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-11153 SW 65th Ave.
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CITY OF TI RDF}r`RM.r. r NO : Bl.lf36].9B
C11iYOFt1i�lIID
• COMMl1f�►,YY DEVELOPMENT DEPARTMENT « � DATE: ISSUED: 10/10/88
13125 S.W.Hall Blvd P.O Box 23397,Tigard.Oregon 97223.(503)639-4175
PRIM _PMT.NO. 881987 --
.1013 ADDRESS: 11153 SW 65TH AVE.
TAX MAF /LOT 151 :36AA 2201 SUBS: LT : BK
I...AND USE:
• LOT SIZE: : VALUATION: $ 1 ,000 SETT ACKS
FRONT : REAR :
WORK CLASS : RELOCATION DWELT.. .UNITS : LEFT : RIGHT:
USE TYPE:: GARAGE NO. E3EDROOMS : EXT .WAL..L. CONST :
CONST . TYPE : VN NO. BATHS : N: S : E : W:
OCCUP .G;RP. : Mi. PROT . OPENINGS :
OCCI_!P .I...OAI) N: S . E: W
TOTAL AREA:
NO . STORIES : 1 1ST : ROOF CONST: 17 IRE. RE T'7
HEIGHT : 1 el 2ND• AREA SE:PAR? RATED:
BASFi:M1=NT? : OCCUP . SE:PAR'? RATED:
MEZZANINE'? E3ASE.M' T
I• I..(:>OR I...OAD GARAGE F'IPE: SPRKL.•R'? ALARM'?
F L.C)W 1 GPM> DETECT'?
HEAT i.Yl: E. : 1•lL)CP .ACGI_'::i5'? CORP'?
(:;l tlE(::K E3Y : r:t t
I: EKMARKS
mctv:r.n4;1 Irtant tai gar rage bock :5(:I1't. RE.:I:SSUE: OF NO.
I?tat.tr3.nc1 rtcrt.. fuundtt.tion LAST REISSUE
1 E:ES
• O I<E.iisL..t I� PIEia{CM' PE:12MI'1' $1 '7 . 'io
W
N 11153 SW 65TH AVE PLAN REVIEW ,I I 1 ;I
pcart1.at.nd or 97219 FIRE DEPT
PHONE (503) 2'16-•6218 STATE TAX
OTHER
DEVEL.OPMENT CHARGES .
O 51)ClSTORM)
N
SDC t 5T'PFi:E::I )
la I?I:)(;l 0 )
A
C PRE:PA:1:1:) <
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fa 'roTAL. : $29 . 16
fTh
RECEIPT NO . /6)/ U<`/.5
This permit is iss.ed subject to the regulations contained In Title 14
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applir:,nle codas and ordinances. and it is hereby GtCi:(:I1.11:RED INSPECT IONS
agreed that the work will be done in accordance with the plans and FOOTING
INC
specifications et in compliance wit.' all applicable codes and
ordinances. T',e issuance of this permit sloes not waive restrictive
covenants contractor and subcontractor.l shall have current city
business tra permits This permit will explie and become null and
void it worn is not started within 180 days,o if work is suspended or
abandoned for a period of 180 days :.ny time after work has
commenced It shall be the responsibiliti of the pet mittee to assure
all required Inspections are request avid approved
/ s
Fr6rmittee Signature
Issued By ,)
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
Li .Li Li Li Li Li.Li Lii �i Li 3 r
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*LAN CHECK APPLICATION�
COMMUNITY DEVELOPMENT DEPARTMENT CIIYOFTIO lm ;U PLAN CHECK # "C.) - /0 /. ---
..
9 3125 SW 1441 Blvd. P.O.Bar 230197,Tipsy,Oregon 97223(SOO)639-417s �� \, n PERMIT # /9 7
DATE ISSUED
• JOB ADDRESS: /"C- -j (,c/ KJ es
-L6-_ / S-f 3&4P'4/
SUB: TAX MAP/LOT z/JeS,ll# .Va.e /
t-/At � LOT: s/ BL44 ___„2,,,11 LAND USE: R.-cf. r
VALUATION': /v 7"6 7 .
OWNER —
SPECIAL NOTES
•
NAM",..-: C.1.:L..Z'1?�u /L KA 1.2= _ REISSUE OF:
ADDRESS: /7/. :- , & cit' V LAST REISSUE:
/h t'r_ i-' • .j)_ �kZ� / 97 _/ FLOOD PLAIN/ -- --
.'t PHONE: 7 . 76 7 SENSITIVE LAND:
/ O �
APPROVALS REQUIRED
CONTRACTOR
I NAME: �Ly ' a PLANNING: —_ --
,�; .w H./1 ENGINEERING:
ADDRESS: .1',/,e2L--/ / Ste- , :2J 2 'I e.4-- ,/ , FIEF DEPT
R.
PHONE: c" ."sj' ITEMS RE UIRED
ARCH/ENGINEER LIST/SUBCONTRACTORS:
BUS TAX:
NAME: CALCULATIONS:
ADDRESS: /----1/21 ,?277 J -41- ti % , - --
• TRUSS' UI_TAILS:
J L '1 / _S's•-. `:-.),/Z AI cii, . PARKING PLAN:
PHONE: , .) �i LANDSCAPE PLAN:
,-f ;.�
OTHER:
C COMMENTS:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
b ,�./4e ' 10-432 00 Brilding Permit: Fees I7 $U
10-431 00 Plumbing Permit Fees -`
_________ 10-431 O1 Mechanical Permit Fees —
10--230 01 State Building Tax (5%) -T`- - - .6,t
Building •—' - - --
Plumbing
Mech
• 10--433 00 Plans Check Fee /`3k
Building ' Y --- _—• - -
Plumbing
Mech
30-202 00 Sewer Connection
30-444 00 Sewer Inspection — - - —
., 51-448 00 Street System Dev Charge (SDC) —
52-449 01 Parks I System Dev Charge (PDC) - - -
• r 52-449 02 Parks II System Dev Charge (PDC) — —
31-450 00 Storm Drainage Syst Dev Chrg (SSDC)
10-230 09 TRFD _ --- ___
10-230 06 Washington County Fire #1 (95%)
10-220 00 Amart/Wedgewood
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TOTAL
REC # A 9', 26 y�
/L....."..46J
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APPLICANT SIGNATURE
Received By: _ Date Received:
ht/3587P/18P
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