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CITY OF . TIGARD
OREGON
Owner: Qu.ad.r.srkt..,Cax.P...................................
... Permit No. .7.1t-144.......
Building Address..... .7.�� ...SAbI....F.41ir .law-l..alta....................... ......_......
Certificate is hereby given this....19th...day of.....N..O.woraolr......... 19.7.3.....
that sari building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
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Building Ingmctor
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City of 7 i Bard
INSPECTION REQUEST
for
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d INSPECTION TIME : /V '�'''� PERMIT NO. — --
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DATE. 11DATE ISSUED'--LJ —
OWNERS NAME : �`''�'�`�'Cg�� GoNF'
ADDRESS : �`L) fir.
CON1RACTOR : -- ---- —.—
TESI xt ,.._I. 'vvlter J , ! 1'CiJr! ;"1
RESULT* Approved DiscpprovO 1 :nding J
SKETCH:
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IPECTOR DATE
! rn tach supplemental test cov heret:ol
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amity of Tigard
INSPECTION REQUEST
for
;NSPECTION TIME. ,_._ PERMIT NC. .
DATE : !?--,#/--'-J JATlr ISSUED .
DWNEIRS wAME
Ar)DRESS. 40 7` �--
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.EST : . �, 4erp , '.ab,�rctory I-j
RESULT:
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NSPECTOR DATE
[NOTE. Attoch supplemental test oa'c: her-t0
MEMMEAMRA
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�,ity of Tigard
INSPECTiON REQUEST
f o r
-176
NSPECTION TIME. PERMIT NC. .
DATE: �` LZ�� DATE ISSUED .
OWNERS NAME : 41+;�tu 1111ADDRESS'.
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RESULs' : ,p r,wed ;(jppr ).vd 0 , :=e-idiop L-1
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^INSPECTOR DATE
CNOTE: Attach suppiemental test data heret�l I
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City of Tigard
INSPECTION REQUEST
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for
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INSPECTION TIME : .'DO _ PERMIT NO. . .----
DATE .' —
O. . ._._._--DATE .' — L.__ DATE ISSUED'---j-'-l—
OWNERS
SSUED• -1OWNERS NAME : . _
40DRESS • )/6/
i C o N 1 R A C T 0 R :
+' TES l � , 'A/nter A ir L,i i c
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RESULT ' Approved,' , Gi5c-pproved 1 �ndi ,,
SKETCH: _ _..._---- -- -------- ---
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INSPECTOR DATE
CNOTC Attoah Supplemental test data herey-
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PLUMBING PERMIT APPLICATION
Turisdiction of TIgQ,__________
No.. Type of Fixture Fee Permit No.
Permit ':ee NJ 00
2 Water Closets Toilets 5.00 Permit Issue /,,
_-7--bath Tubs Z.VVApproved by Ld,
avator Wash basin Building Perms 7;-
I Shower 2.00 Receipt Nc. Z>CL_
Sinks-- Dishwas frig
ff-
minks s 7-itchen
Sinks Ordinary Location of Building
Sinks, Bar 11615 aI ry I ew5n�i -
Sinks Slop
j_—Automatic i s was er 2.00
Di s o s a�-� 2,00
Laundry Trays
Name 8c Address of R�rner.
Drains, Floor Th® Quadrant Cor; _
Drains Area 1750 SN SkyLLnjL8Lvd
Drains Re sera to.' Port j and._2M9n 97221
L4 Rain Drains 5.0
Automatic Washer 2,00 Name & Address of Plumber
ountains r n in ITpgrial PbISJ Hta Inc
Fountains ..oda P Q Box ff12 -.__
Hot a to r Tan __Port 1 and Qregon 97 ,Q6_ —
Water ServiceSize •_00 -
Urj.nals Buildin Old or Newer Alter. Repair or
a c F- as i ns - Y a-r-d Eris .aNew
Lawn Sprinkler stem _ —
Swimmiri Poo . _ er —
:� rink er Sys�em ,�_
This permit becomes null and void if: work or constmiction authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of. 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond.
I hereby certify that I have ad and examined this application and know the same
to be true and correct. All r.ovisions of laws and ordinances governing this typ
of work will be complied with whether spe;:ified herein or not, the granting of a
permit does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
tmrser I a l P l umb i nq b Heat I mg, I nc.
�1Zy �� j1GP�p iature2 of-Applicant
qja Surv.
/, t `1173
Address11615 S.W.Fairview Lane Permit No. 4e6e
,..ter. ....... ----
Permit charge _
Owner Connection fee 425. —
Paid by
Type of bailding residence Date connected A-9-71
Service rate 3,20 per month Inspection fee 2S
Contractor Quadrant Corp. Paid by same date
Size of connection 411 _ Assessment paid
9 / o - ��
p
of -Tigard `
INSPECTION REQUEST
for
N,.,PE(,'TION TIME : i�pa PERMIT NC. . .
DATE : -_3L9.-"- DATE ISSUED -.
OWNERS NAME :
ADDRESS: --- --
CONTRAr;TOR
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RESULY* ,%p-roved :''�uppr� ad G eidi, c►
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ItdSPECTOR GATE
[OTE: Attach supplementol toot
CITY OF TIGARD MECHANICAL PERMIT �
DATE 3 1 PERMIT NO. a 4 t) RECEIPT NO.
BY FEE
1. Permit shall be obtained prior to commencement of installation.
2. Permit shall be obtained for all appliances which are to become
a fixture to the building.
3. Relocation, replacements, alterations, or changes to burners and
duct work require permits.
4. All. work to be concealed must be inspected before cover up.
New Installation [fl Replace ❑ Relocation ❑ Addition ❑ Altei ption ❑
CONTR. Quadraat OWNER_QjjAfjynnf
WORK ADDRESS 11.52*S W FairIKKNview I
ADDRESS 1720 .�i W ��,y1ine R�vd_ � ---�
_Ysr ., Iriu
TELEPHONE NO. 7 7 7-1Rn I
FURNACE - MANUFACTURER r.V _ TELEPHONE NO. 646-11.61
HEAT Input rating (Btu Per Hour) inn*nt)a Vent Size Flue Size b
FUEL OIL [j GAS ❑ ELECT ❑ OTHER _
TOTAL SQ. FT. Top Floor ---------- Main Floor 1490 Basement - --- - __
GENERAL
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit 3.00 Boilers Over 50 Hp
New - Under 100 000 Btu 4.00 Air Hand i .000 CFM
New - er _ u it an iri Over 10 _
oor FurnaceEvaporative Cooler00
Vaa - F- loor- bus enT-eT-- 4.00 Vent Fan '
Install Vents . en S' ' _em
e��air - Heat be Coolin 4.00 ood
nnilexS�Jnder-3 11 7—n r Domestic ncinera or
Boilers 3 10 !7H Incinerator 20.
Tro-fiers 15 t(=_1 $1_) 10.00 er�To- �e�—`
Noilers o > p .�
INSPECTOR'S COMMENTS
Imperial. Plumbing 51V Heating, Inc
APPROVED BY _ DATE 13 ISSU D BY _ /DACE k 1
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SiOnature of Applicant
et : 'IzAtjng Supervisor
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City of Tigard
INSPECTION REQUEST
for
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I INSPECTION TIME : PERMIT NO. . . ---
DATE '
O. . . _ —
DATE : DATE ISSUED'_---L1-
OWNEHS NAME :I
0w&"00&-
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4 D D R E S S : IL-"6 ift h 4 4
C.)N 1 R A C T O R : -
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RESULT Nppro�ed C7 GiscNprova+4
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71S�FCTOR DATE
C;!7E : Attach auppleirpntal lost , o'r neret]
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City of Tigard
INSPECTION REQUEST
for
I INSPECTION TI PERMIT
G
DAT � r DATE ISSUED`__-,---1-
0 W N E R S NAME
ADDRESS * _
I C 0 N 1 RA CTU R :
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TEST r�:�ter �7
RESULT A pro ed :�isrpprov0
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NSPECTOR D ATE
E:N0T'E : Attach supplemental fast .:air; neretol
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I City of Tigard
I
INSPECTION REQUEST
for
INSPECTION TIME :/ ' 3b _ PERMIT NO. : .
DATE . 7_ 7_3 (SATE ISSUED*.__1__L__
OWNERS NAME : _ Z
elm. I
ADDRESS ' J
I CONTRACTOR :_
TEST `{ r Water L'7, llisvalw, La', ,rator� (l
I RESULT; A roved Disapproved PP /� , VP roved _.I
Nr ging 3
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NSPECTOR DATE
I COTE : Attach slin
plamental feat data heret-10
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UNIFIED SEWERAGE AGENCY NO 4868
WASHINGTON COUNTY DATE 1.13
CITY O F---- -- -----I�i— 'r - — --
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER 2..a:i'int Curr. -----._
OWNER'S ADDRESS: 17'_j() A-W.- Zkylius .--------__ ._----------- ----
STREET
CIT 8TATF ZIP
BUILDING SITE: LOT__ BLOCK ._ __-_ _ . ADDITION hc�lly�z'B>��_-___—___
TAX LOT NO _ _ _ _ TYPE OF OCCUPANCY Rc�i.der,cf.
ADDRESS 11015 S.W. FAirvicw 1,une
DWELLING UNITS -.. FIXTURE UNITS
50 to Derry Da11.
SURCHARGE IF APPLICABLE
PERMIT FEE ' INSPECTION FEE TOTAL. DEPOSITET) '
((NFW) (EXISTING) BUILDING SEWER SYSTEM
Tl f, ApphcaI ,t ,agrees to comply with all rules and regulations of the Unified Scrwerage Agency.
APPLICANT.
SEWER PERMIT
THI; PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM,
LINE SIZE �iif INSTALLER 46a4xwLt Gurp.
RECEIVED BY
IA '_V 11 AGENV
CttMMENTS �
T�r. Anplic,,tion ,Incl permit expires in ninety (90) days. The amount paid will he imfeitod
,,Il, t ld expir,mo n occur.
CITY OF TIGARD
12+20 S. W. Main Str.et
TIGARD, OREGON 97229
APPLICATION FOR BUILDING PERMIT
New Construction ❑ Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING—a-( DATE ISSUED_ u-2d-73_ BUILDING PERMIT r
DATE RECEIVED Jun i}, !;(;BUILDING FEL $ do,pu No.
BY FSPLAN CHECK $ it,
1 ��
--:�v.ee- '"
OTHER $ VALUATION S 22,2W OD
TOTAL $may - RECEIPT No. :,i3
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT N MAP N ?JI iC CENSUF TRACT
Architect or Engineer 4usdrant Curpuration
Address llw :i W. ;,.y..ne B.vu, vortlara., Oregon Phone
Owner ame
Address __Phone_
Builder .game
Address _ _Phone _
BUILDING USE Single Res. R❑ Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP I _ No. of Stories_ 1 — Total Height 1., Area of Lot---
Type of Construction XXXXLTXX)M=J= V Floor Area B— 1 2`
Set Backs: Frort _ Backe _ I,.Side_
Private Sewer ripe Size _ Sewer u:li T gbr,, Septic 'rank ❑
Water Service Pipe Size .1,''V Storm Sewer ❑X Ditch ❑ Drywell❑
Street and Curb Requirements_!___kj,,LL,,,,,-
Driveway Width -- —` _No. of Parking Spaces 2
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATt(Iri
ADDRESS ASSIGNED XIM 11u17 S.W. Fairview Lune
FIELD CHECK BY SSi__
PERMIT APPROVED BY,
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregcn, and that the building will
not be occupied until a Certificate of U ancy has been i,e d bbr the City of
Tigard Building Inspector.
(�v S / IL "'t
Signa ure o A cant