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11357 SW GREENBURG ROAD
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Jtnr JS >ztz�c,t PERMIT N0.
ADDRESS
PERMIT CHARGE none
OWNER LA , CONNECTION FEE 41e
PAID BY
fPE OF BUILOING DATE CONNECTED _
i� � C>
SERVICE RATE 1�2� INSPECTION FEE 34.
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
tsull_UINV ur.r,;r I I,Irw t, I WiAl'.0
I PWP/iSItVG PEr��+?IT M
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holder of a val;d p!ufnbiny contractors livens+! is hereby
authorized to cause plumbing wore; as herein noted to be installed in ercordance with the plumbing code of
Tigard. SUCK installations require inspection by the City Inspector who shall be notified not less thdrl four
(4) hours prior to the time the installa+ions are ready for inspection. City of Tigard Business Licensu required Y
for all cciitractors and sub Contractors. r }
Owner_ I�
NUM39R OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITE&'S FEE :)N EACH AMOUNT (Office UN Only)
Sin I. Family-1 bd-.h-each —` 25.00 �^
Ouolrrq_Each 1 bath unit — 25.00 _ —�--
Addition-0 h+throumt-aach - A 10,10_ -
Mot)i18 Horace Space_each 15.00
INDIVIDUAL FIXTURE FEES
1 to 50°i<tur4t In 1 building_each 3.00
51 to 100 Fixtures in 1 buildir -each wr S
-� _ _i__._. _ 2.50
'1 101 to 2r)U Fixtures in 1 bui11'.r.i;;_each
201 or rnori Fix. rel in 1 bui1d:n9`earh 5555.- _ 1.50
fti11-SC ELLAVEOUS
8uii_tl�r3 se.v'r-1st 51) t!.
10.00 _
:�ewer�each 2r!•ai �OnlN !00 ft. _.__.- _._
10.00
Wrrer Sirvictr to bu,IdintL`—_ 5.00
"
Private N1?t+r Svar^.-11th 1050 ftp
PFR.11'� � �� p(+ for?lurn5rng in;c : �.ti P,'torrA 639.4171
.� 4 Si•3iR_ r_ Plumbing Contractor By
I L _TOTAL � D� RECEIryT NO. Issued By __--------
S 7Fs'll ER P E 17 N I! 15820
Unified SRwaraya Agency
of Washington County CITY OF - Tl�;;jud DATE March 16, 1918
OWNER s Cpnr j!.Irk-4C PHONE s. 245-6613
OWNFR 'S ADDRESC)s
TYPE OF INSTALLA71ON3
91 BUILDING SEWER El 5(JjLbING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
N F 14 DSINGLE FAMILY 0 COMMERCIAL
EXIST. (PRIOR TO 7-1-70 ) Y MALT. RES. [:] INDUSTRIAL
FIXTURE UNITS UWE[ LTN3 UNITS 4
ADDRESS OF STRUCTURE :
PERMIT CONDITIONSt THE APPLICANT AGREES TO COMPLY wipi ALL RULES AND
REGULATIONS OF THE UNIFIED SUWERAGE AGENCY. WHEN CALLING FOR INSPECTION,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN UNE-
HUKY:?L-D AND TWENTY ( 120 ) DAYS. TPF AMOUNT PAID WILL BE FORFEi'rED SHOULD
EXPfi?ATTON OCCUR.
FEE'S1
PERMIT FEE $ - 35.00
CONNECTION CHARGE 2400.0
SIDE SEWER INSTALLATION
OTHER ISSUED BY
"t-FAL 2435.00
APPLICANT DATE
r
PA IT
ADDRESS OF STRUCTURE 1.13 S. J. Grvtab(!_Eg_R0. , B.tclg #5
MAP 'r�.X Lol
SYSTEM Fatitio Creel;
LUT -- ,C3LOCK OF
APPROVFD BYl:iSUkD BY DATF
D- U- ' S REMARKS Bldg. #--1.966
CITY hlarcil 1�a� 1 7;3
BUILDING PERMIT APPLICATION of TIGARD DATE— 19 245-6613
THE UNDERSIGNED 1-ILREBY APPLIES FOR APF-R�.11T FOR THE WORK HEREIN INDICATED BUILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACClt'L;rtanberg
Y'ING PIANS AND SPECIFICATIONS OWNER PHONF
' r LOT NO._—�—_
Gurie flm-kr it Rd.
OWNER JOB ADDr2ESS HOME ADDPE3S q_
ARCHITECT V.
ENGINEER
BUILDER __. ADDRESS DESIGNER u
�SIJIAJCIURE _ nNEW _❑REMODEL O [] EJ
RENEWAL—
REPAIR LRENEWAL �OFIRE DAMAGE []DEMOLITION
lJ RESIDENCE COC.OMM DEDUCATIONAL. E ,OV'T ORELIGIOUSCJPATIU OCAR PORT OGARAGE O STORAGE[]SLAB OFENCE
OBOND []MOVING ❑CONDITIONAL USE []DESIGN REVIEW []COUNCIL APPROVED []SIGNS
OCCUPANCY —LAND USE ZONE BLDG.I YPE _F IRE ZONE.__ PLAN CHECK BY _HEAT____-_._—
onst. multifamily dwelling Bldg, #5j, with 3 Type A Unttm nnki I ryp'. B Unit. --
Sewe>< T'armi t
17,820 F'ea 24WO + 35.00 I.nuper.t.
--- - 40 20 1 3572 7d,(,00
OCC .LS29R flOORU42A.2__--- -REJ HI --__
BUILDING DEPARTNi� JT SET r �Ntl P4a17
BACKS FRONT REARLEFT SIDE RIGHT SIDE
XPerniii 5.00 THIS PERMIT IS ISSUED SUBJECr TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, /.ND IT IS HEREBY AGREED THAT THE.
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICAI IONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAI' F.
----- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax N° -�_ LICENSE. SEPARATE PERMITS AEGUIRED FOR SEWER, PLUMBING AND HEATING.
T,)tal .80 SM 960.00
BY — PDL #1 - 240.oU
Ar `CANT OR AGENT
Approved Receipt No.
ADDRESS piu)fVF
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit P
I .-o -13- 7 Z
Rough-in
Fixture
-Final
HEATING
---------------
Contractor
Permit No.
Gas or Oil
Rouah in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainag
(Rain Drain) Final
Sidewalk
Curb&Street Final
ADproach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
I Landscaping
--toning Final