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Owner:... .... ......_. ........................................... ........Permit No ..... '
9495 5W Brentwood P1. Lot 533
BuildingA.dOxess..................................................................... ...............................
77
. � Certificate is hereby given this....3....0.. .....day of.....December. .......-.................. 1
that said building may be occupied and
that it complies with all requirements of
'• � the Building Code for the City of Tigard,
aJ t
ns approved by the Tigard City Council.
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Building Inspector
riDURFst, PrM111'r NU. .0
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OUNEFI .... .._.... CONNECTION FU1 ._. ......_. s�.._._....._._
r... ....._.... ...w._..._. . PAID BY
TYPE OF BUILDINE _ , DATE COP:(,, f TFU
SFRUICE RATE I 114SPf.CTION FEE
I�ONTRACTOR PAID BY DATE
',,IZE OF CONNECTION ..__..._. �_. ASSESSMENT _„ PA 11) w
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CITY
TIGARD DATE— - ?.-17'19-- 14t 4 8
BUILDING PERMIT APPLICATION of
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE9"'3ii
_,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER T. '.i.� JOB ADDRESS 948 SU ' ,,? O'JQME ADDRESS _
ARCHITECT
ENG INEER
8UIL2ERf33i1mL r�---rr ADDRESS ^� DESIGNER
STRUCTURE XX®NEW CREMODEL ❑ADDITION ❑REPAIR ❑RENEWAL [:]FIRE DAMAGE_ [:]DEMOLITION
OftESIDENCE ❑COMM GEDUCATIONAL ❑GOV•T ❑RELIGIO--US❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
DBOND ❑MOVING ❑CONDITIONAL USE LJDESIGN REVIEW ❑COUNCIL APPROVtD� []SIGNS
OCCUPANCY_'l—LAND USE ZONEBLDG.TYPE )hx FIRE ZONE_.—" PLAN CHECK By tLIL 6 HEAL :�
Lot r;:�33 h ntclati ru-ietarltu wamga as11,x' "7r Sj Gregilleat Tgrksce T —
�i tic►e�ld frame dueU.J ncj u/eLt8ch8ci ereqvo 2 r riraom 2 beth
MQ,LQ6.Q —____--ILQ-QB—LQAD ---_.-Hg1GHT r No STORIES � A1jEA��_ _JN4_99DIi00MS• VALUE.-
_BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIOE RIGHT SIDE
Pe,rnit 111.00
THIS PERMIT IS ISSUED SUBJECT TO THE. REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check �,�)�QCJ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK HILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 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 ,�1� �{ LICENSE. SEPARATE PERMITS REOVIRED FOR SEWER, PLUMBINp,�Ql ATING.
,�itlll•
Total
By
— ---- APPI i(-ANT OR AGENT -- -- �—
Approved — __ Receipt Ne r
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor /
Permit No. i
L Rough-in
Fixture
Final _— —
_ _ HEATING
`---�--� I o k Contractor ri
Permit No.
Gas or OSI
Rough-in
Final
SEWER
--- Final
DRIVEWAY
Final
Storin Drain a e
(Rain Drain) Final
Sidewalk
— Curb bi Street Final
A prroach
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY _
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
SEWER PERMIT '
u 4 M 12160
Unified Sewerage Agency Tigard 5-11-77
of Washington County CITY OF DATE
OWNER : nT _ _ PHONE :
OWNER ' S ADDRESS: — —
TYPE OF INSTALLATION:
)bUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
QIEW SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) 0 MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHE14 CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR .
FEES:
PERMIT FEF 25,
CONNECTION CHARGE 575.
SIDE SEWER INSTALLATION �-
ISSUED"'BY
OTHER
TOTAL $ 600.
APPL,I ANT DATE
SEWER PERMIT N° 12160
ADDRESS OF STRUCTURE 9405 SU Brentwood P1. _
TAX MAP TAX LOT _ _ SYSTEMFanno Creek —
LOT 533 BLOCK _ OF —
APPROVED BY DATE ISSUED BY DATE
REMARKS Bldg. #1446