160 days,nr If work is suspended or
abandoned for a perlad of J§P days any time after work has
commenced It RhAll t..,%W t 5onsibility of t;1-9 permittee to assure
-ill required ins f j'( Ifni lUested and ar.Forve&
Pormitt e SlfpEltrf 0
Issued By I F tjR J.N!:s PFU'1 1 IFIN 6-39-44 17.5
SEPAFAATE PERMITS REQUIRED FOR WORK 0 1 JER THAN DESCRIBED ABOVE
IMP
PI U11BING PEPMI.T
MTT NO . : PI 0913941
PE'*P
�'�0 F ��1��R"'O'
CITYOFTWARD ATE ISSUED: Er/23/09
COMMUNITY DEVELOPMENT DEPARTMENT P P I M PMT .NO 891.394
13125 S.W.Hall Elvd..P O.Box 23397,Tigard,Oregon 97223.(503)6394175
ADD164F.Gs : 1,6570 SW 93RD CT
FAX MAP/L.OT SUB : ("AFFAL-S LT : 2 BK :
I AND USE: 1tZ] 15
I_OT S'_Z E :
ITEM NO: NO
WORK (:I_ASS : Nl;-::w W04TIli-J4 CLOSET 3 TRAP
USE TYPE- : SINGI F. 1::'AMJ'L..Y UPINAL, BKFLOW PPIJIN'T'R
CONST . TYPE_: VN L.AVOPATIJAY 3 TRAP PRIME:R
0(:',CtJP . GPW 143 TUB SI-40WEP i' (CREASE TPAPS
DISHWASHEP 1.
('.,AV1UA(.'sE DISPOSAL.. I
NO. STORIES : 2 WASHING MACIAINI:.: 1.
DWELL .UN I I'Fi I L.A(.INDPY 'T'RAY .1 1:4-1)(3. DRAIN ( DIA
FL_OOP DRAIN
SINK I SEWE*14 (FT)
tJA'I*F*-'P HE' TEP :1. GTOPM/PAIN (F-'T' :1.00
OTHEP
REMARKS :
T_
SE BAST'IAN BANDY 1:)I::-'PMI:'T' !N1.'1O 0O
W C) �.?043 WAI—DEN ST .
N WPMt lif-II'll 113 r FIXTURES
E STATE TAX
R
OTHER
C CPOSS CARL 13
0 FKAGLE PL_UMBINL; CO
N
T J.03P6Gr-_' HOLGAIE BLVD
R Port JoLtrid OP 97266
A
C PHONE (503) 760-5565
T Aiii"GISTPAI ION NO . 4791.4 TOTAL- : 1417 . 0 0
0
WECEIP'T NO.
This permit Is.Issued subject to the regulations contained in Title 14 pr:QU1 RET)
INSPE117TIONSs
of the TMC. State of Oregon Specialty C:)des,zoning regulations PI-.8 , UNDEPSLAD
and All other applicable codes And ordinances, and It Is hereby
agreed that the work will be done in accordance with the plans and POST & 1.1EAM
specifications and in compliance with all applicable codes and WA'11;'.A I.-INE.
oidinRnc,,s The Issuance of this permit does not waive restrictive 1:4.11 . TOPOUT
covenants Contractor and suhcontractors shah have current city PAIN DRAINS
husineas tax permits This permit will expire and become null and
void if work Is not stoned within 180 days.or 11 work is suspended or FINAL
abandoned for a period of 140 days any tinie after work has
commenced. It shall be the"Oonsibillty of the permittee to assure
all required Inspect 9 equeste ap7ved
milt 11 V
FOP INSPF11TTON 639-41:x75
Issood By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
MECHANICAL PERMIT
CITY®F TI17A IaEF2MIT' NO. : MEC�9139"5
CITYOFFTWARD DATE:: ISSUED: 6/23/89
COMMUNITY DEVELOPMENT DEPARTMENT PRIM. PMT .NO. 891395
13125 S.W.Hall Blvd..P.O.Box 23397,Tlger0 Oregon 97223,(5k A 09-4175
JOB ADOPESS : 16570 SW 93RD CT — —
'TAX MAP/LOT SUB: CAFFF'AI._S C:OPNE P LT:2 BK :
I...AND USE; Fra.5
LOT* SIZE:
,i-rEM: NO: NO:
WORK CLASS : NEW FURNACE (100K AIF? HANOLP (1.0
USE TYPE : SIN('..LE FAMILY F'UPNACE 100K+ 1. ATR HANDLR 10K
CON51' . TYKE::: VN FI_.C)OP FURNA(�E: F_:VAP .COOLER
(3(:CUP . GPP. : R3 HEATER VENT FAN 5
VENT VENT . SYSTEM
bLR/COMP (3HP HOOD 1
NO . STORIES : 2 BLP/(COMP 3•-15HP INCINERATOR(DOM
DWELI... UNITS : 1 BLP/COMP 15-3014) IN(;INERATOP(COM
F"UE::I... 'T'YPE BI-P/C(.)MP 30-- i0HP PEF:PAIR UNITS
MAX . INPU'T' BLP/COMP 90+1•4V OTHER 2
1•F'114k.. DMPPS? CTAS PIPING OU'T'LETS 1.
1-11tH PRFESS?
L,0W 1:FiI:SS?
PE(ARKS :
j
FEES :
S=BAST':I:AN DANDY PERMIT $1.0 . 00
C)
20A.-3 WALDEN S T . PI-Al' RF:::V:I:E::W $12 . 00
UJ
elr FIXTURE'S t43 G. as
R STA'T'E:: 'TAX $2. 40
R
OTHER
SANUHET ALAN ^ -_
T r-1I--(.,0UN'T'Y 'T'EMP ('L)IN'T TOL
N
T 10.505SE 55TH
R 10:1.1.WUmki.e or 97222
A
C
T PiL:(.ISTI7ATZ(- N N(). "529 a0 TOTAL.. : $0112.410
R
— — HLCE:IP'T' NO
This permit is issued subject to the regulations contained in Title 14 i ., rF.
of the TAAC, State of Oregon Specialty Codes, toning regulations RE"GU1�FiLI INSF E L.TIC)N.,
and all other applicable codes and ordinances, and it Is hereby OAS LINE
agreed that the work will be done In accordance with'he plans and POST 6 E)F:AM
specifications and In compliance with bll applicable codes and ROUGH-IN
ordinances. The Issuance of this permit does riot waive restrictive F1 NAL
covenants Contractor and subcontractors shall have current city
business tax permits This permit cilli expire and become roll and
void if work Is not started vvithir101days,or It work is suspended or
abaASignnt
erto days any time after work has
comr oneibility of th er tee to assure
all S quested and a q�ov
Per
Issued By
C'•ALL_ FOR INSPECTION 639-4179
.�"`�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TIGARD
13.12 HS 5 SHALL BLVD.
PLUMBING PERMIT � � � P. O. BOX 23397
.1Micants must botd Oregon Registration to conduct a plumbing TIGAR.D, OR 97223
Fwsiness«must be ptupe-rty awrner/o(nerator not hiring outside help.
Nanw of oe.rrksprern (503)639-4175
Plumbing Permit Na__ _
Address () � 0
0
scrip1
1n
OAS 814-21-610 DUAN. PRICE AMT.
J'14) Tax Lof Map.No.
Address
- FIXTURES
Lot" - _ - Block Subdivision -
S�nk
----- emeTcx nwrw61
/uusess lavatory ---- 7.50
rrAl-5 S O/I% Tub orTub/ShowerCornb. 7.5'
q Address^ss 7.50
Owner zipKr Shmvw Only
C/ Nater Closet 7.50
C /Stats -
r -c n U�Z o 7.2Dishwasher 7.50
Phone Garbage Dis,cwsal _ _ 7.50
--- Wa.lnirngMactune
Fkxx OraK, 7.50
i Phone Water Heater _ - 7.50
Occupant 7.50
p CilylState zip
llrioa� 7.50
Name----- suer f acw:s(Specify) i 750
.,. f�vfk? vgvh2 �p vG� c. P ---- - 7.50
Phone -� - ---- -- - 7.50
Contractor O:;fy/;Aate 73p -.-_
MISCELLANEOUS -_
City Bus.Tax No. r 1st•rt0' 90.00
State 's
a a 's tele s�moo. Sewer_4,a_Ad:14.100" 15.00
(Nesrdentiat) Water Service 1st 1010' 20.00
1 horetr/sclvawledge duet F have reed ells a(nA canon.that ere ksformation Water Samoa sa-;ddit �- - 15.00
given is correct dvat 1 am regWoredivith eie`;Yale&A-s is Boenl•and also Storm d Rain Drain t st.100' 3U.00 -
hwve a Slate Pkxnbknp koernse that dw numbem given are Dotted-Vial all - - -
Ncxtnbwng work will be done in s000rdenas with appt cst-Ae provisions of Oke- Storm 6 P-in Drain Addit.100' 15.00
porn Revised Statutes CIW4ers 447 and 693 and appllrybls codes and tKat Mobile Home Spam 25.00
no help will be emlAayed unto"""ad under CMS CAI Of exempt hom -------- -
State registration.Please give reason below). Back Flow f1mvention
FKWFOV INEFLa--1 t,eretsy certify ext 1 em due owrrW of the property do- Device or Anti-Pollution Device 750
scribed&&".n which to atlon 1 propose to nuke a pkxnt*V knat"Alkxs hx Any Trap or Waste Not
my own cess^nd ffos propwrty Fe"tx'-g constructed Iry sale.lease of reit, Cernrnerded 40 a Fixture - 7.50
Catch Basks 7.50
kw.of Exist.P1txrbing 40.00 Per Hr.
----_----- Specially Requested InspWions '40.00 Per W.
Pain Drain, 15.00
-1111gle ram. Dw1g. ,
.AUW40f1laE0 f
10MATURE Date
Describe work tmw[] eddition C) alM bon C] repair C] ---
be dotty residerWal fj non-midwtMal
Existing use 4A MINTMUM PERMTT FEE 35.00
bt O&V or ixoporty--- _-- SUB-TOThL
i bt Mosed U"of 5% SURCHARGE
0 - -- TOTE
a plvp"'tY __- -___ - "W
25k PLAN REVIEW
Norxa -
Thls(»rrNt tvtx two�rrll anA«sM1 N wtlrlc a aHub�rxkn a+NwrOted V rx>t Win d
m twnd wlthkr 1 W)d eyarrx M rxrratruic0on or work Oa Mjasarrlad or etwxkxseri -�-
a p«1rx1 M Ian drys N"Cow~%vork is oornrn«x"d
Des lesurc _ ___--- by
ARD TI' I'I-,UM.BING S al9223
CITY OF pER M IT 630-�75
/ a ptl*`L, ;�6
/�.p(.Cuw nwri Fx1W (?. .x1 RcglllraGon b cxx.d�t
�o,�r/axracor rwA hlri-j"-A%;6c�IP- _
I�vtir.ctt0rmv14lcpcopertY IMumb.�K •omit Na.
rKerne o<D".kxw 'nl -�.__-�_-------____-
- .------...---- OeWAN. PRICE AM1
/tdcf+se ORS 01421-610
Job Tu lot FIXTURES
Kddraaa
;.dn,lskxl Sid* y-
lot E3iod - ? T.SO S U
- L xvaWZY -1 7S0
4r b of Yub�Sha"ct CoCrb.
7.50
-------------
_ i
7.50
1 - WeterChsat - 7.50
I l7wner laky/ le ---'� l7�st►.vwstet - ' - 7.50 )Z)
-- L*twne Garba4es__ SU
Wast*V L4xd1"~ 7.50
-_ Kam" floor Oram
7.50
atz .���liooln Tray ---
Occupant Crty/Stata -- lr� lklr»o -7,50 --
oaw R duces(Sptroty)
- - - 7.50
-_ - --A -
Contrector (AYIStat" MISCELLANEOUS
-�-_
city QW fax No SO-Of t d t-oor - - 15.00
-e a_Addre t�� - .00
Servr[ to 10.x• ._._— __�..-.--
Yreter t5.1b
(f Lescter><IaJ) "t/tdQ;1�r _
-- _ don watt s«v M 30.00 ----
W4xn+a taE too'
11»r.0y ecfjloA40dG•t a reaftu rte' KCAILIO�r�►�a mrd-am atnl c vxm a WJn LkaJn --- — 1 s 00 -
Vivvrl it txxnrQ tla1l IIm tered sm comect-tu1 cd -SW,, Prinon%:nMdd•100• --
ha a S(414,PkwT#v)ioorwo tut 1tw Ae Gr�l(xW of U fe-
pl-,b:rq-C.k e,j Lre dw»Irl trolxxds— �f AM that 14.,".;Lrxn"Si— -
oorl Ii.w«I StatAea CfuwO- 417 AM�
Ixlles a ORS
a.K.WI(A h'x^ -
ro M ip..ut be trrrlpby+d ( 04-x f1or, 4% O-r— T.50
S as replara.tbll t +a 0'v+ltraeO^tx+< de Oavfty or/Vlti _
d t'tr ptc>(�erty T nor Waffle t'tot
t10t�tEOwttEFLS-1 he+^abY o«-Ilfy'�I tarn M awn"r trx�x+kx j'r'3' reo b.Fualr. -
ac nbod atsov+..t w(kh be son I ptopa"b rt tr Pd 4a tlr carat t:+ "dam
for a<Ie. - 7.50
^IY o..11 u...rld t.L prt+p«ty tr not L.&v 40.00 Pvc H.
�_.
40.00 P«
rtaq-
15 00 mm
26.0k)mr.
4y Adj"ItIn
AVnlK) ZC-0SKt►tAtUnc- - e I111;:aII]L 1.+`tlIv
--- atteretlOrl[7 rn(tt1lr� � �+''l l u1: -
L?eecldw wtNl. rMw L7 "tktdron(.�tretrrd/A1 _ - •-.-- --•'�"--
ti1 Lb 0-y-___..- rntklortl 1.-._��-.W �..�
-�r-
'Iftl0c Ulu of -tl per.
'-"""
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CI or TWA R1 PLAN CIiCCK APPLICATION
a cm cxT.cAan PLAN C 4ECK H
COMMUNITY DFVrELOPMENT' DEPARTMENT PLRMII' if
111755.w.11.aofd-P.O.floe 23397.14g«d Om4on Mn.fWJi6T.`417S DATE ISSUED
MAP/LOT /c!
JOB ADDRESS: Z LAND use:
SUB: - ,�.C,��� ,�'�,,ciP LOT
VAI-DATION: __ �----
OWNER / �! SPECIAL NOTES _
J1'r REISSUE OF:
NAME:
- _ LAST REISSUE:
ADORE:S: FL(.00 PLAIN/
--- -- ---_ SENSITIVE LAND: _
PHONE: --- '
APPROVALS REQUIRED
CONTRACTOR ,i PLANNING: -
--�—.--
_ ENGIN[F_RING: _
NAME: ` {�_ _ FIRE DEPT
ADDRESS: �` � � � 4✓ L OTHER: --__-- --
.__SCS [ vr2 ----
--- ITEMS REQUIRED
PHONE' -- - LIST/SUBOONTRACTORS:
ARCAVE:NGI:NEE�R �7 �5 BUS TAX.
CALCULATIONS: —
NAME' --- _ TRUSS DETAILS:
ADDRESS: PARKING PLAN:
--- -- _ LANDSCAPE PLAN:
OTHER: —_
PHONE: -
COMMENTS: _
PE MIT N ACCT H DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
�r�_ 10--432 OO Building Permit Fees
..--
��_ 10-431 00 Plumbing Permit Fees --
10--431 01 Mechanical Permit Fees - }
10-230 01 State Building Tax (5X) _ 0
Building
Plumbing
Mech y
10-433 00 Plans Check Fee
Building - �
Plumbing
30-202 00 Seater Connection c
30-444 00 Sewer Inspection - --��
51-448 00 Street System Oev Charge (r'.• 1 __ `
52-449 00 Parks System Uev Charge ( ,III' " - --
31-450 00 Sturm Drainage Sys,t Oev Coir 1C)
10-230 09 TRFO - - - -
10-230 06 Washington County Fire N1 (9: -j
10-220 00 Amar-t/Wedgewood
10TAL ��-
RFC M
APPLICANT STGNn111RF
Received By: Date Received: -
r:n/3587P/18P
--j ---- WAMP
,� PLAN CHECK APPLICATION
CITYOFTIVA'rRD CtTYOFn-AR1) PLAN CHECK
COMMUNffY DEVELOPMENT DEPARTMENT o .9m PERMIT I -
u12s&W wa Mod.P.O.Ba■2X47-Ns'-Z!OMOOn 9�=OW)x'11� DATE ISSUED
OB ADDRESS: TAX MA,A/TAT
T:
LAND USE:_��
'ALUATION: SETBACKS: FRONT: REAR.: LEFT: RIGHT: ,
WORK CLASS: HEIGHT: �� TOTAL AREA'
USE TYPE: 4; l - FLOOR LOAD: -_ `�� 1ST:
CONSTR TiTE: IVHF"T TYPE: 2ND:
�iJ _
OP GROUP:
DWELL'TINITS 3RD:
OCCUP LOAD: NO BEDROOMS: __ BASEMENT
NO STORIES: —_ — NO BATHS: — GARAOE: _
IMP SI''R.FACE:
IPPROVALS REQ'D SPECIAL NOTES ITF14S REQUIRED
PLANNING^ REISSUE OF: L'iST/,3UBCONTRACTORS:
ENGINEERING: LAST REISSUE: BUS TAX:
FIRE DEPT.: FLOOD PLAIN/ CALCULATIONS: —
OTHER: �^ SF.N L.NP.: TRUSS DETAILS:
PARKING PT.AN:
LANDSCAPE PLAN:
PLAN CHECK BY: OTHFF:
COMMFNTS:—: -._ -------------«-- _
ACc DESCRIPTION AMOUNT
OWNER 10-432 Building PerrAit Fees ¢ T
NAME• _ 431-600 Plumbing Permit Fees
ADDRESS: ___� 10-431-601 Mechaatcal Permit Fees �
10-230-501 Suite Building Tax (5x)
—� ---�— 10-433 PJAv.s Check. Fee
PHONE: 30-443
30--202 Sewer Connection }
CONTRACTOR '0-444 Sewer Inspection
NAME: 51-°448 Street System Dev. Charge (SDC) s
ADDRESS: 52-449-610 parks System Dev. Charge (PDC) t
— -- 52--449-620 _
-- — --- 31•-•450 ;storm Drainage Syst Dev Chrl;(SSDC) �
PHONE: - — -�_— 10-230-505 -WD (95x)
1.0--435 TRFD (5%) -
ARCH/ENGINEER 1.0-230--506 Washiagton County Fire 11 (95I)
NAKF: 10-435 Washinmton Couw.y Fire 11 (5x)
ADDRESS: -��- r--- 10•-220 AmartlWedgewoo.l =
TOTAL S
PHONE:--- t—• PREPAID -----
RFC /—
BAIARCE DUE —�_---
APPLICANT SIGNATURE.
i,1f
FA
Rticeipt Ar - ----____-,
CITY OF Tf GAf�D MECHANICAL PERMIT Pe(mi( #
D:ccrlptlon' � ~
Table 3A Me0ranlcal Code —_� an PRICE AMT
City of Tigard 1) Permit Fee -0. -o- 10.00
13125 S.W. Hall Blvd. - --
P.O. Box 23397 2) s tnplemental Permit 3.00
Tigard,OR 97223 --- —
639-4175 1 Furnace to 100.000 BTLI 600
incl.ducts&vents
2) Furnace 100,000 BT1.1 + '- 7.50
incl.du(As&vents r ��
Name a oerekhw+he�+ 3) Floor Furnace 6.00
incl vent
St,sperrded heater,wall heater 600
.lob Addi1 ss ^- — 4) or floor mounted heater
Address _ _
�)
r.,r(a Mari tvo. Vent not incl.In 3 t i0
appftnoe permst
ea.* subdivision -
- Narthe(«namc a b<nane551 --- 6) Repair of heating.refrig., 6.00
ding,absorption unit_ --
tMifirhq Address Phone _ Boiler or comp to 3 HP 6.00
Owner abs(rp.unit to 100,000 BTU - -- -- _---
cnyi;torte zip --- 8) Boiler or comp to 3 HP-15 HP 11.00
_ absorp.unit to 500,000 BTU -- -
__ Name g) Boiler or comp 15-30 HP 15.00
absorp.ut Alb-1 million_ _ -_
—_- �- 10) Diilarorcompto34-50HP - 22 a0
tAaainq Ab koss absorp.unit 1-1.75 million -I -
Boiler or comp to 50 HP 31.50
Ctxttradtx C:.;!state u�.__� --- 11) absorp.unit 1,750,(00 BTU___ --
, - e Air handling unit to 4.50
sure Registration 140 Cityo— -- ,y t3<rs Ta
12) 10,000 CFM
Air handling unit 750
her" adknovAodge that I have,.,ad this aPPWabw that twomre
inktmn given I% 13) 1t),000CFM 1' i_ _
mn-rrl.that I am the owner of authorired--owd a the owner,tut IrAn"s wvnitted are an --'Non portable
crxrrrhrurhne witch sura taws.that 1 am registered with the Sete nuitders'Board,that tM 14l 4.50
rrrmher given is comic! (it evefro Pum Stats r• o' •base give reas<.h t•dbw) -- evaporate Cooler
t 5) Ver it tan connected 3.00
- -- to a single dud
Ventilation system not 4.50
included in appliance permit -
_ —
17) Hood served by 4.50
mechanical exhaust
Stgnaaas Irawrter«�I -- =— nate 1 g) Domestic type 7.50
Describe wotlo _ O addition (A 0eration D repair Cl _ incinetatot -
to be done tosidential O non-residential O 19) Commercial or industrial 30.00
--- ----
_type incinerator
Existing use of Other i.e.,woodstove,water '1
Imil ing or properly-_-_- � __ __._ 20) _heater.solar,dotfiesd rs.etc. 4
l
Proposed use of
bttitding or property.- _. — 21) Gas piping one to four otAlets 2.00 �.
Type of fuel- oil C] 22) More than 4-per outlet
natural gas U LPG ❑ electric 1 1
- _
NOTICE ^SUB-TOTAL �---
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON - 50"' SURCt qGE
STRUCTION AUTHORIZED IS NOT COMMFNCEO WITHIN 180 _�__-
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PI AN nFVIEW 2S%OF SUB-TOTAL L
ABANDONED FOR A PERIOr)OF 160 DAYS AT ANY TIME AFTER V TOTAL
WORK IS COMMENCED - — -
Special Conditions