9430 SW BRENTWOOD PLACE-1 1
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9410 SW BREN`PWOOD PLACE
OF
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CITY OF 7 IGARU
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T.D.C.
Owner:... I .........1280..... �: f
• ...........
....••Pe Permit No . -
9430 SW Brentwood P1 ` }
Budding Address............................................... . . . Lot...#494......... ........
Certificate is hereby given this.....24........day of.....APW4Pt....... ...... 19....77..
that said building may be occupied and
is that it complies with all requirements of # '�
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
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Building Inspector
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ADDRESS 2ti/��' ,�.r<vrc,� LP� _ PERMIT NO.�_�'j';� 3�/
PERMIT CHARGE n2na
OWNER _ _or '�_' c' _ CONNECTION FEE
PAID BY
TYPE OF `BUJING DATE CONNECTED
SERIIICE RATE INSPECTION FEE
CONTRACTOR PAID BY DATE _
SIZE OF CONNECTION ASSESSMENT PAID
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1
BUILDING PERMIT APPLICATION " TIGARD DATE— ?-2-77 tsOF
_ ~
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS -OWNER PHONE_:_
T.O.L 430 8Y't111twflod Dl,, LOT NO. _
OWNER _ JOB ADDRESS HOME ADDRESS
;.1 Me ARCHITECT
ENGINEER
BUILDER r- ADDRESS --11 ❑
DESIGNER
UD
STRUCTRE rrC�INEW REMODELO
_A DADDITION REPAIR ❑RENEWAL FIRE DAMAGE `,DEMOLITION
RESIDENCE 000MM DLDUCATIONAL DGOV'; DRELIGIOUS❑PATIO GCAR PORT ❑GARAGE ❑STORAGE OSLAB GIFENCE
QBOND DMOVING ❑CONDITION,AL USE DDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
UCCU"aN Y AND US ZONE . . BLDG.TYPE_ FIRE ONE 7�!PhAN�CPECK BY_ HEAT_._,. _ I
9 lQ��_ FLOOR LOAb_� _ 1 1708 2 V x 947..
AF3EA NO #E._DN44M$.__l VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Perm It --t 2 1 Ill U
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THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINFD IN THE BUILDING CODE, ZONING
Pian Check ` REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HF.RE.BY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 171.97� LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING.
Total
By _
-- '�-- - Aa ;ANT OR AO_NT
Approved , Receipt No —�
THON��
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DATE INSP. TYPE INSPECTION
REMARKS PLUMBING
CATE
C
Permit No.
Rouyh in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil 74- 77
Rough-m —
Final
SEWER
Final -
DM E WA Y
Storm Drain
(Rain Drain) Final
Sidewalk
Curb&Street Final
BLDG DEPT FINAL TEMPORARYA roach
URTIFICATE OCCUPANCY CE Final
Landscaning
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UNIFIED SEWERAGE AGENCY NO. _ 11634 - _
WASHING FON COUNTY DATE 7-2-7'( _- - - - —
CITY OF___ Tiy_�rd� _
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: . T . D. C .
OWNER'S ADDP,ESS: ---- - -
STREET
CITY - - STATE ZIP
BUILDING SITE: LOT_ 434 - _ BLOCK ADDITION
TAX LOT NO. -_ TYPE OF OCCUPANCY
ADDRESS 4430-3L1 Hr_gn_tLoad__P.19 -__- _ ----------_
DWELLING UNITS 1_ _ FIXTURE UNITS _
SURCHARGE IF APPLICABLE __---- ------- - -- - ---- _
PERMIT FEE .._575. --- INSPECTION FEE _25' TOTAL DEPOSITED 600.
(NEW) (EXISTING) BUILDING SEWER SYSTEM _-_T".a,nrun__�r-ask__-_-__ -- —
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT�� �c=`� ✓ -
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE INSTALLER
RECEIVED BY
i (AGENCY OR I7S AGE
COMMENTS- Bldg. #1.280
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.