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10700 SW BLACK DIAMOND WAY-1 r 0 U O Un z v 7 u 3 II � 7 1 i rf 1 I ;i I II i .f III _10700 SW BLACK DIAMOND WAY Address 16Zoo Permit �!o. Permit charger] Owner ,¢. , Connection fee ___ .�.._ e Type of building Date connected Service ra_;;e Inspection fee s, Contractor Paid by date size of connection Assessment Paid EWER PERMIT �� 11 N • 13936 of Unified SewerageAgency of Washington County CITY OF Tigard r, DATE 3-1-78 OWNER: S Allen DrEW PHONE : OWNER'S ADDRESS: TYPE OF INSTALLATION: �E*UILDING SEWER ❑BUILDING SEWER AND SIDE SEWER TYPE OF OCCUPANCY: XSXDP4EW XDXSINGLE FAMILY ❑ COMMERCIAL ❑EXIST . (PRIOR TO 7-1-70 ) ❑ MUL.T. RES. ❑ INDUSTRIAL FIXTURE UNITS DWELLING UNITS 1 PERMIT CONDITIONS: THE APPLICANT AGREES TO CCMPLY WITH ALL RULES AND REGULATIONS 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 600. SIDE SEWER INSTALLATION _ ISSUED BY OTHER TOTAL. $ 625. APPLICANT DATE SEWER PERMITN°' 13936 ADDRESS OF STRUCTURE 10700 SW Black Dianond Way TAX MAP TAX LOT SYSTEM Fanno creek LOT 3 BLOCK OF APPROVED BY DATE )Eb EKY DATE REMARKS_. Uld . ;f 1917 BUILDING PERAPPLICATION Co Y T :�-1 -r_, 11017 1 I�AI1QQ DDATE__._ 1!.i___ 253-0484fHc UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR 7HE WORK HEREIN INDICATED BUILT ER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPAN'yINC, PLANS AND SPECIFICTIONS. OWNIRPHONE___ 10700 �,. ,.:..tack Oiatrmgnu Wst LOT NO.— _ OWNER JOB ADDRESS HOME ADEIRESS ARCHITECT---- BUILL`P!; ADDRESS CCNGINEER DE£IGNER }}STTRUCTURE Xh i !NEW ❑REMODEL ❑ADDITION REPAIR CRE E AL ❑FIRE DAMAGE ❑DEMOLITION LJ/iESIDENCE ❑COMM ©EDUCATIONAL ❑GOV'T EIRELIGIOUS,6FATIO_❑CAR PORT ❑GARAGE [:]STORAGE LISLAB ❑FENCE - QBOND- ❑MOVING ❑CONDITIONAL.USE ESIGN REVIEW `❑ OUNCIL APPROVED ❑SIGNS tip — OCC UPANCY __.._LAND USE ZONE —9LDG. TYPE FIRE ZONE ,k J PLA CHECK BV HEAT l"JIIiTiiZy dWPU' 4rttj W nAtschad {dj✓Are , Qa - -- ;i t.adroam 2 tJIEI�,f� garage 4LO t 13936 ea3t.►r,�r cr�nti. b�f� . eaWarr i6sp. ;;-- 46 FJ.Q.OR LOAD .---- HEIGriT Sn I - .__-N-ULL2R.49N!1%--YALUE BUILDING DEM�c+yyT� 113 SET BACKS FRONT REAR LEFT SIDE �El RIGHT SIDE -__-� - Permit --- --- -- — --- THIS PERMIT 19 ISSUED SUBJEIT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check REGULATIONS AND ALL APPLICABLE CODES ANV ORDINANCES, AND I" :S HEREBY AGREED THAT THE - 64,88 - WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC:/IONS AND IN COMPLIANCF WITH Sub-total ALL APPLICABLE CODES AND ORO!NANC.ES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE -`- "-" -- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACIOPS TO HAVE CURRENT CITY BUSINESS State Tax LIfI � SEPA�R J)PERMITS RFOUIRED FOR SEWER, PLUMBING HEATING, Total P.[).C• #1 S100. By q i � nN i NT OR ArrN7 - Approved J Receipt No AggRt SSPHONE _"_ DATE INSP. TYPE IN PECTION .REMARKS PLUMBING DATE ontrar:tor Permit No. Rough in t � '• �~�_iTsy Jam,=.T�/c-c. Final L T HEATING L at Contractor ^_ «K� � ¢,l ,G� �e,•v,., ice/ -- ermit No. - 1TrGa:or oil o Rough in — C I _ Final SEWER _ Final _ DRIVEWAY Final — Storm Drama e Rain Drain) Final Sidewalk — Curb&Street Final _ A roach RLUG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Landscaping Zoning F inal