10670 SW BLACK DIAMOND WAY-1 i
F-
0
rn
0
Ln
Fr-
ID m
!-
(ll
F
0
r•
W
0
0_
E
w
K
r
,q
I
10670 SW BLACK DIAMOND WAY �
ADDRESS Ob" [� <<� �[l�c ' PERMIT NO. i 5-
PERMIT
PERMIT CHARGE _ none
OWNER
CONNECTION FEE fid.
�-��'s� (�D1 , .
PAID BY
TYPE OF BUILDING DATE CONNECTED
SEP,VICE RATE
INSPECTION FEES
CONTRACTOR PAID BY r, DATE
SIZE OF CONNECTION ASSESSMENT PAID
4', 3 -
I
IL
1
{
i
I
7 7
NY 15888
JUnified Sewerage Agency
of Washington County CITY OF Tigard DATE 5-5- 7t3
OWNER: R vnri.innri f nnut.__ PLIONE s
OWNER 'S ADDRESS:
TYPE OF INSTALLATIONS
XBUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XE NEW LJ .NGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO 7-1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS_. DWELL1wv UNITS 1
ADDRESS OF STRUCTURE : 10670 SW Black Diamond Way
PERMIT CONDITIONS: THE APPLICANT AGR'=ES TO COMPLY WITH ALL RULES AND
PEGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE hOn-
SIDE SEWER INSTALLATION — ST.LM.nE_:
ISSUED BY
OTHER
A TOTAL $ 625.
APPLICANT DATE
N? . 15888
SEWER PERMIT
ADDRESS OF STRUCTURE 10670 SW Black Diamond Way
TAX MAP TAX LOT SYSTEM Fanno creek
LOT 2 BLOCK OF
APPROVED BY DATE ISSUEDAY DATE
D. U. ' S l REMARKS bldg. #2074
All IF
BUILDING PERMIT APPLICATION COTFY TIGARD
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE �.14162711
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE`.—
LOT NO.
OWNt.R�' I•Vol"JoUd ;,4311"• JOB ADDRESS •1(X,70 Sid filasck bilnrou
_ R4IMtal1RE53
ARCHITECT
8E3fQtd ENGINEER
BUILDER nn ADDRESS DESIGNER
STRUCTURE A�IJN W 1:1 RF MODEL ❑ADDITION C3 REPAIR ❑RFNEWAL L3FIRE DAMAGE ❑DEMOL!TION
V r,.:SIDEN1. ❑COMM DEDIJCAI(OV ❑
AL 'jGOV'T ❑HELIGIO!JSOPATIO CAR PORT EI
GARAGE [:)STORAGE[:]SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ ❑SIGNS
6
QCCUPANCN R��.LAND USE ZONE f1�7 BLDG.TYPE_ FIRE ZONE-- PLAN CHECK BY >4tw HEAT_ �___�
cmiat. asinUlet VOMLly dwslliny w/attachad Ware jv 3 I bdruuat 2 bath
reissue of permit .4620 garage 46U
sewer paer_seit�l�ioeo — --
Q�c_LDA.Q_____-W_1.WHLDALL4U 1 EIQd- a_0 � sTORIEs 1,AREAL°�9iIN0•HroRooM�—��LUE 40i6$0.
BUILDING DEPARTMENT13 y
-- SET BACKS FRONT NEAR l LEFT F!0E RIGHT SIDE
Permit 166 1 UO _
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONIAINt D IN THE t3UILDING CODE, ZONING
Plan Check 10.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED 1'HAT Tit-
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIr!CATIONS AND IN COMPLIANCE WITH
Subtotal _ 170.DO ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6• ,40 LICENSE. SEPARATE PERMITS REOUIRI:6 FOR SEWER, PLUMBING AND HEATING.
Totai 116.40 }r L .l . 00U.
o.a.c. #i $1()0.
BY
----- -- -- APPLICANT CR AGEN1 --- _��------
Approved Receipt No.
DATEINSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
4 trt>w — — Parm;t No /Y,.3
-) plc.y�
-- ,- --
__,�� { Rough-in
Fixture
7
711- - - _-- r /4 Final
U�;z1-1C. I HEATING
L �_ retia-.t.0. CEJ / �a Contractor
X' ret JA/i_4! „ Permit No.�L�
T
.CC�.�! - � — ---
��-rtd C•t'> �- Gay or Oil
1.4 t 4h f �� , ' �� flouph•in
Final ----- ---
�'7 SEWER
Final
SIS.: J�LdJDT� — DRIVEWAY__.
_ t(Rain
al _.—._
Iv
r
StonDrelnapa -- —
I_L_ �f— Drain) Final
weik
-- b&Street Final
BLDG. DEPT. FApproach TtMPORARY CERTIVICATd OCCUPANCY Final
CEIt'f IfICATL OCCUPANCY
Landscaping
Zoning Final