12155 SW MERESTONE COURT A
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12155 SW WRESTONE COURT
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".d d r e s s Permit i�l o.
Permit charge .._. 2207,7 tf .
Oner i.nnnPction fee �j[1
Paid by 4:.E
.-,/pe of building _.-.� 2� � — Date connected
Irvice rate Inspection fee
n itractor P,iid by date
.i ze of cennnction - n essment Paid
Addreas J.A/56 DL) Il �� .cam Permit ala.
Permit charge �_ c�I� ►�
Owner Connection fee ce ,
�._._. Paid by
Type of building - Date connected '' _
Servicp rate L��� _ Inspection fee y? C
Co,itractor Paid by Date
Size of connection 19sessmant pa i.ri r_�
BUILDING PERMIT APPLICATION 1OF
1T TIGARD DATE._2` �__ 1q_
THE UNDERSIGNED HEREBY APPLIES FOR APE RM IT FOR THE WORK HEREIN IND'CATED BUILDER PHONE—____
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE ______
LOT t 10._
OWNER r�C'� )1�31.IL1li T JOB AC'riprSS �� .1.?�� SI,I "'10 '08tTJIl10 HOME ADDRL-_-'i _
w ( } ARCFIITECT
T''_I_DER 3111 ADDRESS ENGINEER
_. _ DESIGNER
STRUCTURE M EW0-REMODEL CIADDITION__-❑_REPAIR _❑RENEWAL _❑FIRE DAMAGEyODEMOLITION
CJ RESIDENCE ❑COMM DED CATIONAL [:]Gov') EIRELIGIOI S CJI ATIO ❑CAR PORT OGARAGL [:]STORAGE OSLAB rFENCE
OBOND 0MOVING ❑CONr)ITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED— ❑SIGNS
OCCUPANC'r t ._LAND USE 7.0NE_— , l BLDG.TYPE '' FIRE ZONE'} PLAN CHECK BY ids t.lu HEAT_
U/8tLi3Ch6d 01'a , :i ;;adzrooll► 2 usth� —
5wwor Permit## .095 59wor Cann. k__600* `titrsr R25.
USC �QAU __—_ _F1Q4R LOAD 4.0 _ 1iEl�idl__ �[1 ��V52,.;zI4�E.S__.1-AREA_Lkllw_u RI34I?M_$_ _3 MALUE-4 .,90�r
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Perm.t 172, 00
THIS PERMIT IS IS','JEr_` 118.'C7 TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan ChecK 6 f1 REGULATIONS AE(1 kLL AF01_1,ABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- - - WORK WILL BE DG%E IN ACCL)RDNNCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 256.1A ALL APPLICABLE ODES AIID ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 6,80 80 LICfiNSi, SFpk' ATE PERMITS RFOUIRED FOR SEWER, PLUMBING AND HEATING.
—�—_- • • .
Total 265.38 P"n C. 1.
By _
— _
A PLICANT np AGENT
Approved �� Rerelpt No T`
DATE INSP. TYPE INSPECTION REMARKS PLUMBING CATE
TGoottractoi
Permit No.
Rouuh-i-i
7-
Fixture
r A rP R 0 VIE
't—efl, Final
HEATING
Contractor
rl
flE Permit No.
2�5 Gas or Oil
0
Final
0 ntra�_
Permit
t
"0, (
G
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IF
Final
Sil
Final
DRIVEWAY
Final
Storm Draina
!Rain Drain) Final
to'
Sidewalk idewalk
Curb&Street Final
A roach
—P
6F- f.FINAL TEMPORAtly CERT FICA EOCCUPANCY Final
CERTIFICATE OC(-,,- 'NCV
Landscaping
Zoning Final
SEWER PERMIT �h 13895
Unified Sewerage Agency
of Washington County CITY OF Tiqard DATE _ 2—R--22—
OWNER . George HeUsser PHONE :
OWNER ' S ADDRESSt
�T�Yp�Py�E OF INSTALLATION:
l_%JILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY,
RX NEW JXSINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS_ DWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIcD 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.
FEES,
PERMIT FEE $ 25,
CONNECTION CHARGE 6riq_
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL $____f 2Ea
APPLICANT" DATE
SEWER PERMIT 13895
ADDRESS OF STRUCTURE 12155 SW Merestane Ct.
TAX MAP _ TAX LOT SYSTEM_,,f'annu Qxuek
LOT BLOCK _ OF
APPROVED BY DATE ISSUED PY DATF
REMARKS b].dg. #1870_ Paid to Leron Heights r,150. 00
CITY OF 1 ICARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHPRGE
Y < OU
DATE : �� ' � (X,�_ ESTIMATED SALES PRICE:
APPLICANT NAME��' '�T E% �� �� �� TELEPHONE
JOB ADDRESS _EjLDC. PERMIT # ,
AMOUNT OF FEE FOR S. D. C.,�__r_�
DESCRIPTION OF IMPROVEMENT
EXEMPTIONS -PER ORDINANCE #77-26_ —
FEE RATES:
A. Lingle family duelling unit under 3tiU,UQO.- -•----��-- pU.0
B, 5inglra family duelling unit aver $60,000.--------- 3400.00
C. llobilij Home Court Space (New Deve'lopment)----------- 5150.01!
D. Multi-Family Owal.lings--per. unit . -----_- 1$240.00
E. (_omm,.r-•_Lal , Industrial h Institu+.ional;Park. Space) $ 50.CGO each
F. Single family •.jnit ander f40,OOO. --- _--------____�._... 1250. 00
CITY OF TIGARD
ORDINANCE #77-71.
PARK SYSTEM DEVELOPMENT CHARGE
DATE: ESTIMATED SALES PRICE $ti Z/zzj —
�� i-'
APPLICANT NAME 4� v/ &e:�#',TELEPHONE.
39B ADDRESS ar
BLDG. PERMIT ?
AMOUNT OF FEE FOR P. D. C . rG
DES,:RIPJ ION Of' IMPROVEMENT 44
EXEMPTIONS - PER ORDINANCE #77-71
FEE RATES:
A. Single family dwelling unit under $40tOCJ-------------- ?5.q0
B. Single family dwelling unit over $40,000.----- - 'r' 1Op-
C. Mobilo+ Home Court Space (New Development)-------------- ub.00
D. Multi-Family dwellings—per. unit---------------------- $ 60.00
CONSTRUCTION IS LOCATED ON 8.F' W. SIDE OF S. PACIFIC
HIGHWAY. N.W . is Park I . S.E'. is Park District #1I .
ITY
SIJILDING REPUT APPLICATION cOF TIG,�,RD DATE. + —___ ,� _ No /4 2D
11E 11NDE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICAIED BUILDER PHON ;t JOP
LIRJS SHIP N AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICAI IONS. OWNER
SH)
h JS 4 ,,{� /LOT NO
3
_ _. _ 1 1 14 JOB ADDRESS/
J h&& '4z"" ADDRES:i
�ga- t./ ARCHITFCT
`-R !� F4 ,� - ,�:,' �, ENGINEER ADDRESS —
ADDRES'S— r L_ DESIGNER 1/-A -t .
TUBEL REMOD
4EW ❑ E _
❑ADpITION _❑NLPAIR ❑_RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
NCE ❑rnMM ❑EpUf '1L ❑GOV'T ORF LIGIOLISDPh �_❑CAR PORT ❑GARAGE ❑STORAGE OSLAB ❑FENCE.
IP' ND �-(]MOV ING .JCDNDITIDNAL USEDDLSIGN REVIEW ❑COUNCIL APPROVED []SIGNS
i ` ,.Nl:Y t AND USE —BLDG TYPE..- - —F IRE ZONE__— PLAN CHECK BY. HEAT,.".
L,� I
Al lip
`BUILDINGDEPARM
TENT 5E1 BACKS FRONT
----_ REAR •f- LFFT SIDE RIGHT SIDE
efmit
(/ THIS PERMIT IS ISSUED SU,RJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
"Ian Check lr, '�� REGULATIONS AND ALL APPLICABLE CODES ANV ORDINANCES, AND IT IS HEREBY AGREED THATTHE
WORK WILL BE DONE IN ACCORDANCE WITH THE FLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
`,ub total �Z l�'� ALL APPLICABLE CODES AND ORDINANCES. 'EHE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOP AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Itsip ?ax — /� ti LICENSE SEPARATE PERMITS REf)UIgED FOR SEWER, PLUMBING AND HEATING.
Total �Y
AV6l/ICCAN1 R AGENIT
AL717rc7Ved ej�, -Receipt No
-47 DRESS
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