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16485 SW Pacific Highway 16485 SW PACIFIC HIGHWAY 1 OF 1 ' } „.,..,„4 k &, �� f ƒ # f . Vi }tz$ } /K !. \ &/« .»i . pie ; 1#4.:k „, ( r, /34, \f .A ©q 11. \% : •\ q , . 1 \/ < .' ini ilil IU IN \ & $ r 00 II | • • • r _ j 1 ' __ CITI OF TIARD �!' , F'C-�tB T N(:1 : EilJElEl1Ti 63 u1UILDING r a nnanm COMMUNITY DEVELOPMENT DEPARTMENT \\ 0..00i, DATE Ei: IS=;r,1Jj;:C) : 10/ 4/8B 1 a 125 S W Hall Blvd P 0 Boa 23391.Tigard Oregon 97223 (503)639-4175 :) r..11(2.. .— EIt31 . - h---- ---'/ / JOH ADDRESS: 164055W PACIFIC. HWY .. _� TAX MAP/LOTSTUB . KIN(:; CITY < L.T . BK . I. ANI] USE : 1..(:1T 5171 : VALUATION : 11F 134,000 SETBACKS FRONT : PEAR: WORK CLASSREPAIR L)WEI..i... UN1.15 : LEFT : RIGHT . USE TYPE ' C:OMMeRC:IAL. NC). BEDROOMS : EXT WALL CONST : CONST TYPE : VN NO HAMS : N: S : F. W: OC CI IP (::RP : PP(:I' .OPu..N:I:NGS : OtClJP .L.OAD N : 5 : E:. : W TOTAL.-. AREA : NO. STC)PIE.S : 1.51 : HEIGHT : 2ND : AREA REA SEL'ARt' RATED:ATED:1O( F CONST . A = RA ? YES BASEMENT ? 3RD OLCUP . SEPAR? RAD : MEZZANINE? BASE:M' 1 FLOOR LOAD: GARAGE . FIRE SPR<LR? ALM? I . )W(GPM) ETT? L ILAT Trot: r.rE-ALt,sy — PLAN CHECK WY : ..1H RE MAF1K Sa • PFROOF ONLY REISSUE OF NO LAST P T'-r',il IF- I -- — — -- _ 0 W BEVERLY ENTERPRISES PERMIT *3B5 00 N I020 5W VERMONT PLAN REVIEW E R t'(JRTI...AND OP 97219 FIRE E DEPT PHONE 4 503) 620-5141 STATE TAX $19 . 25 — — — . OTHER C DEVELOPMENT CHARGES : O N '.a1:1C:I S T0PM 1 1 GRIFFITH POOLING CO 511.11.:('i 1 REET 1 A A 6815 5W 41104 PDC( * ) C PEAVL.PION OR 9700"1 PREPAID ( ) 0 I PHONE (503) 643- 1596 R REGISTRATION NO . 925 Tt11Al . ` 7� $404.2`t This permit is issued subject to the reyulatlons contained in 1 die 14 PEEL T P T NO /QU / of the ?MC. State of Oregon Specialty Codes. zoning regulations __...._............ ....._.._...._ and all other applicable codes and ordinances. and it is hereby REQUIRED INSPECTIONS agreed that the work will be done in accordance with the plans and F PAM/NO specifications and in cornplia'ce with all applicable codes and .1 N511.11 A 11'.ON ordinances the issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city WOOF NA I I..I NG business tax permits This permit will expire and become null and I- FNAI.. void if work is not started within 180 days.or if work is suspended ur lbandoned for a period of 180 days any time after work has ommenced It shall be the responsibility of the permittee to aasuli' ill required ins - s are requested and approved i 744iitte nattire % ...... ! Iss led By 'tet✓0 – (".AI_L. l on :AT,Pl , T.ION 639-41 79 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE INSPECTION NOTICE 1 City of Tigard Building Department P.O. Box 23397 Tigard. Oregon 97223 Phone: 639-4175 �}- 1 Type of Inspection /- 1:4/Z � / ,, v Data Requested <<7/io L Time L-~A.M. 4"----P.M. Address .. f o f��7�,�li _ . Permit #t -/7/;' _ ( / c� ()wow/ It•L,0 t �* , t/0-,44 e.74 Lot 0 Builder_,s��/L7,a..��- a _ 7 The following Budding Code deficiencies ere r r to a owreated. ' ' -.e -MiiiAe____Sii-e. (71/efe._____ /p . / , ,4(;" i _ .. , , 1 ,," fi = All'4iti-o,, �� l,- Z-#-(eir ' i- .4 -fi _—_ / _ Presented to Approved Inspector INIP - [ 1 Disapproved .q.,...: . ... AP•a!p•.Pete _ a / 4/0 _ ! s Ll{eC-i CALL FOR REINSPFC'TION Li res U No Lrl ! i Vr I IWMI-11J IVILkor1MIVII,ML NtP1IV11 1 Permit N . /., '' _. .."' ii). 91) Description304 T — - — - - -• Table]A Mechanical Code OTS R111Cl Aley City of Tigard NNAh1 — — 13125 S.W. Hall Blvd. 1) Permit Fee •0- •0- 10 00 P.O. Box 23397 Tigard, OR 97223 2) Supplemental Permit 300 639-4175 Furnace to 100,000 BTU 1) incl.ducts&vents 5 00 Furnace 100,000 BTU 4 2 incl ducts&vents SO Name of Development 3) Floor Furnace n(1(t incl vent Job Add 4) Suspended heater,wall heater rt 1k1 Address // N or floor mounted heater � �-) r f Rc,-�rL 15�-/t'1-- Vent not incl.in ---- - 1 00 Tax Lot Map Nil 5) Lot Block Subdivision appliance permit, ermit -- Name(or name of busRepair of heating,refr ig., t, tx� A 8) cooling,absorption unit Mauling Address Phone " ~— Boiler or comp to 3 HP Owner , , 7) absorp unit to 100,000 BTU i, '10 b S �� City,s� tips 8) Boiler or comp to 3 HP•15 HP t t tKt 4 — ahsorp.unit to 500,000 BTU Name �� f • Boiler or comp 15.30 HP �, ��1 / r1 C`y� c 9- absorp unit 1./2 1 million t S ilii i Madtng Address '" L V 10) Boiler or comp to 30-50 HP ,3 y 7 i ,'far-' 1(31K LW-15.3877 absorp unit 1 .1.75 million Contractor city sura - rip 11) Boiler or comp to 50 HP It SO absorp unit 1,750,000 BTU 6 t.rAl.-I_- Y 7d'D___s- State Registration No City Bus Tax No 12)Air handling unit to � 5(t 10,000__CEM herebyg ) Air handling unit • I edge that I have reed this application that the information wen is 13 000 CFM r tiL, owed,that I am the owner or authorized agent of the owner that plans aRnatted are m -- - .---. compliance Mth State laws.that I am regrsteret'with the Stale Buaders Board.that theNon portable 14) J h0 correctgear number given is (If exempt from State registration please grreason below) evaporate Cooler 1J/ e (. ; 4 1 / , P , , ti t 5) Vent/an connected_ 1 00 to a single duct 18) Ventilation system not 4 SO included in appliance permit Hood served by 17) 4 SO mechanical exhaust sires,.towner or eport t-� - -- - - Data Domestic type Describe work C] addition in alteration [7 repair 1 IA) incinerator SO to be done _ residential ❑ next residential i4 t 9) Commercial or industrial k1 txs type incinerator Existing use of - -- ------- _- building or property _ 20) Other i e ,woodetove,waw• tq. rt heater,solar,clotnes dyers,etc / Proposed use of -----.-- bulldlrg Or property 21) Gas piping one to four outlets :00 Type of fuel-- oil ' 1 natural gas Vg LPG ( I electric i - - --- 22) More than 4-per outlet THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- - -- -- 1 STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 190 _ 4%941101MR', r , DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 2961 OF RUR•TOTAL ABANDONED FORA PERIOD r'e fan nAVS AT ANY TIME AFTER ------ - WORK IS COMMENCED TOTAL Special Conditions Date issued - ,_ ,'.', , b, •; ' t art OF TIGARD No. 214 4 4 13125 S.W. MALL BLVD n�)� P.O BOX 23.397 Date TIGARD, OR 97223 it/ Name Address Lot Block/Map Subdivision/Address Permit M's Bldg. Plumb Cash Chick Sewer Other ' Other 'lac. By Acct. No. Description Amount I ' 10-432 Building Permit Fees 10-431.800 Plumbing Permit Fees_ 10.431.801 Mechanical Permit Fees r.......:., 10.230.501 State Bldg. Tax 10-433 Plans Check Fee 30.443 Sewer Connection 30-444 Sewer Inspection 51-448 Street Syst. Dev. Charge • 52-449-610 _Parks I Syst Dev Charge 52-449-620 _ Parks II Syst. Dev. Charge 31-450 - Storm Drainage Syst. Dev. Charge 10-430 Business Tax • �10-434 Alarm Permit 10.227 Bail 10.455• Fines • Traffic/Misd/Parking 10.230• CPTA Traltic/Mild/Vic. Asst. 10-456 Indigent Dea sn a ` 10-122.4 1 _ Sewer Service/U$A T30-122-402 Sewer Service/City 30% • '.1I-1 ewer�evicel ity nt �� _ i�j __ Unmatched- "3t ff� — Storm Drainage _ ` dS77� —� Bancroft Prin Pyymt _ 40.47i Bancroft Int Pymt TOtAL Ow t •11, CUSTOMER