8640 SW GREENSWARD LANE I�
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9640 SW GREENSWARD LANE
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Dal@ Const.
Owner:
_-.. Y8640 SY Greenstdard Lane
y Building Address— ,+
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Certificate is herrh
reby given this �_-.-.____ day of .
' ;j t•hal, said building* may be occupied and that,Ar
�
a•' it co r►plies with H11 i•equirem.ents of the
Building Code for the (pity of Tigard, as �
approved by the Tigard My Co'. ncil.
► � os- ' v
_nom
P a r m i t N o.
Permit. chargo
tli•inc�r _—.� _..._��""`--�''.__ ____ Connection foo,
,rN,pe of tiui 1ri.i.nra .....���? � _._..�. ._. ..... Gate (;onnrictnd
S�alvi.r:n ccs+ �' Tn.pecf-S.on foci
C' .)nt;ract r .. _. .__._...__. Paid tly [yah
i1.{e of c o n o o r•t-.a.o n ...._.Y. . .. .__ ._...__.._...__. l� 7:;, :�:I F?rl f: .__ �.. ..- ».__........_._ p s i d -...»..
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BUILDING PERMIT APPLICATION of"y TIGARD DATE_ -
THE LINDE, SIGNED HEREBY APPLIES FOP !,PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE__
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONb. OWNERPHONE
LOT NO.
LiIAG �.;)FISt• ;�I.i�rti .,.! h,i'L'E :rLil.�<' � tl �.II►
OWNER JOB ADDRESS HOME ADDRESS _,-
- ARCHITECT
50MIF. ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE OTIEW ❑REMODEL _ _❑ADDITION (:1 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
DOESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T_❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE [:]STORAGE❑SLAB []FENCE
❑L3011D ❑MOVING ❑CONDI TIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE— R-7 BLDG.TYPE_ N FIRE ZONE----� PLAN CHECK BY__ tI — HEAT_..-_.
const. stoyle fonily dwelling 'w/attached garage Lot t 1t3—
4S.LOAD__ _ '�FL.44�P.1.9A�__—_b�_._ H HHS_., Q__. N9,�r;eRIES .__BAS_�X� �1Q�JLUR49M�---�1,�� � Ci 0
•
BUILDING DEPARTMENTSET PACKS FRONT 22 REAR 44 _LEFT SIDE 10 _—RIGHT SIDE -
Permit 133s00_ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINS" IN THE BUILDING .:ODE, ZONING
Plan Check 66.50 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 COMPLIA NCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT VIAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITE FUSINESS
State Tax 7.98 LICENSE.SSFP�Af�AL.E,`ERRMITSRm�QW RE ,FOR SE'If,
I f,-sz LSM " AND HEATING.
iyaTotal 207.48 F dl U PERT
nL 1, feU ,U
By y1 --- - ---- - — -
,� APP 'ANI. OR AGENT
Approved Lqg1j,6 Receipt No. —
SS
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
I ( '� Permit No.
T
CD ,� •t 1Q 1,�' �!J c ,lough in
C��( a-^ �Cf4� .w� <<Zc/t.► i��tl GEc Fixture - -
« Final --
-z� T\ ' HEATING
ef,-z -'I' �� Ct�V4 _ _ Contractor
I L4- _ Permit No. 1 2 Y g114
- t� ��
( - 1 V> Anel l — —_- — Gas or Oil'_ -
/Q'J 7 J� ttYC �3 ��J�U!)z tl - --- Rouc�h in --__
77 �_ � _ L� '� / Jit, Final _
SLIJ-L'—= � iJ�/G—�-�— pr` — - ---- SEWER
--- - —
_ � `r ✓�i2ci�,� ? y,�NG_ _--- Final
•3•�� ---- ------ — ---- ----
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb &Street Final
Approach
BLDG DEPT.FINAL T —^ 1 EMPORARY CERTIFICATE OCCUPANCY Final
^` _
CERTIFICATE OCCUPANCY
Landscaping
\ Toning Final �.
I
SEWER PERMIT N° 13469
Unified Sewerage Agency CITY OF Tic,ard _ DATE , 7-•6-77
o/Washington County
OWNER : Dale Const. PHONEt
OWNER ' S ADDRESSt --
TYPE OF INSTALLATION:
CX-46ILDING SEWER []BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
amm )X XSINGLE FAMILY [] COMMERCIAL
❑EXIST . (PRIOR TO 7--1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS
DWELLING UNITS 1
PE^MIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CAL.L:NG FOR
INSPECTION , PLEASE REFER TO THE PERMIT NUMBER. THIS APPLIC4TION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WIC _
BE FORFEITED SHOULD EXPIRATION OCCUR .
FEESt
PERMIT FEE
$ 25.
600.
CONNECTION CHARGE
SIDE SEWER INSTALLATION ISSUED BY
OTHER
TOTAL $ 625. —
DATE
APPLICANT
SEWER PERMIT N° 13469
ADDRESS OF STRUCTURE 8640 SW GreenmWard Lane —
TAX MAP_
TAX LOT SYSTEM Panno creek
LOT 10 BLOCK OF
I SSUED BY DATE
- APPROVED BY DATE
REMARKS1�90 '
City of Tioard Mechanical Permit N? Permit____.
a`7
Fee.-
S c�
New Installation (� rieplace ❑ Relocation ❑ Addition ❑ Alttration ❑ 396 State
TOTAL_':
CC':TRACTOR � �- /e/ Ti/V6 C— OWNER --
L•v,
ADnRESS7 �;—._ 4LA.��lll A✓� _ WORK ADDRESS_s(�i.. t�, ��!'t�L2._
PHONE — �sC �1 ----- APPLICANT`_._- — _--
Heat Input Rating (BTU Per Hour) _ � ecb Vent Size �,/��_ _ lue Size`
FUIL
EL OIL ❑ GAS ❑ ELECT S/OTHER____ _
ITEM NO. FEE ITEM NO. FEE:
For Issuance of Permit3.00 Air Condition Compressor 15 to 30 HP
New- Under 100.000 BTU — 4.00 Air Handling 10,000 CFM 3.00
New- 100,000 BTU &over 5.00 ' Air Handling Over 10,000 CFM 5.00
Floor Furnace4.00 Evaporative Cooler
,.
Wall - Floor • Suspended _ 4.00 Range Vent Fan i— 2.00.
T. Install Vents Only — 2.00 Vent System 3.00.
- _4.00 _ Hood Commercial —� �— — 3.00
Cooling
Repair • Heat & g _
Air Condition Compressor Under 3 HP 4.00 Commercial Duct System _ _ 10.00
Air Condition Compressor 3 to 15 HP 7.50
INSPECTOR'S COMMENTS __—
��
' CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB CONTRACTORS
APPROVED BY — DATE —_ ISSUED BY _ DATE_
,�, tE RECEIPT NO. '
•' 774 Signature of Applica
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