11810 SW BURLCREST DRIVE-1 i S'r q � ASI ® iRi a R' s•
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_11810 SW RURLCREST DRIVE ����
BUILDING PERMIT APPLICATION CITY
TIGARD ATE — 1-1-9-'17 17P0
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONL-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF �97�
NO.
OWNE? Tura y I_it Tune J08 ADDRESS 11U10 SU buriCrest FIOMF.AhDRESS:� LOT
- _ ~
ARcHi,rECT -- -
BUIL,DERfaEti
ADDRESS ENGINEER
1r--11_ DESIGNER
STRUCTURE ❑NEW ' C1 REMODEL _❑ r-� O_ADDITION FJ REPAIR RENEWAL _ ❑FIRE DAMAGE '(-]DEMOLITION
O RESIDENCE ❑COMM ❑EDUCATIONAL C.]GOV'T ❑RELIGIOUS❑PATIO OCAR POOT ❑GARAGE ❑STORAGE PSLAB ❑FFNCE
DBOND (OMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW •COUNCIL APPROVED — ;'13to,S
OCCUPANCY a LAND USE ZONE_ R»7 BLDG. TYPE 5N —FIRE ZONE PLAN CHECK BY � '' ♦cP.T
arlst. ci fA.iot� of 1 x2r ri)cm to axiytiL:� W. nw-1 n�1u t�:�L -- -- —._ --
to include free standing fireplace
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=—IDAD FLOOR LOAD_i HEIGHT f� NO.STORIES AREA ���N_(J.��J�jQQ(�IS __y�►L�� lr!_
BUILDING DEPARTMENT SET BACKS FRONT uk REAR LEFT SIDE RIGHT SIDE
Permit L)6,no. -- -- -- -----
- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ,��y REGULATIONS AND ALL APPLICABIE CODES AND ORDINANCES, AND 11 IS HEREBY AGREED THAT THE
! WORK W LL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAN'.0 WITH
Sub"total ALL APP, ICABLF CODES AND ORDINANCES.
--` THE ISSUANCE OF IRIS PERMIT DOES NOT WAIVE
RESTRICTI%4 COVENANTS. CONTRACTOR AND SUB CONTRACTCRS TO HAVE C11
RRENT CITY BUSINESS
State Tax 1.24--
LICENSE. SFPz9ATE PERMITS REOUIRED FOR SEWER. PLUMBING AND HEATING.
Total
By
-- -J -- APPI ICAN7 OR AG! .4 i- - —
Approved ( Receipt No
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DA(E INSP. TYPE INSPECTION REMARKS PLUMBING DATE
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Contractor _
Ar�-/y _ - P_ermitNo.
12L� �1 �__— — - Rough in
_ �- /_
3_Z�•7pJ -1�1 /QG Y`/tit-1►�7� � � G(�1�I.-L!y Fixture —^
G'� �� Final —
/ O /� 4/o, HEATING
ClZ_ 100T , 0 aJ— Contractor _
j 13• AJ R��—L21.Q_�3�_ a�C4 Permit No.
- (11 d 4 D-��� ,3— -1V� —. Gas or Oil — -- ----
( 5 _f��l.—.-CZ_ x5 —
Rough-in ---
- � Final — -
r._ ��L'_ ,�L�J 1 t-• GSC-C. �p,i• —__ —SEWER -- -
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Final
-- --
DRIVEWAY
Final
Drainage --- --
(Pain Drain) Final
1 Sidewalk
Curt-, &Street Final
Approach
BLDG DEPT FINAL TFP+VURARY CERTIFICATE OCCUPANCY Final
CEP"IFICATE OCCUPANCY —,
Landscaping
' Zoning Final
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 928 DATE — 1
PERMIT IS GIVEN TO
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TO CONNECT ATO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST HE POSTED ON THE DEWRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FU PAID {................, .................TIGARD SANITARY DISTRICT
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CONNECTION INSPECTED AND APPROVED
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Address���ll.. f ���.---- Permit --------
Name of Occupant_.`____ _ Permit charge
---— --- -- _ Connection fee
— ---- --- ---- --- ---- Paid by --
-- - Date connected
Type of Building.- -- _.--� Inspection fee
Service Bate Paid by _ Date
Contractor Assessment _ Paid
Size of connection
A '
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N? V9 DATE
PERMIT IS GIVr;N TO 1
OF y
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT f .;
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION 13 MADE AND INSPECTION OF CONNECTION HAS BEEN COM.-
PLETED.
PERMIT FEE PAID ... .......�..................TIGARD SANITARY DISTRICT
By /
- ------------------ - -- - - - - ------
CONNECTION INSPECTED AND APPROVED
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___ _----Date Suptcintendent