15565 SW 109TH AVENUE-1 wimp
15565 SW 109TH AVENUE
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JOHN [. RECI!,1R01 P;1!M,EjhG, IhCBUILDING DEPARTMENT, TIGARD N0.
P. 0. BOX 119 PLUMBING PERMIT
NEWBERO, CUM; 91131 holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbin, 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 sll contractors and sub-contractors.
OwnerTAddre;s Dateualatin Development Co. 15565 SW 199th ,10/7/81
_
— IM13ER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
RESIDENTIAL
Single Family-1 both—each —125.00 25. 00
Du lex—Each 1 bath unit _ 25.00
_Additional bathrooms—each 1 10,00 10. 00
MoSile Home Space—each _ 16.00
INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 building—each 3.00 E
61 to 100 Fixtures in 1 building—each 2.50 _
101 to 20o Fixtures In 1 building—each _ _ 2.00
201 or more Fixtures in 1 building--tech 1.50
MISCELLANEOUS _
Building Sewar-1st A R. � 10.00
Sewer—each edditic_if 100 ft. _ _ 10.00 _
.Vater Service to bi.ild� r1 5.00 —�-LjO
a
Private Water Systems ach 100 ft, 10.00
ether Spec-i—fy): . 619
PERMIT j'D� For Plumbing ln4rection Phone 639.4191
% Ststo _$41 . G Plumbing Contractor By
TOTAL nrrrIPT NO Its I r„
mumm
BUILDING PERMIT APPLICATION TIGARD DATE__`'r'�t"_'a�'cr_�",;�_ 3923
THE UNDERSIGNED HEREBY APPLIES FOR A PERM r FOH THE WORK HEArIN INDICATED BUILDER PHONE 639-110-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE_ -�_�.y_
LOT No. 704-'7tT..r x7-rfxeld 14
OWNER JOBADDRESS 15565 'ieyl• 109th Ave. -
ARCHITECT
15300 S.W. 116th Ave. ENGINEER Tot,
BUILDER ADDRESS DESIGNEI'
STRUCTURE NEW C'. REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL U FIRE DAMAGE T1.7 DEMOLITION
O&RESIDENCE Ll COMM O EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS 1_1 PATIO ❑ CARPORT ❑ GARAGE G_STORAGE ❑ SLAB FENCE
OCCUPANCY —1 —LAND USE ZONE _$ > BLDG.TYPE _-5 —FIRE_ZONE -- -P'.AN CHECK BY _u� HEAT_-PAM__.
Construct single fau,ily disllin,, With attached garage.
Sne correction sheet attadwil. 2 bedrowis
-- - —,2 57attis —
SEVVZ=R PERMIT M 21-All - $810.06
OCC.LOAD FLOOR LOAD 40 HEIGHT 12 NO.STORIES � AnEA 11('3 NO.BEDROOMS _}_VALUE 51•100
BUILDING DEPARTMENT
-- - � SETBACKS FRONT _REAR t.r-FT SIDE RIGHT SIDE
Permit i 19.1 vo THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
95 so REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
2��.�.a WISH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CON T RACTORS TO HAVE CURRENT CITY BUSINESS
T LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
State Tax !
-- SDC- 400.00
Total 294,11, ------- - -------
-- PDC# It 1t?Qv30 APPLICANT OR AGENT
By
Approved ,. J Receipt No. ADDRESS PHONE---- --�--�-
DATE INSP. TYPE INSPECTION ^SMARKS PLU GING A E
e-/ — ---- - - - - -- Contractor
�n�.. L
ro^� 7 ✓ --- Permit No. i6
Rough-in .2-e7
'el-"o Fixture
ter,-,t J,
Final
HEATING
4Z 10 �� 7b p 21cefi Contractor
Permit No
Gas or OU
Rough-in —
Final
---- SEWER - --- --
Final
DRIVEWAY
_-- Final - --
_�r�--- -----— Stc.m L,.,'nage
(Rain Drain)Final
Sidewalk
Curb b Street Final
A,iproech
t3LDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPAIY Final
CERTI^ICATE OCCUPANCY _
landscaping
Zoning Final.
39 2
BUILDING PERMIT APPLICATION TICAa7 DATE-S ,g
'THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INvvDICATED BUILDER PHONE/V3Z-3ejl —
OR AS GHOWN AND APPROVED II:THE ACCOtA.PANYI�VG PLANS AND SPECIFICATIONS. OWNER,PHON
LOT NO.
z:::D;ER (�Qf / B ADDRESS _�� 0 �
ARCHITECT
ENGINEER
BUII OERQC 4DDRES$/S3 ) $ALJ /��� � DESIGNER %7Z�C
TRUCTURE NE ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITu
RESIDENCE�0 C�ONAM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLABFEN,
---ii'rANCY ...K•'�_LAND USE ZONE P BL DG.TYPE „ � _FIRE ZONE_'_;_PLAN CHECK BY HEAT___
III v1% I
,EWER PERMIT I --�-
CC.LOAD FLOOR_IOAD HEIGHT �,Z NO.STORIES I A IE/��' NO.BEDROOMS 2 VALLI �Op
BUILDING DEPARTMENT SETBACKS FRONT REAR LT_SIDE
RIGHT SIDE
– e R EF
__' _ ,'r' Ali0^rtTtt! 9 .00 THIS �ERMIT IS ISSUED SURJECT TO TAE REGULATIONS CONTAINED IN THE BUILDING CODE,MCI'
f0 REGULATIONS AN', ALL APPLICABLF. CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT T!
Plan Check WORK WILL BE DIINE !N ACCOP.LANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO-MPLIANI
WITH ALL APPLICABLE CODES ANL ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAI'
Sc�trtsl Z e�,SO_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 6USINEc
State Tax
GT LICENSE SEPARATE PE9MITS REQUIRED FOR SEWER,^1_UP.18!NG AND HEATING.
SDC--
Total ---- '�9�•l -
PDCB APPLICANT OR AGENT — - ~By _
Receipt No.
Aporoved ADDRESS PHONE
C - - - ---
WER CONNECTION 5 7
EWER INSPECTION S 3!
WER SURCHARGE S
.m mo rl+p i l.�i/C /��l�!'��r'JV �/ � 70 • a • �•At
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