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BUILDING PERMIT APPLICATION TIGARD DATE 3870
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT
FOR THE WORK HEREIN INDICATED BUILDER PHONE
1
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
I. LOTNO. 1146, 2SI-2CP.-
OWNER I)i 1,q tf,,IdOB ADDRESS 9471.1 tltq
ARCHITECT
ENGINEER
BUILDER Sar, ADDRESS Above DES1614ER Owner
STRUCTURE 0 NEW F1 REMODEL E*ADDITION El REPAIR ❑ RENEWAL C3 FIRE DAMAGE D DEMOLITION
RtrRESIDENCE E-1 COMM P EDUCATIONAL n- GOV'T I] RELIGIOUS 0 PATIO U CARPORT L-1 GARAGE [-J STORAGE D SLABO FENCE
tia J)%"t' Gas
OCCUPANCY LAND USE ZONE BLDG,TYPE FIRE ZONE—PLAN CHECK BY HEAT
(:ons *.rust tan; 1y rooy7j adilitiOn to sjjjqje
correction sheet : ttachod.
SEWER PERMIT#
OCC.LOAD FLOOR LOAD 40 HEIGHT 10 NOSTORIES 1 AREA NO.BEDROOMS VALUE
BUILDING DEPARTMENT — SET BACKS FRONT RFAR LEFTSIDE NIGHT SIDE
Permit 4 THIS PERMIT IS ISSUED SUBJECT TO THE REGULA'JONS CONTAINED IN THE BUILDING CODE, ZONING
REGIII-ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 2, WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
12.00 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 1.92 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total 73.92 SDC—
—-- PDC# APPLICANT OR AGENT
By
Receipt No.
proved ADDRESS PHONE
LA
TE INSF TYPE INSPECTION
REMARKS PLUMBING DATE
Contractor
Permit Nu.
Rough-in
—
Fixture
Final
HEATING
Contractor
Permit No.
Gas or oil
Roug`t,in
Final
SEWER
Final
_�RIVEWAY
Hnal
Storm Drainage
(Haiti Drain)Final
Sidewalk
Curb&Street Final
FLDG- DEFT.—FI—NALApproach
TEMPORART CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPAWY Final
Landscaping
Inning Final
3970
BUILDING PERMIT APPLICATION T((3AR:) DAT
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HZREIN IN ICATED BUILDER PHt7PtEf►�
OR AS"HOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
IA.+� n�j ee�� QQ� � h/A '� LnT ri0.�
MI/ OBADDRESS9WT-9! ) IN�A�_
ARCHITECT
GJ'9.� ENGINEER OwMM,
BUILDER �a1�jQ� ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODE'— ITION ❑ REPAIR ❑ RENEWAL C3 FIREDAMAGE ❑ DEMCLITIO
_ t1E51DENCc :_CCM�1 ❑ EDUCATICNAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE_❑ SLAB❑ FENC
C-CGUPANCY .LAND USE ZONE SLOG.TYPE __FIRE ZONE i PLAN CHECK 8Y MEAT
10L A 148,
SEWiFR PERMIT M —
OCC.LOAD FLOOR LOAD HE!UHT 0 N0.STORIES AREA,2410 N0.BEDROOMS VAL U
BUILDINGD'ePARTMENT _ SETBACKS FRONT REAR�2 LEFT SICE RIGHT SIDE
Permit _ • ��_ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CON rAINED IN THE SU1LDiNG CODE,ZON:N
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCf.S, AND iT IS HEREBY AGREED THAT TH
!Mom Check �T• WORK WILL BE DONE IN ACCOP.CANCE WITH THE PLANS AND S°C%�IFICATIONS AND IN COMIPLIANC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE 151zJANCE OF THIS PSR4q,11T DOES NOT WAIV
Su�talal ' OG RESTRICTIVE COVENANTS. CONTRACTOR AND sus r'_+PITRACTORS TO HAVE CURRENT CITY BUSINES
!" T OY LICENSE.SEPARATE PERMITS REQUIRED FOR SEW-A.PLUMBING AND HEATING.
:,tate Tax •-_ .�••"�"` /
I(Tota)
"' — -
PDCJ1 APPLICANT OR AGENT
BY —._r_ -
Receipt No. ADDRESS PHONE
Approved
!SEWER CONNEC 'rION S _
SEWER INSPECTION $
SEWER SURCHARGE % _. _
PERMIT TO CONNECT
Tigard. Sanitary District
PERMIT N° 1522 DATS 1. 71
.,
,
PERMIT IS GIVEN TOOF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT '
AT t./
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE. AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $ .. . .... ...................TIGARD SANITARY DISTRICT
>Xr +CcC/c'TlAI� �.C�✓mac ,7/'��7.,/
CONNECTION IN; ZCTED AND APPROVED
f[1
Late — �.---- -----Superintendent� --- -- \
Address 9475 S.W. Oma,ra Permit No. 1522
Permit charge _
Owner Connection fee,.,_ X0_4
Paid by ._ .._�._._.. ....�_
Type of building Rei. Date connected___ Z_j.3__7j
Service rate 9.00 Inspection feeq�25.00
Contractor_ Richard Demick � Paid by�
Size of connection 411 Assessment Paid