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BUILDING PERMIT APPLICATION TIGARD DATE " to?�_ 4432
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH EWORK HEREIN INDICATED BUILDER PHONE 266-7t►61
_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICA IONS. OWNER PHONE—. ( ' ? _
!,vp1e!ru�W LOTNO.—A Phase 1 +.
OWNER Jain & it ,cry 1;op1 ADDRESS 1(.t5 10 Stf Canc!„►ry )a!, Drip ti;iNtr(11lT'_ield
t . ARCHITECT+�—+
Niel Koily co. 804 'No Ablerta ENGINEER Suildelr
BUILDER ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL IS ADDITION ❑ REPAIR ❑ RENEWAL O FIRE DAMAGE ❑ DEMOLITION
FJ'RESIDENCE ❑ COMM ❑ rDUCATIONA.L ;_i GOVT O RELIGIOUS ❑ PATIO [-J CARPORT ❑ GARAGE ❑ STGHAGE [_1 FLAB❑ Fli
OCCUPANCY k{- _LAND USE ZONE -. ..�_BLDG.TYPE --i FIRE ZONE _PLAN CHECK BY —fl —HEAT (ram
;'onatru►:t Rath additL-)n 14, bedroom ant( ;►Rios► to exietinr, iwellina --_i---
eeo correction sheet at4actiedi
SEWERPERMIT# lip
OCC.LOAD FLOOR LOAD 4U HE!I)HT t KO.STORICS i ttaw AREA NO.BEDROOMS VALUE 13
Permit BUILDING DEPARTMENT HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS LEFT SIDE ? � RIGHT SIDE
SETBACKS FRONT REAR ?.t
t iU.SU * LATIONS CONTAINED IN THE BUILDING CODF, ZONING
71.831 REUULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERF.9Y AGREED THAT THE
Plan CheckI WORK .'ILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE 1
162.3' 1 WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAI - r"HRENT CITY BUSINESS
Stale Tax
4.42 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEA,ING.
Total I86./5 SOC --
By
K> k d1m] PDCN APPLICANTUR-AGENT
Receipt No. `• .
Approved dwh ADDRESS PHONE --.___--
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
,.ccaa�pp
_ -- � �.^._ Contracto• 20CJ-.ffJr'�
3
Permit PJu.
8 -2� __ r,ouh-In 3e^44 �s_bv a'•27_B3
Fixture
Final — - -
HEATING
Contractor
i Permit No. � C �
Gas M Oil
ac�,ah m
�'K incl
__. S-.WER
11 Final
y DRIVEWAY
—-_— Finals
11 Storm Drainage
— n(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLOB. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY —
ICEPT"ICATEOCCUPAF:CV ry Fhnl
N"e dscaping
Zoring Final
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: L-�.__— PERMIT NO.
DATE : -Y ,_l_r!'75 D AT E I SS U E D
%)",VNERS NAME : —7-D.
ADDPFss: oo --- CoT3P� - -
00NTRACT0R - - -- -
---
TEST : Air LTJ, Water ❑ , visual K, Laboratory - '
RESULT : Approved A , Disapproved O Pending L]
SKETCH.
INSPECTOR DATE
_NOTE . Attach supplemental test data berets
s
City of Tigard
INSPECTION REQUEST
NI for
INSPECTION TIME : ,,-1 PERMIT NO. .
DATE* 1':>7-7? DATE ISSUED*
OWNERS NAME : Ize, A -
ADDRESS e--',&7.AA4Ca4 Zek n
CoNTRACTOR
TEST a r Lj , 'dater !,'I , 'lirwzi, La
RESULT: Ap )roved k, Dincpprove(i --1
SKETCH'
INSPECTOR DATE
rN—OTF Attach supplemental test ,: arc he et 0
i
e
City of Tigard
�
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NQ.; S-i/
I DATE: '�ri�'/�,== DATE i3SUED:_Z&a_zjr
I OWNERS NAME: . T /D. C'
ADDRESS . / • ti Scc. �.. t;, �
CONTRACTOR :_-_
TEST: Air O, Water ❑ , Visual P;Laboratory
IRESULT: Approved La , Disopprovee, p Pending O
SKETCH:
I
I
I INSPECTQR GATE
50TE : Attach s,pplemenfal feat data he►etcl
1�
Citi, cf Tigard
INSPECTION REQUEST
for
INSPECTION TIME: -3;o�' PERMIT NO. :
DATE: La AyI-) DATE ISSUED : Ii-1,
OWNERS NAME :
Let�, , Vit)
ADDRESS.-
CONTRACTOR :
DDRESS:CONTRACTOR :
TEST : Air 0, WaierEj-, Visual a-, Laboratory
RESULT: Adproved 0 , Disapproved 0 , Pending [j
S KET:O*W
tz
INSPEC"*UR DATE
NOTE: Attach sunplemental test data beret*"
f
+u 7 Permit issued j : CITY OF 'TIGARD, OREOCN Permit No.__-..R
>7 �1--
City bail
Application Approved Building Department Cost of Installation-
Application
-- -
IT
4".14-110"a I"Q-a"d• PL"ook Pf fxAAsUaA(aoo Fee for Permit -
Applicant shall fill in cost of installation only,
Date- a_t�3=_'1� above this double line. ;tent Srwer Permit_
d re air
j
Application U M»tq made to altar Plumbing Pipes or Fixtures according to plans and ep,clflcatlo,■and
Install dncription u given below:
Location of building-Number. and 8tnetL�._=I -_ 'r 1 12
v A,, ' I'b z s�
Addtuat_J w. IPR
/`_.-T_.-
4aivri Ar
in
Name and Address of Owner___2� �-
: N yr r��nr7` �„ t S« Al ly e�/�
Name and ArJdress of Plumber _-'
�, r•
Bunning told or New)---�� --Haight to OWiN C y occupied a
SCHEDULE OF woes
NUN= NUMM
I p f'pt F,g New no" Bi�'fplU'cs _ Ff!'l'tlRM New Ilene B'pl:•e_
Water Closets. - Imo--- Fountains, Drinking
Bath Shower _.-I-- Fountains,Yard___
Bath Tub -
Fountains, Soda_ -
-� -�•x/-•-�--') -"— c r
Basins _--.__.___�_.--, not Water Tank----I-�---- �-
Sinks, ordinary---. 7L�- Sinks, Bar _--- -•
�_'_---'' Sinks, f.cp -- -
Sinks, Dishwashing ._.. ------
Automatic Dishwasher Drains, Refrigerator_-_ � -
�� Uralns, Ice BOL_
Laundry Trays - �-I ( -- ---- -
Drains,Flour_ urinals
Catch-Basins, Yard- -Floor-
Drains, Ates--_- _-.I_____I_ ._-_-_ ----
Rain Drains-,_. __ __ _----�--i Cstch•Basina, -I-
Automatic Washer_--- I _ Ib BIL ..----
_I --
Water Permit No.---..- - irldg. Permit No _--__-
REM;RKS: /t Ar n
/__2A 5'_ f rt'L 4 -
Icept as
ted
IMPORTANir-nt the'corshell not be responding build)g plant ain s I�ddwillF,(either
requl.ed by, the`or Building D pa•'men In alcrord nrown or ielNhathe
provisions of the Building Code and Ordinance 62 19 of the City of Tigard.
repDir the pl-tmhing ayAten, areonl1 this description, plans bltd sp Qcallons and the Plumbing Code of the
I n4rer In niter
indnll till Tignro:
Plumbing Firm -Bdpervisor
Mia-
, 4 ilj ,
iM& ._
CITY OF TICARD � .
12490 S. W. Mein Shvef
TIGARD, OREGON 97.
t
APPLICATION FOR BUILDING PERMIT
New Construction X❑ Deailolish ❑ Addition El Remodel ❑ Move❑
ZONING F-D DATE ISSUED 1-16-13 BUILDING PERMIT
DATE RECEIVED 11-29-73 BUILDING FEE $ 74.00 No.
%J 11 e
9Y BH PLAN CHECK $_ 37.00 VALUATION 4 19,941
OTHER $ --r
TOTAL $ 111.00 RECEIPT No.—`233c'-
TWO
o. `7330_TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LUT 1 34 MAP # 281 10A CENSUS TRACT W-8 JOB 1
Architect or Engineer Tualatin nevelop"at Co. _
Address Phone
r
Owner Tualatin Deve.Lopmen. Co. _—
o-:
AdOress _ Phone ,
i�
Builder Tualatin DevrLtopment Cu.
iI
.y Address— Phone
BUILDING USE Single Res. X❑ Multi Res. ❑ Comm. ❑ Industria Ll
OCCUPANCY GROUP, I _ No. of Stories 1 Total Height 16 Area of Lot--
Type of Const i , r_i ,u 1=aLCXXXXK] v= V Floor Area B11 1 ! 2
UOM see conditions of Oo mty P-R and Clzpk'-D
Set Backs: Front Back L.Side h.Side
Private ;?wer Pipe size 4" Sewer U.B.A. TigardSeptic Tank ❑
Water Service Pipe Size—3/4" Storm Sewer Z❑ Ditch ❑ Drywell❑
Street and Curb Requirements Mist owiply vith the street and subdivision oonpliance a�I�
Driveway Width 16 No. of Parking Spaces 2
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
THIS FUGUT FOR KIM O&Y--lei' TO BE OM-WIRD UNITL ALL FNgYMIfI'8 ff _
e rens ntTY sot! g2n.Rn 4uus amos mo-in )an AND A
D.B.Q. 8el1II�RY 91lYMR
o ADDRESS ASSIGNED—___ 10590 9.W. Ce"r= Oak Dr. ,—
FIELD CHECK BY BH DATE 1-16-73
PERMIT APPROVED BYE
It is understood that: all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of occupancy has been issued by the City of
Tigard Building Inspector.
gnature s4k Applicant