11359 SW GREENBURG ROAD 11359 SW GREENBURG ROAD
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ADDRESS . _ PERMIT NO.
` PERMIT CHARGE none
OWNER x�/ c_��r G�% u-c.��ic r CONNECTION FEE
PAJ3 BY
I
TYPE OF BUIL_DING'1,�L��/ �4 DATE CONNECTED
SERVICE RATE INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION __. ASSESSMENT _ _ PAID
I -- .... ._....-._... .... _BUIt_OING•FDE^ARTPr1ENT, TlC,4r-iU....... {
- I PL.UNl:;:iv'3 PERN11T
/7//7 its-_��4 ��" h holder of a valid plumbiny contractor, license is hereby
authorized to cause plumbing work as herein noted to be instai!zd in accordance with the plumbing code df
Tigard. Such instellations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard BIIsiness license required
for all contractors and sub contractors.
Owner_. �`�"_/1 Address_.��3S � p`E'//. __ —`��L -
___l_. --- b _
NUM MR OF�- TOTAL PERMIT NO.'S
TYPE OF PERhtI_i ITEMS I FEE (IN EACH -_OLf4tOUNT (Office Use Only)
Single FAmily-1 bath-a?ch —. 25.00 -
Durlen-Fach 1 ba-,'i unit , 2500
�4ddldonal br.hrooms-each J-� 10,00 -
Mobile Home Shy Et_�ds,:h _..--._._.._. .. ..__.-- ------•-_--- 15.00
INDIVInUAL FIXTURE FEES
1 to 50 Fixtur!s in 1
51 to 100 Fix u••, vi 1 bw ir'in- o.leh
101 to 7U_tl {_rr1....... in 1 funl'1: ti] +Ar.h — _orl,
2U1 .,, ri �i . . . ur I hn .j n� -"':hy�...._�— '-�_-,_ _-... _ 1 5t) _..-- _---.•_..__--_.-.. �r.__• -
I _til TSC E 1 l
tlUil:!i .r :,.,.:, i 4,I •--- - -------.._ ___ _...... to`17- --- - --
I 5. .•. .:n,l '00 ;:. m 9n
F -Sys erns•-azich Ica 10.011 ,---
___
For Plam,. ir?g Ind;. ..;,: '' r'r, 6:1!3-!/71
Pluo'Kng contl!ctor Fly
TOCAI �7'ri�— RECEIPT NO. Iss:1,.1 By r
SEINER PERPA, NY 15821
Unified Sew«raga AgancY Ti arJ March 16, 1378
of Washington County CITY ()(- g DATE
OWNER: Gene Partecr _ PHONE : 245-661.3
OWNER 'S ADDRESS:
TYPE OF INS I ALLATI OIJ:
BUILDING SE41ER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
NEW ❑ SINGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PR IOR TO 7- 1 -70 ) Q MUI_T. RES. [J INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
ADDRESS OF STRUCTURE :
P(:PMIT CONDITIONS: THF APPLICANT AGREES 1*0 COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEVIERAGF AGENCY. WHEN CALLING FOR INSPECTION,
PLEASE REFER TO THF PERMIT NUN'BER. THIS APPLICPTION EXPIRES IN OME-
HUNDRCD AND TWENTY ( 120 ) DAYS. THE AF,10UNT PAID WILL dE FORFEITED SHOULD
EXPIRATION OCCUR.
F LE:S:
PF RMIT FEE 35.00
C0NNFCTIOP' CHARGE �y ?.400.00
S tDL SEWER INSTALLATION
ISSUED BY
OT HER
:'TOTACL $�_•_ 2435.00
APPLICANT DATE
W 158321
ADORES-, Of' S7Rl1CTURF 113«# S.%l. Grc,PnLerg Rd. , R1d(;. #6
l AX hi0l _ .__ . _. (AX LOT ... SYSTEM >:anno Creek _-
LOT _ .-,_ --__-.._..E3 L O C K _ OF
b Wry 1 do n A• Rawlings
AP 'ROVED PY� DATE ISSUED BY DATE
D. U. ' S REMARKS f3�d�;. I'erta l t .46?
CITY F iMazt;h 16 78
fly 7
BUILDING PERMIT APPLICATION of TIGARD DAT —.. ,9
245-661.3
THE UNDERSIGNED HEREBY APPLIES FOR APE RIVIT FOR TNF WORK HEREIN INDICATED BUILDER PHONE— _
OR AS SHOWN AND APPROVED IN THE �AC' ?�,jy�(Y�ING PLAN' F'
ij D SPWf,ICATIONS OWNER ly4 ft!! �Ai C iCr t �1.3�1��1�'T7l"3�IQIbgrR Kq� �O � LOT Nb.- _
OWNER --JOB ADDRESS HOME ADDRESS
ARCHITECT
BUILDER yam ENGINEER ;:I�.41tlMtF? ,KSV'.
7 -, M _`ADDRESS_ DESIGNER
7�S-T,RUCTURE ONEW ❑REODEI ❑_ADDITION ❑REPAIR _-❑RENEWAL ❑FIRE DAMAGE ❑DEMOLI_TION
LJ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAP PORT ❑GARAGE ❑SroRAGE❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW QCOUNCIL APPROVED ❑SIGNS
`I A2 5N 3 --- _ L walden
OCCUPANCY...LAND USE ZONE_ ____BL.DG.TYPE FIRE ZONE_ PLAN L4ECK BY HEAT
t;rJn,striact tm,lt'i-family dwelling Bldg, :46 with 3 Type A Urit• and 1 Type B Unit.
`''elver Cotnaction Foymit # 15821 fN UN-00 - feufor ivaperst. 35.E _
40 - 10 2 TA72 78,('00
f-1.�'9B LQAt1__ — _.HEIGHTQLIM 1.€&_—__ ARA NP HQEIQQM;___YALU_E__ � _--
BUILDING DEPARTMENT SET BACKS vnoNT PEAR LEFT SIDE RIGHT SIDE
Permit
1.45.0 — - ---
— . THIS PEKMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE VOLAE IN ACCORDANCE WI rH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACIOFI AND SUB COI"T'iAcTORS TO HAVE CURRENT CITY BUSINESS
State Tdx LICENSE, SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 764.M :;UL 9w*00
By
PIXPIX #1 - 260.00
r
CANT OR AGENT
Approved �'_-- � Receipt No
1 r
HoNt --_�-
UATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
y13 � s?
Permit No. S_y�
Rou h in
— Fixture
_ Final
HEATING
Contractors
Permit No.
Gas or Oil
------�-
Rough-in �-
Final
J � SEWER
_
Final _
DRIVEWAY
Final
Storm Drama _
(Rain Drain) Final _
Sidewalk
Curb a Street Final
Approach
RLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCv
Landscaping
Zoning F anal \_