9855 SW KIMBERLY DRIVE �r � � � ww rar +� �r ■a �
9855 SV7 KIMBERLY DRIVE
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A00RE5S r�-- - (�� f l ��c q_ PERMIT NO.
PERMIT CHARGE none
OWNER ~`� o--N" n �-;:1 CONNECTION FEE
' PAID BY
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"TYPE OF BUILDING DATE CONNEC/TEO ..._
0C
SERVICE RATE V, INSPECTION FEE %� s �
CONTRACTOR PAID BY DATE
SIZE OF CON,iECTION AS�;cSSMENT PAID
ADDRESS_ C� }�� ��•�dL• --� PERMIT N 0.
PERMIT CHARGE none
OWNER -TZ? . .�/ ;�. CONNECTION FEE
� r PAID BY
TYPE: OF BUILD!NG DATE CONNECTED
INSPECTION FEE
SERVICE RATE ���
cONTRACTOR MAID BY DATE
ASSESSMENT PAID _--
SIZE' OF CONNECTION -
�1 II! ti t�Kvw ALMA= v1�
BUILDING PERMIT APPLICATION Cor. TIGARD DATE i E3l�rL��3tx ,9 r � f
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK FIE REIN INDICATED BUILDERPHONE 521
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PL4NS AND SPECIFICATIONS. OWNER PHONF-
LOT NO.
OWNER {; tStt;ii'' JOB ADDRESS 9ULi:) 54 KimL wr @
' .�. HOME ADDRESS
ARCHITECT
BUILDER ADDRESS ENGINEER
r, DESIGNER
ST
RUCTURE ❑NEW G." 'DEL ❑ADDITION ❑ D
REPAIR RENEWAL [:]FIRE D',MAGE ❑DEMOLITION
0RFS1OFNCE COMM DEDU, �IONAL DGOV'T DRELIGIOUSDPATIO ❑CARPORT ❑GARAGE El STORAGE SLAB DFENC,
DBOND ❑MOVING IJCONDITIONAL USE DDESIGN REVIEW DCOUNCIL APf ROVED DSIGNS
OCCUPANCY__..- LAND USE ZONE__ BLDG.TYPE FIRE ZONE PLAN CHECK_By---!1U---- HEAT--lil
ruct ';inglai Ffirlily Dwelling Witt sittact_oud Garequ t�aldzcacm/�P�e�:h
13931 $625*00
-LQA _�— FLQ4P1QAa If,} _ HE1.�r1iL 2�
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT S' .E
PermitTHIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONI 41NED IN THE BUILDING CODE, ZONING
Plan Check 04.tok, REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPEC'FICATIONS AND IN COMPLIANCE WITH
Sub total 7',3V ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE Or THIS PERMIT DOES NOT WAIVE
RESIRICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total M SOL: ij301.}•00
By
_`— "—"—'-- --- APPLICANT OR AC-FNT
APa")VpH ? Receipt No.
ADORESS ---.... -PII0NE ----- -.__.----------
.......,.,W.n,.�,.„., ,,..,,,...�:w w..ur.WurYi.e.n.lia�► .�:�aM;L.F.t..,„..�wtv....w.:.m:,,;«�Wa�,,. .
•
s �r s a� wr wa mmma
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-�� Contra
rctor _
Permit No,
VE s -�_
Rou h-ir. —_
_ Fixture
�• w r[�QQ . Final
L —"_�c—_�_
� HEATING
Contractor _
VE �'J� x Permit No. �
n �" � ,,,1 „��,��_•+ Gas or Oil
�!•� /�>d ,aUit�
Rough-in ------ -
'1 � Final
SEWER
Iq�� 0 J;ZS-J�' �s�� Final
3_79 _ DRIVE 'AY
- AA,AAAf —
��'7� _244 �►•• v �L. _ Storm Drainage
(Rain Drain) Fina _
Z ! -- __
l
; Sidewalk
1s Curb&Street Final
-�'' �� i -�+•--- _ Approach _q
BLDG DEP' FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY ---- --- —
/ Landscaping
l ( Zoning Final
-D 3
SEINER PERMIT 14-3
N ay 1 .
� � , 31
Unified Sewerage Agency
of Washington County C . ?Y OF Ti,nard DATE _ FiebrUary --2-3-0 197
OWNER : J. A. Hodgson & Son PHONE : 525-7077
OWNER 'S ADDRESS: ;alLtx_2-._.Bja-X 2A6A. S jerwo d, Oregon _97140
TYPE OF INSTALLATION:
UBUILDING SEWER [-]BUTLDING SEWER AND SIDE SE'UE
TYPE. OF OCCUPANCY:
®NEW SINGLE FAMILY ❑ COMMEQCIAL
❑`XIST . (PRIOR TO 7- 1-70 ) MUL.T . RES. INDUSTRIAL
FIXTURE UNITS DW,=LLING UNITS 1
PERMIT CC)JuITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERIGE AGENCY . WHEN CALLING POR
INSPECTION. PLEASE REFER TO THE PERMIT NUMBER. THIS ArIPLICATION
EXPIRES 1N ONE-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFE I TEU SHOU'_D EXPIRATION
FEES:
PERMIT FEE '?5. 00
CONNECTION CHARGE 600. 00
SIDE SEWER INSTALLATION
OTHER
TOTAL $� --
�� —Fphrtiary -19713 .
j A PP 1_ IC;ANT DATE
SEINER PERMIT M' 13931
ADDRESS OF STRUCTURE U SW Ki[EboUy--.Djjve, Tigard
TAX MAP TAX LO.1 SYSTEM _Eanno Creek
L01 BLOCK i i OF
_ ET 2/23/70APPROVED BY DATE-: ISSUED BY DATE
REMARKS Bldg. Permi_t _#_j912
11TY TICARDOATE N2
31JILIING PERMIT APPLICAT!'ON OF
"IF (INDI RSIGNED HEREBY APPLIES VOR APERMIT FOR THE WORK HEREIN INDICATED 8 U I L U F R P H d
OR S "')H(DWIN AND APPROVIF,%)IN THE ACCOMPANYING F ANS AND S51,1170" ICA11ONS. OWNER PHONE
LOT NO.—
:)DRESS Zmo&-ADDRES
ARCHITECT
ENGINEER
NEER
ADDRESS DE GN rR!
-3ENEWAL [:3FIRE DAMAGE y!q_ W DRE MODE L 0 ADDII ION [:IRLPAIFI [3, E [3DEMOLITION
L)FNCF Or-nmm [:IEDUCATIONAI. 0GOV-T [3RkLiripus0PATI0 OCARPORT [IGARArr, 0STORAGEOSLAB OFENCE
]POND 0MC-VING 000NDITIONAL USE [:)DESIGN REVIEW DCOUNCIL APPROVED (JSIGNS
mo_
LL-rANCY jf� L AND US NE G.TY -.tBLD PE_ j�j E ZONE PLAN CHECK BY HEAT.
2,
7 44
Fl, AOR LOAD ✓ HEIST__.".. EA 4,ow—e RE
SUI LOING DE PARTME SIT SET BACKS- FRONT REAR LETT RIGHT SIDE
_ �
r rimit
THIS PERMIT 19 IRSUFV SUBJECT TO THE REGULATIONS C)NTAINED IN THE BUILDING Cc-DE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 11 IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
sub-total ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUR CONTRACT 1S TO HAVE CURRENT CITY BUSINESS
Tax LICENSE SLPARATE PERMITS REOUIRED FOR SEWER, PLUMBIN. AND HEATING.
7&
Total 9–112
APPI IEA-N-tOP Adi-NT
A pp t c wad Receipt No
PHONr--
/ 60
CITY OF fIGARJ
ORDINANCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE Park #2
DATE : ^_ February 23, 1978 ESTIMATED SALES PRICE $ [3_,700 + lot
APPLICANT NAfhF g. A. HQdason & ,1j2n TELEPHONE # 625-7077
208 ADDRESS 9855 SW Kimberly Drive BLDG. PERMIT #1912
AMOUNT OF FEE FOR P. D. C . District #2 - B100. 00 _
DESCRIPTION OF IMPROVEMENT Single Family Residential Home
EXFMPTION5 - PER ORDINANCE x{77-71
f �F RATES:
A. Single family dwelling unit under 75.00
B. Single family dwelling unit over $40, 000. ----- ----------Wo, OLD
C . Mobi.'.o Home Court Space (New Development)------- ------- 50. 00
D. Multi-Family dwellings--per. unit------------ --- 60. 00
CONSTRUCTION IS LOCATED ON S.E . N .W. SIDE OF S . W. PACIFIC
HIGHWAY . N .W . is Park District #I . ST—. is Park District #11.
a� � w w �w � � � ■r �r
CITY OF TIGARD
ORDINANCE 1177-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE: 2-23-78
ESTIMATED SALES PRICL 43, 500 + 1_o-t
APPLICANT NAME J. A Hodgspn & Son _TELEPHONE #^625-7077
9_ 855 SW KirnDorly Drive
BLDG. PERMIT
J0B ADDRESS
AMOUNT OF FEE FOR S. D. C._ 3LO. Q0
DESCRIPTION OF MPROVEMENT 5in . ec.L 1 FamilyResidential Home
_..r r
CXI hHPT11J 15 -PER ORDINANCE. #77-26
E E-E
$300,00
A. Single family dve.11i.ng unit under a60,0nn---,_____- ; 400.00
B. Single farnily duc!lli.ng unyt o .er 4bOr 5150,00
C. Mobile !-tome Court Space
(New Develapment)�__`------ 240.00
0. Multi-Family Dwellings--per unit-
E . Commercial , Industrial & Institutionol(Park. Space)- 5250.00 each
F. Single f@mily unit under y�40,UU0.
i
I �
GIy of Tigard c ; `
INSPECTION REQUEST
for
I INSPECTION T E: v .�.:R T NO.: >a
DATE: DATE ISSUED: Z
OWNERS NAME:
ADDRESS :
I COOTRACTOR :
ITEST.Air 0, Water , 481,ual ❑ , Laboratory ❑
RESULT: Approvmd CI Disapproved ❑ Pending ❑
SKETCH:
I NS&EbTOR DATE
COTE; Alla-ch sdpplementol fest data hereto
City of Ticic-Ird Mecliar-iii-al Permit NTY PermIt__j5300
Fee
Pon 0 S-31 P
New InstaUalion Relocation 0 Addition Tr)TAL-----2E;3,X---
-k WN E R C?-5.e)17 I
C-�NTRACTOR
WORK ADDRESS
ADnRFM 32
APPLICANT(
PHONE --- Flue Size
Heat Input Rating (BTU Per Hour) Vent Size
FUEL OIL U GAS L ELECT
FEE ITEM NO, FE
ITEM NO.
3,00 Air Condition Compressor 15 to 30 HP
For Issuance of Permit
New- Under60
4.00 Air Handling 10,000 CFM 1-
J 1—000 BTU —-- 5
5.00 -Air Handling Over 10,000 CFM
we—W• ICT6,005 BTU & over 3
Evaporative Cooler
Floor Furnace 4.00
2.(
r - Suspended 4.00 Range Vent Fan
Wall - Floor 31
Install Vents Only 2.00 Ven, System
nst A n H-.iod Commercial 3
Repair - Heat
oohng —
4
Y 110
Air Condition compressor Under 3 HP .00 Commercial Duct System
Air Condition
ompt essor 3 to 1 c) HP 7.50
IP +
INSPECTOR'S COMMENTS
R ALL CONTRACTORS -)R SUB-CONTRACTORS
CITY BUSINESS LICENSE REQUIRED 10
ISSUED BY. DATE
APPROVED By DATE
A RECL IPT NO...__._-