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14255 SW 114TH AVENUE-1 w w WNW0 14255 SW 114TH AVENUE I t crJ in U) N .-1 ADDRESS - 5 =� �: W �1 PERMIT NO. PERMIT CHARGE none OWNER c2 CONNECTION FEE _ ad) . PAID BY TYPE OF BUILDING tJ• DATE CONNECTED SERVICE RATE _ I of INSPECTION FEE a CONTRACTOR P+ IO BY DATE . SIZE OF, CONNECTION ASSESSI'IENT PAID _ m,� PL%J 1131iVG PERMIT ' f/ hoider of a valid plumbing contractors license is heresy au►horized to cause plumbing work a herein ne:sd to be ins;a,;ed in accordance with the plumbin, code of Tigard. Such installations require inspection by tiie City Inspector who shall be notified no, less than four A4 hours prior to the ti.r-e the installations are ready for inspection. City of Tigard Business License required for all contractors and sub-conuactors. Gwne' A+✓dres� � � 1 as;a NUNT r 0, - TU.h. PERMIT INC.'S TYPE OF ?Zi'.1iT ITrD5 C' ZACH AMOUNT I (Office Use Oniy) :;.-•Ip "n-n: —1 both,—each h.�—/�—_---_--.. 25.00 __I �`71�Z� .Ij i)u�',x—each 1 bath unit _ _I 25,00 r"rd trona, bathrooms—each I�_ w _— 1000 z C CZE V,b a Homo Space—each 16,00 I �VDIVlOUAL FIXTURE FEES _ 1 to 3o Fixture. in 1 building—each 3,00 ' i' to 1CO Fixtures in 1 buildin7—each I I 2.53---- 1,11 .50 _____1,11 *o 2u"0 Fixturn in 1 building—each 2.CO _ — _ 2J1 or more ziR ures in 1 bui'ding ouh i 1 GJ i t/ iS:EILAPIEOUS — II _uiiuiug Sower-1st 50 ft, „_�_ , I y-10.G0 - w h -Adi:ional 103 ft. 10,OJ lkau'S t'vico to buildin 5'OO 'r v is W:tar SYsto. s—ozch :3G It. �,_,•. — for Plumbinj Insp7cdon Phono 6394191 _-- Plumb!% Contractor 8y Lt, it 707A`� RZCciP; NO. Issuad By ___.--- i BUILDING PERMIT APPLICATION COF TIGARD DATE 11/2V ,y THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE LOT NO. ` `- OWNER ii 18, I, `} J. ;. JOB ADDRESS1 12 1:7 SW 114th _HOME ADDRESS ARCHITECT — ENGINEER BUILDER ^_ ADDRESS DESIGNER STRUCTURE [:]NEW _D REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION RESIDENCE ❑COMM ❑EDUCATIONAL DGOV'T DRELIGIOUSOPATIO ❑CARPORT ❑GARAGE 0STORAGE DSLAB [:]FENCE �DBOND ❑MOV ING — ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS OCCUPANCY "'" _LAND USE ZONE_11—7 BLDG.TYPE a! FIRE ZONE `j PLAN CHECK 8Y � 1 HEAT sin(J& family duellink4 wf att$chma gatrege - 4 bodraum - ,3 Ji. - -- 'rawer Oermit #17556 �_ 1625.00 UCC—LQAU___, -__-- F1.448_I.99P._-.4q _.b€�SaN_I '�L�._�0.STORIES J .' AREA----� NO.BEDROOMS Y9LU!"ul BUILDING DEPAR I MEN7 SET BACKS FRONT REAR 1 " LEFT SIDE I RIGHT SIDE Peimit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF BUILDING CODE, ZONING Plan Check :QJ• REGULATIONS AND ALL APPLICABLE CODES AND JRDINANCES, AND IT IS HEREBY AGREED THAT THE Subtotal 31u. AWORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND St1B CONTRACTORS TO HAVE CURRENT CITY BUSINESS State Tax u.441 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total ' 324, 94 ijUL til 21U0e 00 f 1 BY Approved im ta"!t1 Receipt No. ``1.c tip APPLIC,4N1OpAGENT------ ------ _ I1M� - rr r� Ise I!Fos NWw w DATE INSP. TYPE INSPECTION REMARKS PLrIM81NO I DATE Contractor — ` / J• _ Permit No. : Fi_— -- Fixture / Final tS l -- ------ ---- HEATINGi Contractor 22 � p _ /- -� 79 / i i �/SS/dG1Por/� Permit No. Gas or Oil Rough•in Final SEWER Final DRIVEWAY Final Storm Drainage (Rain Drain)Final Sidewalk Curb&Street Final Approach 0LDGI. DEPT.FINAL TCMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final -- -- Landscaping Zoning Final i TY 3! IL DING PERMIT APPLICATION �� F -�,RD DATE _ �� ,t92Z N2 J A C OF -��F l:%'1E H�;IGNED HEREBY APPLIES FOR APE RM IT FOR THE WORK HERt-.IN IN ICAJ-FD BUILDERPHON 7� R AS SHCVJN AND APPROVED IN THE ACCOMPANYING PI ANS AND SPECIF ICAs IONS, OWNER PHONE:!• / R 'd LOT NO ��� I I K✓ I–1 _HO_ME ADDRESS ADDRESS ARCHITECT ENGINEER ADDRESS _ DESIGNER �1 YP7NEW OREMODEL �[3ADUITIO_N�y ❑REPAIR_—LRENEWA_L_ ❑FIRE DAMAGE T ❑DEMOLITION `. IC!.NCE ❑C13MM ❑EDUCATIONAL OGOV'T ❑RFLIGIOUSCOPATIO ❑CARPORT ❑GARAGE ❑STORAGEDSLAS ❑FENCE I-Ir^Nn ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS r _ OUSE ZONE Bl DG TYPE._ FIRE ZONEI PIAN CHECK BY H Ot Ole- Z:.-.P3E&11)-3_hW—PE?ROOMTALUE (01,10W _ _ BUILDINGlDEPAHTMENT SET BACKS I RONT V I REAR r, LEFT SIDE 7 / RIGHT SIDE ��^ �+ y, --- –" –"– THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Pian Check — Jr RFGULATIONS AND 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 Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONN HACTORS TO HAVE CURRENT CITY BUSINESS F�1bte Tax LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING, Total Z BY AF+pI ICAN1 Op AGENT —.�..- --�--- Appl Hued Receipt No. S~?a