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EJIL.DING DEPARYMENT, TIGARD NO ;
PLUMBING PEh",t1T
��__ holder )f a valid plumb: (I contractors license is hereby
autharizerl tc, cause plumbing wc�r'k as horeitt noted to btu installed I11 acfortlanre with th, plumbing code of
Tigard. Such installations require inspection, by the City Inspecto who shall be notified not less than four
(4) hour's prior to the time the installations a-e ready for inspection. City of Tigard 3usiness License required ;
for al' contractors and sub•co, tractors.
0 Job
�f Address.—..- Date /ALL
l.�
NUMBER OF F -� fC1TALI^
IYPE OF PERM IT I7Eh15 FEE W11 EACH AAAOUr�l c j,
9 E
.,llr ria-m?vl
ou-'ax—Each 1 bh unit _ 25�0
_Add itionalaus-
btnromeach -- - 10.0
�;
I hlobda Home Soace-each _ - 1G.00
Ir.01VIDUAL FIXTURES COM EH AI ---
-
1 to 50 Fix;,re1 ;-i 1 building-each h 30
ng-eac _ - --- .0-- -------� -----^-
_ 4M
51 to 100 Fixtures in 1 building-each— 2.5.)__ --• --
1-101 to 200 Fixtures in 1 buildin -e-ch - -_r _- _.__.7.00._.- —, —• _
201 or more Fixtures to 1( bulldin9_^ac'i 1.50 _MISCELLANEOUS _-' _ —y - ^----
Sewer-each additional 1001t. X0.00
�-
Water Service to bt�ildir2 5.00_ ___.
( Other (So-rityl:
PE?ti11T U �� For Plumbing lnspPc!'on^hone 6394171
4%State Plumbing Contractor By
TOTAL RECEIPT N0, Issurd By
r
BUILDING PERMIT APPLICATION CIS fY TIGARD DA1 L
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHJNF_,___.,.,,.,�.�,�,
GR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE,_..
LOT NO.
OWNER p11L'nartter-5mith JOB ADDRESS 4J ( � i. . HOM_E_ADORL _
ARCF-ITECT
ENGINEER
BUILDER ���--�rn0 ADDRESS
Ct �� :I-: ®�;�� d.� __ f1ESlGNF.F7 _
STRUCTURE INEW ❑RFMnDFL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ,, [:]DEMOLITIONB nDEMI-OLITION
❑ RESIDENCE ❑CCOMM ❑EDUCATIONAL F–!(-,F–!(-,('V'T( 'T ❑RFLIGIOUS❑ ❑
PATIO CAR PORT ❑GARAGE [:1rrLI
STORAGE SLAFENCE
OBOND LJMOVING []CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _
OCC_UPANCY LAND USE ZONE_ BLDG.TYPE_ _FIRE ZONE_— PLAN CHECK HEAT
--
w11k'. .__
-- Sower Ourmi t _1683b — *62 j.00 �`' � sq. ft. ----- -
14 3
rte•LOAD _ --- . qQ.5D ,t . �� S
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SDE RIGHT SIDE
PermitTHIS PERMIT 1` ISSUED SOBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODFS AND ORDINANCES, AND IT 1% HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SFFCFFICATIONS AND IN COMPLIANCE WITH
SLIb total `F ALL APPLICABI F CODES AND ORDINANCES THE ISSUANCE 0.7 THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6.76 LICENSE. SEPARATE PERMITS REQUIRED FOR SFNER, PLUMBING AND HEATING.
Total :`2E- . 70
By
(/ ApPLICANI Ori A(.i NT
Approved FAf-celpl N. ��a 9
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
pop Contractor
Permit No.
6- -3-
Rouffi-in
Fixture
Final
I Al HEATING
Permit No.
Gas or-11 NI? IV I
Rough-in
F:nal
SEWER
Final
DRIVEWAY
Final
�Slwisn Drainage
(Rain Drain)Final
Sidewalk
Approach
CERTIFICATE
TEMPORARY
BLDG. DEPT FINAL CERTIFICATE OCCUPANCY OCCUPANCY Final
Landscaping
Zoning Final
Its Illlw s tll� Iltt � IIS �
it "'y TIGARD DATE_.�la�-- ,92t AT 2�3 'l
BUILDING PEF.f 4lT APPLICATION ! OF
'THE U :E)ERSICYNED HE'RERY APPLIES FOR APER.YIT FON rHE I,IOIlr� HEREIN IND:C.ATED BUILOER Piior�zyy.37"
OR AS SHO.";N AND APPROVED IN TFIE ACCOMPANYING PLANT AND SPECIFICATIONS,
LOT
1-q
&0� = so lei ? (4.
--
ARCHITECT
/ ENGINEER
QIJILD[7�JQ•��I G�..P.h G� A1r14 )AUC1REs_^.(O�QD � Osetom Ri. CESIGNLR �-
STRUCTURE _ NEW ❑FlL
___ -111r)EL. L,JADOtr10rl QFRE"AIR 11RENE4';AL AFIRE DAMAGE
�—t �-1 – cc--_�1 ❑OEMOLItIJN
N9@SIOENCE ! JtOMM � ' .r'fATlf)nle.L ❑GOVT uREUGtOU5�aarlU QCARPpRT ❑GARAGE QSTORAGEQSLaB QFENCE
�1r`Ct;pArJCy!1�'3�ANq USE ZON= —_�4_`_L ._E3LOG�T'YPE __,FIRE TONF. PLAN CHECI: aY--a�6![l PEAT
Sap
S W E R P E R m I r # --
���_l9�Q_ ��r�_a 4j4�_�^�!5�11' L�4�4R1 • aFE_� 3QNo_;}FDRootiisy9rr,r —
t 9UILOIr:, DcP,aATAtcP4Ta �--�—
SE r E \CKS FRONT 20 REAR ,2,� LEFT SIDE �j RIGHT SIDE
Permit --- ==—..
8 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 9UI:GING CODE, ZONING
Plan Check V REC:ULATIONS AND ALL APPLICASI-C CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT THE
i �'��' J� v%JRP\ MILL EE DONE IN ACCOROANCE WITH THE PLANS AND SPECIFICATIONS AND IN COhlPLI,0.N•CE WIT),
�U7•Wldi 3� �� ALL APPLICABLE COQFS .AND ORDINANCES THc ISSUANCE OF THIS PERMIT DOES NOT WAIVE
"—"---'-- RES TRICrIVE COVENANTS, CONTRACTOR AND SUB CWITRACTORS TO HAVE CURRENT CITY SUSINFSS
S;1re Tax I �� ,'�V LICENSE. SEPARATE PERMIT ?EOUIRED FOR SEWER, PLUMBING AND HATING.
Tori! b 0,.2 lr--- 50C. - +
----- PD
C#
ACPLICAPIT OP AGENT
�j AppfUVEd ReCe'pt No --
SDC
PDC
SEWER COr!rIECTIDN C
SEWER INSPECTION 7. b
SEWER SURr_HARCE
Comments :
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