9825 SW SERENA WAY � s s
9825 SW SERENA WAY
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IC -fE OF OCCt7pANCY
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CITY OF TIGARD
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OREGON .
O�•nei: Tom Miller, Builder Pcriliit \v. 3962 j
address:_ 23550 SW Grahams Ferry Road, Sherwood ,
Bttildin(��jAddress:
5825 SW Serena Way _
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Occupancy: P-3 Land Use Zone: R-5PD Bldg. Type 5N
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Comments:
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Certificate is herebygiven this 15th day of January 19 82
that said building may be occupied and that it complies with all =
requirements of the Building Code for the City of Tigard, as approved �
7- '
by the Tigard City Council.
} CT
3 , e Fire Dept. f' ng Inspector
". _ Building Official }... V
j +! .
Post Certificate in Conspicuous Place
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96
BUILDING PERMIT APPLICATION TIGARD DA k.�
THE UNCERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE: 04��'�L�
OR AS SHOWN AND APPROVED IN THE ACCONIPANYING PLANS AND SPECIFICATIONS. OWNER,PHON; __
0J
lFi_�JOB ADDRESS LOT No. !?s'
J'S�• "��t�l X94
CA� --ARCHITECT
NGINEER
BUIICcit d � ADDRESS LSIGNER -
STRUCfURE — NEW ❑ REMODEL — Cl ADDITION J REPAIR ❑ RENEWAL ❑ FIRED MAGE .1-1101
C ❑ E G STORAGE ❑ SLAB❑ FENCR � CV ❑ G
0CCUPANCY -
_LAND USE ZNE '10_.BLDG.TYPE N—FIRE ZONE--- PLAN CHECK®Y HEAT•
SMNER PERMITA
OCC.LOA0 FLOOR LOAD #0 HEIGHT L NO.STORIES — t AREA_ 39� NO.BEDROOMS VALUEj?,G6a
BUILDING DEPARTMENT_—•_ SET BACKS FRONT /�— REAR ,� Y L.EFTSICE S,S' RIGHTSIDE f 'J
P-ormit 3 /3-60 T-F115 PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE EUILDiNG CODE,ZOld1Nt
�-� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERM AGREED THAT TP,.
PCheck /4l'ID"d-0 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CO,#IPLIANC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV,
�Sust4tal RESTRICTIVE COVENANTS. CONTRACTOR AND SLIS CONTRACTORS TO HAVE CURRENT CPTf BUSINES`
i LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax • '. +52
Total soc
-- PDU► APPUCANT OR AGENT
BY _
Receipt No. ADDRESS PHONE
ApproveA
MC _, $ ,�._._._ _-
oc
EWER CONNECTION
SEWER- INSPECTION
CIAER SURCHARGE
Rid.
1
1 $2 b- ox
l:�w.r
Flock- OAK s x 2(o 2qo
-(P X t z-$ 193
s= 9.x 29 I>s
74 x Z$ G72
2o )r Z o 400
I I- t x 3 34
I .'50 Q, 4 G
& o0
I
3962
BUILD114G PERMfTAPPLICATION TIGARD DATE.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMI i'FOH THE WORK HEREIN INDICATED BUILDER PHONE 636-4 1`1
OR AS SHOWN AND APPROVED IN THE ACCOMPA14YING PLANS AND SPECIFICATIONS. OWNER PHONE -_
LOT NO.5—Coppor Crc'k
OWNER ;_]..1 t�' ILIr40BADDRESS 9tk2l-i :" ':?TGTta I'AY _
j!�j �:'hrxti,Tood ARCHITECT
ENGINEER
BUILDER f �:t:Y'.4 ADDRESS_!aa�ofl ;'y irrc'tl"163ms F'orrVESIGNEA _ i'irlt".a'_'ti?.YYC_j,?y
STRUCTURE NEW ❑ REMODEL L.) ADDITION ❑ REPAIR ❑ RENEWAL lI FIHE DAMAGE C DEMOLITION
C RESIDENCE D COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 11 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY P" LAND USE ZONE T':}PU BLDG.TYPE '�'a __ FIRE ZONE—PLAN CHECK BY HEAT—
— conr;_r,ruf-!t single faTnily dwelling w/attaCbfR!d jarage. v 3 lindrooins 2 'katl .
SEWERPERMITM t; 1 '^ vAd.'J�'� game 4 ,;, sgoft.
OCC.LOAD FLOOR LOAD__J ,yEIG-IT L4 NO.STORIES _1 _ AREA 1'199 N0.BEDROOMS 3 VALUtt','
BUILDING DEPARTMENT SET BA01+3 FRONT 16 REAR 3` LEFT SIDE _RIGHT SIDE
Permlt THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
1 f_ �`fI REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check + WORK ,JILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
ANCES. THE ISSUANCE THISDES ANU
Subtotal `' •r'Cj RESTRICIIVENOT AIVE
WITH A0. �PLICABLE COVENANTS CONTR CTTORIAND SUB CONTRACTORS TOO HAVE CU RIENTOES CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATIN
State Tex
Total SDC- �s�n.t,o 1 L"Lki it
., ,:`'?.L1 —
PDCM ,(;[ R j,o o♦o 11 APPLICAUT OR AGENT
By
Receipt NokC) 4v
{ �; / _A HP ONE
Approved r t��=,w ! RM
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE '
Contractor
il- ------ Permit No, C 13
Rough-In
L �t Fixture —
Final
HEATING
Contractor I
Permit No. 6 ,..
Cies or Oli
—�—---- -- -- -- Rough-in -
- ------- Final — - -----
-
SEWER
Final
- � — ----- - -- -- DRIVEWAY. �.
.. —_______— -------- ------------------- Final � .---
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCC NCY —
CERTIFICATE OCCUPANCY ) Final
Landscaping
goring Final
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1
City of Tigard Mechanical Permit NO. _
Now Instal'atioll Replace [] RelcaDun t_� Addition Alteration DATE:
HEATING r7CONTRACTOR �� C'
OWNER7?i , rJ ► � _ _
ADDRESS/:S' -Y2e�U� ► 100 ADDRESS_
PHONE /An;//5 _ APPLICANT
Heat Input Rating(BTU per Hour) Vent Size Flue Size---A—/ ----
FUEL
lze_ _A!FUEL OIL[J CTAS U ELECT OTHER
_ ITEM —._____.__.___I N6 FEE ITEM N0. FEE
For Issuance 0 Permit SEE BELOW _ Each Air Handling Unit or Duct System 7.50
Naw-up to & incl. 100,000 BTU_ 6.00 Commercial Hood 5 stem 7,50
New 1001000 BUT's & over 7.50 Other E ui rnent - Each 4.50_~
Woodburning Stove 4.50 1 Trip Inspection 4.50
Wa►I-Floor- Suspended 6.00 Air Condition Compressor - up to&incl.3 H.P. 6.00
Vent Sy tem w Fan4.50 Air Condition Compressor-3.1 to 15. H.P.inci. 11.00
Re air•Wleat Cooling 6.00
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS !
PERMIT ISSUANCE 10.00 Comments: _
FEES
SUB-TOTAL.
!G STATE___ Issued By.
-25%PLAN CHECK wq rug