10255 SW GREENLEAF TERRACE C7
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10255 SW GREENLE;AF 'TERRACE
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ADDRESS DS ( ,� c P E R M I T
PCM11IT CPARGE nonce
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PAID BY
TYPE OF BIJII.DING tail, _ DATE CONNECTED
CRUICE RATE _ /5 ZL INSPECTION FEE
CONTRACTOR _ PAID BY W� DITE
5I7E OF COi; JECTION �__ ASSESSIIENT PAID
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C.l' I Y OF TICaARD ��C,
C.. a OREGON �< �
Owr.er:. ..... ...T.D.C. Permit No... ... . 1051 R2
Building Address........ 10255 SW Greenleaf...Terrace . Lot 259 ;
s `I Certificate is bereby given this.....20....._day of... .Ma.y-_................ lit . .77
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building
3 I that said ung may e occupied
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�. ' that it complies �cifh a;l requirements of
t the Building Code for the City of Tigard,
C ced by the Tigard City Council.ris a �ro
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>� ,.. Building Inspector ►+ C;y`
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JOHN E. REINHARDT PLUMBING, INC. BUILDING DEPAIiTML-NT, TIGARD
NMBERG, ;IREGON 91131 PLUMBING PERM111' _
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) Fours prior to the time the installations are ready for inspection, City of Tigard Busine,s License required
for all contractors and sub-contractors.
le
Owner
NUMBER
NUMBER OF ! TAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Single Family-1 both-each �_. 25.00
Duplex-Each 1 Wth unit - 25.00 _
Additional bethmims-each _ �� 10.00 ly U
Mobile Horne Spece-each _ __ 15.00
INDIVIDUAL FIXTURE FEES _ -•
1 to 50 Fixtures in 1 building-each 3.00 -
_ 51 to 100 Fixtures in 1 building-each ___ 2.50
101 to 200 Fixtures in 1 building---each _ 2.90__ _ ---
201 -)r more Fixtures in 1 building-each -- - 1.50
MISCELLANEOUS _ _ ----•
Building_Sewer-1st 50 ft, 10.00 _-
Sewar--eoch additional 100 ft. 10.00 _
Water Service to building v, i5.00 _
Private Water Systems-each 100 ft. __ _ 10.00
Other Speclf :
_PERMIT S ' CFor Plumbing Inspectrna Phone 6394191 :� �•
% Strte / -3 PluiTlbing Contractor By '
TOTAL J RECEIPT NO. Issues By
r
I Csty of Tigard
INSPECTION REQUEST ,
for
INSPECTION TIME : PERMIT NO. : --_—
I DATE: ` '_.i1 ' a. DATE ISSUED:—L1—
OWNERS NAME :
AD D R E 5 S : LL/ 2-C `
CONTRACTOR : �C �0;,l!f /0V:
TEST: Air CJ, water p , Visual 0 , Laboratory p
RESULT'. Approv.-O 91'", Disapproved 0 Pending U
I SKETCH:
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I SPECTOR DATE_
COTE Attach supplemental test d 04 hereta�
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1111111 ON 1 10, low 11"1 010-011 1 map
BUILDING PERMIT APPLICATION 1CI Y TIGARD DATE 971' 19 78 � 1 �
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THF WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFIC:ATIOrtS. OwN=RPHONE
LOT NO.--,--
I
O. __I WNER rIDIC, JOB ADDRESS 1U255 Stj Green.tluaf T HOME A[,DRESS
same -- ARCHITECT
ENGINEER
BUILDER ADDRESS _ DESIGNER
r+S►1�R_UCTUR_E-- L,^.Ew _ ❑_REMODEL ❑ADDITION QREPAIR []RENEWAL [:]FIRE DAMAGE rte_❑_DEMOLITION
LJ RESIDENCE ❑COOMM ❑EDUCATIONAL ❑GOV'T ❑'AELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE [:]STORAGE❑SLAB ❑FENCE
❑BOND DMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY.__.-___LAND USE ZONE__.— BLDG.TYPE FIRE ZONE PLAN CHECK BY HEAT— _
I +i �� CJ h--T LIII i t f 1C6imf 0 wini _0_uW C u n T.a 1 nwj I n y 19 1 4 1 F.,q*r,r, xIaor11 --_
e Deilff-56ma anticoo EJAWMant, --
-._ JUL) 1 -ZLI - -- — -- — - —---- —__— -- -
OCC -LQAQJ___,_F_WQR DAP_.__. ___ HEICL.E1Z-_---� I11�9.IES ..,�-aflEA NS! g --yAIS'�ett�tj'tr►�r�
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
—
14-4701'
Permit —�
TENS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAII•ED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
`- WORIt WILL BE DONE IN ACCORDANCE WITH -HE PLANS ANO SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANu-S. THE ISSUANCE OF THIS PERMIT DUES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUS04ESS
State lax LICENSE. SEPARATE PEE�NITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total J ` rz—
�
By
NT OR AC7EN'I
Approved Receipt No
PH-nFJE--
7176
3-7G
/,- 6- 76
1,.7- CT-
26 41
1.21/7/76
-Aa 77 z�
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