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INSPECTION NOTICE
City of Ti 3ard Building Department
P.O. Box 23397
Tigard, Oregor,97923
Phone: &I i-41-t5
TVpe of Inspection
r 2 fTime _-- A.M.---_- -P.M.
Date Requested_
Address Permit #
Owner �� n""w ` --- I_ot —. --
Builder --- — --- — ——
The follo,•iing Building Code deficiencies are required to be corrected:
Presented to
Inspector —.-_ __ -_-. — [� Disapproved
Date -
CALL FOR REINSPEI_'770N
F, YES 11 NO
CITY OF TIGARD PLUMBING
App k&W RuM hold OreLW Ra(Iltt WW to MWW a OWrd q PERMIT X75
bum"Or erw9t be owrler/ope rstor not amide IWP.
Plumbing Permh No. -07
Aft"s Deeor"m
L ORS 614.21410 OUAM. PRICE AMT
Job Taxta M9p.No.
Address
FIXTURES
t.or _Block $M1k 7.50
Or reefae u r.� Lmlory 1.50 - -
Tub or TublShower Comb -- _ - 7.50
np reu Shower Only 750
Woof Clow --- - - 3 --- --7.50 --
Owner / to _ ... _ -_ _ --
�'sL' Dishwasher — - -- 7 50
Phone Garbage Disposal 750
tJ s Washing Madwne - - L ^7-50
Floc Oram 750
Address Phone Water Healer - - - 750
Laundry Roan Tray. -- 7.50
OtxUprnt C1fY/Stile---- ZIP Urinal --- 7.50 _
}1 xxie OtherFhawes(SpebtY) __-- - ?10 -
e �__. _ — 750
-T rte-
COntlectoI le ZIP
` '-7 1 -) -2 _ MISCELLANEOUS �J
Bus Tar No Sewn 191100'_ _ 30 00
( M s Sever-ea.Addif. 100' Is 00 -
( o T` z"/- r3 WowServlo.rat 100 i__ _2000. c
1 trarebtr adrnaeMdpe Meal l 1lrvea reed Mete rplebcasOre e►al Meo kelorneatlon
Well SonAm ea.Addlt.2a)e 13.00 --
pMare M oorleol,Meet 1 am HeQlelered wllh Mie 81aM gliders Borrel rrxt areo Skem&Rahe tkMn 1 et.100' 3000
hm a SWO ftm*6 tloeresr MeM Mee numbwa pMm ere oorrect M1M all
pkmftV nork wN be d"b a000rdvnoo will+rpppoeh' Pro0sions or Orv- Sbrm i P W Or'r1n Adds 100' - 15,00 1
pon Revised S amuse Choo s 447 and 03>.ed sppb=bM oodp and M+M
16.00
no►@1R WS be anttbynd anises Mfleneed under A00 (M eeoW WO Garry MobM Honse
Stall reghlreror+r pbW ghre resew bob0. 5411/r Fbw Pruwrtlbr►b 760
HOMEOVMAM-1 hefty y all*TM 1 em M1e almsr d Mee property dr- OeA m or Anb�olkilon Gov" ---_-
wrbed rbw^st sMdab( pO
01 011IpoM n im epllaablrlp free- 1,-,n for Any Tm or VVerN No
Orem vee weed NY paepely IN low"ommomw lar see.lessmo or rant. IOmrom lel b e Fb*" - — 7.60
<","SMM 7.60 1
40.00 Per HM
ANW,of Ptordft.44*
16.00 nun
KOO T1JRE - Old" Nell er ftft, m "W% i
Grim"
_WIN _._�...___..._-------.--�- �-
IMMly keommeam -,11
:, 011e Weed __�J_�,� LS, h1►
INSPECI ION NOTICE
City of Tigard Building Department Cl►
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _ -----
Date Neq„u�ested—Ali� , ,me __ A.M.
P.M.
Address-` 1 � --_` "A� Permit
Owner----- __. Lot #
Builder ---
The folio Building Code deficiencies are required to be corrected?
Presented to _ _ rr VApproved
Inspector _ _ _, t-1 Disapproved
Date
C14LL FOR REINSPECTION
❑ YEd 0 NO
'-1737
1111.1 1 V AJ 1- 1 1 x.711 N t" U IVj rAo r1 A 141%wo A L t-M rti iYll l l Permit it . . t•
Deaerlpllon r a" PRICE AMT
Table AA Mer fusnk:al Code
0. .0. 10.00
City of Tigard 1) Permit Fee --
13125 S.W. Hall Blvd. --�
---- ---- --
P.O. Box 23397 2) Supplemental Perms 3.00
Tigard, OR 9x'223 / _ �[� Furnace to 10o,000 BTU � 600
639-4'?5 fD y� 1) incl.ducts b vents - --- -
Furnace 100,000 BTU I 7 50
F3)
G incl.ducts 8 vents- - _ _. . ------
Floor Furnace 60(
Name of Development incl vent
Suspended heater,wall heater 00
Job Addrsa � // or floor mountedted healer
_. h
Address ---- - Vent not Incl in 300
Tax Lot -hep ° JJ ') appuance pormil _
Lot c,y ,lock u ry sion Pepalr of heating,refr lg 600
Na name of sinoss� 6) cooling,absorption unit
Boller or comp 10 3 HP 600
ng rasa �1O 7) absorp.unit to 100,000 BTU
Owner Boilertoromp to 3 HP-15 HP It 00
cityBute - Zip - 6) absorp.unit to 500,000 BTU _ _
—Boiler or comp 15.30 HP 15 00
Name 9) absorp.unit'/x-1 million
4--� [oiler or comp to 30-50 HP 50
Melling Address - Phone 10) absorp.unit 1 -1,75 mlllion _._-._--
Boiler or comp to 50 HP 31 50
Contractor CityrSlete Zip 11) a: )rp.unit 1,750,000 BTU
Air handling unit t„ 450
State Regisiratxm No Clty Bus Tax Nn 12) 10,000 CFM
13) Air handling unit 7 50
i hereby acknowledge that I have read this application that the information given is 10000 CF
ctxred,that I am the Mixer a wlhonzad agent of the owner,that plans submitted are in Non portable 4 50
compliance with State laws,that I am registered with the State Builders'Board,that it* 14) AVaporate Cooler
number given le corned.(tt exempt from state registration please give reason below) - _ --
Vent Ian connected 300
15) to a single duct - Z
Ventilation system not 450
_ __--- ---- 16) Included iappliance permit - -
- Hr i served by 4.50
- --_ — -- 17) r shanical exhaust _
ate OomMtic hrpe 7.so
slgnatwe(owner or i 9) Incinerator -- -- _ -
Describe work ❑ addition ❑ alteratjon U repolr U CFO
or industrial s0 00
to be done residential Q non-residential 0 19) incinerator --
Existing use of -- zCtt Other i e ,w0odslove,water a so
Existing
building or properly _� '�' - N �' h9eter,soler,clothes dryers.OIL
Proposed title M -- 21) Lias piping one 10 tour outlets 200 L�-
building a property --- -
Type of fuel - oil O natural gas W LPG U electric 1 I - -
22) More Than 4-per outlet
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON. - -�-" � 4%BUAG'11A110E
Jf
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 Z
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN F1E1flaw 26%OF sU'1roTML
ABANDONED F OR A PERIOD OF 180 DAYS AT ANY TIME AFTER - - TOTAL f!
WORK IS COMMENCED
Spe&iI Condltklne
Dale iasufttl �f r 1�5 tw
Lel 1 Y Vf 1 IUAHU IVIrkorl,ANKPAL t'LMY11 1Permit N - --
Description
!�bla JA Mechanical Code ory PRICE AMT
City of Tigard 1) Permit Fee •0- •0- 1000
13125 S.W. Hall Blvd.
P.O. Box 23397 2) Supplemental Permit 300
Tigard, OR 97223
639-4175 �Q 1) Furnace to 100,000 BTU
600
incl.ducts 6 vents
2) Furnace 100,000 BTU + 750
incl.ducts 8 vents
+� Name of Development - 3) Floor Furnace 6 D)
incl.vent
nddrea _ Suspended heater,wall heater ��
Job //// �,,/J 4) h
Address �� ell .vim-�/ or floor rnounled heater
Tax LotMa o. P 5) Vent not incl in 3 00
Lot 5 Z Block u rvision appliance permit _
_ Name or name of P at 6) Repair of heating,i air ig., 6(to
� j cooling,absorption unit
ng A41fress r'hnna 7) Boller or comp to 3 HP 600
Owner absorp.unit to 100,000 BTU
City/State — Trp^ i 8) Boiler or comp to 3 HP-15 HP 1100
_ absorp.unit to 500,000 BTU
Norrie9,% Boiler or comp 15-30 HP 1500
absorp.unit'/,-1 million
,ling Address Phone �- 10) Boiler or comp to 30.50 HP 2250
absorp,unit 1 -1.75 million
ContractorCity/State Zip _ 1 1) Boiler or comp to 50 HP t
absorp.unit 1,750,000 BTU 50
Sgte Registration No —- City Bus Tax Nn 122 Air handling unit to _ 450
10,000 CFM
I hereby edge acknowi Air handling unit
7
that I have read this application that the information given �s 13 111,000 CFM 4
correct,that I am the cnvner or outhoni:ed agent of the owner,that plans submitted are.. -- - ---- ---
compliance with Stale lows.'hot 1 am registered with the State Builders'Board,that the 14) Non portable 450
number given is coined (11 exempt from State registration please give reason below) evaporate cooler
- 1 5) Vent fan connected ! / 3.00
- to a single duct T, J
----- -- Ventilation system not
t 6) 4.50included in applianco permit
17) Hood served by 4.50
� �ta1 '- ______.-
mechanical exhaust`
Slpirature towner M� ooh 18) Domestic type 730
Describe work L1 addition LI alteration t I repair I _incinerator __
to be done- _ residential Ila. non-residential U _ 19) Commercial or industrtat 30,00
Existing use of type Incinerator —
building or property_ _�.,� u ,0) Other i.e ,wtaodstove,water 450
Proposed use of hoaler,soler,clothes dryers,etc
building or property 21) Gas piping one to four outlets 2.00
Type of fuel- oil [_I natural gas [iQ LPG [ . electric I I
22) More then 4-per outlet
Sun-TOTAL �.t
THIS PERMIT BECOMES NULL AND VOID IF WORK. OR CON-
STRUCTION
ON 4X SURCHARGE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ _•
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW"%OF f!US-TOTAL t'
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER TOTAL
WORK IS COMMENCED
Speolel Conditions-- —_-.-.-- -- ---_—__--.------ -
lit
Date Issued 1_I/7_A�
CITY OF TIGARD 639.41 666471 DATE y �19___
BUILDING PERMIT
TAXMAP •:1. "W� LOTNO. SUBDIVISION
OWNER _ F1y JOB ADDRESS D241 IV. IIJ11. It. �5:_�
3r11.09 2
BUILDER ,. STATE REG.NO EXP.DATE
BUILDER'S PHONE
ARCHITECT _-M PHONE __ OTHER _
STRUCTURE I NEW REMODEL ADDITION REPAIR MOVE L] OTHER L: DEMOLITION
RESIDENCE COMM EDUCATION IND .'ELIGIOUS ACCESSORY GARAGE: OTHER FENCF
OCCUPANCY LAND USE ZONE - BLDG TYPE FIRE ZONE PLAN CHECK BY _ HEA I
SEWER PERMIT M
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES_ AREA NO BEDROOMS (,,l VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SI(lE ~
Permit_ _ '. .t" _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
Plan Check ,+ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANC SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PI.Ck.Fire _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACT ORS TO HAVE CURRENT CITY BUSINES i
TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING ANE.`",-AT'ING.
State Tax
SDC
Total ----
Cr`l(1 APPLICANT OR AGENT
.4 4 Receipt No. ADC?RESS �_ --__ ----- PHONE --
Bal.
Due-' — Issued By -_ . Approved By__
..'...w......._...ar..r.n,....a,.-i�+cli.+..r...,.f,.(.w.... _ w...ieSM►.:.J.Ywr,�+w.:. taw.....Y+ia.....u+.LyY.MWW.�iir..W.___ ....,,.. ... ....._.._......
DATE INSP. TYPE INSPECTION ^— REMARKS PLUMBING DATE
- Contractor
Permit No. j 20 S
_ Rough inih—k
- , - - Fixture _
Final
7 Ar
�. HEATING
��--^- Contractor ( rV yVSt1 y 17
—^7 Permit No. 4 Z 37
�od`' Nr GasorCil
Rough-in
------- -- ---- --- --____—_ Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
— (Rain Drain)Final
Sidewalk
Curb 8 Street Final
-77
Approach
BLDG.DEPT.FINAL CERTFICATE TEMPORARY NCY CERTIFICATE OCCUPANCY Final
OCCULandscaping
Zoning Final
1f1fIII,
tt 4.
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