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11030 SW NORTH DAKOTA STREET 11030 SW NORTH DAKOTA STREET u 0 z 3 M O CITYOF TIGARD No. 1163 12755 S.W. ASH P-0.130TIGAR , OR 9 Date—2 b'�y - TIGARD, OR 37223 lr rIr ILOlNtI Name - f� I 1t o�u. Address Lol JBlock/Map S dlvlsion/Address --y Pormit #'s Bldg. Plumb Cash Check Sewer Other Other Rec. By Acct. No. Descrl tion Amount 10-432 Building Permit Fees 10.431.600 Plumbing Permit Fees _ 10-431.801 Mechanical Perm.I -ees 10-230-501 State Bldg. Tax 10.433 Plans Check Fee 10.435 Other Licenses & Permits 30 443 _ Sewer Connection 30-444 Sewer Inspection 24-448 Street Syst. Dev. Charge_ '- 25.449.610 Parks I Syst. Dev. Charge _ 25.449.620 Parks II Syst. Dev. Charge 31.4_50 Storm Drainage Syst, Dev. Charge 10-430 _ Business Tax 10-434 Alarm Permit- 10-227 ermit _ 10-227 Bail �� 10.455- _ Fines - Traffic/Misd/Parking J v- 10.230- _ CPTA Traffic/Misd/Vic. Asst. 10.456 Indigent Defense�V _30.446.401 Sewer Service/USA 30.446.402 Sewer Service/City 31.447 Storm Drainage 40.475 Bancroft Prin. Pymt. 40.471 Bancroft Int. Pymt, 10.451 Other Charges for Services _ TOTAL]F DEBT. `i BUILDING PERMIT ;'�PPLIC ION TIGARD DATE_LIBC'OMbOr 3 84 51.03 THE UNDERSIGNED HLHEBY APP: 11,=8 FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _ OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 6�9-4650 OWNER _W• HO1CO>�Y JOB 1103© SW fiorth U&kat& LOT NO.____' Q� -....v __ 1�U$ ARCHITECT ENGINEER BUILDER 14ar! ADDRESS DESIGNER STRUCTURE_ ❑ NEW ❑ REMODEL LAADDITION ❑ REPAIR _❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION ❑)OESIDENCE L COMM ❑ EDUCATIONAL ❑ GOV'T Cl RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE OCCUPANCY -_ i"I —LAND USE ZONE _jam BLDG.TYPE-- -FIRE ZONE----PLAN CHECK BY � HEAT- - Coartrwt sttacb d carport to saietiag gar& e. SEWER PERMIT N OCC.LOAD FLOOR LOAD C011t. HEIGHT 10 NO.STORIES I AREA 336 NO.BEDROOMS VALUE 440. - BUILDING DEPARTMENT SETBACKS FRONT 100 REAR I 0 LEFT BIDE R13HT SIDE 11 Permit _I5.00 __ 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 AGREED THAT THE Plan Check ��� WORK W,,-L BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH A!.L APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE Sub-total 11 15•Uu RESTRIC ;VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINES3 State Tax .6U LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. Total 15.60cz PDCM APPLICANT OR AGEN'r Approved ULR Receipt No. ----.---_--- ���III -A—DDR-ES-8 PHONE REMARKS PLUMBING DATE DATE INSP, TYPE INSPECTION Contractor Permit No. Fwuoh-in Fixture Final HEATING Contractor Permit No Gas or Oil Rough-in Final SEWER Final pvrW;Y Final Storm Drainage ——— (ficin Drain)Final Sidewalk Curb&Stint I-Inal Aroroact---- DEPT FINAL TEMPORARY Final C-ERTIrIcATE OCCUPANCY Landsceirilng Zoning Fin,11 .............. BUILDING PERMIT APPLICATION TIGARD DATE___THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TIME WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVk?D IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE4L 5::. 6 r LOT NO. 2 ti JJBADDRESS — C/ �lC ARCHITECT ENGINEER DESIGNER BUILDER _ BUILDER ADDRESS _ — STRUCTURE O NEW ❑ REMODEL _ ADDITION ❑ REPAIR_ ❑ RENEWAL ❑ FIRE DAMAGE Cl DEIAOLITIO RESIDENCE ❑ COMM ❑ EDUCATIONAL cl GOVT ❑ RELIGIOUS ❑ PATIO Cl CARPORT Cl GARAGE Cl STORAGE ❑ SLA130 FFENG -- Oc-aI iPANCY /!/ LAND USE ZONE ► BLDG.TYPE pLNN CHECK BY _Ly HtJ11�, (2_A I�p2/Q T E '-. Cs SEWER PERMIT k OCC.LOAD FLOOR LOAD „ HEIGHT t> NO STORIES f AREA-',_ lr NO.BEDROOMS VALUrJ-•'- BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE 1 RIGHT SIDE Pcrm!t 'r --`" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE.ZONIN REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT T ,alanCheck WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPUAN WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF 'I HIS PERMIT DOES NOT WAI Sub-total RFSTRICIIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSIN- LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. State Tax c' Total pDC# APPUCANT OR AGENT By Receipt No. ------.._--- _--------- ------------------- - AODRESS F'tiONE Approved �.s..f SSDC --- $ SDC - PDC — _$ SEWER CONNECTION & SEWER INSPECTION $ SEWER SURCHARGE $ ----------