12525 SW HALL BLVD-1� IN
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12525 SW full Blvd.
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41 ERMTT NO. : MEEW0300
CITY OF MARD
uUMMUNITY DEVELOPMENT DEPARTMENT DA11". T!5SUED: 4-2/16/89
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223,(503)639-4175 P P 1:M PM'T' .N(7 (390300
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This permit Is Issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes, zoning regulations G1FWI I i 1:41:.1..) :1.r4ci I.,I::(:,.T 1.ot, i
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and GA15 1. 1:1,41,
specifications and in compliance with all Applicable codes and
ordinances The issuance of this permit does not waw,.. restrictive
covenants Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void if work is not started within 180 days.or if work is suspended or
abandoned for a period of 180 days any time after wurk has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are request d and approved
peinli Signature
Issued 3y -.41 1
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DEscnIBED ABOVE
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INSPECTION NOTICE
City of Tigard Building Department
12'20 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
G
Type of Inspection
Date Aeyvested Time A.A.M. P.M.
Address _.�� -�� —d�— '6 -C Permit
Owner__ _. Lot #
Builder
The following Bniiding Code deficiencies are required to be corrected:
Presented to _ s r Approved
Inspector
Lj Disapproved
Date __ —Z �
CALL FOR REINSPECTION
❑ YES NO
i� JLJR =
BUILDING PEWIT APPLICA-riON TIGARD DATE_-_ _._� __� ,�� _.._ 3477
THE UNDERSICNEC '.-IEREBY APPLIES FOR A PERMIT FOR i HE WORK HEREIN INDICATED BUILDER PHONE _ _-_
OR AS SHOWN AND APPA!)VEI)IN I HE ACCOMPhNYING PLANS AND SPECIFICATIONS. OWNER PHONE 1, `a
Ta X LOT NO.
OWNER jLick 'aycaux JOB ADDRESS _l 2 525
ARCHITECT
BUILDER OW ENGINEER
ier r
ADDRESS Ribs?vt' DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL C ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
EI'RESIDENCE ❑ COMM ❑ EDUCATIONAL Cl GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLA91_1 FENCE
OCCUPANCY _7 LAND USE ZONE A.12 BLDG.TYPE ) FIRE ZONE_.--_PLAN CHECK BY _!I HEAT__'''' '
Cot `�Lyicl: t r.'taCt)p±! i"r Diniiig �?r�G3m a dr,. tC�_t?Xl±if: . 191r1�'j ' At;lj:.jr (al ell ?
See crarr�=c t1�7r� NEtt rpt r�lt:nrlt�ae�• _
SEWER PERMITAI
OCC.LOAD FLOOR LOAD 1r1i __.-HEIGHT 1,j NO.STORIES 1 AREA 2t)4 N0.BEDROOMS VALUE y41i:,r
f_ BUILDING DEPARTMENT SETBACKS FRONT RE=ARj .; LEFT SIDE RIGHT SIDE
—_ -— -
Permit _ F THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINFD IN TNF BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 4. WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND CRDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
Total .
v—
PDCIM APPIIC�NTi7RAG-ENtf u
By
-- Receipt No.
Approved AVUAESS �' i� PHONE
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DATE INSP. TYPE INSPECTION --_—`— REMARKS PLUMBING DATE
Contractor ------
y='r ^�f Permit No. ---
Rough-in
Final
HE'TING --- —
Cnntractor
Permit No.
Gas or Oil A �`
�- Rough-in
Final ----
Final
DRIVEWAY
Final ---
A` Storm Drainage
(Rain Drain)Final
Sidewalk --
-- Curb R Street Final
_ Approach
ELM DEPT.FINAL TEMPORARY CERTinCATF' OC ANCY
I CERTIFICATE OCCUPANCY I � Finar�--
a Landscaping
Zoning Final
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N9 1048 DATE
PERMIT IS GIVEN TO
OF + r
TO CONNECT A
TO TILL SYSTEM OF TIGARD SANITARY DISTRICT
AT ..
THIS PERMIT MUST BE POSTED ON THF DF9CRIBED�REMISF.S IJNTII.CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COW
PLETED.
,J
PERMIT FEE PAID $......A...........................TIGARP SANITARY DISTRICT
,_. /O d By
� 7'
CONNECTION INSPECTED AND APPROVED
Date Superintendent
Address Permit No.
Name of Occupant 'e, Permit charge
Paid by
Date connected
Type of Building Inspection fee
Service Rate Paid by - - - Date-
Contractor Assessment .11513 Paid
Size of connection
Address/
/,I Permit No.
Name of Occupant Permit charge
A,
Connection fee-A-0.0-Aj-!.V--
Paid
Date connected A 7
Type of Building4-Uw.A�iW- ,---- Inspection fee _/47
Service Rate Paid by ---Date
Contractor. Assessment --Paid
Size of connection-,
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7�inu ry 20, 19(6
Mr.. Howar(! Ll-�acl>
Route 1 , Bnx 2
;nest Iain,%, Oregon
Res Mi.tnAl Weber Proporty
1752* S.T,r. ftwty.. 217
TIgIrd, Oregon
noar ?!Y rbache
Thos will confirm our xecent conversation regarOjnr the
sewe.- assessment on the above r•royorty. The amount of
$285. 30 was paint .for assessment and a $30.00 houses branch
charge was paid by Mrs. webher.
Very truly yours,
C'r'.t"5' OF TIGRRD
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