10385 SW HILLVIEW STREET-1 10305 SW BILL VIEW STREET
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD. OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant 'to Section(s) of the Uriform Building Code., the
following item(s) require correcing:
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F-An CJ0,L^.eC-
P-I
Date: Permit No. .
Inspector
CALL FOR REINSPECTION
t3U11_IJ11VLi LI:.1'ris'i 1 Prl%i`1 1, 1 iQi-A L! �
PLUNISING PERMIT t
� d holder of a valid r!umbing ccrltracrors licensly is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing coag of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
f
(4) hours prior to the time the installations are readyfor irlsraction. City of T:g;,,rd Business License required t
for all contractors and subcontractors.
C �. DateM4
Add
4-
4 NUt.13ER OF TOTAL P ffice NO.'S TYPS OF PERMIT Il'F.P!S FEE ON EACII f AMOUNT (Office Use OnIY)
t.� J-I.Ej1 — _ - —- ..1 -I(—
Simla Family-1 Ga'h—tach _ � __.__
Won
O-IoIPx—Each I bdth unit 10
� .00
Addidotiel ha.hroums_aach �__ 10.00 —
_M:bila Home Spaca—!&ch __ ______r�_ 15.00 a
INDIVIDUAL FIXTURE FEES I ��
1 to 50 pixturPt in 1 building—e30 3.00
�51 to 100 Fixtures in 1GuilCir:—�aeh — 2.50 r
101 to 200 Fixtures In 1 buildira�each _ 2.00 _
-- .__ i
201 or more Fic.res in 1 !�iuil.l:n
fY1 I S CSE L L 9,N S O U 5
s
8J� Sever—I it St") ft, 10.00
Sowor—a.ich additlo_n4l 100 ft. 10.00 _
Wirer 5ar-A a to building _ _+ 5.00
Private Fiat+r 3v3tPrrs—eirh IOU ft. —_ IU JO^
othar fsat:if-):
PERh11T ; For ftriWng in:.,•:. _ .n P'.,n-0".39•+'171
_ Plumbing Contractor B
n si1l� � _ � y
TOTAL �' RECEIPT NO. Issued By _ _ _
.�-'Wi"+Glii�'Fi+l:'�'FNi1CM3M6+�bAlo�rx�If6P�W��x�'uew�r►.,s�•f+�s"'�, r°°�°in►lY'iW%�n�-+11'�t�ra
clry TIG�RD DATE------- �°��''�------.19 79 M263BUILDING PERMIT APPLICATION of
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE .--I—
LOT NO.—
OWNER • Le 1.L21ii JOBADDRESS}'•'},}t. i Uj.J6 Wb-ME ADDRESS --
ARCHITECT
v..tign 9w rc Tony "• ENGINEER
BUILDER _ ADDRESS DESIGNER _— rr^- --
STRUCTURE ❑NEW_ DRF ❑ [:]RENEWALL
MnOEL OADDITION — REPAIR
RENEWAL DFIRE DAMAGE — _JDEMOL.'tION
[:3 RESIDENCE GCOM;A ❑EDUCATIONAL OGOV'T ORE LIGIOUSOPATIO ❑CARPORT ❑GARAGE DSTORAGELOSLAB OFENCE
iDBOND ❑MOVING DCn":'✓ITIONAL USE — ❑DESIGN REVIEW nCOUNCIL APPROVED ❑SIGNS
uL
OCCUPANCY._..._-__TLAND USE ZONE __BLDG.TYF. FIRE ZONE J PLAN CHECK BYHEAT
---- — imll.y dwelling w/a ttechou galra .,jo. 3 bim0l'Uuma
E LC.?i'i131TTION SHELT ATTACHED*
�. c t'1`sTplavt ,J ,769 - rr1x5.00lft
oC�._LOA�_ F14Q I-L9ADtib.iC:NT----.----,__.1N.Q-MBJ11----ABEA__ NQ,BEQ800.M.�S
DEPARTMENT BUILDING DE «
—_ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
- -`` THIS PF.RMit IS ISSUED SUBJECT TO THE 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 PLANS AND SPECir.CATIONS AND IN COMPLIANCE WITH
SLib-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RFSIRICTIVE COVENANTS. CONTRACTOR AN') SUB CONTRACTORS TO HAVE CURP"NT CITY PJSINESS
State Tax LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
5UL; - $-'uju.uu
Total I - poc 1xJo c()
[Appi
._...__..___ APPLICANT OR AGEN't
ovedRecvihi N(i �' J
F
I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
i Contractor _
Permit No. ��o� •� �'x`79 )
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Roughen
Final
SENER
-v�.. Final
DRIVEWAY
_ Final
Storm Orah,age
^~ (Rain Drain)Final
Sidewalk
Curb .Street Final
Approach
( BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final _
CERTIFICATE OCCUPANCY ------
Landscaping f
Zoning Finai
1fi•
7
i
my
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(
CI i y 0f l �� i' r'4f e,�ht7riic�tl P�r,r�it NT e7 Permi — QSLw.=
Fee_
P„?nx Ini*,;,'ation Re:):e=e ❑ Relocation n Addi•ion ❑ A!;'tr ..On __1 3'.cstaIt.
TOTAL._ 7 Z
C,., i RACTORCJ:' r.cPJPA
ADOR_!M c,2 „/ _ WORN; ADDRESS / "�S c4_” 4&y1m,) .
pHnNE 7 — APPLIC�NT
_ Teat ln;jt Rating (STU Per Hour) Vent Size Flue Size
FUEL OIL CD GAS ,-J ELECT OTHER___
ITEM NO. FEE ITEM NO. FE
!
For Issuance o'?error _ y j _ s_ 3.00 Air Condition Compressor Ib to :30 HP 10.0
A New •Under 100,000 ETIJ � L` j 4.00 Air Handling 10,000 CFM �3.0
5.0
1100.OU0 STU be over _ j 0 Air Handling Over 10,000 CFM _-1 5.0
Floor 'u:Hats �r_ 4,0J_ Eva,,rative Cooler j 3.0
Wall •_Floor Suspended =�� 4.0_Or Ran��Vent Fen (�2.0
Ir•„tall Vents Only _ 2.00 Ven'System _ —t—=-
Ferair • 1; &_Cooling _ _� _ 1 �4.00� Hood Commercial
_Air_Condition C_omprrssar Under 3 H? -' _ ___ _4.00_ _Curc,rn_rciat Duc; System
.Air COnditiOn Corrl �lfc;or 310 1S HP _�_ x.50
-.—z: ..s�t-_.r:J :+.e•..a._ . .�..sa�rr�.ar:--�_.:.r^=�-sres_._w. _.:.___.�ra.c-.s.� -�_-
Cc►f l 7aYcJ�t_e�e
INSPECTOR'S C0,1M,1,ENTS�
CITY pu,ir,-EjS LICENSE REOUIRED FOn ALL CONTRACTORS OR SUB CONTRACTORS
APi'RO% c0 RY_ _ _ — DATE ISSUED Bl'—__._�. — _ DATE