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f INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
...�
Type of Inspection
Date Requested Time A.M. P.M.
—
I Address
Permit #—
#
Owner Lot------ —�
Builder
The following Building Code deficiencies are required to be corrected:
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Presented to
Approved
Inspector 1 � 7 Disappro%ed
Date
CALL FOR REINSPECTION
�l YES 0 NO
AL
-- ---------
—... aranature of Applicant
C� of Ti a�c Mechanical Permit NO. -
flew Installation Replace Relocation❑ Addition [j Alteration El DATE;
HEATING
j� 1
CONTRAC 1'UR A^ Y r�i.Lt.+t Isci J�t�l�. �WNER. J.
s; Lc�.,�'�,_'• +
ADDRESS f ` /JOB ADDRESS.,,.
c c
PHONE 4` �� / > � _S� APPLICANT T�
Heat Input Rating(BTU per Hour) —__` _._ Vent Size Flue Size—
FUEL OIL CJ VAS (A ELECT [] OTHER _
ITEM rNO.T FEE ITEM N_O. FEE
For Issuance o4 Permit SEE BELOW Each Air Handling Unit orDuct System — 7.50
New-up to !ri incl. 100,000 BTU6.00 Commercial Hood System T 7.50
New 100,000 BUT's & over 7.50 _ Other Equipment - Each 4.50
Woodburninq Stave 4.50 1 Trip Inspection _ _4 50"_`__
Wall-Floor- Suspended 6.00_ Air Condition Compressor - up to&incl.3 H.P. BOOT
Vent Systern w/Fan 4.50 _Air Condition t�ressor-3.1 to 15. H,P�incl. 11.00
Repair-Heat Cooling 6.00
CITY BUSINESS LICENSE REQUIRED BY ALL CONTF!ACTORS OR SUB-CONTRACTORS !
PERMIT ISSUANCE 10.00 Comments:
FEES
SUB-TOTAL _.....�_ _
76 STATE Issued By
25%PLAN CHECK ��C}'
BUILDING PERMIT APPLICATION TIGARD DATE
3745
T', E UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR i riE WORK FIEREIN INDICATED BUILDER PHONE _
OR AS SHOWN AND APPROVED IN*THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER
PHONE
W613t1�l�ADDRESS 8FJ3a Sl�l Scheckle Drive Park Ee a�W,
OWNERi;icha�rd 0. — -- ARCHITECT
NPpINFER
4115 SW F'rairvale Dr.Pt29BIGNER R, 0. User
BLILDER Ba" (Oardin�Wa�StlUnp�DORESS ---•• ----- —
_STFUCT_U_RE_ Ill NEW ❑ REMODEL _❑_ ADDITION [I REPAIR ❑ RENEWAL E] FIRE DAMAGE ❑ DEMOLITION
_ RESIDENCE [I] COMM M EDUCATIONAL ❑ GOV'T El RELIGIOUS ❑ PATIO O CARPORT ❑ GARAGE E] STORAGE_❑ SLAB❑—FENCE
U!
G � duh HEAT—
OCCUPANCY Ft-_�_._LAND USE ZONE-. R"?-_BLDG.TYPE a�_FIRE ZONE----- CHECK BY — r_ _, �
:_
Construct Mingle family dwelling w attached Ejarage. 3 bedroume 2 b8th8-
SEE. CORRECTION SHEET ATTACHED.
SEWER PERMIT M ,�_ ,�,•Q -- ���fl_fl __—�._ ----"--S�t - -��
OCC.LOAD FLOOR LOAD 40 __HEIGHT 20-- NO.STORIES 2 AREA _ 14_j0 NO.BEDROOMS 3 VALU��3����•
BUILDING DEPARTMENT SET BACKS—FRONT 20 REAR i LEFT SIDE ��. b RI(JHT SIDE _
Permit S191).00 THIS PERMIT IS ISSUED SUBJECT TO THE REGU:ATIONS CONTAINED IN THE BUILDING CODE. ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND OT IS HER :BY AGREED THAT THE
Plan Check PAID WORK WILL BE DONE IN ACCORDANCE. WITH THE PLANS AND SPECIFICATION 3 AND IN COMPLIANCE
�- WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
tal 195.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE ;URRENT CITY BUSINESS
Sub to
--__ LICENSE.SEPARATE PERMITS REQUIRED FON SEWER,PLUMBING AND HEATING.
State Tax 4 7.80
SOC-
1300. 30
Total � +�.•� �. VVVJJ
---- PDC# '�I 4100.00 AP"LA ORAQEN�
By P1 _
d- Receipt No. �. 7 AODIR
—
Approved _ __
DATE INSP. TYPE INSPECTION — — REMARKS PLUMBING DATE
Permit No.
Roughen
Fixture
�iCt- r final _--- ---
y,�Q H ATING
Controc o
Permit l4o.
Gas or Oil
Roughen
Final
SEWER --- --
_�. Final
---------------.—.----- DRIVEWAY
------ — -�_��_�..___------ Final
Storm Drainage
(Rain Drains Final
Sidewalk
Curb&Street Final
— ----
Approach
19LDoOL DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY _
Landscaping
Zoning Final
1
BUILDING PERMIT APPLICATION TIGAR:) DATE 110fdU
THE UNDFRSiGNED HEREPY APPLIES FOR A PERPAIT FORT}iF JVORK HERF_IN INDICATED BUILDER PHONE D•
OR AS SHOWN AND APP OVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
ER Q,04. Q� SS 1 ,�1e511048 ADDRESS ' �•�X11 (7� LOT NO.�_�C�
:�.......... �83a �W J Pte'. _ E C,
Q �
BUILCER J4+M� `U� !^•�tiS��w+'� � AENGINEER
RCHITECT
-�A RESs 11 �ll��gj.�ya�C�: DESIGNER , Q2) Baer
STRUCTURE NEW Q P.EMOCEL :3 ADDITION ❑_ REPAIR _ ❑ RENEWAL —❑ FIRE DAMAGE ❑ DEUOI_ITION
FiCSIDcNC{ C CO,MM ❑ EDUCATIt NAi Q GGJ'T�Ci RELIGIOUS C PATIO u CARryiiT GARAGE 13 STORAGE Q $LAgr? FENCE
OCCUPANCY LAND USE ZO'4E -R —�
BLDG.TYPE - N--FIRE ZONE_—T PLAN CHECK BY _,t HEAT_Qb
SEWER PERMIT 9
OCC.LOAC FLOOR LOAD � HEIGHT 20 NO..STORIES hLV uE S 3 gop
9UILCING DcPARTMENT -��__ _`--- - -----►--___
SET BACKS FRONT 2 U REAR : LEFT SIDE (s. RIGHT SID
"itF— THIS PERMIT' IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE EUiLDING CODE,Zp===
R p EGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED-II HAT THE
plan Check r . 5a - DRK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO'i:PLIANCE
i
z WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PER-MIT DOES NOT WAIVP
Su�tatal 2 R . ,5��
r —, RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSI`ES,
r I oU LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMISING AND HEATING.
'ate Tax _�_ / SDC—
1
Total d 3 d IR D Wee1
By POGO APPLICANT OR AGENT
r Receipt No.
L
Approved ADDRESS
- PMONE
'DC lop
EWER CONNECTION $ 7011_3
EWER INSPECTION S .257
.EWER SURCHARGE S
n mm o rl t n ■ Qatl'd. LZ-31-00(. 0 904 . Puna"-,oK(j V a T-u Q*' 1'G'8 � �.
VTK OF TIGARD—12420 S.W.MAIN—TIGARD,OREGON 47223
/ RECEIPT
DATE: ---1 6_=_�C AMOUNT: S
I �
DOLLARS
NAME: — CASH: _
ADDRESS; CHECK:
OF
FOR- _ ACCT. t PERMITS SURCHAROt AMOUNT
SEWER BILLINGS 40-364
BUSINESS LICENSE 05-331
PLUMBING PERMIT 05-332
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333
SEWER CONNECTION 40-363' _
SEWER INSPECTION 40-365
SYSTEM DEV.CHARGE 25-366
PARK DEV.CHARGE *1 30-367 _
PARK DEV,CHARGE #2 30-368
ZONING ADJUSTMENTS 05-362
TOTALS
RECEIVED BY:
PiRMIT NUMatR3 A f10Nta: - --
Numher Amount _Number _Amount Number Amount
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RECEIPT 0
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CITYOFTIFARD
VASHINGTON COUNTY,OREGON
BUILDING DEPARTMENT
PLAN CHECK APPLICATION
This is to certify that the following plans have been submitted
for plan check pursuant to the Oregon Structural Code and Fire
& Life Safety Code, 1979 Edition.
Ownel. l°C.aw �.��'i IUH
-b Sob AdJress
I.ot No.
Owner/Applicant Address
1�a 0a 22.1 Phone No. ,2'400 3:2t
Description:a Jath Ie t7oh,'t'` �`)(4vellto-Ak !O — e.
B
City Tigard, Building Dept,
By
--- --- 12420 S.W. MAIN P.O. BOX 23397 TIGARD, OREGON 97223 PH: 639-4171 __