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LN9 F.CTI.99NOTT-0
City of T.tgard Building Dipartaent
13125 NA Ball Blvd. Tigard, (tr't!gon 47223
Inspection Line (Rec-0-•Phone): 639-4175 Business P!ione• 639-4,171
Inspection: —_ ---
looting Plbg. Underelab Hoch. Rough-in Appr/Siulk
Found. Plbg. T.)p Out Gas Line FINAL=
P08'l;/Beam Struct. San. Sewer Framing ( -Bldg• 1
Paet/BoM Hoch. Rain Drain Insulation Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -Hoch.
Date Requested: - Timet AN
Addreea:
Builder:--t�"�`�,.4"^�
THE FOLLOWING CORAECTIONR ARE REQUIREDt
Inspect.Ort—. ------- Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
INSPECTION NOT1CIE
City of Tigard Building rlepartmOnt
13125 BW Ball Blvd- Tigard, Oregon 97223
:nspectlon Line (Rec-O•-Phone): 639-4175 Business Phcne: 639-4171
Inspection: -------
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbq. Top Out Gae Line FINAL:
Post/Ream Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Ineu_ition -Plumb.
Plbg. Underfloor Water Line �p. B.'\ -Hoch.
Date Requested:_ � + TSme
L PH
Addiess:_ g 7:�`� ' �- ��! Permit 0
Buildpr.
THE FOLLOWING CORRECTIONS ARE REQUIRED:APPROVED DISAPPROVED API'ROVFI) SUR.:r,-T TO ABOVE
Cnll For Rpinsp.
INSPECTION NOTI �'
City of Tigard Building Oeparteent
13125 BN Ball Blvd. Tigard, Oregon 97223
Inspection Line
(/R,ec-O-Phone)t 639-4175 Businnns Phone: 639-4171
Inspection:
Footing Plbg. Undersla, Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gari Line FINAL:
Post/Beam Struct. San. Sewer Frami� -Bldg.
Post/Roam Mech. Rain Drain Insulation -Plumb. i
Plbq. Underfloor Water Line Gyp. Bd. -Koch.
1 Datu Requeeted:_4 -� '_._`7�_�� Tim s AK ----PH
_ _ y ^
Address: -'7 Permit 1
Builder:_---_ : e;;; 6-7
THE FOLLOWING CORRECTIONS ARE REQUIRED:- -�—�
i
Inspecto Oitr s ��r)
APPROVED DISAPPROVED APPROVRD SOMM TO ABOVR
Cali For Reinep.
v
INSPECTIQN NOT-,CX
city nt Tigard Building Department
13125 8W Hall Blvd. Tigard, Oregon 97223
Inspectian Line (Roy�yb-Phone): 639-4175 Business Phone= 639-4171
�� R
Inspection:_ 7L_% f-7'�,�G ✓ , �.. �,-
Footing t"Vibg. Underslab Mach. Rough-in Apps/Sdwlk
Found. Plbg. Top Out Gas Line FINAL=
-
Beam Struct.} San. Sewer Framin -Bldg.
(42 rt/Beam Hoch. l Rein Drain Insulation -Plumb.
Plbq. Un e r , /Wateer Lens Gyp. Rd. -Hoch.
Date Requested=_ a'1 _(!� AM PM
Addrers= � -� y ������ � _ Permit #tqr—)
Builder:�Li
THE FOLLOWING CoP"CTIONS ARE
REQUIRED:
A,...au�
i
Inspector: 1 Data: 7 s _--
APPROJ'PD �DISAPPROVRO APPROVED SUBJECT TO ABOVE
call For Reinsp.
�NSPEC'TION NOTICE
City of Tigard Building Department
13125 BW Ball. Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-phone)s 639-41°5 Business Phony: 639-4171
Inspection:
ooting ) Plbg. Underelwb Mach. Ro—h-in Appr/Sdwlh
l
aund. ;� Plbq. Top ot:t Gas ..ins FINALt
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Ream Mach. Rain Drain Insulation -plumb.
Plbg. Underfloor. Water Line Gyp. Bd. tech.
Date Raquestodt ,,_� /-L�-- _Times _AM __—PM
Address:__. 1/� .�/Z�/.r/1.//� 071- leA?IC#:Y__1 31
Bull.der:_L_ 1 Com.
TIDE FOLLOWING CORRECTIONS ARR REQUIRED: v
Inspector:_
// -- ----_-------- Date:
• AP MIOM DISAPPROVED -_ APPROVED SUBJECT TO ABOVE
—_Call For Reinsp.
CI�� T'��� MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT 0110M i-,L:.RM I T #. . . . . . . . M G T9 V1 17.;:3 1
13125 SW Hitil MA P.O.8cm 23197,Tl ad,Capon 97223(503)6394176
4 , Ila-ry Tc'( .IJET).
JJE ADDRESS. . . : 127-35 SW MARIE CT PARCEL: 2G104AD--00501,-
*UBDIVISION. . . . BELLWOOD ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 10
BUILDING
:1E I ESSUE DWELLING UNITS: 1. BASE MENT. . . . . . . . :0 f
,:;LASS OF WORK. :ADD BEDRMS:O BATHS:O GARAGE. . . . . . . . . . .0 s
i`YF
DE OF USE. . . -SF FI-00P REOU I RFD SETBArl-',S--
I YPL OFXONST. :5N F I RE'T. . . . :200 S f LEFT. . :0 ft RIGHT. :5 ft
1CCUPANCY GRP. :R3 SECnND. . . :0 s f FRONT. :20 -Ft RE=AR. . :0 ft
,il'URIES. . . . . . . .. I THIRD. . . . :0 s REQUIRED---------------------
1-1EIGHT. . . . . . . . : 1 "21 ft TOI'nL--------C-200 of SMOKE DETECTORS. :
FLOOR LOAD. . . . :40 p s f VALUE. . . . . $.- 9200 PARKING SPACES. . :0
Remarks : addition of 200 sf/i-t wood ,; (;OVP r3ev-Mit added I.n
P-'L(-)MRING
31 NKS. . . . . . . . . . 90 frLOOR DRAINS. . . . :0 b"CKFLOW PREVN1-R5. . :0
,'-AVATORIELj. . . . . .0 WATE=R HEATERS. . . 30 TRAPS. . . . . . . . . . . . . . :L71
TUB/SHOWERS. . . . :0 LAUNDRY TRAYS. . . tO CATCH BASING. . . . . . . :0
WAIER CLOSETS— :0 SEWER LINE (ft ) . :O GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . :0 WATER LINE (ft ) . -0 OTHER FIXTURES. . . . . :Q!
5ARBAGE D I SP. . . :0 RAIN DRAIN (ft ) . :O
WASHING MACH. . . :0 r3F RAIN DRAIN S. . :171
MECHANICAL FEES
r1JEL TYPES----- ----- UNIT HTRS. . :0 type amount by date recpt
VENTS . . . . . :0 J3PRT $ 80. 50 PLL 03/06/92 9P
MAX INPUT:O BTU VENT' FF-)NS. . -0 BP1-C s 5,':*-'. •.3.3 PI.-L 03/Of,/92 92-
FURN ( 100K . . :0 HOODS. . . . . . .0 B5PC 1 4. 03 PLL 01/06/92 92-
) =100K . . .-0 WOODST(P)ES. : 1 M17.RT g 25. 00 PLL 03 )6/92 92-
1=LOOR FURN. . . . 10 CLO DRYERS. : 0 M51:1(' is
1. 25 PLL 03/06/92
13OTL/CMP ( 3HP:0 OTHER UNIT,13.0 MPLC 6. 23 PLL 033 0F, 2 92--
GAS OUTLE=TS:O
Owner,-
BRUCE ABRAHAMSON
l735 SW MARIE CT
fiBARD OR 972E3
I-phone #: 639-0094
contt-actov,.-
OWNE=R
1-.41cine 44:
Retj #. . . 00000
$ 16'x. :36 TOTAL
'pis permit is issued sub)ect to the regulations contained in the REOUIRLD INSPECI ION'.,
:card MUPICIDal Code, State of Dre. Specialty Codes and all other Foot /foland Insp Mechanical Final
avo)icable laws. All work still be done in Accordance with approved POSt/Beall! Stt-Lirt Building Final
Wars. This oernit will expire if work is not started within IN Framing Insp Erosion Control
days of issuance, or if work is &Mended for ave tfoe 5. Insulation Insp Cr-awl Pain
(3yp board Insp
'permittee Signati.ti,e Lt;aw Pain di'ain Insp
Mi sic. Inspection
I s S 1-t e d F Misc. Inspection
%
Call fc), inspection 639-4175
Permit No:
Address:
t-
:' z Issued by: Date:
`� •. .••'/ —_.__--_____.-- __FOR OFFICE USE. ONLY - -----.-_.__ _--
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential construction permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permitG. Licensed Architect and Engineer applicants, exempt from registration
unuur QRS 701.010(7), need not submit this statement. This statement will be
filed with the permit.
Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
I own, reside in, or will reside in the completed structure.
2. 1 understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion.
3. A. My general contractor is - ___ _ _ __ -
Contractor registration number
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
3. B. [_� J I will be my own ;general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors Board
and I will immediately notify the offir�z issuing this building permit of the name of
the contractor.
I hereby certify that the above information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reve7e side of this form.
'Stgna ure of Permit Applicant bate
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
LALMR
CITY OF flGARD REGF-.1PT OF PAYMENT, RFTF IPl' NO.
CHECK AMOIANT 169, 36
ABRAHAMSON, SRUCC U. CASH AMOUNT n N. 00
ADDRESS F.'*AYMF.'NT DATE : 0,3/06/9' '
12735 SW MARIE COURT SE.BD I V I c I ON c
TWARD,
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMUNI AMOUNT PAT D
BUILS)ING PERM MS192-31 80. 50 MF-CHANICAL PE 015. 00
FiT, BUILD VT-R 5. 28 PLAN CHF--(,'K FE 58. 58
TnTOI.. AMOUNT PAID 169. 36
CITY O F TI .ARD 13us Bo 1{au 1i1vd. P1_NCK/RECT
ro o"`2J397 PERMIT # �V_�f]
COMMUNITI' ULVGLOI'MI-.N'1'1)GI'ARTMI?N'I' Ti pry Oregon 972D
(503)639.4171 DATE ;ISSUED
100 ADDRESS: 1 3, � `��1 TAX MAP/LOT 25104AC1-00-50()
SUB: __. LOT: LAND LIS[: —
VALUATION: � � O ?
OWNER SPECIAL NOTES
NAME: �`� ✓'`U �_ �2W N N 1,,150 k _ REISSUE OF:
tADDRESS: LAST REISSUE:
FLOOD PLAIN/
PHONE: 3 J�la G`z _ SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME ' "� S 'a6 PLANNING: --
ADDRESS: _ _ ENGINEERING:
FIRE DEPT:
PHONE: OTHER: /UO '71,"-
CONTR.
T/FCONTR. BOARD #: EXP DATE:
ITEMS REDUIRED
SUBCONTRACTORS: PLUMB: _ LIST/SUBCONTRACTORS:
MECH: BUS TAX:
ARCH ENGINEER CALCULATIONS:
NAME: TRUSS DETAILS:
ADDRESS: OTHER:
PHONE:
PROPOSED BLDG. USE:
COMMENIS: �QZ� rt��lti✓llllc r _ �_� --- -
APPLICANT SIGNATURE
Received By: � � _— Date Received: -'
INSPECTION NOTICE
City of Tigi,•d Building Department
P.O Box 23397
Tigard, Oregon 97213
Phone: 639-4175
f
Type of Inspection __ �T.G� - -- ------- --- --
�_
Date Requested_.__ � Time _ A.M. P.M.
Address
Owner_ _ __—� Lot
Builder�5�4�.` t��`>✓-�s_t�h --- -- — -The following Building Code deficiencies are required to be corrected:
I
i-7 &t.Ck
Presented to _ 11-4-AApproved
Inspector ' ❑ Disapproved
Date
CALL FOR REIMVECTION
❑ YES ❑ NO
PERMIT # ACCi # DE:SCRIPTION AMOUNT AMOUNT PD. BAL. DUE
y11Lf13rvo , 10- 432 00 Building Permit Fees
_ 10-431 00 Plumbing Permit Fees
10-431 01 Mechanical Permit Fees -25.•0, 2 w
10-230 Ol State Building Tax (5%) 5,2-Y
Building .. 3
Piumbing
Mechanical
10-433 00 Plans Check Fee Sb�.�� _�_�_ .5
Building
Plumbing
Mechanical
10-230 06 Fire
30-202 00 Sewer Connection _.._
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PUC)
31-450 00 Storm Drainage Syst Dev Chrg
24-445-01 Water Quality (Fee in lieu of) _____
24-445-02 Water Quantity (Fee in lieu of)
TOTAL �6�•3 `�� �i 6'
nm/3587P.WPF
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
y /� /Phone: 639-4175
Type of Inspection
Date Requested �� Time
A.M. /P.M.
/Address 2 _ � ���C . f�TiPermit #p 5-2,27�1
owner ---- - _-- _ Lot 0.—
Builder ._Builder —___----.-
The following Buildinq Code deficiencies are required to be corrected:
I
i
Presented to -_ U Approved
ii
Inspector �'- bisapproved
Date .,S z c
CALL FOR REINSPE,MON
YES 0 NO
MECHANICAL PERMIT
C17YOFTIIFARD
PERMIT N0. : ME892274
Cti OFMARn I
°�EOON 1. TE TS'=11F-1)c 19/27/89
COMMUNITY DEVELOPMENT DEPARTMt4iT ' ,
13125 S.W.Hall Blvd..P.O.Box 23391.Tigard,Oregon 97223.(503)639.4175 I M.PMT.NO. 892274 I
J014 ADDRESS: 1.273; SW MARIE CT
TAX MAP/LOT SUP: IT: BY,:
LAND USE:
LOT SIZE:
ITEM: NO: NO:
WORK CLASS: ALTERATION FURNACE (100F AIR HANDLR (10
USE TYPE: SINGLE FAMILY FURNACE 100K+ 1 AIR HANDLE 10K
CONST.TYPE: FLOOR FURNACE EVAP.000LER
OCCUP.GRP. : HEATER VENT FAN
VENT VFNT.SYSTFM
PLR/COMP (3HP HOOD
NO.STORIES: PL.R/F,OMP 3•45HP INCINERATOR(DOM
DWELL.0NITS: BLR/COMP 15-30HF' INCINFRATOR(COM
FUEL TYPE GAS PLR/CGMF) 30-•50HP REPAIR UNITS
MAX. INPUT PLR/COMP 50+HP OTHER
FIRE DMPRS? GAS PIPING OUTLETS 1
HIGH PRESS?
LOW PRESS?
REMARKS:
Owner installing Natural Gas furnace
----------- ------_ I FEES
O Abrahamson Bruce I PERMIT $18.88
N 12735 SW Marie Ct PLAN REVIEW
E
Fa Tigard OR 9'�223 FIXTURES $9.5®
PHONE (50;3) 631-00'.14 STATE TAY $.98
OTHER
C
O
N
T
R
A
C
T
O TOTALS $28.48
R
RECEIPT NO. /06--�F4 -7
This permit is issued subject to the regulations contained in Title 14 __.________________-_.
of the TMC, State of Oregon Specialty Codes.zoning regulations RE0UIRED INSPECTIONS
and all other applicable codes and ordinances. and it is hereby GAS LINE
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city FINAL
business tax permits. This permit will expire and become null and
void if work is not started within 180 days.or it work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
1
Permittee Signature
Issued 9y: ...r> __-- __ 1NGP TInN 639 ♦175 -- _
V
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
oof
"�Y �✓id .N� V �'�-".�'Ilf'��' 'bp''r.` ..:�� +"�!`-I'7ySh'",F'iA':,fF �a r �kryY,sd�s.- xr. � Valla li��A .•�>• x�t .
AMM
CO
� �•,7111N' fff f1� �IN4* l71�.,'���e'�Ipti, �dll�" �j�'�1+r�h1�4�`,,,�Ili�l�""-'�y'atNM','�/h!'��'.•'MIIII`�Ml�.y' ���.'NMprx�'�f� �!`.A/ f
-
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 i
Tigard, Oregon 91223
Phone 639-4175
Type of Inspection
., ^F T E� •'3 C'
Date Requested Time A.M. P.M.
Address ��� � �lcy �`'7�Q,�P/ _ � Permit # /r�.3_ �•__
Owner_ — Lot #
Builder —
The following Building Code deficiencies are required to be corrected:
Presented to lj�'Approved
Inspector Disapproved
Date
CALL FOR REINSPECHON
El YES ONO
J
C17YOF TIFARD
OREGON
May 10, 1988
Bruce Abrahamson Permit #E: 7133
12735 SW Marie Ct Date Issued: 10/28/87
Tigard, OR 97223 Address: 12735 SW Marie Ct
Job Description: Addition Single Family
Date of Last Inspection: 11/25/87
Dear Contractor:
Our. records indicate that the above described jot' has not been completed as
noted:
Needs approved final inspection
Needs Certificate of Occupancy
Please advise us of the status of this .job immediately. Permits become void
if no action has taken place for more than 180 days from date of last
Inspection.
Sincerely,
Brad Roast
Building Official
ht/4590D
13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171 --
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon on
b-1 M—
Phone: 639-4175
Type of Inspection
Date Requested Time A.M. P.M.
Address c—, Nc'y- Permit
Owner Lot
Builder
Th, following Building Code deficiencies are required to be corrected:
Presented to 0) Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES 0— NO
743
BUILDING PERMIT APPLICATION � DArE____�
THE UNDERISIGNED HEREBY APPLIkS FOR A PERMIT FOP THE WORK HEREIN INDICATED BUILDER PHONE 639-0094
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING P!.ANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
NO.
OWNER F"
Bruce brahPtttmvn JOBADDRESS 12735 S.W. Marian Ct. _ 2S1-4AD
_,... -- -uARCHITECT --_�
tsar ENGINEER
BUILDER ADDRESS C ESIGNER
STRUCTURE ❑ NEW C REMODEL ❑ ADDITION ❑ REPAIR_ LJ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
I91 RESIDENCE ❑ wmim ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO U CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB Cl FENCE
OCCUPANCY ..__�? LAND USE ZONE _BLDG.TYPE ^a?$ FIRE ZONE__"PLAN CHECK BY -AJ:I HEAT
Remodel axisting single family c wei lin,A - small additionT,-
SEWER PERMIT M
OCC.LOAD FLOOR LOAD 4() _HEIGHT NO.STORIES AREA 4 8 NO.BEDROOMS _ VALUE 3,000
BUILDING DEPARTMENT SETBACKS FRONT 2 S 1 REAR 15+ LEFT SIDE R ' RIGHT SIDE l 2 it
Permit 38 • SO THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
•�� 3 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ __ RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
3 • 93 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBI�'a AND HEATING.
_State Tax _ _
Total 6 5.46 SDC--
— - --- --- -
PDC$ APPLICANT OR—=AGENT
By 65. 46
Approved 0.011 Receipt No. �UDRESS - PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/'14 Contractor
0,0'f Permit No.
Hough-in
—-----—------
Fixture
Final
HEATING
Contractor
Permit Na.
----------
Gas or Oil
Flough4n
Proal
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Pain Drain1l Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
i-e, 4:1 Z, 1.
owNER � ALEX ��k
U65 ADoczEss -, 12533 MAIN fir , T«,ARD
LAIC 10/-27/181 CNIMNEj'
1u5IAL, OAc, RNNACIE
GN Ib" UA54 vvtik
0
MAWwN `:A4op RA FIoL.K WACY—
STORAC,E i oun LUS iN WE
owwl� -ri I%M Ktu
VV�LUW F VIZIJ/K.E
KP
I uS-rAIL 'ME i CAP
/ FM FUIVRE N>LA�tEtZ
1��a CJAS PIPE ( A5 PIPE
�REQLk..E EVI511WC, 15U MOTt1
J UNI'f NEAtLK wll Fi UwNE RL
IoU M gt L Vu i i HF-Al R
r
'S#A op AREA
E- i 5,T wcc, I��i �' �A 5 Pt t-C
V4 " CCAS Li uE
I F.KS 150 HMU
R�wc-�-t c7vJN
15-1 w o Low ~ U N rt F RO-1 OFFI C E
JKE55v1ZE q A _Tp sHt AREA f
SCALL 32 = 1 d
MAI N S-r TI y A uD
BUILDING PERMIT APPLICATION "nF TIGARD OATS_i "' 1 19 1767
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED SUILOERPHONNE 4i'�r..t7flr�id
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
LOT VO.-
OWNER.Mr'S. U.J. i, jk JOB ADDRESS i .t.r, ;.. HOME ADDRESS
ARCHITECT
BUILDER r ADDRESS ^`QI ENGINEER
_ DESIGNER
STRU,iURE ❑NEW El REMODEL ❑ADDITION_ hREPAIR ❑RENEWAL QFIRIE_DAMAGE -1 QDEMOLITION
El RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIG,�IIS❑PI'.r10 ❑CARPOR--T ❑GARAGE CJSTORAGEOSLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ODESIGN REVIEW OCOUNCIL APPROVED ❑SIGNS
C)GCUPANCY i LAND USE ZONE r _____BLDG.TYPE FIRE ZONE PLAN CHECK BV HEAT
7o ccllurarL =xxesta,:::; �ca(.3e intr? iHrnxly z.IJ+gym_
r X11 for ir7r`pecticir/priur Ca cuUnring wells -�
( ,),Iumt)irl(j permit requirad priow tt.r instraallatiult)
()cc.yQ-AD_-. FLOOR
BUILDING DEPARTMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 161 Q''li
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 6.00 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
Sub-total 24,001 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax ?; LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total Q I kJ
By
APPI-ICANT OR AGENT —'
Approved Receipt No ;
ADDRF55 PHONE
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i
DATE INSP.j TYPE INSPECTION REMARKS PLUMBING DATE
6 Contractor
_ Permit No.
Rou h-in _
Fixture
Final
HEATING
Contractor
Permit No.
f Gas or Oil
Rou h-m
Final_
SEWER
_ Final _
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
A roach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CEFITWCATE OCCUPANCY --
Landscaping
Zoning Final
i
}
r•e. ; 127q5 S-W 1krie Ct. Permit No.— 1593 _.._.___.__.___..
Permit charge
OWI-,,,r Mr. & We. Thomas D. H&Us Connection fee 400'00
Paid by r.._Dale Construction
T�-pe of bui lei a ric* Residence
Date connected4-i9-72_.�_.____.._-_..
L,ervice rate 3.00 per monthInspection fee ?S.w00
____._...,. ......_
Contractor Dale Construction Paid b Dale Const. Da t p 3-14-72-
Size
-14-72Size of connection 4" Assessment Paid
PERMIT TO CONNECT 2
Tigard Sanitary District
PERMIT N? 1593 DATE
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
THIS PERMIT M'7ST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NEC71ON IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $_. . .... ......:.............TIGARD SANITARY DISTRICT
B7
CONNECTION INSPECTED AND APPROVED
__Superintendent l `