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CITY OF TIGARD C,y
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................................................_........... ..Pe mito. ....... .... . .. .N
i Building Address—.9.51P.._W...Q.zqntwoq.d..P.1..........1o.t..#5Q1 .......... .. . ..
Certificate is hereby given this.19..........day of.....S.ep.tember....... 19..-7.7.. l`
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that said building may be occupied aad
j�. that it complies with all requirements of
the Building Code fota the City of Tigard, .
as approved by the Tigard City Council.
v I Building inspector
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Address :, ?j Permit No.
Permit charge 22 c•+ �� �=
Owner �° Connection fee
Paid by C). (' -
Typc of buildingDate connected
Service rate Inspection fee ¢?s
Contractor Paid by Date
Si.zr of connection Assessment Paid
BUILDING PERMIT APPLICATION 10 Y TIGARQ OATS �� 3� ! -- I9 '�If� i 71
601
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILUERPHONE W
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LC-r NO —
OWNER T •_ t�` JOB ADDRESS 9J310 SLI 8r,9n tW0Qg P NOME ADIRESS
ARCHITECT
ENGINEER
BUILDER pa'rm? ADDRESS r-1 DESIGNER
STRUCTURE MONEW ❑REMODEL_ ❑ ❑
ADDITION REPAIR ❑RENEWAL ❑F-IRE DAMAGE ❑UEMOLI HON
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS LJPATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
_❑BOND [:]MOVING ❑CONDIT'IONAL USF i ❑DESIGN REVIEW ❑COUNCI;.APPROVED_— ❑SIGNS
OCCUPANCY N LAND USE ZONE R-7 BLDG.TYPE �N FIRE ZONE PLAN CHECK BY ate
Lut. ;,�501 toinstran re—Issue some as 10320 SU Greenleaf Terr.
1?* t.�ILh�d frame c�ur�llin yj&tt,e-r,�had — 2 ha r nm 2 hath
OCC I_rJAb ._�_�LSZ4P�QAD ____L-IF.1 ►iT._ NS�_SI R1 .5-�---AREAJl�� � NQ.gifpgo9M8 2 VALUE3s*9613,
BUILDING DEPARTMENTr
tyS'T BAr,;KS TFRONT 1�/R�11 REAR "3J+ LEFT SIDE � RIGHT SIDE
Permit 14a.00
THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINEC IN THE BUILDING CODE, ZONING
Plan Check 1 .00 P�GULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— ----' WORK Wit L 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 DOL'; NCT WAIVE
-— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4o65 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Tota; 590 6`
�y APPLICANT OR AGENT _
Approved 'etu Hvcv pt No, _
Aoraess � �
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UATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-- /t c " _-- Contractor ry
Permit No.
Rough in
u' ove Fixture
Fi:icl
HEATING
Contr,ectoi _
_
Permit No.
Gas or OSI
Riau h in
Final__—_— -
SEWER
Final
DRIVEWAY
------- -- - __.__— Final
— Storm Drainage --
_ — (Rain Drain) Final _
Sidewalk L G G'y- - '
Curb&Street Final
---�- - — A roach
BLDG DEPT FINAL TEMPORARY CFnTIFICATE OCCUPANCY �^
CEHTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
SEWER KOH
N'?
12110
Unified Sewerage Agency
of Washington County CITY OF Tigard
DATE 3-31-77
OWNER
PHONE , 639-3101
OWNER 'S ADDRESSt
TYPE OF INSTALLATION:
[XIBUIL. DING SEWER L] BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY,
®NEW SINGLE FAMILY COMMERCIAL
DEXIST . (PRIOR TO 7-1-70 ) L-3 MULT . RFS.
INDUSTRIAL
FIXTURE UNITE, DWELLING UNITS
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLN WITH ALL RULES
AND REGULATIONS OF THE UNIFIFO SEWERAGE AGENCY . WHEN 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 FEE $ 25.
CONNECTION CH ',PqGE --575.
SIDE SEWER INSTALLATION
-el
ISSUED B'Y
OTHER
TOTAL� -boo.
X7-2
�APPLICANT l DATE
SEWER PERMIT N? 12110
ADDRESS OF STRUCTURE 9510 SW Brentwood Pl.
TAX MAP—_ TAX LOT SYSTEM— nno_ rebk
LOT 501 FLOCK OF
APPROVED BY DATE ISSUED BY' DATE
REMARKS Bldg, #1371__