11215 SW FAIRHAVEN STREET r
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11215 SW FAIRHAVEN STREET
Avoid Verbal Messages
CITY OF TIGARD _
from
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Permit. charge
fonnoction fee
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Date connoctn(I
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Inspection fi S
Paid by date
Aosesament Paid
M
ION F R 0 E F',[Vi I T N?
13464
Unified Sewerage Agency
of Washington County CITY OF___:rjjLi.j DATE ___ 7-5--7Z _
0 N E R PHONE : 635-6187
OWNER ' S ADDRESS t
TYPE OF INSTALLATION:
[�gBUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
Bf�EW XEJXSINGLE FAMILY Ll COMMERC I AL
[]EXIST . (PRIOR TO 7-1-70 ) MULT . RES. L] INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FELSs
P7_RMIT FEE $ 25.
CONNECTION CHARGE
SIDE SEW'-:rR INSTALLATION
ISSUFD BY
OTHER
TOTAL 625.
APPLICANT DA iF_
SEWER 11 E VIMIT M 13164
11215 SU Fairhaven 5t.
ADDRESS OF STRUCTURE
'FAX MAP--- --,----- TAX I-O*T---.---..—.------- SYSTEM fa no nu_;;,k
L UT Bl_OCK OF
APPROVED BY DATE 1 5 S Lt=D BY DA
R E MA R KS .1
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7-5
BUILDING PERMIT APPLICATION CITY
TIGARD DATE 4w, �- 7 , j9__ 1i
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13UILDER PHONE •- .--' _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PFfONE _,--
LOT NO.
OW_ NFR �jj 4tl�r `!�1jy L4 Iti;.r JOBADDRESS f airhgUF-Iti j4b&AE_A_DDRESS
>RCHITECT
cNGir'
BUILDER „iaitEElt: ADDRESS _DESIGNER
STRUCTURE M'❑qEW _ ❑REMODEL ___❑ADDITION ❑REPAIR ❑F,=NEWAL ❑FIR—�E DAMAGE ❑DEM-IDEM
QLP�DENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑(;O,JNCIL APPROVED ❑SIGNS
OCCUPANCY--L—LAND USE ZONE BLDG.TYPE JN FIRE ZONE APLAN CHECK BY �tw _ HEAT t"l V f-•
r►inyll;, family dwallit-tiy w/:ittachad yaraya, all pur plans appruved.
o+ t wdroom 3 bath N"'T['. t 1ccupency not allowed on this permit unti.11 atreet
improvement is cOMN1e66 1411d aubdicioion is racoraed. garage X04 mta.ft.
A- �_UU NO.BEDROOMS—{t VALUE
BUILDING DEPARTMENT SET BACKS FRONT 37 REAR ,fib LEFT SIDE �(] RIGHT SIDE. 174
Permit 189900 ----- _--- — —___ --
THIS PFRMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 94e50 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 CURRENT CITY BUSINESS
State Tax 11*34 LICF�N�E.tS PARTE PEFMfTS'REI�UIREptFOR SEWEA, PLUMBING AND HEATING.
,J L� Ii9 T VPEf ITS' t 11
Total 294.84
-- APPLICANT OR AGENT
Approved _Y( w 13o cent NO
AC�LTF SS ---
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1
7
1
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
r A�,,w1 oA o w* lu, — .-22f e a � ,w ra "' Contractor p
_ C _ Permit No. /0.37
"ixture
J, nipcg � t� c„ cve Final
HEATING
Contra:-
3
ontrac � u T
Permit No.
Gas or 0il
�y.�-.�,,, /_��._I—._ Rou h-in --- -- --_—
a.),�-Po ti-�'�' r s a1a'r�l—s—v Final
PATip341 T GCh—,dLt�`'f � SEWER
j I Final /T
a-- U — ---- — DRIVEWAY $
--- - --. cinal _•
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
_ --__ -------------- Approach - --- �
St DG DEPT.FI t- TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping r
Zoning F inal r
..........
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