13815 SW 114TH AVENUE-1 1
13815 SW 114TH AVENUE
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CITY Of
BUILDING PERMIT APPLICATION TIGARD DATE ? 19—:- 0 8"
THE UNDERSIGNED HEREBY ArPI_;ES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIF ICAT IONS, OWNER PF40NE _
OWNER iEen blunchare ADDRESS s361"' BUILDER PHONE
ENGINEER
BUILDER _-_— ARCHITECT _. DESIGNER —
STRUCTURE ❑NEW 1:1 REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T DOEI_IGIOUS❑PATIO OCAR PORT ❑GARAGE ❑STORAGE CISLAB [:]FENCE
❑BOND _ ❑MOVING ❑CONDITIONAL USE DDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY___-_LAND USE ZONE BLDG.TYPE_.__ _FIRE ZONE_ FLAN CHECK BY___r HEAT
-- rTeixuc.t G x 20 woad duck without. — -
OCC. LOAD FLOOR LOAD_ HEIGHT NO.STORIES AREA VALUE _
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit -..- —�-- - - ----- -_
" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check RFGI.A ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-- '— WORK WILL 9E DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES THE 'SSIJANCE OF THIS PERMIT DOES NOT WAIVE
--T '— - RESTRICTIVE COVENANTS. CONTRAC70R AND SUB CGNTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PL IMBING AND HEATING.
Total .; ;
By
--- APPLICANT OR AGENT
Approved Receipt No.
ADDRESS ---
�DATE
IP SP.I TYPE SPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
- ------_-_-
Rough-in
Fixture
Final
HEATING
--- _ Contractor
Permit No.
Gas or Oil
- -
Rough-in
--_-_ -- -- - Final _
---- .. -- - — SEWER - -
__ Final _
DRIVEWAY
— ---- ------ - - — Final
-- - - --- - --_ - --^_�--- _ Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
-- _ Approach
BLDDEPT.EPT. FINA I TEMPORARY CERTIFICATE OCCUPANCY —
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
City of Tigard
INSPECTION REQUEST
for
NSPECTION TIME :.Z2L-kTlrn1z iJERMI-T NO_ - _
DATE . J_ - .. ')ATF
ISSUED'
---
--
�� OWNERS NAME '
WDRESS : .1 '
C-)N-IRAUT0R :. -- --- ---- - -- ---
i. .S I
RESULT
SKETCH:
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INSPECTOR _
DATE
CN'J*TE : Attach vapplemental !v;l tu•r- rerot]
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�ity of Tigard
INSPECTIai4 REQUEST
fc � ;
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NSPECT10N TIME PERMIT .NC. .
I
DATE . _'73 DATE ISSUED i
OWNERS NAME * �
ADDRESS '. -
C O N T R A r T n R : ----
I
EST ier❑ , V' ....., '.ahc r
S KETCH:
I
INSPECTOR DATE
COTE : Aft 0crl sup pie men IaI tast uota Icer -tI
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of Tigard
INSPECTION RL.'WEST
fcr
INSPECTION TIME . PERMIT NC. .
DATE '. -)ATE ISSUED
OWNERS NAME : 'ter° L ,er
'�C,N RA�.TOR
: EST •y, ter[3 V'
RESU
L :uppr� ad G =e►idi. �
SKETCH: I
INSPECTOR DATE
NOTE : Attach sut:piementol lest uutu hereto]
A d d r e 8 8_;,U,5_,5,11._J- Ali — p e r mit No. � ----�-
Permit charge
Connect i c�n� f sa '415
nwner Columbia Custom Homes _ ---
pend by
Type of building Ax res Date connected 8-3-1
Service rate 3. 00 ��er month inspection fee
Contractor „- same . --
Paid by same__,- da t o
Sizecf connection 4" __ Assessment paid
I
www w w w w s
City of Tigard I
INSPECTION REQUEST
for
INSPECTION TIME: PERMII NG. :
DATE : 81LL,-73 13 ATE ISSUED
OWNERS NAME : --
ADDRESS: 5-- �� `" 114
CONTRACTOR
EST - , Water sual* , Laboratory r3
RESULT'. Ap•,rcved );scjppm ad Lj , bending p
SKETCH:
INSPECTOR LATE
NOTE. Attach suPPIOM OI test dasa beret]
TIG
ARD.Issued CrrY OF MU, OR AOH
7-�$-7�_._ city H&U Permit No—
Application Approved
lEtt111d1n.T Departsawt Coat of InetelLtlon__-._.—_._ C�
BI._. AU&I-4t ill 4pp"Aisim"i"pos"aal Pkoagilli"F' Fee for Fermit
Applicant shall fill in cost of Installation only,
Date- abo,!e this, double line. street sewer Permit --_-
Application u hereby made to .(der- Plumbing Pipes or Fixtures affording W plans and spec:flcatiom and
Install description an given below:
Location of building--Number and Street
Lot. _ .-...- Block---
Name
lock _Name and Address of Ownev� ,�— A'sauV1-
ti
Name and Address Of^lumberT�y►e
Building (Old or New) _ r _Itelght to f3torte6 —— Occupied -
SCHEDULE OF WORK
NUMUR
MTtWS _ NOW lIm IA-el MT_URU_ Now Move kRVIles
Water Closets .
-.�.'_. Fountains, Drinking_____
Bath Shower___ Fountains,Yard__.
tlslh Tub ___. _ Fountains, Soda
Basins - �_�-. — tint Water Tank ----�--`_ `_
Sinks, OrdlndllfC�PO Sinks, Bar
Sinks,Dishwashing _ ;,inks, slop
Automatic Dishwasher.._I
Laundry Trays, Drains, Ice Jinx ^—
Dralns,Floor..._..
Drains, Area—
�,/� I_ I _ _ Calrh-Basins, Yard_
RaleDttlm _ _ t'atch•Baslns, Curage_-_..--
Automatic Washer Lratch•Buhu, 8u6 80l
-- - _ —_
Water Permit Na, _�.._ Illdg. Permit No
IMPOPTANtf Plu+nbing %hall not be Intfolled In any building, ;alll,er now, altarad,or repaired), ox*W as shown or 6"lNlated
on the correspondingbuilding plans as filed with, or to q Ired by, the building Department in accordance with the
Provislena of the Bulding Cada and Ordinance 62-19 of the Cily of Tigard.
I agree to plumbing system according to this description, plans and speclflcatioas and the Plumbing Code of the
Inel.0 cur of g.rd.
Plumbing a'hm_
Supervisor
FEW
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it of Tigard
and
INSPECTION REQUEST
e I
for
9 INSPECTION 'TIME : s `361 PERMIT NO. : . --
+ DATE: ZZI-4 FATE ISSUED'OWNERS NAME --
I ADD R E S S
I CONTRACTOR : ----
TES'1 a r J, Wnter 'Ll , `lisrwcl J , La*- .rctori ('1
RESULT ' Approve DisopproveH 1 r-ndrng
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I I SPECTOR ATE
rN,JF tach supplemental test data her�r�
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT
DATE: DATE ISSUED:---j '
OWNERS NAME : 44d-a�lgr, _-
ADDRESS: /v _._ 33
CONTRACTOR : - ----------EST Air Ll , 'Water0 , V,sual 173 , I_aboratory Fj
RESULT: Aporoved [ ilisapproved G Pending U
SKETCH.*
INSPECTOR DATE �
NOTE Attach stipiemental test data her .t.1
k
UNIFIED SEWERAGE AGENCY NO, 4870_
WASHINGTON COUNTY DATE June 29, 1973
CITY OF_ T:.iaru
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: .____ __..__ Columbia Custom Homes
OWNER'S ADDRESS: T@rraCe
STREET
Laze uswego Oregon
CII V STATE - ZIP
BUILDING SITE: LOTBLOCK ___ ADDITION _ Vtewmaunt
TAX LOT N0. _ TYPE OF OCCUPANCY Rec:icten,e
ADDRESS ljcil�- ll5th Ave.
DWELLING UNITS 1 _. FIXTURE UNITS
SURCHARGE IF APPLICABLE .. iU-.ta carry ".L1
PERMIT FEE INSPECTION FEE TOTAL DEPOSITFD 4�,O _
NEW►' (EXISTING) BUILDING SEWER SYSTEM __._ itAI'd
The Applicant agtpes to comply with all rules and regulations of the Unified Sewetaile Agency.
APPLICANT E r t.1 1'e
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE INSTAL I r n L1i21= Co.i umaia C"."tum Homes
RECEIVED By
,G OR ITS AGENT)
i.
COMMENTS.
This AhpIICdtion and hermit expims in ninety (90) days 1 I,, ,-ri mUnt Ir,n►I will h" fw I•,rtr!d
should r�Ypiration Occur.
CITY OF TIGARD
12420 S. W, Main Strwt
T.GARD, OREGON 97423
APPLICATION FOR BUILDING PERMIT
New Construction ❑ Demolish ❑ Addition ❑ Remodel ❑ Move ❑
DATE ISSUED u-2.1-f3 BVILDING PERMIT
ZONING it_( No.
DATE RECEIVED , _ir_�, BUILDING FEE $ lU4.u0 7.I .143: —
BY F., PLAN CHECK $ VALUATION
'-'- OTHER $ lu.uu
TOTAL $ 11L.oc, RECEIPT No. '
-- — '
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WIT11 APPLICATION
LOT # 3-'' MAP # --- CENSUS TRACT W-1L JOB #
Architect or Engineer CoLunbla Cuatum 6—m
-i Mt. Je.f.'cc'_,un Terrace, lane Uuwegu Phonies
Address ---
nwa
Owner_ _ -------- -
Address-_ — T_ __ ----_------Phone ---
Bui ider
Address ---Phone—.--
BUILDING
_____PhoneBUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP_— No. of stories__2_ Total Hei,•ht_-_--_- Area of Lot
Type of Construction Y*Q03jXCXEY V Floor Area B--:-_ 1_
Set Backs: rront _?u' _ Back 46' L.Side J� _ R.Si ie
Private Sewer Pipe Size 4Sewer rn.,u 'I rIA Septic Tank ❑
Water Service pipe Size_ ,/ - Storm Sewer E] Ditch ❑ Drywell ❑
Street and Curb Requirements— Exibting
Driveway Width! No. of Parking Spaces__
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED -- ?l� Q•w 114thAyQ__—___-__—
FIELD CHECK BY __ �i.L__-_-_- --_----- - ____DATE
PERMIT APPROVED
i
It is understood that all work will conform with applicable codes and ordinances
of the State of Oreqon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of,pccupancy has been ,}slued yy the City of
Tigard Building Inspector. (. 4t '<•.•.r -ems (it A.4e01
gnature o Appl
Ficant