11840 SW 113TH PLACE 11840 SW 113TH PLACE
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CITY OF TIGARDNC
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Owner:- � 1224...... „�
�. .._.................. Permit No. .....
Building Address..... 1.1840 SW 113th P1. h
Certificate is hereby given this...30.........day of........qune 19 -7.7_ t .�
that said building may be occupied and
that it complies with all requirements of
fi the Building Code fur the City of Tigard, :}`'•
as approved by the Tigard City Council.
Building Inspector
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City of Tigard
INSPECTION REQUEST
fro ;
INSPECTION TIME: _ PERMIT NO. : _.
;1ATE ISSUED / ,
OWNERS NAME
ADDRESS:
CONTRACTOR
*E ST ' Air 0, Water � e��al l_aE°►atory
C'ESULT: Approved Disapproved C Pending []
SKETCH:
. 41
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PECTOR DATE
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UMFIE" D SEWERAGE A('1 ',,--NCY No. 11035
WASHINGTON COON 1.y
DA IF i-3--77
C I T Y 0 ------Tig a-rd- - -- - -
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: Herb Mcris.,3�t1e
OWNER'S ADDRESS: ..-------
T F"i ET
CITY SIAIE ZIP
BUILDING SITE: LOT BLOCK ADDITION
TAX LOT NO. — W------ TYPE OF OCCUPANCY re-idence
ADDRESS ...--118AD S1J- 113th Pl .
DWELLING UNITS -1 FIXTURE UNITS
SURCHARGE IF APPI-ICABLE ----------
PERMIT FEE--575.--- INSPECTION FEE -- --25�- TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYSTEM - - -F artria-Cx e a k
The Applicant agrees to comply with all rules and regulatipiris of the Uni iced Sewerage Agency
APPLICANT
SEWER PERMIT
THIS PERMIT AUTIAORIZFS CONNEC I ION TO THE SEWER SYSTEM.
LINE SIZE INSTALLER
R E C F I V E D B Y
(AGENCY CIA ITS AGENTI
CONINIENTSBldg. #1224 Paid To Leron Heights $150. 00
�
This Application and pe,,ni*k expires in one hundred and twenty ( 120) days.
The amount p.jid will be forfeited should expiratioi, n-::.jr.
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BUILDING PERMIT APPLICATION OF TIC ARD DATF 1-3-77 %24
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICA'. D BUILDER PH ONF. �6_S`�03�,,.
OR AS SHOWN AND APPROVED IN THE ACCCMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE `"����
LOT NO.
OWNER 8�l)1<L�J14�t�1: JOB ADDRESS HOME ADDRESS
ARCHITECT
ter,: ENGINEER r?t)fJt'x'tf
BUILDER ADDRESS DESIGNER
STRUCTURE_❑NEW ❑REMODEL ❑ADDITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDE14CE CCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSE]PATIO ❑C1.R POPT OGARA(= ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ ❑SIGNS
OCCUPANCY_- __LAND USE ZONE _—BLDG.TYPE FIRE ZONE.._ PLAN CHECK BYHEAT__._,
L)
— -- :y (W81 1!. Iuom 1 Val 1 W 4�kcai_, ii j YPU3 5pal _—
17� 1 11,54 i 5r;.
"_LQAD FLOOR_�,OA_D, )jEIGHT __�(Q�.S.IQ.Bl�,S__—_—LREA NO.BEDROOMS �[9LUE
BUILDING•DcPARTMENT SFT BACKS FRONT ,t REAR 13, LEFT SIDE_ RIGHT SIDE 1L
Permit �� 1`'4,00
1HIS PERMIT IS ISSUED SUBJECT TO THE RFCULATIONS CONTAINED IN THE BUILDING CODE, 70NING
Plan Check RcGULATIONS AND ALL APPLICABLE CC'DES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— WORK WILL BE DONE IN ACCORDANCE WITH THE FLANS ANDSPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT 'NAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax / LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Totalkf•(�'
By --- ,�, ANT OR AGENT --- ------
Approved Receipt No
ADDRESS T HON
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
'✓r r , Contractor A
Permit No. OP9
�✓Jh ' ���c�_ �_
Rough-in —
Fixture
Final
( 4 HEATING
���� t-+ �• n_ �� Contractor _
��_ ✓ n L. Permit t o.
-Uit�t 1/ Gas or Oil
Rough-in
Final _
SEWER
Final
DRIVEWAY
Final
Storm I' di. age
_ (Rain Drain) Final
Sidewalk
Curb&Street Final
oproach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CIERTIFICATE OCCUPANCY Final
-andscaping
( Zaiing Firal
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APPPOVED FOR CONSTRUCTION
OF TINA► D
R I I
PE M T NO. SITE ADDRESS_
BY__ __ TITLE DATE 7
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116-40 �..UJ. 113Y}-= l't,1 CE
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City of Tigard Mechanical Permit A Permi _-3.00
New Installation I(� Replace El Relocation n Addition 1--JAlterati��n (� -- ---
Fee 4 . 04
` TOTAL
CONTRACTOR
OWNER___LLL R ptyi Q $T S C P TTF lI
ADDRESS WORK ADDRESS--7 �11C_111L.h '_'I
PHONE _ APPLICANT
Heat Input Rating (B a u ll Vent Size ----1-ai
ARM .� Flue Size `•,�;
F�,tL O;L ❑ GAS ELECT C'_l OTHER
ITEM NO. FEE ITEM NO. FEE
For Is:.:ance of Permit 3.00 Boilers Over 50 HP 25.00
New - Under r00�000 BTI! —^ � 4.00 Air Handling 10,000 CFM 3.00
New - Over 10C`,000 STU 5.00 Air Handling Over 10,000 CFM _ 5.00
Floor Furnace 4.OG -Evaporative Cooler3,00
Wall - Floor • Suspcndell 4.00 11 Vent Fan _ 2.00
Install Vents i _ _ 2.00 Vent System M 3.00
Repair - Heat & Coolin — 4.00 Hood 3.00
Boilers Under 3 HP _ 4.00 Domestic Incinerator _ 5.00
Boilers 3 to 15 HP 7.50 Comm. Incinerator 20.00
Boilers 15 to 30 HP 10.00 Other Not Listed 3,00
Boilers 30 to 50 HP 15.00
INSPECTOR'S COMMENTS
CITY BUSINESS LICE SE REQ I ED FOR,ALL CONTRACTCM OR SUB-CONTRACTORS y
APPROVED BY DA;E ISSUED 9Y_ DATE _
RECEIPT NO.
774 9
Ark
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IC
ADDRESS rn PERMIT NO.
PERMIT CHARGE none
OWNER CONNECTION FEE
PAID BY
TYPE OF BUILDING DATE CONP'ECTED —
SERVICE RATE INSPECTION FEE
CONTRACTOR PAID BY DATE
4 N� ON ASSESSMENT PAID
SIZE OF CON _CTI
E