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• CITY OF TIGARD
OREGON . �; .
Jim Christensen -_399
'.:
'1 Own,-r: Permit No. ` Y
11590 SW Berkshire, Portland
Addr ess: _
i
'r Buildin Aadress• 9665 SW Serena Way C ,
g
Occu;)ancy: R-3 Land Use Zone:R?PD Bidg.Type_5N Fire Zone:
Comr►ents: ' ;
r
:; = Certi c ate is hereby ,riven this 1st day of Dec emtLp r 19 pri_
s . teat said building may be occupied and that it
complies with all requirements of the Build-
y ing Code for the City of Tigard, as approved I t•;,��.��
• -�=x by the Tigard City Council.
i n I, Building Inspector
4 Ai
/ A; •J
\11 r:i •i� � I Building Official _
Post certificate in Conspicuous Place `'
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'NSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 839-4171
Address ___----�_- _-- Permit #`
Type of Inspection
The following Building Code deficiencies are required to be corrected:
Presented tc,_ --__ _. Inspector _..-.-_ _---.--_.._.___..---------.— --�,.----__-._--
Dete
C4L.L FOR REIWEC77ON
G VES L1 No
s
ff rN
INSPECTION NC;TICE
City of Tigard Building Deparimen!
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.41;1
Address —_ _— Permit
Type of Inspection _ —__---.____�— �— -------------- — ... ....
The following Building Code deficiencies are required to be corrected:
ee
Presented to ____. _ __ __ __—_ _-- Inspector —
DatR ---- --- ---- --
CALL FOR Rfl!1iTE'C770N
[� YE& ❑ NO
HJll_i.)ING DEPA>`IAIEN , 1•IGARDPLUMBING PERMIT
�rf7
d 1
� r c _ t J
L7 ��____ valid plumbing contractors licens i. her,
aut lorized-t work as herein noted to be instalicr.l in eccordi?nce with the plumbing coda. of
Tigard. Such installations require inspection by the City Inspector who shall be nodficd not less than f aur
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License rcquired
for all contractors and subcontractors. Da to
�5
Owrer /-�tf -L11/ldd� d'i.2tlt -- _ Ad�r�s._-
NUfr13ER OFv TorrL PERMIT NO.'S
TYPE OF PERMIT ITE,tS FEE ON EACH AIM OUN r — (Office U;•Only)
J
(Q G& ..—t
Sinala Family-1 bz: —loch _ _ _ _25 00r t
Du lex—each 1 beth unit 25.00
Addi:ivn l_b.t-,hreum;-each - 10.00
Moble Home Spars-each 15.00 _
INDIVIDUAL FIXTURE FEES
1 to 50Fixture+t in 1 buildiraach 3.00
51 to 100 Fixturet in 1 buildir.,•-ach 250
101 to 20Q--Fixtura- t in 1 buitjiny-tea h —_ - __— 200.
j
201 or more Fix:uret in 1�uilrin�
&IISCELLANSOUS -
Suildirg_so.ver-1st 50 ft. _--_ _ — 1000
Sower--each ed,+i:ional 100 ft.,_— _--_ 10.00
water Service to bu'Idina _ -- _--- _ -_. 5.00
PrivatoWv-• Systarrs-arch 1ri0 ftp _—
Othrr ISO-rifv):
PEr7"AI'rFor?lurrtsrng rlori 639.4i71O
1
0 Slam (b17 Plumbira Contractor By /20(CClL
_ •roi'Al_ r (oma RECEIPT NO. Isst:cd Ey --
1
I�
r ` � � - j I
City of Tigard Mechanical Permit M Permit
Fee,_______________
N�iw Installation Repldce ❑ Relocation ❑ Addition ❑ Alteration ❑ 47 TOTAState_
i L
H FAT I NC.• /�` j
CONTRACTOR RSG OWNER r
- _ ,= WORK 00RES /C'�—
PHONE �� - /�,� ----- - APPLICANT ;21 Le'g
F,eai Input Rating (BTU Per Hour). d'�i Vent S;r-e S" Flue size_.S"
UEI. OIL ❑ GAS [9 ELECT 0 OTHER '
4
ITEM NO, FEE ITEM NO. FEE
.-or Issuance of Permit CE ABOVE Air_Condition Compressor 15 to 30 HP_ 17.00 _
Near-up to & irtC 1.100,000 BTU 4.00 _ _Air Plandling 10,000 CFM 3.00
f'Izw-100,001 BTUs & over 5.00 Air Handling Over 10,000 CFM 5 Op i
Flcor Furnace 4.00 Evaporative Cooler 3. p
0ja!I - Floor - Suspended 4.00 Range Vent Fan 2.00
Insta!I Vents Only _2.00 _ Vent System 3,00
Peaair-Heat& Cooling _ _ 4.00 Hood Commercial_ 3.00
Air Condition Compressor Under 3 HP, 4.00 Commercial Duct System 10.00
/sir Condition Compressor 3 to 15 HP � 7,50
!N:-PECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED F09 ALL CONTRACTORS OR SUB-CONTRACTORS
iJ'PROVEO By DATE _ _ ISSUED BY DATE
17ECEiPT NO.
"' Signature of Applicant
3399
BUILDING PERMIT APPLICATION TIGARD DATE_________
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. ONER P
T NO.1�O,�lE�i_ �-.--�
OWNER .Jim f.fliIStar'BE"' JOB ADDRESS 966b 51,1 aaruna 033
----- ------ ARCHITECT
ENGINEER
BUILDER 63t11E7 ADDRESS�1_��� _5U 130rkshiruol#SIGNER-, (7i8��ac3TC11ifY _
STRUCTURE [ `NEW ❑ REMODEL U ADDITION F-1-REPAIR __ ❑ RENEWAL ❑ FIRED NAGE_ ❑ DEMOLITION
I�ll(RESIDENCE ! .1 COMM ❑ EDUCATIONAL C1 GOWT ❑ RELIGIOUS L1 PATIO [.1 CAR PORT ❑ GARAGE-❑ STORAGE ❑ BLAB FENCE
OCCUPANCY 'S LAND USE ZONE (�7P1) BLDG.7YPE 5n FIRE ZONE PLAN CHECK BY _dtl�h_HEAT=4aB-
ranstruct single family 1.11,111111'19W/atterhad garage. 3 k�edrt�am 26808.
SEE CORRECTION SHEET ATTACHED. —
SEWERpERMITM 22045 ?`a 17.00 __garai6y 4% siQ
1 ..�5� NO-BEDROOMS 3 VALU661.13gQ-
>` OCC.LOAD FLOOR LOAD aU HEIGHT 11�- NO.STORIES _ AREA - —
BUILDING DEPARTMENT SET BACKS FRONT 2n REAR 70 LEFT SIDE v I RIGHT SIDE
ING
Permit_ ;p2ll.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING AO CODE, AT THE
IpS. 5� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH The PLAITS AND SPECIFICATIONS AND IN COM�LIANVE
WITH ALL APPLICABLE CODES AND ORDINAI..'ES. THE SSUANCE OF THIS HERMIT DOES NOT WAIVE
Subtotal 316.50 RESTRICTIVE COVENANTS. CONTRACTOR. AND SUB CON 'RACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLl MRING AND HEATING,
State Tax h •44
SDC 4 u U. ,.�i-I
–i32-4. °A
Total _ PDCN 11 41100-00 APPLICANT OR A Y T
By -- -._ —_� -- -- PHONE
-- - dwh Receipt No. AbDRE§R
Approved
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Ulf - Contractor
U l (� U - 4.wv��. _ f1P- Permit No.
Fixture
Final
-
0-xj-Yo a �
l -_Cti 1 HEATING_!
(0_L-L,W qql i -�-/.� Contractor ��/ �Q
16-A 7'H l 1-•1• — — Permit No. �p /Q y1-TV
�'Ly Gat or Oil
--
T Rough-in
Final
SEWER
�—_—� -- Final 9-/9-,FO �� v
DRIVEWAY
Final
t• Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICr'tTE OCCUPAI''CY
Final
CERTIFICATE OCCUPANCY —-
Landscapinq
Zoning Final
r
t
BUILDING PERMIT APPLICATION TIGAP..3 DATE_ _ y� _ a
THE UNDERSIGNED HEREBY APPLIES FOCI A PE vAIT FOR THE WORK HEREIN INDICATED BUILDER PHONE W-227
OR Ali SHOWN AND APPROVED IN THE ACCOI+"PANYING PLANS A?I03PEC IFICATIONS. O',"1NER PHONE
.0- LOT N0./t� �_.
O- en
NNER �� � -jer► JOB ADDRESS 9��5 �a _ 4=rA m '! _3-.
a_1_ _ �f/JARCHITECT
BUII_CER 1 e/ ADORES.. (J,� .� RC1 �40ESIG EER �1 , e
DESIGNER Q Q
SCRUCTUREi- NEW ❑ REMODEL ❑-_ADDITION - ❑ REPAIR ❑ RENEWAL ❑ FI'IEDAMAGE ❑ DEMOL.ITIO
RESIDENCE C COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT 1:1 GARAGE G STORA E ❑ SLAB❑ FEND
OCCUPANCY �U D USc ZONE p .BLDG.TYPE N FIRE ZON�F) -:_n-- PLAN CHECK BY HEAT
SEWER PERMIT If —
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES �(3 ARAREA NO.BEDROOMSyL VALUE(1.300
BUILOING DEPARTMENT I SET BACKS FRONT 20 REAR PO _ LEFT SIDE RIGHT SIDE
Permit 2. • b0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN"HE BUILDING CODE,7ON:NG
I REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT 1;HEREBY AGaEE1' THAT THE
IPlalCheck / O f''fO WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC-%TIONS AND ?N COMPLiANCs
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF TH'S PERMIT DOES NOT WAIVE
i Sut}ta.al �' Sv ' RESTRICTIVE COVENANTS.CONTRACTOR AND SUS CONTRACTOa3 TO HAVE CURRENT CITY BUSINESS
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUi` GING AND HEATING.
;3tate'ax _ `f
_ _.... SDC-
Total -----
PDC.# APPUCANT OR AGENT
By
-�Receipt No. ADDRESS PHONE
Approved
3DC -
BEWER CCNNECTIM! S 72--
;EWER INSPECTIC'N �S
;EWER tUFCHARGE
-q-80 _ PU F1 i- 1ev, )1 //•J9.6 V --
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