9625 SW BRENTWOOD PLACE MALOOM
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C.'ITY OF TICx.���D 1�ft-
k OREGON
' T.D.C.
Owner:................... Permit Nn. . 13.86.... .....
Building Address........9625 SW.. Brentwood..P.1......Lo,t..#522............... ......
. Certificate is hereby given this....30..... play of....December. .....,, 19...77..,
that said building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard, "
I as approved by the Tigard City Council.
Auildinq Inspector 4k
� (4,G u
Address �S1��5 /r,.4,</u�c�� Permit No. / b
Permit charge 22077_
Owner �a C� Connection fee IS JS
Paid by 6j L�
Type of building Atj . Date connected
Service rate �S�C� Inspection foe r5— ;Le
Contractor Paid by date _
Size of connection _ Assessment Paid
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BUILDING PERMIT APPLICATION �orY TQC AR® DATE A—�-77
THF UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE--_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.T.—
:iUZ J SW LirEin�Ll%1G1u i I.
OWNER JOB ADDRESS _ HOME.ADDRESS
-- ARCHITECT
TII ENGINEER
BUILDER ADDRESS_ DESIGNERSTRUCTURE Q6EW ❑REMODEL CApOITION ❑REPAIR��tt ❑RENEWAL ❑FIRE DAMAGE [:]DEMOLITION
QItESiDENCE ❑COMM [:]EDUCATIONAL ❑GOV'T ❑RELIGIOUSQPATIO []CAR PORT GGARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE nL`ESIGf;REVIEW EICOUNCIL APPROVED CISIGNS
311lI
OCCUPANCY_____L,AND USE 70NE- --BLDG.TYPE )'. FIP.E ZONE "q PLAN CHECK BY____ __u� HEA1_„-___�
Lut p,� ., YySiG�ull-- Attachpd frnm& _L.jt:ll.u►4 AJ/A a _t';.c
bedroom Z Oath -- _ -•
f..
OCC,QA[)___-. ____fL QB L4A2__ _ HEIGHT_ _, NO SnRIES --mEA 340 No.uDROOMs_�yAl -,,.-1 a
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 227*00 -- - - ------
THIS PERMIT IS ISSUED SU13JECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 63.9n REGULATIONS AND ALL 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 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 Co TY BUSINESS
State Tax Ei.• LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Total 196*Z7
By .w.=�._ —_ APPLICANT OR AGENT _
Appfovet I Receipt No t/
UArE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
C s ��� _ Permit No. " -
lt� Rou h in
Ir(� Fixture
�t 2A1 �.�f5� PJB Final
HEATING
Contractor
'' LCy++•� t� t� t/ -ec Permit No.
Gas or Oil
Rough-in — —
Final
SEWER
------ -_ - __ — Final
DRIVEWAY
Final
Storm Drainage
— rFinal
Drain) Final
alk
d Street Final
oach_
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY caping
g Final
SEWER PERMIT
Nu 1.2120
a
Unified Sewerage Agency
of Washinglon County CITY OF-_-Ti3 rd _ _ _ DATE 4-T-77—
OWNER 539--3.101
O lV FJ F R ' S ADDRESS:
TYPE Of' INSTALLATION:
[-�]BUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCYs
LJNFW Ll SINGLE FAMILY Ll COMMERCIAL
[..]FXIST . (PRIOR TO 7-1 -70 ) El MUL.'T . RES. INDUSTRIAL
FIXTURE UNITS____. DWELLING UNITS ��_____.__�
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 ) n�YS. THE AMOUNT PAID WII_I_
BE FORFEITED SHOULD EXPIRATION OCCUR.
F E E S s
PERMIT FEE t 25.
_ONNECTION CHARGE 575• _r / �
SIDE SEWER INSTALLATION
I _,SJEb BY
OTHER
T O T A 1,
APPLICANT DATE
SEWER PF.HIN1111T NV
ADDRESS OF
T A X MAP _ TA X L OT ._ .___..._ _. ._ S Y ST E M F a n P_Q_r
L O T E-2 2 +___�_ BLOCK ______-w._ _._... O F— •-.-_.._.._ __/_'� _ _-- __ _ ____.
APPROVED BY CATE ISSUEDIBY DATE
REMARKS Bldg. P1386