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1021:5 SW GREENLE;AF TERRACE
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PERPIIT N0.
PERMIT CHARD
OWIN R /!�, „� M� C0NNECTI0N FEE ^_^R-
_.- PAID BY
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE INSPECTION `"EE
CONTRACTOR _ PAID .Y DAl t.
SI7.E OF CO;;NECTI"ON ASSESSMENT PAID
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CITY OF ]yIOAR D Y <y
' G OREGON -�
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T.D.C. . .Permit. No.... 1.048
10285 5W Greenleaf Terrace Lot 256
Building Address................ . • . �
�•` Certificate is hereby given this....2�........day of..May.... .. ... .... .. 14 . ?..
7
t that said building may be occupied and
} f' that it ccnnplies with all requirements of
the Building Code for the City of Tigard, +
as aphrovid by the Tigard City Council. ? D
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��- .........
� F3uildinR Inspector
\ � •". .1! . �' C• r'p � .i�� � s { ♦ ♦ �✓ C.-.., � _�`�' 1`, _..� � s� `; '�w�� �• • 1, -
11 BUILDING DLPAK fML-N-1 , TIGARD
JOHN E. REIf..,,4ROT PLUMBING, INC. NO.
r. 0. BOX 129 PLUMBING PERMIT
NEWBERG, Of,'NON 91131 holder of a valid plumbing contractrws license is hereby
authorized to cau,a OlUmbing work as herein not,-,d to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) flours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. '`, ,
ownert��� Ir �� _�'_ `�� _ Address lz[�''�� � � �k0ata_L���
NUMBER OF TOTAL. PERMIT NO.'S�
TYPE of PERMIT _ ITEMS FEF ON EACH AMOUNT (Office Usn Only)
T IAJ
-Single Family-1 bnth—each 25.00_ moi,OCA _
D_uplax-Foch 1 beth s ni; �_ - _ 25.00
Additional bethrooms--each ✓ 10.00 _��j. ;),;t�
Mobile Home Spaceeench _ 15.00
INDIVIDUAL FIXTURE FEES
1 to 50 Flxturer in 1 building-each _ 3,00
51 to 100 Fixtures in_1 building-ench_ 2.50
101 to 200 Fixtures in 1 building-each 2,00
_201 or more Fixtures in 1 building-each _ 1.50
MISCELLANEOUS _
Building Sewer-1st 50 ft� — - -� 10.00 �--�
Sewer-each edditionsl 100 ft. 10.00
Wates Farvice to bulldlnB _ 5.00
P,ivate Water Systema--each 10C ft. - 10.00
_ Other (Spocify): - ET
PERMIT J . C? 0 For Plumbing Inspection Phone 6394191
% State 0 .7 Plumbing Contractor Ely +e _l ,�= j
I—TOTAL _ )�� RECEIPT NO. Issued By Y
oe
City of Tigard �-
INSPECTION REOUEST
for
i
INSPECTION TIME
T ''''► PERMIT NO. :
DATE: — DATE ISSUED:—_L_-Z—.
OWNERS NAME : `=
ADDRESS : --
CONTRACTOR —
LOf
TEST'. Air G, Water 0 , Visual O , L•aboratora ri
RESULT: Api:►oved Diaappr, 44 G , Pending
SKETCM:
T R DATE
50TE Attach Supplemental feet data heretol
11T
14
BUILDING PERMIT APPLICATION FY TIGARD DATE �-- _, 1q�__ 639-3101t148
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHJNP
LOT NO.
OWNER • " JOB ADDRESS 10285 SU 4:wenlear TE X'Y' �--
LE ADDRESS
ARCHITECT
ENGINEER
BUILDER __
_ ADDRESS DESIGNER
STRUCTURE IJNEyy ❑REMODEL _❑_A_DhITION — ❑REPAIR ❑ .NEWAL ❑_FIRE DAMAGE _❑_DEMOLITION
t3 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GON 'T C1 RELIGIOUS❑PATIO ❑CAR PORT Ll-"RAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND _ DMOV_ING ❑C_ONDITIONAL USE ❑DESIGN REVIEW QCOUNCIL APPROVED ❑SIGNSgas
-�
OCCUPANCY-------LAND USE ZONE_ ._BLDG.TYPE FIRE 70NE_— PLAN CHECK BY _ HEAt
a 6 tinit t01,01house [:(7f1 a31 n f1r� i-: (3tyw • nn oflu Fluor W attacnea
c��r�I��enr� ec3-nrim�i k��t nu TO Z,5,
Tori IES t•! q; 3QOL��__-- VALE _
BUILDING DEPARTMENT A
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
12749n — --- - - - --...- ---
----- -- --
n•tJar _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 131.111 DING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND OROINA 4CES, AND IT IS HEREBY AGREED THAT THE
-- WORK WILL BE DONE IN ACCORDA E WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND O►MDINANCES. THF ISSUANCE OF THIS PERMIT GOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CIYY BUSINESS
State Tax 4.11 LICENSE. SEPAp�1it�P€RMITS REOUIRED FOR SEWER. PLUMBING AND HEATING.
Total •
BY --
'"—` -- AF SANT OR AGENT
Approved — Receipt No.
Yu.. rbe..a.........wwwYr ADDRESS ------ HON '-
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