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CIS Y OF 'TIGARDY � •.
OREGON
�" >• t O�tiner: J.L. Li.9'r!t ................................. .........Permit No......1.039.........
.. �8• ',. G4
Building Address.............. 20
.,Sp.rinywood. Dr....•.............. ... R
Certificate is hereby given this.... of..Ma.r'Gh.................. 19 .?.7... `
1 �' I L , .
that said building may be occupied and
°d t that it complies with all requirements of
the Building Code for the City of Tigard,
as apl�ro�-ed by the Tigard City Council.
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Building lnspet , v
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PERMIT NO.
ADDRESS61
PE,,"IlT CNAr"GE none
+— -- CONNECTION FEE
f.,W N E R
r PaID BY
DATE CONNECTED __ -•
T Y F-l_ u. �C l L 0 I N f: /�-t.�a�,,._, .._.__—•--.— o
TIE INSPECTION FEE 'S
CONTRACTOR
PAID B Y ,� DATE
�__
_._.__ - -- - ---- _-_.__._...__ �_.._
_
S I Z E OF C O N N E C i I 0 N ASSESSMENT PAID�.
17
R� MSU `1v
=00Z
City of Tigard
INSPECTION REQUES i
for
�e?4e4 < //,?1�,%:, I
INSPECTION TIME: _ �� PERMIT NO. :_...__�—.�
DATE: DATE ISSUED : Z
OWNERS NAME : <�� ✓
ADDRESS: f�O��u A' .
CONTRACTOR : 'tc" *!Tt_______�.
TEST : Air 0, Water❑ , Visual , Laboratory p
RESULT: Approved �' , Disapproved O Pendini p
SKETCH:
INSPECTOR DATE
[NOYE : Attach suppi amental test data dere?]
SOMERSET P!,`�`j PIJG a }I'EA!I.N1 BUILDING DEPARTMENT, TIGARD NO.
1700-5 N. W. CORNELL iD. PLUMBING PERMIT
SEAVERTON, CRECOy holder of a valid piumbing contractors license is hereby
authorized to cause plumbing work as herein nc ted to be installed in accordance with the piumbing code of
Tigard. Such installations require inspection by the City inspector who shall be notified not less than foes
(43 hours prior to the time the installations are ready for inspection. C.ty of Tigard Business License required
for all contractors and sub-contractors.
Owns L L AGdres� r Q ccC-- PIN.'4.tc� Date ! , �I g'
NUMBER OF TOTA' PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT tOffice Use Onty1
A L —�— —)
Single F&nil —1 bath—eec+t 25.00 r
C Duplex—E Bch 1 bath unit 1 25.00
Additional bathrooms—each 10.00
Mobile Home Space—earn j 15.00 r
INDIVIDUAL FIXTURE FEES
1 *0 50 Fixtu7es ;r. 1 building—each 3.00
r 51 to 100 Fixtures in 1 budding—each 2.50 I
101 to 200 fixtures in 1 building—each 2.00
201 or more Fixtures in 1 building—each 1.50 _
MISCELLANEOUS
[3uildi Sewer- 'st 50 ft. 10.00
Sewer—each additional 100 ft. 10.00 I
Water Service to budding 5.00
Private Water Systems—each 100 ft. I 10.00 I
Other iS i i
PERM- or Plumbing inVect7crt ?hone 639-4191 i
—3%7 State i Plumbing Contractor By �_ ,�1{.c_L � 7t=
TOTAL ;C. RECEIPT NO. Issued By
/1
City 9 of Tigard
_ INSPECTION REOUEST
(� for
INSPECTION TIME : 7`2u , _. PERMIT NO. :
DATE: -*J// / DATE ISS D: L_
OWNERS NAME ,'
ADDRESS :
CONTRACTOR :
- -L- K 1
TEST. Air ❑, Wover�❑],, Visual ❑ , Laboratory []
RESULT: Approved B- , Disapproved ❑ , Pending
SKETC&.
IN�IIECTOR DATE
Ct0'rE Attach supplemental tett doto heret]
I
I
.. ....--rl••..,. ,•„...,...,.q�w��..i.,m�e.r..>•a«....,..�-...v_y. •-wry,�`;•-+w.iritwa's^—u«.I�+.r�{"fJlllN�{'!'T'+!n^^.�4'r""'^ '"'"'
BUILDING PERMIT APPLICA-LION CoF TIGARD' bATE_9-8— _' �y� " 9
THE UNDEnS.;NFQ HFRE:BY APPLIF�; F%-'R APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF,
OR AS SHOWN AND AM..JJFD IN THF' 'ACCOMPANYING PLANS AND SPECIFICATIONS. 01rNERPHONE
LOT NO.-
OWNER 1_i� L,jght - 4PBADLRESS 12605SW Springwood Gf6MEADDRESS
ARCHITECT
ENGINEER
BUILDER 88M1+l11 ADDF ESS DESIGNER
STRUCTURE f_ NEW ❑REMODEL ❑ADDITION ❑REP41R ❑RENEWAL ❑FInE DAMAGE ❑DEMOL,T1ON
❑_RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
—❑BOND_ 0MOV ING ❑CONDITIONAL USE _ [:]DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
".
OCCUPANCY__I—LAND USC ZONE fL— BLDG.TYPE �— FIRE ZONE Z► PLAN CHECK BY L ild
wanvt. 1 single ! family dwell6fig u/attachad garage 3 bedroom 7 betn garage 50(: a c;.f t. -----------
-&b 2 z - _. ----– ------ —
AS,`-�
6 411 1 1538 3 370800.
OCC-LOAD ---FLOOR LOAQ _ HEIGHT____.__�1V4 SI4H1��_�_.__�13�—.�_ NO,BEDROOMS YALU—
BUILDING DEPARTMENT SET BACKS FRONT 211 REAR j J LEFT SIDE n RIGHT SIDE b
Perm:. ___---------- ------ ---�_----
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLIC .BLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED -THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. 1HE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
--- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4,103 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEAIING.
Total 16503 ......
By - — - - --
- AP i ICAN? OR AO NT
Approved :TlJ Receipt No.
....�..w..,.,.....�m..sue.,.,..._s—:••w-a..+.war:. •-��— ..nrr.u.r.urre....w».u:..r....: .u.w_.Ue.nu+Yw....wri.rNwewYira rdleMe.+.wr..,.....,..........u.ue...-.... ^W».r.�.e-n...r.wa..�wa..w.Yh:Lw:w�.--......... ...,,...............
qlel�
919b&
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CITY O F �f� _
nt .rr t r r 11 P Ur. AT��Nr T'IGARD DATE _. /9 L_._ :`*'2 `�
►�:c :1N^ERSIGNED HERESY APPLIES FOR APER%WT FOR THE WORK HEREIN INDICATED
09 AS SHOWN AND APPROVED 1, THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
��/1'JDRESSBUiLDER PHONE
ENGINEER
;_'_7Ep qqt► y ARCHITECT �r DESIGNER
S'Rl1C�L'FE ,q NEIN REMODEL ADDITION Cl REPAIR ORENEWAL AFIRE DAMAGE JDEM-I 'T!OR'
RESIDENCE -COVV -E0VCAr!ONAL _GOV'T '-2REL!GIOUSrPATIO ❑CARPORT ^GARAGE ❑STORAGE QSLAB 2FEkCE
-40ND _ MOVING -CONDITIONAL USE --�DESIGNREVIEW -,,--.;COUNCIL APPROVED ❑SIGNS
OCC PAN:_Y_-r !AND USE ZONE—A-1-91-013.TYPE_ -�iFIRE ZONE PLAN CHECK HY "' HEAT 4's�
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES Ji AREA S 3 VALUE S7 too
RL'"' 7" lG DEpART4!r^:�
SETBACKS 1 RGNT REARLEFT SIDE RIGHT SIDE
permit f S/ ---
THIS P£RMIT M ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
P'an Chec'< /e REGULAT":,e"S AND ALL APPLICAS .E CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
" WORK WILL BE DONE IN ACCORDA^JCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE COS-,ES AND ORDINANCES- T.4E !SSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVF CVNTPIACTOR A 13 CONTRACTONS TO HAVE CURRENT CITY BUSINESS
o Stit te c.�,SLICENSE.". ::. _ ��: ; REQUIRED FOH ;ER, PLUMBING AND HEATING-
Tota! /
1 Sy'— J _
AP^LICArAl u4 AGS
Approve Receipt No_
ADORESS PHONE
� r �v
10622
UN1F1 ,'.:-D S E W L" R A(.3*" E AGENCY NO.
WASHINGTON COUNTY DATE 9-8-76
r7 Tigard
COITY O� .
APPI-11'."I'ATION FOR SEWER CONNECTION PERMIT
OWNER:
OWNER'S AI)DRES"):------
STREET
CITY STATE ZIP �
BUILDING SITE: L.OT--.----- BLOCK ADDITION
WAX LOT NO. TYPE OF OCCUPANCY residence
ADDRESS ---- 12005 SW Sprinowood Dr.
DkAIFLLING UNITS.- FIXTURE UNITS
SURCHARGE IF APPLICABLE
PE RMIT FEE -- __575. I)Q. _ INSPECTION FEE 2t5-+_O0 TOTAL DEPOSITED --50-0----00-
(WAI (EXISTING) BUIL DING SEWER SySj-EM Fanno rreek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
AP,'L I C A N
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE - INSTALLER
RECEIVED BY 7
IAGLNCY OR ITS AGENI)
C C)Y'M F_N I S:
This ,&pplication and petrnit f,
,xpires in one hundred and twenty (120) days.
-rvie arnuunt [)aid will be forfeited should expiration occur.
it p f ;� �� ;- Mechanical Permit ��u Permit �f
y Fee !
New Installation ❑ Replace ❑ Relocation ❑ Addiuon ❑ Alteration ❑ TOTAL r
S�}�ft�5ci PLUMBING $ HEATING y (( (
CONTRACTOR
OWNER J 1 1161-'T
;0 nREs; __
'EAVERTON, ORECQN WORK ADDRESS
PHONE APPLICANT —�- -
Heat Input Rating (B-1�: !iourl
Vent S;ze_ >i Flue Size—fl,
FUEL OIL E_' GAS ELECT ❑ OTHER NO. FEE
11 EM NO. FEE ITEM
t Boilers Over 50 HP
Permit ' 25 00
3.00
For Issuance of . ermit — _
New Under 1�Q000 BTU ' 1 4.00 Air Handling 10.000 CFh1 300
5.00 Air HandlingOver 10,000 CFM 5.00
New - Over 130 000 BTU 3.00
Floor Furnace 4.00 Evanort:ve Cooler
I 4.00 Vent Fan 2.00
Wall - F?nor - Suspended 3.00
Instal' Vents 2.00 Ment System
400 Hood 3.00
Repair- Heat ?i Ccolin . I 5.00
Boilers Under 3 HP 4.nn Domestic 'Incinerator
Comm. Incinerator ! 20.00
Boilers 3 to 15 HP � 50 3.00
Boilers 15 to 30 HP 10.00 � Other No' Listed
�
Bal
Boilers 30 to n0 HP 15..0 0 .I
INSPECTOR'S COMMENTS — -
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRA.;TORS OR SUB-CONTRACT RS /
APPROVED BY DATE ISSUED BY CATS _
RECEIPT NO.
S:j,nature F Applicant
774 ___ _ ____.- - _ __— _- ..._.+ —..r�r-•c_��_rs._^- ^-_� �".