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15515 SW 74TH AVENUE 155.15 SW 74TH AVZNUE -' t 4 Lor inspections call 639-4175 � 731 CITY OF TIGARD 639.4171 _ .-19 19 1 -1 El �• 35 BUILDING PERMIT TAX MAP 251-121)11/ 800-_ __SUBDIVISION _ LOT N0. _. ©frwal 0. Johnson JOB ADDRESS OWNER — BUILDER same P.O.Boy 276 Beeverton 91015 _.- STATE REG.NO _---_.___ __EXP.DATE— - BUILDER'S PHONE "6-5136 _- ___ PHONE .__OTHER ARCHITECT ----- ---- STRUCTURE I 1 NEW W [-IU OTHER REMODEL ❑ ADDITION REPAIR__ MOVE z' DEMOLITION- f--1 REL iGIOUS ACCESSORY I ! GARAGE I ! OTHER FENCE n RESIDENCE COMM L_, EDUCATION IND OCCUPANCY iia LAND USE ZONE BLDG TYPE _ FIRE ZONE FLAN CHECK BY _ HEAT _ _7_rim �• tss dunce Lo i ,� ,.�nw •i�cd(to be burned b� Tualatin Rural Fire ll etr ct septic systewtho be capppd for future use. 5"elll ent to he 1i11N"! level. SEWER PERMIT k VALUE OCC.LOAD FLOOR LOAD HEIGHT _ NO_STORIES AREA N0.BEDROOMS NG DEPARTMENT LEFT SIDE RIGHT SIDE BUILDI SET BACKS FRONT REAR — �— Permit _�_._ THIS PERMIT IS ISSUED SU3JE0T TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING "— REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND Ii IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE Plan Check iWITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DUES NOT WAIVE PI.Ck.Fire RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CL'RRENY CITY BUSINESS -- TAX PERP1ITS,SEPARATE PERMITS REQUIRED FCR SEWER,PLUMBING AND HEATING. ; state Tax .60 _ SDC- i ( PDCM - ✓ d!"•"•_ Tota) 15.60 A PLIC�IiVT ORA �-��+Y� -- Prepd. 4PHON - ---- -- Receipt No. � ADDRESS Bal,Due 15.6U _ _Approved By_. DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE Contractor — D��� / Permit No. Rough-in — - --_----- —__- Fixture --- -- — ---- — Final ---— -- HEATING -- ^—v�-----T --�---- Contractor Permit No. Gas orOil Rough-in — _.----------- -- -- Final - — ------- --- —._�_ SEWER — — Final DRIVEWAY — Final — - --- — Storm Drainage (Rain Drain)Final -- —�------ _ ---- Sidewalk _— — -- -----—_----- Curb 8 Street Final -- - -- Approach BLDG.DEPT.FINAL CERTFICAT EORARYOCCUNCY CERTIFICATE OCCUPANCY Final — _ — l_andscaping Zoning Final IN B ■! R CITY OF TIGARD 639.457) DATE �%t" A BUILDING PERMIT r TAX MAP�J 012 OT NO, SUBDIVISION OWNER - '% — ��A BADDRESS SS/ `_,Lt2 : ,O 3��{ Z 7 L L' k 9 �. 0(7SBUILDER — TE REG.NO. EXP.DATE --- BUP_DER'S PHONE 06-1 --- - /,RCN'TECT PHONE __.,___OTHER STWCTURE_ ❑ NEW _ ❑ REMODEL O AODITICN O REPAIR U MOVE U OTHER EMOL TII ON LESIOENCE ❑ COMM O EDUCATION ❑ IND ❑ RELIGIOUS FJ ACCESSORY ❑ GARAGE U OTHER L) FENCE OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CHECK BY HEAT 7­4 -7 SEWER PI M11 1 -- OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.REOF40OMS VALUE — BUILDING DEPARTMENT SET VACKS FRONT REAR LEFT SIOE RIGHT SIDE PermlI 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 Cfwk WORK WILL BE DONE IN ACCORDANCE WITH THE PLOWS AND SPECIFFCATIONS AND IN COMPLIANCE WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOtS NOT WAIVE PI.CIL F" RESTRICTIVE COVENANTS- CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRE►'T CITY BUSINESS TAX PERMIT'S.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBIIIG AND HEATIN( Stals Tax c'�- -- Told / APPi 1t.ANT ON AGI NT Prspd. P1InNE Receipt No. ADDFiL55 Bal.Dun -- -- -- Issued By -- -Approved By SSUC - $ SOC - POC - SEWER CONNECTION S SEWER INSPECTION S SEWER SURCHARGE S , Comments: �-^- � lUfl � flll � flUfl � � � � � fl P O BOX 1?7 a TUAL. T11 .AEGON 97067 0 PPONE 682-7601 • RUSSELL WASHBURN. CHIF7 Wi1IVFR CF UARILP!Y - HEI-EASE: FUM we, the undersigned, bei.rrj legal owners, or authorizes: representatives of the legal. owners, of the property at /�;:r"`j • ; - _�,_____ hereby donate the following described buildings un said property, '' l', ,r '�'•" < =��F:• /7,- W t„to the Tualatin Rural Fixe Protection District for use as they shall dean appropriate to train their personnel in the arts arra skills of firefiyt►tirw.J. ,Use” shall mean, but not be limited to, tearing down, demolishlrr3 and/or the burning of any and all described structures. it is agreed that the above described buildings will no longer be insured against loss by any cause including fire; it is also aqreed to hold hannless the above named fire department, all participating fire departments, their personnel, the State of Oregon or any aub-division thereof, for any damages sustained by any structure and/or property riot described in this agreement. Further, the owners of the above described property shall m)t be .liable for any injl.tries to personnel, damage to equipment or damages to structures and/or property not described in this agreement. It is further understocil that the owners of the above described property shall be responsible for acquiring any and all necessary demolitiol permits; although the Tualatin Rural Fire Protection District shall talc(! all reasonable action to leave the property in as neat arvi clean appearifY3 condition as possible, it will not be reslx)nsible for debris resm)val or site rehabilitation. The Tualatin Rural Fire Protection District hereby agrees that it shall have ceased all traininy activities on the above described property on or befoz'e and further agrees to immediately cease activities at any time prior to the above date upon written request of the owners. 7mS W LMR MLW E£ SIGNED ON 114E EBUR[: SIDE: IN OFMER 70 E£ VALJ'D w S IN I i I I waiver. of Liability - Release :'Orn Page 2 "OoL41DI'M NS OF ACCGPPANC:E " arxiitioru, of Described Building on Said Property: 1. The buildiryj must be in structurally sound cccxiition. . The floors, walls, roof and foLuYlation must be intact. 3. Windows and doors may be remaved, however, they should be covered to prevent unauthorized entry. 4. The building cannot be located in plain view or close proximity to major roads or freeways. Reinove or disconnect the fo!lr�wing itesn(s) before returning form: Electricity _ Telf-phone Gas k Water Sewer Attach the following item(s) to the form before returning: (Photocopy is acceptable) Demolition permit from the building department having jurisdiction over the building. Comer or Cir's RepresentAt ive Tate---_-Y- -- ___-_--Witness ----- - -- -- Eire t9linf -----