11381 SW LAKEWOOD COURT 1i381 SW LAKBMD COURT
�a
cl
�r
sry � ew � 1a
OF
MECHANICAL "":F'MI1'
C,17YOFTIOARDITYOPERMIT :'0. : `92048
' ',artu
COMMUNITY DEVELOPMENT DEr,`R4ENf TE ISSUED: '.1/29/89
13115 S.W Hall Blvd..PA.BOM 23397.Tigard,Oregon 97223.j5Gdl tia_ '75 �` P I M.PMT.NO. 892048
JOB ADDRESS: 11381 SW LAKEWOOD CT
TAX MAF'/LOT SUBe ENGLE' ISD LT: By.
LAND USE:
LOT SIZE:
ITEM: NO: NO:
WORK CI.NSS: ADDITION FURNACE. (10E A'R HANDLR (10
USE TYPE: 13INGLE FAhIILY Fl;*eNACF 100K, ',IR HANDLR 10r
CONST.1VPE7 VN FLOOR FURNALF EVAP.COOLER
OCCUP.6rP. : n3 HEATER VENT FAN
VENT ViNT.SYSTEM
BLR/COMP QHP HOED
HO.STORIES: fiL.R/COMP ' 15HP INC;NERATOR f DC hl
D:JF LL..UNI i S: 1 BL.R/COM►' 15-30HP INC i NE RAT OR(CL.'''
FUEL T1PE WOOD BLR/COMP 30--`0HP UNITS
MAX. iNPUT BLR/COMP 50+HP TITHER 1
FIRF DMPRS? LEAS PIPING UUTLE,S
HIGH PRESS?
--
REMARKS:
In all Wood Stove
FEES:
W' Ha11,y David PERMIT $18.89
N 11381. Sw la{-ewaod ct PLAN REVIEW
IT ;_ Bard Or 97223 FIXTURES $4.58
R
PHONE ( 03) 684-248G STATE TAX 1.73
- OTHER
C
O
N
T
R
A
C
T
TOTAL: $1',.23
RF(EIPT N0.
This permit is Issued suhlect tone regulations contaired in Title 14
of the TMC. Stale of Oregon Specialty Codes. toning regulations REQUIRED INSPECTIONS
and all other applicable cedes and ordinances. and It is hereby
agreed that the work will be done in accordance with the plans and OTHER*
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
,ovenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work is not started within 180 days,or if work Is suspended or
abandoned for a period of 180 days any time after work has
rnmmence.' .-hall be the responsibility of the permittee to assur:-
all required inspections are requested and approved
t if C,- d�W,
Permiltee Signature x i nS to l l a t i
r
Issued By l.L--f OR LNSRECT10 "9-4475 -
SEPARATE PERMITS REQUIRECi FOR WORK OTHEr THAN DESCRIBED ABOVE
L) o,15
_.C:L PFRMIT NO.
ADU'i
PEF,,-'i,T CHARGE none
o
OWNER CONNEC-frION FEE
PAID BY
TYPE F R I.I T L D I N 6 DAJE COWNECTEI)
SERVIC:E RATE INSPECTION FEE
CONTRJkC'TOR PAID 13Y DATE
SIZE OF CONNEC410N ASSESSMENT PAID
.2 5- 16
7
�.
OREGON
1015
i > hPrujit No....... .
Ca«ner:.. 6ob...Smith.......... .... . ...........
Building AdJres; ......11.381 SW,.Lakewood <:
� ? Certificate is hereby Lrivc•n this...... .... . .c.ay of.........3anua.ry........ 11t 77
that Faid building may be oc,7'allied and
that it, complies «"ith all reyiliremel,t ref .j
tllc- wilding Code for the City of Ti,,, FY
r
as approved by the Tigard City Cc-uncll.
JII'i r Z // '; .............. r�
Building inspector
i ` '/�� � �'ter? � ry �; o �1 !:Y r� �_ r l'y, '• '° � �'� w�jr�.�. 7'r � b.„�' l� S
City of Tigard
INSPECTION REQUEST
INSPECTION TIME: PERMIT NO. :---—
DATE:
O. :DATE: DATE ISSUED
:
0WN ERS 7'
ADDRESS:,:L3ts '
CONTRACTOR : --
TEST
ONTRACTOR : .___—_TEST : Air 0, Water[I , Visual ❑ , Laboratory (]
RESULT: Approved Q Disapproved L� , Pending ❑
SKETCH:
INSPCC'10 R r)ATE
Cotes: Attach fupplementnl test doto hsretol
w w off— qw =— rt
,w.q...er++...�n+rev+.*nre+rlar.,..ti.ww..�..—...... ,,,u•:•p•K•,r -•#�RsrT.r .•fir'
BUILDING PERMIT APPLICATION CIT TIGARD DATE AYQUIlt 16 1916— Ills
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK H"REIN INDICATED BUILDER PHONE 29 P- 115
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICAFIONS. r,',VNERPHONE_ _—
y LOT NO.
OWNER OQb amif n _ JOB_ADDRFS1S .14,13U4 Jt.; L.2kewu..)d UI.WME ADDRESS
ARCHITECT
ENGINEER
BUI' OER Aii17' ADDRESS _ -----RESIGNER
tSTRUCTURE UNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑PENEWAI ❑FI'-`E DAMAGE ❑DEMOLITION
LJ SIDENCE ❑r.,OMM ❑EDUCATIONAL ❑GOV'T ❑REL.I(ACIUS❑PATIO ❑CAR POR' ❑GARAGE ❑.STORAGE❑SLAB ❑FENCE
LJ13OND ❑MOVING ❑CONDITIONAL USE [:]DESIGN REVIEW ❑COUNCIL APPROVED ❑SI ',JF
I OCCUPANCY_._LAND USE ZONE_-- —? BLDG.TYPE J FIRE ZONE_.- PLAN CHECK BY T 1' T_ HEAT
Cr utstr.LJc-A sin la farnily duelling W/,atU,.ched yareg>so 3 00droum 2 Meth
"4x Map 1F1 3430 Lot 1300 �
QC!;.L -_ F1G9131QA�— _ HEI�I �Q.SLQBIES I _SEA 1408 Ng,ngFiQ4!a3__�t.91.�.. _ 380i
BUILDING DEPARTMENT SET BACKS FRONT 25 Afj LEFT SIDF ;,s _^,IGHT SIDE 6 —jj
Permit 13,-'.011 -_--
THIS PERMIT IS ISSUE: SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check lel.null REGULATIONS AND ALL :PPLICABLE nnpEb AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANDSPECIFIr;ATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE rr THIS PERMIT DOES NOT WAIVE
—� — RESTRICTIVE CCVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 408 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 150038
By
— - ---------- APPLICANT OR AGENT
Approved l� i-T' I Receipt No.
ADDRESS te1�iNF
I
I
-
A9-'76,
f
I
V/0 r
UNIT- IED SE=W[-_' RAt� E A( 1.7.NCY Ne. _ 10615
WASHINGTON (30U N1 Y DATE —Auquet 18,_1976
CITY OF __ Tigard
APPLICATION FOR SEWER CONNECTION f Ef�MIT
OWNER: bob Smi,th
OWNER'S ADDRESS: _ _ - -- - --- _
STREET
-- --- -- - -- --.
CITY STATE
BUILDI,,IG SITE: LOT__ _ —_-__ 13LOCK _. -__ ADDI110N
Tax Map 1S1 34AD
TAX LOT NO. 1300 , _ _ TYPE OF OCCUVANCY - e-aldange._
ADDRESS . _ 11381 SW Lakewood Ct.
DWELLING UNITS - ---1--- ____ __ FIX►-URt_ UNITS
SURCHARGE IF APPLICABLE .___ - - --.. - ----
PERMIT FEE .-575.00 _ INSPECTION FEE 25. 00 IOTAL DEPOSITED 600. 00
Fanno f Beek
(NEW) (EXISTING) BUILDING SEWER SYSTEM -- _ -- - _---._--
The Applicant agrees to curnply with all rules and re
gu
lations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
mis PERMIT AUTHORIZFS CONNECTION TO THE SEWER SYSTEM.
LINE SIZE -- --- - - INSTALLER -_-__
-- --- — _---— - --
IAGENCY OR IT�KGENT)
C0MMENTS:___B1d1Qi_41.01A5 _-- ._.-
This Application and permit expires in one hundred and twenty (120) days.
The a nount paid will be forfeited should expiration occur.
G
f
1
1 I
\ r W \ J W I w N
� w r \1 z .. F >w
0-
� u O Q w ; 7
w y pO Cc' 3aQ2 >
° m z u. F
U
w w a �WU
o� JJ �J I > v°i ZQOOw
f w w w F > ~ Q l
U;
z
z OQ Q �wT - .�
m ¢ ¢ vt�
I Q w Q O 0 ¢ == may> r
[� 2 ui 2 ° 7
w O w W \ Q ~ y y I W
z '� M Q ❑ > 1 �� z~ � FIOS
f.O O a w ODUJ - 2
❑ ¢a Q zQ �! cu) '. d
d m W ww0
\ W z Q e J Y a z w y V v ?
OLu
f'tj z in
V2aQ � �
�JO 0 U �� ❑ U z w z4Za
w - y - 0
z LL � u T ❑ Q Z w "«
z U " Q J a '� 011
W W a C w \. gacaF 0� r
` GC nzw yid z
0 zn tn `d' r/ r aUV' 70Qo Q
a Q a u O ° w° ~ Qcr v
T CU)
uj 1L 4 Q ¢ a O cr w .� _, Q �f w
C acr
W �4o � ` w a a
F a0 o ❑ 1 3a0x 2 °a
v�... 13 LU
z w H z w 0 N� a .`'ixpzw
r? 0. ¢ z i 0 a1: w M wd — aaa
_ cr :; a 0u F L1 u' > 2 F VV'� a2Uww
W a z a. a N z yZOw > �
O U Q W d ° 1 / W 0: yQD .iOcr
C3 d Q d > Q Q \ XOT I u F. Lqmdwn
Q
Q 0 w ❑ O � O �J > y o
U. _ ❑ a
C ) t H cxi WC ; uui
a L J Y ¢ y Cl
i- as
�.. 00. Q w 29.
U Q h � � 3Q� J Q
Q Q cr
> o - — ,
w � z (gyp � � MMI
o Q o N
C7 (, ► �� 1
Z w O y 0
v �� 2 Q f r J
b n �� z ' �. cc $ `
p i z Q 3 ° o 0 a
�► 6w 5 ri ¢ 1 Q
lL wUJ
1
:L7
n z N w C7
7 0
w w cr
W > ,
En F- O a '�
cn
E c
Q ¢ v
a o ° 1c. Ia t•' a
.e s.t t: .. atE to ttra tt tray
City of Tigard
13125 S.W. Hall Blvd. MECHANICAL PERMIT
Permit M b
P.O. Box 23397 -
Ti(Jard OR 97223 Uesc–ptlon
J r Table 3A Mechar,kal Code CITY PRICE MAT
539-4175 -
-- --- 1) Permit Fee - -0- -0- 10.C`
Name of Devek"nom 2) Supplemental Permit 3.00
Furnace to 100,900 BTU
Job
d .
!Address 1) ind.ducts S.ven.- 6.00
Add
Tu(a1 _ IAap No. 2) Furnace 100,0(X3 BTU + 7
Ind.ducts&vents
.50
tol Bleck Sttbd*Aon — '--
---- Floor Fumace
Name(or nuns of business) 3) 6.00
bICI- (a P 1Al l incl.vent_—_
Suspended heater,wall heeter
Owner Mal tVAddreft ( �F'""'1,911zyit- 4 q 6.00 or —
cityrstate zo 5) Vent not incl.to 300
_ appliance pArmit _
(- u Repair of heating.rotr Fg.,
cooling,absorption unit 6.00
ess Poor» Boiler or oonip to 3 HP ----
absorp.unit to 100,000 BTU 6.00
Boilertxco to3HP-15HP
Occupant P,ityiSiste 8 absotp.unit to 500,000 BTU 11.00
Name --_ 9-) Boiler or comp l5-301W ----- -
absorp.unit 1,1i-1 million 15.00
Boiler or co to 30-50 HP
Maflarg Aderess - Phone 10 absorp.unit 11-1.75 million 22'50
Contractor citytState lip - 11) Boiler tx comp to 50 HP ---- -- 31.50 —
_ absorp.unit 1,750,000 BTU
State Iteg stntion No- - -- city Bus.Tax W1?) Air handling Unit to Y` 450 ---- -
10.000 CFM
I hereby ockt wwA% ,Ow ad this orn*r,tion. m
aat tha kdorafion given h 13) Air handlFM -1 7.50
coned,that I am the u ad agent d the owner,that plans sutxrrtred are in t 0,0V0 CFM _
cornl**rv" with suto taws.that T i registered with ere Sine Bu9ders'Board.that era 14) Non portable 4.50
ntanben given i%cared. lt(11 eremtrtxn State registration please give reason below) evaporate cooter
1�) -Vent tan connected 3.00
' to a single dud
_..._..-------- --- - --- -- ----- Ventilat"i system not
t G) 50
included in appliance permit 4"
-— --- 17) Hood served by 4.50
mechanical exhaust
signatue( a llgent) -- ---- - cele 18) Domestic type 7.50 -...
Describe work O addition D alteration p repair O inc:t erator -
to be do;,,1 residential p non-residential O 19) Commercial or industrial 30.00
Existing use of -" type incinerator
building or property,,-.-, _ _ 20) Other i.e.,woodslove,water 4.50
Proposed use of
heater,solar,clothes dryers,etc.
---- -
building or property _ - 21) Gas piping one to four outlets 2.00
LType of fuel- oil L] natural gas P LPG O electric 13
22) More than 4-per outlet
NOTICE SUB-TOTAL
,1115 PERMIT BECOMES NULL AND VOID IF WORK OR CON- - --—
STRUCTION AUTHOR17ED IS NOT COMMENCED WITHIN 160 5% SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN I IEVIEW 25%OF S;JB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ---- --- ------- - -- _ _-_ - —_
WORK IS CO`.AMENCED TOTAL
Special Conditions