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13855 SW 114TH AVENUE 13855 SW 114TH AVENUE u LN c� t — — � I i v cN1� y �s7 U ti r�I Ctrj Cy l 1 r Cf1 11r C� C1+ Y� ^ � r V � R P-4 � � H 4LrN kIN F. Ie7 t., Iii cq W R. Z i JEW—LIM I CITY OF J t/ 1/j— BUILDING 0233 BUILDING PERMIT APPLICATION TIGARD DATE J �, 19__ THE UNDERSIGNED HEREBY APPI ES FOR APERMIT FOH TW- I.VORK HEREIN INDICATED OR AS SHOWN AND APPRO VED IN THE ACCOMPANYING PL.).F6 AND SNI_CIFICATIONS. OWNER PHONE OWNER f e ADDRESS __ �._._ _ BUILDER PHONE EN_GIIIEER =LD-Lg_ __ ARCHI)iCT _ _ _ _ DESIGNER STRUCTURE ❑NEW _REMODEL ❑ADDITION DREPAIR 08ENEWAL ❑FIRE DAMAGE UDEMCLITION ❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSC]PA110 ❑CAR PORT ❑GARAGE []STORAGE❑SLAB ❑FENCE ❑BOND ❑MOVING ❑CONDITIONAL USE ODESIC N REVIEW ❑COUNCIL APPROVED ❑SIGNS OCCUPANCY_ LAND USE ZONE _._BLDG.TYPE __1 I iE ZONE_ PLAN CHECK BYHEHEAT__ „r/ /1 ,.�'j 1 r �{ .. � �S'' }ter :/ � J,`' • �4 ! OCC, LOAD �F—OOR LOAD HEIGHT NO.STORIES AREA VALUE BUILDING WPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit 4 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING f Plan Check REGULATIONS ArID 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 ALI. APPLICABLE CODES AND ORDINANCES. Th E ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS 1%State i LICENSE. SEPARATE PERMITS REQUIRED FOR SEVIER, P;UMBING AND HEATING. Total Bv APPLICANT OR Art NI Approved_ t /,!/. Receipt No -- — - ---,-- ADDRESS PlIONE xwkmff-���f DATE INSP. TYPE lf?'PECTION REMARKS PLUMBING DATE Contractor Permit No. Rough-in Fixture Final HEAT114G Contractor Permit No. Gas or Oil ough-in Final S E W E H Final DRIVEWAY Final Storm_Drainage (Rain Drain) Final Sidewalk Curb&Street Final Approach SLOG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Landscaping Zoning Final �3 City of Tigard INSPECTION REQUEST for INSPECTION TIME: _ __-- PERMIT NO. : '/'- -' DATE : __1LL1.,7 D AT E I S S U E D : <- OWNERS NAME ' ADDRESS: CONTRACTOR : __ ------ ✓.c e.��oK 'T TEST * Air ❑, Water[] , Visual Laboratory RESULT: Approve�dz, Disapproved O Pending I] SKETCH: INSPECTOR DATE [NOTE At;ach supplemental test data beret] ■ if ffw w I l; City of Tigard INSPECTION REQUEST for ` INSPECTION TIME .' Z,'VQ PERMIT NO. : — D AT E: 'y l Z7 3 DATE ISSUED:-2--L— OWNERS SSUED:_—L--LOWNERS NAME : Cy � �a �i�C �y„� lo — IADDRESS : =ALL-1 - I CONTRACTOR - PEST. Air Cl , Water 11 , Visual ff- Laboratory ❑ RESULT: Approved Disapproved LJ , Pending SKETCH: I I I I INSPECTOR DATE COTE : Attach supplemental test data heret- 1 1 lam_c �i 23 q Address 13855 S.W. 114th Ave. Permit No. 47� Permi charge _ -- Owner Columbia Cust.3m Homes Connection fee 425 �_._.--- Paid by Type of building Date connected a-e-71 Service rate _ 3.00 per month inspection fee - 95 _.-- Contractor rr,i ,,,hj, r..a4ga Paid by date Size of connection _4" Assessment Paid -- i City of Tigard INSPECTION REQUEST for --------- INSPECTION TIME: �3 0 _ PERMIT DATE: J//.J/2 DATE ISSUED : OWNERS NAME ADDRESS ' C 0 N T R A C T O V . I�1C ---- TEST . Air Ci , W.itar Q Visual.L�Laboratory Fj RESULT . Appioiedlief Disapproved ❑ Fending L] SKETCH.' � ffr INSPECTOR DATE COTE : Attach supplemental test data beret i Ld —I 1 w w w w 1 � City of Tigard INSPECTION REQUEST for P Ii INSPECTION TIME : PERMIT NO. : DATEDATE ISSUED: OWNERS NAME . 4 - I ADDRESS : �r-_ �.�' 4 I CONTRACTOR :— I TEST . Air P,, .......�u�ctcr p , Vi;zual Er, -Laboratory p RESULT. Approved p , Disapproved J Pending +�J ' SKETCH: STra� �' To Loa ,i To I I -- - Azzr INSPECTOR DATE ICOTE' Attach supplemental test data heret] I I I I City of Tigard igard INSPECTION REQUEST for i INSPECTION TIME: PERMIT NO.: X. /9 -1 DATE: � I K123 DATE ISSUED:_.LL OWNERS NAME . ALLIM-Lw &t4 , ADDRESS : 13X55 `-IL` WILL, � - I CONTRACTOR : �°�*+��� N�.b- ITEST: Air Cl, Water ay,- Visual ff Laboratory p RESULT. Approved EY Disapproved p , Pending L] I SKETCK. I INSPECTOR DATE ' EOTE : Attach supplementol test dato heretJ i i I I City of Tigard I INSPECTION REQUEST for INSPECTION TIME: L � " PERMIT NO. : > DATE: DATE ISSUED : Ld OWNERS NAME : `a,. — ADDRESS: CONTRACTOR *. TEST : Air El, Water ❑ , Visual n", Laboratory RESULT: Approved L3 , Disapproved O , Pending L] SKETCH.' INSPECTOR DATE CN07E : Attach supplemental test data herevo� CITY OF TIGARD MECHANICAL PERMIT DATZ l•+L-73 PF]tM I T NO. t _ REC E;I PT NO. By FEE. 4& L t' 1. Permit shall be obtained prior to commencement of .installation. 2. Permit shall be obtained for all appliances which are to become a fixture to the building. 3. Relocation, replacements, alterations, or chRnges to burners and duct work require permits. 4. All worktobe concealed must be inspected before cover up. j New Installation (' I Replace ❑ RNlocat.ion ❑ Ad itian El Alteration ❑ CONTR. 6u:uet .►al 6 ►ut OWNER Coluabia CIOU04ibay_.. A ADDRESS 2.1e, 3 a 'Ors-0 WORM. ADDRESS 1r+ bA 5 W 1-ULh APPLICANT TELEi HONE NO. ZL-;1, FURNACE - MANUFACTURER Carrier TELEPHONE NO. HEAT Input rating t8tu Per HoudW -- 00 Vent Size b' Flue Size FUEL OILj_j GAS© ELECT ❑ OTHER TOTAL SO. FT. Top Floor Main Floor 11a:;�mant GENERAL ITEM NO. FEE ITEM NO. FETE or ance :>f Permit ( - 130o1C' 1er o Over o c s°nep rd P Under r ' Air an in arF M over r an n cva ora ive oo er 0 or rnrce e ►Floor - Sus erer m ns all Vents en s epair ilers Under Domestic omm. n— nera or o o 30 UP — Ilers 1 o F INSPECTOR'S ------ APPROVED 8Y DATE ISSUED BY __. DATE Signature of Applicant I crry or k laaued- ,r1. ! ___ Permit No. City Halt Applicatiooss Approved Building Depa. :nlient Coat of InstaWtiois___ Fee for Permit�r J Appik-ant, shall fill in cost of installation only, Date above this double line. Street Sewer Permitrepair - Application is hereby made to a Plumbing Pipes or Fixtures according to plans and specifications and install description as given belcyw: , Location of building-Number and Street Lot ______ . __ _. Block Addition __— Name and Address of Owne Name and Address of Plumber ' 1-11--3S_?J- .7 or Building (Old or New) ___ y_ Height in Stories __ __ Occupied as.- SCHEDULE OF WORK i NUMBER _ I_ NUMBER FIXTURES _ I New Move (R'pl'ce FULTURES I' New I Move I R'pl'ce Water Closets— LL �_�_i tr- Fountains, Drinking Bath Shower____ _~_ !— Fountains, Ya BathTub-._--. �I_./ a) L Fountains, Soda__._ Basins AJ--1V Hot Water Tank- _ _- Sinks, OrdinaSinks, Bar Sinks, Dishwashing _ Sinks, Slop. _ �_� --� �� Automatic Dishwasher Drains, gerrtor _ .I_1 _ i I I i I Laundry Trays.__.- ___ I .I -__ _ Drains, Ice Box -I-.— Drains, I-.Drains, Floor_ _ _ — __ Urinals Drains, Area_ Catch-Basins, Pard_- Rain Drains Catch-Basins, Garage Automatic Washer ._ __ _ ____rL_ Catch-Basins, Sus Soil_____-.I_. Water Permit No..-.-_ .__.___ _ _ _-_ Bldg. Permit No. NFMARKS: a7, COLL- I IMPORTANTI-Plumbing shall not be installed Its any building, (either new, altered,or repaired), except as shown or designated on the corresponding building plans as filed with, or required by, the Building Department In accordance with the provisions of the Building Code and Ordinance 61.19 of the City of Tigard. rthe plumhing system according to this description, plans and specifications and the Plumbing Coda of the I a4rer to in Cityr�offTiTigard. Plumbing FIrm.L - -- - -- ---- -Supervisor . City of Tigard INSPECTION REQUEST for INSPECTION TIME : 2:02 PERMIT NO. : DATE: DATE ISSUED: OWNERS NAME ' __.LLia-4 — ADDRESS ia . 4 ..ADDRESS CONTRACTOR :— TEST'. ONTRACTOR :_.TEST. Air ❑, Watet �j , Visual 0 , Laboratory ❑ RESULT'. Approved ❑ Disapproved ❑ , Pending ❑ SKETCH' INSPECTOR DATE IN:OTE : Attach supplemental fest data heret] UNIFIED SEWERAGE AGENCY NO. ___ 4792 WASHINGTON COUNTY DATE Feb. 2, 1973 CITY O F _Ti APPLICATION FOR SEWER CONNECTION PERMIT OWNER: Columbia Custom Home e OWNER'S ADDRESS:_— 9 Mt. Jeffersgn.merrsca _ -_ - STiaEET -- CITY STATE ZIP BUILDING SITE: LOT ..-_35 BLOCK T.- ---- ADDITION Viewmouat TAX LOT NO. TYPE OF OCCUPANCY _ Bt's1l3 oat ADDRESS . -_-13855 : 114tkk Ager DWELLING UNITS-. _ _____. 1 _ _�� FIXTURE UNITS .-._ 16 SURCHARGE IF APPLICABLF __ _ .50 to DO:'='Y.n!u_.__._.___ —__.— PERMIT FEE - 425 -__._-__ ___ INSPECTION FEE _25._._- TOTAL DEPOSITED —.�►�9.�______. (NEW),' (EXISTING) BUILDING SEWER SYSTEM The Applicant ,igrees to comply with all rules and regulations o1 the Unified Sewerage Agency. APPLICANT SEWER PERMIT' THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE SIZE __- 4" INSTALLER _ Copper Plbg. RECEIVED BY___ . fAGEN OR ITS AGENT) COMMENTS: This Application and permit expires in ninety (90) days. The amount paid will he forfeited should expiration occur. f# 1 e�ww w j• O� 7. - CITY OF TIGARD f 12420 L W. MWn a►n.� T"ARD. 06640" APPLICATION !•OR BUILDING PeFU4 IT a Remodel MON O Addition .w Construction a] alish — ____ -_. ____------- -- BUILDING PERMIT UATt: ISSUF:U��T3 — No. 73- 16 NG ,�-L -' NUILDING FEE RECEIVED-yi!Ri.�- pLAN CHECF S- -44.40.- VALUATION 39.40 _�. OTI{ER = RECEIPT No TOTAL • �- S _ S OF+PI.A'NS AND pt.OT PLANS MJST BC FUR JOB WITH APPLICATION Two SET ,tOH I__,_,_. MAP 1 mat CENSUS TRACT 35 ,____— _ — �al„si�la - ,itect or Engineer Phone`_...__-_- e s s 9 MSS-.JW2 AhAltl -- .r lder___. phone----- ress — Comm. —• 11Industrial Single Res. Multi Hes. Comm UDING USE Area of I,otA. No. of S>;ories,3_— Total Height s_�.._ JPANCy GROUP_IL I-' �� V Floor Area ,• of Construction R,gide ltackst Front 13.5 Hack 15 , L.Side_1—_.__. - �Septic Tank vate Sewer Pipe Site T site-i/40 storm Ditch ❑ Urywell er Service Pipe ts__ lsist -_ ---_'--.---- est and Curb RequirvwnNo or parkinq Spaces_ — veway Midth____�1 ----------------- — SEPARATE pERMITS pF.VUIREU FOO, SEWER AND PLUMBING SPECIAL 1NFoRMAT11W )RESS ASSIGNED`._____ ----� DATE__. F.LD CHECK By -•--�'"__. --__--- --- --—___ i • r' pERMIT APPROVED By with &P it codes and ordift*" 40 is understood that all work will of Tigard, Oregon, and that the buildi� the State of �;regon and the City has an issued by the City occupied until a Certificate of Occupatlr q&rd sui ld inq Inspector. ,. cf:n- r-*--0 PP wf ■ i i VFC-r� f-Loou". o?� 090, 5" 1C�4,6 0 = ��aa 9 3�i,yo v��u.=�7��►,� k.MIT '�1D4 adv rGAw GNE�.✓ y52,oc� oaf► J