15505 SW SUMMERFIELD LANE MINIMA
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15505 SW SUMMERFIELD LANE
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CITY OF T [[ARD
OREGON
OWn ; 1'.D.C.`............................................................ .Permit No.....Z451.......... I '
15505 S.. Summerfield• Lane ...ot
Buildirrg Address.. ................. ............... �................... ,.
y g� 14th...-day of November 77
Certificate �s hereby wen this.. .. da• ......,,19.........
that said building may be occupied and
r that it complies with all requirern ,nts of
>: the Building Code for the City of Tigard, i
C, °0 as approved by the Tigard City Council. '
yC"�►�'� 1luilding Inspector
t _
L`' L�.. /-` �� ?llcNa� pl a +, V".a.__eta �• ,�, .�+�� �»•�Paww�� ile., _,r y,� lµ
ADDRESS.,,/ PERMIT
PERMIT CHARGE norip
CONNECTION FEE
OWNER
PAID BY
TYPE OF BUILDING
DAIL CONNIEC-fED
,�c-
SCRVICE RATE INSPECTION FEE
("0 NTR A C.T 0 VPAID BY DATE
SIZE OF CONINECTION ASSESSMENT PAID
I
1098 E.111MR91 PIUMBIRG,INC BUILDING DEPARI'MENT, TIGARD N17.
P. 0. i,9x 179 PLUMBING PERMIT I
NEWI'ERG, OREGQ;1 911x2_ holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted 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 pr'or to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
dd e S:�rJ f...` � . �1.1e. (E c !Date_'!' / I
NUMBER OF TOT'o%L PERMIT NO.'S
TYPE OF PFt1MIT ITEMS FEE ON EACH AJIA(Jl1NT (Office Use Only)
Sial, remily-1 bo�tn—each 25;00 _ ,ti 0 c
D,oler--Each t both unit 25.00
I.dditional bathrooms—each 10.00
-f lobi @ Home Sece—each_ _ 15.00 M
INIDIVIDUAL FIXTURE FEES
1 to 60 Fixtures in 1 building-eoch 3.00
61 to 100 Fixtures in 1 building•-each 2.50
101 to 200 Fixtures In 1 building—each 2.00
201 or more Fixtures in-I p►p—each 1.60
MISCELLANEOUS _ _ }----�—
E1u Idle Sawer-1st 50 ft•'.1- T 10.00
Sawer—eech additi.Ynal 100 ft. 10.00
Water Service to building 6.00 _
Private Water Stems—each 100 ft. 10.00
Other S if
PERMIT_ ;�I For Plumbing Inspection Phone 539.4191
Plumbing Contractor By
TOTAL ;,.: y RECEIPT NO. Issued By _ ^��—
r
r
r
■
r
r
F!Ord ,1�tecf�anica' err t �V g"emiit t oo ■
New '.nst:"dti m 5VReplace ❑ Reloeatior, 77 Addition `_7 Alteration C3 --- Fee �—
TOTAL
�
CONTRACTOR�g ls��Z�_ �Z�Y>'�Lr • � � OV11N E R i��.rut-�, 1��i. C�. Lj�.
ADDRESS WORK ADDRESS
OHONE 6nSGl-- APPLICANT AR %AS.,2 C)SO �
Heat Input Rating IBTU Per H �` _ _ mr� Vent Size S'� r ��>
Flue Size
FUEL OIL C1 GAS Ge✓He
OTHER
fT>:M NO. FEF ITEM NO. FEE
For issuance of Permit 3.00 Boilers Over 50 HP 25.0C
New - Under 100,M0 BTU 4.00 ' Air Handling 10,000 C!--m 3.CC
New- Over 100,000 BTL' I 5.00 Air Handling Over 10,000 CFM ! S.00
Flcor Furnace 1 4.00 Evaporative Cooler 3.7C
WWI - Floor - Suspended 4.00 i, Vent Fan i + 2 OC
4rulf Vents 2.00 ii Vent System 3.00
Rhe air- Hr c & Cooling 4.00 Hood 2.0C
Boiler Under 3 HP _ 4.00 Domestic Incinerator l 5.'K
Roifeis 3 to 15 HP 7.50 Comm. Incinerator I 20.00
Boilers 15 to 30 H? 10.QO Other Not Listed 3.00
Boilers 30 to 50 HP
15.00
INSPECTOR'S COMMF':TS-
CITY BUSINESS LICENSE REQUIRED FOR-ALL CONTRACTORS OR SUB-CONTRACTOPS
APPROVED BY DATE _ _ ISSUED 3Y OAT7
RECEIPT NO. �
n. Signature of App;=r ..�` ---I1
s7L
i
I
City 9
ity of Tigard
and
INSPECTION REQUEST
for
JINSPECTION TIME : ` �'x PERMIT NO. : --
I
DATE: /L121 DATE ISSUED:
OWNERS NAME '
NAME : - ------ --
IADDRESS : ------
CONTRACTOR : -p-�--- -- -�
TEST. Air ❑, Water Visual ❑ , Laboratory [j-
RESULT'.
RESULT: Approved LDisapproved ❑ , Fending [J
I SKETCH:
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INSP CTOR DATE
ICOTE Attac,, supplementol test data heretJ
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■
SEINER PERMIT N 12163 r/
Unified Sewerage Agency 5-11-77
of Washington County CITY OF Tigard — DATE
OWNER : T.D.C . PHONE : 639-3101_
OWNER ' S ADDRESS: --
TYPE OF INSTALLATION:
(2BI'1LDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑NEW Q SINGLE FAMILY [:) COMMERCIAL
❑EXIST . (PRIOR TO 7- 1-70 ) ❑ MULT . RFS. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
PERMIT CONDITIONS: THE APPLICANT AGRE=ES TO CON'PLY WITH ALL RULES
AND REGULATIONS OF THE. UNIFIED SEWERAGE AGENCY . aHEN CALLING FOR
INSPECTION, PLEASE_ RE,=ER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE—HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID NII_L
BE FORFEITED SHOULD r_XPIRATION OCCUR .
FEES:
PERMIT FEE $_ 25. —
CONNECTION CHARGE 575.
SIDE SEWER INSTALLATION � G ! �Elc —
I SSUEiS BY
OTHER
TOTAL . $ 600. _
C`
W PLICANT DATE
SEWER PERMIT N? 1216L
ADDRESS - OF STRUCTURE 15505 SW Summerfield Lane
TAX MAP TAX LOT--.---.-- SYSTEM Fannu -Creek—
LOT ._333 BLOCK OF�.�'
APPROVED BY DATE I $ ED BY 1 DATE
REMARKS_ RL g- ,#] 451 -- — --
A
CITY OF TIGARD
ORDINANCE Ir
4'77-26
STREET SYSTEM DEVELOPI"IENT CHARGE
DATE : 5-1.1-77 ESTIMATED SALES PRICE 5_ 55,000. �-
APPLICANT NAME T,D.C. � TEL EPHONE T_.�3�31L11. _
JOB ADDI'ESS 15505 SW Summerfield Lane BLDG. PERMIT #_14L;1
AMOUNT OF FEE FOR S. D. C . _5300. 00
DESCRIPTION OF I111PR0VE1'IENTy __ sin le family-dwelling
XEMPTIgNS -PER DRDINANCC #77-26 _
FEE RATES:
A,. Single fawd ly dwelling unit under $60, 000. --------- $300. 00
B. Singh family dwelling unit over $60. 000.-- ------ $400. 00
C. riobile Home Court Space Developripnt)---------- 5'_50. 00
D. Multi-Family D�-pings- -per unit•------------------- $240.00
E. Commercial , Industrial & Institutional ( Park. Space) $ 50. 00 each
F. Single family unit under 540, 000. -- --- ---_-- $250. 00
MEN
BUILDING PERMIT' pPPLICATfON COF
IT TIGARD DATE -11-77 19 — �"S
THE UNDER I(;NED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHO\AN AND APPROVED IN TIME ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE _
LOT NO
OWNER Lj �_ _-1r�!! A[)DRLSS _ �__ HC)MOADCRE.!"S
A'?CHITECT
ENGINEER
BUILDER !1aQU ADDRLSS �-J�_ DESIGNER
STRUCTURE 1NEW ❑REMODEL ❑ADDITION ❑REPAIR LRE_NEW-4 ❑
L FIRE DAMAGE ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL 0GOV-1 ❑RELIGIOUS❑PATIO ❑CAR PORT (]GARAGE ❑STORAGE❑SL.AR [:)FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVEG _ ❑SIGNS
OCCUPANCY _LAND USE ZONE _BLDG.TYPE "` FIRE ZONE___3 PLAN CHECK BY 1.1d HEAT_"14 U
Lot #333 r1� ra- issuw dame Baa V5613 SW 5ummerffai
egme dualling s.I/aattachad garage 2 bedraum 3 bath. _--J
Q.Q"QADZ _—F1Q.Q.B LOAU ' HEIQH1 NQ.STQ$1y5.__j _Au_A j6V No.oEQB4JMS L VALUEA-001.
BUILDING DEPARTMENT1'
SET BACKS FRONT L 4i REAR 17LEFTSIDE RIGHT SIDE
Permit --
-- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10,00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BF DONE IN ACCORDANCE WITH THE PLANS A'JD SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE IS' MANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CON.RACTORS TO HAVE CURRENT CITY HUSINESS
State'Tax LICENSE. SEPARATE PERMITS REOUIREp FO� SEWER, PLUMBING AND HEATING.
Total 1 f31.21'I
BY — - -—
APPI ICANI OH AGENT
Approved [aL Receipl No.
ADDR 3PHONEj
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7�N e E
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor —
�_ Permit No.
�S
Rough-in
,)_I X11 Fixture --
-�-�1. Final
HEATING
'rI1 �� �T,-�� _ — _ Contractor p
Permit No. 0 3CD _ 7 a l 4- 30
Gas or Oil
Rough-in
-- ------- ---- -------- Final _ —
SEWERlo
672-7
_-- Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT. FINAL — TEMPORARY CI HTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
(� Landscaping
\. Zoning Final
L;Iiii_ �C PERMIT APPLICATIONt` t,1°
THE JNDLi1S1GNED HEnEr,1i' APPLIES FOR APEftr;11 T i•01 Tt;'-: `,`;OE?K HEREIN INDICATED
Oil A" SMN AND ArP!IOVED IN THE ACCOI� PA'4YING _: � AND SPECIFICATIONS. 0lMNEFl PHONE
I- '
c�vr, j�la}tr-3 ve ;mtie '� ADnnt:sS Lam nUlLnrn PHo is
ENGINEEn
Qj11�[ti AFlrIIIT- CT DrS!GNEII
STnUCTUnE P4171M ❑FIENIMEL ❑ADDITION ❑nEPAM ❑nENEWAL ❑r-InE DAMAGr- ❑DEhfO!.ITION
r;. E-LiDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑nELIGIOUSOPATiO ❑CAnPORT ❑GARAGE ❑STORAGr- OSLAO ❑FENCE
(]Want_
❑MOVING ❑CONDITIONALUSE ❑DESIGN nEVIEW ❑COUNCIL APPnOVCD ❑SIGNS
__- ----- — - - - _ -
Ct'CUPA"`CY _nh:D USC 7C•JI_ —BLDG.TY°E—:�FInC ZONr�-. PLAN CHECK BY / r—_� NEATI�C
F r M
fcr_! OAD F,-001`1 LOAD G HEIGI,T -2� NO.STORt ES AREA p�4 VALUE�3 mcg)��`
111YI_(IIIJ:, {II-1-AM M1 N r SET (IACI<; FRONT s v hrAll LEFT SIDt s _R I G I IT SIDE
1--�� THIS PEnmIT IS ISSUED SUBJECT TO THE'RE-GULATIONS CONTAINED IN THE BUILDING CODE. ZONING
P:rIrl Checl: REGULATIONS AND ALL APPLICAnLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THA'. THE
--� Y,ORK WILL BE DONE IN ACCOnDANCE SMITH TIME PLANS AND SPECIFICATIONS AND IN COMPLIANCE Y,IITH
{�r_or,irnl II ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PEtih1IT DOES NOT WAIVE
1F nESTRICTIVE COVENANTS. CUPITfIACTO11 AND SUB CONTnACTOIIS TO HAVE CUI1nENT CITY B11SINE"
1 I,."S, C ____ LICENSE XPAr1ATE PIESMITS REQUInED FOR SEWER, PLUMBING AND HEATI. G.
Torii
'✓ Recci t No.
L
AL)UkLs r�wa.t
Ds .C�
S75 _