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TOTAL_ 8. -3 2 _
C,^.tiT?ACTOR C��4J�6' _ �tlfa�:l�1e.�._ � G`�'�ticR� L tiTt�
WOR✓. ADDRESS
_
S1 APPLICANT .
Heat Input Rating (,BTU Per Hour) 1('-�nVent Size Flue Size
FUEL OIL `1 GAS L EL-ECT ❑ OTHER
ITEM NO. FEE ITEM NO, FE
For Issuance of?e:mi; _ T_ 3.00 Air Condition Compressor 15 to 30 HP 10 r
(dew• Under 1Q0,000 BTU 4 Air Nandlmg 10,000 CFfA 3•t
New• 100,000[3TU&over ��---� -�_ 5.00 Air ;:andling Over 10,010 CFM—
Floor Furnace 4.00 Evaporative Cooler 3.i
Wall-Floo: -Suspended 4.00 Range Vent 7an� I 2.l
Install Vents Only 2.00-1— Vent System _ 31
Repair• Meat & Cooling _ _4_.00 _ Hood Com_merc�ial�_� � v�i
Air Condition Compresses Under 3 IIP 4.00_ �Conimercial Duo; System -� 10.(
,Air Condition Cor-r or 3 to 15 HP 7.50
INSPECTOR-c' COIJMFNT.S___
CITY BUSINLSS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BYDATE _ ISSUED BY DATE
RECEIPT NO.
ts• S;gnature of Appl' ant
xae e
PIT, +�+ BUILDING DEPARTMENT, TI iARD
JOHN 1 r.. R(ItiH41D1 Pll`1t1. �, I,.L N0, �
P. D. Opti 19 PLUMBING PERMIT l
KE'i,'jEKr, F10% 91132 _ , holder of a valid plumbing contractors licerse is hereby
authorized to cause plumbing work as herein notes to be installed in accordance with the plumbing code of
Tigard. Such insv,-•111tiors require inspection by the City Inspector who sliall be notified not less than four
(4) hours prior to the time th,3 installations are ready for 'Inspection. City of Tigard Business License required
for all contractors and/sub contractors.
Owner. zc� :V 14.J y 11112 -- Address.&��yi��Ll - Date
NUMBER OF TOTAL PERMIT No.'s
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
R-E I 1 O -.
8i le Famll 1 beth_aech V'____ 26.00 _ 61 0c'
'� Y�___ �_ .— --
hu lex-Each 1 b.th unit _ _ 25.00
Additional bathrooms-each __ r 10,00
Mobile Home Space_eec,1 15.00
INDIVIDUAL FIXTURE i:EE_8 -
1 to R) Fixtures In 1 buildi% eech _ 3.00
51 to 100 Fixtures in 1 buildir�g_eech y 2.50
101 to 200 Fixtures in 1 build'.n -dash _ 2.00 _
201 or more Fixtures in 1t�uildhgn__rech _�1.50_
M I S L E L L A N E O U S ----------
aulldlno Sewer-1st 50 ft. 10.00
Sawnr-eech additionel 100 ft. __ 10.00
- ..-
Water Service to building 5.00_ _ - -----
Private Water Systems-esch 100 ft. _ _._ 10.00 _ ----- ---------
Other IS if
PERMIT r (,� For Plumbing Msnecrion Phone 6394191 �
Plumbing Contractor I V
RECEIPT NO. Issued PY
�fOTAI f U �..---
- -----__..... __-., ___... .. _,....._-.�,r....r,Te.....-.....m.._. ..-�-•.o...a.w�snawsww�estws+
.r..�,�,, � .., �... _._�. ..,...j+rt4t' ",�,f „"ESQ! ��Nks.'�kx!�If{a"1fJi �+�"w,'�Y+aSk'"�. 6j"+"•+�. tftirµ�,Yrl�ri,±'nt;s1a�+'t. � � ....
BUILDING r.- CITY TIC ARD DATE_—._ , 19----
BUILDING PIERMIT 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.,
LOT NO._------
_OWNER 1616,�E3'�in boy. L3• JOIS ADDRESS 1)10• :.rtur•HOME ADDRESS
_ ARCHITECT
ENGINEER
BUILDER _ r-t
i!lfll!? ADDRESS _�_�_� DESIGNCR
uRENEWAL ❑FIRE DAMAGE LJDEMOLITION
STRUCTURE _ ONFW ❑Rt M_DOEL ❑ADDITION U-tREPAIr� ---
Q#-ESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSC IPATIO ❑CAh
PORT
-T1 ❑GAF AGE ❑STORAGE [ SIGNS ❑FENCE
DBOND ❑MOVING __COtJ
NDITIONAL USE ❑DESIGN REVIEW COUNCIL APPROVED LSIGNS
�w I CHECK BY.----..DO HEAT__ _
OCCUPANCY LAND USE .0NE 41 7 _ _-BLDG.TYPE _FIRE ZONE_ " PLA. 2 �,j (1T'own t F/ �-
I. unIsLruct singl a fami3 y dw*Allirt /ak talc hlrt� ynregil. -
R•-,. '%ve z&me B , 1,G18 Std Sumt3lerfir�1d L+o<ne I(Ma;k
ti t,,rrx: !��rznil: tilt F37? — S1705t,00
_— ---- uC N9,_;zTS1HIFS_ 168N��€.�ES�QIIQ;z_ _V&L.UE�';��v
OCQ L4.AQ-_—___��1.9QB_LQ130 a RIGHT SIDE
BUILDING DEPARTMENT SET BACKS FRONT_ 10 T REAR 1.916" LEFT SIDE
Permit, �%1!17.00
THIS PERMIT IS ISSUED SUBJECT TO 114E REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10.00 REGULATIGIv,, AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT rHE
WORK WILL BE DONE IA ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE V ITH
Sub-total _ ?IUD ALL APPLICABLE CODES AND ORDINANCES. THF ISSUANCE OF THIS PERMIT DOES NOT Wf IVE
RESTRICTIVE COVENANTS. CONTRACTOR 4ND SUIT CONTRACTORS TO HAVE CURRENT CITY BUSINiSS
State Tax �',` 6 8 LICENSE. SEPARATE E M REQUIRED FOR SEWER, PLUMBING "ND HEATING.
PDC 02 31000(l
13V ��� APPLICANT OR AGENT
—�
LAPPfwved fivreipi �sHONE
- anr�ar�s
v 3.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING FYATE
• Contractor --
8 Pormlt No. / - 6
Rouph_in f — a'--—
Fixture
HEATING
`J Contractor
Permit No. •� 3 y_ Q-7 /- �`l r¢Y
Gas or Oil
Final
- - -- -__.._�..�.__.__------------- - SEWER
_ --- --- - Final
DRIVEWAY
— Final
Stor0n Drainage
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL. TEMPORARY CERTIFICATE OC ANCY
CERTIFICATE OCCUPANCYT Final
7
Landscaping
-�
Zoning Final
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