11050 SW SUMMERFIELD DRIVE 11050 SW SUMMEREIELD DRIVE
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'JILDING PERMIT APPLICATIONCIT .i*IcJ#4,RD DATE�_�e —, 19.E-1..— N2
k1N',-)1;HSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HER FIN INDICATE b BUILDER F'HONE_�_ Q
�i AS SHOWN AND APPROVED IN THE ACCOMPANYIN , PLANS AND SPECIF ICAT IONS. OWNER PHONE _.--
�,.. LOT No. ..-
1 lY SS OGRESS
S ARCHITECT
ENGINEER
ER ADDRESS —__-_ DESIGNER _ y
--- �..- �//_».�—
L_W _ ❑REMODEL_ ❑ADDITION_ _ REPAIR.,/ URENEWAL ❑FIRE DAMAGE _ ❑DEMULITION
C1
LIRE
NCF_ 000MM ❑EDUCATIONAL ❑GOV_T ❑RELIGIOUSOPATIO ®AgPORT_ GARAGE ❑STOFIAGEOSLAS ❑FENCE
"NLS LIMOVING —�IJCONOITIONAI USE_--q�CODESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
t
:'t,NCY LAND USE ZONE—_....._—_._BLDG T YvE._ __. FIRE ZONE.__. PLAN CHECK BY�-�_- HEAT-.,-_
Ing r_jp'uX
! c)aQ _!._L _FQFELQALL __��_- ._.HF�HT �.1`____►LQ SIS29 _.-L_---9REL___" NQ 9EDROQMS VgZ•..�rr
Ni iILDING DE PARTMEN7 SET BACKS I RONT REAR_ LEFT SIDE_ _- _ RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check T� G� RFGUI.ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
�p WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
�UIn—Io181 QFC ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- --- - �— RESTRICTIVF COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Strop Tex IU G' LICENSE. SEPARATE PFRMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
- -- --�(" (—k
-BV `��--- API IcANT OR A T ---
Appioved Rpcpipi No
ADDR ss
Lp-
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ADDRESS^11 Uy 5 I7�/�)c e ^. Aa il
P E R!1 I'�. N 0. ¢
PERMIT CHARGE none
OWNER J, �r)� � _ CON^:ECTION FEE
-- --- - - _ _ PAID BY
TYPE OF' BUILDING /�+�f�Y.fc/'/c1�,a/ O� DATE CONI`;ECTEU
SERVICE RATE Ir;SPECTION FEE
CONTRACTOR PAID BY DATE
EN
r
SIZE OF CONNECTION A55E55,11ENi PAID
-;2
BUiLDING DLiAFrp.,iF-NT, TIGARD
/7 PLL PE-JUN-11T
Afill -t A&&Ak Ade: w a valid piumbing ceoirac- ;,,,i is hereby J:j ��- , h�
authorized to CZIL---C pLi-obing work as/�-----reffl i-! -d tc be It! ilii. in accoida,—? wit L!. , c-Au. of
Tigard. Such instaVations require insnection by 4v- City Iaspec-r whu shai, be rinii'll', lo'. il-,%s dri.-i four
(4) hours prior to t1he time me :nstillations irt City of Ti o— -s-- Licence required
for all contractor., and ub-contrdctot s.
--A-3
NUM FIE 71 OF -I r'1--
A PFPMIT NO.'S
TYPE OF PERMIT ITEMS I -FE ON E'Xil AN
kUSIDENTIAL
Single Pamilt-1 tathZw-�.h___
Dupl x-Ea&- i bath uni* - 25 00
Addition! b athrooms-earh 10.110
Mobile Home Sp ace-each
15-00
INDIVIDUAL FIXTURE FEES
I to 50 Fixtures in I building-each
51 to 100 Fixtures in I bwldim=!---h 7.50
101 !-) GO Fixtures in 1 build201
201 ri more Fixtures in building-eacb 1.50
MISCELLANEOUS
Buildina Sewer-1st 50 -loll
LSewer-each 3ddWanal 100 lit
Water Service to building 5.00
Private Water Systems-t-ach 100 It
10.00
Ovipr iSpeel`y)-
PERMIT L) 1 For Plumbing InspMrion Phore 6394191
096 Stats'4,
/0 C.C)--4 Pfwr!--;f-,u, ContractorContractor13y
TOTAL RECEIPT NO. Imied RY
u�L t)to• >:� ik,L
BUILDING PERMIT APPLICAT!'01V CITofY
fir' TIGARD DATE_ iq �� 19
THE UNDERSIGNED HEREBY A?PI.IES FOR APERMIT POR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVE? IN THE ACCOMPANYIrlG PLANS AND SPECIFICATIONS. OWNER PHONE__ _
1 $ L.OT NO.-..' _
OWNEFfUsalat,in Day +C7 J0,3ADDRESS1,40- l _�,urt1nnCF�JQ.I�HOMEADDRESS
APFI-IITECT
EN(.. NEER
BUILDER_ ADDRESS DF_ IGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑RE,'AIR ❑RENEWAL ❑FIRE DAMAGE (IDEMOLITION
❑ RESIDENCE LICOM" ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAN PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE DDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY__��-___LAND USE ZONE >rd BLDG.TYPEFIRE ZONES PLAN CHECK BY__' t 14EAT��'t!
2 Stlory +sf,':4.
He-Issue of A»1
�aV,er rr - 174a2 - y1 T)*00
OC��,jAD FLOQR_LQAQ ___ 4'U _J+EISt'IT d0 NS-STQHIES ' ARC�i� '11�_.NO. DROOMS i VALlJ�'_'ti t� LfC•
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit :,•
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check ale on REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANO IT IS HENEBY AGREED THAT THE.
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCF.WITH
Sub-total .�1 �+��SQ ALL APPLICABLE COL)E;, AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVFAANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax_+,., 1_,-,32 t ffNSF. SEPAP..aTEIPENMITB REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total S40t. .11'.% PUS, -, [ :J4ulJ.:,,,
ByP1 ---------- —— - -----
Approved C. Uelden Receipt No. "r� APCI I( ANI nq n(;I N1
i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
—
Convector
Permit No. �63� do lY-/l-7g
-------
Rough-in
Fixture
Final
HEATING
—T —' Connector
Permit No.
Gas or Oil —
_-- — — -- -- Rou n
-- ----— -- _ Final
— _ -- -- - SEWER e
Final --- -- —7
— DRIVEWAY
--- ---� �� -- Final--
Storlh Drainage
�—
(Rain Drain)Final
Sidewalk
— Curb&Street Final
— Approach
BLDG. DEPT.FINAL TLMPORARY CERTIFICATE OCCUPANCY
F6ial
CERTIFICATE OCCUPANCY 77
! _
Landscaping
Zoning Final
=l i itf SING PERMIT APPLICATION CU Y TIGARD DATE— —_ - - to Ll_ Np
J�F 111 D; H+JGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONEE;3q
UR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHON _
LOT NO
JOB ADDRESS i +
ONG
CH ECT
c - n ) INEER
=L.R_ Yc`��.--���//"" _ADDRESS - -- - --- --- DESIGNER -
iC1I;RE fJ EW ❑REMODEL OADDITICN ORLPAIFI —ORENEWAL []FIRE DAMAGE-- [:]DEMOLITION
`_.> 'l Nr. j,-(:MMOEDUCATIONAL OGOV'T ORELIC;IOUSOPATIO ❑CARPORT^ ❑GARAGE ❑STORAGEOSLAB ❑FENCE
�P'-ND ❑MOVINGw C❑CONDITIONALUSE ODESIGNREVIEW ❑COUNCIL APPROVED ❑SIGNS
���-�—--•—_�? r cam-\
LAND USE LONE , - �LDG.TYPE..,�.�_11_._.FIRE ION�_�L PLAN CHECK BY_ I; HEATy� -
NQ
(._ 1AQ__. FI QQjR_LOB.IZ__�-�_ HE�CZHj__.�_fL_- ►!14-�?S2RIEF>�._ARE9Y!S^S!_OL4 9EDRC,OM3 7ti VALU��i�S�.`�
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS uNTAINED IN THE BUILDING CODE, ZONING
Flan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGPEED THAT THE
------ -<"`�"' WORK WILL SE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT D04+ NOT WAIVE
- RESTFICIIVF COVENANTS. CONTRACTOR AND SUP CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Tate Tax _ A; LICENSE SEPARATE PERMITS REOUIRED FOR SEWER, PLUMP:NG AND HEATING.
T o T e lby ------ (--.
APPLICANT OR AGENTI
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