15613 SW SUMMERFIELD LANE SWIM
1`613 SW S"EHIELD LANE
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ADD
,��, FCRrIT CHARGE _ none
O �r CONNECTION FEE
OWNER — _
-^- PAID BY
DATE CONNECTED -
TYPE_ OF BUILDING f�,�� -----
rQ ?C
I ,SPECTION FEE ------
SERVICE RATE _---------
CONTRACTOR __.__.__�-_�.. .�__.__
PAID 8Y SATE _
SIZE O F CONNECTION
ASSES!!MENT �_— � _ PAID -- -
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Owner: T.D.C.......................... .. . ..... Permit No...�?..i..... ...
....
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1661 3 SW SummF. Field Ln. , s<
\ t. Building Address...... . .. . _. _...................
Certificate is hereby given this......9........day of.December...... ....• 19. 76
that said building may be occupied and
that it complies with all requirement: of `
y the Building Code for the City of Tigard,
<u� approved by the Tigard City Council.
Building ]nspectoT � • �,�.r��
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City of _I igard I
INSPECTION REQUEST
fr !
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IN8PECT!ON TIME: PERMIT NO. :
DATE: 16) /S' /7G DATE 1,SSIJED
OWNERS NAME : ��G --
ADDRESS:
CONTRACTOR : -
rE S T : Air 0, Water[I � Visual L] , Laboratory p i
9ESULT: Approved 0 , Disapproved C Pending 0 I
SKETCH.
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INSPECTOR DATE
ENO?E: Attach supplemental tw data beret]
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City of Tigard
INSPECTION REQUEST
for ► I
INSPECTION VM4't ' PERMIT NO. : _ —
DATE: `T� 211L DATE ISSUED:
OWNERS NAME .-
ADDRESS :
AME ,ADDRESS : Zc'7 � �i►� - �� /�c
CONTRACTOR `.r��' wcnf� --
I 4 -
TEST* Air 0, Water ❑ , Viswil ; , Laboratwy O
I RESULT: Approvad Disapproved ❑ Pending ❑
I SKE"CH:
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014
1.
I INSPECTOR DATE
IOTE : Attach eupplementol test dato heret:
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wTwjwjjwjpF
City of Tigord
INSPECTION REOUEST
for
INSPECTION TIME - ""- PERMIT N 'i :
DATE: ef' LIE(- RATE I SSUEiY.__.L.L..
OWNERS NAME : I__.jL'^_ - -
ADDRESS . -Z-Z -:f9'6 --
CONTRACTOR :----------,-------------
TEST'
CONTRACT0R : ---_---__._—___--._ ----
TES's': Air ❑, Water [] , Visual Cr, Laboratory []
RESULT: Approved , Disapproved ❑ , Pending [j
SKETCH:
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INSPECTOR DATE
E:NOTE : Attach supplemental test data her.10
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UNIFIED SEWERAGE AG .-:NCY NO. __ ___ 10630
WASHINGTON C!)U NTY DATE
CITY OF T:ic, =d- - -
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: Tualatin Development
OWNER'S ADDRESS: .
STREET
CITY STATE ZIP
BUILDING SITE: LOT-- 345 BLOCK- ADDITION
TAX LOT NO. _ _ TYPE OF OCCUPANCY residence
ADDRESS 15613 SW Summerfield Lane
DWELLING UNITS__-- 1 __ ____-___ _ FIXTURE UNITS
SURCHARGE IF APPLICABI-E
PE=RMIT FEE 575000 -- INSPECTION FEE _ TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYbFEM
The Applicart agrees to comply with all rules and regulations of the Urified Sewerage Agency.
APPLICANT .. `—' � � �rl'' --- - —
SEINER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEINER SYSTEM.
LINE SIZE _ , INSTALLER
--
RECEIVED B Y.___ __---_• -- -__ _ +�`�-- --.--_.___...__.--__. _
(Ar LWlY OR ITS AG EN Y
COMMFNTS•. - Bldg. #0923
25.00 Insp. fee paid July 13, 1976
This Application and permit expires in one hundred and twenty (120) bays.
The amount paid will be forfeited should expiration occur.
JOHN E IZEINIIIAROT PIUMBINC, INC.
P. 0. BOX 129 BUILDING DEPARTMENT, TIGARD NO.
NEWUP11, OREGON 911j1 PLUMBING PERMIT
holtar 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
(q) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all corliractors and sub-contractors.
Owner -,l 1 GLA( � __ � -, — !Wdress�U tlGc-tdc_�f C�(cl� -�? Date NUMBER OF OF ` TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Single Family-1 bath--each _ _ ✓ _ 25.00 --
Duplex—Each 1 bath uni; 25.00 _
Additional bathrooms—each _ 10.00,_
Mobile Home Space—eoch 15.00 —
INDIVIDUAL FIXTURE FEES --
_ 1 to 50 Fixtures in 1 building each — 3.0_0�—
_ 51 to 100 Fix,pres in 1 buildi_rig—eoch _ 2.50
101 to 200 Fixtures in 1 building—each. 2.00
_201 or more Flxt6res in 1 building each 1.50
MISCELLANEOUS
Building Sewer-1st 50 It, — _ 10.00
_Sewe —each additional 10e .t, 10.00___
_Water Service to building_____ __ 5.00 �_ y
Private Water Systems—each 100 It. 10.00.
Other (specify)__ A`
PERMIT , UJ For Plumbing lriVvction Phone 6394191
'XD State � Plumbing Contrectc• By
TOTAL i RECEIPT NO. Issued Ey
City of ward
INSPECTION REQUEST
for
INSPECTION TIME : -/Z. 7t;L PERMIT NO. :
DATE: DATE ISSUED:_
OWNERS NAME :
ADDRESS :
CONTRACTOR :______
TEST: Air ❑, Water (] , Visujl D , Laboratory C
RESULT: Approved ❑ Disapproved ❑ Pending ❑
SKETCH:
INSPECTOR DATE
EN OTE Attach supplementol test doto hereto]
City o7rd 1 °ecanilre.,' prr!? t iljo Permit 53.00
L'
Fee ` —
New Installation Replace ❑ Retxation `�' Addition 71 A'?era''.�n - —
TOTAL
CONTRACTOti_-_-_')r s, r u -ti- "4Z.4— OWNER03.
' •�' / �
AL'JRESS Q O_Bn xr ��tZ WORK D D E/ U}. +�l�M^LR.F L�- �w.��. Q(14� 3
PHONE 6S fo — GI>�1.2-jr-: APPLICANT
Heat Input Acting (M Per H ��c� `lent Size F1 Fze
cUEL OIL C CAS ILS ELECT OTHER
ITEM NO. FEE ITEM NO. FEE
For issuance of Permit 3.00 2'ui'-7s Over 50 HP 125.00
New- Under_100.000 BTU 1 4.00 I Air H3rdl*.nel 10.000 CFM 3.00
New- Over 100.000 BTU 5.Q—?I Air Handtinq Over 10,000 CFM 5 OC i
Floor Fumam 4.00 jE
Evaporative Cooter 3.0C J.
Wall - Floor-Suspended 4.00 ! Vent Fan 2 O: aT✓l
Install Vents i 2.00 ! Vent S 1 3.00
Repair- Heat & Cooling 4.00 Hood 3.00
3oiters Under .-IP 4.00 Domestic Incinerator S.00
Boilers 3 to 15 HP 7.50 ii Comm. Incinerator 20A
Boilers 15 to 3:: HP 10.00 t Other Not Listed 3.0(
Boilers 30 to 50 HP i 15A0 It
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INSPECTOR'S COMMENTS.
C17 B1:SINSTS5 LICENSE gEQUIRED FOR-ALL CONTRA-=RS OR SUB-CONTRACTORS
Ap^ROVE0 3Y DATE ISSUED BY DATE
RECEIPT Nc.
774 SignaR`re of Af _
(City of TiccrH,
'or
INSPECTION TIME *---, PERMIT
DATE : DATE
O'VNERS NAMC :
AD DR FSS .
CONTRACTOR
TIEST*. Air rl, Water U04—T, Laboratory (3
RESULT: Approved Disapproved 0 Pundmg i--
SKETCH:
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4' CaTY OF
BUILDING PERMIT APPLICATION TIGARD DATE�� 19_—No 0923
1 H UNDERSIGNED HEREBY APPUES FOR APERMIT FOR THE. WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PFONE
OWNERk9i f J tis1 L� iY` 1 , 'r ...3, 61
ADDRESS --��--FUILD!=R PHONE
ENGINEER 1 l)PY74/{W
1JUILDER __.._r--_ DESIGNER
STRUCTURE ❑NEW _0P,EMODEL ❑ADDITION ❑REPAIR ORENEWAL OFIRF DAMAGE- ❑ LI
DEMOTION
D RESIDENCE ❑COMM ❑EDUCATIONAL. OGOV'T DRELIGIOU50PATIO OCAR PORT ❑GARAGE [3 STORAGE OSLAB [-]FENCE
GOND _ �IIMOVING _ OCONDITIONAL USE DDESIGN REVIEW DCOUNCIL APPROVED OSIGNS
OCk; PANCY`_—LAND USE ZONE-- —BLDG.TYPE � FIRE ZONE____ PLAN CHECK BY_—_, HEAT_
2000 • frame duelling w/dttectTwd urgrsge _
bedroom 2f beth
OCC. LOAD _ FLOOR LOAD HEIGHT NO.STORIES 17 AREA 2000 VALUE
BUILDING DEPARTMENT SET BACKS FPCNT REAR LEFT SIDE RIGHT SIDE
Permit tilJ.00 — —
THIS 'ERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 113e 00 REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
r— - WORK NrLL BE DONE IN ACCORDANCF. WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recordinq ALL APP. ICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTI rE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State _— LICENSE. ye?ABATE PERMITS REQUIRFO FOR SEWER, PLUMBING AND HEATING.
Total 14iin SAM rr Insp. 25.00
By
�--����-_--
Approved Receipt No.
f 55 P11r)NF.
DATE INSP. TYPE,. ,SPECTION REMARKS PLUMBING DATE
Contractor
Permit No, -7
Rough-in
Fixture
Final
1A HEATING
Contractor
Permit No.
Gas orOil
Final
SEWER
Final
DRIVEWAY
Final
Storm
(Ra:,n Drain) Final
Sidewalk ri-)$--I(,
Curb&Street Final
Approach 7P, —1P
BLDG.DEPT. F.,4A1 TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
- 7 Landscaping
Zoning Final
OiYY OF
I PERMIT APPLICATION TIC�AP r L t9 Ie(° -Z 3
BUIL G ■
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIF�CAIIONS.
OIYNF_R T/tet yrs ./s ADDRESS
ENGINEER
ARCHITECT ^^ DESIGNER
STRUCTURE }ANEW 0REMOnEL REPAIR ❑RENEWAL ❑FIRE DAMAGE [:]DEMOLITION
® RESIDENCE CCOMM C1EdUC. �,XJAL LJGOV'T ❑REL]G!CUSOPAT!O ❑CAR PORT� C'GI.RAGE_C�STORAGE SLAB ❑FENCE
CROND ❑MOVING ❑CON:lIT1nNALUSE ❑DESIGNREV!EW UCOUNCILAPPROVED ❑SIGNS
} HEAT
oCCUPAIICY LAND USE ZCNE ICs.7var Fi7E ZONE L PLAN CHECK 8Y
10 i T'zi 4,G
4 G
.j J
OCC. LOAD FLOOR LOAD _ HEIGHT NO.STORIES ✓ AREA �4VALUE
IIUILOIN(i DEPARTMENT SET BACKS FRONT � � REAR LEFT SIDE RIGHT SIDE
Permit Ot'
.ssu THIS PE--MIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
D OD REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERECY AGREED THAT THE
Y10RK WILL BF DONE IID ACCORDANCE WITH THE PLANS nND SPECIFICATIONS AND IN COMPLIANCE WITH
RecCrding — ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTF.iCTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
:State L� LICE-NS`. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATiNG.
Total
R`/
APPLICANT OR AGENT
Approved Receipt No. ,
AD PHONE
ADDRESS v
i
Cl `/ Ll f110-
I lyd ��r'CElc�tll�t7� f'tCti)I{ lI te:+nit___.__ 3,uu_.__•_-
1 —�7� . Fee _Id_ �(��r_ _
r, 1.
I•:c-al;i+'.iOn }_..,.- RC:' ^.0 ❑ RCIJCiilibn �_j ;�Ci_ii;iOfl �1tilrillOfl '.J #;;State
IOTA L
.CC.%TRACTOR _!-"u' l_- �.LT�-_-- e;,r:cFi fyuti >LQ._ 69A1.—____._�—.
Ap;-IREc.S SI 3 p Sal.(.' _�L��Z/3E7T � POFalltl_/dV WORK ADDRESS �s� 13 • s a,
PHONE
cc LI �� APPLICANT_f)) .�PLV
_ -y_b _ - — -
Heat Input Rating (BTU Per Hour) _ Vent Size Flue Size
FUEL OIL C ) ELECT OTHER -�- -. ----
tTFM NO. FEE ITEM NO. FEE
For Issuance of Per ,3.00 _- Air Condition Compressor 15 to 30 HP
TU --`- 4.00 Air Handling 10,000 CFM _ 3.0:
New- Under 1_00,000 B _
. Ne.v• 1UU,000 BTU
over - -- S.OU Air Handling Over 10,000 CFi.4- 5.0.
_ _ 4.00 Evaporative Cooler3.0,
Floor Furnace ___-•--- -- --- - -- 2.0;
1�'alt - Floor •Suspended 4.00 Range Vent Fan _
- t _ -+ - 2.00 _Vent System 3.0�
Install Vents Only -___-� ______ _ _ _.--- -.---. _ _.
4.00 _Hood Commercial_ 3.Q(
Repair- Heat& Cooling` - -- +` 1U 0(
Air Condition Cumpressor Under 3_VIP 4.00 �Conimerritil Duct System _ _
-' Condition Co rr ssor 3 to 15 1 _ 7.50
v;ir mF e � VIP
INSPECTOR'S COt,11MENTS — -- - --
CITY BUSINESS I ICENSE REQUIRED FOR ALL CONTRACTORS OR SUBCONTRACTORS
APPROVFD BY —_- --_— DATE _, ISSUED BY E �d�E -
FtECFIf'T NO.- 1 'fib- `? �-
,,.
ignatr� : of Applicant
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