11415 SW FAIRHAVEN STREET-1 cn
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1141.5 SW FAIRHAVEN STREET
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BUILDING DEPART tE ;;, TIGARD
& PLUMB114G PERMIT N? 2 9 0 6 �I
, holder of a v-.lid plumbing contractors license is herehy
authorized to cause plumbing work as herein noted to be incta!;ed in accordance with the plumbing cod,.. of
Tigard. Such installations require inspection by the City Inspector who shall be notified riot less than tour
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all cr)rttractors and sup cont actors. ,•7
1 Job
Owner -� _ Address__11 ' � '� - `7 c'*'_^� Uat j f
NUMBER OF TOTAL
TYOE OF PERMIT ITEMS FE: ON EACH AMOUNT
A I D E N T I A L —
Sleyll_F_emlly--1 beth-each __.__- —� - _ 25.00
Duple-- Each t bath unit y _— _ 25.00 —_
Additional bathrooms-each _ 10.00
Mobile Hom Space-Teach— _ _ _ 15.00 _ ^�
INDIVIDUAL FIXTURES COMM[ RCIA
1 to 50 Fixtures In 1 builds -each —__- 3.00
51 to 110 Fixtures in 1 builds, -each ,__ 2.50
1101 to 2c10 Fixtures in_1 building--each _ 2.00
_201 or move Fixtures in 1 buildirrg-each� 1.50 —
MISCELLANEOUS --
_.,ewer-_each eddltionai 1 ft.��
Water Scrvio 6/b lldi v 5.00
Othar (Socclf , ---��--- - —^— - ""
_ I _
PERMIT — For Plumbing Inspection Phone 639 4171
_4�Statr_ r4 Q Plumbing Contractor By ,';•,_'
TOTAL - RECEIPT NO. f S��/� ed By _
CiPermit.— $3,
ty of Tigard Mechanical' Permit M �_,72
Fee
Neu Installation Replace Relocation Addition E] Alteration U 4%State
HEATING TOTAL__.aj_
CONTRACTOR OWNER
ADDRESS WORK ADDRESSj
PHONE APPLICANT
Heat Input Rating (BTU Per Hour) Vent Size
Flue Size—
FUEL OIL LJ GAS ELECT LA OTHER
-.,.ter"
NO. FEE ITEM NO. FEE
For ssu
an-.e of Permit SEE ABOVE Air Condition Compressor 15 to 30 HP _00
New-up to &—tnrl.1075 10 UOBCU 4.00 —Air Handliny 10,000 CFM 3.00
New-1n0L001 BTU=s & over 5.00 Air Handling Over 10,000 CFW------- 5 -
.0d
Floor Furnace Evaporative Cooler —.3 cd
Wall - Floor --Suspended 4.00 Range Vent Fan 2.00
Install Vents Only 2.00 Vent System
Repair - Heat& Cooling 4.00 Hood Commercial 3.00
,%ir Condition Compressor U�ai�r_3HP
Commercial Duct System 10.00
Air Condition Compressor 3 to 154P
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY DATE j� ISSUED BY -,,f DATE
RECEIPT NO.
770 Signature of Applicant
NEW
W 43
CITY
IIGAR�
BUILDING PERMIT APPLICATION of DATE__ ,g�_
64
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BIJILDERPHON/- 4.i',��° �Q
OR AS SHOWN AND APPROVED ;N THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONELL,�I� / _
td: y� LOT NO._.
OWNER . ITM.
JOB ADDRESS HOME ALiDRESS
•...,.r,�,,, ARCHITECT
BUILDER ADDRESS 19 3' CNGI EER
��--yyCICS(�NF.R
STRUCTURE ❑NcW�RFId�1DFL LJ ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE _❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'r ❑RELIGIOUS❑PATIO ❑CAR PORT ❑,ARAGF ❑STORAGE❑SLAB ❑FCNCE
❑BOND DMOVING� ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIG".S
OCCUPANCY __._LAND USE ZONE_____'._ BLDG TYPE FIRE ZONE, PLAN CHECK BY___ HEATLJ
' Y
�
BUILDING DEPARTMENOTAD -NO TORIE•5-
-- — SET BACKS FRONT REAP. LEFT SIDE RIGHTSIDE
Permit — — --- ___— - _
'— THIS PERMIT IS ISSUFD smill-CT FO THE RF.GULA110NS
CONTAINED IN THE BUILDING CODE, ZONING
Pian Check — REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Sub-total
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF fHIS PERMIT DOES NOT WAIVE
State Tax
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-- V LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
-'--" APM (CANT OR AGENT —
Approved Receil„ N(,
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
CrALLFr� /0-!2-77 - /1�e APyy Permit No.
--- - Rough-in — —�
Fixture
Final
—^-----___� HEATING
Contractor
Permit No.
Gas or Oil
--- ----------- Rough-in ----
Final
— — — -- — -- SEWER —`
Final
— DRIVEWAY
_—_ ____-� ------ — Final —
Stonh Drainage
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TCMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
{
I INSPECTION NOTICE
j City of Tigard Building Department
!( 12420 S.W. Main St.
Tigard,Oregon 97223
f Phone: 63,9-41171
Type of Inspection
Date Requested__, 'q y h�J
f Time�.._— A.M. P.M.
Address 114 p/S �(� r i 4"&" Si. _ Permit
Cwner Leet Lot #
-tuilder� (�
The iolinwing Building Code deficie cies ayr requited to he corrected:
i
Presented to
4LCA
Approvd
Inspector U Disapproved
Date
OR REINSPECTION
YES 0 NO
9