15671 SW SUMMERFIELD LANE IBM__
15671 SW SUMMERFIELD LANE
1
m
c
ro
a)
.-q
a
ti
m
E
E
J
cn
.-1
I`-
in
1
R iR�iRRit No.
d d r s s
Permit chargey r2
Connection feeOWner
' r
Paid by
Type of building �t�� _ Date connected
Service rate Inspection fee
Contractor _ _ Paid by _ _ Date
Size of connection _ —_� Assessment Paid
w-!1 7
KWIW >� l�
JOHN E. 1106P,R01 RUN'.91NG. RIC. BUILDING DLPAI'. WLN-r, TIGAHD NO. D
P 0 BOX, 129 PLUMBING PERMIT `
NEWBERG, OREGON 91132 _ _ _ 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 corse of
Tigard. Such installations require inspection by the City li.tpector who shall be notified not less than four
(4) hours prior to the time the installativas are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. � t :�S 0 /-5 6 �7/ _�� '/
Address` 'U - -- --- t—�Datr;—__L,[/K
NUMBER OF TOTAL PERMIT NO.'£
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT _ (office Use Only)
-B-E 51 P EKTJA L —- $ —
Single Fomily-1 bati,-each _ 25.00 —
Duplex-Eoch 1 hath unit 25.00
_Additional bathrooms-each — 10.00
Mobile Home Space-each _ 15.00
INDIVIDUAL FIXTURE FEES _ -- -
1 to 60 Fixtures in 1 budding-each 3.00 -
51 to 1t)O Fixtures in 1 building-each _ I 2.50 —_ —
101 to 20) Fixtures in 1 buildin -each J I 2,00 -
701 or more Fixtures in 1 building-ench _._ 1.50 771
_
MISCE'. L A N E 0 U S --
Building Sevier-1st F0 It, 10.00
SewP,-eact odditional 100 ft. 10000__ -
Water Servico to builr,in2-_ _ _ __ 5.00_ _ —
Private Wnter Systems-each 100 ft. _- 10.00 --
Other (£perif �—
PERMIT C0 For Plumbing InVectir,n Phone 6394191
% State /- O> Plumbing Contractor By A _
TOTAL )r RECEIPT NO. Issued Ey
i ■
■
■
■
■
■
.1-A ■
V � ! � - ?ermit X3.00
Mect1an call Permit+� #�/ �f '?oar �° Fee --4.00
New !nstailation R Replace C Relocation = Addition ❑ Altera-'on ❑
TOTAL -1•')-'I
--'TV-4Q�n�.;� v���JA.c.L 'lR�
CONTRACTORCYJNER � `•
3� WORK ADDRESS aLOS�Nn�•�t.�'-'F` EAG ''�`) � : 3So� ■
ADDRESS;�Zn t�n>c �.J- -;. G.+: S �• �.
PHONE APPLICANT
Heat Input Rating (BTU Per Hoyy1__�a�d� _ Vent Sits .4.4 F!ue Size
FUEL OIL C"], ,GAS ELECT n OTHER
ITEM N,0. FEE ITEM NO. FFE
For Issuance of Permit 3.00 361cm Over 50 HP , 25.Ot
New- Under 100^00 B-fU 4.00 Air Hand'ina 10.000 CFM 3.CC
Air r;--ndfina Over iojl i0 CFM f 5.0C
New - Ovec 100-000 BTU 3.Ot
Floor Fumaec 4.00
Evaporative Cooler
Wall - F!oor - Su ed 4.00 � `•1K
'lent Fan '
Install Vents ?-00 it Vent S stern 3.0c
4.00 li Hood ! 3.00
Repair- Heat & Cooii . `5
SoPers Under 3 HP 4.70 Domestic Incinerates
I 7.a0 Comm. Incinerator 20•a
Soifer 3 to 15 HP i 3.0C
Boilers 15 to 30 HP 10.0G i Other Not �.___
Boilers 30 to 50 HP i 15.00
!NSPECTOR'S COMMENTS.
CIT'r 3USiNESSL! ., RED =C'?�A'_+.. Ct?NTI?A';TOI'.S JR SUB-CONTRACTORS
APPROVED, DATE ISSUED BY DATE
9ECEIFT NO.
774 v'^maths of APP' nt tO--�
I
City Of Tigard
i NSPECT;ON REQUEST
Q ST ,
for I
INSPECTION TIME: PERMIT NO. : I
DATE: DATE ISSUED :_
OWNERS NAME :
ADDRESS: �' � �,� S '� _-.�mSC•l ' I
CONTRACTOR : S.6 ZI
TE ST : Air D, Water[9c;5'V+ t 0I [3 Laboratory Ll
RESULT: Approved Cl.-, Disapproved C Pendi-q (] i
SKETCH:
I
i
I
I
; INSPECTOR DATE
NOTE: Attoch supplemental loft doto b*retoj
1
UNIFIED SEWERAGE AGENCY :40. __ 10638
WASHINGTON COUNTY DATE
CITY OF Tigard
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: ..______—____ Tualatin Development apsx co.
OWNER'S ADDRESS:
STREET
STATE- --� -- -ZIP
P'JILDING SITE: LOT 350 BLOCK ___ __— ADDITION
TAX LOT NO. TYPE OF OCCUPANCY ..__ —.fie once
ADDRESS _ _1567.1 SW Summerfield Laee
f)VIELLING UNITS ._____ FIXTURE UNITS
SURCHARGE IF APPLICABLE __________
PERMIT EEE ._575. 00 INSPECTION FFE __ TOTAL DEPOSITED _575. 00
(NEW) (EXISTING) BUILDING SEWER SYSTEM ___.F_.arinn
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
SEWER PERMIT
THIS PERMIT AUTHOPIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE - __.____ ______._�._.._ INSTALLEh
RECEIVED BY . �'--tet` =- .1 .t
(AGENCY OR ITS AG[N' I
COMMENTS: __ .PId9• 1070 �2F. 00 Ince. fee paid 9-17-76
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfei'ed should expiration occur.
pip �,..
BUILDING PERMIT APPLICATION SOF TIGARD DATE '�'•�� '78 � ''"Q
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED SUILDERFHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIWS. OWNER PHONC
LOT NO.
• d.r � .`.x 1t!'�^-IIYR'^7111NDM9'!� '
OWNER _JpB Af)DRESS.t' �ME ADDRESS
ARCHITECT
ENGINEER
BUILDER �� ADDRESS _ DESIGNER _
STRUCTURE ❑NEW Q REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL_ ❑FIRE DAMAGE. _❑_ DEMOLITION
❑ 1RESIDENCE (:]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT DGARAGE ❑STORAGE❑SLAB—❑FENCE
QBOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPHOVED ❑SIGNS
QCCUPANCY ► LANU USE ZONE BLDG.TYPEFIRE ZONE_J,— PLAN CHECK BY_ HEAT_
xxlS Frame duelling ko/'a.4tso:.ft.w atteched gii rage 2 bedroom 2 beth
Q—QC_ QAD FLOQ,P_1,QAI)- HEIGHT _____1!LQ STORIES _.
AREA 1264 NO.
BUILDING DEPARTMENT SET BACKS FRONT FEAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSl1F:!!, SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CUDF_, ZONING
Plan Check 10*0Q REGULATIONS AND All APPLICABLE CODES AND ORDINANCE';, AND IT IS HEREBY AGREED T4AT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPC-CIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSI;ANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVF. COVENANTS. CONTRACTOR AND SUB CnNTRACTORS TO HAVE CIIRRENT CITY BUSINESS
State Tax 3066 LICENSE. SEPARATE PERMITS REQUIRED FOR 3EWEF PLUMBING AND HEATING.
Total 125.66
By _
--- - APS' (CANT OR AGE► r ---�— ----------.
Approved Receipt No.
—_-- FIUDRE55 —PHONE — --
...".y....w,...:r:...,,w.r..,. ...,...,.. .. ... ,..__ ..,:..e.:n.wnW...�— �+..gip,. a.MW....,,..-;....w..,«.,w.r..c.w ..,.......drmW......<.wr:.w.........--►.rww,w;......,...ui....:.:.w..u.....-•:.r._.�._..«�
{
i
i
26,
114170
//--7-;,1,
11-16-26 4?oW
—/9-76 o7o-rJc,ar��
74
clrY o ►= I -
BUIL IG FI RMIT APPLICAT ON TIG ARS L -1=��-- ���-- N° �d � E' �
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WOR'.: HEREIN INDICA ED
OR AS SHOWN AND APPROVEJ IN THE ACCO%.PANYING PLANS APED SPECIFIC TION$. ObNNER PHONE Gag" ���
OIER Ti..+/s1 i� vivi� ..���' ✓v ADDRsSS � [' S. �— BUILDER.PHONE
:YA
ENGIINr-ER
BUIL DER t�� rr11 ARCHIL FCT rr--11 3ES1GNER
rSTRUCTURE ❑NEW ❑REMODEL �-1 LIADDIT10N ❑REPAIR L_RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
KI RESIDENCE [:]COMM ❑EDUCATICNAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB El FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE [—]DESIGN REVIEW IJCOUNCILAPPROVED []SIGNS
v.:CUPANCY--.-r._LAN OUSE ZONE_ BLDG, I YPE—FIRE ZONE PLAN CHECK BY HEAT
Ap
OCC. LOAD FLOOR LOAD HEIG:AT NO.STORIFS / AREA rz-44 VALUE --ZL}, ']q =S
BUILDING DLPA!IT66ILNT SET BACKS FRONT ,' = 'EAR % LEFT SIDE RIGHT SIDE
Permit
ssvr THIS PERMIT IS ISSUED SUBJECT TO TI-IE'RCGULATIONS CONTAINCD IN THE BUILDIP" COD[, ZONING
' REGULATIONS AND ALIAPPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
:O o0
' WOfti:WILL DE DONE IN-ACCORDANCE Wi"fFi THE PLANS AND SPCCIFICAT►ONS AND IN COMPLIANCE Y'!!TH
Recording _ A'_L APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PFHhiiT DOES NOT WAIVE
RE_-TRI.TIVE COVE^IANTS. f_O"1T'IACTOR AND SUB CONTRACTORS TO HAV- CURRENT CITY BUSINESS
S[' dte j � LICENSE. ;LPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total f ``
APPLICANT OR GENT
Approved Receipt No. I G
ADDRESS PHONE
i