9585 SW BRENTWOOD PLACE-1 a
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' � 9585 SW BRENTWOODPLACE
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CITY F TIGARD �
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OREGON
` 0% ner:. ......-T .D.C.. . _...._ .... . - Permit No...J 403.._._
Building Address.............9.58.5SW._Oren,tyood..P.I...........Lnt.. 5.25 ...........
Certificate is hereby given this.2..... ...... .day of_D.e.c.9mtlex.. ....... . , 19..7.7...
that said building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard,
fis approved by the Tigard City Council.
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Building ]nsnector +
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ADDRESS ;Jf'��y t Z .�`.5�-,,l ' PERMIT N 0. /d /,7 j - —
PIRMIT CHARGE none
OWNER o� (7 ' _ CONNECTION FEE _ X575
PAID BY _r � S- (I
TYPE OF BUILDING .121-o DATE CONNECTED
SERVICE RATE _ J INSPECTION FEE , 2 --
CONTRACTOR — PAID BY DATE
SIZE OF CONNECTION ASStSSMENT PAID
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City of Tigard
INSPECTION REQUEST
for i
! !SPECTIUN TIME'v__-���- ' ' PERMIT `NU.-: ---W
DATE : l �''':' DATE ISSUED .—..11._
OWNERS NAME : --
ADDRESS'.
AME : __ADDRESS: -----
CON TRACTO R . ? _ I
EST : Air L, Wot6r ❑ Visual El , Laboratory p
C E'SULT: Approved R Disapproved C Pending Ll f
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SKETCH6'
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—5i' 7" ' OR DATE
COTE Attach supplemental lest date hereta] I
t
A
BUILDING PERMIT APPLICATION " TIGARD DATE 4-14w2 1 � 3
OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE ._.
OH AS SHOWN AND APPROVED IN THE ACCOMPANi(ING PLANS AND SPECIFICATIONS OWNERPHONE__
I.- -."NO.—
OWNER
NO._OWNER H P JOB ADDRESS :iW kiruntwuod ii''J.HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER =en' ADDRESS DESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑gENEWAL ❑FIRE DAMAGE t UDEMOLITION
Q*SIDENCF. ❑COMM ❑EDUCATIONAL GGOV'T ❑RELIGIOUSOPAT'O ❑CARPORT ❑GARAGE ❑STORAGE❑SLA13 ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY � LAND USE ZONE Fd E SLOG,TYPE �� FIRE ZONE_ PLAN CHECK BY ltw HEAT
Lot #575 Fontaine re—issus same as 10235 SU Gi inenleaf 'tsrr.,
attached Praha duyllin" ulattzaiud aarGam __ 2 Lcidi com 2 buth-
OCC LOAD F1QQR LOAD__ N�lSitlL__._._ __SIO,-STQFiIF..$__I__ AREA 1J1U NO. EF EDROoIYIS._a__YBLSlJc� + •
BUILDING DEPARTMENT SET PACKS FRONT FILAR LEFT SIDE RIGHT SIDE
Permit .
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1000ii REGULATIONS AND ALI. 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 APPLiCAHLF CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State.Tax 4.92 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By _— — -- - - - -------
APPI n ANT OR AGENT
Approved C.Ij Receipt No
UAfE II TYPE INSPECTION �----
REMARKS PLUMBING DATE
-- _ Contractof
----- Permit No
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Z 1 IV.lip �
rRough-in
ft )n�c..
,- � �-- Fixture
Final
,S 77 - HEATING
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_ Contractor
-- -- —..._ Permit No, -/�'•-�
Gas or Oil
Rou h-in
-- — Final _ — ��—
__ SEV;FR
-- ---- __ �_ Final
DRIVEWAY -
---— — — ----- ------ ---
Final
^_
-
_
Sidewalk
-- -- ----` Curb 6 Street Final
BLDG DEPT FINAL TEMPORARY — _ A roach
CERTIFICATE OCCUPANCY CERTIFICA [ O(^•IJPANCY
Final
Landscaping
Zoning Ftrial
I
�. SEWER PERMIT N ? 12128
t!nJied Sewerage AgencyTigard GATE 4-1.4-77
of WCITY OF._ashington County -
OWNER : T.D.C . _ PHONE :
OWNER ' S ADDRESS:
TYPE OF INSTALLATION,
BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
ONEW ❑ SINGLE FAMILY ❑ COMMERCIAL
❑FXIST . (PRIOR TO 7- 1-70 ) ❑ 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 . 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 CHARGE 575. --
SIDE SEWER INSTALLATION -
ISSUED BY
OTHER —
TOTAL a_ 600.
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AF LICANT DATE
SEWER PERMIT M 12128
ADDRESS OF STRUCTURE 9585 SW Brentwood P1.
TAX MAP_ TAX LOT __. SYSTEM Ennno f'raak
LOT 525 BLOCK , _ OF
APPROVED BY DATE ISSUED BY DATE
REMARKS 61d.q.__# 1403