10980 SW 115TH AVENUE i
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10980 SW 115TH AVENUE
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ADDRESS PERMIT NO.
PERMIT CHARGE none
OWNER --•••.. `' CONNECTION FEE J '�S
PAID BY
TYPE. OF EUTLDING DATE CONNECTED
SERVICE RATE `' INSPECTION FEE
CONTRAICT:iR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
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Owner: _ _Dob Smith _ _Permit No. _ 1436 1
-' Buildiri;Address,_11)980 .SW�._ 15th St..
y Larch
Certificate is hereby f;iven this 16 _ da q�f_ '
that said building may be occupied and that
' it ty complies with all requirements ments of the Building Code for the Gity (if Tigard as
approved by the Tigard City Council. '1
Qt ing Inspertur -
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APIA,
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CITY OF TIOARD
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Owner: Bob SnithPel'n�14 No...1.348..........
...............
,sI Building Address..... �.2.G7.........................
Certificate is hereby given this......0........day of....kug.uat........ ...... 19...7.7... �'
that said building may be occupied and �.
that it complies with all requirements of
the Building Code for the City of Tigard, +�
as approved by the Tigard City Council. > �
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Building Inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :—
DATE: _ I DATE ISSUED .___L Z '
OWNERS NAME : __ —
ADDRESS:
CONTRArTOR : ---
TEST : Air ❑, VMter❑ , Visual , Laboratory D 1
R : A roved Diso roved C Pending p
E'SULT pp r V? _
SKETCH:
Il I
INSPECTOR _ DATE
OTE Attach supplemental test data beret?]
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4C' BUILDING NLBMiT APPLICATION 1oF TIGARD DATE J-3"77
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE �1
OR AS SHOWN ANL APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. —�-�
OWNER '' .F� r.(7� JOB ADDRESS 8_) �I 2 �1r HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER _ ADDRESS DESIONER
STRUCTURE __:_GQNEW ❑REMODEL ❑ADQITION ❑REPAIR —[]RENEWAL [-]FIRE DAMAGE^ ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL CGOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT [:]GARAGE ❑STORAGE USI-AB ❑FENCE
❑BOND ❑MOVING QCONDITIONA'_ -JSE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SI(.,NS
OCCUPANCY '----,AND USE ZONE .__BLDG.TYPE_— --FIRE 'CAE___ PLAN CHECK BY _ - HEAT._ _
Lcirist. *sirjuja family jigelling a/at rid �;arrr -Fa--- 6 bLdruoni 3 butti
Lut _.20E 6asomfort 41A sq.,' ft. garage ::,75 on,, t t.
40 :. 1196 6 711
1lElcaliTN�$i.4.Hl�S__ __.Af3€��—i� 'L�H�•ROOMS VALUE
BUILDING DEPARTMENT E$ T BAC, z) rPONT REAR �; LEFT SIDE 1t1 RIGHT SIDE
1 'R
Permit al.IQ17 PC,z)— —__-- —THIS PERMIT IS ISSL:ED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check H), REG JILATIONS AND ALI_ APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
vWJRX WILL BE DONE IN hCCORDANCE YVI TH 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 SUP CONTIIACTnr,S TO HAVE CURRFNT rI I Y RUSINESS
State Tax4.83 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING %NO HEAPING.
Total x,50,83 I hF 1 100
By
------ APPLICANT OR AGr i
Approved I Receipt No,
ADDRESS PiiinvE
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UATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
V
Permit No. 3e0-
Hough-in
Fixturt.
Final
-Z2 Lag ILej,4_re
HEATING
Contractor
L., Permit No. 77
rZa.-a k`6' 4&?jko�&, Gas or Oil
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SEWER
_1224A!r'_l Fal
DRIVEWAY Lc sq 7
Final
/ ,7
s7hiie
14-)A_u2 12jaliL
q Q jJ2 (Rain Drain) Final
2 _019 ']i2,i-?i3yS7j0#U AlAe- Sidewalk
Curb&Street Final
1p - A.pproach L S 17
BLDG DEPT.FINALTEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
c Landscapivig C
Zoning Final
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CITY OF TIGARD
ORDINANCE " 77--26
STREET SYSTEM DEVELOPMENT CHARGE
DATE 5-3-77 S 409000.
ESTIMATED SALES PRICE
APPLICANT NAME Bob Smith
JOB ADDRESS 10950 SLI 115th
PERMIT
AMOUNT OF FEE FOR S . 0.
DESCRIPTION OFle
lY dwe_llino
EXEmp*ri�,,,s -PER ORDINANCE 77-26
FEE RATES:
A. Single family duelling unit under $60, 000.--------- $300. 00
B. Single family duelling unit over $60, 000- ----.- ---- $400. 00
C. Mobile Home Court Space (New Development)----- si50. 00
D. Multi-Family Detillings--per unit------------------- $240,00
F . Commercial, Industrial & Institutional (Park. Space
$ 50- 00 each
Single family unit under $40, 000. ----------------_- $250. 00
SEWER PERMIT - -77
N • 12152
Unified Sewerage Agency
Of Washington County CITY OFTioar DATE S-3-77
OWNER : Bob Smith PHONE : f6AAm@Q5$
OWNER 'S ADDRESS: 297-2715
TYPE OF INSTALLATION:
kyvUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
DINEW '!^J SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) MULT . RES . Ej INDUSTRIAL
FIXTURE UNITS DWELLING UNITS , 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FCR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED ,r MOULD EXPIRATION OCCUR .
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE _mss
SIDE SEWER INSTALLATIONS- l� ZP� �
OTHER I SSUED'-lSY
�-� TOTAL $ 600,
J�k -,,,,Y 3 -7 -1
AP ICANT DATE
SEWER PERMIT NV 12152
ADDRESS OF STRUCTURE 10950 SW 115th
TAX MAP TAX LOT _ SYSTEM Fanno Crggk
LOT 208 BLOCK OF
- ,< <
APPROVED BY DATE TSS4ED BY DATE
REMARKS Rt rin- #I G'{5 _
City of Tigard
INSPECTION REOU ST
for
INSPECTION TIME ' 4v PERMIT NO.:
DATE: DATE ISSUED:—
OWNERS NAME '.
ADDRESS :
CONTRACTOR :—
TEST'
ONTRACTOR :_TEST: Air ❑, Wotr L] , isual ❑ , Laboratory p
RESULT: Approved - `. Disapproved ❑ , Pending IJ
SKETCH:
b
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INS CTOR DATE
EOTE . Attach supplementol reef dnfo heref��
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City of Tigard
INSPECTION REQUEST
or,
I INSPECTION TIME. ._ PERMIT NO, : - ---
DATE' A�L22DATE ISSUED-.—�-J—
OWNERS NAME .
AODP.ES:)-
TEST* Air 0, Water [;Visual D , Laboratory
RESULT.'
Approved 'Y, DiSQPPIOled 11 , Pending
SKETCH.'
e 5 tv Is'e<
IN&E-C—TOR DATE
C01"E Attach supplemental toot data heretol
UNIFIED SEWERAGE AGENCY NO, 11695
WASHINGTON COUNTY DATE 3-16-77
CITY OF- Tigard
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: Smith
OWNER'S ADDRESS:
STREET
CITU STATE------ ZIP
BUILDING SITE: LOT 207 BLOCK ADDITION
TAX LOT NO. TYPE OF OCCUPANCY residence
ADDRESS 10920 SW 115th. Ave.,
DWELLING UNITS -– --- --- 1 --.___ - ------ FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE _ 575. INSPECTION FEE __25*-- TOTAL DEPOSITED 600*
(NEW) (EXISTING) BUILDING SEWER SYSTEM Fanno Creek
The Applicant agrees to comply with all rules and rEVd
Tiris of the Unified Sewerage Agency.
APPLICAN,
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE —INSTALLER
RECEIVED BY 'L' '/te
1AGEN!qV OR ITS AGENT)
COMI'1ENTS:
This Application and permit expires in one hundred and tv enty (1120) days,
The amount paid will be forfeited should expiration occur.
NMMRK
� i„"TR4'Y�.\�!;�!p�Rw7l�u11n11en _ I►,. 1rR'�R1R��
BUILDING PERMIT APPLICATIO14 COF TIGARD DATE_ "1'�"" t9 1348
THE UNDERSIGNED HEREBY APPLIES FOR AFERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONr- ,i��'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE—
LOT NO.
OWNER '*" I w.wl�ul JOB ADDRESSy]QS'I 5W 1l5th A V4* HOME ADDRESS _
ARC;TITECT
BUILDER 5CA,idU. ADDRESS ENGINEER
DESIGNER
STRUCTURE "K NEW ❑REMODEL _ ❑ADDITiON ❑REPAIRr, [-]RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
Q fIESIDF.NCE [:]COMM ❑EUUCATIONAI- ❑GOV'T ❑RELIGIOUS OPATIO ❑CAR PORT OGARAGE ❑STORAGE QSLAB ❑FENCE
—OBONU ❑MOVING ❑CONDITIONAL ,ISE El DESIGN REVIEW
13COl1NCILAPPROVED _ ❑SIGNS
OCCUPANCY 'I .LAND USE ZONE �" BLDG. TYPE Jia _FIRE ZONE—�� PLAN CHECK BY OtiV HEAT
.;rtat. sinyl f', family dlijelllnt� W,/aatdled yaragr Lrat #107 Englewood
-_ 3 bodruum 2 bath
GCQ,-LQAD -LOU,B LQAD HEIGHT 40a
--NO,STORIES I AREA IAQF��Q UROOMS .___Vgl l 0.;?QQ.
BUILDING DEPARTMENT
SETBACKS FF2I?ONT REAR 28 LEFT SIDE 6 5 RIGHT SIDE
Permit 142.00
THIS PERMIT Ili ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10•,Jo REGULATIONS 4ND ALL APPLICABLE CODES AND ORDINANCES. ANO IT IS HEREBY AGREED THAT THE
WORK WILL BE )ONE IN ACCORDANCE WITH THE PLAN-,AND SPECIFICATIONS AND INCOMPLIANCE WITH
Sub-total ALL APPLICAB.E CODES AND ORDINANCES. T.- ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE C]VENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4o!36 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 1 J6*5b
BY
Approved
w Receipt No ``_-_ APPI�f ANI OR AGENT -- - --- __-.
A65AIESS -----
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DATE INSP. TYPE INSPECTION REMARKS
=_/; j — r•-7`ii`t _
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PLUMBING
�DATEltor
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Fixture
V! Final
~'^D HEATING
-- Contractor
Permit No. '�� 7�i V—/5-
lGas or Oil
Rough-in
— Final
'SEWER
— Final
DRIVEWAY —
------- —___ Final
(Rain Drain) Final
Sidewalk _
m_- --- Curb&Street Fi ia1 ---- ---- —
BLDG DEPT FINAL —_ 4 roach _
TEMPURARV CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Fina'
/ Landscaping
__ 1 Zon nq Final
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