12235 SW 126TH AVENUE w w WWIW�w
12235 SW 126TH AVENUE --
L
�O
N
3
N
Ln
0
N
N
.-1
1 1
J = H > U)
O
LU
J LL Q NIaU � 7
� Ll ui� Qo
o
w y o 2 F>
m z ui UwaNU
�►• �I g cn W w O � zwF
OJI ❑ CI > zao � W
L+ W7. � y2 ~ a Z
Z O C7 C7 'w Zea O
_ I x a m
(1� 0 a ¢ ¢ wwQQwz 6
I ¢ u a O I = Z ° >1=
Ot; 0ul
z ° �, C7 > � � ° =3:
LU
LU U. O
a at_ o
O m O CI a: Q U. 2
Cw7 as > Q a u. 2
a m a U 0, r,
j w z Q J U z U y z U 2
' Q Cl I U z Y H a z ► o
UU LL NzayZ
a U uJ U 2 J zpiny0a I
z z ►
oW= Qd OaFJz
IQ N
CL w aaOa,
¢d WN u ul
Ll El W W 3: , �C
'�o
z LL_ > OzOuOw z
1 ¢ ¢ N ¢ � vwnF
�
z w Q z ¢ r,W Ou; Udr t viYL ul .i a a C7 2 � m � b W
�`ry u d J
0. n V Q Z O 2 c O
Q: 7. o ( II TaoaU � (a
�`►D LL ¢ v NagWN �
W W F Y w oQzC,
�! d ¢ 7 I 2 ¢ w tr
a Z F V01 Cl
L l y 7 N c g W >
w
c- '� O 0 F o yap _IOQ
C) Q v u' a > Q [Ui z ul 0
yci < wcr a
LLl Q N 5 -� '� H� O
LP 2 LI t: QI aZkILUui a
Pu F c, ' X4ccz
_ 7 NJa f w
J 7 , Q O �, w0iwv
C1 an U LFII Na3a ¢ J Q
CL Q LLI C Cl - _
mO w Q I u, `I
.. LLI a. a u
U, dC% . . L I u l u o +.
It 1 w 1 g o�� a O
z z
n
I CII [ I
u
C] C' rn a w z
�^ u' r I n o C' v
]I o > a' t+ o cr u
ftl U ci rn R
c
cr
IFr i Txl I O ( e
I'
{
P will w"mm~
BUILDING PERMIT APPLICATION 11 FY TIGARD DATE 12-16-7619 ` % '4
O
THE UNDERSIGNED HIcREBY APPLIES FOR APE RM IT FOR THE WORK HEREIN INDICATED 13UILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO..
OWNER E.U(�e17kz Lr .Jcll...Ut.;JOB ADDRESS"'ZG 35 SW 126th HOME ADDRESS —
ARCHITECT
ENGINEER
BUILDER !:JldT er ADDRESIS r. DESIGNER
SST ❑ LJ QG
STRUCTURE r- NEW _ REMODEL
ADDITION ❑REPAIR RENEWAL ❑FIRE DAMAGE DEM�O�LITION
L� RESIDENCE ❑COMM ❑EDUCATIONAL C_JGOV'T ❑RELIGIOUSDPATIO ❑CAR PORT ❑GARAGE ❑STORAGE QSLA] 'FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED EJSIGNS
OCCUPANCY_. ----LAND USE ZONE BLDG.TYPE __-------FIRE ZONE.._ PLAN CHECK BY------ HEAT____._. ..
Ins all 71 high f __. _ -- E"�--_'3." '-$'+ . i,,er code reaux r,
OCC . _F$
LOAD �. -LQQR LQAD — HEIGHT_ NO _Af __ W__N_Q2 BF.D_Q9l�__---VALUE 4n0�Q0
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 REGULATIONS 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 CONTRACTORS TO HAVE CURRENTCITY BUSINESS
State Tax •1-' LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
TotalBy • cT
nt r nNT OR AGENT
Approved __..._. Receipt Ne ` --
- ADDRESS �i L
GATE INSP. TYPE INSPECTION 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 Drainagt,_
(Rain Drain) Final
Sidewalk
Curb&Street Final
u'b
Approach
SLOG !DEPT al
,�F L TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Sidewalk
Landscaping
Zon i rig F i nal
-----------
y� 1� 13 U,
_ z2:
o W
r az_
V F- w
Q
0ui
� p m z
Cl 5N
N N u Q O O O~
��^^--�� = Z U � Z
_Ot w ❑ L.I > H OY2FQ w
.r w w m 2 z
w z 0 a = O w a : 7
O d d mm Z � UC1
w a p K w = N a w z a
Z
7 H Q
O m Q LL C] Q u, ° ULLOz
C� a y 2a � 0
z0
z
4
\ w z W
a H;
i
F Q U UOz,
t z z� azar¢ �
O F 3 Cl O' v LL Nzdyz i
L) U w u Z J �QN - Oa
Z LL w ¢ a ` o z w s w
a o g n 2 x
W W \ CI Q 2 O z u H
Q W N V 3 O W H ~ u s
O T n I w w �Cw � ZQO Y
Y Q N Cl W 0 z = p ~ ¢ O
O to n a r- z u' d Owcw.tQ � G S uNi
ry z w d c� Cl w
u W K a ut u G m � O U] c
I off! N 3 /`� C] C� n � w L'C', I o
N o
y Q. L7 7 � 0, 0CL 0QuCA ¢ ¢
Ut o °_ Cl Hd < N , �
Ur " Q w cr
cr
w h z ui w azOda
� a K 7 = O K n O wtf7w
� `l O D U t C� N > 7 N 'l_ Ow > Q
1 a Q uZi a s f W Q Ndam� m
C) Q U t U T u Nw d Q
>
cr Q d (1 z
O 2 t J u! o
U W O O �y yt OO Y' 2 -�y f N 7
Lc? r CI U� wdsaUu;
L� enF- J x Q z n
J 7 t t Z m NSC _lyw V
(~L a O O w uj _t w u a.
C u1 C u' 7 �ta
l twn � � dK J Q
r..
u v 1 v 1 t
_ ut a: j c ,
Q
.rte or, CI ° U u n �. o —
1: I I 7 J Q
C;" n ci > o o F
L l w4 O a O a
CL Z Q 3 :i 5 Q u a
C7 7 t O r w
cl
CW1 N w cl
C 1 7 n
W c u w u > x a
Q u a w O U n t u �_ u i
et m 4 �' = v v �!
t C I 1 t Ct a L' uV. �,i N
o ei a S a c'
W W
Addres--12235 S.W. 126th No
Permit
Owner Mr. & Mrs. Eugene L. Jackson Connection fee 400*00
Paid
Type of building Residence Date connected—.Not available
Service rate 3.00 per month Inspection
Contractor Dale Oonst. Paid by Dale Const- Date 2-29-72
Size of connection Assessment.---Paj.d
0
� _ �_ _�/ ..__ .
-----PESMIT TO CONNECT
Tigard Sanitary District
PERMIT V 1584 DATE
1'FNMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF (70NNECTION HAS BEEN COM-
PLETED.
OM-
PLETED.
PERMIT FEE PAID ...... ...... TIGARD SANITARY DISTRICT
CONNECTION INSPECTED AND .APPROVED
Z4,14 y. /' t 'A"e I/
Date e perintcut
1110