9410 SW BRENTWOOD PLACE 1
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'94.1.0 SW BRENTWOOD PLACE
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CITY OF TIGARD - •
vl �' OREGON )
> I T.D.C. Permit .do. 12.77
Owner:......' ...................................... ....
9410 SW Brentwood P1. Lot #492
* Buildinv Address--...... .....
3 •+', 24,....... Au ust..... .........
Certificate is hereby given this...... day of. .. 9..
that said building may be occupied and �t
that it co...lint.s with ali requirements of
the Building Code for the City of Tigard, ; <-1
I as approved by the Tigard City Council. '` „)
i' '' ' II / Bui ding inspector
C7 4:;; mow-r = y� sus LTsty i'�; �w�U r++4 {��►+U .„+1$
•`' .Wens..: 1 '�'//•-'� .;'�.^ " .� ♦b :�!Y.1..f_"'�_.'i�f4 / yNh4. h J T`'
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ADDRES5MPERMIT NO. r/6• ,3/ _
PERMIT CHARGE none
d u
OWNER C, 0 CONNECTION FEE J-75-
PAID BY
TYPE OF PUILDING
DATE CrONNECTED
SERVICE RATE INSPECTION FEE
CONTRACTOR _ PAID BY DAVE
SIZE OF CONNECTION ASSESSMENT _ PAID _�
.,.
FPO 04
BUILDING PERMIT APPLICATION 11To Y TI'S ARD DATE ' ts_ j 1777
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACC.OMPANYINv PLANS AND SPECIFIUAIIONS. UWNLH PHONE
LOT NO._,
OWNER J06 ADDRESS i0 ME ADDRESS
ARCHITECT
g3EIiiIFj ENGINEER
BUILDER _ ADDRESS _ DESIGNER
STFUCTURE LJRIEW ❑REMODEL _ ❑ADDITION _❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOVT ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BUND ❑MOVING ❑CUNDITIONAL 'JSE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY _LAND USE ZONE d BLDG.TYPE .I ,....FIRE ZONE PLAN C_H_ECK BY _L HEAT__.",____
L:A , 492 iluti$,f.'a.a,Li t. issuo f'Ui ras as 102P' J .!A. Ltrewi. Lot TurrF3ce. ---
nttacF r-A FrAmra dwal,l,ing w/attachlad ,dsrugs 2 bodroum 2 baths
QCS_QA0_____F.LQ,QR LOAD HEIGHT .jQ_2TORIaS 1 AREA1208 NO.BEDROOMS f VALUES;7_Ct f'1'i.
BUILDING DEPARTMENT SET BACKS FRONT 1/4 REAR � LEFT SIDE tj RIGHT SIDE
Permit 131.00 -- —�
THIS PERMIT IS ISSUEn SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal 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 ..193 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 34.93
By
APJ?J ICANT OR AGENT
Approved R Rei el t No
DATE INSP, TYPE INSPECTION REMARKS
— _ PLUMBING DATE
Contractor
•� ' Permit No.
aw• i
Rou h in
Fixture
l
. a c
Final
` ` HEATING!
13 ---
Contractor
Permit No�j •%%>> ��` ._•�7
Gas or Orr
Rou h in
Final
SEWER_.`..__Final
DRIVEWAY DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
-- Curb &Street F nal
BLDG t EPT FINAL TEMPQRARv _ A roach
CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCv
Final
Landscaping `
Zoning Final
UNIFIED SEWERAGE AGENCY( N0. 11631 -_--
WASH I NGTON COUNTY DATE _____ 2-2-77
CITY OF------
jir�ard
-_ _---
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: -_----
OWNER'S
WNER: --- ---OWNER'S ADDRESS: ----- -
STREET
ZIP
- CITY -- SfATe
BUILDING SITE: LOT. 492--- BLOCK _..._- -_ . _ ADDITION
TAX LOT N0. -- _ - __
__ TYPE OF OCCUPANCY
ADDRESS9
. 410 S__W_ - - ---� --
i__ Brentwood P1 .
DWELLING UNITS -
1 - - FIXTURE UNITS
SURCHARGE IF APPLICABLE --
PERMIT FEE _.--.57-5-, -- INSPECTION FEE 25. TOTAL DEPOSITED
NEW (EXISTING) BUILDING SEWER SYSTEM - _.__E_2no__L-rem -- - -The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICAJ�XE�Qd1 -t.� —
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION 110 THE SEWER SYSTEM.
LINE SIZE - -- INSTALLER -- –
RECEIVED BY-_ `-..�aETN�Y oa i AGENT)
i
COMMENTS: - 61 dg. # 1277
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur. -