12045 SW BURLHEIGHTS STREET .I
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BUILDING PERM„ APPLICATION DATE__ _ 19 4728
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN ANf',APPROVED 44 THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE 67�I6-7—
OWNER Pat 001dSlOnOiOB ADDRESS 12045 SW Eturlheightn Drive LOTNO. 1S134( n,TT, r900
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ARCHITECT
BUILDER ADDRESS Ccn&t. AaaRESB 232-1106 DESIGNEENGINEER
J.X.oidll.ard
STRUCTURE ❑ NEW ❑ REMODEL ❑)ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ REVUENCE ❑ COMM C7 EDUCATIONAL_❑ GOV'T ❑ RELIGIOUS ❑ PATIO 3 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
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OCCUPANCY M LAND USE ZONE .- °'—BLDG.TYPE _FIRE ZC NC_ —PLAN CHECK B� HEAT
--_C Fjtruct dQlghed carport, all per approvnr? Plans arta, code requirrmenta._ -
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SEWER nF.RMI M
OCC.LOAD FLOOR LOAD HEIGHT 1 NO.STORIES 1 AREA 324 NO.BEDROOMS VALUE 20('0
BUILDINGDEPNRTMZ:NT SET -t
S BACKS FRONT FEAR 1, LEFT SIDE ':ARIGHTSIDE `"i
Permit „��_ _ THIPERMIT Ib ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
n'EU�!ATIONS AND ALL APPLICABLE CODS AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _— WORK BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH AL, APPLICABLE CODES AND ORDINANCES. THF iSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub•tutal RESTRICTIVE COVENANTS. CONTRACTOR AND ;un CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Stale Tax 1. 3 G
!IrENSE SE)ARATE PERMITS REOUIREU FOR SEWER,PLUMBING AND HEATING.
� -SDC--
Total.-
DC--
Total ;_.93 - —_
B , 2,L.12--iL-- PDCA AA PP (CANT OR AriENT
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� Receipt No
Approved \ -13•gQ A664ESS -- - - - PHONY
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DATE INSP. TYLE INSPECTIr1;' REMARKS PLUMBING DATE �•
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Rough-in
— _ Fixturo _���--- - ---
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I) HEATING
Contractor
P-rmlt No.
Gey or 011
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Rough-in
Final
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Final
DRIVEWAY
Final
Storm Draln^qa
(Rain Orsini Final
_- —^ Sidewalk
Curb&Straat Final
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®LDG. DEPT. FINAL TEMPORARY C:ERTIFICA''E OCCUPANCY Final
CERTIFICATE OCCUPANCY
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Address .�O�,Sa✓dy� iiLM&L Permit No._J / _W_-------__ ._------
Name of Occupant___._____ Permit charge Z ""
Connection fee 7 )I) —'
Paid 1.)y
Date connected 'J - C- 7
Type of Building Inspection fee
Service Rate-___ Paid by Date_
Contractor Assessment Paid
Size of connection
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1.011 DATE
PERMIT 1S GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANT..ARY DISTRICT
AT N, �� ...1 ._.
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES TINT➢L CON-
NECTION IS MADE AND (INSPECTION OF CONNECTION HAS BEEN COM-
I'LF,TED.
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PERMIT FEE PAID $........*.' ......................TIGARD SANITARY DISTRICT
By
CONNECTION INSPEXTED AND APPROVED
Date Superhitendent