12650 SW KATHERINE STREET 12650 SW KATHERINE; STREET
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PER11ILT LA;,195E none
OWNER CONNECTION FEE
P A 10 13 f
TYPE OF DATE CONNECTED
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SERVICE RATE C NSPECTION FEE
PAID BY DATE
CONTRACTOR 1A A
SIZE OF CONNECTION ASSESSMENT PAID
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liNSPECTION iREQUEST a '� '
for
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TEST . 41- CA . J y�3 :GI „� . . -)-iInr,4 ;� t
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City of Tigard
;ANSPECTION REQUEST
for
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I ` `� S_ PERMIT NO.:
I IN.:�PEC1'ION TIME : _
DATE: LAG? . DATE ISSUED: '. L
OWNERS NAME :
ADDRESS
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C 0 N T R A C T 0 R :.�i�'< < �Ni�/
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ITEST: Air D, Water [+, , Vieuai Laboratory []
RESULT: A roved
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SKETCH:
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I INSPECT(DR DATE
INOTE : Attach supplemental toot data heist]
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City of Tigard
INSPECTION REQUEST
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for
INSPECTION TIME. 1`-i 5 PERMIT NO. :--
DAT E
O. :___DATE: & ai DATE ISSUED
OWNERS NAME : —
ADDRESS:
CONTRACTOR
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TEST : Air ❑, Water❑ , VisualA, Laborciory ❑ I
RESULT: Approved , Disapproved ❑ , Pending (j
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SKETCH: kf�
INSPECTOR DATE
NOTE: Attach supplemental telt data beret
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. : —..—
DATE: .Z L21 'DATE ISSUED:__L1._
OWNERS NAME :
ADDRESS :
CONTRACTOR :
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TEST: Ai► O, Water , VisualLaboratory []
RESULT: Approved , Disapproved L7 Pending []
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I INSPECTOR DATE
EN OTE Attacl, supplemental lest data hereto,
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UNIFIED SEWERAGE AGENCY No .
WASIAING'TON COUNTY DATE
CITY OF-_ Tiqard____._---
APPLICATION FOR SEWER CONNEC-1-10N PF-HMIT
OWNER:
OWNER'S ADDRESS:
PL1rt1and_-_
CITY SLATE L1P
BUILDING SITE: LOT------+jVg__._ BLOCK ADDITION _84?1,11 in
TAX LOT NO. TYPE OF OCCUPANCY
ADDRESS
DWELLING UNITS __-_ I FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE _.---525- INSPECTION FEE TOIAL DEPOSITED 550
rWW) (EXISTING) BUILDING SEWER SYSTEMFanqo _g-reek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage agency.
APPLICANT __7
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM,
LINE SIZE 411 !eIN TALLER
RECEIVED BY--.-- AJ:
CA
tt of- Tigard
(AGENCY
OR ITS AGENTi
COMMENTS: -_ Building parmit # 0119
Thia Application and permit expires in n;nety (90) flays. The atTIOLInt pail will be forfeited
should expiration occur.
..,_. .,,.„....»...a+r.a.;;.F«,..dry,.r,�•.wyw,:,„�-,MN'�'+.yyw.'>�ev+�war'+..w.a,",►-+4,y,. •w;pr,..y�,y�".,�F,tl}w1�4�°.....K .,.,
CITY OP
BUILDING PERMIT APPLICATION TIGARD DATE 11-14 —r_, 19 jNs 0119
THE JNDERSIGI`IED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND��EC�FJ�y , N a.l+ I.�uriPI' —
1Q_NNER `:”_CIArt, T. MAri smottsII ADDRESS 12650, 5,W. Ketherins St.BUILDER PHONE
ENGINEER
BUILDER _—Q_1_ f� ARCHITECT _ DESIGNER 1'l,l.• fir$ t
STRUCTURE ONEW REMODEL LJ.',UnITIONOREPAIR ❑RENEWAL CIFIRE DAMAGE_ []DEMOLITION
❑ RESIDENCE OCOMM I,_JEDUCATIONAL OGOV'T []RELIGIOUSOPATIO ❑CARPORT ❑GARAGE []STORAGE[]SLAB OFENCE
OPOND _ CJMCVING V� []CONDITIONAL USE _ ❑DESIGN REVIEW ❑COUNCIL APPROVED `_^❑SIGN',
Q�CUPANCY.�� LAND l;oE ZONE— _ _BLDG TYPE FIRE.ZONE S PLAN CHECK.BY `� _ _ HE'.T_ _ __
,,low Single family Re®ida nce to be constructed according to plana s�tuw, �
-- rrlame ijith attac hod QArvj* no hN toaalament
QCtCt,LOAD _FLOOR LOA_U 40 Lbo. HEIGHT NO STORIESAREA VALUE
- 20� — •,;,:�a i��:;a —_���-
`BUILDING DEPARTMENT $ET BACKS FRONT REAR LEFT SIDE _ RIGHT SIDE
Permit
--- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 'D1 REGULATIONS AND ALL APPLICABLE r,OOES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— — WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE V41TH
Recording .0(; ALL APPLICABLE. CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE .O%/ENANTS. CONTRACTOR AND SUB CINTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND YEATING
Total�T `
By RA — _ — ---_-- —
�.__ APPLICANT OR AGENT
Approved Receipt No.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
�l1 17 —_—4 --— Contractor
Permit No.. e2c,; v
I Fixture
_ yr Final
f � � l r fJ e 7G' ►=t "� __ HEATING
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ALF - DO No7 �OLIP _ Contractor
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� q4- - s ntti_�,ri.� 1,a6� J7 Permit No. !7.if✓T
- DowpAwLcu I`,g, 5%c�a r� Ip1 5� _ rjjgA Gas or Oil__ —
____� AL-W It44,06, 6nC,e 7u r ie", -�014JSy7'r Rou hin
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_r 75 /�` ►t'n t �rtln �1�vZ<.2i.r 4- /yYlt� ! Final �- -- — -
/ t (�lJ�L� '+' •_ _Q .l.Cne–»; _ _ SEWER
Final
DRIVEWAY
-- Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
A proach
BLDG.DEPT, FINAL T TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
_—
` � Land caping
Zoning Final !
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