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11351 SW GREENBURG ROAD
ADDRESS 3JPERMIT NO. 7 —
PERMIT CHARGE none
-Qit� r.
OWNER ,��„� q. CONNECTION FEE �257e0�.,_
PAID BY
TYPE DF BUILUING ' -�. DarE CONNECTED
SERVICE RATEINSPECTION FEE 5+
CONTRACTOR
PAID BY OATS
SIZE OF CDNNECTIDN ASSESSMENT PAID_ —
B1JIL0V'4G DE?:;('- TPr1CN1 , TIC-'-A:-,D.
— PLU,;1;::,:,3 PERMIT NO `
LN Sd
holder of a valid plumbing contractors license is hereby
authorized to cause plurnbi•1g work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such inst-llations reyUire inspection by the Civ/ Inspcctor 'v: -) shall be notified not less than four
(4) hours prier to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors anc su contractors.
Address— 1 __��t°s'1���Da
.S_ te L?!ro
NUN1RF_R OF TOTAL PERMIT NO.'S
r TYPE OF PERtAIT ITEMS FEE ON EACH AMOUNT (ottice Uae Only)
5incle,F trri�r-1 bath-e�oh _ W 25.00r—
Dunlex-Drh 1 bath unit —___ 7 _— 2500
Additional bathrocrta-•anh --.--. --_ to:o0�____
- Il(obll± F?orae Sv+• eaah 15.00
INPIVIDU4L FIXTURE FEES
-- -1 to 50 Ft-tor•. in 1 building..earh - - -- — — - -----�=0r1 r`— --- --- — i
51 to 100 Fit:u+ s in 1 bulldin4••.:rh_-_Y— �„ ,2.50 _
101 to 200 rixtwes in I building A_h - - _ ___.--- 2.00_
2U1 0+mor,! Fixtu g� In 1 1150 I
A1ISCELL/1N%0US
1Q,on
Sive, Orr! 7,"i idrml 100 --
Wtter Strrrra to tful�r;lrr 6_00
Prlvzc 1M1ta .rr Sratarns-sech 1Q0 N.
F'or Phtnt,hirrg r'n;,; t!crt 639•1171_ _----
/ 'r,cr?rn .►b Plumbirrg Conti ictor By
r Tt1 I AL 11I.CE IPT Pi O. lest+d Ely
NY
-17
Unified Sewerage Agency
of Washington County CITY Or DATE March 16 197 8d
0 14 rl F Gune Paaker PHONE : 245-6613
OWNR 'S ADDRESSt
TYPE OF INSTALLATIONS
ED BUILDING SEWER El BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
mEw El SINGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO R MUL'I . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 4
ADDRESS OF STRUCTUREi
P17PMfT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AfrinD
REGULATIONS OF THF UNIFIED SEWFRA13E AGENCY. WHEN CALLING FOR INSPECI-10N,
PLEASE-.'. REFER TO TH(- PERMIT' NUMBER. THIS APPLICATION EXPIRES IN OfjL-
l!UNDRED AND TWENTY ( 120 ) DAYS. THE A1AOJNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
F1 E 5:
PE RitIT FEF $ 35.00
Cf.11JNr-CTION CHAPGE 00
SIDE SEWER INS-rALLATION
OTHER ISSUED BY
11 TA L $ 2435.00
APPLICANT DATE
N ?
SE M I T
AODRES�) OF STRUCTURE A
berg (.L I1L. #2
_I ., H .L
TAX MAP TAX LOT- SYSTEM Fanno Crock
LOT OF
B. _-15511E
flawlIngs 3/16/7x;
APPROVED HY DATE 15 5 li E D BY -- ---
DAIL
D. U . If;
�f MIARKS __b do. Permit P 1963
I
BUILDING PERMIT APPLICATION CIT" TICARD OATS. 1T.f:ta �u ___ ,yf> - 10 63
THE UNDERSIGNED HEREBY APPLIES rOR APERMIT FOP THE WORK HEREIN INDICATED BUILDERPHONE_ y`'i,.(1�'
OR AS SHOWN AND APPROVED IN THE ACC MPA)YING PLANS AND SPECIFICATIONS. OWNER PHONE_ __
1 I LOT NO.
JWNER �'yr �_ JOB ADDRESS HOME ADDRESS
A464ITECT
BUILDER ENGINEER
ADDRESS DESIGNER
STRUCTURE ❑NEW ❑REMODEL - ❑ADDITION_- ❑REPAIR-� ❑RENEWAL ❑FIRE DAMAGE _G_UEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL❑GOVT ❑RELIGIOUSOPATIO ❑CAR PORT ❑ IIGARAGE STORAGE❑SLAB []FENCE
❑BOND ❑MOVING —000NDITIONAL USE - ❑DESIGN REVIEW ❑COUNCIL APPROVED OSIGNS
Q UPANCY_A_LAND RS__EL ZONE+1_ -BLDG.TYPE 1 FIRE ZONE 1 PLAN CHECK SY i.. •ALL sae --HEAT
_ Crnnt.� dlLa•Eecnil�,,t� laink, LticlrL. ?, wl3 Tyge A Units aild 1
it at.IItl_icupactiom --
40 _HELO.t1L_2Q __ AREA--"2 NO BEpB44.M$_ VALUE
BUILDING DEPARTMENT SET BACKS FRONTSee Plan RE..",R LEFT SIDE RIGHT SIDE _
Permit 2245.00
Plan Check 10.00 THIS PERMIT IS ISSUED SUBJECT TO THE P"GULATIONS CONTAINED IN THE UUIL.DING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED (HAT THE
- WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal — 255.00 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 Ta,( ' 9.a (j LICENSE. SEPARATE PERKTS REQUIRED FOR SEWER PLUMRINO AND HEATING
Total SM 960.00
264.l�CI
BY — PDC 41 240. _ _ _ ._--- --- - ------- - ---
Approved jAPPI icnrn nIt nr,I ra r
Rw.mw No.
�DDRF,SS
- fir lc ifJF _--
DATE I NSP. TYPE INSPECTION REMARKS PLUMBING DATE
C'n
t,
Contrd,:tor
*)i Permrm
it No, 1
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough.in----
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewal!-.
Curb&Street Final
Approach
BLDG DEPT. FINAL TEMPORAFlY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning
Final