11030 SW SUMMER LAKE DRIVE 1 I
11030 SW SUMMER LAKE DRIVE
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CITY Of TIGARD
OREGON
Owner: John Brewer Permit No. 5133
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�- Address:
�k 16795 IOW Somerset Beaverton. OR 97006
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c Building Address 11030 SW Summerla;r- Thrive
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Land UseZone:- ,Jcupn :f Bldg. Typeft
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Comments:
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6th December , 19 35 -
4�: _'• Cei*ifieate is hereby given this day of
A � t tb3t said building may be occupied and that it complies with all _ \
� yTigard, �
r? c Building Code for the City of as a roved
s requirements of the gPly
by the Tigard City Council.
' A-t. Fire Dept. Building Inspector
%- Building Official
Post Certificate in Conspicuous Place !
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
i igaru,Oregon 9722"
Phone: 639-4171
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Type of Inspection ' 7 A.--I
Date Requested / ' 2--'- A.M._ P,%4.
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Address i >(��,,.�t_t.�"r� % ' ' r/r./. _ Permit
Owner-- _ L-1 _ Lot # -----�
Builder
The following Building Cade deficiencies are requi;cd \o be corrected:
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Presented toam% Approved
Inspector - -------��--ySSGI� _ Disapproved
Date
CALL POR RAMSPECTION
t �ES Cl NO a
INSPECTION NOTICE
f City of Tigard Building Department
12420 S.W. Alain St.
Tigdrd,Oregon 07223
Phone: 639-4171
Type of Inspection
f}
Date Fiequested.! �v Time—_ A.M. P.M.
Address 1�...1 Permit #_ 5�_
Owner ��1�11'/(/ Lot #
Buil0er _
The following Building r=ode deficiencies are required to be corrected
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Preiented to _ Approved A `
r inspector _ _�___ ___ ❑ Disapproved
Date
CALL FOR REINSPECTION
L-1 YES NO
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St. j
Tigard,Oregon 97223
Phone- 639-4171
Type of inspection
Date Requested—__-_. 3 Time Q P
Address —�� 3[J �� 7 ___ Permit
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Owner � L2 _ Lot # ._
Builder _—_— -- ------�___-- --___---
The following Building Code deficiencies are required to be corrected: j
Presented to _ _ pproved
Inspector ❑ Disapproved
Date - G .
CALL FOR REINSPECTION
❑ YES ❑ IYO M
I
CI1YOF TIGAR® No. 153:5
12755 S.W. ASH �����" ��f
p.O.BOX 23397 Gate[ .b`a
TIGARD, OR 97223 i
Namey
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Addreb.s /
Lot �BlockI►vlap Su bdivislonlAddress
Permit M's Bldg. Plumb Cash Check
Bower <<„ Other Other Hec. �y
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 A33 Plans Check Fee
10.435 Other Licenses & Permits
30-443 _3ewer Connection
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30-444_ Sewer Inspection
24.448 Street Syst. Dev. Charge
25.449.610 Parks I Syst. Dev. Char e
25-449-620 1 Parks II Syst. Dev. Charge _
31.450 Storm Drainage Syst. Dev. Charge
10.430 Business Tax
10434 Alarm Permit
10.227 Ball -
10.455 Fines -TrafficlMlsdlParking
10.230- _ CPTA TrafficiMisdlVic. Asst. _
10.456 Indigent Defense
30.446.401 Sever Service/USA
30.446.402 Sewer Service/City
31.447 Storm Drainage
40.475 Bancroft Prin. Pymt.
40.471 Bancroft Int, P mt.
10.451 Other Charges fr Services
DEPT.
BUILDING PERMIT APPLICATIONTIGARD DATE _ 1�_,19_'i4_ 5133
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR 1 HEVVORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOl NO. 26
OWNER lsrev_gr.t:onstvuo 0B ADDRESS 1I04U SW Suumarlake U�ve __
4! ARCHITECT
ENGINEER
BUILDER, AM _ ADDRESS 16795 541 SA1MT"t br. DESIGNER
STRUCTURE - At NEW O REMODEL _ ❑ ADDITION ❑ REPAIR ❑ RENEWAL_ ❑ FIRE DAMAGE ❑ DEMOLITION
[31 RES!DENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑ RELICIOUS ❑ PATIO D CARPORT L GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ _�"3 LAND USE ZONE .-_ � MALDG•TYPE _ 58 FIRE ZONE .-_PLAN CHECK BY EAN_HEAT 048
CanatrwOt siagl* f8mily dwelliag w/attachad garage.
3 Bathrooms 4 badroomn
SEWER PERMIT# - 28282 ---- Garage 563�
OCC.LOAD FLOOR LOAD 46_ HEIGHT 18+- NO.STORIES 2 AREA 2377 NO.BEDROOMS _4 VALUE kI,1,UU1).
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 32 LEFT SIDE 1 U RIl;HT SIDE 11
Permit _ .376000 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 THAT THE
Plan Check _ L44.40 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_ 620.4U RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUR';LN"f 'ITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PL JMBING AND HEATING.
State Tax 15.04 Y i
-"--" - SDC—
Total b35.44 1 15U.UU -
PDC# APPLICANT OR AGENT
By SSU(, 150.U0
1 Receipt No. -- —---- - --1.-,._
Approved CE J ADDRESS PHONE
- - Zz= M
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
.Z
Jr ContractoV
qqq X��_
_ �_ _
P2A Rough-III
Fixture _ --
Y' ` A 11 14 f I mie,--- � — Final
HEATING
Va OU— alt $ �,'�+�- Ir�i,.a Contractor,
_ _ - -- -- -- I--
Vim_
Permit No. -a,z— /�
Oil
---- - -
Rough.
Final
(� SEWER
- -- Final ------- ---
DRIVEWAY
final � ---
-- --- - - -- — -�-_..------ Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
_ Approach
BLOt3. DEPT.Ft!� .i- TEMPOP./.F Y — CERTIFICATE OCCL NCY
CERTIFICATE cx. y Final
I � Land raping
1 I Zoning final
flu ildiny Permit No. —_/,, -3
Location -367
-�
Oate
Certification of Registration
With the Builders Board
I, O 4-*-� w E72.
doing business as (dba) ,
am registered under the provision;
of ORS Chapter 701 Oregon Homebuilders Law) .
My Builders Board Registration Nmiber is L76?
Ply registration is in full force and effect and expires on
•i nature .._�_
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BUILDING PERMIT APPLICATION TIGARD DATE _ 1 �j -r p�
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN IP DICATED BUILDER PHONE""�y —tlw
OR AS SHOWN
/AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER EWES l0N L• � KMN c,eG,A,rt 'j'�C? , aR • LOT NO.
ST•` JOB ADDRESS 1�1 ..2LL1_.zO c-.L c Mll E— �MI'� SUMMER
/�� i(„7C/r Nl•V1t1. SO/LlE.-/21 ✓� ENGINEERT�L�(//� '/�' (/�/
BUILDER �REwk72 �-F/N� _ ADDRESS _�Eq✓-a C4 T?obs DESIGNER
STRUCTURE NEW ❑ REMODEL f ) ADDITION ❑ REPAIR ❑ RENEWAL U FIRE DAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T-❑ RELIGIOUS ❑ PATIO ❑ CARPORT-❑ GARAGE ❑ STORAGE i 1 SLAB❑ FENCE
OCCUPANCY -IL-3 LAND USE ZONE -9-- 1 1 ,BLDG.TYPE -2Z::,X FIRE ZONE_PLAN CHECK BY _ES, � HEAT
SEWER PERMITN
OCC.LOAD -./^ FLOOA LOAD . HEIGHT NO,STORIES Z- AREA NO.BEDROOMS - VALUE
_ BUILDING DEPARTMENT SETBACKS FRONT Z�� f REAR ,?j i' LEFT SIDE RIGHT SIDt_lj
Permit THIS PERMIT IS ISSUED SUEJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
1c/� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check Z� F•`IQ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS P::yMIT DOES NOT WAIVE
Sub-total 0 _ "0 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUM91NG AND HEATING.
•° � 5. Ute}' i
SDC-
Tote���- y
PDCM APPLICANT OR AGENT
By-f -- ---- --
__
Approved Recolpt Nu. ADDRESS -T
s�l'viz_M wE�� 2 50, 00
D6 1G0�12 - 139$ 35.it = 48593
P D i✓ r 50.c)c� �n �.. - X143 �3.2t7 ,^.f��1 r'
SeWLIZ Co(�NEc1"roN Rz5�vr_' —�
5Ew{-R Z 537
5EMAr SURCRAPW 340.00 AMART- (,7) 10,131
It 11 16-0.00 LERC?N µTQ .(SE r tx� cI1��,K)
CITY OF TIGARD-12 120 S.W.MAIN-TIGARD,ORr-GON 97223
RECEIPT
DATE: _-Z-� _T C_ AMOUNT: $�_�-�
DOLLARS
NAME -��4 �d�' �iL_ _ CASH: _
ADDRESS: -7J R
# OF
FOR: ACCT. M PERMITS SURCHARGE AMOUNT
SEWER BILLINGS 40-364 $
BUSINESS LICENSE 05-331
PLUMBING PERMIT 05-332 $
MECHANICAL PERMIT 05.332
BUILDING PERMIT 05-333
SEWER CONNECTION 40-363 —.
SEWER INSPECTION 40-365
SYSTEM DEV,CHARGE 25-366 _
PARK DEV,CHARGE #1 30-367 _
PARK DEV,CHARGE #2 30-368 _
i
ZONING ADJUSTMENTS 05-362 _ ---
---- -TOTALS
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RECEIVED BY: _ ti1"!' -- - -_ -------- -- ---_ {
PERMIT N S R SIGNED:
Num hr Amount_ Numbor Amount Num�� Amount
RECEIPT 0 J�`� Cl
.. ���. ... ... .. a .... ._ ___. .... ..y ,_. ...� .. -_- _. /' ... .• _ _ �..
BUILDING PERMIT APPLICATION T'IGAR DATE_
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR T�iE WORK HEREIN INDICATED BUILDER PHONE 0040-sc
OR AS SHOWN .AND APPROVED IN THE ACCOMPANYING PL-AVS AND SPECIFICATIONS. OVJNEP,P• O :F
1 1' � p LOT P10. �o��_
NOw1eSJ0[3A_DORESS ((b 3L7 S� i�`It1�. S,,�w►.h�. Lo4k� _
e ' ! ARCHITECTENGINE '-
BUILDER Jame, _� ORESS�U�� 1yick - lia DESIGNER �„� -
BUILDER DESIGNER
STRUCTURE NEW ❑ REMODE ❑ ADDITION �IEPAIR Q RENEWA t] f1R@DAMAGE ❑ DEMOL.ITIO
RESIDENCE C COMM D UCATIONA ❑ GOV'T ❑ RELIGIOUS ❑ 0 TIO ❑ CA PORT ❑ ARAGE ❑ Si AGE ❑ SLA60 FENC
C—C;CUPANCY_R-3 LAND EZ.ONE LOG.TYPE LN—FI EZONE. PLA CHECK BY _HEAT
0 10
-- _ L -- -- I%m06.
SEWER PERMIT ft
OCC.LOAD FLOOR LOAD HEIGHT 7 STORIES z AREA;Z,R_MB NO.BEDROOMS VAL.UE;.
BUILDING DEPARTMENT SET BACKS FRONT , 9 REAR LEFT SIDE RIGHT SIDE
Perms! ba THIS PERM l ISSIJED SUBJECT TO THE REGULATIONS CONTAINED IN THE fiU1LDtt40 CODE, ZOPi:fl
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREEU TFIRTTH
�PlenCheck K WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COfi"LIANC
r M11TLL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PER11r11T DOES NOT WAIV
�1Subtolal 7„v, , 0' RESTR TIVE COVENANTS, CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINES
- e2/-
LICEN\No.
TE PERMITS REQUIRED FOR SEWER,PLUP.181PiG AND HEATING.
Stats Tax `
SOC-
Total --_ ,
PDCaAPPLICANT OR AGENT
By , ��/� '
ReceipApproved ADDRESS PHONE -
s �.4.ST)
a D C -• __
fi I rna
;EWER CONNECTION
;EWER IN5PECTIOPJ S _w 2�� /� n/�
SEWER 511RCHARGE 5 3�J nw,a. .`vec�IWaod'
1_0
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ri, w"Womm
t iU 3o Stca gK� .
AOL f h v(ocv,. cit K 2& •�Q�
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7 4'8
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