11885 SW 72ND AVENUE :z
a
rn
E
N
A-
y
C
m
G
to
I
I
+! f
I I
1
qnNIAV CIN'?. MS ggRTT —'
CITYOFT167ARD
PERMIT #. . . . . . . : )aup91-029
CITYOFTNARD
COMMUNrTY DEVELOPMENT DEPARTMENT ...
oMeooer
131266W FWD Blvd. P.O.Bax 23397,TOW,Oregm 97223(IM)630.4176 t DATE ISSUED: 12/16/91
SITE ADDRESS_ : 11885 SW 71-hI0 AV - - PARCEL.: IS13613C-02401
:;UBDIVISION. . . . : ZONING: C-G RD
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
RF_ISSUE: FLOOR UREAS- -- -- -----�-EXTERIOR-WALL-CONSTRUCTION-
CLASS OF WORK. :DEM FIRST. . . . : sf N: S: E: W.
TYPE OF LSE. . . :SF SECOND. . . : S I'DROTECT OPENINGS?.__________
TYPE OF CONST. :5N THIRD. . . . s sf N: S: E: W:
OCCUPANCY GRP. :R:'s 0 s f ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: BASEMENT. : sf AREA ;SEP. RATED:
STOR. : HT. : ft GARAGE:. . . : s f OCCU SEP. RATED:
BSMT' : MEZZ? : REQU SETBACKS-______._ REOL'IF',ED-------___._____._.....____
FLOOR LOAD. . . . : ps f L[".F T: -Ft RGHT: Ft FIR SPKI._: SMOK DET. .
DWELLING UNITS: FRNT: ft REAR: f•t F"IR AL.RM: HNDICP ACC:
BEDF;MS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE. f: 0
Rem�1,rks : Demolish existing SFD. All debris to be removed. Pump and fi l septic
tan41 or Capp sewer. Insp. reryltired for filled septic tank or capped sewer
(Jwner: ------ --•--__.__._____..,______________. FEES -
- -
STANLEY GEORGE (W COASTGROCERS REP. ) type ��amo�.rnt _-by date recp
1 V191 O SW 79TH AVE PRMT $ 25- 00 JLH 12/16/91
TIr3ARD OR 9722: -
5F'CT $ 1, 25 JLH 12/16/131
I-Thune #: 624-6901
r. MMERT INTE:R1,1ATIONAL
1 161 1 S. E. HWY 212,
0-ACKAMAS OR 97015
r 1ti o n e #: t 26. 25 TOTAL.
001305
--- - -- REQUIRED INSPECT 1 ONS - _---.-
Thi; pet-sit is isvied subject to the regulrtions contained in Ue PUmp/f=ill Septic
Tigard Municipal Code, Stato of Ore. Specialty Codes and all other Cap sewer line
applicable laws. All Mork will ,e done in accordance with Final Inspection
approved plans. This pernt will empire if wcrk is not started
within 180 deys of issuance, or if work is suspended for sore
than 18@ day,.
Per,inittee Signature1 - -----_— ----- ----______ _�
1 _ sued B y .
Call for inspection - 639-4.175
t
Address Pe
� ' 7j:- Pf_rmit No.
Permit charge
Owner �N .ti, Connection fee
Paid by
Type of Building_g_ ��-� � _ Date connected
Service Rate ` inspection fee
Contractor _ _ Paid by Date
Size of connection Assessment. Paid
I �