11030 SW SUMMERFIELD DRIVE 11030 SW SUMMERFIELD DRIVE
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ADDRESS 8 ��_'c� _ .NcsMQ/1. .t� IBJ PERMIT N0.__
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PERMIT CHARGE nona _
,Q CONNECTION FEE --
O'.�tiER
PAID BY
TYPE OF BUILDING /�7,c/, (y � DATE CONNECTED _
SERVICE RATE INSPECTION FEE
Cor: r CTOR PAID BY DATE
SIZE OF CO :',ECTION A55E5SMENT _ PAID
.a
gUI•_DtNG UEPAftTP+1LNT, :!,��AflD r � N0.
PLOMBI�,G PER'elIT
hc'de• Of, a valid plumbing con.ra:.�rs {tcrllsC is hereby
authorized to cau_e plumbing war.. as herein no °d to be ;--,t;Wed in amoral1 Code of
be `vii i''`notlless than four
Tigard. Such installatiu-'s ;1 a.ire lnsoection 5y he C t'; t , nes License required
rot �.....rI, mrior to the time the ;nstaiiations arp _,.•,y Fo- inspertion. City G. T., 4
for all coi4ractors and sub ntractors. L��E� J�ka��
tC� 1A,I C1 Adclres -----
O�r�C TOTAL PERMIT NO.'S i
NUMBER OF I AMOUNT (Office Use On:;i
TENTIAL
RESI
YPE OF PERMIT tTfAiS { FEE ON EACH i 1
Single Femiiv-1 bath-each 25.00 _-_--
Duplex-Each 1 hath unit --4--- - 1000
Add Vt.onat t athrcoms-_ ^h _�--- ---
- --- 15.00 -
Mobiie Home SPacr-9-ach '
INDIVIDUAL FIXTUVtE FEES --- X00 -
1 !0 50 Fixtures n 1 build( -each -
51 to 1)0 Fixtures n 1 bu�ding-each 2.50
f
__�___
l
2.00
101 t0 200 Fixtures in 1 bu-Idiny-eacfi ---1.500
201 or more Fixtures in 1 building-each
rMISCELLANEOUS -
10.00 _Building Sewer-1st 50 `t. ---
10.00
Sew•--eacn addtti^^a1 -
Water -tyke to buiAmS
—�-- -
Pr+vote Water Systems-each 100 ft I 10.00
-One- tSPeci`trl' t-
PERMIT 5 C).0'� For Plumbing tnwectiOn ?hone 6394191
% State` 7Ci oiG PI —j-,Ing Contractor By —
TOTAL I- O ! RECEIPT N0. isuel B'�'
•^ �r �l�) 0-3
BUILDING PERMIT APPLICATION 1O1F TIGARD DATE_ ILIZ241 19�
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON0112—OWNER PHONE —
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. W No_ — I -- -
FOWNT-
ER JUB ADURE$��,1j,3� JI.� +:II.�PJ1{�fo�r HOME ADDRESS
ARCH TELT
ENGINEER
BUILDER ADDRESS _. _-- DESIGNERt—� —.
STRUCTURE CINEW rr-tt❑RFMODEL ❑ADDITION ___❑REPAIR UgENEWAL ❑FIRE DAMAGE ODE
❑ RESIDENCE ❑COMM L_IE.DUCAT!ONAL— ❑GOV'T ❑RELIGIOUS,�IPATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ]FENCE
QBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW [:]COUNCIL APPROVED ❑SIGNS -- —_
--. ---- —
OCCUPANCY-- LAND USE ZONE--h---]L—BLDG.TYPE FIRE ZONE PLAN CHECK BY
fle—Issue of
--
20 NO,9F.HEIcH7 P��4M�'� VgLT1kl4i t1C1�7•
_—.—_..
BUILDING DEPARTMENT SET l3ACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BIJILQING CODE, ZONING
Plan Check 10,1!11 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND Il IS HEREBY AGREED 11IAT THE
WORK WILL RE DONE IN ACCORDANCE WII'H THE PLs NS AND SPECIFICATIONS AND IN COMPI IANCE WITH
Sllbtotdl QZ�eC►f7 ALL. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PrRMIIT DOES NOT V'AIVE
RESTRICTIVE COVENANTS. CONIRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITE' RUSINFSS
State Tax ib,LU LICENSE. SEPARAT�E1EDOsTbtEGU1RED FOR SEWER, PLUMBING AND HEATING.
Total 4.y 4 f
By APPLICANT OR AGENT -- --
Approved c � 'a l dllT► Receipt No.
DATE I I NSP.1 Tyr-.E INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No. 4_-0 Mzo I)--!f 7V7
Rough-in T_
11 1— �
Fixture
Final
VEATING
Contraclo,
Per iiit.
Ges of U I
Ro RhinFinal
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain;Final
Sidewalk
L_
Curb&Street Final
Approach
BLDG. DEPT FINAL— T9:MPORARY CERTIFICATE OCCUPA Final
CERTIFICATE OCCUPANCY
s- /l—"7 Landscaping
Zoning Final
j.ill_UiNG [IRMIT APPLICATION �I uFY ____.
-�
HE LIND' RSIGNED HEREBY APPL IES FOR APERMIT FOR THE WORK HEREIN INDICATED FUIL,OERPHONEt2I - .
;.,R AS SHOWN AND APPROVE[) IN THE ACCOMPANYING PLANS AND SPFCIF ICATIONS. OWNER PHONE.. `--
LOT NO
JOB ADDRESS k kQ C ^?
R-CaTd—
ENG
NEEERINR
tR _ ��y,..��►v-..SL..� ADDFiE[[S'��S DESIGNERrr--�� ^^
;' TURE Lam. NEW Cl RFMQ0EL 13ADDI7ION 0REPAIR ❑RENEWAL L.,,�FIRE DAMAGE` ODE-MOL11-ION
�01NCE UcomM ❑EDUCATIONAL 0GOV-1 GREIIG,IoUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGE�.JSLAB ❑FENCE
]POND ❑MOV ING ❑CONDITIONAL USE ❑CILSIGN REVIEW ❑C ',J
SIGNS
APPROVED ', SIGNS
.._ .�.. _ —
l•r:.NCY 44..__l AND USE IONS. .'= LDG,TYPE .._FIRE ZONT�— PLAN CHECK BY�- HEA7,,,._.�,fi��
--F L Q-0-ELLAla-_ _�.___HEIGH Ll--J) --NQ_S.TDRIEbQ ARE "-2AQ–jaDROOMSlD -'ALUG� �l
6UIL6ING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDt
-
-' -- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
°len Check REGULATIONS AND ALL APPLICABLE CODES AND ORI.TINANCES, AND IT IS HEREBY AGREED THAT THE
WORK W11A. BE DONE IN ACCORDANCE WITH THE PLANS ANDSPECIFICATIONS AND IN COMPLIANCE. WITH
Sub total ALL APPLICARLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— - - --- RLST RICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
`.tatp Tax / LICENSE SEPARATE PFRMITS R[ OUIRED FOR SEWER, PLUMB,NG AND HEATING.
Total
By
Approved �eceipt No.
Ar tl-+tss ----- -Sri
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