9847 SW KIMBERLY DRIVEPX kxw�gwmm"%mmm I
9847 SW KIMBERLY DRIVE
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^,DDl'ESS 6 '�.1�,1;:) PFRf1IT NO.� --
PERi;IT CHARGE none -
�R _._. ��. �� CONNECTION FFE cc',
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PAID By ,L-c
TYPE OF OUILOING �' I 1 _ DATE Cor! ,_CTED
SERVICE RATE LL IN5PECTI0.1 FEE
4r PAM 9Y DATE i
';I7F OF COWI!ECTION _ A5SES5HENT PAID
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1 _ ._.... .. ... ... ... _ E'�t11LDIi,1Ci -DEPARTMENT, TIGARD � }
t --1 PLI;i,1 ;�i1'3 PERNUT
hold r of a valid plumbing contractors Fcense is hereby
i ny v�o;k i erg �1 rtyt�d to be installed in accordance with the plumbing code of
i authorized to cause plurn'ni1 ' ^
1
Tigard. Such instryllatiUns require ins . :.ion by ine City Inspector who shall be notified not less than four
(4) hours P.for to the time the insrallatlont; are ready for inspection. City of Tigard Business Licensr required
for all/cy9tr actors and sib-contractors. / c
Address Dater _l�_
_ 'UN-13P: —0F TO '.A 1. PERMIT NO.'S
�-� TYPE. Ci- PERMIT- _ ITEMS FEE ON EACH �A!'.t(JU^17 _ (Office Use Only) �
_ __ ---r� S
Si clIL Lin i1Y:J b:+th-etch �__�-.) __ 25,09
_D_ue'az-Each t_ba:h unit _�________ __ ____�_ 250010.00
5 00
_4 Iitional bathroTrt/1 _tO00,-
.00
1NDIVir)'JAL FIXTURE
_1 to�O Fiztuaas In -._.._3
51,tn 100 Fix urgi in 1 builcini- ,ch ---- �____-_.___ x:50_ - ---------- ------
I I to 700 Fixturei In 1 building -
201 j, rHlr,r Fixtu-cs in 1 bu1!,1'-j
h1 19 C E L LAN 7 O U S
8t il�iruj_a^dw�r-•14t 5i1 ft.
10.x.0
S+,war airy �r'!i 'anal 100 Ct. __ - 1C on
Wrier S•roicn to buildin __ 5.00--
Privato'r'lat., Sv�r.rns•-t!:.c:h 1_00.it._____.._�._.. _.�__..._.._ __-_.. ..- __._ IOCr1
For Plum.Wrly los,;.,;;;'c t?;; 633 !171
PF.itm1 r
I'lunslur,. Cs]ntl_r.r,tr
--'�L�-._._ I
TOTAL. %6-c9 nFCE1n•i• N
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BUILDING PERMIT APPLICATION' cU Y TIC ARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE._-16�__
OR AS SHOWN r'.'rD APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE
LOT NO.__�
OWNER JOB ADDRESS .0047 �,11j&JUJ,; r HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER_ t','M }' jai.tL"srl ADDRErS-S� DESIGNER__
STRUCTURE NEW ❑RI i' 'L �- ❑ADDITION ____ Cl ❑
REPAIR _RENEWAL ❑ r. ❑
_ FIRE DAMA , DE AOL ITION
RESIDENCE ❑COMM ❑EDUCA`I NAL C]GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT_ ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAI_USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS Y `
CCUPANCY.,_:».�_LANO USE ZONE__*...7 __BLDG TYPE _ _.,FIRE ZONE_ PLAN CHECK Hv_..^. ._�,._, HEl.T
-,�
3 bedxoom
OCC.L03� FLOQR�01a� Ql� - �ElG�i7 __ NO._.�I4H€z AREA a$+ [1 NO•gE12R�QM�._YAJ. ,," j 1
BUILDING DEPARTMENT SET BACKS 1 HON IREAR "11 LEFT SIDE ii� RIGH1 SIDE
- -- - - - - —
Permit _
THIS PERMIT IS ISSUED SURJFCT TO THE REGULATIONS CONT."NED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL 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
Sub total _ �• ALI APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO ;!AVE CURRENT CITY BUSINESS
State Tax » LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total � !�� f _ isy.'» • X+>J�r�•
P.U.I. #2 wl l»
By _
—`--- --_.---- APPI_ICANI
Approvad Receipt No.
DATE INS/P, TYPE INSPECTION REMARKS PLUMBING DATE
07 7d Contractor
J1Permit N°' /44o
Rough-in
Fixture
Final
HEATING
Contractor
Permit No 71101 7Y
619 Cies of Oil
Rough-in
Final
SEWER
Final—
DRIVEW f
Final
!Rain
Drain)
in)F
inal
Sidewalk
Curb aStreet
Finall
t Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Find
22=cx.0
SEWER PERMIT NU 15945
UUnified Sewerage Agency
of Washington County CTTY OF jiaard DATE June 14-1978
OWNER : jelwin Cons;._,__ PHONE
OWNER ' S ADDRESS:
TYPE OF INSTALLATION:
A
❑ BUILDING SEWED ❑ BUILDING SEWER AND STDE SEWER
TYPE OF OCCUPANCY:
[] NE W 0 SINGLE FAMILY �! COMMERCIAL
�] EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS . _— DWLLLING UNITS 1
ADDRES-'-', OF STRUCTURE : 9847 Kimberlv
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULE! AND
REGULATIONS nF THF UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( '. 20 ) DAYS . THE AM0UNl PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR .
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE 600.
SIDE SEWER INSTALLATION _ p. robertson
ISSUED BY
OTHER
PTJ fAL $ 62-5
A CANT DATE
60. GLu FQp Thi; S3.'�U PERMIT
M' 15945
EH�lli.
9847 Kimberly
AUDRE.SS OF STRUCTURE" y ".'"'n�M •
TAX MAF' TAX LOT _ SYSTEM Co
Lo-r v �'1 BLOCK _ y OF
E. Walden
APPROVED BY DATE ISSUED BY DATE _
D. U. ' S REMARKS bldo. 2135
r,� CITY Yl A%RD DATE_off t .3 ,97 N2
_111_DiNG PERMIT APPLICA I II �JJ
ON OF
lN[iI P'-AGNED HEREBY APPLIES FUR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONR
S SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHON
LOT NO.
I• w` el-IcAr'JOB ADDRESS , /_ Ot+'E ADD,-?F-SS
- -' r 7- ARCHITECT
ENGINEER
ADDRESS_ - DESIGMER
+E _E .'W _ OREMODELC�ADDITION „_REPAIR _❑RENEWAL ❑FIRE DAMAGE - []DEMOLITION
I ,II NCE or_('MM ❑E4UCATIONAL .,GOV'T ❑RF.LIGIOUSOPATIO ❑CAR PORT ❑GARAGE ❑STORAGE OSLAB ❑FENCE
1H')ND ❑MOVING ❑CONDITIONAL USE C]DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
F' NCY �'' .l OND U �E ZONE `BLDG.TYPE � FIRE ZONE PLAN CHECK BY-( ! HEAT—
::op
EAT_
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UAD. F CSR l.L?AQHE1 L.. _ N� �LQBi. _.. �. AREA_.' Ly VL_BjDRW.mL� VA' LI
HUiI_UING UEPARTNEhT $ET BACK$ FRUt1TREAR LEFT ID: 1 RIGHT SIDE
_ _.,
rrmif �� lw
THIS PERMIT IS F9SUED SUBJECT TO THE REGULATIONS CONTA,NED IN THE BUILDING CODE, ZONING
nl8h Check _ � �5� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCE:', AN; IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WI'tH
`;uh total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS FERMI f DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Ta1P - LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PtUMBING AND HEATING.
Tc�Tel
by _--
___ APPI(CANT OR ACSENT
At,lxcned ecerp, Na
YHONE
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