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APPROVED FOR CONSTRUCi ION Alfi '
CITY OF TIGARD
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PERMIT NO._..� SITE ADDRESS
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NOTE: IF THIS MICROFILMED l lop
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DRAWING IS LESS CLEAR THAN --_
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THIS NOTICk-;-IT IS DUE TO
THE QUALITY OF THE ORIGINAL
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Permit No.
Permit charge ILI
Connection fee
Pnid h,, _
iyP3 of btjiiding ,, _ :Q Unite rannected
` nrvic^ r s-Xc
Inspection fee
�ontract ,:�
Paid by DatOF o
5sessment
paid
as as +■1 ■r LLLILt � Lw � LLQ L�
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BUILDING PERMIT APPLICATION 11 Y TIGARD DATE_ 11-22-76 _ r' �
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HF REIN INDICATED BUILDER PHONE_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF _
LOT NO.—
OWNER Ir• A. Mrs* "JOB ADDRESS i i aA jI1�.}. -%! �_ �.HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER 61L`LrV®y ADDRESS
_ � DESIGNER
STRUCTURE ❑NEW ❑REMODEL KmsADUITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEIVOUTION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
QBONU ❑MOVING ❑CONnITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVE[) ❑SIGNS
OCCUPANCY--LAND USF ZOK' BLDG.TYPE FIRE ZONE__ PLAN CHECK BY_ HEAT_,_.__
,r+ 'x3tt' elulrticlutn ygtij cover j)er �agpro cs._ ulrant„ date11-i' dta — —
oll pei code renuirement
OCA.LOg(Z___E_l<QOR LOAD HEIGHT — N0.STORIES_ AREA NO.BEDROOMS V,A„UE 19 00�•
BUILDING DEPARTMENT _SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 10000
THIS PERMIT IS ISSUED SUBJECT TO THE RFGUL.ATIONS CONTAINED IN THF 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
Subtotal ALL APPLICABLF. CODES AND ORDiAANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax •30 LIC+NSF.. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
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APPI (CANT OR AGENT
Approved Receipt No.
ADDRESS _. ONE—
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DAIE
Contractor
Permit No.
----- __ Rough-in —
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
_ Final
DRIVEWAY
Final
Storri Drama `_
(Rain Drain) Final
Sidewalk
Curb&Street Final
A roach _
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final u�
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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AIR I'AMS
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City of Tigard
INSPECTION REOUE -S"r
for
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INSPECTION TIME : _ PERMIT NO
DATE: "' /-'J�'6 DATE ISSUED'.
OWNERS NAME *
ADDRESS
CONTRACTOR :-
TESTI
ONTRACTOR :-TEST: Air ❑, Water p , Visual ❑ , Laboratory
RESULT. Approved , Disapproved 0 , Pendtrjy '
SKETCH: .�
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� Nb7F Attuch suup'enenturoot du+a hlrhtc i
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JOHN E. P,ENHAPPT PIUMBING, IN�.UILDING DLPAR SMLNT, TIGARD NO.
P. 0. GOC 129 PLUMBING PERMIT
NEWBERG, GP,EG6N 971,12 holder of a valid plumbing contractors license is hereby
authorized to cause Plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owner J� 'vu'= — s O_SC�1._fit _ ._Date_
NUMBER OF � NOTAL I PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Sin le Fom yj-1 beth—ench F V 25.00
Dex�Eoch 1 bath uni; _ e. 25.00
_Additional both roo_r_ns—each
10_00 0l0• c�U
Mobile Home S ace—each —� 15.00
_INDIVIDUAL FIXTURE FEES —
_1 to 50 Fixtures in 1 building—each _ 3.00 _-
51 to 100 Fixtures in 1 building—eech 2.50 _
_101 to 200 Fixtures in 1 building—each 2.00
_201 or more Fixtures in 1 building—each 1.50
MISCELLANEOUS
F3uildin9_Sewor-1st 50 ft. y 10.00 _
Sews r—each additional 100 ft. 10.00
Water Service to_b_ulldi_ng _ _ 5.00 _
Private Woter Systems—each tOv __ 10.00
Other (Specify): _
PERMIT �__ G For Plumbing Itlspection Phone 6394191
°6 State 3 r Plumbing Contractor By
TOTAL RECEIPT NO. Issued By
City Of T IgGrd
INSPECTION REQ0ES -
INSPECTION TIME ' PERMI", NO-
-.-Z -/—
DATE : DATE ISSUED .
OWNERS NAME
ADDRESS:
CONTRACTOR :
R.
E ST ' Air [j, watex-- Vi evu 0)� Lob-Woty E;
9ESULT: Approvedv Disapproved r -e Jng
SKETCH.
INKS (c DATE
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CITY OP
BUILDING PERMIT APPLICATION TIGARD DaTr Match 22, 76No 0725
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK '.IEREIN INDICATED s'ftt
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF
QWNEFP Ttt4ilFii UeV4i'LU;3Rif}Ifjt LaO.r)DRESS lb760 :i.W. Highland Ct. BUILDER PHONE
Simms ENGINEER
9UILDER ARCHITECT _ DESIGNER
ciIIIUCTURE ONEW CIREMODEL ❑ADDITION ❑REPAIR ❑RENEWAL _ OFIREDAMAGE ❑DEMOLITION
0RE1SIDENCE ❑COMM ❑EDUCATIONAL 0GOV'T ❑RELIGIOUSCIPATIO OCARPORT ❑GARAGE ❑STORAGECSLAB ❑FENCE
tJ-�BONG ❑MOVING ❑CONDITIONAL USE CIDESIGN REVIEW ❑COUNCIL APPROVED [JRIGNS
U — rltkO ,I!SIITI.
OCCUPANCY j LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY___ ___ HEAT
I'onstruct 1666 ar,e f to frame dwelling with attached -
4o basement.
a roome +
n C LOAD FLOOR LOAD_ T HEIGHT NO.STORIES AREA VALUE,,77
DEPARTMENT 7~--`�-�- ✓- ��, _ Tr—
BUILDINGSEr RACKS FRONT REAR LEFT SIDE RIGHT SIDE
A, 1
'" --- --- - --
jkj .771 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
Recording ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
"It. RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
IRE State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tonal Sewer Inspection $26.0n
BY
APPI (CANT Op AGENT -- ----------
Approved Receipt No.
_ ADDRESS
-�=Ilw-lpW-1 0
DATE iNSP. TYWINECT ON i _ REMARKS _ PLUMBING �- Q TE
Contractor_ _
4-7- %{ d!ti — Permit No. yS� 6
Rough-in — —
Fixture
Final
HEATING
Contractor
Permit No. _
Gas or Oil � D
Rou h in
Final
— --- ---- -_.__– SEWER ,B
_ Final
DRIVEWAYS-IF&
Final
Storm Drainage
(Rain Drain) Final
Sidewalk S Z 8 76
Curb&Street Final _
JAPProach — —
BLCG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
_'7Landscaping
/ J/ r Zoning Final
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