11540 SW MANZANITA STREET 11540 SW MANZANITA STREET
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BUILDING PERMIT APPLICATION TIGARD DATE_. --- -'- -,19 -'� 4898
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE �►-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNr_R PHONE
LOT NO. -_--
OWNER ti;-itulci_BulyRstuJOBADDRESS__ 1154!! S,d !1i4k9Maita- 5,+_ ------
ARCHITECT
ENGINEER
BUILDER :yatue ADDRESSDESIGNER
STRUCTURE ❑ NEW ❑ REMODEL aADDITION f-] REPAIR _ ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
[a RESIDENCE EI COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE—❑ SLAB❑ FENCE
OCCUPANCY _R-3 _LAND USE ZONE )BLDG-TYPE —--FIRE ZONE_.__PLAN CHECK BY RCR HEAT -
(:ou C uct l_ttC)ry ad itivri to awl stL.1Ll ;L _ 1CittLiillL_ — -- —
SEINER PERMIT N --
.DCC.LOAD FLOOR LOAD 4'1 HEIGHT 11'' NO.STORIES I AREA 149 NO.BEDROOMS,1 VALUE 4.�
BUILDING DEPARTMENT SET RACKS FRONT REAR 2u+ LEFT SIDE RIGHT SIDE
Permit 44.50 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 __ li•.93 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND Sf ECIFICATIONS AND IN COMPLIANCE
WITH ALL At ' '_ICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 73.43 REST RICTIVF COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-�� LICENSE.SEP".RATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax i•7 Mt
-- snc—
Total
S.a PDCN APPLICANT OR AGENT.
By LH _
-- - Receipt No. ` 9o7a10 ADDRES8 ��� PPONF
Approved NCR
DATE INSP, TYPE INSPECTION REMARKS PLUMBING ELATE*
Contractor
7-,2
- Permit No..
- 11_ _
Olf" Rough-in
Fixture
Final
HEATING
Contrart!::,:��
Pe 0 No. 9
Got o, Oil
Rn.jqh-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain'),sin)Final
Sidewalk
Curb&Street Final
Approach
4jct_—--[ ---TEMPORARY ATE OCCUPANCY
13LOG D CERTIFICATE OCCUPAW" CURTirfE Final
Landscaping
Zoning Finsi
THE UNUEHSIGNEU Flf:fiLUY APPLIES I UH APEHN11l F-UIi I IIL ovusin 1,;-IILJ v ..,,,I,..,..., ,,.��40-539
OF, AS SHOWN AND APPPOVED IN THE ACCOMPANYING PLANS ANO SPECIE ICA i IONS. OVINEIt.�lturlc'
_T.VNEI-
4 � I _ L! �J � r J •C U _� �(..,)1../�IGt,9(.f I�- ,s� _ J_'���
-. ARCr11TFCT
ENGINEER
-n-U1�_p.''t ♦ -._.-� C h � )�. S _ AOORESi •.- _ r-'.---- QESIGNER
$TFTUCTIIRE ONEW Ftl'SIn0EL DITIOrEl
I ti ms OR----4E-.'IAL ❑FIRE DAMAGE — EIDEMIJI-11
K RESILII^I( F ❑CO/G&I ❑EDUCATIONAL CIGOV-T CIRELIGI^US CIPATIO OCAR PORT ❑GARAGE Cl STORAGE❑SLAB CiFE
CCCUPAR_Y R-3 _��,E 20NE OLOG.TYPE_ 5NPLAN CHECK OY 2ul.-
_..�Srtrrzst.- r .t�-�`�-'i.: / �/� ��t` � -- ���• aJ =s-4-
: EUER`P Ra1� IT JL
FLQQR LOAD FI H � N�(?�IQR; _ l AREAIY ' NO.BEDROt7ki V�LSlEy r_
SUILOIN•]OEPARTMENT SETBACKS FRONT- -�..^ REAR C-I tLEFT SIDE ' RIGHT SIDE
1 -
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 201
C~'` I a 3 REGULATIONS AND ALL APPLICAOLE COOES AND ORDINANCES, AND IT IS HEREBY AGREED THAT
r---- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO/51PLIA,NCE I
i 5.1ti total II C '�j ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOTS NOT W
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRE/1T CITY BUSK
' :ata Tax I -7 LICENSE. SEPARATE PERMITS REOUIRED FCR SEWER, PLUMBING AND HEATING.
Total ---, -� SDC —
r ------ -� PDC#
APPLICANT OR AGENT
Rerelpt No. � — --
fMAFSS HONE
SJX
DC (Storm)
$
PDC - $ #I —
SEWER CONNECTION
i
SEWER INSPECTIPh $
SEWER SURCHOGE $
Address 3 VL! `l ? 'j, � �, Permit No,
Permit charge
Owner_ Connection fee "e
Paid
J`
Type of Building Date connected
Service Rate �- Inspoction fee_1.6CC,
Con tractorO a � t , ' j
1Lll.' "L4h, � l �m- _ Paid by _k i1,l t ( (can4� Date J .�7-+�°
Size of conr,.ection 7 _ Assessment aid.
PERMIT TO CONNECT
Tigard Saniiary District
PERMIT N9 L Q 8� DATE
I'11011T IS GIVEN TO
I _ OF f f II
r TO CONNECT A !
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THIS DESCRIBED PREMISES UNTIL CVN-
NECTION IS 31ADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID 6. . ............................TIGARD SANITARY DISTRICT
B3
----------- - - -- - - - - - --- - ----------
CONNECTION INSPECTED AND AI'PROV.ED
Date supet:ntendent