8830 SW HAMLET STREET :>W (iAMIJ-°1'
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGOA 97223
PHONE 639.4171
CON"rRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
Permit No.
r 5 p e c t
CALL FOR REINSPECTION
1Wf
CIT' OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD. OREGON 97223
PHONE 639-4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
_0V
Permit No. --------.
lnspector_�
CALL FOR REINSPECTION
ADDRESS a4 �iC� �� _ PERMIT N0.
PERMIT CHARGE none
OW�'ER CONNECTION FEE
PAID BY
TYPE OF BUILDING /rQ.[//, J DATE CONP:ECT
d/
SERVICE RATE � INSPECTION FEE �•��. "-
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
� Zyo 1
BUILDING PERMIT APPLICATION cOF TIC ARD LATE
THE UNDERSIGNED HEREBY APPLIES FOR A°E1MIT FOR THE WORK HEREIN INDICATED BUILDERPHONF'''•' r-IL;,J
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE__
Lor NO.
OWNER Drinraias i'ljgw L IJW AnVRF.SSt1U 3Q SW 4(lalale t _ HOME ADDRESS
ARCHITECT
ENGINEER
BUILD91111rillICO215 HIA19tji LQVIRtl UDRESSi�. _dry r i XGl' DESIGNER r-�
STPUCTURE ONEWO O
� RI MODEL _ OADDITION REPAIR -, - ❑RENEWAL ,FIRE DAMAGE ODEMOLITION
0 RESIDENCE ❑COMM ❑EDUCATIONAL 0GOV'T�ORELIGIOUS OPATIO ❑CAR PORT ❑GARAGE CISTOnAGECISLAB ❑FENCE
OBOND OMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY------!LAND USE 27NE '�--7 ._BLDG,T vPE '�F'—__FIRE ZONE`F PLAN CHECK BY_____ - HEAT
❑11,1trw:.,tgtrtgle family duf1lin4i I„1/ni..tethed yelregel — 3 t. udj:0uA1 — Z d4ttl-
Dewrmit , 17430 — $625.00
" QAb__— _ FLOOR LOAD _.-.N-.EJStHI 1`14.�"SS2281� �L1�A X10.BEDROOMS VALE
BUILCING DEPARTMENT SET BACKS FRONT 20 REAR L:1+ ILEFT SIDE 10 RIGHT SIDE r�
Permit 1, 5 ;.• � -"_ -_ .._.. _� �_______....__.�..--
- --- — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Flan Check % REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TNF
--- WORK WILL BE DONE IN ACCORDANCE WITH THE PLARIr, AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb•taFal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- RESTRICTIVE COVENANTS, CONfRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6.04 LICENSE. SEPAR/ TE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
�11.1
Total 231. _,Q PDC #R ,1uuQ 0
APPL I17AN7 Oq AC:F ti I
Approved 1adp1'1 Receipt No.
J
DATE IN/P. TYPE INISP[CTION REMARK! PLUMBING DATE
tractor
Permit NO.
Rough-in
Fixture
Final
n HEATING
Contractor
P&rtnit No.
Ga or Oil -
_�— Final
SEWER
Y Final
DRIVEWAY
Final a
StoM Drainage
(Rain Dain)Final _—
Sklel MI k —
Curb A Street Final
Approach --
�N DW DEPT.FINAL TCMPORARY CERTIFICATIC OCCUPANCY
CERTI�ICATIC OCCUPANCY FI.W
landocaping
i Zoning Final
J.,
r Permit
CILN/ of Nifechanical Pcr,,i i it 0 Fee
New 1ns,,31:a,.(on Re-)!ace L.-j Relocation LJAddlTi()-1 Aheraiion STale
TOTAL_�*--
�CO`:TRACTORFXXKXXXXXHMMXX General Funajgn OWNER pr,-nrLo�r, 11c)riir,r;
WORK AVFJ S
ADORESS_LA.�����-- 14—irr I en I
PHONE 656-0326 APPLICANT
Host Input Rating (BTU Per Hour) 7 00 1000 Vent Size
FUEL OIL GAS 0 ELECT 0 OTHER---—
R P%Z
ITEM NO. FEE ITEM NO. FE
For Issuance of Permit 3.00 Air Condition Compressor 15 to 30 HP 101
Now- Under 100,000 BTU 4.00 Air Handling 10,000 CFM T3.
"Air Handling Over 10000 CFM 5.
New- 100,000 BTU &over 5.00 , 1
Floor Furnace 4.00 Evaporative Cooler T3.1
Wall - Floor -Suspended 400 Range Vent Fan 2.
Install Vents Only 2.00 Ven:System 3.1
Repair - Heat & Cooling 4.00Hood Commercial 31
Air Condition Comr,essor Under 3 HP 4.00 -—Commercial Duct System 10i
Air Condition r-jmpressor 3 to 15 7.50
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY DATE ISSUED BY DATE
RECEIPT NO.