10245 SW SERENA WAY xwfw
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10245 SW SERENA WAY
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CITY OF TIG_ RD
_ OREGON -
' Omer: Jay Miller Builder Permit No. 4193
Address: P.O. Box 23291 � -
10245 SW Serena Way .
Building Address:
Occupancy: R-3 Land Use Zone: R-7PD Bldg. Type 5N
Comments:
q� Certificate is hereby given this 29th day of December 19 a2
that said building mai• be occupied and that it complies with all
requirements of the Building Code for the City of Tigard, as approved
by the Tigard City Council.
i = Fire Dept. Spector
_ wilding Official
°x = Pon` Certificate in Conspicuous Place
-- - y1wO.N Y S•.
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oreqon 97223
Phone: 639-4171
v
Type of Inspection
Date Raquestod �'�:�"R Time A.M. P.M.
Address _� �/� �J�_ _✓�'��... 0 Permit
001 _—
Owner _ t - /: Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _- _ _--__.---__—_-- _ - -- --_— Approved
Irc,)ector -- Disapproved
Gate
CALL FOR REINSPECTION
D YES y NO
INSPECTION NOTICE
City of Tigard Building Dopartment
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection --�t_��� ✓ — -
Date Requested Time_—_ A. !' P.M.
Address Per.nit #-•---
Owner.__ _
�— Lot #
Builder_ .04 j -- -
j The followin uilding Code deficiencies are required to he corrected:
oo
— / m-
Presented to — [_� Approved
Inspector — Disapproved
Data
CALL FOR REINSPECTION
YES ❑ NO
10F. rm
INSPECTION NOTICE
City of Tigard Building Department
12.420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time-_- P.M.
Address ermit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINIPECTION
F-1 YES NO
BUILDING PERMIT APPLICATION TIGARD DATE— ------- 'y _
419
THE LINDER'3IGNED HEHEBY APPLIE:,FOR A PERMIT FORT iiE WORK HEREIII INDICATED BUILDER PHONE �.—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND&PECIFICATIONS. LOOT WNENO.
RP�IONE�C_T___. ,717
O\NNFR 111er. 1"'rMB ADDRESS 10'4 5 � --- I
- `--- ARCHITEC"
t'. 5ax 23251 ENGINEEP
BUILDER ADDRESS DESIGNtR
STRUCTURE I_f NEW U RU EMODEL _ ADDITION [n REPAIR _ ❑ RENEWAL I0 FIRE DAMAGE ❑ DEMOLITION
- - --
1'flESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ noy,T Ll RELIGIOUS ❑ PATIO ,i CARPORT ❑ GARAGE O STORAGE FJ SLAB❑ FENCE
OCCUPANCY -LAND USE ZONE _BLDG.TYPE r'" FIRE ZONE._ PLAN CHECK 8Y HEAT—..--
-- - -- _
" .—r,,st1'nc't Cf.11clj o f.inily 01V7011.ir, r ,1,
of 1'er,,li.t: f Yl', 12].tl;� . ...anti 1.>.L<tcf• -- ; , ,r �t7'
—� 2T.1;?a ��0.C1f11 H , am
SEWER PERMIT# -- —
OCC.LOAD FLOOR LOAD 40 HEIGHT l NO.STORIES (' AHEA NO.BEDROOMS ., VALUE_^
BUILDING DEPARTMENT
SETBACKS_ FRONT REARH LEFTSIDE RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
-�L 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
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1:a LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMB NG AND HEATING.
State Tax
Total -
pDGq A-W-10,04- OR AGENT
By
- Roceipt 140. - -
Approved —^_ - AD- DIa1€56 PHONE
1 �
DATE INSP. TYPE INSPECTION REMARKS PLUMBING
DATE
/o-✓' V: /Z �� --- - A—------ -- -- Contractor s'�— t✓ �o- 2/^�Z.
Permit No.
I/� lay ) 0 1' G-ta✓ 4�a�_
Rough
_in —
�� FIxt-ae
i 4 , s f Fir91
---
i�'-I HEATING
Contractor�`��-
Permit No.
ee 23Z
Ga r Oil
Final
-- SEWER _
Final /_
DRIVEWAY
_ Final
49-
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
_ Approach
BLDG. DEPT. FINAL �— TEMFURARY ~~ CERTIFICATE OCCUPANCY
(CERTIFICATE OCCUPANCY Final
Landccuping
Jnr;ny Final
k
�l i
t
BUILDING PERMIT APPLICATION TIGARD DATE &,+g,
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR Ti IE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. oUr4�-n PI-+rn.F
-
n --T� _ ,_1 LOT NO. a
OWNER 1 149,.'JOB ADDRESS 10 7.4i -S 4A! -_�- -_
_ -- - --- ARCHITECT
ENGINEER
BUILDER ADDRESS� x�3L4( I DESIQNER _
STRUCTURE NEW ❑ RiEMODE_ ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FmEDAM': ❑ DEMOLITION
RESIDENCE C❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT C GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
or-C; i ANCY --R,---3-.LAN D USEZONO _BLDG.TYPE " FIRREZONE- PLAN CHECK HY -_HEAT _
_.marls? -�----- -
SEWER F.ERMIT M 2'312,+ 1 Q I�' 0 0 -- - --- Game.
OCC.LOAD FLOOR LOAD 4 iEIGHT �," NO..STORIES AREA ' MNO.BEDROOMS YALU�
BUILDING TZPARTMENT SE JACKS FRONT to REAR OL LEFT SIDE ,f.A,r RIGHT SIDE f* J
P�rrnit _7 16 •� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,;ON!NG
O a REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREEIY AGREED TYAT THE
Plan Coack 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
Sudtotel •bd RESTRICTIVE COVENANTS.CONTRACTC,i AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
�•G� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
i State Tax
SDC-
Total - ----------------
--' PDC# ^PPLICANT OR AGENT
By
.T.- Receipt No. _�..,------- -- —
Approved _ ADDRESS PHONE
SDC - G� ,
PDC - S 0 V01,b i "qt lseued 4 J.
SEWER CONNECTION $ ?0 �p � „ S3�Z R�" G•ZQ ,�?°'�
SEWER INSPECTION $ �LAYrR%iv4tat -*J ,
-_—
S E W E R SURCHARGE S ,�-^� Up-lite utme
a-�i,7
eva 700
- -----$y3•G. + 49�D--� _ ''"--�'�' ale '" --� __ _
'�C
C�.•[ti E� ,C-'�'!tib ,,� ,3 �!''1 b' �-
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BUILDING PERMIT APPLICATION -rIGARD DATE_ _.'"`u'' __,1e____ 41 6
THE UNDERSIGNED HEREBY APPI IFS FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PH _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER P E
ilodga.7n & SC►II 0245 Geriena SAY LOT
OWNER 108 ADDRESS
ARCH'(7
ECT
BUILDER ADDRESS <tt 3. ._ _ LAS sharw S13NE I`lr rc1, i'.trc'j:
STRUCTURE U NEW El REMODEL ❑ ADDITION EJ REPAIR F-1RENEW ❑ FIRE DAMAGE L7 DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ P,,TIO ❑ CARPO GARAGE ❑ STORAGE El SLAB❑ FENCE
OCCUPANCY ,_LAND USE ZONE _K-7 F 1)BLDG.TYPE ii:_— 'IRE ZON _ PLAN CHECK BY r jLHEAT y�
'.un:- uct Sil'Ac, waLA1yudwrjj*1% w/aLtac' .4 arab. �e�t�,a�4w�►4e►r
r•rectioc, sheet. .it ;..; ;stili . Ltuilti to providt,. en ,ineerce
r :. c avation 'Anspection by a0i13 :ac: }:
SEWERPERMITN ` �/+ yd N i P t ;r' li �i'' 1 ae>iynf-d Permit
OCC.LOAD FLOOR LOAD HVISPER
I T 1 + N0.STORIES AREA 1 1 ti NU.BEDROOMS VALUE
BUILDING DEPARTMENT S ONT i REArl J, LEFT SIDE RIGHT SIDE _
P_ermitA IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
~— NS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT TFIE
Plan Check L BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE
APPLICABLE CODES AND ORDINANCES. THC ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal , VE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
O. LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax {
SDC -
Total
PDCN AP LICAN r OR AGEN T
By r4
Receipt No.
`Approved L *1. ADDiiE88 - —— PHONE -
DATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATA
Contractor
Permit No.
Hough-in
Fixture
HEATING
Contractor
Permit No,
Gas or Oil
Rough-in
Final
SEWER
Fine(
DRIVEWAY
Final
S"orm Drainer
-7 lRain Drain)Final
f' /I� Sidevolk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARYC E R TfFl Cj�-T-6—OE77tjijjN-Cy—
CERTIFICATr MC PANCY Final
Landscaping
Zoning Final
BUILDING PERMIT APPLICATION
T1ZiAP:] OATE_-__.___� ' t9
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK.-IEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER HIT PRONE _
LOT NO. �
OV'JNER t�eh �M►. JOB ADDRESS �U.Z�r�� ha�aVs
AR CT
G E
BUILDER JC.�MQ— ADDRESS R Qpl _ //�� ENGINEER p
��QZt,2�0�7�CNwoK. DESIGN —
smucTURC NEW ❑ REMODEL _ 0 A001TION_ ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DE►rIOL117t7N
RESIDENCE. ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY ��.LAND USE ZONE -BLDG.TY,P�E��_FIRE ZONE___"PLAN CHECK BY ^ -HEAL'—�—
04/4 (74"4 e- 111-441CAVII
ewft�l6w a id °aQ L
(' Cwro, J18110414
SEWER PERMIT a 2 3 CJ24-- d. ICfte�f /D lr X1.1 ft -'/�00 - - - —
OCC.LOAD FLOOR LOAD HEIGHT !yl NO.STORIES AREA 3/a NO.BEDROOMS VA.LUF
BUILDING DEPARTMENT __� SETBACKS FRONT /Q REAR 3 � LEFT SIDE RIGHT SIDE
Permit -------7-'
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZON?NG
Q REGULATIONS AND ALL APPLICABLE CODES ANO ORDINANCES, AND IT IS HERr.BY AGREED THAT TF.E
Plan Check 7. '�y WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COfAPL:ANCE
� WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
1Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB t;ONTRACTORS TO HAVE CURRENT CITY BUSINESS
1f� LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
j State Tax __! -�
�q `--
Total 7• �r SDC- Pull
PGCE APPI ICANT OR A �
By
_ Receipt No. _
Approved ArIDRE.SS -- — -�-� PHONE
Feeg ct,ll�e� , �dpe .+,� # V00 3
PDC - -
rr,, 1
SEWER CONNECTION
SEWER INSPECTION $ __
SEWER SURCHARGE 8
n rrI m a rI f a; � lJ /�0�'1• �•/� � �Q�P • �'J"��
�D
d �brJ �� looseSW
� * t
,#air. Flea- 2v-G x
$ -&x 3a 2s9
4 x 39 3 err
7 x 23 IG(
Fp X- co to 4/21
�
20-&
5 7)Pe Cal- Of 3
7G
VNM
T" _ m
SIX P�JGc Sow 1310 1310
I
LOT*.27Wc,"Le»j N j 1
JOHN McDONALD ENGINEERING;
SOILS- CIVIL - GEOTECHNICAL
10116 SE STANLEY AVENUE
PORTLAND, OREGON 97722
(503)774-0077
June 6, 1982
I
Waverly Construction
Route 1
Hubbard, Oregon 97032
I
Attn: K.L. Waymire
Gentlemen:
At your request holes were drilled in Lot 27 of Pick's Landing
subdivision to delineate the fill areas. The attached rough sketch
shows the depLAS to original soil in the various levels of the lot.
The indication is that on the right hand edge of the existing trench
the fill is about ten feet deep, and tapering up to zero as shown.
In the May 18, 1982 letter to Jim Hodgson different ways of
dealing with the fill situation were mentioned. The ground has been
cut up such that it is hard to tell whether it would be better to
continua cutting to put the footings on original soil with tall stem
walls or to excavate for an engineered fill. As things stand there
would be a fair amount of fill.
Very truly yours,
--n PRD
� G:N
easy >'
o3eEcon
l/ h
�V y`'c y e
titi � M oo�
l�' !► >•f >1•' B a
4
Curb
I
Upper, . ,ughly
level area
I � I
I �
0'
Approximate limit of fill
material
Pench about 3'
down from upper area
trench about 7'
down from upper area
Sewer easement limit line I
I I
N _
— — � A
Lot 27 Pick's Landing
Rough sketch showing depths to original sui.1 ,
Approximate scale: 1" + 20'
June 6, 1982
John McDonald Engineering
• Ldf Z� PI-A4 c „I x
CC. .x//l'/(&r lo•il•�Z
JOAN WDONALD ENGINEERING
SOILS - CIVIL - GEOTECHNICAL
10116 SE STANLEY AVENUE
PORTLAND, OREGON 97222
(503) 774-0077
May 18, 1982
Jim Hodgson
Route 2 Box 286A
Sherwood, Oregon 97140
Dear Mr. Hodgson:
At your request an inspection has been made of Lot 27, Pick's
Landing subdivision in Tigard. According to your information a sewer
is said to be buried twenty feet deep about fourteen feet from the
planned rear foundation line of a house, and problems arose with wet
soil and running sand during sewer construction. The question is whe-
ther the lot is suitable for house 'oundation support using shallow
spread footings.
At the time of inspection the house area had been clea—d of
brush and up to three feet of surface soil had been removed. wide
trench an additional four feet deep had been made along most of the
rear building line. A number of sticks and branches were visible in
the upper walls of the trench and some of the upper soil had a sour
smell. The bottom of the trench soil was of a gravish brown color with
areas of brown color. On the slopes of the adjacent Lot 26, which is
slightly lower than Lot 27, marsh type plants wr.re growing.
Several hand auger holes were made to check the depth of the fill
soils, which were recognizable by the mixed brown and gray colors, the
stones and pieces of wood, and at times by the smell. Over much of the
existing trench bottom there was two feet of fill before the brown sand
was reached that represented original ground. No organic layer was found
in any of the auger holes. The deeper soils were wet enough to show a
glossy surface sheen when shaken in the hand. The findings are consistent
with the idea of a trench that widened during construction.
In the absence of documentation of trench backfill quality it is
my opinion that the house foundations should not be placed on the fill.
Part of the reasoning is that if it were ever necessary to dig up and
repair the sewer the fill soil might wash out. Therefore it is recommen-
ded that either the footings be placed on original soil or on an engin-
erred fill, or that a piled foundation be made for part of the house.
Placing the footings on the original soil would mean that stem
walls 8 or 9 feet tall would be needed for parts of the house. Rather
than form such walls and work in a deep trench it might be better to dig
a narrow trench and fill it with concrete. If concrete could be placed
2.
at $100 per yard, which is low, a trench 12 inches wide could easily cost
$4000 or more as a foundation. This might. be the safest foundation in
the case of sewer repair.
An engineered fill in a treTLch to original ground is recommP:Lcted to
be either of clean beach sand or graded crushed rock. Excavation inspecrion
and fill testing would be required to insure that densities achieved were
at least equal to 95% of laboratory ,ASTM D698 results. Backfill of un-
compacted pea gravel in such deep trenches is not recommended. For safety,
a second backhoe with vibrating compactor has worked well on other Wes.
The cost of an engineered fill in a trench would probably be about $2,000.
A foundation drain should be installed as low as possible tor open dis-
charge to reduce the hazard of cave-in during sewer repair, and it is clear
that any repair trent_h would have to be heavily shored.
Cast-in-place piles come to mind as buildinv, supports but, depending
in the groundwater condition, open augered holes might not stay open long
enough to be poured. Therefore, wood piles might be more to the point.
Even though piles might be needed only on part of the foundation the pile-
driving move-in costs are significant and would probably result in founda-
tion costs a minimum of $6000 or $7000 over a standard shallow footing
foundation.
In summary, my opinion is that Lot 27 is not suitable for shallow
footing usage and that the other possible foundation types willcost more
money. Cutting so much o� the lot off with the sewer construc' ion really
does not leave much ground to work with. Presumably the lot will le devel-
oped, but to make a proper judgment as to the potentiml of the lot, more
information should have been available before the purchase was made.
Very truly yours,
� � aRIEGO-4
SEINER PERMIT N? 28924
V �
Unified Sewerage Agency
of Washin n County CITY OF DATE
OWNER: •-----��f----�______ �/ �zp� � P H f)N L c
OWNER 'S ADDRESS:
TYPE OF INSTALLATION:
Cl SIDE SEWER ❑ LINE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY:
0 NEW ❑ EXISTING SINGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
ADDRESS OF STRUCTURE : via),
Permit Cenditions: The applicant agiees to comply with all rules and regulations of the Unified Sewerano Agency.
When calling for Inspection, please refer to the Permit Number. The Application expires in one hundred twenty (120)
days. The amount paid will be forfeited should expiration occur.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer is not located at
the measurement given, the installer shall prospect three feet in all directions from the distance and depth given.
If not so located, the installer shall purchase a and Side Sewer' Permit at the current charge and the Agency
will Install a lateral at the location specified by it,., installer.
I
FEES:
PEOMIT FEE $
CONNECTION CHARGE
LINE TAP INSTALLATION
01HER ISSUED BY
TOTAL g
APPLICANT
DATE
NOTICE. - fikY$flr Tri€ . --- -- --- --- - - ------------ - ---- -
ABOVE DATE sLv"Eft SERISSESWER PERMIT
f,NARGE WILL BEGii� X09 THIS,
PERMIT. N:U 23924
ADDRESS OF STRUCTURE
TAX MAP TAX LOT SYSTEM
LOT BLOCK OF
APPROVED BY DATE ISSUED BY f)Alf
D. U. ' S REMARKS
r
BUILDING PERMIT APPLICATION TIGARD DATE.— May 3' 19_�
THE UNDERSIGNED HEREBY APPLIES FOP A PERMIT F OH HE WORK HEREIN INDICATED BUILDER PHONE 05'7077
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNFR PHON E _
LOT NO. 87 —'
OWNER -i i.iIf yTadgaala JOB ADDRESS 10245 S.W. rena lfaw Landint .i
oOe ARCHITECT
BUILDER ADDRESS r Bos 28611r �l1e>R7100dDESIIGNER Pica Baralay
STRUCTURE JNEW ❑ REMODEL ❑ ITION REPAIR ❑ RENEWAL ❑ FIRE DAMAGE U DEMOLITION
h4 RESIDENCE U COMM ❑ ED_UCATI VIT_ IpI0U8 ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ LANDUSEIE ---- p L G.TYPE S �_ FIRE !ONE— PLAN CHECK BY — HEAT
Cbn --� Ing w/attached garage 3 bedws 3 - baths
-- - rzeati eet attached �— re-- --_
SEWER PERMIT# 23 24 $ NT) m 310.00 Garage 420 sq. ><t. � —
OCC LOAD _ FLOOR LOAD I-_HEIGHT 16 NO.STORIES Z AREA 2054 NO.BEDROOMS VALUE 77,71)o
_ BUILDING DEPARTMENT SET BACKS FRONT 19 REAR 31 LEFT SIDE RIGHT SIDE
46 1. (1 - - - -- —-- _
Permit $' U THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZONING
3.��55 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE.
Pian Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
6Ur� r WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
14.68 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC-- ; 400
Total 620.23— /•J��r�
—._-- — _ II 100
i PDC# APPLICANT OR AGENT' d�
Y �'
-- ._ `
Receipt No.
Approved __ ADDRESS hHC)NF
BUILDING PERMIT APPLICATION TIGARD DAT !R
Tl�Ari� �is
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE W OFIK HEREIN I Dlr,ATED BUILDER PHONE ���0•I rJ
OR AS SHOWN AND Ari-HO'r'`n IN THE ACC'N",PANYING PLANS AND SPECIFICATIONS. OWNER PHONE
J LOT NO.
O'rJr�EFl `j QY1 JOB ADDRESS It) 4S' S4� SMIaba a
+� H I TECT
n A Q�� ENGINEER (�r
BUILDER Q� ADDRESS gait .20&4 ins SIGNER
STRUCTURE NEW ❑ REMODEL _ ❑ ADDITION_ ❑ REPAIR ❑ RENEWAL_ ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑YRELIGIOUS_�❑3 PATIO L7 CARPORT C3 GARAGE G STORAGE C3SLAB❑ FENCE
OC;�iiPANC ,LAND UgE ZONE BLDG.TYPE7.1-M-FIRE ZONE "PLAN CHECK BY HEAT _
SEWER PERMIT M 3'Z 0
OCC.LOAD FLOOR LOAD�4J HEIGHT �� NO.STORIES �, AREA 20$4 NO.BEDROOMS
__- -- A _ ODMS VAL_Ur77.1700
BUILDING DEPARTMENT SET BACKS FRONT q REAR LEFT SIDE RIGHT SIDE tp
Permit 00•doD THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZON!NI
/I� ?���� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TN,AT THE
I.Plan Check C 7 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 NOY WAIVE
Sub total RESTRICTIVE COVENANTS. CONTRACTO AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
_sT /�-GB LICENSE.SEPARATE PERMITS REOUIR6b FOR SEWER,PLUMB�i�jj AND HEATING.
j State Tax v `[,
A SDC-- V
Total �.�2 n• •Z 3 � Q __
PDC# APPUG AF0 OR AGENT --"T --
By
Receipt No.
Approved — ADDR SS -'�-
PHONE
SEWER CONNECTION $ ?,s
SEWER INSPECTION $ 3S'
SEWER SURCHARGE $
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