11353 SW GREENBURG ROAD 1
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11353 SW GREENBURG ROAD
ADDRESS PERMIT NO. 5`Fl
PERMIT CHARGE none
OWNER CONNECTION FEE DO. —�
PAID By
TYPE OF BUILDING )JT Lt' ,, �= ' DATE CONNECTED
SERVICE RATE INSPECTION FEE � =—
CONTRArTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT _„ PAID
MEMEAMIMUR
• f:Su l l_r.:l;v i.i u:N;;r; I r,14 rI�, I I�r1::J lid 0
PLUMBING PEBytIT 1� •
_ _r , ho+der of a valid plumbing contractors licens;: is hereby
aurhorizaij to causa plumbing worn, as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by tha City Inspector who shall be notified not less than four
(4) hours prior to the time the instcllations are ready for it,spection. City of Tigard Business License required
for all contractors and subcontractors.
Owrer. k�Y K Address 1_� 3 /p�n �k fzlk�Uate_ --
IYUMV3 R OF TOTAL PERMIT NO.'S
=' TYP£ OF PERMIT ITEMS FO'E ON EACH AMOUNT (Office Us*Only)
EN
TIAJ._ _a-
( Singl-e Family-1 bath-oach 25.00 -
L 3 Dn I.<-Each t b.+ch unit _25,00
f' Additiongl i;-rhroumi-aach .:3 10.00 _
Mobile Home SPa:e-aach _ 15.00
INDIVIDUAL FIXTURE FEES_
i 1 to 50 cixtumi in 1 building-etch _9.00
51 to 100 Fixtures in 1 buildir,-tach _ 2.50
101 to 200 Fixtured in 1 b0d;n.-each 2.00 -
201 or mors in 1 'auildinj 1.50 _ __-
ht15CELLANEOUS -
aui!c:ir Saver-1 a 50 ft � � -- --� -� 10.00 - �`-------
Sewer-each additional 100 it, 10.00 �-
'
Wetar Service to budding 5.00 V� t
Private avatar Sv�terrs-eich 1GO ft. -� _10.00
O,hrr (5oa:ifyl: --
PER_Pyll'f _� 5- �� - For Alumhing insrerticn P,'rone 639.4171
"S,ate _ �',g p Plumbing Crntractor By _
TOTAI ��� ,'�_p _ RECEIPT NO. Issued By
t 5 1,113
IN E il IM I T NY
Unified Sewerage Aqen.;y
of Wa.-Piington County Cl-lr*Y Or V gird DATE March 16, 1978
0 W N ER 3 — g k e r PHONE , Z45-6613
OWNER 'S ADDRESSs
TYPE OF TN3TALLATIONt
Q BUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
NEW El SINGLE FAMILY COMMERCIAL
EX IST. (P R I OR TO 7- 1-70 ) :El MULT. RES. Ej INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
ADDRESS OF STRUCTURE ,
PERMIT CONDITIONSt THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGUI.ATIONS OF THE UNIFIED S[WERAGE AGENCY. WHEN CAI-LING FOR INSPECTION,
PLEASE REFER TO THE PEf?Mi,rNUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDF!"D AND TWENJY ( ipo ) DAYS. THE AMOUNT PAID WILL BE FORFI-ITED SHOULD
EXPINArin occuR.
F E.E S i
PERMIT FEE $ 35.00
C014NIECTION CHARGE 2400.00
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
�OTAL 2435.00
-4.
A.PPLICANFDATE
W E R P E SO M I T
A 0 D R F,
(pm STRUCTURE 11. S.W. Greenberg, Rd. , Blda. #3
tl/\P TAX LOTSYSTEM Fantio Crc-l-k
I.wr –.13 L 0 C K OF
—Wa l.sJ u—
APPROVi.!) 13Y DA I-F ISSUED BY DATE
D. U. Is REMAPKS # 1964
BUILDING PERMIT APPLICATION 11 Y TIGARD DATE z r�►t lb 19 �a r'r
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE 245,6615
OR AS SHOWN /sND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
/115511511 LOT
OWNER Gene Park,..r JOB ADDRESS ®irsunberjj Rd. HOME_'ADDRESS r311*t8t4 -,-
ARCHITECT
ENGINEER
BUILDER ADDRESS _v DESIGNER -
STRUCTURE ONEW _❑REMODEL ❑ADDITION ❑REPAIR — ❑RENEWAL !❑FIRF DAMAGE _❑DEMOLITION
Q RESIDENCE (-]COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIO--US❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE n3LAB ❑FENCF
❑BOND ❑MOVING ❑CONDITIONAL USE LJDESIGN REVIEW ❑COUNCIL APPRO'dED ❑SIGNS
OCCUPANCY___ LAND USE ZONE____A_' —BLDG.TYPE 5N FIRE.ZJNE L PLAN CHECK BV�+t Welder HEAL
Construct multi-family dwIling ►rldy. lyX_with .3 Vie_ A Units enol 1 Type B Unit.
S"atr powhit s 15818 • 2AW.QQ feat + 35.00 ingecL` _
QC(;_QQAD___.._ HEIGHT 20____Ng-STORIES 2 _AREA X572 OOMS VALUE 78P�T'_
BUILT-,NG DEPARTMENT SET BACKS FRONT see PIanREAR LEFT SIDE RIGHT SIDE
Permit 11
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT, IS HEREBY AGREED THAT THF
WORK WILL BE DONE IN ACCORDAN.;F WITH THE PLANS AND SPFCIFICATIONS AND IN COMPLIANCE WITH
Subtotal 255.00 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PC-4M1T DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURP.ENT CITY BUSINESS
State Ta)4% 9.80 LICENSE, SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total SDC • 960.00
-
By FW '!1 - 240.00
- --
APP, IC NT OR AGENT ------
Approved 1.1'6( Receipt No
ADD .51 S
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DATE INSP. TYPE INSPECTION RC'MARKS PLUMBING DATE
Contractor
A&Pa Permit No, lar 5--q-2e
Ce.a J El'e Rough-in —-1) Fixture
` y _ Fixture
Final
HEATING
_ Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final _
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
P,1.DG DEPT.FINAL TEMPORAPY CERTIFICATE OCCUPANCY
CIERTWICATE OCCUPANCY Final
Landscaping ,.
CZoning Final