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11210 SW FAIRHAVEN STREET-1 N O CF) E. "T1 fll H W r m cn 1.1210 SW F'AIRHAVEN STREET ADDRESS r,- 1 10 1. u0 PERMT NO. PERIIIT CHARGE none _ OUNER Jea111-u � M�._ _ CONNECTION FEE _ PAID BY TYPE OF BUILDING , DATE CONNECTED SERVICE RATE / INISPECTIDN FEE CONTRACTOR _ PAID BY DATE 5I7.E OF COUNECTION ��_� __ A;SES5fiENT _ ___ __ PAID _. _ 4SEINER PE R IUI IT NY 15949 Ufn Sewerage Agency of Washington County CITY OF TiaaCd _ DATE June 16 , 1078 ____ OWNER : Barnum Home:; PH:INE : OWNER ' S ADDRESS: TYPE OF INSTALLATION: C7 BUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER TYPE OF OCCUPANCY: NEW SINGLE FAMILY © COMMERCIAL ❑ EXIST, (PRIOR f0 7- 1-70 ) ❑ MULT . RFS. ❑ INDUSTRIAL FIXTURE U14ITS DWELLING UNITS 1 ADDRESS OF STRUCTURE : 11__210 SIV Fairhaven St . PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION. PLEAS[ REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE- HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD EXPIRATION OCCUR. FEES: PERMIT FEE CONNECTION CHARGE 600, SIDE SEWER INS'TAL.LATION n_ rnhnrtcnn ISSUED BY OTHER TOTAL $ 625. A.-PyyCANT DATE N071CC: -LZ,,--) r - V. c ; ,�'iC E N° 15949 ri,�grr 41, ytlil S WER PERMIT R ,.s• p AoDRESS OF STRUCTURE 1121.0 SW Fait haven Street TAX MAP TAX LOT SYSTEM a L O T 4 B L OC K _ -7 O F _ y_ APPROVED BY DATE: ISSUED BY DA i E D. U. ' S 1 REMARKS �bldg. # 21.41 ar BUILDING PERMIT APPLICATIONCIT Y `7ARD TIGARD Xf P14 OF DATE.k'-U E' .�r__-----, 19 THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIIJ INDICATED BUILDERPHONE OR AS SHOWN AND APFROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF OWLOT NO,-___NER JO©ADDRESS r. �*QAtpp _ OMEADDRESS _ ARCHITECT BUILDER ��II: C ADDRI SS- ENGINEER i49 DESIGNER STRUCTURE ❑NEW ❑RCMODEL- ❑ADDITION ❑ PAIR ❑RENEWAE D L ❑FIRAMAGE — --- - _ ❑DEMOLITION ❑ RESIDENCE -❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE. _ 080NU ❑MOVIIJG ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED DSIGNS OCCUPANCY LANIJ USE ZONE a+. � r - -- -BLDG.TYPE V FIRE ZONE Q=- PLAN CHECK BY=-, _ HEAT-__ t o>aalt_S�•nttlrJ rfurilg Dwelling link 1w tktr..RC1l4J•:9 ----------------- o room H7 ' r� 9 :s`� NO.eE�f300M '► rPlanCSheck DING DEPARTMENT iE3 f;� — SET BACKS FRONT REAR LEFT SIDE `ill RIGHT SIDE 1 ` t 7• - — _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING _ �1" n REGULATIONS AND ALL APPLICABLE COI)ES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL. BE DONE IN ACCUHUANL.L WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Subtotal "Ik ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERM17 DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRFNT CITY BUSINFSS State Tax 2== 7.(U LICENSE. SEPARATE PERMITS RFOUIRED FOR SEWER, PLUMBING AND HEATING. Total i'F�.aI() S.D.t'. 1400. By p.n.c,. loo. Mi APPI If-ANT OR AGFNT _.._ - ------_---.-.__-- Approved 1�1i'.- Receipt No i DATE INSP.) TYPE INSPECTION REMARKS PLUMBING DATE --- ----�� - --- Contractor n _ a Permit No. Z Fixtura --- _/ Final hIEATINCr Contractor -- --- -.— --- -- Permit No. -- 42-7 k ��S — V — -- — - Gas or Oil Rough-in _ — ^_— —,__ -------.. Final - -- - - - --- SEWER --- -- -- Final C Z — — ----- - DRIVEWAY Final Storm Drainage (Rein Drain)Final. Sidewalk Curb&Street Final —L— _- Approach BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY ) 7 Final AO Landscaping Zoning Final J 1 }