12920 SW 107TH COURT XRAWW
12920 SN: 107TH COURT
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A d d r /-19.2 4) ► �_� J /D �� �I permit No.
Permit charge
Owner . alp .1G1-- J�'�,c� Cannbcti on f as
[2r�cGu
paid by
Type of bciljing _ _ Det@ .jnnectod < <
Service rate litepection fes
Contractor Paid by date
Site of c a n n 9 c t i o n Aeeeeanntnnt _ __ paid
Ili
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
DATE: a71-21 DATE ISSUED'
--1--J—.-
OWNERS NAME :
ADDRESS :
._�'�- ---
_._
CONTRACTOR :
TEST A.r ,A7 , Water ❑ , Visual , L.a',, ,rotary [1 -.......
Disapproved 1 Pending
RESULT: Approved }�, pp 9
.__..
SKETCH*
I �
I INSPECTOR DATE
ICOTE: Attach supplemental feet data heret-
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City of Tigard
INSPECTION REQUEST 1
for
SPECTI ON TIME : /10 � PERMIT NO. .--
D ATE
O. .DATE: —11-211
2' DATE ISSUED :.__L—Z— I
JNERS NAME ' --
A D D R E S S
)NTRACTO R
.ST . Air LI, Water ❑ , Visuaix, Laboratory (] i
=SULT : Aporoved Disapproved ❑ , Pending L]
►ETCH
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7
INSPECTOR DATE
YE : Attach supplementrl test data hereto?
i
City of Tigard
INSPECTION REQUEST
l
for
INSPECTION TIME: � _ PERMIT NO. :--
CAT E:
O. :DATE: —.(¢ /,)Y/' 7 DATE ISSUED :
OWNERS NAME .
C 0 N T R A,C T 0 R -
—
TEST ' Ai! ❑, Water❑ , Visual [1 , Laboratory ❑
RESULT: Aporov 1 ❑ Discpproved ) Pend;-ip p
SKETCH.
CO f 4A)$,or NOW 10 Q a ✓��i� to
0 60aTW, l�'b Tiro r �t„s
�9+eow �400A
(I A i71 c, S c u7T 4Ar T 0 k�ua
'N
INSPECTOR DATE
COTE Attach supplemental teat data beret
City of Tigard
� 9
INSPECTION REQUEST �
for
INSPECTION TIME: �•
ERMIT NO. :- I
DATE: DATE ISSUED :---/--Z—
OWNERS
SSUED :.,--L_LOWNERS NAME :
ADDRESS:
CONTRACTOR :
TEST : Air p Wotcr � I
❑ r visual Laboratory p
RESULT: Approv`d �/" Disapproved ❑ 1 pending p I
SKETCH. I
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7" p° ti
INSPECTOR DATE I
50TE: Attach eupWemental test data beret]
� � a► wr � � s �►
I City ity of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
I DATE : �/,-71 ?V DATE ISSUED:._ 1.
OWNERS NAME : Lkzc&L4J
ADDRESS :
CONTRACTOR :-----
TEST'
ONTRACTOR :________.._______TEST: Air 0, Water U , Visual ❑ , Laboratory [l
RESULT: rapproved 0. , Disapproved El Pending J
SKETCH'
I
I
I
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I
INSPECTOR DATE
I
:NOTE : Attach supplemental tort dota heret]
1
I
Cit of Tigard
gard
INSPECTION REQUEST
for
INSPECTION TIME: i; PERMIT NO. :
DATE: DATE ISSUED : L_
OWNERS NAME :
ADDRESS: J, /V� ; I
CONTRAC'rOR : G1•
TEST ' Air n, Water[] Visvolp , oratory Lob p _ I
I
RESULT: Approved ❑ Disapproved p Pending p
SKETCH:
i
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I
INSPECTOR DATE
LNn7F Aftoch suCP!ementol fest doto bereto� I
J
City of Tigard
INSPECTION REQUEST
for
! INSPECTION TIME :- _ r ERMIT NO. :
I
DATE : 5-"'L DATE ISSUED:.._LL_
I OWNERS NAME, KZI( --
I ADDRESS
CONTRACTOR :----
TEST'
ONTRACTOR :TEST' Air O, Water �� Visual l?�, Laboratory ❑
RESULT. Approved , Disapproved O , Pending ❑
SKETCH:
L ^
I
�. NSPECTOR DATE
I �N0TF At och •upplementol t> dgfo hnlet�
CITY OF TIGARD MECHANICAL PERMIT
-��/ PERMIT NO. _Zy 9� /1'1 RECEIPT NO.
DATES' - ----f--- ,
• FEE ��.O�
BY -
1. Permit shall be obtaine3 prior to c'ommencemerit of installation:
2. Permit .shall be obtained for all appliances which are to become
a fixture to the building.
3. Relocation, replacements, alteration, or changes to burners and
duct work require permits.
4. All work to be concealed, must be inspected before cover up.
New Installation Replace ��- Rel-ocation ❑ Addition ❑ Alteration ❑
GONTR.� �� L---�� tL .�
ADDRESS _ _ _ WORK ADDRESS /�q2a-5al-la2LC
APPLICANT
TELEPHONE NO.
FURNACE - TiANUFACTURER _ _ � TELEPHONE NO..
HEAT Input rating -�(Btu Per Hour) Vent Size Flue Size
FUEL OIL ❑ GAS U ELECT OTHER ------
TOTAL SQ. FT. Top Floor Main Floor _ Basement��
ITEM N-3. FEE
ITEM N0. F)
For Issuance '.of Permit x.00_ Boilers Over 50 Hp _
flew - Under 10_0,_000 Btu 4.00 Air Nandling 10000 CFM _
New -Over 100000 Btu _ �Q Air Handling Geer 10000 CFM _
Furnace - :00 ^Evaporative Cooler _
Floor Supper e -� x+,00 Vent Fan _ _- _Z
WiAll --Floor,---------•� �_Sya ern
Xfi8 a I Ven L8 _
Bair - Heat & Cooling _ OOr Hood
}3oilers_Under 3- - 4.00 '~Domestic Incfnnerator
Boifi 's 3 to 15 HQ 7. 50 Y Comm, Incinerator 1_U
boilers l to
`30Hp 10.00 Other NoL3 std _
Bo 11 e r s 3-- Oho -50 00 _.x`
INSPECTOR I S COMMENTS
07
APPROVED BY _ DATE _ _ _ _ ISSUED BY DATE
ignat; aof App icant
City of Tigard
INSPECTION REQUEST
for
INS.')ECTION TIME : 3:04 PERMIT NO. :
tL �/
DATE : 7 _ DATE ISSUED:---/----Z
OWNERS NAME : -
ADDRESS :
AME :ADDRESS :
CONTRACTOR Ei1JliVSc�G,� PL16C
TEST" Air O, Water p , VISJGI 0 , Laboratory p
RESULT: Approved ) , Disapproved O , Pending Ll
SKETCH:
jr 06 d5�
INSPECTOR DATE
DOTE : Attoch supplemental test doto heret:01
UNIFIED SEWERAGE AGENCY +`•111
WASHINGTON COUNTY
CITY OF- I!
F_ _
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER �1s� ilp.,�/./ , At J
/7
OWNER'S ADDRESS els 1
.� zk)
SiREEi �/
ptry nett top
B!IILDING SITE: LOT- 3� BLOCK ADDITION
TAX LOT NO . TYPE OF OCCUPANCY
ADDRESS / a� .� GU / D `1 C-t C 4s._O'
r V
DWELLING UNITS FIXTURE UNITS
SURCHARGE IF APPLICABLE
of
PPRMIT FEE------ .... INSPECTION FEE �S TOTAL DEPOSITED sat' S
C(NEWT (EXISTING) BUILDING SEWER SYSTEM
The Applicant agrees to comply with all rules and regulations u! the Unified Sewerage Agency
O
APPLICANT Qu A-�
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM,
LINE SIZE rr INSTALLER
RECEIVED BY
.A ENCS on I1R Aqf to
COMMENTS
This Application and permit expires in rimety (90) days. The -.,- —+rt paid will be forleitod
should expiration occur.
CITY OF TIGARD
+;UO S W Main S1rw/
t fGARD. ORE SON 97113
APPLICATION FOR BUILDING PERMIT
New Construction X Demolish ❑ Addition l_.J Remodel 0 Move ❑
ZONING_ _� _ -- DATE ISSUED -_--4-a3-14 BUILDINGPERMIT -
DATE RF.CEIV)rD AUILDING FEE $
CHECK /,S't'y NO. �!/��
_ —. a `I
BY PLACHECKs � -
�—
--- OTHER §- d&eo iLlreep'A"C- VALUATION C-'7U_,
TOTAL --7 ----��i, ,I#It- RECEIPT No.J0,0_4v
-it ph
TMC` SETS of PLANS AND PLOT PLANS MUST PF. FURVISHED WITH APPLICATION
LOT 1-, MAP /-- CENSUS 'TRACT JOB
Architect or Engineer f3it'� i'L/E,e'__
Address Phone
Address 6 SL&a __._.Phone,.YQ.6 -ya�
Builder
Address
y .�--•--�-__----- ------- -- Phone
BUILDING USE Single Res. Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP /. _ No. sof Stories 'total Height—- Area of Lot ___
Type of Construction I II III IV `I) Floor Area B -. 1�(r� 2
Set Backs: Front Back L.Side_/_6 R.Side
Private Sewer Pipe Size �" T SewerllsAT1C�It�7 Septic Tank l�
Mater Service Pipe Sino �V _ Storm Sower Ditch ❑ Drywell
Street and Curt Requirements
Driveway Width - -�((� No. of Parking Spaces
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS A�SIGNED� O
FIELD CHECK BY DATE
PE.RMiT A,'PPOVED BY f
It is understood that all work will conform with applicable nodes and ordinances
of the State of Oregon and the City of Tigard, oregon, and that the building will '
not be oc,:upied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inrpector.
99na urs o ;;p can --
'I
Permit Issued-------- CITY OF TIGMx RD, OREGON T remit No.-
City :-fall
Application Approved Building Department Cost of Installation_-
By_—�`------ Fee for PermitQ�
Applicant shall fill in cost of installation only,
Date_ above this double line. Street Sewer Permit��___
repair Plumbing Pipes or Fixtures according to plans and specifications and
Application is hereby made to alter
install description as given below:
q a
Location of building--Number and Street / l_ 4 49---T,—W. Q 7
Lot Block----- _I_ _.—_�AAddditiion.__ __PA_r- j `9��DPS____
Name and Address of
Name and Address of Plumber_/��'&es-__V-j�—ys�/�_ .-
Building (Old or New)____ _ __ Height in Stories _ _� _ Occupied as____ 1 Cl _
SCHEDULE OF WORW
NUMBER NUMBER _
FIXTURES New Move (R'pl'ce _ FIXTURES New I Move I R'pl'ce
Water Closets e . Fountains, Drinking_—
e
Rath Shower._ a' — Fountains, Yard— ,.
e0
Bath Tub — ' _ Fountains, Soda___
Basins ._. n Hot Water Tank
•
Sinks, Ordinary_.__. A• _� __-- _ Sinks, Bar _
Sinks, Dishwashing __ — Sinks, Slop—
Automatic
lop—Automatic Dishwasher e _ _._ Drains, Refrigerator---
Laundry
efrigerator _Laundry Trays Drains, Ice Box` _
Drains, Floor`..___-_— Urinals
Drains, Area.—___�_ _____ _ Catch-Basins, Yard_.
Rain Drains—---, _.. Cr.' :.-Basins, Garage —
Z 00 / Catch-Basins
Automatic Washer. ___L� , Sub Soil—
i
Water Permit No. — ___ Bldg. Permit, No..
REMARKS:
IMPORTANT I—Plumbing shall not be installed In any building, (either new, altered,or repaired), except as shown or designated
on the corresponding building plans as filed with, or reqyuired by, the Building Department in accordance with the
provisions of the Building Code and Ordinance 62.19 of fha City of Tigard.
repair the pl s�slrm according to this description, plans an ecificatlons and the Plumbing Code of the
1 agree to filter City Tig d.
install
Plumbing Firm_.__
Supervisor --
I. '