15200 SW 94TH AVENUE 15200 SW 99211 AVENUE —
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CITY CI F T16A RD Cffi�RD PE-PWIT NO . : 1303904460
COMMUNITY DEVELOPMENT DEPARTMENT DATE: :I.'%5(.JE:D : 3/:I.-7/(:9
13125 S W.Hall Hivd..15.0,Box 23397,Tigard,Oragon97223.(503)639A175 PPITM . 1::'M'T* .NO 8904160
J01%; a'.:) '.UO 5W 9X411A AVE�
I1')X MAPill-OT 'r.?5 1.1'1.1:)G:11. 100 SUB: DK :
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VAL.IJA11 ON: IN 5 ,000 SET EIACKS
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1 1.101 f).(, ofl'l I, 1 1:111 i.1) (:)Y I LJ Ily 'ri-ltcl (,)l::' No ,
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This permit is Issued qtibiect to the regulations contained In Title 14
of the TMC. State of Oregon Sp6cialty Codes,zoning regulations
and all other applicable codes and ordinances. and It Is hereby 14AJI,I I VILA) 1:NI!iI,i-I I I 1r,111
agreed that the work will be done In accordance with the plans and 10()'T ENG
specifications and In compliance with all applicable codes and I If 1-11 1111111
ordinances The issuance of this permit does not waive restrictive I
ovenants Contractor and subcontractors shall have current city .1 Wit 11, A 1 1.('.)N
business tax permits This permit will expire and become null and
void if work Is not started within 180 days.or if work Is suspended or (>Yr' 1:3OM-117
abandoned for a period of 180 days any time after work has NAI...
commenced It shall be the respoi,.41bilityofthe permittee toassure
all required pections are requested and approved
C11
*ci tide r f I.r)I)
permittee Sl Wure
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY O TIFA� � PLAN CHECK AF PLICATION v-
ctrrovncalm PLAN CHECK 11 ' "
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT N _ iC�4 G
13125 S.W.tion 91vd..P.O.Box73397.119ard.O,.gm9rM,(503)S:f9'1175 _� DATE ISSUED
MAP/LOT ,Z I' 2Z .LZ
JOB ADDRESS: .5 LAND USE:
SUB: LOT:
VALUATION: --
SPECIAL NOTES
OWNER ^ ,-2 REISSUE_ OF: _
NAME: LAST REISSUE: _
ADDRESS: /-�-^' `' ' `= `'� FLOOD PLAIN/ -
SENSITIVE LAND:
PHONE: �� O �' '� APPROVALS REQUIRED
PLANNING:
CONTRACTOR
ENGINEERING:
NAME: FIRE DEPT
ADDRESS: —" - -
- OTHER:
- _ ITEMS REQUIRED
PHONE: - LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
- T
CALCULATIONS:
NAME: -
TRUSS DETAILS:
ADDRESS:
PARKING PLAN:
- -- - — `- -�- LANDSCAPE PLAN: _
- OTHER:
COMMENTS: L i'�.� 4- / irS
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees --
w 10-431 01 Mechanical Permit Fees ---- -
r 1
10--230 01 State Building Tax (5X) _ --
Building _
Plumbing
Mech
10-433 00 Plans Check Fee --- "j=
Buildinq
Plumbing —
Mech
30-202 00 Sewer C -nnection _-__._- - --.----.- - -
30-444 00 Sewer 11-19pection ---- -- ---
51-448 00 Street System hev Charge (SDC) ---
52--449 00 Parks Sy-sLem Dev Charge (PDC) -
31-450 00 Sturm Drainage Syst Dev Chrg (SSDC)
10-230 09 TRFO ----
10-230 06 Washington County Fire M1 (99X) ----
10-220 00 Amart/Wedgewood -_----
TOTAL
REC M
APPLICANT SIGNf1TURE��-_---.--T----
krce i ved Hy: J Date Received:
cn/3587P/18P
ARCHITLCTURAL CHANGE RG UEs,r
PREPARE IN DUPLICATE.
In compliance with Section 1-11 of. Conditions and Restrictions
Welter Crow, Chairman Rich Charters, 639-8932 Paul Lane, 684-1736
684••9093 Glen Day, 620-8664
The SUMmERFIELD ARCHITECTURAL COMMITTEE picks up your requests from the office
and reviews the plans, inspects the site and discusses the proposed project
with the applicant (if deemed necessary).
Tuwnhouse or Condo 4 Approved Date
NAME „�`l 1�l_1.. J, ��'1 c C o 'i �_r DATE CAT. �a�- b
AUURESS L O 0 5 VY C)4 H' A'41:- PHONE •z D - ��:Z 1�-
-
TYPE OF CHANCE: Building, including structural and color (paint) changes, etc.
Premises - hedges, tree r
emoval, fences, etc.. I
LL2 -f i LAN �f�L�?�CZIL - SC'PTASt �
-AtiCl-IIi-t-: CT R- At15�
PLAN - Dimensions and Detail (Show house location b property line)
(Attach drawings or other exhibits as required to fully explain the
proposed changes)
NOTE:
(1) Adjacent property owners may be interviewed regarding the requested
change and will be given a chance to voice otijectiona, if any. (You
may want to interview them yourself and att+tch a ropy of their
sign,>d approval and/or co:mu,snts)
(2) A building permit mupt be .,btained from the City of Tigard for any
improvement of over $jOV.00, excluding fences.
The plane as submitted have b4en approved disapproved, subject to:
Date Approved__
Whr•n project is completed, please call one of the following numbers for
final inspection:
Phone , Phone ____-_ or Phone_-__
Completed Project Approved
Date Approved
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A 0 0 R E 5 S /,5 , DQ JLc/ �� PERMIT NO._ / 7 p
!1 PERMIT CHARGE none
0 t R CONNECTION FEE fay. —
PAID BY
TYPE OF' BUILDING ��f , DATE CONfiEECTED
SEP.VICE RATE O�C� . INSPECTION FEE �s.
CONTRACTIR PAID BY DATE
SIZE OF CONNECTION SSESSMENT PAID
•Y9as os' �
CityOf T icla d MCChatlicaf Ptrlmit ��� P�::•,it- s'_o�, �
Fee____ 4�4t
1—J r,^1-�, a: On rf f,d•di•ion A!i=--rction _j SiAt___.—_.
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3 TOTAL-_-
CO^:i RaCTO; ��; , , �d.��:'�.e . � _—�`- Q'.M:cP, ,L1XA ,
���E`-S._.r 'G—_ '[___�3�����- (`•--�1..�{��_
WORK ADUpESSt►-
PH0N` a-� fir .__ _ APPLICANT
-Hea; Inpu-, Ra-,in3 (BTU Per Hous Vent Size Flue Siz
j _ ---.—,
FUEL OIL `_) S EV ELECT LJO`THEn_ _
I
ITEM NO. FEE Il EM NO. FE
For ls%.:3ncc oI ?ermit $.03 Air Condition Compressor 15 to 30 HP
New• Unje. 100,003 ETU_ 4.00 � Air Ha_ndlina 10,000 CFM 3.0
New • 10:000 BTU & ovrr � 5.00 Air Handling Over 10.000 CFM 5.0
ce
Floor Fu:na _ ---- 4.00 Evap,,rativeCooler - 3.0
_ �- 'L'— Ran
- S _ i +_Vent Fan 7..0
%all Floor - us,�entled 4.00 g-
Install Vents Only _:� _ _._ _ 2.00 Ven-System � ---- - �3 C
_Fepair • H:at ED Coaling _ � _ -4.00_ Hood Commercial _
Air Condition C0mprY-1-%0f Under 3 HP j- _ 4.00 Conmerciat Duct System
r
- ------------ -- - -_-----_ _ .
Air Condition Compressor 3 i 1S HP � ~7.50 +
:zr�-_e.e-sx—..�:••_••••� ..:ra:-r.:s=rr�.....atiu-�-a_ .yr•..:•-.. .:�•s.:x:utrr.:�:s:rr_a ra:�i.-.c=�a_s-�s•:s-.__ -a—�-
+ INS. ECTON'S CO„jIVENTS _ ___ ...._��
CITY EUSINE LICEnSE REOUtRED FOR ALL CONTRACTORS OR SUEZ CONTRACTORS
APPROVED RY___.._ --.___-- DATE � _-- —. ___ ISSUED QATF _ r y
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BUILDING PERMIT APPLICATION 10 Y TIGARD DATE t9 ---
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONk 1 _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING; PLANS AND SPECIFICATIONS. OWNER PHONE —
LOT NO._
OK'NERTU�•��ti� I JOB ADDRESS `I.: 94tH Ave. HOME ADDRESS
ARCHITECT
ENGINEER
BUI'_DER TT ADDRESS UESI(aNER _
SI RUCTURE ONEW LJ RF MODEL ❑ADDITION ❑REPAIRS�--TT ❑RENEWAL CIFIRE DAMAGE rr-�� DEMOLITION
0 RESIDENCE ❑COMM_❑EDUCATIONAL OGOV'T ORELIGIOUS OPATIO OCAR PORT ❑GARAGE 0 STORAGE OSLAB ❑FENCE
_❑_BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED OSIGNS
OCCUPANCY LAND USF.ZONE {�`�I—_BLDG. TYPES FIRE ZONE PLAN CHECK BY HEAT 4j�
, iont%rav Hinglf� fcrmx.ly — 0_1,:�su�s wale ,,r3 102b!;) Sl, Groonlea�f Twrraal:*
; mea cwv►31ir>., w/ its. xrl�sod f>camaa errs,, — RedrOOT — w "attle
N, rmit i r ,:Cf — 1625.00
9-CS. LQ _.F_I.QS?_R__�QAD __._----�� 1�HI__.___�NO.STORKS- ____AREA ._.._._. .VA91 11WMS VALC3L�':y �__•
BUILDING DEPARTMENT SET BACKS FRONT REAR yt1 T l E F7 SIDE ' RIGHT SIDE
Permit , .:"l.U(I
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check 10100 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AG=REED THAT TH'
hn WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ] Ci7,00 AI_L APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax,., 6, !'i YGENSE. SEPAejAT3 PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ;y173,.. i Poc h'"z S10000C
By P1 APPI (CANT OR AGEN1
Apprrned Ifs d�tt Receipt No.1262
DATE iNSP. TYPE INSPECYInN REMARKS PLUMBING DATE
ej . �� —_ Contractor —
�— Permit No. =IL- �b r. _71 ti
Hough-in
Fixture
Tn - Gl Q�_ Final
HEATING �-
_� �— Contrdctor
Permit No.
Gas or Oil
R ough-i n
Final �—
SEWER -�
----_ --- ---
Final
- DRIVEWAY
Final -�
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
>IJII_LiNG PERMIT APPLICATION SOF TIG,�,RD DATE_10•??.___..____. ,9 78 Na� y407
-1E ONDE HSI GNED HEREBY APPLIES '-OR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONIE6393101
L+-. AS SHOWN AND APPROVED IN TAE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHON
I,� LOT NO—
TDewlopmant Co JOB AD REo�'4•W� Bath Ave. - HOME ADDRESS
kI
ARCHITECT
ENGINEER
LR_. ._.__yam_. ADDRESS ----._ �- DESIGNER
Li
.i(7? RE Q
r %EW_ �0FIE MODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
3Cl9F FNCE ❑C-nMM ❑EDUCATIONAL ❑GOV'T ❑REL IrIOl)SOPATIO ❑CARPORT ❑GARAGE ❑STORAGEC,SLAB []FENCE
]KIND ! JMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW 000UNCIL APPROVED ❑SIGNS
:I'ri NrsR-3 I AND USF_ZONE_I--"-____-BLDG.TYPE _-�.-N—_ _FIRE ZONF.:I= PLAN CHECK BY HEAT
THEAT
Monterey Single Family Re issue as= as 10285 S.W. Greenleaf Terrace
Frame dwelling with attached frame garage
r, ; OAD FIOQP�L4ARH_ELSih1LfyQ:5TORlJ$_ 1 AREA._ 316--NQ..HDYjQOMS 2 vALUE39.360.00
aI�TMENT SET BACKS FRONT V REAR �V LEFT SIDE r F
< „ 1 157.00
V RIGHT SIDE
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Ulan Check 10.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREPY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
F'Ub tb,al ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
6,Z8.- - RESTRICTIVF COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I ' lat Tax LICENSE SEPARATE PE RMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total_.__. _173.28
by
-- ----` - APPI ICANT ORA t
NT �-
l�pllrclvetl Receipt No.
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