9730 SW SERENA WAY 9730 SW SEF;ENA WAY
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CITY OF TIGA 1:1F.1"IM1O
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COMMUNITY DEVELOPMENT DEPARTMENT 0144WON B 09
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard.Omgon 97223.(503)6394175
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This permit is issued subject to the regulations contained in Title 14 ......... ..................
of the TMC. State of Oregon Specialtv Codes,zoning regulations
and all other applicable codes and ordinances, and It Is hereby
agreed the Joe work will be done In accordance with the plans and I ''V43 F.i Y!:i I E.M
specifications and In compliance with all applicable codes and I fit it,
ordinances The Issuance of this permit does not waive restrictive
covenants Comrictor and subcontractors shall have current city
business tax pnimits. This permit will expire and become null and
void if work is not started within 180 days.or it work Is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall tn the responsibility of the permittee to assure
all required Inspections are requested and approved.
Permittee Sign,
IsFued By fill --7T— 1 1771 1 1 1 1
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TIGARD MECHANICAL PERMIT Receipt ey
Permit N
Description
Table 7A Mechanical Code _ OTY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 -- —
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 Furnace to 1000)0 BTU
�) incl.ducts&vents __ 6.00
Furnace 1) )P,,0FU +
2) incl.ducts&vents 7'50
Name of Development _ - Floor Furnace
3) incl.vent 6.)
Job Address -� ---- Suspended dealer,wall heater
Address 1)730 SW Serena Way 4) or floor mot ited heater
6.) -'
iax Lot Map No _ Vent not ini in 1
_ Lot Block Suwivisk)n 5) applOnce'r �rrnit - - 3.00 -
Name(or name of business) Repair of heating,refr ig.,
AL1c3t in Howe G2 i 6) cooling,absorption unit 0') ---
Halling Address phone 7Boiler or comp to 3 HP
Owner 9730 SW Serena Way r_ ) absorp.unit to 1),0)BTU 6.)-
Ciry,is;aie ZIP - Boiler or comp to 3 HP-15 HP
Ti ard, Or 97224 �) absorp.unit to 5 ,0BTU -_- - 11.)
) )
Name Boiler or comp 15-30 HP
9) absorp.unit h-1 million 15.00
YAailing A(4ress Plane 10) Boiler or comp to 30-50 HP --`- ---- 22.50
absorp.unit 1-1.75 million
Contractor �rty�Stete - Boiler or comp to 50 HP
11) absorp.unit 1,750,000 BTU 31.50
State Registration No ~----- racy Ben.Tau No. 12) Air handling unit to -- T-- -- -) 4 -
10, 0 CFM
I hereby acknowledge that I have recd this a g ) Air handling unit
pplieation that the information even Is 13 10,0)CFM + 7.50
aired,that I am thxr owner or author'-wl,rgent of the owner,that plans sutwnmad are in ——
rxxrlpkanoe with State laws,that I am regisleied with the State`?uikfers'Board,1hwt theNon portable
number given it coned (if exempt from State registration please give reason below) 14) evaporate Cooler 4.50
Vent fan connecte
-- --- -- --------- -----_-------- 15) to a single duct 3.)
- - - - ----- ) Ventilation systerr,not
16 included in appliance permit 4.50
- -
17-) Hood served by
mechanical exhaust 4.50
—Signature(owner or ager") Dale 18) Domestic type 7.50
Describe work U additiog 0'-- alteration 0 repair UI . incinerator__
to be done residential L3, - non-rash ential U Commercial or industrial
---_---- --- - 19) type incinerator 30.00
Existing use of -
building or properly 20) Other i.e.,woodstove,water 4.50
Proposed use of _ h eater,solar,clothes dryers,etc. _-
building or property _.._ - 21) Gas piping one to four outlets 2.00
Type of fuel- oil O natural gas P LPG F1 electric n
�— �- 22) More than 4-per outlet
N4lQ
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- ----- - -- SUB-TOTAL 14 50---
STRUCI ION AUTHORIZED IS NOT COMMENCED WITHIN 180 -- 5% SURCHARGE 73
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL_
ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME AFTER _-_-- - -_-..- _---_--- - - _ - -
WORK IS CCAMMENCED TOTAL
Special Conditions
INSPECTION NOTICE
City of Tigaid Building Department
12420 S.W.Main St.
..y. Tigard,Oregon 7223
� Phone: 639-411 71
Type of Inspection
Date Requested— �-�-�- Time A.M.,�—__.P.M.
Address _Z7--��"�'���� " � armit
i
Owner __ —.----------- --_—.____ ---
Lot #
Builder _ —_--- -- ----- _�_—`
The following Building Code deficiencies are required to be corrected: _
I'
I
Presented to _. Approved
Inspector _ _ C...� Disapproved
Date -
CALL FOR REINSPECTION
❑ YES Cl NO
CITY OF TIGARD Plumbing Permit
Building Depart�ment NO.
Residential LJ Commercial
New Installation ❑ Replace ❑ Addition ❑ Alteration Date/ "5' Eae
Licensed y�
Plumber J L� �L.� l it �'7 1r+1 --- Owner __,`tJ vt "44" 6:!::
Address
-- —
Address ^GUS �� � r J%< 3' _ Job AddressJ0 .<<a ,� ``///'///'[[[`��(',,,{d,
1` T--
Phone `f U d Applicant _�Lr a.C�.
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS ARID SUB-CONTRACTORS
ITEM NO. FEE TOTAL ITEM NO. FEE TOTAL
Fixtures-Traps 750 — Sewer:First 100 ft. 30.00
Dishwasher _ _ 7.50 _Each Addit.100ft. 15.00
Garbage Disposal _ 7.5'1 Ejector Pump _ 7.50 —
_Water Heater 7.50_ Water:First 100 ft. _ 2.0.00
Backflow Preventc; _ 7.50 — Each Addil.200 ft. _—_ 15.00
Storm&.3ain Drain:First 100 ft. 30.00_
)�t'� - — T 16 r�0 VEach Addit.200 ft. _ 15.00
Mobile Home Space 25.00
Other(Specify): X Rain Drain-Single Fam.Dwelling 15.00
PERMIT FEE �% Comments:
STATE 4 % Issued By:, G�• __ -- ---•.7 �
TOTAL
Receipt No. __ Applicant.� �-. ��(J ----
-- --- Knr Plumbing Inspection Phone g-4171
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CITY OF TIGARD
OREGON ' . '
3261 `
` Owner: Bob Nelson Permit No. orf
4.i 15900' SW Serena Court
Address: -
' k`3` Building Address: 9730 SW Serena Wayf
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Occu anc R-3 Land Use Zone:R7FD Bldg 'apeN_ Fire Zone: z ,
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Comments:
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Certificate is hereb even this 19th da of Sed�eml:er lg 80 Y '
s= 4 Y g� Y
that said building may be occupied and that it -fix
complies with all requirements of the Build-
Y= ing Code for the City of Tigard, as approved
by the Tigard City Council. `� «
ns
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Al
Building Official
_ y Post Certificate in Conspicuous Place
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411
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'-�,...- - ..,;�c,iiT. � �""� ": +.�" -~ r. _...�•�S ' '.:. .,y0..rte-y.'�- YO J n.{� � C:.Z .��}?'::F' S..�� � y� .py`� -e,, ♦ -�,J• `�'S..T��.
,l � �'•:%�'�n1.., s_:,�.�.��� `^�' i��-,�'"�i:7�`�•`..r;s 'c$' ��.y.-L L. _ a,..-Q, �'Q�'-c� ��a,.,....ie�' ...�
.�G�._�....�' .+`� .,....••• yam+_ ^,,,,-„" ..d,,,.� Y ,.,a.-�
�aoss els
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address
Permit
Type of Inspection 2
The following Building Code deficiencies are required to be corrected:
.5r' 47
Presented to Inspector
DRU
CALL FOR RDAVE-MOX
0 YES 0 NO
BUILDING PERMIT APPLICATION TIGARD DATE /'L____,�e v
THE UNDERSIGNED HERESY APPLIES FOR A PERMIT FOR 1 HE WORK HEREIN INDICATED HUILDER PHONE 639—E17-6
OR AS SHOWN AND APPROVED IN HE ACCOMPANYING,PLANS AND SPECIFICATIONS. OWNER PHONE
Lor NO. 114
OWNER 6LID INSI U'l1 JOBADDRESS 9730 L! Serena We i?lc:I,�endin �
4 Country ` ��Quro
BUILDER LDER Tour) F;gmud�4DDftESS1JgOG ..fIJ ;iETBnB C-� — DESIGNER Piercy 8c OISI:L•liay`_^_
STRUCTURE _ LX]xWEW ❑ REMODEL C7 ADDITION U REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
EX RESIDENCE O COMM O EDUCATIONAL 71 GOVT �l RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABLI FENCE
OCCUPANCY r2—3 LAND USE ZONE .R-7 P-Q BLDG.TYPE FIRE ZONE_.-.3 PLAN CHECK BY -DIu H _HEAT_
Eon®truet aingle family dwelling of/atted'ed yr aye. , 3 bedrourne 2 baths. ,r
.e-Issue of Permit 300I
(It, rimsan Ct. }
SEWERPERMITN 219,;B -- X705,00 472 .3c. ft.
OCC.LOAD FLOOR LOAD Ito HEIGHT 14 NO.STORIES 1. AREA 15 33 NO.BEDROOMS :3 VALUE
BUILDING DEPARTMENT ---I
SET BACKS FRONT Z 2 � RE"•.R LEFT SIDE RIGHT SIDE
Permit 0J,01) THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 10.00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WPrH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 00 RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTOR'- TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax ' Fa• 20
-' SDC- $400,Ml
Total 4 2 s .t. 2 0
PDCr 11 s 3.Ono ()I APPLICANT OR AGENT
By
Approved
d'dh Rer;elpt N0. ��4� ADDRE98 -- ----- _�_._ PHONE
DATK INSP.I TYPE INSPECTION REMAr.c. PLUMBING IAT[
Contractor
Permit No.
Rough-in
Fixture
Finpf
�2 4vHEATING —
Contractor
- Permit No. b `
- -- -
-1911 -�-�--
Gas or Oil
Rough-in
Final
----- �._� gEWER --
---- — -- Final
�- DRIVEWAY
Final
Storm Drainage
(Rain Dra;n)Final
Sidnwal k
Curb&Street Final
Approach
BLDG. DEPT.rINAL TEMPORARY CEUTIFICATE OCC NCY Final
CERTIFICATE OCCUPANCY (� /Q
/ Landscaping
Zoning Final
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BUILDING PERMIT APPLICATION T'IGAZD DATE—La ,s-sQ
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATCD BUILDER PHONE (p
OR AS SHOWN AMT. 4PPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE�y �-
OWNER S eAS0!j JOB ADORESS ? '?� l! CJd � LOT NO.LLI
BUILDER 16ton 0rkOKM R64v0O0v"1RESS �5 005W 3PJ99A DESIGNERPly cy i
STRUCTURE NEW ❑ REMODEL _ !7 ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
— RESIDENCE C COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R-'S .LAND USE ZONE T BLDG.TYPE u_FIRE ZONE_PLAN CHECK BY HEAT_.—Cj-_-,
�Q.r g�su�. �-- `'�+'n+,i-� _�o V /z S 1� iM� ah •F
SEWER PERMITM
OCC.LOAC FLOOR LOAD HEIGHTNO._STORIELU
_S I AREA �� '' NO.BEQROOMS VAE4wQe
BUILDING DEPARTMENT SET BACKS FRONT ilk REAR LEFT• RSICE ' 4T SIDE
_ --tea-
P-3rmit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERFRY AGPEED THAT 7HE
PtanCheckI L C 4 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COtfPLIAtICE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal ��.�� _ RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSI'4 G
.� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stats Tax •
SOC—
Total `�Z3�a� --
ppC# APPLICANT OR AGENT
By
Receipt No. - ---
Approved ALDRESS PHONE
SDC0-- -
pDC — $ L �
SEWER CONNELTION S �
SEi,IER INSPECTION $
SEWER SURCHARGE $ r
---
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