14920 SW 109TH AVENUE 14920 SW 109TH AVENUE _
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ADDRESS
(� D 6ut PERMIT NO JAS 77--
PERMIT CHARGE none
OW ER 9l _ CONNECTION FEE
PAID BY 44VA--
TYPE OF BUILDING % /nL►usi DATE CONNECTED
SERVICE RATE ? � ,=} '� .--- INSPECTION FEE 3
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION _ � A55E55MENT PAID
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BUILDING PERMIT APPLICATION �"o Y �iGA D DATE__ ��Z�� , ly-'
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOH THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE_.
L T NO.
1 ��. 1. . x •� 9 C C
OWNER ,JOB ADDRESS iu. otl, HOME ADDRESS v?lll'�i$X u'11Y y �M.a
ARCHITECT
ENGINEER
BUI'_DER ADDRESS DESIGNFrt _
STRUCTURE ❑NEW D RIMnDEL _ADDITION _ [I REPAIR ❑RENEWAAL ❑FIRE DAMAGE [:]DEMOLITIOND RESIDENCE ❑COMM DFDUCATIONAL DGOV'T LJ RELIGIOUS OPATIO []CAR PORT DGARAGE C]STORAGE DSL.AB DFE.NCE
DBOND ❑MOV ING DCONDITIONAL USE ❑DESIGN REVIEW DCOUNCI-_AF-Rn'/ED ❑SIGNS
OCCUPANCY—:__L LAND USE ZONE VUi� _BLDG.TYPE—___ FIRE ZONE_' PLAN CHECK BY t _HEAT =
Add 16' r' X 1`,f 2'r
Lott al r+�al t i�a.,�sl y upper living uni t -- -
all per plans for unit A & H. Chp ngs •pprwed truss plan.
Area X 2jL G -m 1250 Otsl
Qr,r.,LQAD _F1.D4H LOAD HEIGHT AREA NO_gEDROOMSVALUe
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_BUILDING DEPARTMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Petmit
THIS PEnMIT IS ISSUED SUBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ].ONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IlIS HEREBY AGREED THAT THE
-- '— — -- WORK VVII_L BE OONE IN ACCORDANCE WITH THE PLANT AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total 1O1r1,1`; ALL APPLICABLE CODES AND ORDINANCFS. THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVF. CURRENT CITY BUSINESS
Slate Tax, 2.811 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING.
Tot:, ila.cit!
H� p1
APPLICANT 012 ADEM
Approved I Receipt No. -
bw—
MEN
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Cont.v,*,)r
F,RIA.- A T W-MM-1
Ls:
Permit No
L,,r-e o,-.i cin.k
r
Rough-in
Fixture
Final 4.11
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Fm."
SP"(ER
Filial
DRIVEWAY
Final
�Swiron Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OC7 Cy Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
_!JIL.P'p'G F'i.i MIT APPLICATIGN Cu Y •�-I'- D DATE_. __ 2_ . Te- N2 r7,�
�F ' S''• '.EG HEREBY APPLIFo f UR APERMIT FOR THE YORK HERRN INDICATED bu1LDERPHONE--
�9 C'�l'::'N : t1'J AFP OVED IN THE ACCOMPANYING F'LAP'S AND SFF:l,1F1CA11CNs. LOTH ?H°NE--- 71�
.•'* LOT NO
�L._.;_:_n'E AnDRc•S v
i
— APCHITECT
- I o L
ENGINEER
—_fit
ADDRESS
Y-__- -^----r-� -— CES:GNER
O _-_
URE NEW REMODEL C�OGITION f--OPEPAIR _ LJ_FNEWAL _ ❑FIRE DAMAGE ❑UEMOLITION
:IC`.NCE-
OP
_MM ❑EDUCATIONAL- ❑u0V'T ,L.- F"I IGIOUS �YIG ❑CAR PORT_ ❑_;ARAGE ❑STORAGE C�SLAB ❑FENCE
74CN0 OMOVING ❑CONDITIONAL USE_ CIDESIGN RcVIEW ❑CC JNCIL APPROVED i- ❑SIGNS
_CuPANCY90- LANUUSE TONE—_-X k P—SLDC TvPE.�u_ FIRE70PIE-S4 'LANCHECK BYHEAT..-_.-_,__
.0 LQA4 ______FI.QS?H199D__._.._. �- __►�. L�tHT _---__ =--14-Q-5MR_95._''-A3.EA ��Q_ -4g�41M5 VALUE •V_,L D7_+
-
BUILDING DEPArrRffTMENT — SET BACKS FHONT REAR —_ LEFT SIDE RIGHT SIDE -_
THIS PERMIT IS ISSLIE.) SUBJECT TO THS RFGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check GjCt7j RFGULAI IONS AND At L 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 ALL APPI(CABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES JOT WAIVE
i - --- ----- -—n-�-�- RESTRICTIVE COVENANTS. CONTRACTOR AND SUE CONTRACTORS TO HAVE CURRENT CI rY BUSINESS
cliate Tax ly L.ICENSF.. SEPARATE PERM'TS REOUIRFO FOR SFWER, PLUM91NC 4NO HEATING.
Total-- --•� �)�
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_ _._.. ADPL ICANT OQ 40ENT�
a;'p,aved PNreipt No.
PE55
----SONE
ADD
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31JILDING PERM11 APPLICATION ��Y
'-iF ONDEP,:7MNED HEREBY AP?I.IES FOR APE RMIT FOR THE WORK HER FIN INDICATED bUILDERPHONE -
�; OR AS SHOWN AND APPROVED IN THE t-'C';MPANYING PLANS AND SPECIF ICAT IONS. ov✓NEP PHONE
.i LOT NO. ----- -_ - -
RJOB- ADDRS HOME ADDRESS _
ES _— --- - ARCHITECT - -- --
ENGINEER
a.R__ __ ADDRESS___ �__—_--•----_ — - -. DESIGNER
_URE �CNEW _ _C REM{DEL CADDITION CRE,'AIR LJRENEWAAL [:]FIRE DAMAGE _DEMOLITION
SIOENCF _CCI)MM CEDLICATIONAL CGOV'T E3REL1GIOUSCPATIO CCAR PORT �CCAPAGE CSTORAGE CSLAB ❑FFNCE
I]POND ' ❑MOVING CCONDITIONAIUSE CDE51GNRFVIEW [:]COUNCIL APPROVED [:]SIGNS -
;_CUPANCY—._�.I.AND USE ZONE _ _.._-._.BLDG rYPEI.�`F IAf ZONE PLAN CHECK BY o HEAT-_
A�J?E?P91J�__ VALUE_.
_BUILDING DEPARTMENT SET BACKS_ FRONT _ AiAR_ a LEFT SIDE RIGHT SIDE
?ermit
-- THIS PE►'MIT IS 'SSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDINs CODE, ZONING
Plan Check RFOULAT ONS AND ALL APPLICABLE CODES AND ORDINAMCES, A i IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPE CII-,.;ATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLILABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
--•-- - RESTRICTI #E COVENANTS. CONTRACTOR AND S1!9 CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Swe Tax _ LICENSE. SE°ARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATIN13.
Total
BY
APPI (CANT OA AGE NT
j Approved Receipt No.
I
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I
„'� r�'•-y'Rr•• 7... „w,,,,._ . .T�,,,r. YTt`�Nu' --*r•sr• ��+-.+R„ti—..-y�qt.,..�....�wrCJ''�•.�t''�dt"I'r`
BUILDING PERMIT APPLICATION Coy TIGARD DATE—_. 11 �, 19
THE UNDERSICNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
Oa AS SHOWN AND AFPROVED IN THE ACCOMPANYING PLANS AND SPECIF ICAI IONS OWNER PHONE .r
I ft
OWNERII j i `fijUlC} ,Hg f S 'M11 i'b. JOB ADDRE.'S L .'lCrP JI.1 u ?C.� HOME_ADDRESS _
ARCHITECT
ENGINEEP.
BUILDER n AADDRESS r-I
STRUCTURE NEW ❑R. r1
MDEL _ ❑ADDITION r❑�REPAIR ❑FIENEWAL ❑FIRE DAMAGE ❑DENIOLITION
O RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RL-LIGIOUSI_IPATIO ❑f•.,, PORT ❑GARAGE [:]STORAGE[:]SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.APPROVED ! )SIGNS
OCCUPANCY__''i"--]..LAND USE ZONE. -L___BLUG_TYPE-. -« FIRE ZONE—-�PL, N CHECK BY_ T HEAT_
__�Ilr rL!r r,nij 1L1L•• x_yAt, u/ _ L&cj-tE'Itj .Aa, jjfec, albrir plans by Van !crm
-- :1.''xt'irir ��rCrl� jr�eCt . [l,' �`La+S1aJ111R1 ILI Fiat1T8„ leo- 19GUO Of 6"1c.�q_j
y ;.�•J 111Y. Y '�ui�LLLlLµ�,_t>I�d sLte work 1u 'QQmalwtul•
a
QQ LQA-R —_E_LQQ$J<QAF?---- --------AHI_! NQ.5IQPjs_.,`-gN€L.—if�fD.SEQP�4M& VALJE --
BUILDING DE PARTMENTSET BACKS FRONT A R LEFT SIDE RIGHT SIDE
_ --_e
Permit ,. , y
THIS PERMIT IS ISSUED SUBJECT 'f0 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plant C4&w REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED 1;IAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal AIA. APPLICAJL.E CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTC'RS TO HAVE CURRENT CIT i OUSINESS
State'fax lb ;[ •tjtj LICfjSE. !;EPARATE PERMITS -EOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 1a 7.1 G f'f;'' 600100By P1
Iw APPLICANT r,R AGENT
Appnov id r. • 1,(Nldell Receipt No /
----
DATE INSP. TYPE INSPECTION REMARKS PLUM13ING _ DATE
Contractor _
Permit No.
Rough
J Fixture
HEATING
Contractor
✓� Permit No.
Gas or Oil
Rough-in
-- Fine'
— ---_ SLWER
Final -
DRIVEWAY
Final
'—' Ston DralnagP
(Rain Drain)Final
Sidewalk
Curb&Street Final _ ---
- Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY - -
Landscaping
Zoning Final
1