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CITY OF TIGARD PLUMNNG 1AL1,14Rlu WAL
Applicant, must huid Oregon R".1stralion to corx'uct a plumbingC-PERMI I I� E,,aarJ C
R 972D
business or must be property ewner/operatnr not hiring outside help.
p.
PHrmn No.
Dascliption
y •� M ORS 814-21-010 DUAN. PRICE AMT
Job VAX lel Map.No. —.
Address F!XTUPES
LD4 - B6p c SubdMskxh —sink-- - _ -- ----- _--
or na"Of
nesss Lavatory _ — -/�� 7.50 •
Ngo fes — Tub or TubrShowo;
W req roes Shower Only — 750
Wa1erC1ose1 - - -- _ 7,50 �r�•''
Owner City/stele --
Dishwashor 7`,(1 7•
Ptv-- — Garbagw_Disposal 7.50
Name `
-- Washing Machine _.e 7 50 7
-- -- -�- - -- -
Floor[rain _ 750_
Water Heater 7 750 •
_------- --_ Laundry'Room Tray 7,50
Occupant CFty/State tip
Urinal 7 so
e ---- Otlhcr Fixtures(SpedtY) 750
l iq)
7.50
750
caxttroclor �, '�`�' MISCELLANEOUS ?.50
1
City Bra fax No" _Sower 4w 100' —_._. 30.E - 1
Siue�s.�asrallo Ss..=r-ea.AWN.100_ _- - _ - _ - _+.t 5,00 -
(Resrdentia1) �dy . w� WSW Servlos tst 100 - 20.00 •
1 hereby acknowledge tual I have i wad this fi srOcati tn,OW the Irdormnuon nu
Water Service ea.Addis. ' -- ►5.00
given to oomict.#W 1 am ropJgered with the Stale Bulidoea Board,and also Stene 6 Ralrr Orcin 111 100' 30.00
have a State Pkrrthblrq N woo Mut the numbem giver►arc correct.Out all ---- - - ___ __
pkxnbing rrork will be done kv 000wdence with Applicable provlsrcxur&Ore Stone A,P Jn U sin Addis 100- - - -_ 1500
gon Revised Statutes Chapter 447 and 693 and appAable erodes and that Mobile Home Space 250,
na help will be tmploykl tx4ess Noerwad urxW ORS W3 (11 exempt from
Siete registration,please give reason below) Back Flow Pnwnlion
W>01EOWNERS-1 hereby aer*y that I ern the owner of the Property de Devise or Anti-Pollution Dov"
ecrbed above,at wli t W-&vion 1 pro,
rose to nuke•pMarhbtrhp YuMekstlon lbr Any Trp or Wash Nd
rtuy own use uud this pr VG&,t is not dekko acxxrAruclsd for sale,)ecce or rem C:onnecled to a Fftwe -. --- 7)50
Cr.Acth Basin 7 .94 1
mw.of Exds..Plumbing 40.00 Per Nr 1
--- _-- ----- -- _��. -------- s
.�-RearpwC!^•1»dlors 1 - - - _ 40.00 PM w i
—____�_ --- __-----.----------- ------ --- .____ ANw.of Plumbing w1tMn
an EfdOng Bldg 15.00"on
AUTHOHIZEO SIONATIME - OaM Now Bldg.or Build.AddWort 26.00 MIM
_P-WL,You sirgle faml
Deswork new tlh�ciitlon
oto slWation❑ rW*r f 1 P,)-1rlc� 15��ih - •a
be clone reskiential non roskientlal fes____
Fsdatklp use of �.�•.
buVicip of pre party MN-TDTAL Q
,M ur>t _ _ ill MNK>lUM
bO!
4 `�r
uAIipl tlr plOpodv To
tilrn tr f - - —... _. .. ___
Thee pat. bsoomea"rend void V work or oonstru allon auhorued N new cpm
tt lsrtosd wIM 4 ISO doosm N otrW.% un of work 0 sLoper dW Of"Idm wd It, ••••••••�
a persod of :e0 days al any&.v s^w warh M*"Ymvsd
Dote Issued
to tw rta woe tw rs es tt� Fills
CITY OF TIGARD MECHANICAL PERMIT Pormilth�f�)
Description ——
Table 3A Mechanical Cods CITY Prom AMT
City of Tigard
13125 S.W. Hal; Blvc;. 1) Permit Fee -0• -0- 10.00
P.O. Bax 23397
Tigard,OR 97223 2) Supplemental Permit 3.00
6;39-4175 1) Fumare to 100,000 BTU 600
_incl.ducts&vents
Furnace 100,000 BTU + _ - 7.50
incl.ducts&vents
Name of Deviripm nt Floor Furnace - -
77Tc.z.00
incl.vent
.lob Address '- Suspended heater,wall heater
Address /,�J SLS �j/f��.,�,. . r�� 4,_of I loor mounted heater 6'0
Tax Lot Map No. Vent not incl.In
3.00
lM 5) appliance permit Bkx-k Suhdivision
-� -- Repair ofheatirhC,refrlg.,
Name(ornameofbusiness)
y6) cooling,absorption unit 6.00
Mailing Address Phone' - Boiler or comp to 3 HP
Owner 7) absorp.unit to 100,000 B_T_U 6.00
city/Stale ;;--` Boiler or comp to 3 HP •11,1�1P
8) absc rp.unit to 500,0001 11.00
Name -- -- ) Boiler or.:omp 15-30 HP - 0
9) absorp.unit 112-1 million 15.00
MaNktg,Addreae N PlaneBoiler or comp to 30-M HP
101 absorp.unit 1-1.750 ton _�'�_
ContractorZIP �- 11) Boiler or comp to 50 H' 31.50 �-
absorp.unit 1 7_50,00.)BTU
Owe Raglstrawn No. Cly Mn.Tax No 12) Air handling a iit to �- 4.50
10,000 CFM
I her"ackrgwledge Itrel I have read this rgtplics'.xh that floe Inlormatior;given is 13) Air handling unit 7.50
+
--'t-that I am the rrNnhei or autfadred"t of the owner,that plane autxnleed are 10,000 CFM
in
oompBarae with State laws,that I am registered with the State Buiklon Board, hat tlw 14 Non portable
number given lee sorsa.(n mmno from State registration please give reason bmkrw) ) evaporate cooler 4.50
Vent fan connected
.-
15) to a single duct - 3.00
—" --��-- ----- - ----- Ventilation system not
16) included in appliance permit_ 4'50
Hood served b - A �
) mechanical4.50 exhaust t 7aust Y
Date ) Domestic type
Describe work ❑ addltio alteration El repair [] 18__incinerator _ 7.50 V
to be.done residential non-residential E) 19) Commercial or irdustrial
_ ---- -- typo Incinerator
30Existing use cr �
— _
building or property.-- -L 20) Other si.,won ,water 4.50Proposed use c f v heater,solar,clotheslothes dryers,etc.
build`ng o1 pror erty_`_.__(((� __—..._ - 21) Gas piping one to four outlets 2.00 2.
Type v!furl oil I l natural gas rA"" LPG ❑ elecAc ❑ -
��`r 22) More than 4-per outlet
NQs-1_G)~ SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON.
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ ; RNs SURC14ARGE
IDAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 259E OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIMF AFTER - --�
WORK IS COMMENCED. TOTAL
Special Conditions
-- Dale Issued U by ___
ae ww wrR war wr
BUILDING PERMIT APPLICATION oAIE____"�-` .�_-__,ts—____
v&9 6
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 244-9314
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING Pl.ANS AND FeECIFICATIG dS. OWNER PHONE
OWNER L)Orl JOB ADDRESS Il-778 SW Mor:t.l ig still Drive
ARCHITECT 1S133Ca 1
ENGINEER
BUILDER _ �, _ ADDRESS DESIGNER plan 013 � --
STRUCTURE 51 NEN ❑ REMODEL IJ ADDITION IJ REPA!R Cl RENEWAL ❑ FIRE DAMAGE ❑ Dr*AOLITIQN
L) RESIDENCE C_7 comm GJ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO 1-1 CARPORT D GARAGE fl STORAGE ❑ SLAB❑ FENUB,
OCCUPANCY _ F3 LAND USE ZONE .— `:6LDG.TYPE — FIRE ZONE.—__PLAN CHECK BY ---HEAT—-----
("r-m l-ruct ningin- faMily dAfelilig w attached garng , all per approved planu.
c�cde:. REISSUE of 6569. Subioct to Arwrt $360. _- --
SEWER PERMIT# 34031( LdUl 3 bat12S� 10tr.�lps t� 1-' tLt'CE1 420
. ----x-
OCC.LOAD _FLOOR LOAD 40 HEIGHT :10N �
_O.STORIES 2 AREA NO.BF_D_ROOMS�— VALUE 0-0._
_— BUILDING DEPARTMENT _ SETBACKS FRONT ?(! REAR 3 LEFT SIDE RIGHT SIDE fir,
THIS PERMIT IS ISSUED SIIBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
'Plan Check 1 10 _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLAN" AND SPECIFICATIONS AND IN COMPLIANCE
l WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
8uh•total _ _ RESTRICTIVE COVFNANTS. CONI RACTOR AND SUB CONTRACTORS TO HAVF. CURRENT CITY BUSINESS
_ LICENSE.SEPARATE PERMITS REQUI!VSEVf Eft PLUMBING ANQ HEATING.
Stai4Tax z1 50 SSIDC 250.00
Taal _ BDC— 600.00 1►� r /`� I:�� J
4 Q•OO PDCN
By l",1Q.00 APLICAN7 O NT— —
_
Approved__ J Q.r)1.�71� Receipt No. ��// ��,..v.—� _._. _.-_---._V______.
pp PHONE
!tom its tti tIiALMA livis
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
f3-1,5 K----r-. -1; - 11 Contractolz-4
Permit No.
Flough-in
4.36--1-?
Final
HEATING
Contractor
2J12-- Permit No.
/6 2--7Gas or Oil
Rnuglh4n
7 Final
SEWER
Final
DRIVEWAY
-- ,,G
Storm Drainage
Main Drain)Final
Sidevvelk
Cult,&Street Final
Approach
BLDG.DEPT.FINAL 'TETAPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
I.andscaping
II Zoninq Final
.a ar
w - VLNN WiLLN NV. ,j
for inspections call 6:19'••41;5 PERMIT NO.
CITY OF TIGARG 694.1171 DATE r.,_ L 11--M-- t ✓4C-O
p ILDffNO P gqMT 1•'/- 3 C A ' :uswvl�K)N —
P . liox 2W9MY Tigard OR 9722] TAXMAP - -LOTNO6
OWN , i i i rr1 ISS U i" ( Joe ADDRESS
BUILDER ._.._ STATE REG.NO, ? —��._-�- �DATE
81.1ILOER•S PHONE
ARCHITECT
PHONE _OTHER _-—
STRUCTURE 'l(NEW 0 REMOOEL ❑ ADDITION ❑ REPAIR ❑ MOVE CQ OTHER CJ OEMOUTION
0 RESIDENCE ❑ COMM ❑ EDUCATK)N ❑ IND • C1US,RELIGIO ❑ACCESSUAY I) GARAGE O OTHEROw�F�EN
OCCUPANCY &3 ._LAND USE ZONE fL2—,L BLDG•,TYPE FIRE Z.(MF----PLAN CHECK By ►1EAT
Construct single family dwelling w/a r.ached ap,r 11r a nr-iuvd�l��� --
4u13jpct Lo 85 code _ _ —
SEWERPERMlT#,.3 V a_? / '(1 du) 3 baths, la trans r�2�' raoe �a y vA�uE �i3lt
OCC.LOAD FLOUR LOAD YO HEIGHT 1 HO.STOP, 7; AREA 1:0.BEDROOMS
BUILDING DEPARTMENT SFT BACKS WONT 7 C: F;CAR LEFT SIDE /6 RIGHT SIDE
PemIN L� V _
THIS PERMIT tS ISSUED SUBJECT TO THE REGULATIOYS CONTAINED IN THE NUIL04HO CODE.ZZNING
REGULATIONS AND ALL APPLICABLE CODES AND 01117/NANCES.AND IT IS HECEBX AGREED THAT THE
PIanCheck O WOhK WILL BE DONE IN ACCORDANCE NATN THE F?-ANS AND IFECIFICATIOHS AND IN COMPLIANCE
WITH ALL,APMLICABLE CODES AND ORDINANC IM YHE ISSUANCE OF THIS PERMIT WES NOT WAIVE
PL Ck F" RESTRlCTM COVENANTS.CbNTRACTOR AND WA CONTRACTORS TO NAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REQUIRED FOiA:9EWER.PLUMBING*NO HEATING.
SUa T-� Z / 5-6 SsOC
SOC- ._.._. _..... ._._. ..
Total -3,_6 APKICANTORAGENT
-- Receipt No ivoFtESS
Gal.Due y•��• 3�
__--
/ RECEIPT #
PDC .e l, -�� ��
DATE PD.
SEWER CONNECTION 5 // d-Q AMOUNT P0.
SEWER INSPECTION
SEWER SURCHARGE S
:ommente: �! �l�t. t M..c,�.:T��c�_
1