15275 SW 94TH AVENUE 15275 SW 94TH AVENUE
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ADDRi PERfi1T N0.�1�
,��((�� / PERMIT CHARGE none
OU%ER d.L_ � CONNECTION FEE
PAID BY
TYPE OF BUILDING AA4J• DATE CONNIECTED _
SERVICE RATE I� ' �� INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE. OF CONNECTION __ _ ASSESSMENT PAID
■r +� � n lar � Iloe ® r!r Ir
1 C � L `/ 0 � 103 {-Q l�ft'll)i�l'1)LC7� �'t"iiT�)C � �� te::nit _ --J:UU
1 � ►
N>r. (RS ,� ullOn V se.-)!a.0 Relocation L_J cidl;'.on �t l.�l`r�llOn 3 �t�.X'ic$:7t"
\ TOTA L---r - '�--
C^
TRACTOR �� �, ��.A. ti c Fi _��►4 �1L1-•SJ��I.� �_
.T AG -
�F.c _-33.E --' r- �- '��� -- _ IVORY, ADDRESS
AD ��Z`�S_ 1L.-
APPLICAtJ
PHONE ___- — —
Heat Input Rating (BTU Per Hour) ue-ICZEj Vent Size _ _. —� _ FlSize
T-
E�.
FUEL OIL ❑ GAS Fv� ELECT OTHER
ITEM NO. FEE ITEM NO. FE
For Issuance of Penni, I �L-_'-T 3.00 Air Condition Compressor 15 to 30-HP---
4.001 10.
`I Air Handling 10,000 CFM _) _ 3-
�+ New 100,00^ 6TU _ l_
New- 100,000 BTU & over �- S.OU ''Air Handling Over 10,000 CFM '-��^^_.._-I 5-
- _Floor Furnac^ 4.00Evaporative Cooler w
60 Range Vent Fan
• Suspended 4, r "'`�-"-'------�-?•
Install Vents Only 2.00 Vent System _
r• -
Repair - Heat & Cooling _ +4.0_0 Hood Commercial 3
' - 4.00_ Commercial Duct System 10.
Air Condition Compressor Under 3 HP _ — _
yt.!.. 7.50 ---------_� _. �.�
- rXir Condition C .mp(essor 3 to 1! _J_- _
.:42!" INSPECTOR'S
CITY BUSINESS LICENSE RFOUIRED FOR ALL CONTRACTORS OR SUB CONTRACTORS
I�;:V: ISSUED BY TE
•'ic APPROVED 8Y DATE _ -- -�i!• - ),J/ —
'_ RECEIPT NO. _�_-------- ��
Signature nt Ap
a; »
_ ......` T...�-�w...w.w.ter++-..-.......r.w++..•�e.�w. :.s�a.•o-e+�•^nrvt�w(.wr 1AViY•
er �r tWIWWA
City of Medic �t C��1 hTC7 Permit---_--s'-00
Fve
New Ins,allat on ea!ace ❑ Relocation ❑ Addition Al;era'.iol, 4%%saw----
CC N TRACTOR _ t,u�2ti, k . r,�,�b�� _� G'- 011'Nc _ 111.+.4r�ti _���.►. ��..-
Ai)r)RE.SS _ {�. �"1j�; 15L�Ar'��' WORK ADDRESS."CA_ t-
PHONE der j` — CS��,+�i APPLICANT_
Heat Input Rating (BTU Per Hour) �L►�nj � Vent Size �"•r� _- _ Flue size --- _
FUEL OIL G GAS IH ELECT ❑ OTHER_
ITEM NO. FEE ITEM NO. FE
For Issuance of Permit _ 3.00- -Air Condition Compressor 15 to X HP 10.
New- Under 100,000 BTU 4.00 Air Handling 10,000 CFM
New• 106,000 BTU & over 5.00 Air Handling Over 10,000 CFM _ 5.
Floor Furnace �e 4.00 Evaporative Cooler 3.
Wall • Floor .Suspended 4.00Range Vent Fan _ 2.
Install Vents Only 2.00y _ Vent System 3.
Repair • Hea & Cooling 4.00 Hood Commercial _ 3
Air Condition Compressor Under 3 HP _4_._00 Commercial Duct System 10
-Air Condition Compressor 3 to 15 HP 7.50
INSPECTOR'S COMMENTS__
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS r
APPROVED BY DATE ISSUED BY' DAT
RECEIPT NO.
i. I f
JOHN E. REIPtMARDT BUILbING DI`PARTIVIEW', 'I IC3ANU
PLUMBING
P.O. BOX 129 PLUMBING; PEWIT NO.
t
NFWRFRG. OR.97132
_ , holder ul a valid plumbing contractors licewic is hereby
auttiorizc.d to cause plumbinq work as herein nutud to be installt',d in accordance with Ov, phiml-tily,l curie of
Tigard. Such installations require inspection by the City Inspector who shall be nolifiur !tut u,ti Oi,m four
(4) huurs prior- to the time the installations are rp:uiy for inspection. Cliy of Tigiml Bu moss Lirense required
for all contractors and slib-contractors.
Owner._ ..Q(LI7nir��/a// J7?•
NUMBU14 OF Y_. 10TAL _PFHMIT NU:5 _
TYNE OF PERMIT �y ITEMS _ rFG ON 8ACI1 AM()I1N'r (Utfice Urn Only)
AL
811I8111gIt Paul I -1 bath-aech 7g nn a5,00
Du lex-Each 1 bush unit
Additional bathrooms-car!, J _� � 10.b0 0�6�
Mobile Home S e_a.each -
INDIVIDUAL FIXTURE FEES - --- - -�
1 to 50 Flxtvral In t bulld.ina-each ;1 Dtl
61 to 100 Fixtures
101 to 700 Finzures in 1 Lulld1n9-each_ _
701 or mnre rlxtures Iii 1 '�uhdlny_eech 1 gp
MIllCELLANEOUS
„_,_Building Sewor 1st s0 -
Sewnr-each eddltional 100 ft,
Water Servile to building _ _ 8.00
Private Water 3 ttemi--etch 100 tt_._.._..__Y_ 10.00 i
-cith r j8pulfy):
PERMIT y�-' ,DO �FFor Plumbing IHN)ecKorl Phone 639.4 191A11p
% state J 7p, , D Plumbing Contractor C
TOTAL (a. RECEIPT NO, Issuttd PY
BUILDING PERMIT APPLICATION 1OF
1T TIGARD DATE._._ 10/4/
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE,
OR AS SHOWN AND APPROVED IN THE-ACCOMPANYING'P//1�.Q&NjS� AND SPECIFICATIONS, OWNERPHONE'
X5775 S'Ca� 97`= yam- LOT NO. f1
ONER , Lra:ii tiro_LE V J� JOB ADDRESftt-7M`• �a r �� ��" H
WOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS _ DESIGNER
STRUCTURE ❑NEW ❑RFMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE DCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGF❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE _❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_____ `LAND USE ZONE—_- ( -BLDG. TYPE FIRE ZONe'—' _ PLAN CHECK BY�._I HEAT_,
` l°f �rlLt'ti »tit]. -'s.-iaGue Aamu as1l 1 ;,%:, SIJ i;ruattleaf
rramat.i Townhoutis w/%tt*Uh*d oveyr. _
�alutwr Ffw;mit +11443 a $15,V,.00 _
1 ,349 46� '�,�4(9. (.�I
Q>i�.,LOAD __FJS2S�F1J 4AL) -�.__HtilSitiY _.._►�9 $.___ _—_- ANO-8
BUIL()ING
O.BBUILnING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 00
THIS PERMIT IS ISSUED SUBJECT 10 THE REGULATIONS CONTAINED IN THE BUILDINCtr;Obt, 7.ONING
Plan Check )'0100 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND Il IS HEREB`: AGRELD-7HAT THF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI'ANCE WITH
Sub-total j .j4.01) ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF PHI'S PERMI'P DOES NOT WAIVE
-- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 7.36 LICENSE SEPARATE, J P p7TS REQUIRED FOR SEWER, PLUMBING AND HEATING
..__-
Total i4ijL #2 - 1t1G1.t'
By al
----- APPI WANT OR AQFNT
Approved !_.IJ4:1...Jan Receipt No 999
d'o
car
\\DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
'C C- / �---- --- _ Permit No.
Rough-in
-- — - --- — a:fir
06 jr_ Fixture
Final
--
5—�79HEATING
Contractor p
_--� ---, `_— Permit No.
Gas or Oil 'L•
Roughoin
Final ---
SEWER
Final
DRIVEWAY
Final
Storm Drainage
--__— _ — (Rain Drain)Final
Sidewelk —
_.______— Curb d Street Final
APPr 3ach
BLDG.DEPT.FINAL TETdPORARY CERTIFICATE OCCUPANCY Final
Landscaping
OCCUPANCY
Landscaping
--� !�- Zoning Finat
i
I
i
BUILDING PERMIT APPLICATION cOF TIG RD DATE_____ Q
�, � �, .?-�.. gig.�� N_
'F IINDE R I(;NED HEREBY APPLIES FOR APERMIT FOR THE "EFRIIEIN INDICATED BUILDERPHaN W----AS SH01h'N AND APPROVED IN THE ACCOMPA YIN FCIF CATIONS. OWNER PHONE _,_
_ I.S .7 LOT NO.- CQ J�1-
�� JOB ADDRESS I —.� •_ME ADDRESS
ARCHITECT
ENGINEER
P. _ ADDRESS ----- —•— DESIGNER—I
01, W --
WQREMODEL— QADDITION —�QHEPAIRD_RENEWAL IJFIRE DAMAGE QDEMOLITION
Y I NCE ❑ /,I'AM ❑EDUCATIONAL QGOV'T QRELIGIOUSOPATIO QCAR PORT QGARAGE Q STORAGE QSLAB QFENCE
+'?NO (]NICIVING _ QCONDITIONAI USE - QDLSIGN REVIEW_ QCOUNCIL APPROVED QSIGNS _
NCY _ r-ND USE 70NEABLDG TYPE�_!_L� __FIRE ZONE. PLAN CHECK BY -
-
r : I AuF 104�►3_1529�-- iSz►iL _ NSt_$IORIE� ---_ AP�B�� 7�SLb�QROOMS VALUE ZO/`53�
BUILDING DEPARTMENT SET BACKS FRONT — — _-_ REAR_ LEFT SIDE RIGHT SIDE
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
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANDSPECIFICA'IONS AND IN COMPLIANCE WITH
til, lolal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF "HIS PERMIT DOES NOT WAIVE
---- ----- RESTRICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I;,I, Tax
�v -_ 3G LICENSE SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AN') HEATING.
T(,tai
APP ICANI OR A NT
Retelpl No.
00
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