11735 SW HAZELWOOD LOOP-1 11737- SW HAZELWOOD ,SOP
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Cbwanoe Purdy 620-3863
11.735 s-W- Htzelwaod los,V
^igart Ore.
Englewood # 2 Lot # 105
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APPROVED FOR CONSTRUCTION
CITY OF TIGARD 1 (7 3k" A)
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BUILDING PERMIT APPLICATION TIGARD DATE _ ..'_� �'_ is ___�i- 4032
THE UNDERSIGNED HEREBY APPLIES FOR A PFIIMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 620-3683
OR AS SHOWN AND APPROVED IN THF ACCOMPANYING PLANS AND SPECIFICATIONS. ?WNER PHONE—�
LOT NO.. 10 5—Fln! lewood 2
OWNER Clar'fnce purcly JOBADDRESS 1.1''If; Cj�'' T?,17..r+jjgn .4 Z.0Op?
ARCHITECT _
ENGINEER
BUILDER owner ADDRESS `1bOVe DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL OxADDITION LJ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
[X RESIDENCE ❑ COIA_M ❑ EDUCATIONAL El GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT U GARAGE ❑ STORAGE ❑ S_LAB❑ FENCE
OCCUPANCY — {"• .LAND USE ZONE --E-fl BLDG.TYPE __ ' FIRE ZONE----PLAN CHECK BY _ dorh HEAT-----
ronetruct fireplace in existing single tarily dwelling.
All per plane and code.
SEWER PERMIT k
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.Br:D_Ii00MS — VALUEt j_fI
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit_ F3 Q t THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 1} . t1 WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE-
WITH
OMPLIANCEWITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 4( ,20 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax's S 1 .12
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
,
SDC— �
Total x q ; . 32 SDC-
PDC# APPLtOANT OR AGENT
By
— -- -+�..LI Receipt No.
Approved ADD
AEU
`
ERTMOUN
DATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
F1,181
HEATING
_____
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Uralh)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. AL TEMPORARY CERTIFICATE OCCUPANCY
LERT111CATiC OCCUPANCY Final
'-andsLaping
Zoninq Final
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PERMIT NU ,
A D DR 15 ----
_ PERMIT C H A R G r
C 0 N N F. �' i ION F E.E
OWNER --
PAID R Y f�C
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IP:SPECTION FEE
SE RV I C E RATE ��-""'"�'- DATE
P A I D B Y
CONTRACTOR _._..__..---_.�._..._._�,.._�... - .._._.. ASSFSSMENT PAID
SIZE OF CONNECTION
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : FERMI". K
DATE: P125i.L Z-L DATE 1SSUE .-_l.__�_
OWNERS NAME:
ADDRESS:
CONTRACTOR '
TEST . Air ❑, Water ❑ , Visual P�- , Lat•erntor%,
RESULT. Approved, , Disapproved L Pe" _
i SKETCH:
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1
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1
INSPECTOR DATE
CNOTE Attach jupplemental ten* data het�10:
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City of Tigard
INSPECTION REOUE "I", t
for
INSPECTiON TIME : --3 PERMI'-r NO. ; _ ._. _.._
'
DATE : DATE
OWNERS NAME :
ADDRESS :
CONTRACTOR :
TEST. Air 0, Waler4, VisuaLoll� Laboroto!� ,�,
RESULT. Approve , Disapproved LJ
I 'SKETCH:
•lu Lirvr te* CIA-
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I NOTE' Aflnch eupplemenful fee+ �� hNr(,f,l
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CITY OF �
BUILDING PERMIT APPLICATION TIGARD DATE � _—_ �° 0787
THE UNDERSIGNED HEREBY AFPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.
OWN I:P, --- ---- ADDRESS T._.-_.�—.--------_----_ BUILDER PHONE--_--
ENGINEER
BUILDER._--_-� v— ��hITECT _ DESIGNER
STRUCTURE — ONEW ❑REMODEL ❑ADDITION_ _ ❑REPAIR _❑_R_ENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL CIGOWT ❑RELIGIOUS❑PAT17 ❑CAR PORT ❑GARAGE C1 STORAGE❑SLS\B ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL.APPROVED ❑SIGNS
OCCUPANCY_-._.-._LAND USE ZONE_ BLDG.TYPE---- FIRE ZONE_!' PLAN CHECK BY is HEA-r
• w'iottr�u-ct 1455 sq. Orela :attwrhed mar&ge n0 teseawnt:
11.186 S•W• T rr]nu"d L.UO(1
S
OCC. LOAD _ FLOOR LOAD _ ' HEIGHT NO.STORIES i AREA 143$ VALUE
BUILDING DEPARTMENT SET BACKS FRONT b' REAR 4tz LEFT SIDE RIGHT SIDE
Permit — -
-`�— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGUt-ATIONS 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 WI1H
Recording ALL APPLICABLE CODES AND ORDINANCES. THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVFNANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE nRMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
--- --_.-- --- APPLICANT -�-'----�----
Aporoved Receipt No
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DATE INSP. TYPE INSPECTION REMARKS �PLUMBING DATE
Contractor --
ru Permit No. _61
G- �5'71b, Rough-in _
76 � - Fixture — --
`-2/-76 Final
HEATING
Contractor
Permit No.
Gas or Oil
Rou •in
Final
SEWERG-/0-76
Final
DRIVEWA%-aS-�
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Ap
proach L G ^ ti'- 7`
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY nal
andscaping
oning Final
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30 6170
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