Permit I gne -&4,
'LDING PERMIT APPLICATION TIGARD DATE _ 19 5518
- �- THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 221 -0020
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 224 -2355
OWNER ST JOB ADDRESS 16640 SW 72nd Ave. /f / jT NO. AD
• 111 SW 5th Ave. 2969 ARCHITEC 7
E
BUILDER U.L. Green ADDRESS Portland, Or 91206 DESIGNER 'tliCkenai+f/Saito & AeBOC•
STRUCTURE ❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE O COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY - LAND USE ZONE L . BLDG. TYPE FIRE ZONE PLAN CHECK BY Erd HEAT .
-t' odificati es all per approved plaits and Code.
:es permit 4176 - 1- 14-85
SEWER PERMIT# none required {'freneid plumbiss permit required
OCC. LOAD FLOOR LOAD 40 HEIGHT 30+— NO.STORIES + AREA 27 NO. BEDROOMS VALUE 75.000
BUILDING DEPARTMENT SET BACKS FRONT fee . P$ R LEFT SIDE RIGHT SIDE
Permit 358 +00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
TRIM 143.20 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
CITY , 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
State Tax
1i�32 LICENSE SEPARATE PERMITS REQUIRED FOR SE ER, PLUMBING AND HEATING.
Total 70.22 SDC —
f
PDC# A 7 • - G=
By jj
Receipt No.
Approved �� trillii5 1 I ' �t + PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No. = ;�
Rough -i
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough -in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb & Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
CITY OF TJGARD >l
/ bng Per 5
Q } V( 1 K Z 7 L
�
Residential El Commercia 1� ,„ ,
New Installation ED Replace ❑ Addition Ell Alteration ,� Date f �S/ '
I Licensed
Plumber Lie' 97i1 1..c.0"Peal P4't7 biAl4 Owner P_/Pc '7 Pc $7
Address .3 /i/ ,5 e /3 e-- / 'e771-ON.0 77& Job Address /66 V4 Sw 762 A./..,9
D F',A1J G.i,9.PA '4
Phone .�3 ; y/.5.2- Applicant ;4 6i4%c a -
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUB- CONTRACTORS r '
` ITEM NO. FEE TOTAL - -- ITEM - - ~ NO. FEE TOTAL
Q cry i !
Fixtures Traps 7.50 /S,SG Sewer: First 100 ft. Jo0 ' fe "/ 30.00 ..36`-t-
Dishwasher 7.50 Each Addit. 100 h. 301 -- V. ` / 15.00 /S
I Garbage Disposal 7.50 Ejector Pump 7.50
Water Heater _ L 7.50 15 ' Water: First 100 tt. _ 20 00 ;
- Backflow Preventer 7.50 Each Addit. 200 ft. 15.00 k o,
I Storm & Rain Drain: First 100 ft_ 30.00 _ +'
Each Addit. 200 h. 15.00 ! 1
Mobile Home Space 25.00 j '"
I Other (Specify): Rain Drain - Single Fam. Dwelling 15.00 ' ;'
I -- _— i
. PERMIT FEE T 5 e Comments: 7" /7 = /y9_Z! °��1._ EiPcfp�� C',y 6;<e_. _ ;
p Issued By: _ -I
STATE /{ % ��
Receipt No. ___________ - Applicant _ � - L' — — f
! TOTAL O' n ?---° c.., .......
-1_________-7
—n-
Tualatin Fire District Inspection Notice
841)5 S.W. Elligsen Road
Tualatin, Oregon 97062
Phone 682 -2,601
Building Name A/ Qjj ei (Add ress /a 7
Pursuant to Section(s) of adopted codes, the following item(s) require correcting:
6C-j
/ )(1. dk zAte
Llible go X 1/ ( - / SILL
T 4 , 'vim
n /
Date: 4- Inspector
CALL FOR REIN-SPEC ION
OR
BUILDING DEPT.
W tc,01 tt9 (3 ...... 7..s ....... / s i
BUILDING PERMIT APPLICATION TIGARD DATEJ-1(CK _i
19 4 6g "
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE •Q 0
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE f11.•'
L. OWNER 1'�! G71V` (((J ` .� LOT NO.
JOB ADDRESS �1� 7 �
4 W 5 ,d.*G Si/14•6 ENGNNEER tie
BUILDER L • 1 , . (e-+W • V ADDRESS -w d s,‘i ✓ - 11 . • DESIGNER 4
STRUCTURE ❑ NEW 0 REMODEL ❑ ADDITION ❑ REPAIR . ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOUTIO1
❑ RESIDENCE Q COMM ❑ EDUCATIONAL 0 GOVT ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENC
DCCJPANCY . I;�' `L LAND USE ZONE L -f BLDG. TYPE " • 1 7 ' ■N1 FIRE ZON `
E ' T""` PLAN CHECK BY > HEAT- `f -
•
SEWER PERMIT / 714 / ifae /ecz.c� Pe,-._.s>r ,
DCC. LOAD FLOOR LOAD Ll HEIGHTk f– NO. STORIES I AREAa'75OO NO. BEDROOMS • VALUE - FJ
BUILDING DEPARTMENT SET BACKS FRONT S eei ' --t . - !' LEFT SIDE RIGHT SIDE
Permit . &� O i — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONIN
� / REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT TY.
I lee ) ( �a WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COtAPUANC
WITH ALL APPUCABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
v
Su, ..4c - S 2 0 7 b ' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES
LICENSE_ SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING..
Stitt* Tax • / ' 2
� SDC–
Total
PDC* APPLICANT OR AGENT
BY ,
- . Receipt No. PrtONE
Approy ADDRESS .
'
DC — S
DC - S
1
EWER CONNECTION 5
EWER INSPECTION S
EWER SURCHARGE S
•
i
5 -0 c ;
•