BUP1978-2026 9880 SW PEMBROOK STREET
1
un
Y
O
O
N _
E
03
n.
U
c
a
0
c
SEWER PERMIT
N?
Unified Sewerage Agency •
of Washington County CITY OF �_�� �_..� DATE =���Q z
OWNER : 2 -ic/� j� PHONE :.,._.
OWNER ' S ADDRESS: C� C C� �'- L zt (�/i✓r� ��.�'✓� ti�-s �iu..�i� /960 /
TYPE OF INSTALLATION:
® BUILDING SEWER �] 6UILDING SEWER AND SIDE 5EW;R
TYPE OF OCCUPANCY:
NEW [ASINGLE FAMILY r] C0111MERCIAL
EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUS-TRIAL
FIXTURE UNITS DWELLING UNITS
ADDRESS OF STRUCTURE : � rU S ('fi/
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAG' AGENCY . WHEN CALLING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION EXPIRES IN ONE--
HUNDRED AND TWENTY ( 120 ) DAYS. THF AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR .
FEES :
PERMIT FEE
CONNECTION CHARGE
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL $ z)
APPLICANT DATE
SEINER PERMIT
ADDRESS OF STRUCTURE ��'� ,��C p �cuj N0
TAX MAP _ TAX LOT SYSTEM
LOT _`BLOCK ���� /C� , _ OF0.
/
-----m- - ____ �"//(/
APPROVED BY DATE �J SUED By DATE
D. U . ' S �� REMARKS a ✓Cc�c� �! C /--Ctzsy ,d•� � ✓ '
TIGAR® DATE 7
BUILDING PERMIT APPLICATION �OFY r'i.. - ,y
THE UNr)FRSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE--
OR
HONF —OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
1-0 7'NO.
OWN'BR F CAfik Ph1J)Di JOU ADOR_ESS A180 Gild Valphr Jok HOME ADDRESS
ARCHITECT
r'I ENGINEER
BUILDER' .clOre—f1iIii; r Lun*t.,. ADDRESSI.-' 7jj(3 Ciji DESIGNER
STRUCTURE ❑NEW ORFMODEL `4ENbDITION� Ll REPAIR ❑ L OF-IRE DAMAGE []DEMOLITION
.SIDENgE- ❑COMM ❑EDUCATIONAL ❑GOV_T ❑REL.IGIOUS(]PATIO ❑CG.11 PORT ❑GARAGI. ❑S70RAGE QSI_AB ❑FENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE _ ❑DESIGN REVIEW ❑COUNCIL APPROVED OSIGNS
OCCUPANCY._. --;JLAND USE 7.0NIE �"� BLDG. TYPE_. rsrN..__.•FIRE ZOINE L- PLAN CHECK BY _ 1-4L.—_ KAT--=_==
__'3t. addition 10A16 plus► OAlO Bieck X111 fuer pi,ara rated building cutis.
UCC. LOAD ___-- FI,I)pFl_j�QF�___-._�___HE1G"►�I__.____—_____ IVO,��ORIES-----�A_____N4_:1}1=L7R4_�1M;z� �
BUILDING DEPARTMENT VALUE_ ;.�y�
SET'BACKS FRONT REAR LEFTSIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUl3JECr TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check G 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 4t r)Ci ALL APPLICABI_F CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE. COVENANTS. CONTRACTOR AND SUB CONT9ACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE, SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 49*26
By
- - -- - �. -
— APPLICANT OR AGENT -
Approved —( W Receipt No.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING I DATE
�'/ f� � ,r Contractor
Permit No.
Rough-in `- - `----
P Fixture
-- -- -^- -- - Final
HEATING
Contractor
Permit No.
Gas or Oil
--- ------------
Rough-ir
-- --_- ---------- Final
SEWER
Final
DRIVEWAY
Final
Stonh Drainage
(Rain Drain)Final
Sidewalk
Curb&Strerrt Final
---------•— - -- - Approach
-
6L66-76-EFT.FINAL Tt:MPORARY CERTIFICAT'IP.OCCMANCY Final -
CERTIFICATE OCCUPANCY - --- -
Landscaping
Zoning Final l
S
►JILDING PERMIT APPLICATION `OFY fiIG,'!RD DATE__ 19 71- N2 A62�
ONO! 1`0. 1(.NED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER
C P.. AS SH;)Wk ANC APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICATIONS. OWNER
MPHONE _
_
�� HOME ADDF7ES � LOT NO___
JOBADDRESS7pph�ii0 � S
�
ARCHITECT
ENGINEER
ADDi?E SS Tj 6n r DESIGNER
FiE ❑tiEW--�uRtr+nDEL ADDITION ❑HLPAIRORENEWAL `[]FIRE DAMAGE []DEMOLITION
";)I NCF 0, inmm ❑E'DUCATIONAL QGOV'T ❑RF.UGIOUSOPAT10 1_1CAR PORT ❑GARAGE ❑STORAGEQSLAB ❑FENCE
�F"ND ❑MOVING -_❑CONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED ❑SIGNS
LAND USE ZONE _ gLDG TYPE 'FIRE ZONE PLAN CHECK BY HEAT
r ; y:AD _ FI QQR_443D.._�_.--__.l� ISL_r— -N�_SZQRIES---
f4 —G DEPARTMENT
p 1
SET BACKS FRONT 3(`) REAR 0 LFFT SIDE ZThbRIGHT SIDE t
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
"lar, Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
WORK VVILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND 1N COMPLIANCE WITH
uh ult8! ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
'aata4Tax / LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
7 - L9LL L L-P CcJI�ST
APPI ICANII OR AGE NT --
Avwoved ( ecelpt No
UlI F 55 HQN
I'� r '3L t