14665 SW 97TH AVENUE-1 14555 SW 97TH AVENUE
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ui II:;AW) MI.*,(;11ANICAL PFI RMF a2-
Cit) of Tigard -- _-�
13125 SW Nall Blvd. ---- -- -_---
I'.U. Box 23397 T,oWe 7A Moch+nb
l"Co • QTY �lIIC[ AMT
Tigard OR 97221
639-4175 1) Permit Foo 0 0.ti 10.00
0 2) Supplemental Pornrit 3.00
Furnace to 100,000 BT-U
incl. ducts & vents 6.00
2) Furnare 100,000 B r + - --
Name, of Development Incl. ducts &_vents 7.S0
3) Floor Furnace' - -- -
Job radr••�- `, C)(A) _2Jl i ----incl_ vent -- - 6.00
`���� �J
Address T.x Lot 4) Suspended heater, will he,�tcr
lip �•
or flout mounted heater _ 6.00
Lot Dlock Suhdlvlelon -- — --
13) Vent not incl. in
• (pf dam• f aln• — v- appliance permit _ - 3.00 -_
/A III g Ad dru 6) Repair of heating, refrig.,
Urrner IG !JLL) cooling, al;sot Pb0n r.rnrt 6.00
citytstite Zip 7) Boiler or comp to 3HP -
absorp. tm't to 100,000 BTU ^� 6.00
8) Boiler or (owp to 3HP-15HP
N�-���'�•n��'I--_ - - absorp_ unit to 500,000 BTIJ 11.00 -
al Adr \ �� Phons 9) Boiler or comp 15-30 HP
� ) ,tA ►'1 _ absorp. unit 4i-1 million _ 15.00
Contractor ptyfsiato np 10) Boiler or comp 30-50 HP
absorp. unit 1-1.75 million __ 22.50
State Registration No. — City But. Tax t,). 1 1) Boiler or comp 50 HP
_ a'.)srgi. unit 1,750,000 BTU 31.50 _
I herety acknowledge that I have read thla rppllcatlon that the Information 12) Air handling unit to
given Is correct, that 1 am the owner or suftwired agent of the owner, that 10,060 CFM 4.50
Plans submitted we In compliance with Sade lows, that I am rogleterod with
the State Builders' Board• that the number given Is Correct. (If exempt 13) Air handling unit
from State registration please give reenon betowl• 10,000 CFM + 7,50
14) Non portable
_ _evaporate cooler 4.50_
15) Vent (an connected
to a single duct 3.00
16) Ventilation system not
Sipnatkl a towner or agent) nate included in appliance permit 4_50
1•/) Houd served by -
Describe work ❑ addilionf'l alteration[] repair U mechanical exhaust 4.50
to be done residential Cl non-residential ❑ 18) Domestic type
Existing use or incinerator 7.50
building or property 19) Commercial or industrial
Proposed use of type incinerator 30.00
bullding or property 20) Other I.e., woodstove, water
Type of fuel - ell❑ neturnl gas l_PG[] electric❑ heater, solar, clothes dryers, etc 4.50
21) Gas piping one to four outlets 2.00 o U
NO". ICE _
THIS PERMIT NU .l AND VOID IF ViORK OR 22) More than 4-per outlet
CX)NSTRUCTION AU7IIU:rIZI:O IS NOT COMMENC'F)vVITHIN tue•ttiTAl_
180 DAYS, OR IF CONSTRUCTION OR WORK IS voSPENDEO 1% lURCf1AROE _ti 7Z
OR ABANDONED FOR A PERIOD OF 180 DA'!S AP ANY - - - -
TIME AFTER WORK IS COMMENCED PLAN REVIEW 25%Of 111110-TOTAL 5Ch
r0TA1
Special Condlllons
_ i►,tin. r..,t,Oft
i, t
l.I IA OI TIGARD ME:CPANICAL IILRMIT
Permit 11 4-1 C
. ity u[ 'Tigard
13125 SW [tall Blvd .
P.O. Box 23397 �Machat"code QTY t114C[ AMT
Tigard OR 97223
b39-4175 1) Permit Fee 0 0 10.00
2) Supplemental Permit 3.00
1) Furnace to 100,000 BTU
incl. ducts & vents 6.00
2) Furnace 100,000 BTU + -
-- foram. of oavalopmenl -- Incl. ducts& vents _ 7.50
_ 3) Floor Furnace
+�ddr►sa incl. vent 6.00
4) Suspended heater, wall heater
J ry b i �. i_ '_ -.,
Address r.r< %a"�— p0.._..�_��.
Lot Block Subdivision
or floor mounted heater — 6.00
�.,._.,..�.�... 5) Vent not incl. in
Nema ( a Hama of/Duslnses) appliance permit 3.00
Malting Address^`�! — 6) Repair of heating, refrig.,
Owner . , cooling, absorption unit 6.00
Cftfistate Zb 7) Boiler or comp to 3HP
absorp. unit to 100,000 BTU 6.00
Hams , 8) Boiler or comp to 3HP-15HP
absorp.
_ unit to 500,000 BTU 11.00
Mslling Address Phone rj 9) Boiler or comp 15-30 HP
- _absorp. unit W--1 million 15.00
Contractor .r/Sta1e I - t ZIP 10) Boiler or comp 30-50 HP
absorp. unit 1-1.75 million _ 22.50—.--
State
2.50 `State Reg1 ratlon No. city Bus. Ta. No. 17) Boiler or comp 50 HP
absorp. unit 1,750,000 BTU 31.50
I hW---Iy acknowledge that I have real this application that the Information 12) Air handling unit to
given is oorrect, that I am the owwr or authorized agent of die owner. that 10,060 CFM 4.50
ptans submitted re in comph�norr with Stale laws, that I am registered with
the Stale Builders' Floud, that the nu-nuer gtven Is correct. (It exempt i.3) Air handling unit
from State registration ptes9a give reason below). 10,000 CFM + 7.50
14) Non portable
evaporate cooler 4.50
15) Vent fan connected
--_ - ------- - to a single duct _ 3.00
16) Ventilation system not —
Signature (owner or rrgonti Date —_included in appliance permit 4.50
17) Hood served by
Describe work� ❑ addition❑ alteration® repair❑ mechanical exhaust 4.50
to bo dome - residential ® non-residential ❑ 18) Domestic type
Existing use of incinerator 7,50
building or properly . r.- fi f 19) Commercial or industrial
Proposed use of ` type incinerator _ 30.00
building or property 20) Other I.e.. woodstove, water
( Typo of (tial — oil❑ natural gases LPG[-] electric(-) heater, solar, Clothes dryers,etc 4.50 _
21) Gas piping one to four outlets 2.00
NOTICE
T► ;S PERMIT BECOMES NULL. AND VOID IF WORK On 22) More than 4-per outlet t�
sY'RUCTtO'N AUTHORIZED IS NOT COMMENCED WITHIN — _ _ SUN-TOTAL rl.
1(;,') JAY! OF, IF CONSTRUCTI,DN OR WORK. IS SUSPENDED f 4% SURCNARaf
OR ABANUONED FOR A PERIOD OF 180 DAYS AT ANY -- ----- -- —
TPL/,NREYIEW2510OFtlUt3-Tf/TAI
TIME AFTER WORK IS COMMENCED. t I
_—TOTAL
Special Condit:(-as
ADDRESS. /'�G�/r ; , �, Q:> ,� .__..� PERMIT N 0.
PERMIT CHARGE none
OWNER � CONNECTION FEE
� II
PAID BY
TYPE OF BUILDING ����,� DATE CONNFC7ED
SERVICE RATE INSPECTION FEE
CONTRACTOP PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
f --. _...........................w.....��...............,...__._. :a.xa�uc„+.ia."ts°strtfE•d�;.:_,... ..._.
SEWER PERMIT V •<,
4 13880
Unified Sewerage Agency
of Washington County C I T Y OF T-.a2? DATE ].-14'7
OWNER : --- Waverly Const.
PHONE :
OWNER 'S ADDRESS:
TYPE OF INSTALLATION,
xN UILDING SEWER u BUILDING SEWER AND SJDE SEWER
,,TTV�,,Yv
TYPE OF OCCUPANCY,
> EW SINGLE FAMILY [:] COMMERCIAL
❑EXI! T . (PRIOR l0 7-1- 70 ) MOLT. RES.
INDUSTRIAL
L
FIXTURE UNITS — DWELL ING UNITS
PERMIT CONDITIONSs THE APPLICANT AGREES TO COMPLY WITH I-LL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHCN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBUR . THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( l20 ) DAYS . THE AMOUNT PAIL WILL
BE FORFEITED SHOUT-D EXPIRATION OCCU)p .
FEESs
PERMIT FEE E 25.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION
nTHER
ISSUED BY
1 ' TOTAL E 525.
fF A N 1” DATE +-
IATICE: OF tyE
ABOVE RATE, SEWER kIERNICE
CHARGE WILL BEGIN FOP THIS SEWER PERMIT N"PER
,411T-
ADDRESS OF STRUCTURE 14665 SW 97th -A St
TAX MAP TAX LOT SYSTEM _
LOT 8 BLOCK OF
APPROVED BY DATE ISS ' D E3Y DATE
REMARKS__bldg. #1850
CITY OF TIGARD
� ORDINANCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE=
nc
DATE : , ��?�� � ESTIMATED SALES PRICE
APPLICANT NAME TELEPHONE
JOB ADDRESS - BLDG. PERMIT #
AMOUNT OF FEE FOR P. D. C .
i � •
DESCRIPTION OF IMPROVEMENT
i
I
EXEMPTIONS PER ORDINANCE_ #77-71
FEE RATES:
A. Single family dwelling unit under. �iCl,OUO.----------- --� 75. OD
B. Single family dwelling unit over $40,000.----------------S100. OU
C. Mobile Home Court Space (Neu Devolupment)-•------------- 50. 00
D. Multi.-Family dwellings--per unit---------------- ----- 60. 00
CONSTRUCTION IS LOCATED ON S.O. SIDE OF S4V. PACIFIC
HIGHWAY . N.W . is Park District #I. 511. is Park District #II.
Y
CITY OF TIGARG
ORDINANCE 7177-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE : ESTIMATEC SALES PRICE S :
APPLICANT NAME ^ (i.t. .:, .lc TELEPHONE
r
JOB nDDRESS BLDG. PERMIT
AMOUNT OF FEE FOR S. D. C.
DESCRIPTION OF IMPROVEMENT L
r
EXEPIPTI9NS -PER ORDINANCE #77-26�_
FEE RATES:
A. Single family dwelling unit under $60,000-----------
B. Single family dwelling unit over $60,000.---------
C. Mobile Home Court Space (New Development)----------- $.150.00
D. Multi-Family Dwellings--per unit------------------- $'2Q0.00
E. Commercial , Industrial h Institutional(Park,. Space) 5 50.00 each
F. Single Family unit under $40,000. ----------------- $250. 00
r ie r r r r
BUILDING PERMIT APPLICATION 1OF
1T TIGARD DATE__
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE__
LOT NO._
S?wr _Eft 3kfarly Const♦ }OB ADDRESS 1,419565 5IJ 97th HOME ADDRESS /�/_ r6- 6,39
ARCHITECT
ENGINEEI �`3 9
BUiLDER _ADDRESS _ DESIGN_:I
STRUCTURE ❑IQEW _ ❑REMODEL ❑ADDITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV' ❑REI_'GIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING_ ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUP; '4CY I .LAND USE ZONE H~ BLDG.TYPE FIRE ZONE PLAN CHECK BY stw _ HEAT---_
L.1i1 pit; iiinyjc: mil d:r&11if.16 W,/HL`_aLhed Lt�t, rj0e —._. 4 -jagroup 4 ,,,LP --
rrlul-Irlrittinrl rayuiratd fol all ovar 0461me s-i vrr g 18" above i.,round Ji u.L- - -
ail NO.�TORIE$ AREKNO.BEDROM —VALWf
BUILDING UEPARTMENT SET BACKS FRONT REAR 1: _ LEFT SIDE LU RIGHT SIDE
Permit 137.U('
_�_ — —• THIS PERMIT IS ISSUED SI!^JFCT TO TH[ REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— -- WORK WILL.BE DONE IN ACCORDANCE WITH THE L`LANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal In ALL APPLICABLE CODES AND ORDINANCES. 1HE ISSUANCE OF THIS PERMIT DOES NOf WAIVE
—"-- RESTRICTIVE COVENANTS, CONTRACTOR AND :UB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PEFhtITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Total ,.,.ce ;0.
tr1 0100. .
BV
1 —_--.- -.--- -- APPL(:ANT OR AGENT
Approved Rf-ceipt No A. w(�
—�
DATE INSP, TYFE INSPECTION / REMAAKS PLUMBING DATE
Contractor
[(Jzs ;X_ Permit No. / '0;7T7
af� All _�y�—Y Rou h-in
_G Fixture_
Final
HEATING
J ContY0!r
Permit No.
\J V
– _ Gas or Oil
—
Rough-in
Final
_ SEWER
----- Final
_ -- DF IVEWAY
Final
—__ Storm Drainage
(Rain Drain) Final
___ — --- Sidewalk
Curb&Street Final— -
- Approach _
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final �.
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City of Tio- rd an Permit N9 Parmit_ sLO0 _
Fee
New Installation Q°=r:ete ❑ Relocation ❑ Add ion ❑ AlttfStiOtt :J tate_��
TOTAL
'C-?;TRACTOR _ 0A ER
ADORM -4 WORK ADDRESS r--
PHONEAPPLICANT
Heat Inpu. Rating (BTU Per Hour) —� Vent Size Flue Size
FUr_L OIL EJ GAS ❑ ELECTv OTHER _
IT= NO. FEE ITEM NO. FE
-3 For Issj_ancc o' Permrt _ �T_ -_3.00 �_ Air Condition Compressor 15 to 30 HP 10.
!� New• Under 100,003 BTU — j —�� S.UO ( Air Handling 10,000 CFh4— ^ .
New• 100,000 9TU & over __ 5.00 Air Handling Over 10,000 CFM 5.'
Floor Fumac► _1 4.00 - - -Evap z native Cooler r 3.
Wall • Floor
Suspended _ _ _4.00
Range Vent Fan --� 2.
Install Vents Only _• _ ( _ _ I 2.00- Ven:System �- 3
Repair • Heat & Cooling _ _ --�-- _T -4.00 -_Hood Commercial 3
Air Condition C_ompr:ssor, Under 3H _Co'nmrrcial Duct System
C:oniitsor 3 to la ion CompresH.
7;50
Air
INSPEC-rOR'S _
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS C Il SUB CON S
A•'PPRO�•ED RY_ ..•_. DATE - .. ___ ISSUED BY �_--- -- DATE