15745 SW SERENA COURT 15745 SW SERENA COURT
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"(DRESS _L`� 7�. y � `� .i��. ��� � PERNIT NO.__
PY:R(iIT CHARGE none y
1)'-f ER Illeduw CONNECTION FEE G,
PAID BY 6 uc�•tJ
IYPE OF QUI!_DING DATE CONNECTED
5ERUICE RATE t ,z, �� INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CO(IINIECTION _ ,_`IJF 435ES511ENT PAID _ �
C. ,
of Cj v
I Fee—
AhiV ration
3
cc ❑ Relocation ;:
Nev. X Rv:i!a
C--'-.'T P.Acr 0 R 0►,'NER
WORK ADDRESS J W CT
ADORESS
PHONE Ar?L I C.A NT Pie e,
Heat Input Rating (BTU Per Hour) Vent Sire Flue Size
ELECT OTHER—FUEL OIL 17J G AS ❑
ITEM NO. FEE ITEM NO. FEE
Issuance of Permit k 3.00Air Condition Compressor 15 to 30 HP 10.01.
vew-Unje, 100,000 BTU
4.00 Air Handling 10,000 CFM 3.C'
—
BTU & over5.00 Air Handling Over 10.000 CFM 50'.
-
�rative Cooler 3.0t
Icior Furnace 06
-ace 4.00 Range Vent Fan 2.0
Wall - Floor -Suspended ---
2.00 Vent System
10(
Install Vents Only 3.0:
4.00 1 lood Cummetclal
Repair - lr�eqt & Cooling
Air Contflan CcimPlessO!
Under 3 HP 4.00 Commercial Duca System 10.()(
� T.
ito 15 HII 7.50
Compressor,1ir Condition
-S CC)t%?.MFNTS
INSPECTOR
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
ISSUED BY DATE
APPROVED BY DATE
RFCr-IPT NO.---.-----
SiaTattire of Ammlle-ant
774
BUILDING DEP._-',R1'A;1ENT, TIGARD
PLUMISING PER`NIIT M
. _� _ �.�? � -CA , guider of a valid p!umbilly contractors license is hereby
authorized to cause plumbing work, as herein noted to be installed in accordance with the plumbing code of
Tigard. Such instaHations 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 c Tigard Business License required
for all contractors and subcontractors.
Owner � Address_ , ate__
NUM3c'.R OF TOTAL PERMIT NO.'S
TYP9 OF PERMIT ITEP.+3 FEe JN EACH AMOUNT (office Use Only)
.q
II L
Sin la Family-I ba-t•-aach -�_ —! — 25.00
Orioles-Each 1 beth unit 25.00
Addidonel_bvhroumx-azch ' 10.00
Mobila Home S ace-±ach - 15.00
f' INDIVIDUAL FIXTURE FEES_ -
I to 50 Fixtures in 1 buildin -exh — 3.00 ^- `-
' 51 to 100 Fixtures in 1 buildir,,->ach 250 j
101 to 200 Fixturef in 1 builjir:-each 2.00 _
201 or more Fix.cres in 1 buitring each
h115CELLANE0US l
Built'ir^, StNer-1st 5L7 ft. _ _ 10.00
`;- Sewer•-etch additional !00 .'t. 10.00 -
r wctrer Sarvica to building^� 5.00
Private%Vita Svs;arrs—etch 1GU ft. -- -- 10.00
PES.?AIT _ For PlurnWng Phorri 631.4171 — —�— --
_ State _ Plumbing Contractor By ^--- t
—� -TOTAL RECEIPT N0. Issued By �y— i
220
BUILDING PERMIT APPLICATION 11TY TIGARD GATE 19____
THE UNDERSIGNED HEREBY APPLIL'; FOR APE RM IT FOR THS WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN "HE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _____
LOT
OWNER JOB ADDRESS HOME ADDRESS
_ ARCHITECT
ENGINEER
BUILDER _ ADDRESS DESIGNER
STRUCTURE ❑NEW ❑RfMnDEL ❑ADDITION C1 REPAIR ❑RENEWAL [-]FIRE DAMAGE CIDEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL�OGOV'T ❑RELIGIOUSLJPATIO ❑CARPORT ❑GARAGE ❑STORAGELJ-1 SLAB L..JFENCE
CIBOND ❑MOVING ❑CONDITIONAL USE ❑DE`iIGN REVIEW OCOUNCIL APPROVED []SIGNS
OCCUPANCY_ LAND USE ZONE—.--. BLDG.TYPE ____.FIRE ZONE y PLAN CHECK BY___. __ HEAT
1
OCA.LOAD _ ()QB_L.Q&D HEIGHT __________-NO.ST0RIU_ AREA _N�.� Q ,_M� � VALUE ---
_BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 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 WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
BY --
._�_-_.—___..__ APPLICANT OR AQFNT
Approved RPceipl No
DATE. INSP. Y�E INSPECTION REMARKS PLUMBING DATE -
--_-- Contractor
Permit No.
a' - - — Rough in
Fixture
�n?0-1� --- -
r Final —
HEATING
Contractor
Permit No. �3s� f�,� 1)•�7-�-7�
AA -IL— /fit+ $.. ( n �i e _ Gat or OII —
_ Roughin
Final
SEWER
Tinel
DRIVEWAY
— --------- .—_.—�. -- Final
Stom Drainage
(Rain Drain)Final.
Sidewalk
Curb&Street Final
Approach _
KDo.DEPT.FINAL TtMPORARY CERTIFICATE OCCUPANCY Final
� p CF.RTIFICATEOCCUPANCY —
Landscoping
Zoning Final