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BUILDING PERMIT APPLICATION MOF
TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13U I LDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
`
LOT NO. __Y _--
OWNER '..L� (�Ufl?31 9iil) JOB ADDRESS .11'060 SU Lot.ti{3� uou(JI C14weADDRESS
ARCHITECT
�0VYIS-, ENGINEER
BUIL.UER _—_�— ADDRESS DESIGNER _—
S_1PUCTURE _ ONEW rr++0 REMODEL AUDIT ION ❑REPAIR_ ❑RFNEWAL ❑FIFEDAMAGE ❑_DEMOLITION
RESIDENCE ❑COMM IJEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑JARAGE U510RAGF❑—SLP,B ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL. USE ❑DESIGN REVIEW ❑COUNCIL APPROVER ' ,SIGNS
OCCI!PANCY_..__.__LAND USE ZONE__. BLDG. 1r PE FIRE ZONE__ PLAN CHECK BY
''At 8XI2 eturnyruished un :t1r clot blocks Lwatud per pirind
_.__-HEIGHT NO.si'291 �. AREA —N_4_J��D�4_4.�1z----SA1.UL�_ �)l�•
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
THIS PERMIT IS ISSUED S', :iECT TO THE REGULATIONS CONTAINED IN THE BUILDINS CODE, ZONING
Plan Check REGULAI IONS AND ALI. 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 W'iH
Sdb-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSIP.ESS
State Tax •20 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total •10
By __ -- -- - --------
APP`NT OR AGENT
Approved Receipt No. I
ADUR FF— 4ONE --
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DATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
Contractor
Permit No.
17 Rough-in
Fixture
Final
HEATING
Contractor
Permit No,
G-,,or Oil
-Rough
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidev.alk
Curb 1 Street Final
A2E2-8c-h
BLDG DEPT FINAL
TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
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CITY OF TIGARD �c
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OREGON
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Ow-ner:.. ........Bo.b...Sm.ith ................. .Permit No. 1.309
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Building Address .......... 11060 _SW._.Co.tto_nW...... -t an.e-.--.... t.�
....
Certificate is hereby given�>ven this........?. .aday of......MsY ..... ...... .... . 19 ._7.7
that said building may be occupied and I t
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4 that it complies with all requirements of
? r the Building Code for the City of Tigard,
as approved by the Tigard City Council.'
n
Building inspector E
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City of Tigard
INSPECTION REQUEST �
for
INSPECTION TIME./'Z- c+ PERMIT NO. :. _
DATE: j L-101-77- DATE ISSUED .._._L1._.
OWNERS NAME : _
ADDRESS 7c71 u
CONTRACTOR ' ..._ ►"If-49-.?�'
*EST .'Air Q, Water r] , visual/ Labnratory D
RESULT: Approved , disapproved C , Pending []
uSKETCH.' PG+J � PP01L Tl /�ege-77;7
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INSPECTOR DATE
50TE: Attach supplemental test data beret]
City of Tigard
INSPECTION REQU'E T
for
INSPECTION TIME: -.Om PERMIT NO. :
DATE: /10 y DATE ISSUED . I
OWNERS NAME : S N^k
ADDRESS: 0 o Sao _
CONTRACTOR :
TE ST : Air p, Water p Visual p , Laboratory p
RESULT: Approved F Disapproved C Pending p
KETCH:
I PECTOR DATE
ENOTE: Attach supplemental taft dota 6e►eta,
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ICTION
of Tigard
, i
INSP REQUEST
for
INSPECTION TIME: Q PERMIT
DATE: DATE ISSUED .- Z Z "
OWNERS NAME .'
ADDRESS' t/Dc�g e'
t.'0N TRACTOR : --__- —_—__
`E ST . Air 17-1, Water O ,, Visual p , Laboratory C
R'E'SULT: Approved Ute, niaapproved C Pending p i
SKETCH,
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I
INSPECTOR DATE
COtt: Attoch supplemental test doto beret a]
UNIFIED SEWERAGE AGENCY NO. 11660
WASHINGTON COUNTY DATE _ 2-17-77
CITY OF----IiQarid --
APPLICATION FOR SEWER CONNECTION PERMiT
OWN cR: ____._—_ Bob Smithy
OWNER'S ADDRESS: ------ - - - -_.------ --------_ ------ - --
STREE-
---- ---�v.- -_
CITY STATE 21P
BUILDING SITE: LOT-_ .--- BLOCKADDITION
TAX LOT N0. TYPE OF OCCUPANCY .---...
ADDRESS .
DWELLING UNITS_-__ FIXTURE UNITS
SURCHARGE IF APPLICABLE -
575.
PPLICABLE — - --------- - -- - - -- -------. -- -- —
575. 600.
PERMIT FEE INSPECTION FEE _._25'._ TOTAL DEPOSITED —
Fanno Creek
(NEW) (EXISTING) BUILDING SEWER SYSTEM _-_ . .......
The Applicant agrees to comply with all r;$;
ions of the Unified Sewerage Agency.
APPLIC - - --- - --- ---
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINF S17F
RECEIVED
t. 1AGENCY O TS AGENTI
COMMENTS: - Bldg. #1309 -
This Application and permit expires in one hundred and twenty (120) days,
The amount paid will be forfeited should expiration occur.
BUILDING PERMIT APPLICATION 11T TIGARD DATE 2-17-77 +- flog
OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERr1HONE_
LOT No._. _
OWNER U;VJ✓ J)iaith JOA ADDRESS 11060 `a',i cot tcnwOOdHOME ADDRESS
wars ARCHITECT
BUILDERADDRESS ENGINEER
��+yy ^� DESIGNER
�STRUCTURE UNEW — ❑REMODEL ____ ❑ADDITION ❑REPAIR ❑_RENEWAL� ❑FIRE DAMAGE ❑DEMOLITION
LJ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RE' iGIOUS❑PATIO ❑LARPOP,T ❑GARAGE ❑STORAGE❑SLA.B ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPIIOVED ❑SIGNS
OCCUPANCY I LAND USE 20NE —BCUG.TYPE —FIRE ZONE_ - PLAN CHECK BV IIEAT
const. 84,11910 family dwelling w/attachcid gore%, • — -- -
gerege 504 sq. Pt. a bedzoam 2 both -— -- - -------
OCC, L9-A-L?__ FLOOR LOAJ��T 41-1 SIGHT ZCJ_ . NQ STOI�I $I AREA 1,17�-NO.BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS t-RONT REAR LEFT SIDE RIGHT SIDE
Permit r 136.J0 —THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS 0ONTAINED IN THE BUILDING CODE, ZONING
Plan Check 6 .00 REGULATIONS AND ALL APPLJCARLE CODES ANO ORDINANCES, AND I' IS HENEBY AGREED THAT THE
— WORK WILL Bi DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICAT IONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUAN^E OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRAL,TORS TO HAVE CURRENT CITY BUSINESS
State Tax 5.12 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Total
By
--- - — -- -
'T'---- APPS IC ANT (7R ACE.NT��---�--- -
Approved -- Receipt No.
�r�w�
DATE MSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
7 Permit No,
-7�1
.2
Rough in
Fixture
J
*hell
LIZ2 /� 11" �, & I J� )U.J :ogjj-64 Final
HEATING
Contractor
-7 Permit No.
4��
ft 1
Vas or Oil
R ough i n
Final
SEWER
DRIVEWAY
Final
Storm
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Fin
i
Enandscaping
Zoning Final
1
i
30 1�
%ddres //��,0 �,X ,,,L&-,o,, Permit No.
Permit charge
Tuner ����„ ,�,( Connection fee ,I �-�
' Paid by
-------
type of building w Date connected
service rete Inspection fee =`
ontrector Paid by Date _
ize of connection Assessment
paid
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