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12955 SW PACIFIC HIGHWAY 12955 SW PACIFIC HIGHWAY I co 3 NO U 4-� •.i U ctl a ul X\ o, N ipr call 639-4115 BUILDING PERMIT APPLICATIONTIGARD DATE THE UNDEFiSIGNED HEOEBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 684-0�`�3____ OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE��.. Hudson Plata 129W SW Pacific Highway LOT NO._-_typo—_ -- OWNER JOB ADDRESS ARCHITECTENGINEE —� BUILDER @wntrex Caret. ADDRESS 12900 SW P*CifiC Hibhway DESIGNER STRUCTURE ❑ NEW F�REMODEL ❑ ADDITION ❑ REPAIR L7 RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION ❑ RESIDENCE O(COMM ❑ EDUCATIONAL ID GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE OCCUPAN'Y B,'-LAND USE ZONE BLDG.TYPE 5_ FIRE ZONE_._ PLAN CHECK BY � HEAT__—_ --- Construct tenant etwdificatioa per approved place morn—structural.) SEWER PERMIT# OCC.LOAD FLOOR LOAD _HEIGHT NO.STORIES 1 AREA 9"- NJ.BEDROOMS VALUE 3500 BUILDING DEPAPTMENT� SETBACKS, FRONT _ REAR _ ^ LEFT SIDE—_ _RIGHT SIDE Permit 44.50 _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING 28.93 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE 13.43 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACT')RS TO HAVE CI.IRRENT CITY BUSINESS LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. State Tax 1. 18 - --- - SDC- Total _ 15.21 - - f— C_-4 - ,,':,ti, -- PDC# APPLICANT OR AGENT By jReceiptNo. I( ) Approved ADDRESS - �_ PHONE t DATE INSP.I TYPE INSPECTION REMARKS PLUMBING DATE —� — — - — -- -- Contractor — Permit No. ._—.. Rough-in --- ._.—�_—__---_--_.-_-- ---- fixture Final HEATING Contractor Permit No. Gas or Oil - ---— Rough in -----------` Final — SEWL'R-- — — ----- --------- - --------- Final --_ --- — ----------- DRIVEWAY Final Storm Drainage (Rain Drain)Final Sidewalk Curb&Street Final Approach VBIDG.DEPT.:"INAL TEMPORARY CEERTIMCATE OCCUPANCY Final CERTIPICATE OCCUPANCY Landscaping Zoning Final I BUILDING PERMIT APPLICATION TIGARD DATE- - �!?�`_'- --__,ts��a.. 5647 TNL U14DERSIGNED HEREBY APPL!Ec AOR A PERM I FOR THE WORK HEREIN INDICATFD BUILDER PHONE 6M-0"3 _ OR AS SHOWN AND APPROVED IN THL ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE jiudson Plaza 12950 SV pacific Hi hwa LOT NO. OWNER _ JUB ADDRE=SS �' � � -_-,_ ARCHITECT Centrex Corp. 1290U Sw Pacific Higbwep ENGINEER BUILDER —_ —_ADDRESS _ DESIGNER STRUCTURE ❑ NEW !-3 REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE n1k.101AGE ❑ DEMOLITION [J RESIDENCE [Y COMM '.] EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAN PORT O GARAGE Li STORAGE ❑ BLAB❑ F,-NCE OCCUPANCY�Z-.-�LAND USE ZONE E --___BLDG.TYPE ----FIRE ZONE__,PLAN CHECK BYE HEAL Construct INJUlilflL twdil;icatiota to eziatkq tena.1t spAce Suite a "Pauly 6-Kogers" SEWERPERMITM �,,', Z<,:i . , r��e '�✓ OCC.LOAD FLOOR LOAD_ HEIGHT_ _ _NO.STORIES 1 AREA "2 NO.BEDROOMS VALUE5.OW BUILDING DEPARTMENT_ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit _ 50.50 _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGULATIONS AND ALL AP:,LICABLE. COVES AND ORDINANCES, AND IT IS HEREBY AGgEED THAT THE Plan Check 32.83 Mrd. WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE Tkt U 20.20 p(j. WITH LL APPLICABLE CODES AND ORDINANCES TIIE ISSUANCE OF THIS PERMIT DOES NOi WAIVE Sub-total _ _ RESThICTIVE COVENANTS. CONTRACTOR Atli) SUB CONTRACTORS TO HAVE CURRENT CITY 13USINES-S LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. State Tax 2j02 SDC-- Total – '— PDC# APPLICANT OR AGENT By Receipt No. Approved ADDRESS PHONE -- DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE 441 Contractor 041 vinit No. ough in - --- - - fixture _ 1 `inel — _ - ---- I; HEATING Contractor Permit No. Gas or Oil ^- -- _ Rough-in Final — ------- —�_—�-_ SEWER ��_ ----- ---- - --- Final DRIVEWAY Final Storm Drainage Irisin Drain)Final Sidewalk Curb R Street Final _ __—� IBLDG. DEPT.1'i'IAL TEMPORARY CERTIFICATE OCCUPANCY -incl iCERTIFICATEOCCUPANCY Landecrpirp Zoning Final BUDDING RECFIPi OATF NAME: G / S '� —_------- - /_9 ACCT. N OESCRIPTION AMWNT 10-412 Building Permit Fees 10-431-600 Plumbing Permit Fees s -- tO-431.-601 Mechanical Permit Fees s — 10-230-501 State Building Tax 10-433 Plans Check Fee s ��----•��- - 30-443 Sewer Connection (20X) s 30-202 Sewer Connection (80X) 30-444 Sewer Inspection — 51-448 Street System Dev. Charge (SOC) 52-449- 610 Parks I System Oev. Charge (PDC) S 52-449-620 Parks II System Dev. Charae (f'DC) 31-450 Store Drainage System Dew. Chrg (S!)DC) 10-230-505 TRFD (95x) s ---- 10-A79 TRFD (5x) s — 10-230-5C6 Washingtcn County Fire N1 (95x) f _, 10-478 Washington County Fira N1 (5Y) 10-220 Amart/Wedgewood TOTAL_ (bs/1214P) � � �► � � I� Iii � I� BUILDING PERMIT APPLICATION TIGARD DATE �' ___ ___,�g�`�� 5508 THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE LOT NO. 2600 OWNER � JOB ADDRESS 1"55 ` ' 2S�I-2W _ :,�trf� I.x:cWla;, _ �''!i��Lit: lx4r„�. ARCHITECT ENGINEER BUILDER uelta WestcTn COMt. ADDRESS lo.o. [Am 23961 DESIGNER STRUCTURE ❑ NEW EX REMODEL CI ADDITION ❑ REPAIRy RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION ❑ RESIDENCE EXCOMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE OCCUPANCY M LAND USE ZONE Ct' BLDG,TYPE �`_FIRE ZONE PLAN CHECK BY �� HEAT SEWERPERMITq OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA A NO.BEDROOMS VALUE 6r0W• BUILDING DEPARTMENT SET BACKS FRONT REAR ^LEFT SIDE RIGHT SIDE Permit 56._50 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 Cbeck 36.13 WORK WILL BE DONE IN ACCORDANCE WITH I HE ^I.ANS AND SPECIFICATIONS AND IN COMPLIANCE WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE Subtotal 43.13 RESTRICTIVE COVENANTS. CONTRACTOR AND 1'UB CONTRACTORS TO HAVE CURRENY CITY BUSINESS State Tax 2.26 LICENSE.SEPARATE PERMITS REQUIRED FOR SEV fER.PLUMBING AND HEATING. Total 95.49 SDC— _ • . : PDCM APPLICANT 09 AUNT By Ct. Receipt No. Approved EiL'bt ADDRE8t3 ----- — — PHONE—� c EmFL--- DATE INSP. Y6*19 INSPECTION REMARKS PLUMBING DATE 'ow-actor Permit No. nough-ih Fixture Final Contractor Paimit No. Gi-or Oil Pinligh-in SEWER Final ORIVEWAY Final Storm Drainage (Rain Drain)Final Sidewalk Curti A Street Final Approach OLbO.DEPT.FINAL -;TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Lan73coolmill Zoning Final ....L...._-• ----------+ W, lwyl r�fL36/C+ THE UNDERSIGNED HEREBY APPLIES FON APE Nh11I 1=01i Tllk. 'NU1ti: I.ILJILIN INUR.AILU U ILL-ITNU 1(F OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. LOT1•lo__rZ C T� J'VNE [ )O P. AOQRE55 ^���y—. �.,1._LG- ARC►�IT ENGINE C `LSI~ r OESIGy£R �\ODREW.- ❑REP:�IR ❑RENE-WAL ❑r'IR:OA?AI-GE E'` iTRVCTIIRE _ YEW Rk .If10EL ❑_ ADDITIU*1 /''� --' ❑ RESIDE^ICC COMM I�EOUtiATIONAL C�GOW( []RELIGICUS❑PAT10 L]CAR PORT QGARAGE_❑STORAGE L.-1SLA3 ❑ - --•�-�---'-- -- ---•------—_____ —� NEAT OLOG.TYPE...4=� PLAN CHECK 0•r,x , ��t.�P-�r_�LY ^ `_LAND USE ZONE — •--- CONST.RtJ�_� •�E l!E R �E R f�I T Thr .—_— _____------ - ._�r a K e _—_ —--- . Vs:.C�Lr?�I?_ FLOSINI.Q4R--_ HE1�HZ_ NOXORtES IlE�_ �E DROOAIS VAL SI11Lr:!hG OEPAR TMENT SET BACKS FRONT REAR — LEFT SIDE RIGHT SIDE _ I — THIS PERMIT IS ISSUE4 SUSIECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 1$-:in Chi -CI( ' REGULATIONS AAD ALL APPLICABLE CODES AND ORDINANCES, AND IT' IS HEREBY AGREED TH r------ WOaK WILL BE -'JNE IN ACCORDANCE WITH THE PLANS ARID SP(.CIFICATIOI S AND IN COATPLIJAW, a7ti-C7tAl c� ALL APPLICABLE CODES AND OROINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT 2 v I----� - rt'dSTRICTIVE COTENANTS. CONTRACTOR AND SUB CONTRACTOR4 TO HAVE CURREtTT CITY SO I`''•riteax t7 TI ,C LICENSE. SEPARATE PERMITS HCGUIREn FOR SEYiER, PLUM87N1; AND HEATING. �.._ Total r_ PDC# APPLICANT OP AGENT ._.. ApproveAReceipt No ---- _ l� T nnn F%s r+uN S4)C (St )r- 5 OC rSDC $ - POC SELICR C13NNEtTION $ SEWER INSPECTION ,$ SEWER SURCHARGE 8 Comments „ ( a BUILDINr PERMIT APPLICATION TIGARD DATE - �9 � 53451 THC UNDERSIGNED HERE OY APPL IES FOR A PERM i FORTH;WORK HERE.N INDICATED BUILDER PHONE _649-6541 OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE LOT NO. OWNER Rip1QY'S Furniture JOBADDRES_S_ 14170 Std Pacific Highway_ - ARCHITECT G56-�J329 ' s.4¢ ENGINEER BUILDER m7,�La»on i�oz� It! n ADDRESS X52£1 !,,W20ytu Aloha, 1711 DESIGNER Ralph grn �lnq — STRUCTURE Ll NEW L REMODEL EXADDITION ❑ REPAIR L RENEWAL ❑ FIRE DAMAGE C] DEMOLITION C7 RESIDENCE ISCCCOMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE OCCUPANCY _&•x LAND USE ZONE A;—_!1__BLDG.TYPE _J_N__FIRE ZONE — PLAN CHECK BY _AV HEAT _.___. C,)ikstruct addition to Comwrcial Building. All per approved plane and simmificatioaa as rl code cefluirementm. Ses Site Vrarietme ^� Subject to TRFU Fire Safety Review SEWER PERMIT# OCC.LOAD FLOOR LOAD 40 _HEIGHT 164— NO.STORIES _ 1 AREA NO.BEDROOMS _VALUE IS■UUU BUILDING DEPARTMENT _SET BACKS —FRONT REAR — LEFT SIDE ^ RIGHT SIDE _ Permit 1 10.50 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING REGULATIONS AND ALL APPLICABLE. CODES AND ORDINANe ES, AND IT IS HEREBY AGREED THAT THE Plan Check 1•�g WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AN^ SPECIFICATIONS AND IN COMPLIANCE WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUAN( c. :�r THIS PGi�iwlT DOES j:"T WAIVE SUL•total 44�� RESTRICTIVE COVENANT,. CONTRACTOR AND SUB CONTRACTORS 70 HAVE CURRENT CITY BUSINESS 40 LICENSE_�EPARAT,E PERMIT$REQUIRED FOR SEWER,PLUMBING AND HEATING. 4 State Tax • ;11 a r;'tl*a q.r {.•r.;. Total 130.48 SDC— in l3AL UNE 1 14.90 PDC# APPLICA T OR AGE MY ACA:bjQ Receipt No. I.�O� ,A DR 8E I""=.. A,mk..f �':f kjV-f 1 mo PHONE f F' •_•et�7sa71 Approved —!___ DATE INSP. TYPR INSPECTION REMARKS PLUMBING DATE Contractor Permit No. �-- Final HEATING Contractor Permit No. �^ Gas or Oil Final - SEWER ' Final DRIVEWAY Final Storm Drainage (Rain Drain)Final — — — Sidewalk `~ Curb III Street Final Approach BLDG. DEPT.FINAL -T-- TEMPORARY CERTItriCA5rc OCCUPANCY Final ' CSRT111CATE OCCUPANCY ----- Landscaping Zoning Final UILDING PERMIT#PPLICATION- TIGARD DATE. April 22 __.19 m 5325 THE UNDERSIGNED HEREBY APPLIE:: FOR A PERMIT FOR l HE WORK HEREIN INDICATED BUILDER PIHONE b§j-4k4_4—- OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE LOT NO OWNER Nb 1ju4#gn Ge iter JOBADDRESS 12950 .SW pygtcc_ LI iawa _ 129W SW t!acific Highway ARCHITECT ENCA!NBUILDER Centrkx ADDRESS Tigard, Or 97223 DESIGNER Rutson 631-1 161 STRUCTURE C1 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION C..1 RESIDENCE W COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE_Cl STORAGE ❑ SLABLI FENCE_ OCCUPANCY _k�Z—LAND USE ZONE _ —BLDG.TYPE -1—N —FIRE ZONE--=—PLAN CHECK BY BTT—q _.HEAT Gaa Wnstruct now 2 story building all per approved plLas & Qrlo regairements• Subject to TRFD fire LiEa_Saf.ty Review SEWER PERMIT# ::tee permit #5314 foundation $15,000 Val,.i. OCC.LOAD FLOOR LOAD 40 HEIGHT 20+— NO.STORIES 2 AREA 17 POW NO.BEDROOMS '"" VALUE Ji 1 gUVU BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDET RIGHT SIDE Permit 1111U650 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING 72 i•83 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND ;T IS HEREBY AGREED THAT THE Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE _ i•2G WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE 44 S4VTl,T1'II' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO 'NAVE CURRENT CITY BUSINESS 4i r4a — I LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. State Tax � J - SDC--- � Total 3320.95 0116 � —-- -- PDC# AP Lig (CANT OR AGE VJ --------1 -Pt AAJ. PLIL 1053.06 "— Receipt No. Approved ETWtb - ADDRESS '� DRONE DATE INSP, TYPE /INSPECTION REMARKS PLUMBING DATE +— �Gr✓`r�✓ /,�r '� (/�Asa �/ Coitractor-� N-mit No. Fixtu Final HdATING oo Contractor Permit No. —. Gas or Oiler � 0I Rough-in-i--=� - I/ Q 10-tea ktuz � S Final SEWER — �.� (.' + Final C DRIVEWAY /��/ Final Storm Drainage _ } (Rain Drain;Final Curb t4 Street Final ADpropch _ SLDG. EpT. FINL;ATCMPORARY CERTIFICATE OCCUPANCY U CERTIFICATE OCCUPANCY Fwal j Landscaping u Zoning Final City of Tigard INSPECTION REQUEST for IINSPECTION TIME : r 1>2PERMIT NO.: _ DATE: w DATE ISSUED:-.j OWNERS NAME : 92r� ;�17` _ `. IADDRESS : � `7 " .��1t 'Phi OLIO f! I C0NTRACTOR :.� �--��'�'` rzIFr1r_- f TEST: Air ❑ . Water [3 , Visuax, Laboratory ❑ RESULT: Approved,, Disapproved ❑ Pending ❑ SKETCH: I I I I INSPECTOR DATE ICOTE : Attach supplemental test data heret� I r �► tl�' »a7„r,an...p.,,p,.,......,,.,,.r►.:.nw...y..p,:,.,.ur..r.w.w,,,a�mr,,.,. CITY of 12»11 No 0604 f3UILDi�lG PERMIT APPLICATION TIGARD DATE---­ BUILDING ATE - 19-- 111f IINDER!;IGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE ()H AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. l)1NN1..I1 i�yoss L* Kennedy _ ADDRESS l�ya� sew. r'®tial i:: i♦ gUILpR PHONE – ENGINEER BUILDER ' �rler ARCHITECT �1 _ DESIGNER —. STRUCTURE ONEW ❑REMODEL _❑ADDITION _LJREPAIR --[:]RENEWAL OF IRE DAMAGE []DEMOLITION EDRESIDENCE []COMM ❑EDUCATIONAL _OGOV'T [IRE LIGIOUSOPATIO ❑CARPORT 0GARAGE _CJSTORAGECSLAB OFENCE MOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVEC CJSIGNS OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CHECK BY—�`_- HEAT--_--- o ism#6 Les double faced ,pieta ng Palo _- — ---- _-- OCC, LOAD _ FLOOR LOAD HEIGHT NO.STORIES AREA VALUE A BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE W _ NApproved 10,00 - 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 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH ALI. APPLICARI E CODES AND ORDINANCES. THE ISSUANCF OF THIS PERMIT DOES NOT WAIVE -- RESTRICTIVE COVENANTS CONTRACTOR AND SUB CGNTRACTOPS TO HAVE CURRENT CITY BUSINF._.S LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING. luo ug n�rt is rwt uR iia i e Receipt No. ' "" nitl>RF tiS �r�i 4 , DATE INSP. T;4E INSPECTION REMARKS PLUMBING DATE Contractor Permit No. �llRou h-in Fixture Final �J HEATING Contractor Permit No. Gas or Oil Rough m Final SEINER _ Final DRIVEWAY L J-3c 7�0 Final Storm Drainage (Rain Drain) Final �^ Sidewalk Curb&Street Final Approach Jo -71CBLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Landscaping Zoning Final 1 I 1 �w Address Z .s5���.��, -� Name of OccupantPermit ci,arge __,T Connection fey: 6 -- ----- --- Paid by_ Date connected Type of Building . _1fL'ITLI /�i Inspection fee____ Service Rate_ Paid by - Date_._ i Contractor - ------ -- _ _ Assessment --_--—- —Paid -- Size of connection­ ; C iI �t APPLICATION FOR SEWER SERVICE The undersigned agrees, in consideration of the sewer service connection by the Tigard Sanitary District, to abide by end comply with the ordinances, regulations and rules of the Dist- rict presently in effect or hereinafter ei acted and to pay sewer service charges as the same may be im- posed from time to time when due and before such charges become delinquent. I fully understand that all unpaid sewer service charges become a lien r,.pon the 4' property served as stipulated in O. R. S. 224.220. Connections to the District's system must be made by bonded contractors and/r bonded and Iicense3 plumbers. Owner APPROVED BY Superintendent TIGARD SANITARY DISTRICT 8841 S. W. Commercial St. Tigard, Oregon ii. i i LV � ? 121-7 s Addressh,�►JA A w � ,permit No, r' E Jf Name of Occupant ( 2 Permit cha 11 �.� _ -- _�1..� Connection fee -- _ aid by C�lu --- Date connected `^ i ! Type of Buildinq'� � _ Inspection fee._ Service Rate_-_ / Paid by Date Contractor Assessment _ a Size of connection _ J / l J Address Permit No._ Name of Occupant_ _ Permit charge 1 Connection fee-- --- -- ---- Paid — Date connected Type of BuildingInspection fee - Service Rate-.--- Paid by _ Date._......._-__-- Cor tractor—.—_---...__.__-------_..---__-- Assewiment—______-.... _---Paid -- Size of connection 1 lo Address S.� i /.�, �t Permit No. - -- Name of Occupant G Permit charge Connection fee--- Paid ee _Paid by - -_ Date connected Type of Buildinq Inspection fee Service Rate Paid by _ ___ Date Contractor.-----__— Assessment_--- - -_._ --Paid___-- Size of connection 1 Addreas / 'S _ � i �_ `}�a�� u a Permit No._— ` 23'1 Name of Occupant Permit charge 5-_i 5 g lG'.0 (� - --------- .... — _-- Connection fee J d d, .0 ) _----------_-_-- ___ Paid by.4_a_7 -- — -- - _. date connected Type of Building��7 1�>�J' ''��Q -- -- — ! `�' Inspection fee Service Rate �,(I Paid by _._ ____Dat® Contractor -------- - Assessment___-_____ Paid Size of connection I i i i Address Permit No. Name of Occupant cd' Permit chdrge Ccnnection fee Paid by__ Date connected Type of Building Inspection Service Paid Contractor Assessment—- Size of connection i sir o� d �- D d o �,•t.. .p .L t Address�� t Permit No.------- Name o.___—_ -Name of Occupant—�3_ z Permit charge p arr Connection feo_— _--- Paid by _ Date connected Type of Building_._ —. _.__ Innpection fee Service Rate .3, _____ Paid by _Date.-- Contractor _ Assessment—_ ----Paid ze of connection _