14430 SW MCFARLAND BLVD-1 14430 SW MCEARLAND BOULEVARD
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}APPLICATION - -tREET IMPROVEMENT/EXCAVATION �CO Y TO:
/ r ( HITE)-FILE
ORDINANCE NO, 74-14 �1 , ' 1 ELLOW)-INSP. j
(INSTRUCT;ONS ON SEPARATE SHEb T) ` .. Cl INK)-OTHER AGENCY
\ BLUE)-APPLICANT
APPROVED `\�--,_. APPLICATION NO.:
NOT APPROVED CITY OF TIGARU, OREGON
�] FEE AM r.. E
PENDING FEE. PMT. ❑ C1,11, IIALI. RECEIPT NO.
PENDING SECURITY ❑ PUBL IC WORKS DEPA R TMEN T By — DATE ___.1__L.`�—
PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND >k
PENDING INFORMATION [7 FOR STREET IMPROVEMENT/EXCAVATION AS REQUIREu ---
ANNUAL
PENDING VARIANCE ❑ EXPIRA"IONDATE:
PERMIT NO.: DATE ISSUED: ----._1 1_„_l BY: . -------
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL_
AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENIS.
APPLICANT - - L l __�15�►�F,i�S �`� ":',t , 11 '' LVJILJLN:;i.! `I,LVX._I 1" = �I _:$ti.
NAMEAbL.t:.SS CITY PHONE
CONTRACTOR —�
.. -_� NAME ..- ADDRESS
PLANS BY •- ._., t `. 1 `ti _ C f f_.. a __ _
NAME ADDRESS CITY
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): E
DOLLARS
roR OFFIt:E USE: MIN.
(2) EXCAVATION DATA:
STREET _ _ DESCRIPTION PROGRESS INSPECTION STATUS_
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE ^FMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
STREET
_Qm ED
INSPEC- _—
L3� _ R TION
ESTIMATED STREET OPENING DATE: /,_.�� I� g
ESTIMATED STREET CLOSING DAL E. / T —
E
I_. t.. SYREET
131 SECURITY NO. -_-- __.. _ SECURITY AMT.: S CLOSED _
SURETY CO.: FFINAL cERnrIFI+cHEcn cAsr�-u-—9pN_b � INSPEC. _
(4) PLOT FLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISION'_• 1 CONDITIONS.
FEATURES: EXCAVATION LOCATION AND EXTENT.
A
'1A
(5) NOTE THE CITY OF TIGARU DOES NOT. HEREBY. GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUP TV OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THF REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINFNT TO CONDUCT 01' THE WORK, ANO TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY PESULT FROM APPLICANTS ACTIONS.
APF LICANTS SIGNATURE _ cii Z :__!_
DNTE/T
1
_ 24' 0" MAX. 12' - 0" MIN.
---- DRIVEWAY �- R/W LINE
A
w CONTRACTION JOINT OPTIONAL
SIDEWALK
_ LOCATION
B SIDEWALK EXPANSION aOINT
EXPANSION JOINT
CURB JOINT —
A-f=
6'-0" MIN. 12' -0" MAX. 6' - 0" MIN. 12' - O
FACE OF CURB
SIDEWALK ADJACENT TO CURB SIDEWALK AWAY FROM CURB
PLAN
F 1 1/2 EXR)SURE
...�_--- -r--•'
i
USE EXISTING EXPANSION
ELEVATION B-13 PLACE
OR SAWCUT
E1
P!ACE COLD JOINT.
SEE DWG. NO. CS-3013.
STREETI
`�6-•
TE
COMPACD SUBGRADE� 2" OF 3/4" MINUS
SECTION A-•A
NOTES
I. CONCRETE SHALL HAVE A MINIMUM BREAK114G STRENGTH OF 3000 PS.1.
AFTER 28 DAYS , 6 SACK MIX.
2. CURB JOINT SHALL BE A TROWELED JOINT WITH A MINIMUM 1/2" RADIUS
ALONG BACK OF CURB.
3. EXPANSION JOINTS SHALL BE 1/2•. PREMOLDED ASPHALT IMPREGNATED
MATERIAL OR EQUAL , EXTENDING FROM SUBGRADE TO FINISHED GRADE .
4, SEE DWG. NO. CS--300 AND NO. CS-305.
WASHINGTON COUNTY
,DEPARTMENT OF LAND USE RE:�;IDENT IAL DRIVEWAY
AND TRANSPORTATION
DATE CIVIL EN91NEER DRAWN APWA NO. WASP! COUNTY N0.
!/►T • AEA b.89 NONE DW-- 200
C,TYOF Ti�ARD No. l C 5 7
12755 S.W.ASH
P.O.BOX 23397 Date/-,"-,
TIGARD, OR 97223
i
� Name
Address
Lot B oocklMnp SubdivlsionlAddress
Penult M's Bldg. Plumb Cash Check
Sewer Other Other Rec. By ,
Acct.—No. Description Amount
10.432 Building Permit Fees
10.431.600 Plumbing Permit Fees
10.431.601 Mechanical Permit Fees
10.230.501 State Bldg. Tax -�-
10.433 Plans Check Fee
10-435Other Licenses & Permits
30.443 _ Sewer Connection
30.444 Sewer Inspection
24.448 _ Street Syst. Dev. Charge
25-449.610 Parks IX t. Dev. Charge
25.449-620 Parks II Syst. Dev. Charge --
31 450 Storm Drainage Syst. Dev. Charge
10-430 Business Tax
10.434 Alarm Permit
10.227 _ Ball _
j 10.455- Fines - TrafficlMisdlParking _
10.230. CPTH TrafficlMisd/Vic. Asst.
10.456 Indigent Defense
30.446.401 Sewer Service/USA
30.446.40.2 Sewer ServicelCity___
31.447 Storm Drainage
40.475 Bancroft Prin. P mt. _
40.471 Bancroft Int. P mt.
10.451 Other Charges for Services
_.___ ___ _- — TOTAL► — .r
C")
DEPT.
BUILDING PERMI` APPLICATION TIGARD DATE _-_!_1-1-5� _ 19 • tJ��"
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. OWNER PHO'JE. _ Q
LOT NO._ 7 _
OWNER _, A.• i'itJJr ne — JOBADDRESS 141430 SW VkFurlaud _____ SY,<almm 11;
ARCH17ECt
ENGINEER
BUILDER_ � '' ADDRESSei _ DESIGNER _
STRUCTURE ❑ NEW ❑ REMODEL IN ADDITION ❑ REPAIR ❑ RENEWAL. ❑ ME DAMAGE ❑ DEMOLITION
® RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY - M-1 LAND USE ZONE R-3 .._BLDG.TYPE --FIRE ZONE- - PLAN CHECK BY ._HEAT��
Conatract duck to ezistizig single fammily dwelling per approved plaits
SEWER PERMITN
OCC.LOAU FLOOR LOAD 40 HEIGHT NO.STORIES AREA 678 10(X
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT!
Permlf—` 11•50 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CC ZONING
1 1•:3$ 1 REGULATIONS AND ALL APPLICABLE CODES AND ORDINAN IAT T>1E
Plan Chock _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS A,.v orNnc, riv a.vmrLIANCE
» WITH ALL APPLICABLF rnnFs ANn ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tex •f o
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
_ ..
SDC
Total 29.58
PDC# APPLICANT OR AGENTey drx,
Approved BLJt Receipt No. _
AQnRE88 �--- ral±nNr
BUILDING PERMIT APPLICATION T1GAK) DATE F``-/ _ 19.
THE UNDERSIGNED;IEREBY APPLIES FOR n PERMIT FUR THE WORK HEREIN INDICA fED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCON,.'AN'7ING PLANS AND SPECIFICATIONS. OWNER PI10NE -sf'S/1Z
Lor rlo._�_
O1JNEfl/ t�. ��c'�(2 C iL;�.OB ADDRESS f <( 1 ti,<? c>�_ l` ( ` r�JeC MJIJ
— ARCHITECT
_ ENGINEER
BUILDER �: (�P f 4: ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO Cl CARPORT Cl GARAGE ❑ STCRAGE Cl SLAB❑ FENCE
0C,CUPANGY _2 1 / LAND USE ZONE �-BL.DG.TYPE _-'� PLAN CHECK BY~_ ,�1 HEAT
T- T) r n E X r r . 3 S Al
Ai k-aiirk2 -I'_LAAL5. ---- --
SEINER PERMIT K
OCC_.LOAD_ FLOOR LOAD ...--HEIGHT NO.STORIES AREAE j NO.BEDROOMS VP.LUEL7`) v
BUILDING DEPARTMENT GET BACKS FRONT REAR LEFT SICE RIGHT SIDE
Permit THIS PERMITS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOrt!N:.
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREaY AGREED TkAT 71J.1
Plan Check J WORK WILL BE DONE IN ACCORDANCE WITH TPE PLANS AND SPECIFICATIONS AND IN COIAPLIANrl
Q WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV'
Sut�tetal u RESTRICTIVE COVENANTS.CONTRACTOR AND SU3 CONTRACTORS TO HAVE CURRENT CITY BUSINES!
j C) LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING, ND HEATING.
State Tax
SDC—
Total .r -------------- -- -- ---- -------._.__----- -
pD( APPUCANT OR AGENT
BY
- — Receipt No.
Approved ADDRESS _ -W — - ~— PHONE --
SSDC -- $
SDC - .�
POC -
1
SEWER CON ECTION $
SEWEF INSP CTION $
SEWER SURCHARGE
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1011-
14A
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223 i
Phone: 639-4171
Type of Inspection
Date Requested _ Time A.M. �P.M.
`0^
�_? ______-- Permit
Address #�--
Owner� -- Lot #_
Builder
The following Building Code deficiencies aro required to be corrected:
Presented to
~�-•+--- _ �� Approved
Inspector Disapproved
CALL FOR REINSPECTION
Qc7 YES ❑ NO
F VRDA. C
MnR
P. • HOX131Nk{.{
►'(P.o.RTLAND,ORE.
9 223
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested �-.•+ 7 i Time A.M._`�_ P.M.
Address j `�U c -1 1 +Y lrn Permit # --
Owner Lot #_
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _ I Approved
Inspector — __—_ [._I Disapproved
Date
CALF: FOR REINSPF,CTION
❑ YES L NO
BUILDING PERMIT APPLICATION TIGARD DarE__r?"''^ ''�'? xt3 4678
THE UNDERSIGNED HEREBY APPLIES FOR A PERMS FORTH E WORK HEREIN INDICATED BUILDERPHONE 226-1101
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _
LOT NO.____27
OWNER F'.A-.,.-.I vreno JOB ADDRESS 1443U 3Fi ttcFarrl.arLJ.-__.. 5hadaw Hills _
ARCHITECT
ENGINEER
BUILDER M. -repo ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL Lj ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRS DAMAGE ❑ DEMOLITION
Celt RESIDENCE 17 COMM Ll EDUCATIONAL [-I GOVT `i_I RELIGIOUS 1_1 PATIO 0 CARPORT ❑ GARAGE ❑_STORAGE E SLAB;._1 FENCE
OCCUPANCY --Z~3 LAND USE ZONE -_"= C_BLDG.TYPE ., -N—FIRE ZONE____._-_ PLAN CHECK BY� �Crt HEAT
Construct addition to existir2 ein,�lt► frsr•�ily_ llin �-- --
--� — Plumbing !ieati-m., i'tr"-d t. 'i.tecluited. 4 Bedroom 4 i,athroww
SEWERPERMITM
OCC.LOAD FLOOR LOAD HEIGHT NO STORIES 1 + AREA 1`)J N0.BEDROOMS 4 VALUE 3i),ijoU�
BUILDING DEPARTMENT SETBACKS FRONT REAR L1 FT SIDE 14 RIGHT S DE
Permit 1 1.4 3.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
1?).45 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCE,-, AND !T IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIF,CATIONS AND Iw COMPLIANCE
I��4� 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
State Tax 7.72
LICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLUMBING AND HEATING.
SDC---
Total
DC---Total 32619-17 -
PDC# APPLICANT OR AGENT
By C.1I
Receipt No.
Approved j F1C}1 ADDRESS
DATE INSR YPE INSPECTION REMARKS PLUMBING DATE
Contractor - -
(--�J Permit No.
Fixture --
� `_� _-------------- Final
HEATING
Contractor %,
- Por
' Gas or Oil
Rnugh•in ----
Final
SEWER
Final -'
DRIVEWAY
Pinal
Storm Uralnagr
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY ;F
inal
CFItTWICAYEOCCUPANCY
BUILDING PERMIT APPLICATION TIGARD DATE October ,lA 0 4619
THE UNDL.R&LiNED HERk�BY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON[6ZU-844D_—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER r.-. :4orevo JOBADDRESS 14430 5W McFarland LOT NO.
---- �- —� — -
ARCHITECT --- -�
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL Ll ADDITION L.7 REPAIR ElRENEWAL Ll FIRE DAMAGE ❑ DEMOLITION
L)ARESIDENCE ❑ COMM P EDUCATIONAL G GOVT ❑ RELIGIOUS El PATIO O CARPORT ❑ GARAGE f_] STORAGE ❑ SLAB❑ FENCE
OCCUPANCY ------LAND USE ZONE R-30 BLDG.TYPE _ _FIRE ZONE__. PLAN CHECK BY = HEAT— — _—
DeLmsi.t 2Uu =1 o +444 -1-8 on Qen►p"tY• _
"gtural flow of storawater to be ioaintained
SEWER PERMIT N �—
OCC.LOAD FLOOR LOAD HEIGHT NO,STORIES AREA NO.BEDROOMS VALUE
BUILDING DEPARTMENT _ SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE _
Permit _ .�Z•J'J—� - 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 THAI 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
Subtotal i+ —_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUS!NESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING-
StateTax
•� --- SDC—
Total
_
PDCN APPLICANT OR AGENT
By
fst'tt Recelpt No. 1 — —_.—.____.__—_..._—__
Approved ADDRESS PHONE ----� ------—'
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Plain Drain)Final
Sidewalk
Curb&Street Final
App,aach
BLDG. DEPT.FINAL T MP
6-ii-X—R Y CERTIFICATE OCCUOA�Ncy
CFRTlr-"TC CATE IFinal= ---
Ls,idsvi,iinq
Zoning Final
BUILDING PERMIT APPLICATION TIGA;,lD DATE--L----L_19 �"
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. OWNER PHONE
O'NNER JOB ADDRESS
ARCHITECT
ENGINEER
GUILDER ADDRESS DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL Cl FIRE DAMAGE ❑ DEMOLIT101
(11 RESIDENCE ❑ COMM ❑ EDUCATIONAL (3 GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT Cl GARAGE G STORAGE ❑ SLAB❑ FENCI
OCCUPANCY LAND USE ZONE iBLDG.TYPE FIRE ZONE PLAN CHECK BY --HEAT
SEWERFERMITM
OCC.LOAD FLOOR LOAD HEIGI4'r NO.STORIES AREA NO.BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SICE RICHT SIDE
I'�rinit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOW!4:
FREGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERF-3Y AGREED THAT TH,Plan Check �— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAUr-'
e.+ WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV'
SU�tOlal RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINEs
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
;tarn Tax •. ,_ �'
total ' SDC _
POLO APPUCANT OR AGENT - --
I1y
Receipt No.
Approved ADDRESS
_ 1)C - -
POC -
SEWER CONNECTION $
SEWER INSPECTION S
SEWER SURCHARGE S
Cnrrlmoflf S�
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
T;gard,Oregon 97223
Phone: 639-4171
Type of inspection
Date Requested Tin" A.M. /-N P.M.
Address t/
I Owner Lot
Builder
The following Building Code deficiencies are requirec' to be corrected:
(Presented to Approved
Inspector Disapproved
Date
CALL FOR REIN, PECTION
F-I YES NO
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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Bui'kding Code, the
following item(s) require correcting:
IL
Z ASIZ,-Ad
Date: Permit No.___. ..-
CALL FOR REINSPECTION
CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR:
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
j'2 S.S
Permit No.
Inspector
CALL FOR REINSPECTION
BUILDING DEPARTMENT, TIGARL
N0.
PLUMBING PERMIT
holder of a valid piumbing contractors license is he•eby
authorized to cause plumbing work as herein rioted 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 ctractors and sub-contractors, rr�p�tt � ,
Owner — — - AddressL ' �-1�11-11--
NUMBER OF TOTAL PERMIT NO.'S
7
IF—_- TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only) i
Single Family-1 bnth--each 25.00
0
Duplex—Each 1 bath unit 25.00
Additional bathroorrs—each _�-y 10.00 _
Mobile Home Space—each —
INDIVIDUAL FIXTURE FEES
I to 50 Fixtures in_' building—each I 3.00
51 to 100 Fixtures in 1 building—each 2.50_
2.00
101 to 200 Fixtures in 1 building—each _I +�
201 n,mnre_ Fixtures in 1 building--each 1,5p
BM ISCE1.LANE0US _
uilding Sewer-1st 50 ft. _ 10.00
Sewer—each additional 100_ ft. 10.00 _
Water Snrvice to building B.00
Private Water Synems—eech 100 ft. ip,OC
Other (Specify):
PERMIT For Plumhinp lntaectlon Phona C94191 �.
State Plumbing Contrpctor By
TOTAL RECEIPT NO. Issued By
I t 0 t I C-1 r G1 Mechanical Permit Pur twill_
F t,it
New Installation l Replace Melormion 1 1 Addition 1 I Aln-wtion 1 1 q " state.
TO T A
CONTRACTOR f --e 1�4;r
ADDIIESS
)0;0< AIMM
PHONE APPI I
He'll Inpkil HaIlliq
(HTU Put How) V(,flt it 4, Flue Size
FUEL OIL GAS L] ELECT V1 OTHLH ... . .....
ITLM No. I LL ITEM NO. Fall
For Iminve of Permit .4(11) An Comlitioli Compti,%l,m Ili to 3n 14P 10.00
Nvka U10ci 410,0001111L) .1 00 All H.111,11111.1 M two It I M 3.00
106 606 13 TO 01) All I 1,1111111litl().1-1 10,0110 C.F'V 500
Floor �
_.
Tri1-d0l ()() I val)III'llivo 3.00
Mill Floor Susprnrleil 4 00 II 11,111110 vulit I 'm 2.0
I )00 lit sy"will
Install Vents Only 01 100
Rf!pjir •Heal Iti Cooling Im.1 I l;unnn iri,il _l 3.00
An Condition CumpivVILir Unifri .11111 4 ot) 0111
10.00
An Condition t.ompres%ut .9 in 10 M1 I / !rll }
INSPLCT01i S CONINIf N I
C11Y 1VJSIN1','j I l(A.Wil 141.00110 11 1 (M AI I I (IN A, WW- 'M .11111 i)NIHACIMC,
A.PPI.oV1 1) BY I)AII,
RECEIPT NO
will,1.11 r I
BUILDING PERMIT APPLICATION COF TIGARD DATE--, ___,,_� 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED @UILDERPHONF �6
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. Owr+ERPHOnF
40T NO._._+
OWNER 4 dumLrdY Y ri 1 n &1gDDRE5S tif] _+ !� T,i�t1L�!!� ADDRESS r_
ARCHITECT
ENGINEER
BUILDER
NGIRId I�---tt ADDRESS riCTI 1 ",J2 1 il` Lh i tF,() DESIGNFR (�JCk iLlant;
STRUCTURE D'NEW ,-LJ REMODEL ❑ADDITION QREPAIR_ ❑RENEWAL- ❑FIRE DAMAGE ❑bEMOLITION
CRFSIDENCE ❑COMM ❑EDLICATIONAL ❑GOV'T ❑RELIGIOUS❑PAtIO_❑CAR FORT ❑GARAG_E ❑STORAGE❑SI AB ❑FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY—,,__•_LAND USE ZONE f'-31
BLDG,TYPE FIRE ZONF`PL AN CHECK BY, HEAT _
--- � �►' L !>' P tn�;,ly dwoll inu u attach0d ax•e +x. 5 Bodroonis - 4 E;at V
CfIaB�FrTION SHELT ATTALhLU., _-
Qt�11.3
3Ur,.
i�El�ilil_ 30— —__N9� .U13S2QM�_ �_v3LUE
BUILDINGDFPARTMENTSETBACKS FRONT REAR �J LEFT SIDE 4 RIGHTSIpE It
rPlan
it —_---------
--
►G _ �__ �__ __--
TNIS PERMIT IS ISSUED SUBJECT TO THE REGUL ATIONr, rONTAINED IN THE BUILDING CODE, .ZONING
Check i4f', 00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCESANO IT IS HEREBY AGgEED THAT THE
WORK WILL BE DUNE IN ACCORDANCE WITH THE PL ANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
?otal
444,UO 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 Q 11*84 1 wFNSE. SEPARATE PERMITS REQUIRED FOR SFWEH, PLUMBING AND HEATING.
Total_ 4 is B4 J - 4 400,00
By P11C�1.(l[�
AppFoVed DIM R(,cetpt Nr,
r
DATE INSP. TYPE INSPECTION REMARKS
- - --._ PLUMBING DATE
B-f3-?9 — oor , _ Contractor
/Q
r 5 Pr'UM� ! S 1 03Yud nAT Permit No. �QS 414,R)
i1- r'�`j C (yd✓C,�t QISAPpngy ad Rough-in
JAIf_.__ialS' Rod• "S'421-A .r f� - Fixture --
_ c� r
15_A_POhOur Final
HEATING
Contractor _
- - - Permit No.
-- - Gns or Oil
- Rough-in- -
__- Final
-- _- -- -- SEWER
-- -� Final -
- _ - -DRIVEWAY
Final
-'- -- -- (Rain Drain)Final
- --'- Sidewalk ---- - �_
- Curb R Street Final
-HLDt3. DEPT.FINAL -- Approach -- -
TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY p Final
o
Landscaping
l�
Zoning Final
.•:..:::.nn:n;.+•+>+`)+ii>'1'��"+t1RT7n!;yRriir[rw...-enn++....,--_......,.
r,ITY 'rIvIAR
'► AJ DATEd� _._ ._-- __. 19_�! Na .2787
_lll. 01 IG PLRMIT APPLICATION o�
F oNGE W "C'-NED HEREBY APPLIES FOR APE RM IT FOR THE WORK HEREIN INDICATED BUILDER PHONE�� ✓�Wt .
t A�, SHCWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPFCIF ICAI IONS. OWNER PHONE
�y43��. w LOT NO._ __
JOB ADDRESS ���r�t �i��
-HOME ADDRESS
_ - - _ ------ -- - _dl^n"SL'JARCHITECT - ---_ —
ER
e� hDEGIGNER �C� -
ORF NEW __OREMppEL _DAGUITION -� REPAIR _�IJRf.NEWAL ❑_ rIRE DAMAGk ❑pEMOLITION
N( f I��r MM ❑EDUCATIONAL ❑GOV'T DREtLGIUUSOPATIO ❑CAR PORT C�GARAGE- ❑STORAGEOSLAB [FENCE
"ND L_1 MOVING ❑CONDITIONAL USE - DDFSIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
".NCr R'3 LAND USE ZONE `'_3v�_BLDG TYPE._y_ AFIRE ZONEPLAN CHECK FIY-- W—HEAT___ -- -
4_�'
OAQ .i► ElrH1 30
A
HULLOING DEPARTMENT $ET BACKS FRONT .22. REAR LEFT SIDE 2 RIGHT SIDE lee
1'--' TF/15 PERMIT IS ISSUED SUBJECT TO ''HE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
t,h total 00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
111nte Tax _
P.`8�' LICENSE. SEPARATE PERMITS RFOUIRFD FOR SEWER, PLUMBING AND HEATING.
I � r`
Total — - 84
By
— \
0 AGENT
t,,,pi oved Receipt No.
ADUREaS
400
C- #L /00
SE�ws�-- G8p
o"
/&&0 jlf
(oor- 2v- 52 -(o GG
/3-& )f 2q-o 372
///-o X /9-10 279
/8-a x 20-2 3& 1
4-o x /.t-8 ,s'I
,,r-/p &-w )c e--C::)
175-7 @ 200
upesf- F(n(Y" 110-4x 34-0 Got
!G-& 228
f"ema 32-(. x 20 -4 G&I
/3--(. x 21-0 312-
1A
9z/A.-o k l?-Io 2 S-0
2d -z 3zz
-a x /,2-$ S/
Gp /Z
28. &
7-6 248
3 2 -8
798 E if /19761,
y6 S
BUILDING PERMIT APPLICATION TIGARD DATE--- L9
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _
OR AS SHOWN AND APPROVED IN THE ACCOM,,PAN YING PLANS AND SPECIFICATIONS. OWNER PHONE
II Fes. _ Q
LOT NO. _
OWNER F-�_��� JOB ADDRESS � LI 43O ��`J ll 'L hli�allk �'.5'O�• .</icc
- ARCHITECT
ENGINEER
BUIL GER kLL -J.nt� j.of ADDRESS DESIGNER `
STRUCTURE ❑ NEW C] REMODEL ADDITION J REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEIAOLITIOI
( iESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS Cl PATIO Cl CARPORT ❑ GARAGE G STORAGE ❑ SUB❑ FENC
OCCUPANCY LAND USE ZONE' ,-,� BLDG.TYPE -`-'- FINE ZONF PUN CHECK BY HEAT
baa rN —
`;EWER PERMIT M _ �—
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA//_f NO.BEDROOMS VhLUE� >
�_ BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SICE :' Y r RIGHT SIDE
Permlt I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOU!!1
REGULATIONS AND ALL APPLICABLE CODES AND ORDINAUCES, AND IT IS HEREBY AGREED TFAT Tf!
IPlan Chcck / .Z yS WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPLIANC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
Sub-total c� y S RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES
f
-72 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
:,;6(n Tax
SOC—
Total -
PpCM APPLICANT OR AGENT
By
-- , Receipt No. -- -- ---- —
Approved ADDRESS PHONE
SDC____—___ \
PDC -
SEWER CONNECT ION
SEWER INSPECTION S —
SEWER SURCHARGE S
LL I