9755 SW PEMBROOK STREET 9755 SW PEMBROOK STREE
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ADDRESS _%SS S PERMIIT NO. 4 Y S
PERMIT CHARGE none
nVlER CONNECTION FEE BOO
PAID BY
YI�F: OF BUILDING DATE CONNECTED
E VICE RATE INSPECTION SFE j
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION _ ASSESSMENT _ /PAID
f SERVER PERMIT �--`�
N? 13859
of Unified Sewerage Agency
of Washington County C- .( i " 01 _._ Tigard _��_ DATE -
OWNER: �Mr. & Mrs Victor Seeber PHONE :
OWNER 'S ADDRESS:
TYPE OF INSIAI_LATT0.1;,
BUILDING SEWER BUILDING SEWED AND SIDE SEWER
TYPE OF OCCOPANCY:
XXE3NEW XE3XSINGL.E FAMILY ❑ COMMERCIAL
❑F_XIST . (PRIOR TO 7 - 1 - 70 ) [j MULT. RES. l_] JNDUSTRIAI_
FIXTURE UNITS DWEL-LTNG UNITS 1
PERMIT CONDITIONS: 'HE 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 WILI.
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
tERMIT FEE 25.
CONNECTION CHARGE 600. r
.SIDE SEWER INSTALLATION t)LA) �
_ — 1 551 ED BY
OTHER
TOiPI $ 625
ADPL I C ANT DATE
44
L ►L: i+ , . SEWER PERMIT N 13859
PEHi�It.
ADDRESS OF STRUCTUPE 9755 SW Pembrook Bt.
TAX MAP TAX LOI SYSTEM fannocreek
LOTS BLOCK El _
APPROVED BY DATE ISSUED BY DATE
RFMAf7K�>'hld9• #1018
15 BUILDING PERMIT APPLICATION COFIG�RD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONtp43-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
LAT 1 1 L _
U Pembrook ��r.
OWNER Mra 'ILGtOr .�F3 6,D�ESS HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER 1,1.1m juhnfAurl ADDRESS, ald4j_ i 13 PrC]I;AGlsli DFSIGNER
STRUCTLRE XUNEW El REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DE.MOLITION
❑RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO CIGARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FEN CE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
QC�CUPANCY I LAND USE ZONE BLDG.TYPE FIRE ZONF_ PLAN CHECK BY L':• J HEAT-
c�tlat. sir,,41 �a f rimily owellinij w/attschud WarafAw
3 bwdrn.Jm 3 hath
lh 2 2824 U00OD0.
4g��.19AD.__--__._ELg9R LOAD - NEIGH]_ . Rg S QEUL._ ABEA NO.BEQBOQM;:_�V LUE
BUILDING CEPARTMENt6
5ET BACKS FRONT 2') NEAR 48LEFTSIDE � RIGHT SIDE
Permit 207.00 _
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF BUILDING COLE, ZONING
Plan Check 10315U REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DUNE iN ACCORDANCE WITH THE PL AMS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 310.50 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RcSTRICTIVE COVENANTS. CONTRACTOR AND SUB C"JIMTRACTORS TO HAVE CURF ENT CITY BUSINESS
State Tax 8.28 LICENSE. SEPARAT:' PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
.i .. s
Total X10.68 pouec• #k *100.
By --- _ -- __
APPLICANT OR AGENT
Approved - Receipt No.
_ — -- - - --
D KESS PHUrIL
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
T
ontractor —
J _ rftv.e_ L /Le�n�• Permit No. 13~I — 4/6
Al Roi�in-in
�- -� - -► ' Fixlure
1
Final
n HEATING
r-
-79 „t ���`— _ _^ Contractor
J�- J — —`----- --- Permit No.
Gas or Oil ^
"Sa`:5�,�.nv.[L. _—�----
_ Final
_— — SEWER _.._
_ Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT. FINAL TELSPORARY CERTIFICATE UCCUPANCY
CERTIFICATE OCLUPANCY Final
Landscaping
C.- Zoni•ig Final
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CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE : 12-15-77 ESTIMATED SALES PRICE S '72 , 000.
IPPLICANT NAME Victor Seeber TELEPHONE n ,i
JOB ADDRESS 9755 SW Pumbrook Dr. SLOG. PERMIT m 1618
AMOUNT OF FEE FOR S. D. C. ; 300.
DESCRIPTION OF IMPROVEMENT S.F .D. `
EXEMPTIONS -PER ORDINANCE #77-26
FEE RATES:
A. Single family dwelling unit under j60,000.-----•----- 3 30U Q
B. Single family dwelling unit over 350,000.--------- 3400.00
C. Mot i.le Home Court Space (N ai Development)------- 5150.00
D. Multi-Famiiy Dwellings--pe, unit-- _____._..___...____ $240,00
E. Commercial , Industrial R Irstitutional (Park. Space) 5 50.00 each
F. Single family unit under 540, 000. ------------------ S250.00
CITY OF TICARU
ORDINANCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE
DATE: _12_1_S-77 _ ESTIMATED SALES PRICE $ 7
APPLICANT NAME Victor Seeber TELEPHONE {�
JOB ADDRESSg7=,s si,i Pgmhrnr,,L, Dr BLDG. PERMIT _Iola
AMOUNT OF FEE FOR P. D. C . _ 9100.
DESCRIPTION OF IMPROVEMENT S.F .D.
EXEMPTIONS - PER ORDINANCE #77-71
A
FEE RATES:
A. Single family dwelling unit under $40,000.-------------$ 75. 00
B. Single family dwelling unit over 540,000.-• ---- ---_ 100. 00
C. Mobile Home Court Spare (Now Development)------------- MOD—
D.
ODD. Multi-gamily dwellings---per unit-- ---------_-----_-- ..� b�� 00
LONSTRUCTION IS LOCATED ONXXX 5.i=' i. N.W. SIDE OF 5. PACIFIC
HIGHWAY. N.W . is Park District #I. = i Park Dietri-t #II.
/ >
�jILDiNG PERMIT APPLICATION 10 Y TIG,!kRD DATES�_�1�' Np
LINDE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF�y3
LiEi AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICA'rIONS. O"ER P o e
LOT NO.
, HOME ADDRESS
ARCH:T'#-T
Rl,,,pppI ENGII ER
- _ ADDRESS ��9Q W_ - - /4.� _ DFSIaM'R —
-1 REMODEL ❑ADDITION_ REPAIR RENEWAL 13FIRE DAMAGE ODEMOOTION
' ; INCE OCOMMFOEDUCAT10NAL OGOV'T ORELIGIOUSOPA110 OCARPORT OGARAGE OSTORAGEDSLAB OFENCE
1 r•p 13MOVING _ ((OCONDIT_IONAL Ust ODESIGN REVIEWOCOUNCIL APPROVED ❑SIGNS
LUFANCY ,� -IND USE ZONE JI__7�1_BLDG TYP�� FIRE ZONEr7�r_ PIAN CHECK BY.
-
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"AC2 _ FLOQp1S?BQ_. H_ I HL_— ._ �1Q._$IQRIEE_ Eta"S�Q 4NOE_EQRQOMS Vigj�UE_
UILDING UEPARTMEN7 "�
_ —[{_ SET BACKS FRONT 2 J _— REAR_ If` -- LEfT SIDE—� RIGH1 SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
^Ian Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. A4EJ IT IS HEREBY AGREED THAT THE
WORK WILL BF. DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIGNS AND IN COMPLIANCE WITH
h 101al At L APPLIChBLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT S^IAIVE
O pRLSTRICTI%?t COVENANTS CONTRACTOR AND SUB CONTRACTORS TC HAVE CURRENT CITY BUSINESS
tate Tex _ 9 LICENSE SEPARATE F[aM1IS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Tu181 � m
BY --------._ �_.—_—..----. ---
_�__. A.PPI ICAN1 OR AGtNl
Approved Receipt No
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