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9565 SW BRENTWOOD PLACE;
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City= of Tigard Ailechanlcal Permit NO..
New Installation LJ Replace 0 Relocation E] Addition LLJ Alteration 0 DATE:
1 11
HEATING '► -"
CONTRACTOR��t ��w(ye1� ii .►�_w �_ OWNER_ �l '1�_ T�
ADDRESS �� �x � ��S— J09 ADDRESS
PHONE APPLICANT _--
Heat Input RatinglBTU per Hour) Ve:c Sha FlueSize -
FUEL OIL CJ GAS [] ELECT Qt ' OTHER w �' —�� --
ITEM NO. FEE ITEM NO. FIEF
Fyr Issuance of Permit SEE BELOW V�hi Handing Unit or Duct�stem 7
Now-up to & ind. 100.000 BTU 6.00 ial Hood System ___ T•�
New 100 A' BUT's 6 ov 7.60 Wj rrnant - Each x.60
Woodburnin ;stove 4.30spectian �_ __ __ �•�
Well-Flow- Suspended 6.00 Air Condition-Compreasof - up to&in 3 H.P. 6.00
','ant Smoot,wo n 4.50 Air(:ondition t"om�ssor 3.1 to 15.H.P.Ind. 11.00
Repair .Heat Cooling _ 6.00 --
CITY-BUSINESS LICENSE PEQUI RED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 --------
FEES
-- T
OTAL
ieaued By
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CPU
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CITY OF TIGARD
OREGON
mss.
Owner:......7..!?.,C.,.—............... ......... .. ................Permit No.....14.01...........
Building Address.........9.5.6.5..SW.. ...Lp.t...#52.7....................
'
Certificate is hereby given this..... ........day of Ia.al:.amhar.........., 19..7.7..
that said building may be occupied and q
that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council. 1
F'.
t
Building lnspe:;or
F'L
ADDRF SS ���(05` ��! PERMIT NO._ 1.21.3 D _----
PERMIT CHARGE ncne
OIJNFR C CONNECTION FEE 157;j
PAID BY
TYPE OF BUILDING ZZA.-I DATE CONNECTED
SERVICE RATE INSPECTION FEE ,:lS�°
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
9/> /T
—4�
ci BUILDING PERMIT APPLICATION SOF TIGARD DAZE. �-4A=j 7 -., ,s � ��►
THE UNDERSIGNED HEREBY APPLIES FOR APE IMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN T 'E 1r.CGJIPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
t LO-r NO.-
OWNER T � �C� JOB ADDRE>S 'J67 aW brentuood' illWOME ADDRESS
ARCHITECT
ENGINEER
BUILDER �I�-.-. 'I_ ADDRESS DESIGNER ____
STRUCTURE ONEW _D REMODEL ❑AUDITION _ ❑REPAIR _ ❑_RENEWAL _DF IRE DAMAGE ❑DEMOLITION
URESIDENCE ®COMM DEDUCATIONAL DGOV'T 0RELIGIOUS DPATIO ❑CAH PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
CI13OND ❑MOVING__ DCONDIT'IONAL USE ❑DESIGN REVIEW A DCOUNCIL APPROVED ❑SIGNS
Ql_CUPANCY-1_-._LAND USE ZONE BLDG.TYPE T FIRE ZONE.___ PLAN CHECK BY__ :— HEAT
L J. _ _�>7 i'1 int t,� .: I.-�i r �.. • ._-.__ _-_ �_ .(l2'7`_, :.L, J;;Lwanir—:a f Twrt_
,t..att nc�i PTI�Ir1E� tlt.►81 3.�nc. s :.: .1 c 8�reg� 2 bedroom 2 bath
1 1266 — <l 17„IM7.
N2 LQRIF,S.. . �H A—_ NO,.B�JZH44M5 VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 1laI7C1 ---__
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10.lip REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- a"— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICARLF CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
– RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 3-93 IACENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total I 4,9-1
By
------- ------ - --- - _...-— ------ -
-- APF'LICAN7 pR AGENT
Approved ILI Receipt No.
ss
DATE INSP, TYPE INS°ECTION _ REMARKS PLUMBING DATE
> - Contractor
C'' �, a
Perm t No.
' Rau h nt
-ZL 17 �7 Lj Fixture —• -
rl�
-25--"►'1 $13 .l�L"{'� ____.�_.��__ ___ — HEATING
1 Contractor _
r _..� _ Permit No.
Gas or Oil
Rough-in _
Final
SEWER
Ftn_al
DRIVEWAY
final
—� Storm Drainage _
(Rain Drain) Final _
Sidewalk
Curb 6 Street Final
rinoachBLDG DEPT FINAL TEMPORARY CERTIFICATF OCCUPANCYCERTIFICATE OCCUPANCYscaping
ng Final
�. SEWER PERMIT
N 12130
Unified Sewerage Agency
of Washington Courty CITY OF _g3 � DATE 4--14-77
OWNER: T.Q.C. PHONE :
OWNLR 'S ADDRESS:
TYPE OF INSTALLATION:
[XIBUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑X NEW ❑X SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO 7- ] -70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
PERMIT 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 FEF g 25.
CONNECTION CHARGE _ 575.
SIDE SEWER INSTALLATION DA
L,
-u ISSUED BY
OTHER
TOTAL : 1100.
r�l• �. .�e`L.-I-II- .—
'A PLICANT DATE
SEWER PERMIT N V 12130
ADDRESS OF STRUCTURE _ 9565 S!J Brentwood P1.
TAX MAP TAX LOT _ SYSTEMFanno Creek
LOT 527 BLOCK OF
APPROVED BY DATE_ ISSUED BY DATE
REMARKS _ Al dT. #1 4[]1