15130 SW 92ND AVENUE-1 15130 SW 92ND AVENUE
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PERMIT NO.
ADDRESS W �r-�-
PERMIT CHARGE none ._.._.._.r-
CONNECTION FEE
OW%ER �4d
PAID 8Y
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TYPE OF BUILDING ��, - DATE CONNECTED
SERVICE RATE ��' � INSPECTION FEE o2S• 1
CONTRACTOR
PAID BY DATE
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SIZE OF CO�,,,ECTION A55ESSMENT _ PAID
CITY +f 9
BUILDING PERMIT AFPLICATIQN o f TIGARD DATE 10 �
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE G44�3t;,-4
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE — qq
LOT NO.——..2Z
OWNER I, J I',:.yi, -�i Pow i L a r JOB ADDRESS 1.30 5W 192nd HOME ADDRESS
ARCHITECT
BUILDER ENGINEER
��--1I — ADDRESS 1 DESIGNER
STRUCTURE ONEW 1:1 REMODEL fr_1� `J_ADDITION REPAIR []RENEWAL DFIRE DAMAGE ❑DEMOLITION
u RESIDENCE ❑COMM DEDUCATIONAL I.JGC,V "f ❑RELIGIOUS
-]PATIO OCAR PORT OGARAGE D STORAGE OSLAR OFENCE
❑BOND ❑MOVING DCONDITIONAL USE DDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY "-3 LAND USE ZONE BLDG. TYPE FIRE ZONE PLAN CHECK BY F T _ HEAT_
,anatruct single family dwelling w/attached garage. .1 Oadroom - i ,,Alii. —
Sauer Permit 'F17451 -
1�°
1.10 20 lir 1416' • •°, X11 ,600.VC:
OCC. D_ __.___fLOOgLQA� HEIGHT f�0.STORIES_T iAB-F _____NQ BEDROOMS _-YALL
BUILDING DEPARTMENT SET BACKS FRONT 2(1 REAR 30 LEFT SIDE 12 RIGHT SIDE 12,
Permit 1175.00 —_ -- - - – —_--
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 87.5U 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
Subtotal 262,A ALL. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACIORE TO HAVE CURRENT CITY BUSINESS
State. Td)f6 7.00 LICENSE. SEPSUL ,ARd " E PERMIT REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total iw4U �.1 0
�626y. G PDC #2 - 1100.00
By P1
APPLICANT MR AGENT
Approved Receipt No. -- _
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DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
79 d b�_.t Permit No.
1941
Rough-In
Fixture
Finan --
N HEATING
Contractor
7 91 ;. Permit No. l
Gas or Oil
Rough-In
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
IRain Drain)Final
Sidewalk
Curb&Street Final
Approach
d.DG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -----
/� Landscaping
`j Zoning Final
DATE _
BUILDING PERMIT APPLICATION OF C►TY TIGARD - ' __�w
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK. HEREIN INDICATED BUILDER PHON
0"' 'SHOWNretk-1(-4J
APPROVE IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE __
C LOT NO
�N' / ADDRESS / L/�" / HOME ADDRESS
ARCHITECT
ENGINEER
�ER -�'^ ADDRESS DESIGNER
"ICTURE ld1NEW ❑REMODEL ❑ADDITION CIREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
ESIQFNCE ❑CO_M_M_D_ EDUCATIONAL DGD
OV'T RELIGIOUSOPATIO O CAR PORT DGARAGE D STORAGE DSLAB []FENCE
r2 OND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW []COUNCIL APPROVED — (:]SIGNS
AQ 0 PA Y_._ 2 _L D USE ZONE BLDG.TYPE -��f IRE SONE PLAN CHECK BY HEAT
T��
F_LOOR LOAD HEIGHT l�iL N.4.5IS2LIFS -_ LA�$EOROOMS VALUE
1 BUILDING DEPARTMENTSET BACKS FRONT 7,U REAR i!7 LEFT SIDE I-)— RIGHT SIDE
f t rITIt
- -- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODFS AND ORDINANCES, AND IT IS HEREBY AGREEC THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax L- LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PtUMBINo AND HFATING.
Total 7`v
BY _ APPLICANT OA AGENT - — ----
►\pproved� Receipt No
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SUiLDIrNG DEF';"%RT,`,IENT, TIGARO 0
PL.UI`�MNG3 PERMIT i
Central Plumbing—Inc. of Oregon , hoidar of a valid plumbing contractors license is hereby
authorized to cause plumbing work; as herein noted to he in talied in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the tiro a the installations are ready for inspection. City of Tigard Business License required ,
for all contractors and sub-contractors. ,(Q 7'` _79 ;{
Owrer �l�l �' Cr. 4?,c -�e� f1`/- Ad�ire:; Date_- — !
NUM3FR OF - TO.'
OTAL _ PERMIT NS
TYPE OF PERMIT ITE&IS FEE ON EACH I AINIOUN T (Office U:e Only)
Sinald Family-1 hash-each _ 25.00
Dwlex-Each 1 bath unit 25.00
Addicianal h-+::'ircum;-arch --
Mooila Home Space-each _ 15.00
INOIVIOUAL FIXTURE FEES
1 to 50 Fixturat in 1 hum;r,-etch 3.00 -`—
51 to 100 Fit:ar±t in 1 buildir"-!ach 2.50 — _ �-
101 to 200 F:nturrtt in 1 bu)I�i^. -each - " — -_ -- 2.00
201 e,mora Fix_iras in 1 building enh1,50
MISCELLANE0US
B-Aeir;Sd. ee-•1st 50 f!. --- _10.00
S*w*r-e.!ch ad,!i;1onAl '.0o ft. 10.00 _
to building 5.00 -- -- t
Private N12:. Svstems-ev_h trio It. _ — 10.00 —
oth••• (S21S A. j
PGii;,l1'f ForPiurr.'Irng P;rorr?639-:i71 / _M-
o Scala Plumf!inn Contractor By
TOTAL _:�f,yG_ RECEIPT NO. Isaueti By ___—