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BUILDING PERMIT APPLICATION TIGARD DATE July IG _,1s---''`.-- 491.5
THE UNDERSIGNED I-IERE BY APPI IFS FOR P PERMIT FOR I HL WORK HLREIN INDICATED BCILDER PHONE h9'1!--A3UZ--_
OR AS SHOWN AND APPROVED IN T HE ACCOMrANYING PLR NS AND SPECIFICATIONS. O��NER PHONE
LOT NC.,--- __—_--
OWNER '[Olm Wat L JOB ADDRESS --
ARCHITk"T
ENGINEER
BUILDER ;, _ ADDRESS DE&'C;NER
STRUCTURE O NEW lit REMODEL ❑ ADDITION ❑ REPAiR 0 RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE El COMM ❑ EDUCATIONAL C•7 GOV'T ❑ RELIGIOUS ❑ PATIO 0 CARPORT F] GARAGE ❑ STORAGE ❑ SLAB FENCE
O XUPANCY 1". LAND USE ZONE —_3_MBLDG.TYPE __S[i__-FIRE ZONE PLAN CHECK BY —61W HEAT
_--Construct addition to existing sign& fautily dwelling all uer
L,rcayf plans sc,�f cede reyuieumnts.
SEWER PERMIT° Nuri - Irequiritd.
OCC.LOAD FLOOR LOAD wU HEIGHT I h+ NO.STORIES ! AFEA JUU NO.BEDROOMS I VALUE
BUILDING DEPARTIk �� SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULAIIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 4s.A 3 ;YORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH .ALL APPLICABLE ' DES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 122. >>_ RESTR17fIV[• COVENANTj. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLU'iBING AND HEATING.
State Tax �•N
SDC–
Total 125.t�1 �. f
By tG6PDC# APP idANT OR AGEN f
Receipt No. --- -- – _– —_-
Approved --�• K'C�i _ -Tii�6Fi€88ofWNr
Its
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No
-A Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gen or Oil
Rough-in
SEWER
Final
—T
DRIVEWAY
Final
Storm Drainav
Main Drain)Final
Sidewalk
Curb&Street Final
CERTIFICATEApproach
--a:012.DE >I. TEMPORARY
CERTIFICATE OCCU.ANCY Pinel
�_.ndscapinq
?*rtinp Final
w�
BUILDING PERMIT APPLICATION TIGA?D DATE_ 19C
THE UNDERSIGNED HEREnY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHOhL�
OR AS SHOWN AND APPROVED IN THE ACCOff PANYI PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
M r JOB ADDRESS
ARCHITECT
ENGINEER
ADDRESS DESIGNER
BUILDER
ADD_ -------
STRUCTURE_— C] NEW _v REMODEL __❑ P OOITION-, ❑ REPAIR ❑ REN_WAL ❑ FIRE DAMAGE ❑ DEMOL.ITIOt•
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T Cl RELIGIOUS Cl PATIO ❑ CAR PrgT CJ GARAGE ❑ STORAGE ❑ SLAB❑ FENGI
OC.GiiPANCY LAND USE ZONE 1 PQ BLDG.TYPE FIRE ZONE _PSN CHCC:K 8Y —HEAT____
Aw AA
SEINER PERMITM___ -- �— —'-"
OCC.LOAD — FLOOR LOAD L' HEIGHT --NO.STORIES (- AREA Q Cf NO.BEDROOMS �� Vh.LUceJNd
-�BUILDING DEPARTMENT! SFT BACKS FRONT REAR LEFT SIDE RIGHTSIDE i'P'nrmIt _� O THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 6UILDING CODE,ZOr1:!t:
-4- REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TN,
IPIaeCheck WORK WILL BE DONE IN ACCORDANCE_WITH THE PLANS A;�D SPECIFICATIONS AND IN COtdPL1AlIC'
�--" -- WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
Subtotal RESTRICTIVS COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINu:
4 G LICENSE.SEPARA.-E PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax _ ��/Q'
- .- -- SDC—
PDCN APPLICANT OR AGENT
By
- v Receipt No. ADDRESS fT1i�Nr_�
Approved — -__--
5DC —
PDC —
SEWER CONNFCT1114 5
SEWER INSPECTION
SEWER SURCHAnG" 5 _
INSPEC1 ION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
i igard, Jregon 97223
Phone: 639-4171
Type of Inspection01 --—
Date Requested �II — Time,--- A. P.M.
Address < wif Permit
Owner 1;Y, (Aj 0—f�- I-at #
Builder 1
The following Building Code deliri)ncies Pl,.j required to be corrected:
�94
A
Presented to
--:7'rApproved
Inspector Disapproved
Date
CALL FOR REINSPECTION
El YES El No
ary OF TIGARD Plumbing Permit
Building Department No.
Residential � Commercial ❑
Newinstallation ❑ Replace ❑ Addition ny Alteration [I
Licensed 4_�
Plumber Owner
Addr6ss :wJJettAd cress
-
Phone Applicant
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS ANC SUB-CONTRACTORS
ITEM NO. FEE . TOTAL ITEM NO.- FEE TOTAL
Fixtures-Traps7.50 --__1 Sewer:First 100 ft. 30.00
Dishwacher 7.50 Each Addit.100 ft.. 15.00
Garbage Disposal 7.50 Elector Pump kyyyt 7.50
Water Hea,',?r 7.50 Water:Firs 20,00
Backflow Presenter 7.50 EachA 15.00
I )rt
Storm& r .1 30000
LAI h
Each Ack"00 15.00
Mobil is Home,§o25.00
L_Y
Other(Specify): Rain Drain vTg dam.Dwelling^ 15,00
PERMIT FEE Comments:
STATE Issued By:
Receipt No. Applicant
Signatuit
For Plumbing Inspection Phone 639-4171
ar w
I
PERMIT NO._ -
iDDRESS
nERflIT rH,'IRGE none I
CONNECTIrN FEE
PAID 6 Y
I YPE OF 8U I LO I NG h-e-� --
DATE CON JF=CTED -
IN5PECITION FEE
;ERVICE RATE
PAID BY DATE
I Z E OF C 011 IJ E C T 10 N _
A 5 S F:5`.i i l E N T ,____y P A I li
r
CITY TIG,"��RD DATE�______�- , t9 N2 40 �d
BUILDING PERMIT APPLICATION OF �---�
c
HF ONN HSIGNED HEREBY APPL IES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE. -
�!F AS SHOWN AND APPROVED IN 1HE ACCOMPANY NG PLANS AND SPECIFICATIONS. OWNER PHONE
� ��� LOT NO._�u�__
R � _''�` _ JOB ADDRESS li G _
ARCHITECT
ENG
NEER
R_ IW.'1L�_.__1J1.'f=.L1G:� ADURESS�'�Q���^L� qr� �IMN }._ DESIIGNER
ir'TURE 4wEWQREMODEL ❑ADDITION—�_OHEPAIR _ ORENEWAL ❑FIRE DAMAGE ❑DEMOLITION
(7f NCE ❑I_C,MM OEDUCATIC iAL OGOV-T ❑REUGIOUSOPATIO OCA
RPORT IJ GARAGE _YD STORAGEOSLAB [:]FENCE
T, OND OMOVING — ❑CONDITIONAL USE ODLSIGN REVIEh []COUNCIL APPROVED _ [:)SIGNS_ - -� ---_ _ PLAN CHECK BY_.C_�-, HEAT_—
f NC�'. T NU USE ZO E_L�' 'BLDG.TYPE__.l.L�._FIRE LONE —_ — -� —
F149H-LQ y I H nJQ._.;zLQ.RIE$. PPS ` � �5�@IEpRQQA�_._�!.31.+J
_BUILDING UEPARTMENI SET BAT'KS_FELONY— REAR LEFT SIDE /. RIGHT SIDE
rl mit� d/
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, CONING
Flan Check _ J/ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANP 1T IS HERL•BY AGREED 'HAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
`;uh lotal _ pp ALL APPLICABLE CODES AND ORUINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
'.t_ait, Tax /Z LICENSE SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING L.ND HEALING.
T c,t a I !' 'p' I t
HY apPtiCANG NT
I,I, Hued - Receipt No --
--
2 -TA a< Am .
Gu
el,
/ v v
.m.._.M,.,,,,-„Is,p�.__._�•--_. .__..P......._.,r�,•.�._�,.,.�._,-.._.-t.., ._,. . .,..w . .,,p�••yy,.',,,�..,�_.,,..._...,,,_.._. ._.�-. _.__.- .,. -.._.._. ..�1 _• i!<. V' 0f 0 •••
'a M1 i
BUILDING PERNIIT APPLICATION Co Y TIGA�tD DATA_-' r- T9_
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDIU 'TED BUILDERPHONt��r
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNERPH!ONE
LOT NO._
OWNER ova HOM1139 JOE',ADDRESS CJ860 SIL) i1IIIIR UaL 1, 'HOME ADDRESS v
ARCHITECT
ENGINEER
BUILDER_ N&IItl3 _ADDRESS Uo'x 204! ",St Li UDESIGNER;1 r�
STRCTURE__ "044EW ❑RE [:]ADDITION ADDITION _ ❑REPAIR L.JREI:FWAL O
FIRRF DAMAGE ❑DEMOLITION
[IFIESIDENCE ❑COMM_❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT LIGARAGE CI STORAGEOSLAB ❑FENCE
❑BOND 0MOVING ❑CONDITIONAL USE Or SIGN REVIEW ❑COUNCIL APPROVED _ ❑SIGNS
Lit'�"I HEAT_
OCCUPANCY_.___--- kAND USE ZONES W1=..BLDG.TYPE ''1 FIRE ZONE__? PLAN CHECK.BY. _
_.J, wt.• siglIt; feeily dWeIllinyo W/attedieef jas � qtr 3 :.Ie:c�L, l.l,x :e �atht caara.,u �0
-- satisr perituti l jUIL'..
4C7
Q,U—LQgD ,_______--UQ-QR LO.gD____-__ - HEIGHT NO��IQFILEj _A.AEA_ NO.BEDROOMS VALUE
BUILDING DEPARTMENT _ — _
SET BACK.F FRONT 22 REAR LEFT SIDE RIGHT SIL)'_
Permit 17tr.['!q
ri THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Cherk J• l REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAI THF
WORK WILL BE DONF IN ACCORDANCE V4ITH THE PLANS AND SPECIFICATIONS AND IN COMPI_!ANCE WITH
Sub-total ALL PPPLICACTI_F CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
12 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFG''
State Tax • LICENSE SEPARATE PERMI CS REQUIRED FOR SEWER, PLUMBING AND HEATING,.
•L. a • . • ,. 'a i-T l�•
Total �7 4' '” � g
_ APPLICANT OR AGENT
Approved ,,'.w Receipt No. f
g�r ---- -
"'I SS h �
I ..�
�' rice elle� nllr I�r eller rlwl eA�[ 1�
9 DAT'fE� INSPP, TYPE INSPECTION — REMARKS PLUMBING DATE
5 �•�-�R� � ����C� 4j/�y� , Contractor
Permit No. 1.(/U� .3�e•'!� Jr �l
Rough-in �T
bra-312_ ��ei. Fixture
�,�
1 Final
t'S-I HEATING^ —
Contractor -
-- Permit No.
Gas or Oil
— _ -- Rough-in
—� - Final
---SEWER ^— -
Final
DRIVEWAY
Final
Stork Drainage
(Raid Drain)Final
Sidewalk '—
Curb R Strew Final
Approach
BLDG- DEPT.FINAL �TETAPORARY _ CERTIFIa_ .TE OCCUPANCY Final '—
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
i
SEWER PERMIT
IVB �58�
Unified Sewerage Agency
of Washington County CITY OF _ �, gar d _ DATE 5-4-78
OWNER: Nmin Hnmg PHONE :
OWNER 'S ADDRESS:
TYPE OF INSTALLATION:
xr, BUILDING SEWER ❑ BUILDING SEWFP. AND SIDE. SEWER
TYPE OF OCCUPANCY:
xQ NEW x
® SINGLE FAMILY ❑ COMMERCIAL
❑ FXIST. (PRIOR TO 7-1-70 ) ❑ MOLT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
ADDRESS OF STRUCTURE : 9860 SW Kimberly Dr.
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY 'WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALL-ING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWEAI'Y ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 7�
CONNECTION CHARGE 0r
SIDE SEWER INSTALLATION _ H. Greene
OTHER ISSUED BY
TOTAL $ 625.
7
APPLICANT DATE
t�
SEWER PERMIT M 15886
ADDRESS OF STRUCTURE 9860 SW Kimberly Dr.
TAX MAP TAX LOT SYSTEM fanno creek
LOT 7B BLOCK DE
E Wa 1 r1PU —5-4-78
APPROVED BY PATE ISSUED DATE
D • U• ' S 1 _� REMARKS ?da X1010