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CITY OF TIGARD PLUMBING LU25 SW W1 M%d-
TigKd 97M
Wk&ft amst hoW O"on Its Watim ki mricluct a plumbing PERMIT at
bul*wu Of MW be Prop"kv*rnwtoperator not mfiside Mp.
Pkwnbor*Nmil N4n,-5
Address
ORS 14-2A 14-21410
OUAlt MICE AMT
,;ob TAX Lot Map.No.
Addre"
L44 Block sub*Aslon
Sink1.60
7.50
N"_jTj"(vi bu Lev
?.So _57)
Tub or Tub/Showw rAxft
Sho~Onty ?.so
Owner Wider CA-0w 7.50
piehwuM ?w
Ptvxe Garnave Dspasxl 7.50
I I
wmsNng Machne 1.50
Fk)(m 0(ain 150
50
kW;-V Address —Phonot Walef Healer
Occupant zip Laundry A00M it sy ?.50
Urinal
Cttw Fb*m(specify) 7,50
Cy�r
7.50
7.60
7.50
A,
Tax No itSCEUANELIUS
30,00
mais Bldg$ so�;o sBus OF no-, ftow-va.Addit.100' WOO
was,Serviom 10 100 1000
r
waft Swviw a&Adds 2m IS.00
I hereby w*nmv%t%w VW I he"re.-d Mole application,that the w*xms§M
®Ivan lowork kfWfarn egisim *FW ftStall WWxWbBoard,and Mao Storm SRale OrMlinl9t,100' 3000-1--
he"a SIM*ftmftV boonse,that to mmtws oven am mawlt,lint SAI
0-t*v work wit be dons in mccomomw w4th apple ply of Ow 1500
gon Revised Staples Chogftm 447 cm M and sp;Aadft Godes and#w MOW*Holm Spam ?Sao
no holp wN be w"00yed wiloom Noonsed urm:lor ORS 003- (W am, from
SUM fOgWISOM p""Vlvv reason beimv), Back Rpm Prevention
HOWOWNEM-1 tnrsby owvty Im I am lineQwrw of I*pmp"do-
Mvloa w Ant4kabAlon 0ow"
wvt)od above.sit wild IoosMon I propose to mW*a pkwri*V kwk*odm for Any Trap at Vftso W
"W own use and 11 is POOMOv im not bskv owv*wcWd Im"Is.Wm Of rwA ooramcftj to a Fbours 1,60
Cosh Bain 1,10
4400 POP It
#ago PW w
Mar of Pkm"WW*
Ewe"
TDHbm SIGN ok n w DW Now Mft.or dtlbd.A*O@w @No;,
Fain rkmLW&jrW& LWCAY
t*watea work rw"Cl addift [I MM MW C) rW*k C7 J dmuiN
lek2am-
1: , N QUKOI
Id of
hno—WAW v
Vft PU"M Mt Ukft MA WW%'W Sy at*N 00rWVWftn S*WrAW it WA OMM,
Dft "md
elr noref a� wn rte► � � till► fl�l
CITY OF TIGARD MECHANICAL 13ERMIT --
Permit N
Description
To"7A Mien" aI Code _---_ —___-_------ '1TY PRICE AMT
City of Tiqard 1) Permit Fee -0- -0- 10,00
13125 S.W. Hall Blvd. -_-
P.O. Box 23397 Y2) SupplemetltalPermit 3.00
Tigard, OR 97223 -
639-4175Furnace to 100,000 BTU
I) incl.ducts&vents ( 6
2) Furnace I00,t101)BTU + ^- -- - -
� i_ G 7'50
incl.ducts&vents
Name of Development 3) Floor Furnace 600
incl.vent
Job Address4) Suspended heater,will heater 600
Address zQ _S C7f, (/Il'li, G'. or floormo�ntedheater
Tex Loi ;Z ;Iq Q.1? Map No. 5) Vc ni not incl.in 300
Lot d, I Block Subdivision/ L,e,w _--- appliancepermi! -
N ow(or norm of txwr nmas) G) Repair of heating,ref r ig., 6.00
)'n( �I� G �Cr I cooling,absorption unit
Matlkw Address - PWne 7) Boiler or comp to 3 HP 6.00
Owner absorp.unit to 1(10,000 BTU _
:fyiStale — dip 6) toiler or comp to 3 HP-15 HP 1100
absorp.unit to 500,000 BTU_ -
Boller or comp 15-30 HP 15.00
Name -° 9)
a".unit'h-1 million
arearaNing ArMheN Frf+orte 10) Boiler or comp to 30-50 HP 22..50
absorp.unit I_ 1175 million -
Contractor - ----- - - Boller or comp to 50 HP
City/sure Zkr 11) 31.50
at>srxp.unit 1,760,0008TU
State Raokroailm No !City Bu,.Tax No. 12) Air handling unit to 4.50
10,000 CFM _
1 her ank that I have read this application that the information tven is Air handling unit
ea' °"""`"�+" � to 13) 10,0_00 CFM + 7.50
norrW.that I am the ow;ler or suthoriyerl sWI of the owner,that plane submitted are in ---- --
oompliance wfM State laws,that 1 em registered with the State Builders Board,that the 14) Non portable 4.50
numl)w given Is(xirrer l (If exempt from State regmiralian please give retson below) evaporate cooler
Vent fan connected
15) ton single duct 3.00
- --- Ventilation system nv!
16) irtcluded in appliance permit 4.50
---- — �-- — / ---- Nood served by� ti.a0
171 rnerhanical exchaust 4 5 L
(dorm or DAIet P) 'Domestic type 7.50
Describe work ( addftion ❑ alteration I_1 repair LI incinerator _ __ —
to be done reslu .C-A ❑ _-_non-residential U 19) Commercial or industrial 00
Existing use if type incinerator_
building or property._ �) Other i.e.,woodstove,water 4.50
Proposed use of _heater,solar,clothes dryers,etc.
building or property - ----- 21) Gas piping one to Mur outlets I 2.00 1 t-v
Type of fuel- oil Ll natural gas U LPG ❑ electric F l _ -
22) Mote than 4-per outlet
"Q-T= SUB-TOTAL 3(Sa
THIS PERMIT 3ECOMES NULL AND VOID IF WORK OR CON
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 190 S&10 456 SURCHARGE
(DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL (�((
---______ __---_- _----_-_--
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ---.-.
TOTAL �
WORK IS COMMENCED.
Special Conditions %
Dateissued '__ ___ by -- --
MR-Emil Raw_xw_xi
BUILDING PERMIT APPLICATION DATE_--- ___.,�H___�" "19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATt l) BUILDER PHONE 62'5-6167a
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANC AND SPECIFICATIONS. OWNER PHONE,
L( T.N.0 -Co
OWNER ,.,,,>rrm, ki51 ir,►rJOB-ADDRESS 12290 SW T+1.i..I.�.Y�l.ew �" --- --
ARCHITECT
AiF.tK"_ic ENGINEER Irkiight 75' 9-•21
BUILDER ADDRESS DESIGNER
STRUCTURE ftp' NEW ❑ REMODEL ❑ AnDITION ❑ REPAIR ❑ RENEWAL L7 FIRE DAMAGE ❑ DEMOLITION
2 RESIDENCE ❑ COMM n EDUCATIONAL CJ GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT O GARAGE ❑ STORAGE ❑ SLA90 FENCE
OCCUPANCY --R3—LAND USE ZONE Rd_% BLDG.TYPE .— FIREZONE _.PLAN CHECK BY ---RT—HEATS
Construct single family dwelling w nttached narage.. a I nor arit)rovd p1.gj:7 ----
Sijbject to 85 coO11::, REISSUE of 0791. _Sul7ject to Apart n3rri
SEWER PERMIT# r)47( '.[lu�—_ 3 baths ] 10 Lraps garaq ca.roa .1
OCC.LOAD FLOOR LOADi'HEIGHT 2.0t N0.STORIES 2 AREA 14 7R'O.BEDROOMS 3 VALUE ry400
BUILDING DEPARTMENT
SETBACKS BACKS FRONT 213 REAR l rs LEFT SIDE Z O RIGHT SIDE
r
Permit .Et+d 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 ,C'1 WORK WILL EE DONE IN ACCORDANCE WITH THE PLANS �,ND SPECIFICATIONS AND IN COMPLIANCE:
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HE"ATING.
1. 2 r ::>:al,
State Tax •
Total 382.25 SDC—
PDCM APpI IC,4 1�T CR,4&eNT
FAPP1.1*1
40.00 T 150.00
;4 1.2�i Receipt No. i�//,.��1 iMDRESB ------..-...�_ --- - ------- --—PHONE —
DATE INSP. TYPE INSPECTION REMARKS PLUMBING -- OATK
Contracts ♦Gl / 7' /�
Permit No.
_ r Hix tulle
Final
ox,�+ w�a / �.r__� HEATt'.s —
^�
Contractor
/ Permit Ni.
��_. -
Qk• Gas or Oil
Rough-in
Final
SEWER
4p' Firial
DRIVEWAY
Final —
Storm Drainer
(Rain Drain)Final
S idem!k
Curb R Street Final
tADPr^aoh
I3LOG- DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY —.— --
IIl_andscaping
ro�ing Flnal
USO/ �"'�ICS PLAN CHICK NU. `71/1/ �_�
for inspections call 639-4115IF
E IT N0. 4 _
CITY OF TIGARD 639.417 i DATE to
BUILDINA PERMIT S cULOTNO. SUo0wIS10/,�l����JI�r16
P.O. Box 23397, Tigard OR 91223 TAX MAP�!'31_ "'' —
! h111 c a'
OWNER.._ MUM, Irl JOB ADDRESS _L_''�90 'V
``
BUILDER •.'7AU :,' _ _ STATE REG.NO. EXP.DAEE
• uj
@riILUER'SPNONE _
ARCHITECT. ��',,,_. PHONE__.____-._______ OTHER
STRIJCTUnE NEW t7 REMODEL_ C)ADOITION^ (I AE:PAIn— C) MOVE C] OTHiR _ t1 OEMOLIiIUfr
C) RESIOENCE 0 OOMM C) EDUCATIOU U IND 0 RELIGIOWS C)'ACl:ESSORY Q GARAGE 0 OTHER 0 FENCE
OCCUPANCY ;�� LAND USE ZIJNE V(i�BLEY_•TYPE `' �) :FIRF IANF_, _ i LAN CHECK BY s✓�—�.L__H+EA T
Construct single fam i 1y_dwe1 1 1 n:�.1XLhQd-_gB1-agP-f--311Pa -- -------Subject Lo B 5 cgAg — - -"----- ---
e..� Z " —
SEWER PERMIT I, cC '� __(I�Lu) j b 05, /c `SraPs _._
�U NO.STORIES iL ` ] 77 NO. VALUE'
OCC.LOAD FLOOR LOAD HEIGHT _AREA HEOROOMS.a_._�_.J
�6UIL—NG DEPARTMENT S'TSACKS FRONT REAR `7 j LF..FTSIDE nIGHTS10E
Pefmll HDI
,� THS PERMIT IS ISSUED SUBAECT TO 1'NE REGULATIONS CONTAINED IN THE BUILDING CCOE, ZONINGRrout.A 10NS ANO ALL APPLICAB!E CODES AND ORDINANCES,AND IT IS HEREBY A<1Ft=D TI4AT THE
Jr D WO,AK WILL DE DONE IN A(=RD.ANCE WITH THE PLANS ANT)SPE(3FICATWNS AVO IN COMPLIANCE
WFT14 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RES�1'RICTIVE COVE.NAPITS. CONTRACTOR AND SUB CONTRACTGRS TO HAVE CURnENi CITY bUSINES---
TAX PERMITS.SEPARATE PERMITS REOUIRED FOR SENER.PLUMBING AND HEATING
�(� vc ) SSDCSOC-
APPLICANTORAGENT
Prepd POCS
RecelCl Flo ADDRESS
/ �Z
Issued By
SSDC --- $ a _
SQC - ,
RECEIPT #_
PQC -A DATE PD.
SCUCR CONNECTION S //vc AHOUNT
5CUER INSPECTION S
5`UCn SURCHARGE S �(�U r?N
ommente ; _