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9480 SW BRENTWOOD PLACE
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B'ailding Address...94.6.0...SW...B.r.9n.twood...P1........Lo.t #499...........................
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akr� Certificate is hereby given this......17......day of.....9.ugust, 119.....
that said building may be occupied and
j 4 ' that it complies with all requirements of
j = ; the Building Code for the City of Tigard, ;, . X ,
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' i• � t as approved by the Tigard City Council.
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Building Inspector Wf ry
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ADDRESS PERMIT NO. ZZ rl_3
PERMIT CHARGE none
OWNERCONNECTION FEE
PAID BY v�r GY c
TYPE OF BUILDING Z.C4 DATE CONNECTED _
SERVICE RATE — � C INSPECTION FEE :;57 "y
CnNTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID ._.__
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City of Tigard
INSPECTION REQUEST ,/
for
ISPECTION TIME: PERMIT
DATE: :3-VVV,72. DATE ISSUED ._.1. ,/
WNERS NAME : C
AXRESS: I
,)N TF,b L POR :
0
ST : Air 0, Woter�❑ ,, Visuof ❑ , L.abnratory p I
ESULT: Approved GY, Disapuroved C , Pending r3
SKETCH:
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IN CTOR DATE
[OTE: Attarh supplemental test data beret] I
�lYILI BUILDING PERMIT APPLICATION cOF TlGARD DATE —+3-?7 -, ,y
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE..__
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWN£RPHONF
LOT NO.
OWNER ry n•C• JOB ADDRESS -x430 SU HrgAtWoOd P 1 r-IOME ADDRESS
ARCHITECT
ENGINEER
e'JILDER acfrrlt. ADDRESS
_ DESIGNER
STRUCTURE ;;DNEW ❑REMODEL ,❑ADDITION ❑REPAIR_ ❑RENEWAL ❑FIRED,'MICE ❑DEMOLITION
RFSIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND C1 MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE_.- -BLDG.TYPE-5FIRE ZONE' PLAN CHECK BY f TI'� HEAT- r ��
;'19 Fontain Re—issue same as .10235 SW Gruonleat' Teri . Attached dwelling
F_LOQP_LS?A�.____._-- N�1 til _—NQ$SPIE$_-I____. R.�.A__�_.'-_`13 NCbEEQR�QM$—_i VALUE 38,E_•(la,
BUILDING DEPARTMENT _ SET BACKS FRONT 1G REAR „4 LEFT DE j; RIGHT SIDE
Permit l�d*CIO - — — -- -- —SI�� Lt
—
THIS PERMIT IS ISSUED SUBJECTTO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HFRFBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANO SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL .APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE.
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB 7NTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4.92 LICENSE. SEPARATE PERMITS REOUIRED FOR SEINE PLUMBING AND HEATING.
ToraiBY ---
-- ApPi.ICANI OR AC3FNT
ApprovedOW Rvc vipt No 1/
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DATE INSP. TYPE INSPECTION REMARKS I PLUMBING DATE
Contractor
Permit !Vo.
Rough in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil 411—"7& 77
-1 L 7
Final SEWER
DRIVEWAY
Final
Storm Drainaue
........ (Rain Drain) Firil
Sidewalk
Curb&Street Final
Approach
RI.DG DEPT FINAL TEMPORARY --T CERTIFICA( ANCY Final
CERTIFICATE OCCLIPPNC Y
Landscaping
Zoning Final
_J J
UNII- IL-' D SEWERAGE AGENCY No. 1.1__b�3_ ------ --_
WASHING FON COON IN DATE _ 2-8-77
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CITY
APPLICATION FOR SEWER CONNECTION PERMIT
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OWNER:
OWNER'S ADDRESS: .___,_. ----. -__- -- -- — — ;
STREET
E
CITY r STATE ilp
BUILDING SITE: LOT 499— _ ADDITION ._
TAX LOT N0. ____ ____ TYPE OF OCCUPANCY .___..._ reS. sit1c_a ._-
ADDRESS __._ 4,8 0=_IL__B_r.E n t w o o d P1 .
DWELLING UNITS __. 1 - _ FIXTURE UNITS
SURCHARGE IF APPLICABLE -- -
PERMIT FEEINSPECTION FEE ___ 'TOTAL DEPOSITED _6 O
(NEW1 (EXISTING) BUILDING SEWER SYSTEM _. FT_a_nn ��! _ -------------
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Ayency.
APPLICANT 1r _� �`��;_ Lv —
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNF_CTION TO THE SEWER SYSTEM.
LINE SIZE _ _ INNSTALLER
RECEIVED RY -i4 t{� t�-i t ��_� ti - `-�-•L - ss`..�t�.�.�
(AGENCY OR V AGENT) G V
COMMENTS: Bldg.#12138
This Application and permit expires in one hundred acid twenty (120) days.
The amount paid will be forfeited should exuiration occur.