12065 SW MORNING HILL DRIVE 12065 SW MORNING HILL DRIVE
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to bection(s) of the Uniform Building Code, the
following item(s) require correcting:
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Oat FIcr, t No._-_
Ins pec to r
CALL FOR PEINSPECTION
MIT NO .____/g
o PER
ADDRESS
PERMIT CHARGE none
0 w%,E F, CONNECTION FEE
PAJO BY
TYPE OF HIJTLM �!(., _���_._..V _ �� DATE CONNECTED
SERVICE RATL INSPECTION FEE
C 0 VT.01 A C T 0 R PAID BY DATE
SIZE OF COI.ItJECTJON A55E53MENT PATO
w(dYr�llll 1� Y+r.�.rr.-,r.. ...ry ..v...Hip....._r...«....-wrTPl�"w.'.�a..w,.....^yr-.,.."Y.ha^�D'+I,M'�'" .. • Y4'9''
CITY
BUILDING PERMIT APPLICATION of TIGARD DATE 19._.x_.
THE UNDERSIGNED HEREBY APPLIES FDH APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE—
ORAS SHOWN AND APPROVED IN 'I HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.—
f LOT TO. ----
OWNER ;•1b'..atlC� I'^�1C1 F*3 �r1i.JOB ADDRESS 'i f?I�1 "r19tr1 d '1{f.,�..1HONIE ADDRESS l r1 , 1411)
- - – _ ARC,iITECT~
--
ENGINEER
BUILDER .knL)RESS DESIGNER
STRUCTURE. _ONEW — ❑RrMODEL [J ADDITION 0REPAIR _❑RENEWAL ❑FIRE DAMAGE , ❑DrM-JLITION
❑ RESIDENCF ❑COMM ❑EDUCATION,".L ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR FORT EIGAHAGE L STORAGE❑SLAB ❑FENCE
❑BOND OMOVING DCONDITIONAL USE FJDESIGNREVIEW LICOUNCIL. APPROVED ❑SIGNS
OI:CUPANCY__T._._.__LANin I.oE ZONE_ _,BLDG TYPE, —FIRE ZONE. PLAN CHECK BY------ HEAT
i1 y
ald61 . c�r1, carirf•ot bw oaecS f'oz s.lsbvpir14� pus• ';;;ws w/o sm{ak{.
_ w• I ra dui �t' .._._ .�—. _.____--
NO.BEDROOMS _YA1.Q.E.Y���5�
iBUILDING DEPARTMENT SET BACKS FRONT REAR SIS LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check lu.LJ O REC'.ILATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HER6CY AGREED THAT THE
WORK WILL BE DONE. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total '�.[?f' ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOER NOT WAIVE
- — w� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTPACTORo TO HAVE CURRENT CITY BUSINESS
State Tax If �dt.� LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total .1.4E3 t.:t.:. !4 lluu.Lit'
By __ ...�I...._........._-- APPU(AN1 OR AGENT
Approved i L E R{reihl No �
t
DATE INSPP, TYPE INSPECTION r_ REMARKS PLUMBING DATE
Contractor
-— ---- ---- Permit No. -n V
R•wgh•in
Fixture
Final
15 fig' W
C pll+[ /AI HEATING
v Contractor
--
�, > Permit No.
/- �'rf D ,1 _moi-✓..�—.__ —_------- - - �
Gas or Oil
- -- — -- _-- Rough-in —
_ Final
— — � SEWER _-
-_ Final — 3�i 0--,7 9
DRIVEWAY
Final
Stoma Drainage
(Kala Drain)Final
Sdewalk
z — I Curb&Straot Final
..Y—. ------� .— Approach
BLnG. DEPT.FINAL TEMPORARY CERTIFICATE OG' NCY HCERTIFICATE OCCUPANCY final
H
Landscaping
7 ming Final
19
31 '� N PERMIT A►PPLICAT ON CITY •I 1�:.�r,ww' ID DATE��7 __._ __13_ NO Zy��
_ .�III_DI G P uF +�
7 64 UNDEkfl(;NED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATFD BUILDERI'HONF�`�d'�S�riJ
JR AS SHOWN AND APPROVED IN THEACC )MPANYING PLANS AND SPECIFICA11ONS. OWNERI'HON
1 Q 46 5 LOT NOM-L
ADDRG `-39":
5 �'i j,& ,I nc 4M DO HOME ADDRESS
ARCHITECT
ENGINEER
'\ AOnRE5" ��� ��l�i `l l��T�y�\L. _ 4ESIGNER
;URE '0NEW 0REMODEL � DA_DtIINION 01.1t'r,A"k �DRENEWAL ❑rIREDAMAGE_(]DEMOLITION
r r - "IM ❑EDUCATIONAL ❑GOV'T L..�RELIGIOUSOPATIO ❑CARPORT I�GARAGE C��STORA'E0SLAB ❑FENCE
I J90_ND_�—OMO_VIN_G_ ❑CCINDITIONAL_USE M 0DF.SIGN REVIEW 000UNCIL APPROVED OSIGNS
:CUPANCYh LAND USE ZONEj �a BLDG.TYPE 'N FIRE ZONE,-L PLAN CHECK BY_._. � HEATd__.
r
Iv AR�A!__e N9 >�.F43Q9MA1E_�_._..__
__.
AUILDING DEPARTMENT ` r
SF.T RACKS F RC1NT ! REAR_1� LEFT SIDE U RIGHT SIDE
-- — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
i Pian Check / p AFGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS �4EREBY A$711EF.D THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total •� AL1. APPLICABLE CODI'S AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
7 RESTRjCTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS I'D HAVE CURRENT CITY BUSINESS
State Tax 7 y� LICENSE, c&PARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total y y
By
t..-.__. .i_...-.._._-._,......-..____.— APPI SCA 1 OP AGrNT Cy
Appi UVed >.,//+� FlecelI11 N0 Y' \I y� 1�)--
- ADUNrSS ������
w J11,
4
s�
City Of T !lord Mechanical Permit Permit 300
New Installation ED Replace ❑ Relocation ❑ Addition ❑ Alteration! [1, .� FeeSit,--�---
,_, TOTAL
CONTRACTOR LIJ f I`u a.� ';�_ OWNER U-) 1
ho�.�- '1
wfler WOR1C ADDf1ESS_ � 7 r.- .CL1 C
PHONE n' '( APPLICANT Set ,,i I L'i !_Lu %_V. y
Heat Inp n Rating (BTU Per Hour),,_/o o-u� gp p Vrnt S'lae � '� Flue Size____�r �
FUFL OIL ❑ GA.S ELIECT ❑ OTHER _
ITEM NO, FF. ITEM M —� _ _NO_ FEE
For Issuance of Permit 3,00 , Buiicr; ver 50 HP 75,Q
New• Under 100.000 u y 4.00 Air Handling 10.000 CFM _r 30
New • Over 100.000 BTU 00 Air Handiinq Over 10 000 CFM 5 OC
Floor Furnace 4.00 Evaporative Cooler
Wall • FloorrSus nded4 00 Vcnt Far, 3,0�0c
Insiell Veots L 2.00 Vent System
Re air • Heat & Cooling 4,00 Hood 3 pC
Boilers Under 3_HP 400 Domestic Incir,erator
Boilers 3 to 15 HP r 7.50 Comm, Incinerator 20.0(
Boilers 15 to 30 HP10 QG Other Not Listed
Eloilers 30 to. -50 HP —`—
INSPECT'OWS COMMENTS.
CITY BUSINESS LICENSE- I'IFOUIRED FOR-ALL CONTRACTOVS OR SIJ" CONN- A:.TORS
APPROVED BY—� DATE _ ISSUED 13Y DA7E—_ —
RECEIPT NO.
-- e3imature of Applicant
S>t� t� # # # # '�P '➢A' 70X
BUILDING DEP TIGARD
MILWAUKIE PLUMBING CO. PLUMBING PT.RMIT NO
_ P. 0. BOX 393
�--- holder of a valid plumbing contractors license is hereby 7
autharized � �IINg work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than fou
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License requ' �
for all cc,-tractors and sub-contractors.
�1 Job
Owner— _ ��_� Add res _ ! _` ate 3
NUMBER OF
— TYPE OF
WPMIT _YITEMS FEF ON EACH AMO
R IS I D_. NS1._A _ __$____—__.—_
Sir. I� Fami —1 bath each 25.00
_ rJ
Ouplex—Each 1 bath unit_ v 25.00
Additional bathrooms—each _ 10.00 �~ 1� �C7 C9 _
_ _Mobile Nome SL FIIJtX ch _ — 15.00_4
INDIVIDUAL TURESCOMMERCIA
1 to _50 Fixtures In 1 building each 3.00 — :A
51 to 100 Fixtures in 1 building—each — 2.50_!_ _ A
101 to 200 Fixtures in 1 juildin3—each 2.00 ^-
201 or more Fixtures in 1 building—each 1 50
t.1ISCELLANE0US�
_Sewer—each additional 100 ft, 10.00 —
__water 5arvireto buiWin — —�� 5.00
Other IS:ecif !:
PEAm.j r l,ea V For Plumbing Inspection Pham 639.4171
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_ ` tat
� Plumbing Contractor By
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