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INSPECTION NOTICE
City of Tigard Building Department
12420 S W. Malo St.
Tigard, Oregon 97223
Phone 639-4171
Permit
Type of inspectionThe following Building Code deficiencies are required to be corrected:
-✓ -
Presented to__.-.-_----_ _------------------- ---- lnspector --.--
Date --
(ALL FOR REINSPECTION
❑ VES ❑ NO
1 '
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.417'1
Address / s < E` Permit
Type of Inspection --— ----- --- ----- - __ —
The following Building Code deficiencies aro required to be corrected: ._ _�.� '' _ •'
Pretented to _—.—. Inspector
Date
CALL FOR RFIWFCTION
❑ VES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.4171
Permit $
Type of Inspection
The following Building Code deficiencies are required to be corrected:
Presented to - - -- - ---- - -- - - -- Inspector - — - ---- -- -- -- - - -- - - ----
Date
C4LL FOR REIWEGTION
❑ VES ❑ NO
11
Noll1
BUILDING DEPARTMENT, 'TIGARD
�/ PLUMBING PERMIT Nn
holder of a valid plumbing contractors licerlse is hereby
authorized to cause plu king work as here;n noted to be installed in accordance with the plumbing code of
"figard. Such installations require inspFr-'inn by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business license required
i for a!I contractors and sub-contractors.
• � { � Job �,�t5w /�3,��
01wner �Lx� L/�t Vu4.� _ Ad_dress- Date__
NU ITEMS TOTAL
ITEMS r
TYPE OF PERMIT FEE ON EACH Atr10UNT
1
R E$j_P3_N_ZIA I_
Sir. Ig a Family-1 beth—each __ _ _ 25.00 KIK
Duplex—Each 1 bath unit _ —__ 25.00
Additional bathrooms—each _ _ V 10.00 __ f
Mobile Home Space—each _ 15.00
INDIVIDUAL FIXTURES COh1P1ERf,1__A
Ito 50 Fixtures in 1 building—each _ V 3.00 _ ;h
51 to 100 Fixtures in 1 building—each _ — __ 2.50
101 to 200 Fixrures in 1 building—sash 2.00
1` ! or more Fixtnr s in 1 bulldin -�— — _— —^ 1.50 -- � --`— l
_20e g—each. _ — _ _----
M1IISCELLANEOUS
Sewer—each additional 100 It. � .� 10.00
'Nater Service to building_ _ y 5.00
Other 13n+c4y►. ---
_ I
_FERMIT for Plumbing Inspection Phone 6394171 I i
4—Stat' Plumbing Contractor By
���.
•^�Txl Ot•/'O Ir1Y �Ir1 1.......1 v,.
i
I
i
BUILDING PERMIT APPLICATION TIGARD DATE_.__ -_Viij 3393
THE UNDERSIGNED HLREBY APPLIFS FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
QR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
\ LOT NO. +`�"'��
�7WNcR Q1Et;y Q06111.. - nEltQaADDRESS 12150 Sul 123rd r.Ourt 'Jrldmill
same ADDRESS-121F,0 S6.' 123rd Lt. DESIG�
B�IILDER Piercy far lay
— --- -------
STRUCTURE ®XVEW ❑ REMODEL ❑ ADDITION ❑ REPAIR RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
U RESIDENCE O COMM ❑ EDUCATIONAL ❑ GOV'7 ❑ RELIGIOUS ❑ PATIO l CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R-3 LAND USE ZONE 0`7—SLDG•TYPE �JN FIREZONE_—_ PLANCHECKBY _ Uh HEAT_ s_
Construct sirlala family fjWe11in W att ached 3r8e• 4 [iodruoms 3 baths.
SEE CORRECTION SHECT ACTACHEO.
aru a
SEWER PERMITk 2040=�750.00 491 s_ f t�__.Q--� �L� # __.—_ ---
JCC.LOAD FLOOR LOAD 40 HEIGHT _12 NO.STORIES— 2 AREA_t:i b7 N0.BEDR_00_M_S 4 VALU%60 0 500•
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 4h LEFT SIDE RIGHT SIDE 7
Permit w2 9•au THIS PERMIT IS ISSUED SUBJEUT TO THE REGULATIONSCONTAINEDqN THE BUILDING CODE, ZONING
REGULA'!IONS AND ALL APPLICABLE CODES AND ORDINANCES. AND 11' IS HEREBY AGREED THAT THE
Plan Check 104• 'aO !WORK WILL Bi DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH A'..L APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-iota! X13•all RESTRICTIVc COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
4 LICEN£-E.S'cPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 8,30
- SDC- yuui.l.lilJt
Total °6321.8
PDCM .I ,1 00.(30 A--P-��ANT OR AGENT
By -- P 1
- ----- dW h Receipt No. PHONE
Approved _ .---
I.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
n Contractor
21-1Lv - ------ Permit Nr. �3 I --- .t�0 /67-
l p ool� —
�•�- CO.) �lC �4-� .�� A�wie Rough-in _--- --
d� ---
�� final
k0 /-O�� /ilrwt�/ti Ulr ._— HEATING
_ Contractor
fir' /-•z y fi —�^�� sny._ e_C. --
1 PrrmitNo. �Q�� �,32 /0 -6-Sra
///��2L_}Q �cJ� �/1L.�CJL•w� �,t I O`/-1 d -- Gas or Oil -- ---
'�7�� Rough in -- ---
/d, Final-- ----
S �� r •L- - -- —-- -- — S'E W E R
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk ----- ---
-wh A Street Final
Approach
B11-DG.DEPT.FINAL _ TEMPORARY CERTIFICATE OC ..Q+ANCY
CERTIFICATE OCCUPANCY Final
I-andwAping
�. Zoning Finat
Ili. •t• � i `,�'��h ��^� ,s1�',iF;' I�f��;t�'�f¢�•11���'�� � +wlP.�'�'�'1!
i u
1
BUILDING PERMIT APPLICATION TIGARD OATE —I�_____•tg$o ✓�•�+'
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPPPROVV;ED IN THE ACCON PANYI�N+G PLANS AND SPPE�CIFICATIONS. OWNER PHONE
J'�:'t:ERJ4NIL�S ht'OeJ&� 121-5-07
OB ADDRESS I�� P 1.� 3 C.:r1. LOT NO
Q� �T
BUILDER �GibhQ. ADDRESS
STRUCTURE _ �2l(aC �_( �_ fZ�_Y� Cq- Toes
REMODEL
DDITION REPAIRC RENEWAL 0 DAMAGE ❑
DEMOLITION
RESIDENCE C COMM ❑ EDUCATIONAL :1 GOV'T C RELIGIOUS G PAT 10 Cl CARPORT C GARAGE C STORAGE Cl SLAB❑ FENCE
OCCUPANCY /L— S LAND USE ZONE._BLDG.TYPE �_. FIRE ZONEPLAN CHECK 8Y NEAT
liu�// S i K q��y�.�,'� //�� H w�a�.Yfl�.Q�t, ew•ag L,
'?pe. V!awGtvOw ��QQ7� Gt.r.Ne T r, rDOn+•$ -
SEWER PERMIT N
OCC.LOAD FLOOR LOAD /l{p HEIGHT 2,Z. NC.STORIES ,2 AgEA/8j-7 N0.BEDROOMS Yj
BUILDING DEPARTMENT---7SET BAC"3 FRONT .2D REAR #49 v LEFT SICE ,25' RIGHT SIDE �7
Permit �O .00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDI*qG CODE,
NG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT PlTHE
Ian Check I IO •� WORK WILL BE DONE IN ACCOP.DANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV'
� fatal 3�a•v RESTRICTIVE COVENANTS. CONTFACTOR AND SUB CONTRACTOR3 TO HAVE CURRENT CITY 6JSINESS
3cateTax
LICENSE.SEPARATE PERMI IS REQUIRED FOR SEWER,PLUMBING AND HEATING.
: 3�
Total '3 'Z 8 6 SOC
By —
POr,# APPUCAN7 aR AGENT
Receipt No.
Approved __ ADDRESS pl,tC�E
SDC - S 1440
RDC - S TL- # too
SEWER CONNECTION S 7,2a
SEWER INSPECTION S
SEWER SURCHARGE e
t s , �er dQ _4-s P/l1 t N Wt✓D Z"rzu�g ^l�r��G�+A�ls��c N �L(lc,�'�_q_�l
Wiwi t W W R M I
JAI AA e s ��,� �� eo"-s-r vG� In Pa �n g��, so
t 2c y`d S z� ' C}. l�� � _ Yc at�?e 1��► li
//anN V-(0&4- 17-A?�( 26' '# 4fz
7 x 32 2xf
6- # ?% *2&-& z z i
Roto Cw
Q-9 r C X31
3-,?, 9c�z
s 38
fao ,y V o
�itji 03la��"d Mechcnical Permit N? Per mit_____-,gy
Fee,
Installation r�nsW lat o,� r[n Replace [] Relocation [) Additi.�nC�) [_) L' :tate
Alteration
i
HEATING TOTAL _
(' )NTRACTO,R _ �-( %/ ; OWNER
}1 (k
T� WORK ADDRESS_! _al.
P1ION E �'1C`���,1 -�2 APPLICANT _
Keat Input Rating (BTU Per HOW) ��,�-- —`�
`��LL2J_� Vent 5iie -- Flue Size
UEL OIL EJ GAS ELECT ❑ OTHER__
ITEM
NO. FEE ITEM NO. FEE `
- ___
or Irivance of Permit _
@ E AEiOVE; �_- _ Air Condition Compressor 15 to 30 HP 10.00
,v—tJp tc & iriC 1.100,000 BTU_ 4,00 Air Handling 10,000 CFM 3,00
r`levv-100,001 BTU'S & _over - 5.00 _Air Handling Over 1fJ,000 CrM 5 00
'ricer Furnace _ -- 4.0:F
00 _ Evaporativa Cooler _ _
`lall - Floor - Suspended _-- 4.00_ —Range Vent Fan - 0r0
In�tall Vents Only _ _SO
YVent Systemat -24R-zoair - He � Cooling _ _ _ _
Hood Commercial 3.00
Air Condition ComUT
i,Uer 3 !-IP __ --- 4.00 Commorcial Duct System 1G.G0
Air Cnnditiort Compressor
—3to 15 HP 7.50 '---� - _-
!N-'PECTOR'S COMMENTS_
CITY 6USINESS LICENSE REt,"'IREDvFOR ALL CONI RACTORS OR SUET CONTRACfOfIS -
r.PPROVED BYr� DATE —_—__ ISSUED BY DATE �I
'I .CEIPT N0.
Signature of Applicant
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