9785 SW RIVERWOOD LANE 9785 SW RIVERWOOD LANE
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CITY OF TIGARD—12420 S.W.MAIN--TIGARD,OREGON 97223
RECEIPT
DATE:: am-_ :s'_..�L __—_-- AMOUNT: $-
- 77'� s DOLLARS
NAMt: IZ2" J ��J. _ CASH:
i
ADDRESS:
c -- — —_— M.O.: ——
,/ OF
FOR: ACCT. 0 PERMITS SURCHARGE AMOUNT
SEWER BILLINGS 40-364
BUSINESS LICENSE 05-331
PLUMBING PERMIT 05-332
MECHANICAL PERMIT 05-332 _
4,. IG PERMIT 05-333
SEWER CONNECTION 40-363
SEWER INSPECTION 40-365 ... �Q
SYSTEM DEV, C,TARGE 25-366
PARK DEV.CHARGE #1 30-367
PARK DEV.CHARGE #2 30-368
ZONING ADJUSTMENTS 05-362
_----._--
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TOTALS
RECEIVED BY: -
PERMIT NUMRYERS ASS44NRD:
Number Amount_ Number_ —Amount Numbw _ArftWd
13
RECEIPT
BUILDING PERMHT APPUCATION TIGARD DATE- --...'� .I(' --,19 4435
THE UNDERSIGNED I---REBY APPLIES FOR A PERMIT FOR THE.WORK HEREIN INDICATED BUILDER PHONE ___1 2r3-.
OR AS SHOWN ANG APPROVED IN THE,ACCOMPANYING PLANS AND SPECKLCATIONS. OWNER PHONE
OS
�' LOT N
OWNER 34LY 13113r Bldg- InNBADDRE_SS- 9115 SIR i?�yenmOd' 61-161
— — AR HITECT—
rtnta !'7 Box 23291 T 3. . t cl EN INcER ri l lean
BUILDER ADDRESS D IGNER
TRUCTURE _ 1:3 NEW ❑ REMODEL ❑ ADDITION \REPAIR 'Ntl R EWAL CJ FIREDAMAGE—_Ci DEMOLITION.0,RESIDENCE ❑ COMM ❑ EDUCATIONAL FJGOV'T C! RELIGIOUSTIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
t,�rd/SdX�
� OCCUPANCY _ Y.-3_LAND USE ZONE t!;J!'i� (31-DIA.TYPE _F ZONE N CHECK BY - � WHEAT
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Construct 'iia In ker;i ti l i�sl� iaf'i�tt� ... eci ,� ---=- ��— -
--- atee rorreetion at+et chnd. 4 bedrm.-m - -
- -- 3 br.ths --
SEWER PERMIT# �= �l31y0•�)t� r �r
�raue ---- --- ---
OCC.LOAD FLOOR LOAD '4D HEIGHT NO.STORIES AREA 1 g1 ► NO.BEDROr,"dS 4 VALUE �'�,�it1U
BUILDING DEPARTMENT SET BACKS FRON 6 REAR 12 LEFT SIDE RIGHT SIDE 32
Permit THIS PERMIT IS 15�UED`6UBJECT TO THE REdULATIONS CONTAINED IN THE BUILDING CODE,ZONING
2Fi�1.0{} - 1 REGULATIONS AND ANLL PPLICABLE CODEC-AND ORDINANCES,AND IT IS HEREBY AGREED THAT THE
Plan Check_ WORK WILL BE DONE CCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
�Ej(1 (tii WITH ALL APPLICABLE ES AND ORDINANCr-S. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS.CONTRACTOR AND!;UB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
16.t,� LICENSE.SEPARATE PERMITS REQUIRED FOR S'6WER,PLUMBING AND HEATING.
t' �f'•Illl
SDC— 4(30.00
Total
dt.l+,! PDC# 1'X i(MJ.OU APPLICANT 0R A'Qi•N( — ----------- -- _� --
By
rlt�t Receipt No. _ __.___ ------------.— PHONE
-- ----
Approved AAOR€99 PN
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BUILDING PERMIT APPLICATION TIGAirl DATF_��Q,(�_—.
THE UNDERSIGNED HERI_E)Y APPLIES FORA PERMIT FOR Tt iE WORK HEREIN INDICATED BUILDER PHONE(S>'�•Z'��
ORAS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER,PHONE
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JAYALL R��oBA'DDRr_sS _��7� �,�wv �CHIrECT
ENGINEE
BUI,..CER .+RNA R► _ ADDREiS P � Aa-
ST
a- DESIGNER,
STRUCTURE NEW Cl REMODEL Cl ADDITION _❑_REPAIRr] RENEWAL ❑ FIRE DAMAGE Cl DEMOLITION
REbii]ENCE ❑ COM', I7 EDUCATIONAL ❑ GOV'T Cl RELIGIOUS ❑ PATIO ❑ CARPORT Cl GARAGE ❑ STORA E 0 SLABC1 FENCE
�J• %ii?ANCY �� LAND USE ZONE BLDG.TYPE ___FIR ONE ti PLAN CHECK BY
Al
Ar— Al
SEWER PERMIT N ______ Ati^� � — Sty ___---
_ e� '+�
OCC.LOAD FLOC71 LOAD /`O HEIGHT Isco NO.STORIES ARES+I O NO.BEDROOMS VP.LU- O
BUILDING DEPARTMENT SET BACKS FFIONT 140, REAR ��� LEFT SIDE_ RIGHT SIDE -
P�rrnit _ THIS PERMIT IS ISSUED SUBJEC'T.TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOWNG
)IIEGULATIONS AND AL APPLICA6t.E CODES AND ORDINANCES, AND IT IS HEREBY AGREES]THAT Th',E
r•IanChack ORK WILL BE DONE I ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPLIA14CE
' ; —' WITH ALL APP44CABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERFAIT DOES NOT WAIV;
Sub-total �• RESTRICTIVE CQVENANtS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SF:PARAh PERWTS RE UIRED FOR SEWER,PLU$ING AND HEATING.
stats Tax • y "//�1��//,,
SDC
Total — _ - -------- -- -- --
---— �— JI APPLICANT 4R AGENT
PDC �b ---—— ---
_ Recelot No. yDORE55 PHONE
Approved
soc - _ Qo
POC -- i� /0c)S_ EWER CONNECTION
SEWER INSRECTION $
SEWER SURCHARGE $ �-'
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