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15855 SW SERENA COURT 15855 SW SERENA COURT 4.3 U m C N f� n� cn 3 to Ln to m un r-I 1 Iddresa Permit No. Pe; mit charge 77C�7� Owner . Connection fee (VOd n Paid by ` - ten-otic Type of building ^ice � Date connectod Service rata Inspection Fee S Contractcr Paid by _ dato Size of connection Assessment Paid Address Permit �i o. Permit charge 2.2 1-2, � Owner �.(�, t-- Connection fee „^ D, Paid b y ! Type of buildingDate connected co_ Service rate �,i<��; '� _ _ Inspection fee Contractor Paid by Date Size of connectionAssessment paid ---------- g/, /ys SEXIER PERMIT N 13921 Unified`,ewerage Agency of Wc.shington County CITY OF Tigard DA TL 2-22-7ti OWNER : -_ Bob Sarnuels M—,— — PHONE 246-473 OWNER ' S ADDRESS: 8735 SW Lehman Stx et, Portland, Oi.ekon 912.23 TYPE OF INSTALLATION : ®BUILDING SEW!_R ❑BUILDING SEWER AND SIDE SEWER TYPE OF OCCUPANCY: ®NEW ® SINGLE FAMILY ❑ COMMERCIAL ❑F_XIST . (PRIOR TO 7- 1--70 ) ❑ MULT . RES. ❑ INDUSTRIAL FIXTURE UNITS_ DWELLING UNITS I — PERMIT _,PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CAL-LING FOR INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN CINE–HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILl- BE FORFEITED SHOULD EXPIRATION OCCUR . FEES: PERMIT FEE $__ 25.00 CONNECTION CHARGE SIDE SEWER INSTAL LAT I ON _ _ Imo- Wi 1=�u _— ISSUED BY OTHER TO February 22, 1.978 APPLICANT DATE SEWER PERMIT M 1:3921 ADDRESS OF STRUCTUREa,- T:Ipar.cl TAX MAP ___ ___ TAX 1, HI SYSTEM Fanno Creek L O T !>`�_. P U C K . 2122/78 C�- —...2/22/78 .� APPROVED BY DATE 5 U riff BY DATE REMARKS-____-_-,:::: CITY OF 'TIGARD ORDINANCE #77-71 PARK SYSTEM DEVELOPMENT CHARGE PDC - 42 D February 22, 1978 ESTIMATED SALES PRICE $_55.600_00�'� ATE : APPLICANT NAME Bob Smuels TELEPHONE # 24G-4730 JOB ADDRESS 15855 SW Serena BLDG. PERMIT #__1902______ AMOUNT OF FEE FOR P. D. C. X10.0.00 -- DESCRIPTION OF IMPROVEMENT__ Sin&1e Family Residential Home EXEMPTIONS - PER ORDNANCE #77-71 FEE RATES: $ A. Single family dwelling unit under $40,000.------ ------ 00 -------$L 7575. 00 B. Single family dwelling unit over $40,000•-- 50. 00 C. Mobile Home CLurt Space (New Development)---------------$-----$ 50.00 D. Multi-Family dLellings--per unit----------- ------_ CONSTRUCTION IS LO,,ATED ON S.E . N.W. SIDE OF S.W. PACIFIC HIGHWAY . N.W . is Perk District #I . S.E . is Park District #II . CITY OF" TIGARD OHOI MANCE 177-26 STREET SYSTEM DEVELOPMENT CHARGE DATE : February 22, 1978 w_ ESTIMATED SALES PRICE S 5.5,600.00 + I-v't APPLICANT NAME Bob Samuels TELEPHONE. 246-4730 JOO ADDRESS 15855 SW Serena aLDG. PERMIT #r 1902 AMOUNT OF FEE FOR S. D. C. $400.00 DESCRIPTION OF IMPROVEMENT Single Family Residential Home EXELMPTIrJNS -PER ORDINANCE: #77-26 FEE RATES: A. Single family dwelling unit under 560,000.--------- 3300.00 H. Single family dwelling unit over 360, 000.--------- ;1400.00 C.. Mobile Home Court Space (New Development:)----- ---- x150. 00 U. Multi-Family OwuLlings--per unit-------------------- 5240.00 E . Commercial , Industrial & Institutional(Park. 5pace) 5 50. 00 each F. ;tingle family unit under 540, 000. ------------------ $250. 00 ...+'M�i•Nlwhsw�.�R.A, �r. ..r�w1�M.�► RM'MM^I...r1.�.�wAi...e. wA^"1�nYT BUILDING PERMIT APPLICATION 11TTICARD DATE Fgbivi LYv ? _. ,s.? or'0 THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BU.LDERPHONE iN6-4731) OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OVINER PHONE LO"i NO. 116 OWNER ?lob :+gNalA JOB ADDRESS L.5855 >�; erena_ HOME ADDRES3 _ ARCHITECT ENGINEER BUILDER _ADDRESS _ DESIGNER STRUCTURE ONEW ❑REMODEL L ADDITION OREPAIR CIRENEWAL �COFIRE DAMAGE DEMOLITION 0 RESIDENCE CJCOMM ❑EDUCATIONAL ❑GOV'T CI RELIGIOUS OPATIO ❑CAR PORT ❑GARAGE LI STORAGE CISL.AII [:]FENCE MOND (]MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW LICOUNCIL APPROVED 0SIK3N6 OCCUPANCY LAND USE ZONE I{-"—__BLDG.TYPE J _FIRE ZONE 3 PLAN CHECK BY �' ' HEAT_ �'BS ColiaLrUCUOU Gina«. family Uwall]ui, W/At,tached 4 6*tixulmt/2 Batit Kei&6ue of Lot 0.32 —� Sewer t'atitllt yr 13921 i'ae ;;600-00/lnapftt. $15-I.tU Gattap�e 44t; _ �GLQpifd--.EL00R..19AJ2._40 HEIGHT 2A _ NO,ST08IE.`z_. i ABEA20L6 NQ,_0€LFFT49M�_ VALUE _BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE Permit 199.CJ0 y THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, TONING Plan Check LO.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Sub-total 209.00 ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS State Tax 4, 7.96 LICENSE. SEPARATE PERMITS RECUIRED FOR SEWER, PLUMBING AND HEATING. Total 216.96 -- 1,UC 42 I By ICANT OR AGENT Approved Receipt No. ME-- - ---- --•-- CIATE INSP. TYPE INSPECTION REMARKS PLUMBING �_ DATE -2- -7-7 _7 Z^f) Contractor---_------_— _ 1 Awl XPi° R0vI_�� Permit No. Ll 3-L—_ ��V� t-, fit .. c L11 ,'sc e fo „ {�6 ��_ Rough-in ------ —_ I—_—_— U Fixture _— — -- ----- -to-? > / e .= C.�--- -- Final — -- — — _ 2 in_� HEATING y- I'-I? Contractor 4-.-�-2 N(� -- —__ — Permit N�— Gas or Oil Rough in Final SEWER Final —` a--- DRIVEWAY --- — — - --- Final --- -- storm DraT!!j� (Rain Drain) Final — — - -------- — - — - --- — Sidewalk -- Curb&Street Final - — ----- BLDG DEPT. FINAL — —TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Fina-- L andscaping inaLandscaping - � mooning Final n,UILDING PERMIT APPLICATION Gam' TIGRD DATE� ??-.._. __ ,s 7g . Np •1i UNPi RSIGNED HEREBY APPLIES FOR APERM17 FOR THE WORK HEREIN INDICATED BUILDERPHONIEZ1-10-�473-cj ,,F AS SH')WN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICAT IONS. OWNER PH [� LOT NO JOB ADDRESS J "444eHLOME ADDRE s ARCHITECT tNGINEER R — ADDRES5 DF..5IGNER ORE 'SEW OREMODEL 1:1 ADDITION 0HLPAIR— ❑.R- NEWAL ❑FIRE DAMAGE DDFMOLITION INrf DCCtMM ❑EDUCATIONAL DGOV-T 1:3RELIrIOUS0PA1I0 [3CARPORT`DGARAGE OSTORAGE❑SLAB [:]FENCE ]POND — _ D_MOVING ❑CONDITIONAL USE C]DLSIGN REVIEW _❑COUNCIL APPROVED OSIGNS N;v L USE LONE _ .+_ BLDG.TYPE JN1�! r IRE 7 NE AN CHECK BY —�—_ HEAT— _ �--� E ..__ _ _- PL_-._ C•_ :UAQ__.-.--- _F1�QF1�.4eD_ ._v__ MEI�HL._ _.�NlZ..SI4RIES_r___.._ REV��N� Ep�O MS VALUE--` ——BUILDING DEPARTMENTSET BACKS FRONT REAR LEFT SIDE RIGHT SIDE THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING i'lan Check a REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE ---- — —' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH rW)loial _�y _, @� ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RLSTRICTIVF COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS ';tate Tex �7 C�'/ LICENSE SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING, �.s� P,y APPI 1CAN1 pp AGE N1 yplroved - --,GC Receipt No AUUHE SS .n-a�,�+P�+ti:�ti►waw..c�t wr.�.rra.r..uv...•. ..r+�..+.-+.....«a..w�.•wrr....�..ws..w.....•-wrur....w � ry mare Mechanical Permit LTd Permit %AQ.- Fee_ 5,.00 Ne tallation ® Replace ElRelocation G Addition EDAlteration E3y�.B9tState TOTALv—•.32 -- A NTRACTOR —McCollisterHeating & Air Cond. OWNER Bob SemU@18 _ ADDRESS__- 2] Q4Q_jt�a_�� .ins d _��f 3te ton WORK ADDRESS 158 S-W. Serenal� APPLICANT McCollister Heating &_Ajr �nd, +� PHONE - - _h �:_SS -- Heat Input Rating (BTU Per Hour)__. 100,000 Vent Size _ j" Flue Size_ - FUEL OIL ❑ GAS CI ELECT ❑ OTHER _ ITEM NO. FEE ITEM NO. FLI _--- 3.00 Air Condition Compressor 15 to 30 HP 10.00 For Issuance of Permit O� - New• Under 100,00_0 BTU �- - 4.00 Air Handling 10,000 CFM 3.00 New 100,000 BTU&over -� OO 5.00 _'Air Handling Over 10,000 CFM —� 5.00 Floor Furnace _ 4.00 _ Evaporative Cooler 3.OD Well Floor •Suspei��ed r4.00 Range Vent Fan 2.00Vent System3.00 Install Vents Only - Hood Commercial3.00 Repair Heat & CoalingAir Condition Compressor Under 3 HP Commercial Duct System10.00 -'k -Air Conditior Compressor 3 to 15 HP _ _- _ i f+ INSPECTOR'S --- f '— ±;-� CITY BUSINESS LICENSE REQUIRED FOR 4LL CONTRACTORS OR SUB CONTRACTORS .: APPROVFD BY --__- - ---.._—_ DATE ISSUED BY _ _ —_ RAi RECEIPT vc ii »4 Signature of Applicant