9740 SW PEMBROOK STREET-1 WIN
9740 SW PEMBRDOK STREET
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City of Tigard Mechanical Permit Permit__=-
Fee
New Installation I--1 Replace 11 Relocation
❑ Addition Ll Alteration ❑ 3%State
TOTAL---
CO'
OTAL _CO' 1 RACTOR __ OWNER
ADDRE.%_ WORK ADDRESS__ --
PHONE _ — �.� APPLICANT --
Heat Input Rating (BTU Per Hour)— Vent. Size �.._ Flue Size ___
FUEL OIL ❑ GAS ❑ ELECT ❑ OTHER__—_____
ITEM NO. FEE 1IKM NO. FEE
- - -� 3.00 Air Condition Compr&sor 15 to 30 HP 10.00_
For Issuance of Permit__ _ _ 3.-06-
4.00--
0_
New-Under 100,00()BT_U 4.00 Air Handling 10,000(:FM
_Ne_w_ 100,000 BTU Si oover — 5.00 Air Handling Over 10,000 CFM — 5.00_
4.00 Evaporative Cooler 3.00
Floor Furnace — -- �- 2.00
_Wall-Floor-Suspended 4.00 Renge Vont Fan
Install Vents Only 2.00 Vent System -i.00
4.00 Hood Commercial __ 3.00_
Repair -Heat&Cooling _ ---� _ 10.00
Air Condition Compressor Under 3 HP _ 4.00 Commercial Duct System
Air Condition Compressor 3 to 15 HP 7.50
INSPECTOR'S COMMENTS---
CITY
OMMENTS --CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPRCVFD BY _____._.____—__ DATE _ ISSUED BY __ DATE
RECEIPT NO.
77A Signature of Applicant
BUILDING PERMIT APPLICATION Co Y TlGf,%M^ DATE a '______ 1�—__
,a:564E3UU
THF UNDERSIGNED HEREBY APPLIES FOR APERMIT FJR THE WORK HEREIN INDICATED BUILDER PHON
OR AS SHOWN AND APPROVED IN THE ACCOMPAN`; NG PLANS AND SPECIFICATIONS. OWNERPHON�T�yp��
x 1.11E JIUUU
" -SUE)di
OWNER lr
?(ihn artiutt: JOB ADDRES0740 SLI I)*irbrook HOME ADDRESS. �JtJd f e`J V11 ion
�3 IBN6JU'."•fu ARCHITECT
�y
ENGINEER
BUILD ISI n 6jyn, lwe PU01.8i ADDRE-422)00 SU_Toriquin Rork, DESIGNER all& d• uoughan
STRUCTURE ri NEW ❑_REMODEL ❑AUDITION_ -REPAIR ❑RENEWAL ❑FIRE DAMAGE DDEMOLITION
ITR ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIG�OUSOPAT10 ❑CAR"f:RT—DGARAGE (:]STORAGE CISLAB [:]FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.APPROVED USIGNS
0CCUPANCY_!i_—_2i_LAND USE ZONk=+ __BLUG.TYPE—_- _.,1=1RE ZONE 3 PLAN CHECK BY TIs) HEAT y
swilii INQ P0.1 _- Alk pcvr plane for john bartlat;t rjy hulls be uoughen, Pit .
1"yFjw g RjUst Us in_L�Is :e buf 0TO peal is Gilled - Loll for inspection before- -
QQ<'.. LOAD F1QS�h1S?A� . ------ JHE1_CHI--_______ NO,StOBI€;is__ AREA __._ � S `,,,', �u
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit ----.— - -_---- --
--�� THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANO SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total i4*00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO YAVF CURRENT CITY BUSINESS
State TAX 1.44 LICENSE. SFPARATE PERMITS REQUIRED FOH SEWER, PLUMBING AND HEATING.
Total a ;.44
By pI -__------ _ _ .--- -
APPLICANT OR AGENT
App-oved idelden Rf,cf iht Nf,
�► ww w www
DATE IINSP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
—
Permit No.
— Rough-in
Fixture
Final
— — -- --_..---- -- HEATING
Contractor
—� — — Permit No.
-- — Gas or Oil
Rough-in
�— --_ Final
SEWER
Final
-- ----- - — --�--
DRIVEWAY
Final
— -- Storm Drainape
— ------- ------ (Rain Or i;n)Final
— — _-- -_-- Sidewalk
------ _ --_- Curb rk Street Final
Approach
BLDG.DEPT.FINAL - Tt`_MPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -----
Landscapiny
Zoning Final ��
.3 JIL DiNG PERMIT APPLICATION CITY ri OF ,'.RD DATE._
--F .1%,)� 4E1IGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HERE III INDICATED BUILDERPHONv43L
+ Ac SHCWN AND APPROVED IN THE ACCOMPANYING PLANS AND CATIONS SPFCIF AOWNER P al 1E 670 -:0 �-
f� p J ��.���7�+/+ r/ ���jM1LKpO �MkR-OT NO.ARCHJ������r�
JOf3 ADDRESS �'_2� � S
�_IiY—L�fLIC�` HU�.aE_ NLICJF7xSS�I V• T��,�`�SI�
7 IT , L-� I
/ /� .BOL /7-5F.R LIEN <'K-1'�'�� ADDRESS 12-coo (.'�.� G/V /��,.,,_ ENGINEER
DESIGNER
UNE EW OREMODEL — OADUITION w ❑REPAIR ❑RENEWAL [:]FIRE DAMAGE ODEMOLITION
p�!IC I.JCOMM ❑EDUCATIONAL ❑GOV'T ❑REt.IGIOLKOPATIO ❑CARPORT OGARAGE OSTORAGEOSLAB [:]FENCE
?OND ❑MOVING OCONDITIONAI USE ODESIGN REVIEW OCOUNCIL APPROVED OSIGNS
dh
I",-NCY LAND USE 70NE.—K 1,--.-BLD
_. _BLDG TYPE.. FIRE 7ONF1 PLAN CHECK
- - - - --- ���+-fit -�-•b�•.--- '-- ..1'-�. __�' -- — -
01 117 L-Q!+Q _, ._FLD9p_LQAf� —_�F�StH1_._ YA. E` _
BUILDING DEPARTMENT SET BA K5 FRONT REAR LEFT SIDE RIGHT SIDE
Firnit
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check_ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE 1
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH '
ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
I
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CCNTRACTORS TO HAVE CURRENT CITY BUSINESS
Stele Ta LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HE
AT
Total — u
i3v OTC 7?
A i (CANT OA A3ENT
ATcimed jkgpipl No /IvoO �,4 7t yk
Y �
4
i.
r
■ li WHOM
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i
?ddress Permit Na.
Permit charge 22Qr,
9uner. .•
ct �� -� I c fLL Connection fee
Paid b y
+ype of building Date connected 41A
:;arvice rate % InSpect.ion fee
Contractor Paid by date
5.iza of connection Assessment Paid
i
BUILDING PERMIT APPLICATION ceFy TIGARD DATE_____—___---_ 19_.ZL. e�n
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WnRK HEREIN INDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
LOT NO. L-
_ larttett
OWNER John a Gauna J(:)13 ADDRESS A.' PasbroG)c HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER :utile A;i !>ovv- —ADDRESS Karen 6t. DESIGNERr-��
STRUCTURE _ENEW ❑_REMODEL. LJADDITION El REPAIR _ ❑RENEWAL DFIRE DAMAGE ❑DEMOLITION
DRESIDENCE [:](.)MM ❑EDUCATIONAL ❑GONVT ❑RELIGIOUS OPATIO ❑CARPORT [:]GARA(;E CJSTORAGECISLAB [FENCE
OBOND ❑MOVING QCONDITIONAL USE ❑DESIGN REVIEW ❑COUNCI'_APPROVED CIS-GNS
r
�CUPANCY I —LAND USE ZONE_— BLDG.TYPE--.-5 � FIFE ZONE__.. PLAN CHECK BY +___— NEAT a
c.ow tir w- Jingic cr►mily &)-! Ling, w/Attached garadIL
QQC LOAD --ELQQR LOAD 4() HEIGHT 20 NL STORIES 2 AREA X164 ND$F,D.ftQ-Q�= _Y..A1LlEs`��
BUILDING DEPARTMENT SET BACKS FRONT REAR 38 LSFT SIDE RIGHT SIDE lt,
Permit SilS'.90 � _ = -- -_------
"— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS <;ONTAINL•fl IN THE BUILDING CODE, ZONING
Plan Check ,3•SO RFGVLATIONS AND ALL APPLICABLE CODES AND ORDINANCES. ANI.- IT IS HERERY AGREED THAT THE
WORN WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIr#NB AND IN COMPLIANCE WITH
Sub-total 280.50 ALL APPLICABLE CODES AND ORDINANCES THE ISSIJ.*J':E OF THIS °F.RMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRAC11011t; TO HAVE CUPRENT COT BUSINESS
State Tax 11.22 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 291.72 Pei k u6Yvc0lupillulit L416t b(d Jolut .
By 1 ; --
APPLICANT OR AGENT
Approved Receipt No.
--- - --- -
AaD" mss— -----'- 1
UATE n I�NSP. TYPE INSPECTION REMARKS PLUMBING DATE
Coiltractor
b-►�-�17 _� Permit No. -4132
]Rough-m _ `^
r�-2. —Q I< Fixture
$ Plo''tOVE� -tc�. gev.0 Final
_ HEATING
3 -rte eCtio� _ 6 G Contractor _
e Permit No.
Gas or Oil
t ,y—
Final -- --
3 -121
2 —4 - SEWER
_ Gr►t/ r/tet "� -f�•�/4�LJ�/Z1ts/L � ,181 — -
_�I1Z4il/1t___(z 11 J7-ym ATIiD A�11� DRIVEWAY —
1:7S'T• 62;0 eA4hIA4,140-) �Nll� 2jZ* _I Final ----. _
���-}����(-� ��� A� ms's-►A.✓A ar Storm Drainage
�r i4"r�9Jg J (Rain Drain) Final
_ Thy"' _ _ Sidewalk
-�� OK Curb&Street Final
_ A roach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Itoning Final
I
G
17-5-
SEWER
75SEWER PERMIT y//3177
N° 13769
Unified Sewerage Altency
of Washington County I TY OF Tigard DATE WSe tember 13. 1977
OWNER: _,Inhn E. & Launa M Bartlett PHONE
OWNER 'S ADDRESS: 126b SW Karen Street #6. Tigard Oregon
TYPE OF INSTALLATION:
®BUILDING SEWER �BUILCING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
["j(fNEW OX SINGLE FAMILY COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 '. MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS l
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE—HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE E 600.00
CONNECTION CHARGE 25.00
SIDE SEWER INSTALLATION _
ISSUED BY
OTHER
TOTAL 625.00 _--
APPLICANT r! DATE
NOTICE: DAYS OF THE
ABOVE DATE SEWER SERVICE
CHARGE WILL BEGIM FOR THIS
PERMIT SEWER PERMIT NTV 13769
ADDRESS OF STRUCTURE 974Q SW Pembrook, Tigard. Oregon _
TAX MAP TAX LOT SYSTEM Fanno Creek
LOT 12 BLOCK OF
FT4► __ 9-13-/7
APPROVED BY DATE ISSUEW BY DATE
REMARKS
r s w
CITY OF TIGARD
ORDINaNCE T'-
STREET SYSTEM DEUELO�MENT CHARGE
DATE • s ❑ n112�L13�._1.9-7Z ESTIMATED SALES PRICE $ 50,000.00
APPLICANT NAME john & fauna Bartlett TELEPHONE
JOB ADDRESS 274Q—SW Pembrook _ BLDG. PERMIT #,_L6_90
AMOUNT OF FEE FOR S. D. C . $300.00
DESCR.IPT:--N OF IMPROVEMENT Single Family Residential Home - New Construction,
EXF"('1PTI jNS -PER ORDINANCE #77-26
FEE RATES: _
A. Single family dwelling unit under $oU, 000. ------- - 300.00
B. Single family dwelling unit over $60, 000.--------- 8400. 00
C. Mobile Home Court Space (New Development)--- ------- $150. 00
D. Multi-Family Dewllings--per unit------------------- $240.00
E. Commercial , Industrial & Institutional ( P:�rk . Space) $ 50. 00 each
F. Single family unit under $40, 000. ------- -------- $250. 00
CITY OF TIGARD
ORDINANCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE
DATE • S ntember 13, 1977 ESTIMATED SALES PRICE
APPLICANT NAME John & L.auna Bartlett TELEPHONE #
JOB ADDRESS 9740 SW Pembrook BLDG. PERMIT #_1690
AMOUNT OF FEE FOR P. D. C . 5100,0Q
1
DESCRIPTION OF IMPROVEMENT Single Family Residentja hom - NEW Const12ct1v1L_
EXEMPTIONS - PER ORDINANCE #77-71 _
FEE RATES:
A. Single family dwelling unit under 440, 000. ------------ $ 75. 00
B. Single family dwelling unit over $40, 000. --------------$100. 00
C . Mobile Home Court Space (New Development)--------------$ 50. 010
D. Multi-Family dwellings--per u it-----------------------$ 60. 00
CONSTRUCTION IS LOCATED ON S.W. N.E . SIDE OF S PACIFIC
HIGHWAY . N.E . is Perk District #1 . (—S W. is Park District I-T�.-:�
r
- iJli..DiNG PERMIT APPLICATION yp' TIGARD DATE__y�.�!� ,9_�? N2ll� v
•4i LI' N r HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
.-P AS Sty 4ND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICAI IONS. OWNER PHONE ---
+� ? LOT NO.— /�� y
NJN C_ f .ks. rLt T109 ADDRESS �!L,� S.W / fM/liloul�.--HOME AUGRE /2SS � 1��� S.GG'. //SLC-A,
ARCHITECT
/ ENGINEER
�-f�L�4A if ADDRESS Z�6� SW /��tf�✓_ Y• I��_ DESIGNER
..RE _ 1 %E_w__ ORFMODEL L.J
-- ❑ADDITION ❑REPAIR RENEWAL [:]FIRE DAMAGE ❑DEMOLITI-ON
r� ;JN('E _ (IKAM-OEDUCA-TIONAL OGOWT ORFLIGIOUSOPATIO OCAR PORT ❑GARAGE OSTORAGEOSLAS ❑FENCE
�-"'ND OMOVING 000NDITIONAL USE ❑DESIGN REVIEW OCOUNCII.APPROVED OSIGNS
NC'Y I N[! USE ZONE ___ BCUG TYPE ., FIRE ZONE. PLAN CHECK By HEAT
4
— _ _ -------- -- ------- �_ i 14- `4 5—b --
J— --tea•
AD FI.QyFi�SJ1�D - -— �_ H�!.GHi_. �--NQ_SIQRIE4 _--PR�91dl� Nc,HEDp412MS �' V A L Sb
BUILDING DEPARTMENT 5E1 PACKS _FRONT REAR LEFT SIDE a RIGHT SIDE �.
irntt - - — (a U
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
"Ian Check 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
uh Iotai _ �( CJ ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-'— - RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
lair lax- - J / 7-'L LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
T c,1al 24_ ` Z
by -------
- ---- �> APPI (CANT OP AGENT
%wwoved �t celp. No.
PHONt --_---
_3
I
Permit Issued_ _ CITY OF TIGARD, OREGON Permit No._
City Hall
Application Approved Building Department Cost of Installation
By-- 4pp call" dme /�e�tnu�, n�is�r�ii�sgjjWdta& lars
Cee for Permit �
A pplicant shall fill in c,)st of installation only,
Date__ _ _ - above this double line, Street Sewer Permit_.--
---- -—__._ — ----_
repair PlumbingPipes or Fixtures accordingspecifications and
Install
Application is hereby made to alter descriptito n as given below: plana and p
Location of buildirig--Number and Street_ Sg40 -8•W• RDD)K
Lot_ Block____._ Addition_
Name and Address of Owner_ JOHN BARTI.E,"TTI�eM�- P'E7MBROOK
Name and Address of Plumber_ LAW A -SONS 9:300 N.E. HALSEY POH'1'LAMD _
Building (Old or New) _—_ Height in Stories _._ _. . __ Occupied as
SCHEDULE OF WORK
_ NUMBER I NUMBER
I
- FIXTURES I New 1 I
Move +R'pl'ce FIXTURES New Move It'pl'ce
Water Closets____ _- aFountains, Drinking
Bath Shower__ _��� Fountains, Yard--
Bath Tub. _-- --- Fountains, Soda.__--- �—
Basins ------- � II 1 --------•
1._----I--- Hot Water Tank-
Sinks,
ank_Sinks, Ordinary__ 1 Sinks, Bar_______.
Sinks, Dishwashing ( I__--� --` _
_I!<. — Sinks, Slop
Automatic Dishwasher _+ 1 _ Drains, Refrigerator _
Laundry Trays--... _-. . Drains, Ice Box
I I
Drains. Floor_..._ __-'.-- Urinals
Drains, Area—_ _ I Catch-Basins, Yard..-_—__�_
Rain Drains.._ _ I _ LCatch-Basins, Garage—. _I_
Automatic Washer__ 1 Catch•Rasins, Sub Soil-I_ I_
Water Permit No._-- — Bldg. Permit No,.
REMARKS: - --
11 RIXTURI f 3e00 MOO
SURCHARGE
TOTALPEWIT _. -_ 34.32
1 Plumbing shall not be installed In any building, (either new, altered,or repaired), except as shown or designated
on the corresponding building plans as filed with, or re 'red by, the Building Department in accordance with the
provisions of the Su (ding Code and Ordinance 62.19 of the City of Tigard.
repair
r the plumbing system according to this description, dans and specificationrand the Plumbing Code of the
Install
[ ag a to alter City of Tigard. p I
_.
ter'
Plumbing Firm_._-41w