11655 SW SPRINGWOOD DRIVE 11655 SW SPRINGWOOD DRIVE
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C;ty of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :
DATE: - 16 Z;;�6 DATE 13SUED :-LL_
OWNERS NAME :
ADDRE 3:
CONTRACTOR :
TEST . Air p, Woter , visual,/, Laboratory p
(RESULT. Approved , Disapproved O , Pending p
SKETCH.
114SPECTOR DATE
EUtE : Attach iuppl-mentnl telst data heretc,
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City of T19crd
I NSPEC OON REQUEST'
for
I N c-PE CT I O N TIME' -_ PERMIT N0, :—DATE: 6//4/7(c DATE ISSUED .__4,..k:_
'N E RS NAME ; _._ �'1�4.'t : I
r• ____.._.. .
T ' Air (�, Water` , Vi�suo► (' Lobo>ratory
SU1 T. Approved hiaopprovRd irq Q
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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE_ 1pri1 7.1l 19 -v N° 0763
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED ;N THE ACCOMPANYING PLANS AND SPECIFICA1pNi. OWNER PHONE
ADDRESS BUILDER PHONE
3wnL9 r ENGINEER
BUILDER ��ryry ❑ ,-_-� AR HI T 11 _ DESIGNER
STRUCTURE L_.1NEW REMODEL_ ❑ADDITIONG
_ REPAIR ❑RENEWAL []FIRE DAMAGE- ❑DEMOLITION
uRESIDENCE []COMM LJEDUCATIONAL ❑GOV'T ❑REI-IGIO--US❑PA-710 ❑CARPonT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
L.IHOND ❑-MOVING LICONDITIONAL UFE QDESIGN REVIEW ❑COUNCIL Al-ROVED ❑SIGNS,
OCCUP/`. ICY LAND USE ZONE—.—BLDG.TYPE FIRE ZONE._,,. PLAN CHECK BY HEAT__
Cnfljtl'lat:t 1:2E.t) aLt• P,,„ frame daJSal:lin4 with attin' ` 4d garage
– No boftemont. Rulasus 46 ironwood Loop --
Qs�o .� bH Y'Opm
1411 lb 17 5 U
OCC. LOAp -., ! LOOR LOAD HIEIGr_ NO.STORIES AREA - VALUE
-- -- -+ ,T-- --�}-- --
IJILIJING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit $130,00
_. ----- _� -=-- — -- _ - –
�Q oo THIS PERMIT IS ISSUED SUBJECT TO THE REGULATION¢ CONTAsNE1 IN THE BUILDING CODE, ZONING
•
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- - WORK WILL WS DUNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF ',HIS PERMIT DOES NOT WAIVE
14, RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I�96State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUM31NG AND HEATING.
Total -- 144. 20
Y
APPLICANT OR AGF Iv t
Approved Recr�ipi No
-- ------------ ADDRESS
OATE INSP. TYPE INSP CTION REMARKS PLUMBING OATE
A#,o;o-7 Contractor
/-7� -- Permit No. o */6
40 1
-2
—t? -,,e, -- —111 Fixture
Final
HEATING
Contractor
Permit No. 7-21 61117176
Gas or Oil
Rough-in
Final
S E W E R
Final
DRIVEWAY L cl
Finai
Storvi Drainafe___
(Rain Drain) Final
Sidewalk
Curt) &Street Final
F
S
Sidewalk
Al
RLIDG. E pproach
TEMPORARY CERTIFICATE OC"UPAINCY
I
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning
oning Final
00
City of Tabard Mechanical Perm L�o Permit ' - 0
r^
Fee �.CO -
New Installation 0 Replace ❑ Relocation Addition Atter3tior, --- j.21
TOTAL, _
CONTRACTOR - �g.- OWNER
WORK ADDRESS =• W. �?ri rgwodd Or.
ADDRESS V711 S. 'a. 'arxweod '7 -
_ £ Air Cond. inc.
PHO NIE APPI-ICANT —
Heat Input Rating (BTU Per Hour) Vent Size Flue Size _
FUEL OIL '- GAS a ELECT v OTHER
ITEM NO. FEE ITEM 111.7. FEL
For I Ll ce of Permit _ 3.00 Bolters Ovcr 50 HP 25.00
New Under 100.000 BTU 4.00 Air Handling10,000 CFM 3.00
New - Over 100,000 BTU 5.00 Air Handling Over 10 000 CFM 5.00
T
!=Iuor r=�,rnace
4.00 Evaporative Cooler I ; 2.00
Wall - F1oor - Suspended 4.00 Vent -an -
Insta+i Vents 2.00 Vent System 3.00
Repair - Heat & Cooling4.00 `food ! 3.00
Boilers Under 3 HP 4.00 Domestic Incinerator 5.00
Boilers 3 to 15 HP ?.50 Comm. incinerator 20.00
Boiiers 15 to 30 HIP 10.00 Oti-er Not Listed 3.00
Boiier<_ 30 to 50 HP 115.00
INSPECTOR'S COMMENTS -_-
CITY BUSINESS LICE^:SE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPROVED BY DATE _ ISSUED BY_a / ATE
RECEIPT NO.
774 Signature of Applicant
PERMIT N 0.
A D G R ESS
PERMIT CHARGE none
OWNER -- Lc'-s "�_ -- CONNECTION FEE
PAID BY ,_ 'Z:2�''` —'✓z�-�, � 7,c�
DATE CONNECTED
(YPE OF BUILDING
SERVICE RATE INSPECTION FEEu___�_------
PAID BY _ DATE
SIZE OF CDNNECTION ____.Y.._--
A55ESSIIENT _ PAID
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