13575 SW 115TH AVENUE-1 V �
13575 SlN ].1'?TH AVENUE
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BUILDING PERMIT APPLICATION TIGARD DATE _ 1t]r1 151__�� 3428
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE5_0".b ,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER P S E�,.��b�__ _
�.c►, LOT NO. •UUUL
OWNER druce W. Llark JOBADDRESS 13':-j7: 51, 115th Avenur
ARCHITECT
ENGINEER
BUILDER Idestaide 0emodelers ADDRESS 12:x55 SW Summarcrest DESIGNER Westaide
STRUCTURE ❑ NEW ❑ REMODEL IN ADDITION ❑ REPAIR O RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
a RESIDENCE ❑ COMM Ej EDUCATIONAL ❑ GOV1 ❑ PELIGIOUS ❑ PATIO ❑ CARPORT ❑ GA. 1GE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY F"' LAND USE ZONE p-10 BLDG.TYPE =�t� -FIRE ZONE_PLAN CHECK BY HEAT_.__ r�
Construct 4' bedroom addition to existinrLsinyla family d�!elliny..
�r,!a Machanical or Plumbing.
SEWER PERMIT# _
OCC.LOAD FLOOR LOAD 40 HEIGHT-`_ 11 NO_STORIES 1 AREA 100 NO.BEOROOMS - VALuA 4,00 L!.
BUILDING DEPARTMENT _ SET BACKS FRONT 3n REAR -- LEFT SIDE 4 RI",HT MICE --
Permit U'i10 _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINS) IN THE BUILDING CODE, ZONING
1« On REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. ANN) IT IS HEREBY AGREED THAT THE
Plan Check • _ _ WORK WILT BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL I PPLICABLE CODES AND ORDINANCES. THE ISSUAN(;E OF THIS PERMIT DOFS NOT WAIVE:
Subtotal 42, 00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTCI'IS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING r'ND HEATING.
State Ta#% 1.1•'•
-
Total U43.12 SDC
13Y P
POC# APPLICANT OR AGENT
1
Approved
dWh Receipt No. ADDRESS
`DATE INS TYPE INSPECTION REMARKS PLUMBING
DATE
Contractor
Permit No.
hough-in
Fixture
Final
HEATING
rI Contractor
Permit No.
f
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Stern Drainage
:main Dialn)Final
Sidew3lk
Curb&Street Final
Approach
13LD(-Z DEPT. FINAL TEMPORARY CERTIFICATE OCCUPAr-CV
CERTIFICATE OCCUPANCY Final
Landscriping
Zoning Final
--- ----_--— --- - .—.. - - _ a --.19
BUILDING PERMIT APPLICATION ION TIGARD DAT J "?"A2
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH EWORK HEREIN INDICATED BUILDER PHONE621D.S`1
OR AS SHOWN AND APPROVED IN THE',CCONIPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
w . _ 7a19 LOTNO., 2451-
0
�
O.°.r:ER 0 ruse,CA 0"-tt. JOB ADDRESS I',T_5W (IS �e
ARCHITECT
�/�� Q.-� L ENGINEER .1 _,�11
8UILoEF! afS �e�0&J�• ADDRESS 1 ,SJr4 &1 +�h4��,_DESIGNED �- Ipl9j�S1//t�Q•
STRUCTURE ❑ NEW O REMODEL XADOIT!ON — -1 REPAIR C3 RENEWAL ❑ FIRE DAMAGE ❑ DEMOLMON
RESIDENCE C COMM (] EDUCATIONAL � GOV'T Cl RELIGIOUS ❑ PATIO Cl CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAd❑ FENCE
OCCUPANCY - LAND USE ZONE "10-SLOG.TYPE S�.�E ZONE— PLAN CHECK BY --HEAT
0Iw -
01 40 e 1s r
SEWER PERMIT It
OCC.LOAD FLOOR LOAD s/j_V HEIGHT II _NO.STORIES_ AREA NO.BEDROOMS VALUE4600
BUILDING DEPARTN'ENT SET BACKS FRONT 30 REAR LEFT SI CE RIGHT SIDE !"
P�rml� t '�p THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE,T_ON:A
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TH
Plan Check WORK WILL BE DONE IN ACCOPCA`ICE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAN
— WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVc
!FSuI}tetal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY SUSIN ZS'
I LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stau3 Tax SOC—
Total_ 00 3. 161
pDAPPUCANT OR AGENT
By
�""-- Receipt No. ADDRESS
PMONE
Approved
SDC �
PDC — s
'"EWER CONNECTION S
SEWER INSPECTION S
SEWER SURCHARGE S
t�0 mm e rt'f 5: R P+'�i_µ:..-I -.1-�a `^.-n. 10- Z -
`�e,,� ����-�-�- a-Ido-,r./(�• -- -
CITY OF TiGAM
WASHINGTCN COUNTY,OREGON
July 16, 1980
Mr.. Bruce W. Clark
13575 SW 11-9th
Tigard, Oregon 97223
REFERENCP : VARIANCE, V 7-80 (Bruce Clark)
Located 13575 SW 115th (Wash. Co. Tax Map 2S1 3CD, Tax Lot 300)
Dear Six:
Please be advised that the Tigard Planning Commission at their regular
mee::ing of July 8, 1980, approved your request for a side yard setback variance
to allcq remodeling of existing home.
There art, no conditions subject to this approval.
If, at the expiration of one year from the date of approval of the Variance,
construction of the structure of initiation of the use giving rise to the
need for the Variance has not begun, the rights given by the Variance
approval shall terminate without further action by the City, the Planning
Commission, or the City Council.
If we can be of any further assistance, please do not hesitate to contact.
this office at 639-4171.
Sincerely,
AeH
P1_a ig Director
NOPE: This acknowledgement must be signed and returned to the City of Tigard
Planning Departmnt.
Sicnat-..re Date -`
A1vmc `
--- 12420 S.W. MAIN RO BOX 23397 TIGARD, OREGON 97223 PH: 639-4171
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : 7>0 _ PERMIT NO. : __.._.._.
DATE : DATE ISSUED.
OWNERS N.'.ME :
ADDRESS '. /,35=
CONTRACTOR :
TEST. Air ❑, Water ;] , Visual j�, L.aborator, ❑
RESULT: Approved Disapproved ❑ , Pendinq 4�
SKETCH'
INSPECTOR DA'rE
NOTE' Afteeh fupplemeroul test du4a horst]
CI-ry OF TIGARD
12420 S. W Main Streat
TIGARD, OREGON 97213
APPLICATION FOR BUILDING PERMIT
New Construction Demolish ❑ Addition � Remodel ❑ Move El
ZONING DATE ISSUED __ BUILDING PERMIT
BUILDING FEE $�yNo.
DATE RECEIVED J/7�_ _
PLAN CHECK $ VALUATION $
BYOTHEr. Scc4 t�iu -- —
TOTAL $ �.OsECEIPT No.10
Tho SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT # MAP #� CENSUS TRACT _ — JOB #
Architect or Engineer_
Address 1�53._ Phone3
!'.
Owner-
Address—� lS !—�.�C_ .._ i — -- _P'ione - -O7_rrr
Builder Si9.rt --- -- -- .------- _______._-.-- --- -- -
Address`�fJ.rt G A— ---Phone----
BUILDING USE Single Rea. Multi Res. Comm. ❑ Induatrial�_�
OCCUPANCY GROUP t-4 _ No. of Stories—— _ Total Height_ Area of Lot_
Type of Construction I II III IV V Floor Area B /OX Z01 _ 2 �_
Set Backs: Front---- Back _ I—Side R.Side`
Private Sewer Pipe Size ,v,¢ Sewer`_ Septic Tank ❑
Water Service Pipe Size_,( Storm Sewer 0 Ditch ❑ Drywell❑
Street and Curb Requirements V/!
Driveway Width_ A'tj _ _—_,No, of Parkins- Spaces_
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFOORMATION/��
ADDRESS ASSIGNED_JJ57
FIELD CHECK BY-..___- — -- --..--- ------ DATE_ ' 7S�
PERMIT APPROVED BY//,
�`it is is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a certificate of 4ature
has been issued�bythe�Cty of
Ti.gard 7uildtng Inspector.
Applicant —�