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± � ...... J,.�.,...�1.9.................. .. . ....... . .. .............Permit No....1369.......... o'
`. . Building Address,11205 5W Boxwood Ct.
Certificate is hereby given this........??....clay of.pugust 77 '
L" ...., 19......... t
that said building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
DZ
Building Inspector
it
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7ddreGs Cf_ Permit No. 1;2 IL-1
Permit charge
t u n e r ��' .�_. .,
Conner+.ion fee .. _ww s
i P a i d b y .�r�--•,tit
Type of building ,/&,:, Date connected
Service rate Inspection fee " +
Contractor Paid by date
Size of connection _ Assessment Paid
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City o Tigard
INSPECTION REQUEST �
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------------
.f18PECTION TIME: PERMIT N0. :
DAT E .' .
DATE ISSUED .__-L-L_ i
WNERS NAME .' y I
ADDRESS: /Zo2 C�
J N rp 4 C TOR .
- I
E ST . Air [J, Water Ej , Visual ❑ , l.abn,otory p
,ESULT: Approved Disapproved U Pendin j
SKETCH.
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I
I Plr'CTOR DATE
NOTE: Artoch jupplomr. -: � r1 •., hereto]
i
BUILDING PERMIT APPLICATION 10 Y TIGARD DATE "-h 13
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. GINNrRPHC+ JE�� _
rr
LOT NO.____
OWNER i r�..1. � C 10 onst.JOB ADDRESS �•1 4: 7W GlaxwQ4(,' HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ��--++ ADDRErrS--1S ---DESIGNER
STRUCTURE UNEW ❑REMODEL E.JADDITION ❑REPAIR ❑REN_E_WA1. ❑FIRE DAMAGE ^^ UDEMULITif N
RESIDENCE ❑COMM EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORA.GEL.JSLAB ❑FENCE
❑BOND ❑MOV ING []CONDITIONAL USE ❑DESIGN REVIEW— []COUNCIL APPROVED []SIGNS
OCCUPANCY LAND USE ZONE _-.BLDG.TYPE FIRE ZONE. PLAN CHECK BY..—_..-._ HEAT
fare, y d1jelling w/bei. gerayo _`--.--
7213 iiaaament 733 —.---- —
9_G".QA_QFLOQB LOAD EH IGHT RQ -NO,$TQFIIE- < ARE-P 3:a3 NN-Q,-UDF404MS____---YALUE J7 r 0C-0!
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 52 LEFT SIDE RIGHT SIDE
Permit x 4FJ.nL,
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE t'UILOING CODE, ZONING
Plan Check tCI.Lin REGULATIONS AND ALL- APPLICABLE CODES ANC ORDINANCES, AND IT IS HEPEBY AGREED THAT HE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AVD INCOMPLIANCE WITH
Subtotal ALL APPLICABLE CURES AND ORDINANCES. THE ISSUANCE OF THIS PEFIMI'T DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax a 66 LICENSE, SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total t:e'�.66
By -- - --- -- --
APPLICANT OR AGENT
Approved 1 SLA Receipt No -- -�---
_�
i
EmELML---.AL
DATE INSP. TYPE INSPECTION REMARKS PLUMBING, DATE
zContractor
Permit N o. I Wi/I 7T
Rough-in
Fixture
v ri
12)1--7 12L Final
s "'''1HEATING
4 4 L 0 Contractor
Permit No.
Gas or Oil
in
Final
SEWER
Final DRIVEWAY
sinal
Storin Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
toning Final
SEWER PERMIT 37S,/l,
J�jl ) K ,
Unified Sewerage Agency CITY OF Tigard DATE 3_30-77
of Washington County ----- 3--30--77—
OWNER : J.L. Lht PHONE : 6398560
OWNER ' S ADDRESS: __TYPE OF INSTALLATION:
EBUILDING SEWER ❑9UILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
k]NEW k�j SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7-- 1--10 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE_ UNITS DWELLING UNITS _j__...—.
PFRMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE--HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR .
FEES:
PERMIT FEE _ .._—�5•
CONNECTION CHARGE _ 575- —.
SIDE SEWER INSTALLATION —
I
OTHER
TOTAL E finn._
APPLICANT -- TDATE
SEWER PERMIT N° 12108
A D D R L S S OF S T R U C T U R E ____-_112II5 Sly'-H ax-UD d__Gt,-- ---
TAX MAP_. TAX LOT SYSTEM Fenno -Cimeh-
L 0 F — 178 --- BLOCK -
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APPROVED BY DATE ISSUED Y DATE
REMARKS Bldg #1369___ �_