12910 SW GLACIER LILY CIRCLE MOXIM
12910 SW GLACIFR LILY CIRCLE
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UUII.DING DEPARTMENT, TIGARD NO
PLUMBING PERMIT
holder of a valid plumbing contractors license is herel,y
authorized to cause plumbing work as herein noted 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) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owner� .i `�v�/ AdJob
y/a�;�� C,rc e__ e =1
.__. � . Dat
NU?Zd r1 OF TOTAL
TYPE OF PERMIT _ ITEMS ^FEE ON EACH Ah10UNT
Single F:rmIlY�1 bath--each _ 25.00
du (rx-Each 1 bath u
----_ -___._nit it 25.00 �
Additional ba brooms-each ---
�
o:i.. t�rnn•Spy^n _ w._
rich 1r.0 _
rV1UUAL FIXTJHEQ C;QI1�lEFtCTN _ _!_�__.
1—to 50 Fixtures in ----
_51 tri_100 Fixtures In 1 building-each
__ __ 2,50__ •
101 to
_200 Fixtures in 1 building_each _w— �� —200
_201 cr
I':f 1mors Fixtures in 1 buildinp�earh v-- - ^! 1.50 '-" -----
5 C E_L-L A
SAwer-:cach ndditicmal 100 ftr 10.00
water `5rerwlce�tn bulldin - —�— _
6_00 --�
_________ 1_--- -•-..__ _
_.Other ISnPci►yl: _.._.._ -•-- --- -------___..._.. --------- �.._._�...._...`__
_PEHAAIT—,,$-d.42�j _ For Plumbing Inspection Phone 6394171 Y
Plumbing Contractor By
Sa. OLS RECEIPT N0. Issued By
e
WXW
JtIKUWMIZMFLW �i
a?
BUILDING PERMIT APPLICATION TIGARD DATE.-
.gun .air i9AP 3251
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE 620-8080 _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. Oo NU� �NE t•bul r
OWNER Trademark Homes JOB ADDRESS 12910 S.W. Glacier Lily Circle _ Lake
ARCHITECT
ENGINEER
BUILDER Sates ADDRESS 7185 S.W. ,>andburg St. DESIGNER_` �!
STRUCTURE _ iI_ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
A RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT El GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY RY3LAND USE ZONE 1�- -p—Cj BLDa.TYPE --- FIRE ZONE PLAN CHECK BY= HEAT
--- Cotastruct e1L%Is fmily eiwellin�_/attached ;,erage -------
See correction *beat attached. � ? bedrooms
SEWER PERMIT# 71945 --
OCC.LOAD _ FLOOR LOAD_ �'0 HEIGHT l l.- NO.STORIES AREA 213" NO.BEDROOMS 3 VALUE 80.600
BUILDING DEPARTMENT SETBACKS FRONT YO REAR 17 LEFT SIDE -b RIGHT SIDE w_
Permit 249.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGPEED THAT THE
Plan Check 12��• WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL ADPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 373.50 RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARAT:PERMITS REQUIRED FOR SEWf R,PLUMBING AND HEATING.
State rax 9.96 Awmr t Liue /COPtlledt VIJ�.�
Total 383.By 46 SDC- $400.00 r-1.�1f l_.lir 4r 4l
PDC# T 100.00 APP ICANT OR AGEPT
iReceipt No. 1 _; ADDRESS T PHONF
Approved J
DATE: iiNSP. TYPE: INSPECTION REMARKS PLUMBING DATE
X", Contractor
Permit No.
- 7
7--ej--Ito I &S7-+ --------- Fl..gh.ir,_
kF
Find)
HEATING
Contractor
Permit No.
Gas or Oil
Final
SFWER
Final
-A DRIVEWAY
Final
Storm Drainage
Main Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE'
CEr?TmcATE OCCUPANCY Final
7 Lencitcapinp
2wing Final