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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4 171
Permit
Address
Type of Inspection
The failow�nq Building Code deficiencies a- required to be corrected:
Presented to Inspector
Date
CALL FOR REWSPECT/01V
VES 0 ,40
City f Tigard Mechanical hern':iIt 17
_ DATE: �...._
New Installation �_J Replace Relccatinn�� Additio i j Alteration
HEATINGCONTRACTOR --
JOB ADDRESS
ADL)RESS_ -_!_-------
PHONE__..__._... APPLICANT - —- ___--_`__
F I a Size
Heat Input Rating(BTU per Hour) ---------- --- Vent Site_
-.. t: _ ------
FUEL 01L� GAS r ELECT OTHER Y _ LI NO. FEF �( 17EMEE__._ITEM - ---i- _50--` _ SEE BELOW Each Air Handier Ui nit or Duct S�rste --
For Issuance of Permit _ __ - .50New u to !� mcly 1� 000 BTU 6.00Commercial Hood System5U --
�.-_'I _ _-_ _ --. - - 750Other Eguipment_Each_�New 100000 13111' to o� r 4.90_- 4.50 1 Tri Inspection __Woodburnin Str_,va _ --- 6:OQ Air Conditio�� Comprasso, up to&in8.00-
Well-Floor- SusEAir Condition Com resso > "(S+4.50 � ._.Ventepair I leaf Coo;
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB.-CONTRACTORS !
PERM T ISSUANCE 10.00 r•Nmments:
FEES --
U&TQTAI�_ -.�
_ 9t, STATE Issued BY -_
25 PU N CN--.K --
TOTAI.w_ RFC. 1R _ ! -•---i- --- Signature of tkpplicant
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
'Tigard, Oregon 9'223
Phone 639-4171
Permit #
Type of Inspection
The following Building Code r eficiencies are required to be corrected: — -�1 -- -----
_ Inspector
IPree,ented to — --
CALL FOR REWECTION
VEc ❑ NO
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INSPECTION NOTICE
City of Tigard Building Depa•tment
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address—_ _ Permit # r
_
Type of Inspoction
Th- following Building Code deficiencies are required to be corrected:
_.�._. � 'S.r. f ' .r.....n 2 .gL'..P„r,�� s. .,. .o- �'R..��.-...�. .-' a •?_..yw.. tiTk'f.'"� _�..� ...__—._ .._
Prevented to__ _ -�--- Inspector
Data
GeV FOR REJIIMEG 17ON
❑ YF5 El NO
BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT NO
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as;tferein noted to be installed irr,accordance with the plumbing code of
i igard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. Job
Owner % / �' Address. ^�S ��j %'L_; x, bate–_ 2—_ i
.._.._ NUMBER OF TOTAL r
TYPE. OF PERMIT ITEMS FEE ON EACH AMOUNT
R yT I A L
Single Family-1 bath--each 28.00 _
Ou lax-•Each 1 bath unit 25.00 _ rY 1
Additional bathrooms-each _ �� 10.00
Mobile Home Space-each 18.00 _
INDIVIDUAL FIxTUREe, C01''IIYIERCIEI
1 to 50 Fixtures In 1 building-each _ 3.00 _
y51 to 100 Fixtures in 1 building—each 2.50 ' t
101 to 200 Fiirures in 1 building-earh 2.00 e A
201 or more Fixtures in 1 bill id ing_each 1.50
MISCELLANEOUS V
Sower-each additional 100 ft. 10.00
Nater Service to building _ 5.00 �-
Other.(Specify): ^�— � �- �� �•
_PERMIT for Plumbing Insoection Phone 639.4171 I
4L State -� Plumbing Contractor By _
Tr1TGl '�— AFr PIPT NO Ii9ued Rv !.
BUILDING PERMIT APPLICATION TIGARD DaTE19Fitl 3270
THE UNDEPSIUNEu H 'A PPLIESrOR A PEI-MIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND AP. ,—;VED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNED
LOT NO.
OWNER 0,-Lra t3lODx'C JOBADURESS 33` 5 SW Murdock `,trent; _
BUILDER ClaSSiG HDITIR Impr. ADDRESS1233b SU Pnn Court _ DESIGNERR _ WiuTCy HsrCLey
STRUCTURE ISI NEW _❑ REMODEL _—_❑_ADDITION El REPAIR` ❑ RENEWAL 11 FIRE DAMAGE ❑ DEMOLITION
11 RESIDENCE ❑ COMM CI EDUCATIONAL 11 GOV'T ❑ RELIGIOUS 0 PATIO C] CARPORT ❑ GARAGE C STORAGE L] SLAB C FENCE
OCCUPANCY r_J LAND USE ZONE f"7—BLDG.TYPE _ Jk1 FIREZON- E- _PLAN_CHECK BY HEAT—
Construct single Family dwelling w/attached garago, 3 BedrDDr�s - 2 uALhs.
1*40-18sus of Permit 13269 (12275 5161 Ann Court) -
SEE ABOVE PERMIT FOR ALL CORRECTIONS.
SEWER PERMIT# ,� — 0?:1D_t][] --
OCC,LOAD FLOOR LOAD 40 HEIGHT 14 NO.STORIES .I AREA 1 J 33 N_O_.BE_DROOMS 3 VALU#613.600.
BUILDING D—EPARTMENI SET BACKS FRONT 1.CI REAR 36 LEFT SIDE RIGHTSIDE 17
Permit �1 "1019-00 _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check l0.�(] REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
—j WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total21-.3000 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWCR,PLUMSING AND HEAPING.
State Tax 4'. _ 13,36
-- SDC-- '400.LI U
Total 1227.36
--- -
By PDC# I I �l.pU„(lrf..�____. —r
APPLICANT OR AGEN i
_ _
roved dwh
AppReceipt Ca/` ADDiIESs --- ---L " -
PHONE
NO Mal -- - I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
T-rY-S,ci,-• --- — — contractor -- --- -
--- n
Perm't No. y/1� 1.4 0 7�1Ix
Xf— to., AL Rough in
41.1. Fixture
Final ----
HEATING
ti Contractor
Permit No. (C'(/(( 7.2
Gas or Oil
Rough-in
Final
SEWER
Final %—
DRIVEWAY
Final
-- Storm Drainage
_ (Rein Drain)Final
Sidewalk
Curb&Street Final
_ _ Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUP CY
CERTIFICATE OCCUPANCY /�_ y/ (�_`J Final
vLandscaping
Zoning Final
�I
BUILDING PEPMIT APPLICATION TIGARD OATc�.
THE UNDERSIGNED HEREBY APPLIES FOR A PERPAIT FOR THE WORK HEREIN INDI ATED BUILDER PHONE -`► v
OR AS SHOWN ANS APPROVED IN',HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONEIr
OWNER Pele BloomJOB ADDRESS 37V��_L� 1��' LOT NQ—J ,� �
A,44CHtTecr
BUIW[F 'Q��YG I�AYh�.l, n�vp�M - RESS��2 3�L /-1 VtYI • _ DESIGNER
STRUCTURE NEW ------❑l R''EMOOF_L ❑ ADDITION ❑ REPAIR Cl RENEWAL L7 FIRE DAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMM Cl EDUCATICNAL ❑ GOVT Cl FIELIGIOUS G� PATIO G CARPORT Cl GARAGE: Ci STORAGE ❑ SLAB❑ FENCE
OCCUPANCY -��..LAND USE ZONE k—!7-7—BLDG.T"PE- a,2� --_ _FIREZON�_�;Z_PLAN CHECK BY HEAT
— - liC!'lla 4 �d!tN �c111rl GO 4 R __
3 712
SEWER PErRMir# - _ w________C,LNhK-P" q _�
OCC.LOAC' FLOOR LOAD HEIGHT �NO.STORIES ARE " NO.BEDROOMS *3 VALUE 600
BUiLCING DEPARTMENT SET BACKS FAONT ,ZO REAR ,'3� LEFT SIDE 4C& RIGHT SIDE t
Pima 20� PHIS PFRMIT IS ISSI.IED SUBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZON:yG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan C Teck WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND Its COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 2-� I•�'�C✓ RESTRICTIVE COVENANTS- CONTRACTOR AND SUE CONTRACTORS TO HAVE CURRE14T CITY BUSINESS
Isldt9 Tar,
`3k) LICENSE.SEPARATE PERMITS R=QUIRED FOR SEWEP,P1UfIF':'G AND HEATING.
• _]
- - F-!�3P SDC—
Total
pDt APPLICANT OR AGEeNT
E3y
Receipt No.
Approved — ADDRESc3 PHONE
Jnr
FIN
SEPER CONNECTION
:,lencrTION �, o26—
r�
7,CWFR 91!RCHARGE _ $
ell-
comments: "�D '!^ ,. �` .� d�o°4+o►�r� �' �� -_- —____ -
��op** Z4 ___._-----
v- lq w I I Ll I'cl Vc,-i;)jf
O
New Installation '*ewlp�,F)IdCel F-I Relocation E-A Addition f.'A Altcra6un El I'/.Stitt: -
TO,rAL .7.
VI tAT I N G
CON MiACTO r-, AzLn--� UYINIM
iN:,DRE.cZ ADRESS
lk
PHONE APPLICANT
Ha3t Input Rating (BTU Per Hour)_ Vent si Flue Size
FUEL CIL UJ GAS ELECT
ITEM NO, FEE IT L rVI NO. FEE
*E1, AbQVI"l
! !.I I If PlItmit Air (.-wlitiun Cnm;.,iu-,or 15 to $(l Hl'
_Q tf66-b- - -
up Lo l.nc - ------ 4. Air I 1,!)Jlill-'j 1P,W10 Cl-NI
Pi l C10,00 BTU s & over Air I l,jrl, ')V J()(IQLICFr,'j' 5.00
4j,l)
2.Wi Vull,
00
-4.00 Hu,) I iii ,l N 03 r�
I " I till 4.01-1 0
INSPECTUR'S WKMENTS
Cl rY 80SINESS LICV.NSE nciui4cii rOft All CON I HACTOW')i Ok Wit cull rNACTWIS
AF'J'jJ0Vr-,[l By DATE ISSUED BY DATE
HLCEIPT NO.
114 Sirinaturo of Aoml;rnmt