11065 SW 106TH AVENUE i1065 SW 106T.H AVENUE
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r PERMIT NO.
_ PERMIT CHARGE _ none
OWNER J � CONNECTIG l FEE --
__ _
PAID BY
TYPE OF BUILDING , DATE CONNECTED
SERVICE RATE 1Q_ c� . INSPECTION FEE 2,T
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
3/7 y
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t tSUILLJ ,ut_� L)t.r��.;; lr,f:»wt, itUHtlu .
j MARTIN T. M02LAN PLUv13',N0 CCS51tvG PERMITO
4829 N. E. UNIOi l AVE. - 284-1109
—, holder o` a valid plumbing contractors license is hereby t
authorized to cause plumbing work as herein noted to be installed 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 time the installations are ready for inspection. City of Tigard Business License required
for all contractor; and subcontractors.
iOwner
1 NUMViR Or TOTAL PERMIT NO.'S {
TYP£ OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Us*Only) d
RESIDEVT1 * _ s
Sinali Family-1 ba.h-anch _ _ 25.00
OIi I0<-Each 1 bash unit _ 25.00
Additiarnel b tthroums-each _ 10_.00
Mcoile Home Soace-•:+ach 15.00
INDIVIDUAL FIXTURE FEES �-
1 to 50 Fixrirei in 1 builddr9-e.tch 3_00 _
i
51 to 100 FiAtur?s in 1 buildir;-each 2.50
101 to ?00 Fixtures in 1 bull3im: Rach 2.00 1
201 Or mor9 Ficvres in 1 yuilr1i113 -earh___ -- 1,50
MISCELLANEOUS__
SJileirg sewer-t;t 54 ft. -_ —� _-- 10.00 _
Sew.tr-each ad•!i0gnei 100 ft. _ 10.00 _
Warm Service to building• _ 5.0u —
Private Vila r Svit?rri-eich_I00 ftp--- - 10.00
Other Iso- h;l:
i
PER.WIT S For Xuri';rng 1n.r, ^Phone 639.4171
1
J,&State �,TO Plumbing Contrar.tnr Ry
I L
TOTALi �Tc, _r RECEIPT NO. Issued By
i
CITY �. � y
BUILDING' PERMIT APPLICATION of TIGAR �
D DATE ; __, t9j
THE UNDERSIGNED HEREBY APPLIES FOR APFRMIT FOR THE WORK HEREIN INDICATED BUILDERPHONT'
OR AS SHOWN AND APPROVED IN THE ACCOIVPANYING PLANS AND SPECIFICATIONS, OWNERPHONC-
LOT NO.
OWNERw)Ou91.150 ( cAlfillM JOB ADDRESS 41esu J1.1 I U(J th AVG' HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER !ior`.hland flnmk ADDRESS 1021.1 10 ' $1!!rbLI* `202DESIGNERdiu ci
STRUCTURE ❑NEW OgtMODEL ❑ADDITION ❑REPAIR ❑RENEWAL [)FIRE DAMAGE _C1 EmOLITION
Q RESIDENCE ❑COMM ❑EDI. CATIONAL ❑GOV'T ❑RELIGIOUS[-]PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND ❑MOVING ❑CONDITIONAL USF ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
yyOCCUPANCYir� L.NO USE ZONE—__ BLD3.tYPE :,Pd _.FIRE ZONE. 3 E.TW. PLAN CHECK 8V HEAT____-_
Ti-; construct slnL_ _f'am11y dWelltn w attecrtact ,jeragw - 3 Umdruum - '?---- --
SSSS:-LUAU FLOORLDAD 43 N_FIStH2_ 13.�-_ _Mal E�+" j _ k NO.BEDROOMs3 VALE ��p, ��I.f•rli.
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 4a LEFT SIDE i.1 RIGHT SIDE 12
Permit -
f 1�.�.00 _
- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAI►IED IN THE BUILDING CODE, ZONING
PI9n Check ; � (� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AVD IT IS HEREBY AGREED THAT THE
--_- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
u!i total3"�, �7� Al L APPLICARI.F CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
r -- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
tate Tai i) 20 I.IGEJVSE. SEPARA�TJII�EA(pIITS RF.UUIRED FOR SEWER, PLUMBING AND HEATING.
U •
Total 241,711 POC #1 A100000
By P1
-- ----- APPI_IC,%NT OR AGENT
Approved I . rAdrare Receipt No. /
I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
a� 3 o ---- ---- Permit No. -
�_ Rough-in
k.-l9 ,� v.�. Fixture - - — — ---
�`Ai sK V 1,v .,, Final Y----
�� _-- -` —HEATING
Contractor
Iii-A
ke
Permit No.
Gas or Oil
Rough-in
F64
SEWER
Final _ y_J
DRIVEWAY
--- ------- 'renal —
Stom Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TCMPORARY CERTIFICATE OCCUPA CY
CERTIFICATE OCCUPANCY Finel
Landscaping
Zoning Final
1
24 1
1 1 MY ';IG,'.RD DATE Q�� t� 19--7-Lf'+9
V Jil-DING PERMIT APPLICATION OF
' , ' WN
HEREBY APPLIES FOR APE RMIT FOR THE WORK HER FIN INDICATED BUILDERi'HONE �y 3 ��
WN AND APPROVED IN THE ACCOMPANYING PLANS AIJD SPECIFICATIONS. LOT NO.ER HON��
` , (�L LOT NO. �.._
Douglas Graham AOR ADpRkSSI'IL�/s'W'--1VVtb V HOME ADDRESS -
- -- ----
ARCHITECT
.�,�� ENGINEER
,ER Northland_ _Homes ADDRE.5S 10211 SW A3T�bLl �2. _ ENGIN ER t11C11 Q rJ
URE —_L NEW ❑REMODEL 0ADUITION_-_ RE PAIR GRENEWAL ❑FIRE DAMAGE [:]DEMOLITION
X NCE OCC!MM_OEDUCATIONAL OGOV'T,ORELIGIOUSOPATIO ❑CARPORT OGARAGE ❑STORAGEOSLAB OFENCE
�1F`ND MOVING -- - CONDITIONAL USE ❑DESIGN REVIEW [:]COUNCIL APPROVED ❑SIGNS
(� F NCv ,� LAND USE ZONE -OLD TYPE,�I�I1T__---.-F IRE ZONE.3-- PLAN CHE :K BY HEAT
To nstr t 1330 sq _ft with attached c�araq.e
Three (3)_-bed_o_om� two j2 L. �t_ �____._ ... . -._--- _ -- —� —_
4.:.......__f l.S?DR_l._Q.n�O_1b_81EStHt._ 1.3_ t4.4--EL4H1fS 1
Bl.III DING DEPARTMENT SET BACKS_ FRONT--?O-- REAR- _4J_^ 11 RIGHT SIDE 1Z
THIS PERMIT I� ISSUlO SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
J PIAn Check '�� �V REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
/ ------ -f--- 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
RESTRICTIVE COVENANTS, CONTRACTOR AND FiUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
nioe Tax LICENSE. SEPARATE PERMITS RFOUIRED FOR SF.WER, PLUMBING AND HEATING.
TotalBy
113111.4L WN
AnPt ICAN1 C'p AGE N7 p�
q4;�, d -- Receipt No .3���1 _C� ���a oivQ+_- �1f'R�J�0e e
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