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CITY OF T'�� FILUMHING
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PEPM]''T' NO . : P 881,4139
RD (c.1ry OF TW4RD
COMMUNITY DEVELOPMENT DEPARTMENT ORMON DA'Tri. ItsSUED : 7 1. tla
13125 S W.Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223,(503)6394175
J111318 ADDIPESS : 1 2 190 SW
TAX MAS)il-01, L T ElK
LAND USE :
L1111 SIZE:
I TEM NO NO
WORK CLASS : 14--PAIP WAT':Jl 1.11-11SE:)1:T 11 A P
I.JSF.:: 'T'YPE : SINGLE FAMILY UP]NAL BKFLOW PAVNTP
('.,ONST . I All OAA*1 UNY '11:4AP PpIll-IF"P
UCLUP.CIPP
VUB SHOWED (*.,',Rr,-::ASF: 114APS
DISHWA51-11EP
GARLIAGIF." UP5POSAL
NO. S1 Cil"1lk*:.*5 : WASHING MA('111-43'NE
13WEI I- ,UNITS : I AUNOPY BLDG. DRAIN (DIA
FLIR.111P DNAIN
!SINK SEW::P (F'1") 11.00
W(*)*I,Er4 l-4F-A'TK.J*? 5*T(:)V,,M/RAIN (FA
OTHEP
%ewc.-ii, r-c4pad.i- only
W W i in k 1.e?I glendia $30 00
NC t
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E
R ti.glax'(1 or, 9*7,ry;.?.3 I FIXTURES
S*I'AI'E I AX $1 . 50
0 T H r--':P
C
0 1)3�I won-Y-14 WILLIAM 1)
N
T W11 LIAM SON CONE IPLIGIION
R 6533 5iW 32ND
A
C portle.11(i
0 T PHONL (503) 2416-719ti
R PEC3,1STPAIJON NO. 12P-007 'r O'r AL $151. . 90
PEUETPI NO. 32711 7
This permit is issued subject to the regulations contained in Title 14 .........
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances. and it is hereby PEQUIPLU INSPF.*.:(",'T TONS
agreed that the work will he done in accordance with the plans and S EW E,P
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
business tax permits This permit will expire and become null and
void it work Is not started within 180 days.or if 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 ap rova�—,
Permittee Signature
Issued By w.j rnTT--TNr,-PT.-". TT.W---A19 A I I e1
SEPARATE PERMITS REWIRED FOR WORK OTHER THAN DESCRIBED ABOVE
e
BUILDING PERMIT APPLICATION 1OF
1TY TIG•ARD DATt __..`_ -_ . 19�--
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR TiAE WORK HEREIN 'NDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATION.-.)', OWNERPHOtjl. w �..
LO'r NO,
OWNERIru xfl�l- OB ADDRESS ~ . HOME ADDRESS r
'— ARCHITECT
ENGINEER
BUILDER _ A0DRE�-SS — DESIGNER
STRUCTURE _ ❑NEW 0Rum_t_1DEL OADDITION ❑REPA_IR ORENEWAL OFIRE DAMAGE UDEMOLITIGN
❑ RESIDENCE OCOMM ❑EDUCATIONAL 0GOV'T ORELIGIOUSOPATIO ❑CAR PORT OGARAGE O STORAGE❑SLAB OFENCE
OBOND ❑MOVING! ❑CONDITIONAL USE CI DESIGN REVIEW OCOUNCIL APPROVED_ ❑SIGNS
..� o-7
OCCUPANCY _LAND USE ZONE _BLDG.TYPE --FIRE ZONE PLAN CHECK BY HEAT.
mstruct addition to AinWia family dwellinUtr all pat plan.,) alto 'I�q
Add tecreation T0011a, stursg0s NO PlUmbir*g.
'rC C I- PfI "CT1011 ACET ATTACHCO• ----
ty r .a34 — E 900.
4C��_L.Q.�__._�FJ�S7S213�..�?A�._.—.__ `..._._HEI�CK7 -`_- ►�.Q..STQRI���_�_AN.�A_^—.N4_.HEURQ2M;z_.�__YBLUE ..�
BUILDING DEPARTMENT SET BACKS FRONT_ d.. REAR ' LEFT SIDE "' RIGHT SIDE
Permit ` •01i
THIS PL-RMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGI'LATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL 13E DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 4• 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 ' * r} LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total I'
By
_ APPLICANT OP At3ENT
Approved Receipt No
—
t.. ,
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
y�p_71 —_ — --� JRough-in
ontractor � ---
✓f'-3 7 -----_��,. _ _ ermit No.
_ Aa�tleLL fti�w� NiAa,v r'. ixture —
Final
HEATING
Contractor
Permit No - -
.
Gas or Oil
Rough-In ..-
Final
---�.----- SEWER
DRIVEWAY --�.-----
--^---- Final
Storoh Drainage
(Rein Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Fi
Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
(
�.r �I � ■w w wn Iwr sr
BUILDING PERMIT APPLICATION C0F YIGARD DATE
T'rIE UNDERSIGNED HERBY APPLIES FOR APERMI r FOR THE WORK HEREIN INDICATED SUILOER 0.110NE
OR AS SHOWN ,AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS O�'/rJ£F?PHOr'F-
ONINEF
L . � � V"(A/kCE1e.J08 AOCRc95 � LOT NO_f�_._
\( J ��� 9Q S�(,����
ARCHITECT
ENGINEER
AUnRe.sp _ _�� _ �-I DESIGNER
STRUCTURE -Ct�t,r. +! _ [i REa1n0E1.�1- DOtTIONCI�IREPAIRr� LJRENEWAL ❑FIRE DAMAGE ��•--�� QDEMOLITION
RESIDE1yCE CCOA1r.1 ❑EDUCATIONAL UGOV'T QRELIGIOUSLIPATl0 LICAR PORT ❑GARAGE ❑STOR:.GE 6.ISLA,E ]FENCE
0I7UUPArJCv-Q-l-LAVO USE 20NE 2'-rZ—.BLDG.TYPE—SA--�Fme ZONE-3 PLAN CHECK BY��/,,
c
SEWER PERMIT �
c_!,2ap F`94�?1�4�4a� _ lSak��___Y Z � I'��?t ._2_ a SAO NO oR cZ�� vAl.iL� �a
9UILOING DEPARTMENT
SETBACKS FRONT REAR 20 LEFT SIDE 14— RIGHT SIDE
Permit
00
i THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 70NINC
Plan Check ,�,�, REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
6ORK WILL.BE DONE IN ACCORDANCE WITH THE PLANS A'ID SPECIFICATIONS AND IN COMPLIANCE WITH
u7•total I O v ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTFIACTOR AND SUB CO`1TRACrORS TO HAVE CURRENT CITY BUSINESS
State Tax Z tit LICENSE. SEPARATE PERMITS REC1l11RED FOR SE-VIER, PLUMBING AND HEATING.
Total �LL� 5DC - •
r PDC#
Approved Receipt No
PHONE
SDC -
Poc _ $ #
SEWER CONNECTION $
SEWER INSPECTION
SEWER SURCHARGE
Comments :
w,.
,y ,�pw.,iF\ M wjyr•"�ptlp"W .v NN.{M�IRNIWgyY�f,1Py��r+� �yit�y�(�vlvA' •r ep. .IF (�
CITY OF 472
BUILDING PERMIT APPLICATION TIG ARD DATE�_'�.1 __'+��___, 19 N2
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INr CATER
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWI ER PHONE-
WNER OL.iAN1° lA,;##V •"L4 k" ADDRESS % ,rll� BUIL ER PHONE
ENGINFER
BUILUENIvL+
ARCHITECTDESIGI 4R —
STRUCTURE ONEW ❑REMODEL ADDITION 0REPAIP ❑REN4'WAi.__❑FIR_E D MAGE ❑DEMn!1TiU''
LJ RESIDENCE ❑COMM [:]EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO OCAR PORT ❑GARAGE. –❑STO, 'GE SLAB OFENCE
❑BOND ❑MOVING QCONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED — ❑SIGNS `
OCCUPANCYLAND L'SE ZONE r BLDG.TYPE y FIRE TONE— PLAN CHECK BY '� HEAT—
QC,C LOAD FLOOR LOAD __ HEIGHT NO.STORIES AREA VALUE(E' tr
BUILDING DEPART M� T i
SET BACKS FRONT ' REAR LEFT SIDE RIGHT SIDE
Permit ai
- ' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ; 4. ' 1' 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
1--'/;41
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
f%State LICENSE. SEPARATE PERMITS REGUIREO FOR SEWER, PLUMBING AND HEATING.
TotalBY --'----+------ -- APPI It'!1✓<!1 riil 4(-�fNi
Approved Receipt No
ADID RFSS -- --- P"13 NE
CITY OF TIGARD
12119 $. W. MAIn $free
MAUD. 0*900N Vltf$
APPLICATION FOR BUILDING. PERMIT
New Construction ❑ Demo IIsh U Addition Remodel l� movel
ZONING � � DATE ISSUED BUILDING PERMIT- -'�
DATE RECEIVED BUILDING FEE $.___s• 00 No.
By PLAN C11FCK � -�-
- OTHER $ OS /jl ?�� VALUATION $ ._U-___,_.
TOTAL
_._.._____..._.._.__._.. ._6N_._._...._. $
��_._.._...__._�.__ RECEIPT No
TWO SETS OF PIANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT t MAP 1 CENSUS TRACT JOB 1
Architect or rngInee r�`____
Address Phone
Address-1077YOS_!v._ _! e G°7'._ _ Phone_
Builder
Address �_. _ .__ �._. Phone -
BUILDING USE Single Res. Multi Res. ❑ Comm. Industrial
OCCUPANCY GROUP -T No. of Stories / r— Total "eight______ Area of Lot___
Type of Construction 1 It III IV C9 floor Area B�V 1_ 2- -
Set Backs: Front _ Hack_ L.S R.Side___
Private Sewer Pipe war ^l�septic Tank ❑
�7 111 --
Water Service Pipe e � Storm Sewer ❑` Ditch ❑ Drywell❑
Street and Curb
Driveway Width_._..__ __._.,_No. of Parking Spaces__
5ErAPATE PERMITS REWIRE') FOR SEWER AND PLUMBING
SPE:CTAL INFORMATION
ADDRESS ASSIGNED 4eS1r1AVe.-.._.. /a7PW .r-aW. G7`
FIELD CHECK BY___ JP.
_MATE.Z� C _+�
_
PERMIT APPROVED
It is understood that all work will conform with apT:licable codes and ordinances
of the State of Oregon and the City of Tigard. Oregon, and t[,at the i,,fitding will
not be occupied until a Certificate- of Occupancy has been issued by the City of
Tigard Building Inspeet.or. f Y
xignatur,e o kppl cant
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pc'7E?rr?,% F�2 cc��fs rN r/Ir- ,,�.�[ ri��c /,3c_-{e�rzc Mo7rCcsb
gar-�►-�-�-�.i /3h.��ry:�
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APPROVED FOR GONSTRUCTION
CITY OF T G ,RD
s` ERMIT Ni O.— _—_—__ SITE
ALo BY __—TITLE _____.DA E —
ALL SPACES MUS E ENDORSED
PRIOR TO APPROVAL OF THESq PLAI S
r T
PUB IC WORKS DEPT. BY _ �Td
P N111•r DEPT. QY.._.____..._.____.__.. DATE
BUILDING DEPT. 4.-� .__ DiIZ 12
TIGJIR l':174:2 D: aT. 17Y_____.__......_._—____.. D1T.:
GENERAL TEI_L`PIAUNE E3Y__ D
USA BY _ ____ -•- t
N. W. NATURAL GAS Gy..___�.__ .._ -_ D 'Ji:
P. G. E.
T. R. F. D.
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