9870 SW KIMBERLY DRIVE 9870 SW KIMBERLY DRIVE
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AODRESS PERMIT N0. LS -
PERMIT CHANGE none
OWNER y' �^ CONNFI-TION FEE &.0c,
- Y PAID BY -
TYPE OF BUILDING DATE COw.ECTEO U
SERVICE RATE ��,r _ INSPECTION F EE ^;r -6:
CONTRACTOR _ - PAID BY DATE
SIZE OF CONNECTION ,� ASSESSMENT � � PAID
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BUILDING P;:R%11T APPLICATION "OF
TTIGARD DATE—_ —__, 19
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED 13UILDERPHON _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING; PLANS AND SPECIFICATIONS. OWNERPHONE
LOT NO.
OWNER I._ C I it ([lll __1013 ADDRESS I ''� HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER _ ADDRESS _ DESIGNER_
'Tr' JCTURE: _ QNEW ❑RI.'MODEL ❑ADDITION ❑REPAIRr-±— ❑RENEWAL OF IRE DAMAGE ❑DEMOLITION
31DF-NCF ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO GCAR PORT ❑GARAGE ❑STORAGE❑SLAB [FENCE
❑BOND ❑MOVING [:]CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
Oma(C IPANCYY____LAND USE ZONE __BLDG.TYPEF='='( FIRE ZONE-'L PI-AN CHECK BY , __ HEAT
3 oodroom
2 bathroom
464
OGS .I.Q9R-__ FL.Q_QB_LQAQ. ➢__—_�IEIStI�I '20NQ STQBl�
BUILDING DEPARTMENT SETBACKS FRONT r>rr REAR {1t LEFT SiUE � RIGHT SIDE
Permit 1` 7
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIOVS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGIJLATIONS AND ALL APPLICABLE CODES AND ORD'NANCES, AND IT IS HEREBY AGREED THAT THE
WO;�K WILL BE DONE IN ACCORDANCE WIT14 THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sul- total ;;0. 50 Al.L APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— - RESIRICTIV.r COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 7 .4fn LICFNSE. SEPARATE PERMITS HEOUIRED FOR SEWER, PLUMBING AND HEATING.
Total r ,
BY ---- ---- --- –
---------------- -
APPLICANT OR AGENT
Approved Receipt No ..r..i.
DATE INS" TYPE INSPECTION REMARKS PLUMBING,
DATE
Contractor
Permit No. '/n
Hough-in
Fixture
Final
HEATING
T'"I Contractor
Permit No.
42-ell Gas or Oil
Rough-in
Finn)
SEWER
Final
DRIVEWAY
MOv
the jk• qi�,1-1 Final
Istorm Drainage
(Rein Drain)Final
Sidevvelk
Curb&Street Fine'
VTEMPORARY
7�
Approach ppr
o�ach
BLDG. DEPT. FINAL TEMP6RkkY CERTIFICATE occup
CERTIFICATE OCCUPANCY Final
Landscaping
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3UR-DiNG PLRMIT APPLICATION CITY TIGARD 0 A T F N?
OF
.iNDI, HSJ(,NE D HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILOER
nS SH,)Wt4 AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIFICAIIONS. OWNER PHCO) E—
LOT NO–,Z?----
JOB ADDRESS .... .....
A9CHITECT
ENGINEER
R i ADDRESS DESIGNER
(7i RFMODEL OADDIIION CIRLPAIR OnFNEWAL OFIRE DAMAGE 0DEMOLITION
"L)fNCE 0�.',Mfvt [DEOUCATIONAL 0GOV'T ORE LIG OUS OPATIO OCARPORT 13GARAGE 0STCAAGE0SLAB OFENCE
0 mov:,Yr. OCCINDITIONAL USE ODLSIGN REVIEW C]COUNCIL APPROVED OSIGNS
HEAT ni
Or-UNCY&.:3 L aNP I ILE ZONE P1 DG.TYPE FIRE 70NF Pt.AN CHECK HY--7 -- AOT
Y
t." U-Qp.10 ARIAJ�O A -BE MR VALUE44 srg)c.)
SL LDIi60iPT.1 T SET BACKS FRONT—X— REAR SR! RIGHT ID_E
A-4----
� = L— ��
0170 -7
—.— ---j 4k- THIS PERMIT IS 19SUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 413 ST) REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 17 IS HFREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RUS7RICTIVF COVENANTS CONTRACTOR AND SIJEI CONTRACTORS TO HAVE CURRENT CITY BUSINESS
PT LICENSE. SEPARATE Pi nMITS REOUIRED FOR SEWER, PLUM13ING AND HEATING.
by -A`PPIICAW't—0P AGENT
Rempi No
I
� I I
-�USEWER PERMIT NY 1.5956
0fUnified Sewerage Agency
of Washington County CITY OF Ti€ axd DATE June 20 , 1078
OWNER : NI.IL. Clayton PHONE :
OWNER 'S ADDRESS: — —_
TYPE OF INSTALLATION :
D BUILDING SE',IER ❑ BUILDING `'.EWER AND SIDE .EWER
TYPE OF OCCUPANCY: I
El NEW ❑ SINGLE FAM.LY ❑ COMMERCIAI I
❑ EXIST. (PRIOR TO 7- 1-70 ) ❑ MOLT. RE'.)' . ❑ INDUSTRIAL
FIXTURE UNITS SWELLING UNITS 1
ADDRESS OF STRUCTURE : 9870 SW Kimberly Drive
PERMIT CONDITIONS: THE APPLICANT f�GREES 'TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBtzi . THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THF AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR .
FEES,
PERMIT FEE $ 25.
CONNECTION CHARGE 600•
SIDE SEWER INSTALLATICN p. robertson
ISSUED BY
OTHER
TOTAL $ C25•
A P P L I C A I I T —�� DATE
SEWER PERMIT N`► 151956
ADDRF`-. 9870 SW Kimberl T)rive
�S OF SI hUC IUF�E y ,
TAX MAP TAX LOT SYSTEM
LOT _29 BLOCK OF
1 ��-
APPROVED BY DATE ISSUED BY DATE
D . U . ' S 1 REMARKS bldg. # 2150