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INSPECTION NOTICE
City of Tigard Building Department
P.O. Brx 23397
Tiq?;d, Orequr 47223
Phone: 639-4175
Type of Inspection A n
Date Requested �//S / Time A.M. X P.M.
Address / /:�fJ ( C/) 7/.lC -� Permit # L�7 C
Owner _ Lot #_
Builder
The following Building Code deficiencies are required to be corrected:
(� C.(�I V``YT1l �1 GSL � ��L.Y�•l-L'-L� '�.�U t`r�. :�
P,L
> f l ce v c1 )
'1
Oil
r
Presented to� —.. ---- ---- — Approved
Inspector -_ _-_ _ .� Disapproved
Date - _g7
CALL
CALL FOR REINSPECTION
❑ YES ❑ NO
i
I
INSPECTION NOTICE
City of Tigard Building Department n
P.O Box 23397
Tigard, Oregon 9722.3
Phone: 639-4175
Type of Inspection
Date Requested 2 ,3 ! Time
�' A.M.i_ —P.M.
Address l 2.O l- o- 1 d OSI ) � i Permit #_51 1 13 J
Owner Lot #
5J -
Builder ._ � Y1
The following Building Code deficiencies are required to by corrected:
/.�
Presented to F❑ A
p
p
r
o
v
ed
Inspector ^-^gg _ ��-unapproved
Date G
CALL FOUR REINSPECTION
NO
1
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 F
Tigard, Oregon 97223
Phone: 639-/411/75
Type of Inspection —
,-,fo taquested V /j�n / Time1 A.M. P.M.
At it i �� l ['JZ l ��r^ Permit 0
Owner u� �_ Lot #
BuilderThe following Building Code deficiencies are required to he corrected:
iPresented to _ ppraved
Inspector _ ❑ Disapproved
Date3
CALL FQR LINSPECTION
C] YES 11 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested__.._— Time A.M. P.M.
Address y l�� ` �� 7 %C.� ) r _ Permit
Owner_ ___ �.—_ Lot 4•
Builder C The following Building Code deficiencies are required to be corrected:
s - / L✓�,(
Pre-crted to _- }'Approved
Inspector / C_l Disapproved
� r
Date
CALL FOR REINSP SCTION
❑ YES ❑ NO
INSPECTION WFICE
City of Tigard :wilding Department I '
P.O. Box 23397 C,
Tigard, Oregon 97223
Phone: 839-41175
Type of Inspection `-
Date Requested _ - y 7/ - - TIn1M A.M. _P.M.
Address Permit #
Owner (� �_ Lot
Builder 1'.The following Building Code defiriencies are required to be corrected:
Presented to - i_7 4pproved
1 Inspector _ _ [� Disapproved
Date v__�L-- - =—
CALL FOR REINSPECTION
❑ YE9 ❑ NO
INSPECTION NOTICE
City of Tignrd Bmiding Department
P.O Box 23397
Tigard, Oregon 97223
PhoneI 639-4175
Type of Inspection C-V� r ck
Date Requested . �r Tltne k A.M. P.M.
Address �-� ___L ��'►<-t CJYI C t Permit s!
Owner Lot #k
Builder
The following Building Code deficiencies are re wired to b- corroded:
r A,d!, Q-L42
— ----
__,�
Presented to ❑ Approved
Inspector ❑ Disapproved
Date
CALL FOR REINSPECTION
D res D No
awR wa ew s swr a. s, AL
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection -i
— - Time A.M. P.M.
Date Requested _.�----=
Address
C Permit
L4^d # -- —
Lot
Owner
Builder .
The following Building Code deficiencies are required to be corrected:
.t.C' 'ud
—Lam`-'>Y_ T•
[IApproved
Presented to
__ ❑ Disapproved
Inspectow _.r
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department ef
P.O. Box 23397
Tigard, Oregon 97223
Phone 663,9-4175
Type of Inspection "II,Y �) �( �y�� 7-0 Ra.G ) � L t_t*14
Date Requested---// o Time V A.M._ P.M.
Address . 7rt� ! ,Lam( L� _�_ Permit *S73-�
Owner_ __. Lot #
Builder — --- -...�----
The following Building Code deficiencies are required to be corrected:
r
Presented to _ _ __ I Approved
Inspector _ -____ Disar roved
Date. — — -
CALL FOR REINSPECTION
�]
YE-8 0 NO
CITYOFTIFARD BUILDING NO. : K>ERMI'i'
Fy1RMI'T NO. M31.1(�E)1"l;i5
C17V OF TI6�tRD
Oal60M
COMMUNITY DEVELOPMENT DEPARTMENT 0A•TEi: 1:SSUE:U: 19/26/(38
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 PRI M. PMT .NO. 8031.735
..J08 AUDRI~:SS : 9'720 SW LONDON Cl
1 AX MAP/L UI I S 1. 33(::D 6500 51.18: LONDON S QU(-'NPj::. LT : 17 BK :
I..AND USE: 1 25PD
I...(:)T SIZE:: VALUATION . !il :'):'1 ,000 SETBACKS
F lIONT : 20 REAR: 8
WORK CA-ASS : NEW DWELL .UNI T'S : 1 LEFT: 5 RIGHT: 1'o
USE TYPE : SIN(:,I...EF: FAMILY NO. HEDPOOMS 2 E.X1' .WALL. CONST :
(MNST . 'T•YPE: : VN NO. BATHS : 2 N: 5 : E . W:
(IM.UP .(:;RP PROT .OPENINJS :
OCCI.IP.LOAD 410 N: S : E : W:
TO'TAI... AREA: 1207
NO. STORIES : 2 1.S'1 : 613 ROOF" CONST : C FIRE RE:'T'7
22 'r.'.'.NIJ: 59A ARF::A SEF„PAR'{ RATED:
1'4ASEMF.::NT'? MID : OC('.,LJP . 5E'PAR'7 RATED:
MEZZANINE? HASEM' '1
F1».f.)OR
LOAD : C,ARAGE:: : 235 FIRE: SPI4KL14'{ ALARM'?
FLOW((:,F)M) DE.'TEiC'TT't YES
IIII:A1' 'T'YPEI:. El_E.0 HD(:P . AGCEi.'SS7 CORR.?
PI.-AN (;14F--CK HY : r•:1.'t.
f1EI:MAIIKS
REISSUE: OF NO. (:)808:15
I...AST REISSUE (38UH1.9
IFE.'Et'i
0 NATIONWIDE F:INAN('.:IAC_ SE PV Pli'A4MIT $2 92. 00
W
�iR�
N NO B:)X 1133'7 PLAN RI•-:V IE:W C3
R PC)RTI...ANS) OR 97228 F ME I:)H 'T
:P
I•'H()NF (50:3) M-2 3-04159e' !i'1'A'T'E?: fAX $1.A. 60
(31,11CAA
DEVELOPMENT C:HAF4G:.'S :
C
o HPAIJY PAI IL SUC:(STOPM) $250 . CO
N 13P 1NC . !IDC:( S 1'F r--:'1'> $600 . 00
T
R 1.9 1.'i1Qi 5 MOI...AC.LA AVI”. PIJC(t 1 ) $250 . 00
A el'1•aeSc111 c::i t rar, 970/15 P RE PAII..) < 1b40 . 00)
T PHONE. (:90;3) 650•»•0698
0
R RF.::("ISTPATTON NO. 52476 10 TAL : +6 J. ,'tato 6 . .1U
RE'(MIP'T NO.
This permit Is issued subject to the regulations contained In Title 14 w—•— •- -•-••_•»--••- - — - — -of the TMC. State of Oregon Specialty Codes,zon,ng regulations C EQj.)IREI:) IISISPII'CTIDNS
and all other applicable codes and ordinances. and It Is hereby FDO 71.NG SEi:W(:R
agreed that the work will be done in accordance with the plans and
specifications and In compliance with all applicable codes and FUUNDA'1 ION WALL RAIN DRAINS
ordinances. The issuance of this permit does not waive restrictive POST & BE::AM WA'TE:P LINE
covenants. Contractor and subcontractors shall have current city PLR UNUE.RSI..AH CITY Ar-"PR(::H/SW
business tax permits. This permit will expire and become null and ryl AR FINAL
void if work is not started within 180 days,or If work is suspended or PI.F1 T'(:1F'OU T'
abandoned for a period of 180 days any time after work hes
commenced.It shall be the responsibility of the permittee to assure VRAM I NG
all required Inspections are requested and approved. FIRE::PI...AGE
GAS LINE
INSULATILIN
L (:;YP. M)ARD
Perrnittee Signature
Issued By .. _
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF T16A RD CITY4�Tw F+' PLUM81W., PEP1111T
COMMUNITY DEVELOPMENT' DEPARTMENT
RM I T' NO PI 00 1.02 1
13125 S.W.Hall Blvl.,P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175
DATE 1'---)!--iLJE:U:
PRIM. PM'T .NO. 681135
JOH ADDAESS : 9720 SW I ONDON CT
I AX MAF /I OT ist "VIR'.3) 0.)"J00 SIM: LONDON SQUAPEK LT : 17 Fal!
A N U U 5 E: : P 12.5 P 1)
I..-GI, SIZE :
I TEM: 40: NO
WORK CLASS : Ni:;:W WATER C-LOSET 2 TRAP
USE TYPE: S*.1N('.-AA.. FAMIL.'Y' UPINAI BKFL.01611 PPVNTR
CONS 1* . 'T*YPE*.' VN I AVC)PATORY P TRAP PAITMIH-W
OCICUP . Tl SH(WER THAP15
DISHWASME.34 1.
GoAPBAGE DISPOSAI
NU . STOPTEKS : R WASIAM.s' MACKENE. 1.
DWELL. UNITS : I LAUNDRY 'T'RAY F3L.D(3 . DRAIN (DIA
ll-!'L(:)C.A DRAIN
SINK (FT)
WATER 1-4FATEP 1 STOPM/RAIN (i 1.
0
W F1;
: ..F—S
N NOT.11:ONWJ.DL FINANCIAL SE.KPO P E:P M IT $110 00
R
E InO 0 0 X :9;3;.37
PUPTILAW) 113P 9,12211
FIHONE (503) 323-6592 S MIT, TAX 45 .50
C
0
N 11A(;KIN POHEAT I
T
R 1:.*., 11-10AN
A
C pall:)UX1038
T cPr*A9c)ri t-ity or, 97045
0
R Pl-KINE (303) 631-2385
N414Qv:X*73- TOTAL : I 1 15 5
This permit is issued subject to the regulations contained In Title 14 RECEIPT' NO.
of the TMC. State of Oregon Specialty Codes zoning regulations
and all other applicable codes and ordinances, and it Is hereby
agreed that the work will be clone in accordance with the plans and PE-QUI PED INSPECTIONS,
specifications and in compliance with all applicable codes and PL.B .UNDEPSLAB
ordinances The issuance of this permit does not waive restrictive POST & BEAM
covenants Contractor and subcontractors shall have current city WA'TF.A L.TNE
business tax permits This permit will expire and become null and
void it work Is riot started within 180 days,or if work iSsuspended or
abandoned for a period of 180 days any time after work has PAIN DRAINS
commenced. It shall be the responsibility of the permittee to assure 11"*I NAL.
all required inspections are requested and approved.
Permittee Signature
Issued By
UP :INSPECT-1014 639--11.'79.s
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
VIA W-JL
NO . : ME113810c.
CITY OF TIOA RD
UCITY�—OFLTL'AN)
COMMUNITY DEVELOPMENT DEPARTMENT 04100H DATE ISSUED: 1/26/88
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223.(503)639-4175 F,1141M . PMT .No. 38:1.735
ADOPESS : 9*720 SW LONDON
T. ,X MAP/LAXT 15:1. 35CD 6500 SUB: I-ONDILIN Vii(:UAPF-K 1-7 : 17 I?,K :
I AND USE: : RP5PD
S'1ZE :
1:TEM: NO: NO
WOPK CLASS: NEW FILIPINIACE <1001K A1141 IAANDILP (10
USE TYPE: SINQ..K. FAMILY FURNA(:E 1.001(4- ATP HANDLA 10K
CONSTA*YPE : VN ri-oort I::'UPNACE EVAP . COOLER
OCCUP.(7,11,41-D. WIi.ATE R Vl-'-N*T* FAN
k1EN1 VENT . SYSTEM
BLA/COMP <31-4) HOOD 1.
NO ST0P3:E'.-) : 2 UI-.P/C('.)MP 3-151-11P INCTNERATOR(DOM
DWEI L. . UNITS : I BL.A/CUMP 15--30HI'-" I ISIC1NEPATOP(COM
I..L E C. DLP/COMP 30-501-111P) 14EVIAIN UNITS
MAX . :I:NPU'r 1-31...n/GOMIJ 504.1-IP OTHER
F-TPF.:-. r.)MPr4t.'-? GAs lr�IPING OUTLETS 1.
HIGH
LOW VIPESS'?
V1 E M A A K
FEES :
0 NATIONWTOE F-11SIANCIAL SFPV P11i".44ml r *11.0 .00
WN 1:)(I BOX 5337 VLAN PE.Vlr:--'W
&.3
E PUPTI AND Orl 97228 FIXTURES X50
R F:'H(:)NF.:: (503) 323-6592 5TATE TAX
(TT FIER
C
0
N
T
R
A
C
T
0
"T'OT'AL T .5
OAL: $4-1.8
r4E:Ci:--- IPT NO.
This permit Is issued subject to the regulations contained in Title 14 - »•-•-•-•_-••-•» »•-•••-•.-.•-22.2_2..-.._._..„.
I S PE:(.;I 1 S
of the TMC, State of Oregon Specialty Codes. zoning regulations REQU N. P T. N
and all other applicable codes and ordInancts, and it is hereby (.-PAS LJ:NE
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all applicable codes and POST & REAM
ordinances, The issuance of this permit does not waive restrictive :CN
covenants. Contractor and subcontractors shall have current city F1 NAL.
business tax permits. This permit will expire and become null and
void If work is not started within 180 days,or It work is suspended or
abandoned for a period of 180 days any time Filter work has
commenced It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved
Permittee Signature
Issued B- "- " _11:11:tr N G N- 6 3 --,,fUJ,5
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWEP PEAMJ:T
CITY Off' T167A RE) CM�Y440FMWRD Pr--�PMIIT NO . : SEC3131823
COMMUNITY DEVELOPMENT DEPAHTMENT ORIGIN! DATE-;. :ESSUED 9/26/B8
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Omgon97223,(503)639-4175 PP IM. PMT.NO. eel,133
JOR ADDPE"55 : 9720 SW LONDON USA NUMBER: 03 6A 3
TAX MAF'/L.O*T 11,51 1,55C.0 6-500 FAJD : I.-OND(.')N GGIUANk: LT: 17 OK ::
I.-AND USE: 1:425FI10
LOT slzr :
SEC TXON: 35 J'JAJ(.) : :1.JJJ PNG' : 1.w
)OAK CLAS"a : NEW
USE 'T'YPL-* : SiNU E F"AMJ.*L.Y
file akpil):11A.Ullint iligir'Weill tQ UUMPly WJ-th ft'll. l"k.11coss atrid 1"UQU.14atitintiri rii-V than Lliii-r*I.e(.1
�iewer-age Agenr-,y . *rho pei-mit v#xpj.reqj 1.t2() (ijaym fr-ain the date isint.ted . T,I I e t n It.MA,
i-ILIVICILIll't. J;)il1:LcI Will 131ve liovi-cl i-P Lhia, per-mit (lines I I t.)1, J;J 1.1 41L r,
lasitee t1l'ie., (j4' than loc,:ation of the 'flicIL, inewer, latvir,*As , I , the i5ewev, :i.%
not luc:wtad at the mem%ii.ii,emerit given , than J.1-11fil-K]JAMI" WhiiLT]. 3 foot in
00.3. dir-ections fl-olh thir? cliffit'sinee given . 1-11 not loo 1oV4&t4V'?(1 ' 0-14P tri mir'MAJ01" filhala.l. l
pi l'01PAW(W ilk ml-10 S:I.cle tiewor", pir:�v.lrllt lancl the Ageney will
INSTAL.I.— TYPE : I MPE-RV11JUS A14F.A:
FIXTUPE UNITI-i
..:NAN'T' XMPROVEMr--':N'T* :
0 W E'll LANG'o UNIT : I.
NO. OF 11.31-DO45 . I.
NAT T.(-.)NW 1.DE: FAlISIANCIAL. %E"V PERMIT
W 11135 100
N PO BOX 5,1337 CONNECTION GHAPGE. $1. 100 . 00
E
POR1 LAND OR "07per.4 LINF-. TAP TN514'41-11.—
PHONE (;503) 3RJ----6'.5993
OTHER
C
0 HPADY PAUL
N
T BP lNG .
R 1.91.Y9(3 MUL.A-11A.-A AVL-:'
A
C ci r et 41 u i 1 i t Y
T PI-K.)NE (503) 6,110 069a
0
R PE11'alSTRATTIMIN NO. 15PA'76 TOTAL $1, 00
This permit is Issued subject to the regulations contained in Title 14 •
PECEIPT NO.
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It is hereby 1:41EQUIPED INSPECTIONS
agreed that the work will be done In accordance with the plans and ROUGH—I N
specifications and in compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shelf have current city
business tax permits. This perrihit will expire and become null and
void if work is not started within 180 days,or if work Is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
'00F
Pe r m I tteSignature
Issued By ry
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED Af "If
CM(OFTIFARD ,� �� U �)PLAN CHECK APPLICATION
COMMUNn DEVELOPMENT DEPARTMENT (01 TIGARD PLAN CHECK # 2
13125 SW Hall Blvd. P.O.Bnr: ,7 OR[aON �� RERMIT # 7 3
.aroo�, (5W)6394175 A DhTE ISSUEfI
JOB ADDRESS: `]'J��; S W I_o•v�� �-], TAX MAP/LOT
SUB: LOT: LAND USE:
OWNER
VALUATION: ,� =� c• C
- -
SPECIAL NOTES
NAME: N w,,(k_. 1;,U, 6C-5 REISSUE OF: G I �i
ADDRESS: I.( '36 5337 i-{�,c
--- '� . _ ^ LAST REISSUE:
.� -- FLOOD PLAIN/
PHONE: 3 3 - wsy•7- _ SENSITIVE LAND:
'JUrr. 5 lor�no , 1] T
CONTRACTOR APPROVALS R_ EQUIPED
NAME: PLANNING:
r�j I:� 1,,,, ENGINEERING:
ADDRESS: 3,1 r r --
a L:? _ FIRE DEPT
OTHER: _
PHONE: Soho ITEMS REQUIRED
ARCH/ENGINEER LIST/SUBCONTRACTORS:
NAME:
BUS TAX:
CALCULATIONS:
ADDRESS: TRUSS DETAILS:
--" PARKING PLAN:
-- PLAN - —
PNONE: LANDSCAPE .�.
_
OTHER:
COMMENTS: �/; .( L-la t�ru ( (���.,u
PERMIT # ACCT it DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees y
10-431 00 Plumbing Permit Fees
Z. 10-431 01 Mechanical Permit Fee3
10-230 01 State Building Tax (5%) )=-
Building --
Plumbing S,s o
Mech _ / ?L::_
10-433 00 Plans Check Fee
Building el0,�.`,
Plumbing
Mech
z 30--202 00 Sewer Connection
30-444 00 Sewer Inspection o c• — -- -�� ��'_
51-448 00 Street System Dev Charge ,DC) 3�-
52-449 01 Parks I System Dev Charge (PP.;) -2 SZ
52-449 02 Parks I1 System Dev Charge (PDC) — ` -
31-150 00 Storm Drainage Syst Dev Chry (SSDC) Z_fU —`
1G-_-230 09 TRFD � -5 u
10-230 06 Washington County Fire #1 (95X)
10-220 00 Al„art/WedgewoodTOT -_ - -
- RF_CA# 77-7—
AP tM
-7-APPt'i W 8 �CNATU --
J
Received By: _ /.�r Date Received: /J �
ht/3587P/18P —�'��
BUILDING PERMIT APPLICATION TIGARD OATF 19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INUICATEO BUILDER PHONEsJ
OR kS SHOWN AND APPROVED IN THE ACCOIAPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
COINER JOB ADDRESS i r
7t16 2-. ARCHI TELT
. n C- I ENGINEER (_
BUILDER (� "j 1� AOORESS1/4,0 /�• Z OESIGNEP
STRUCTURE �NF1N O RE140DEL O AOOITION ❑ RE AIR O RENEWAL ❑ FIRE DAMAGE ❑ OEtAOLI
`RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STORAGE 0 SLABO FE
()i UPANCY +..�LANO USE ZONt BLOC.TYPE FIRE ZONE PUN CHECK BY HEAT-
TX r•
M L
SEWER PERMIT it
OCC.LOAD `FLOOR LOAD HEIGHT NO,STORIES /Z AREA NO.BEDROOMS VALUE
BUILOING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
h"^h THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COVE.ZO
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED TkAT
I.rna^_Chec _ WORK WILL BI:DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPO
WITH ALL APPUCABLE CODES AND OROIMANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W
�SU�talal RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY SUSI
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUTA4IEIG AND HEATING.
Stats Tax •
Total G SOC--
POCO APPIJCAHT OR AGENT
By
Approved RttcwlDl No. ADDRESS hfONE
SOC
POC -
SEWER CONNECTION 8
SEWCR INSPECTION $
5EWER SURCHARGE S
(r n rrt m a D f t:
13
CGAAA Cir //X.2
� y2
s'97r 23 " --/ 3cP9�
2 vg- /,p r-
5i3�G
3 93j.1�
if(I i Id i rio Perm it No.
tovation _?7 p -Son
-W,
U�tv
Certification of Registration
With the Builders Board
doing business as (dba) ,
am registered under the provisions
of OR`_; Cha t 1 Oregon Hornebuilders Law) .
P
MY Builders Board Registration Number is
My registration is in full force and effect and expires on
nature /
r
BUILDING RECEIPT
NAME: Czz DATE:
ACCT. N DESCRIPTION AMOUNT
10-432 Building Permit Fees
10--431-600 Plumbing Permit Fees =
10-431-601 Mechanical Permit Fees f —`
10-230-501 State Building Tax f
10-433 Pians Check Fee
30--443 Sewer Connection (20X)
30-202 Sewer Connection (80X) $
30-444 Sewer Inspection
51-448 Street System Dew. Charge (SOC)
52-449-610 Parks I System Dew. Charge (PDC)
52-449-620 Parks II System Dow. Charge (PDC) s
31-450 Storm Drainage System Dew. Chrg (SSDC) $ cin Cl• �d
10--230-505 TRFD (95X) $
10-478 TRFD (5X) s
10-230-506 Washington County Fire N1 (95X) s
10-478 Washington County Fire M1 (5X) s _
10-220 Amart/Wedgewood =
TOTA.:
(bsi1214P)
BUILDING PERMIT APPLICATION TIGARD DATE19 5394
1 - r
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER.PHONE 6134-2761
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT NO. --a----- -----
OWNER century c!_ ------.JOBADDRESS 9720 S14 London Ct.
Tualatin 97(}62 ARCHITECT
ENGINEER
BUILDER Sam ADDRESS 1160 SW Hatelfarn Rd. DESIGNER
STRUCTURE (g NEW I i REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL D FIRE DAMAGE DEMOLITION
C RESIDENCE ❑ COMM O EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE l-1 SLAB f_.1 FENCE
OCCUPANCY --E—L— LAND USE ZONE'_ k-12 BLDG.TYPE s 5N FIRE ZONE �L PLAN CHECK BY --!�R`HEAT_ ---
--- Construct single family dwelling w/attahead garRge. — — -�
2 ftdrtsom 2 Bathroom
SEWERPERMITk 28435 Garage 242
OCC.LOAD FLOOR LOAD _4U HEIGHT 22 NO.STORIES ' _ AREA 1300 NO.BEDROOMS 2 VALUE 39,5UU•
BUILDING DEPARTMENT-- SET BACKS FRONT 10 REAR 10 LEFT SIDE S RIGHT SIDE IU
Permit 238.U() THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check b4.7U WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPAIAU�
State Tax 9.5 2 r I IYRMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
a _ SDC— $50U.00
Total
By cz
PDCRI 4 15G.UU APPLICANT OR AGENT
_ _ _
Receipt No.
Approved BC1t ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING
OATC
Permit No.
Rough-in
Fixture
Finsf
HEATING
Contractor
Permit No.
Gas or Oil
Rminh In
Final
SEWER
Final
DRIVEWAY
Final
Storm Dralr4ge
fRair Drain)Fir.El
SIdoweik
Curb&Street Final
Aaproaoh
13LOG DEPT. FINAL --TEMPORARY -CERTIFICATE OCEL_iiAj�`CY
CERT IMCATE OCCUPANCY Final
r
, Landscaping
Zoning Final