12255 SW 106TH DRIVE 12255 SW 106TH DRIVE
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ADDRESS �� � ; ��iQ� �Il i PERMIT NO. Svc
PERMIT CHARGE none
OWNER y_ CONNECTIONFEE
---�— _„ PAID BY
TYPE Of BUILDING DATE CONNECTED
SERVICE RATE _ INSPECTION FEE
CONTRACTOR /� PAID BY DATE
SIZE OF CONNECTION u '' ASSESSMENT _ PAID
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CityTigard of �
i SPECTI ON REQUEST
for
INSPECTION TIME: PERMIT NO. .
DATV? - 4JP—S' DATE ISSUED _LL _
OWNERS M A NI . _PIP IuW47 c Z4o;ou sT,arr
A D D R E S S ' 12,2 •S S— -r.&to;
CONTRACTOR
TEST: Air [D, Water[] , Vtsuol ❑ , Laborofory I
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4ESUL T: Approved Disapproved ❑ Pending
SKETCH. I
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City of Tigard
INSPECTION REQUEST
for
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INSPECTION TIME: PERMIT NO. :-
DATE.- u"- 1317a DATE ISSUED ., Z I
OWNERS NAME , 3 ,0,L is _..
ADDRESS: /As_s' S
CONTRACTOR :
TEST .' Air ❑, Water EJ , Visual Laboratory ❑
RESULT* Aon•,7uodN Bier ,,r-, , n
Pending ❑
SKETr.lC
70
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City of Tigard
INSPECTION REQUEST
for I
INSPECTION TIME: PERMIT NO. :—
DATE:
O. :DATE: DATE ISSUED .'—..-/ Z_
OWNERS NAME .
ADDRESS:
CONTRACTOR : _(CS
_ Q �S�+�►_.____—_
TEST : Air U, Water[] , visual, Laboratory ❑
RESULT: Approved X, Disn, pr-ved 7 Pending ❑
SKETCH,- 4
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INSPECTOR DATE
[OTE: Attach iuPrOementnl telt data hereto
CITY OF N° 0220
BUILDING PERMIT APPLICATION TIGARD DATE19_--
THE IJNDCRSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICT6?NS. OWNER PHONE _
lOt f:lyr
WNER utA.1L�.la t.Li: Didustt ifias ADDRESS 4'• a'_,fa1.h a BUILDER PHONE
'jU .:isnua9 N Marm -IVIon ENGINEER
allILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑--�IREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑_RESIDENCE_❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
f❑BOND ❑MOV ING C��USE—O
XSJ9 ❑DESIGN REVIEW ❑COUNCIL APPROVEC _ ❑SIGNS
--- — i'�— 1 NA
OCCUPANCY--L—LAND USE ZONE—_ BLDG.TYPE_. _FIRE ZONE_ PLAN CHECK BY IIEA7 _
r:0rj8truct 1581. sq, rt. . frame t1welling attached yaArag end---- _���
bsoemnnt according to approved plans 3 bedrooms
:z4 0 lb
-
CO C• LOAD FLOOR LOAD HEIGHTNO.STORIES AREA_ VALUE i
BUILDING DEPARTMENT — --���i �s 0
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
—�—
Permit 130.0(1 _ —_--___
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 65,on 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
Recording ALL A:PLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONYRACTOR AND SUB CONI RACTORS TO HAVE CURRENT CITY BUSINESS
1%State 1. 30 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 146. 30
By — --- _
_._ APPLICANT ON AGENT
Approved Receipt No.
ADOnE55-- —_�__ MioNE
IN v v v ■0► v v ■r
DATE INSP. TYPE INSPECTICN REMARKS PLUMBING DATE
------ Contracto 1 `Ja�
—
�/' Permit No.
l 7sv 3
-7- Rough-in
�e��DItiG �Vl
6,L, Fixture
Final
S_�''-� f✓a-�.7r-, ____ �� HEATING --__
Permit No. a
Gas or Oil
Rough-in
Final
SEWER
— ---- — --__ — Final
DRIVEWAY
Final
Storm Drainage _—
_ (Rain Drain) Final
Sidewalk f
Curb&Steet Final
_ — Approach
_
BLDG.DEPT FINA� TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
v Zoning Final
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UNIFIED SEWERAGE AGENCY NO. 5064
WASHINGTON COUNTY OATF _ 3-26-75
CITY OF Tigard
APPLICATION FOR SLVVER CONNECTION PERMIT
OWNER: _ .-XMXMXXKNX Futuristic Ind. _—
OWNER'S ADDRE:3S: ---�7 �- .�.-�el�uialn_-St., - --
5's IFET
----- Pas�Ytlar�rl --- -- _arTAe art_ - ---- - - - --- 97223 ZIP
- --
BUILDING SITE: LOT.--I BLOCK - ---- ADDITION -Cly-desdale
TAX LOT NO. — __ __ TYPE OF OCCUPANCY
ADDRESS - ---I:2-255 S.A ._ 106th
DWELLING UNITS - --1-- --_____-____ FIXTURE UNITS
SURCHARGE IF APPLICABLE -- _- - _ - _ - —__ pi
PERMIT FEE 525 . -___ INSPECTION FEE 25_ TOTAL DEPOSITED __ 550 — f
e
(NEW) (EXISTING) BUILDING SEWER SYSTEM _— Fanno Creek
The Applicant agrees to comply with all rules and reguations of the Unified Sewerage Agency.
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE Orr INSTALL7R
RECEIVED BY-- -.-{_�r8n }�ui hta -paid
(AG Y—OR IIS AGENT)
COMMENTS
This Application and permit expires in ninety (90) days. The arnount paid will be forfeited
should expiration occur.