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BUILDING PERMIT APPLIVATION SOF TIGARQ DATE
THE UNDERSIGNED HL11EBY APPLIES FOR APERMIT FOR TIME WORK HEREIN INDICATED Ht IILDERPHONE �,..,�
OR AS SHOWN ANC APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE--
LCT
HONF _-LCT NO.
OWNER r� I_.f,�f l:r L. Cl r JOB ADDRr7SS-' 4420 SL HOME ADDRESS
ARCHITECT -”
�tBff11B ENGINEER
BUILDER t--t ADDkRS DESIGNER _
STRUCTURE X@NI:W ElR'MODEL —_❑ADDITION ❑REPAIR ❑RENEWAL []FIRE DAMAGE ODEiMOLITION
Q'0ESIDENCE ❑COMM ❑EDUCATIONAL ❑GCV'T ❑RELIG!OUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN RC--.VIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY— L--_ LANO USE ZONE—.—,---L—BLDG,TYPE'' F .F IRE ZONE PLAN CHECK BY_ E L t,: HEAT_��__
frnsily dwdllin�j w/lattec;had garw A bourruum 2 both _
Q-Q'Q LQAQL -ELOQt-JWA1)—Af) __ NEI..G IT LID NQ3IM.ES 1_.__AM-A—i1 i2RQ-QM.S4-__y.ALSlE�a��+�_�
BUILDING UfPI'.RTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 16ll100
tN15 PERMIT IS ISSUED SUB:1'CT TO THE REGULATIONS CONIAINED IN THE BUILDING CODE, ZONING
Plan Cher k 80*00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE W'(H THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total j40*J)() ALI. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENAN.'S. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 411 LICENSE. SEPARATE PERMITS REQUIRED I ^ SEWER, PLUMBING AND HEATING.
Total So£ro'L• OUU&
By �. ;� 3r«� $1.pU•
A PLP ICANT OR AGf-NT `— —_—._
Approved +l al Receipt No
xW
IN
DATEINSP. TYPE INSPECTION REMARKS PLUMBING DATE
�~. — y Contractor
n—fib- P�rmitNo.
C 7�[i3.-. _� Hough-in
Fixtuf
— -�j.--ice_�%t5 �7 ��. �7_-_��� •��e� Finar_._� — — —
., HEATING
iCrtyty _.Z'�m � ' 1SLd '- crud [ Contractor
tns �Zr. �.c` ��_e s«�e.� =Y. z 3 2 V -- y_/2 �8
Gas or oil
./ AL'h_ Rough-in
Final
SEWER _ - _ ----
Final
DRIVEWAY —
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
_ — Cura&Street Final
Approach
r3LDG. DEPT.FINAL TEMPOPARY 7 CERTIPICATa OCCUPANCY_ Final
:EPTIFICATE 1,CUs"%NCY /
_ n — —
r �/ Landscaping
Zoning Final
Rim
SEWER PERMITu s �
U 4
N • 15909
Unified Sewerage Agency
of Washingtcn County CITY OF _ Tigard DATE 5-12-78
OWNER: Dale Const. Co. _ PRUNE :
OWNER 'S ADDRESS:
TY°E OF INSTALLATION:
>FXJ>8UILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY-
XD NEW
CCUPANCY:XDNEW " tM NGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO 7-1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS_
ADDRESS OF STRUCTURE : 1 �L�n SII H7+I,S1
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 UNE.-
HUNfREC AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE $--23—
CONNECTION
75CONNECTION CHARGE f,nn.
SIDE SEWER IMSTALLATION
OTHER
ISSUED BY
TOTAL $ 625.
-`-4PPLICANT --
DATE
15903
ADDRESS
N"
SEWER PERMIT
ADDRESS OF STRUCTURE
144205W 87th Ct.
TAX MAP TAX LOT SYSTEM fanno creek
LOT 20 BLOCK OF
rp
E. �1,19�deri 5-12-78 r , •'�✓
APPROVED BY DATE ISSUCD RY Cif
DAT =�..—.
I C'
I D.U. ' S 1 _ REMARKS bldg. #2096
Z'UILDING PERMIT APPLICATION CIT'IF TIG"•RID DATE -�_: ' 19-.7� TAY
ai i DE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE: WORK HEREIN INDICATED BUII.,DER PHarJ�V-.- '2-- -3j61
f ' q; %I ND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICAT IONS. OWNF..R PHONE—
(J�` _ LOT NO.
N - JOB ADDRES 4 ` HOME
ARCHITECT
ENGINEER
"•e.R ADDRESS DESIGNER
4
URE % ❑REMODEL El ADDITION �QREfA1R ❑RENEWAL UFIRE DAMAGE DGFMOLITION
' '[II NCE DCOMM DEDUCATIONAL OGOV'T DREIJGIOLIS DPATIO ❑CAR PORT OGARAG� D STORAGE DSLAS ❑FENCE
�- 'ND ❑_MOVING DCONDITIONAL USE rE IID�LSIG_N REVIEW DCOUNCIL APPROVED [:]SIGNS
:.N;1' MD USE ZON � BL — PE _.aJY—FIRE ZONE PLAN CHECK ECK BY—4+ G�--,— HEAT__
-- --=- DG TYPE -z-- --_
__N
`'uLl
- F L O-QP-L QAD-_ Z HEIGHT �_-N�4,_;�Qpll;�__. "-AP���1'1..�1SL@E�H99�_--..YALl1E
BUILDING DEPARTMENT — SET BACKS FRONT RE AR LEFT SIDE RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE. REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check G1 �-�/ 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 WIT14
Subintal ALL APPLICABLE CODES AND ORDIVANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
` Lir lax V LICENSE SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
TUial..�_.—
__.. .. � APOI (CANT 00 AGENT
,I I roved^ Rererpt No.
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City Of Tlciaf d Nto hati cal Fcrtuit NY
New Installation L: Reo!ace ❑ Relocation ❑ Addition ❑ Alu:ration 3a State`_
CC":TRACTOR
ADnRESS_Zd/.Z1_ 5, /HO_1 ��_ �•._..__Q•C• WORK ADDRESS �/�_
PHONE _ -"�.Z_�,Q APPLICANT__C�! _1
Heat Input Rating (BTU Per Hour) Vent Size J Flue Size
FUEL OIL GAS ❑ ELECT O'rH E R-______. __�
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit _� —� _3.On Air Condition Compressor 15 to 30 HP �� 10.0_(
T New Under 100,000 BTU ✓ 4.00 Air Handling 10,000 CFM 3.0C'
New• 1 oU,0d0 BTU&
over S.CO "Air_Handling Over 10,000 CFM _ S.OG
_�---1___._�
Floor Furnace _ 4.00 Evaporative Cooler 3 UG
_Wall • Flow Suspended 4.00 Range Vent Fan 2.00
Install Vena_Only 2.00 Vent System
Repair •_Haat &_Cooling � r 4.00_ Hood Commercial _..__� 3(►''
Air Condition Compressor Under 3 HP ' 4.00 Commercial Duc System tU OG
it Condition Compressor 3 to 15 HP 7.50 _
INSPECTOR'S COMMENTS______
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVED BY. DATE ISSUED BY _ DATE _
RECEIPT NO.__. _____.�_
Sinnatiiro of Annlinant
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P.:�r m i t r..h n r j r rte 0-n �
N� "-,nnr,c.ion Fe ---
Paid by
Date connectRd
In pection Fee
Priid by date
Assessment Paid