12475 SW BROOK COURT-1 a
• I
�l
Y ,
12475 SW BROOK COURT
i
+w 7liM rr-*w.Iyw.MV�e+p,,.rwyY w�..y.. �,MPy„ +14"'E'N��►��' ".,:.+or•,-MCI- ^s�vrr.,..-w .,�w•.�u-hwar
CITY 3F
BUILDING PERMIT APPLICATION'(CATION' TIl ARD DATE —._— G
1,
THE UNDERSIGNED HER;_BY APPLIFS =Oil APEHMIT --08 THE 00R HEREI'•I I A)TATED 620-
OR AS SHOWN AND APPROVED IN 'HE ACCOMPAV LING PLANS ANL, SPECIF•CATIONS. OVINER PHONE —.___._
OWNER stey'al Wargo ADDRESS l2t4761 5..Ws, BX•ooli Ctr 620-12'4
—. ..�
F.NGINEEP I
—r -
Columbia Poaln
BUILDER [IESIGNF.F'__ —__�••� �Ir
STRUCTURE ❑Nr-"% _ CIREMGDEL_ _ OADDITION_ _ ❑REPFIR ❑RENE_WAL ❑F•IRF ')A',NG_C_F �� j_DEMOL:TIO'-4 1
M RESIDENCE ❑COMA rDEDUCATIONIAL ❑GOV'T ❑RELIGIOUS❑PATIO O CAR PORT ❑GARAGE C.)STO=AuE OSI -NI3 DrENCE
QBCND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ —,�' GNS
C)CCUPANCY--LAND-USE ZONE_--.--BLDG.TYPE. FIRE ZONE PLAN CHECK BY_ _—___
- --- ---
QC1C•_LOAD FLOOR COAD_ ---HEIGHT NO.STORIES — AREA--_`VALUE 6400
BUILDING DEPARTMENT— SET BACKS FRONT REAR LEFT SIDE RIGH i•SIDE
Permit 4U.ilf) ---_--
-- "— 1HIS PERIMIT IS ISSUED SUB)FCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plim Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINAM:ES, AND IT IS HEREBY AGREED THAT THE
" —— WORK WILL BE DONE IN A!.CORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE COOFS AND C'ROINANCIES. 'fHE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATC PERMITS REOI)IRED FOR SEWER PLUMBING AND HEATING.
Total •��41—i—__
[Ely
--- -- — --__�_..�—��—_
--- — — APPLICANT OR AGENT
Approved Receipt No.
pi-
i•i
DATE INS°. TYPE INSPECTION �^ REMARKS PLUMBING DATE
S/ e<z U/��1��+t� ___ — -- — Contractor
Permit No,
Rough-in
Fixture
Fin3l _
— HEATING
Contractor
- uv
Permit No. iYM1
Gas or Oil
Rough-in
Final
SEWER
Final
— � DRIVEWAY
Final
LStorm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach _
BLDG. DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIF;^ATE OCCUPANCY Final
Landscaping
Zoning Final
I
t
Address 12475 S.W. Brook Permit No. 1503
Permit charge
Owner Connection fee 375.'C
Paid by Allan Paterson
Type of building Hes. Date connected_ B-9-71
Service rate _ inspection fee _ 25.00
Contractor— _ Paid by Date __-_._,w___
ize of connection 4" Assessment Paid
*� PEP.MTT TO CONNECT
as Tigard Sanitary District
PERMIT Nv ) 1503 DATE -
PERMIT IS GIVEN TO
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $- y.. .......... TIGARD SANITARY DISTRICT
n.n s i. B�• .9.. � �y
CONNECTION INSPECTED AND APPROVFI)
Date Superintendent