9890 SW KIMBERLY DRIVE-1 9890 SW KIMBERLY DRIVE
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'ODREs5 _......`z.�. '' ,amu � � PERHIY NO.
PERMIT CHARGE _— nono
CONNECTION FEE
PAI 0 B Y -
1 YPE OF BUILDING ��_ DATE CO1'dNECTF[)
;ERVICE RATE / i INSPECTION FEE
"UN1RACIOR PAID CY w _ NiE
SIZE OF CONNECTION Y _ A;5MhENT PAID
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HILLSBORO PLL);"I;iNG
P. D. BOX 487
CORNELIUS, OR 97113
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PERMIT
CITY .4- P,0 f 2
BUILDING PERMIT APPLICATION OF TIGARD DAT1 �_ 19_��
14E UNDF�tSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE-,.,._
OP AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHgNF
LOT NO. _
OWNER 'lt,l lPilljYt JOD ADDPcSS 99C, Stj Klili(at!'(l yMOME ADDRESS
ARCHITECT i
ENGINEER
BUILDER 08E1 ADDRESS DESIGNER _
ccmT� i-��
STRUCTI1^.Z AX'L 61116 ❑REMODEL QADDITION C1 REPAIR _ ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
0_4SIDENCE ❑COMM ❑EDUCATIONAL- ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING _❑CONDITIONAL USE —_ ❑DES GN REVIEW ❑COUNCIL APPROVED 0SIGNS
_ — �
OCCUPANCY LAND U � 1 -VE-- ____BLD/G,.TYPE_ --FIRE ZONE— PLAN CHECK BY_{t� HEAT,
glCly��itf �alfallY 1�49tl:.iitiv�ld�sl�e @O�i�ld Y ,mak?__ Le
garage
i
uCC.J.OAD FJ-QQEi-_LQAQ._ �-_—HEIGHT 21) N-0.sl?81fS 2 ARF_A 6 fN_Q314TR2QMS VALUE 47r QU� i
BUILDING DEPARTMENT SET BACKS FRONT 2U REAR 6+k ___LEFT SIDE - _ RIGHT SIDE
Permit
170,00
-- --
THIS PERMIT 19 ISSUED SUBJECT i0 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONINC
Plan Check 199,Ci CJ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS 14EREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORITAMCE WITH THE PLANS.AND SPECIFICATIONS AND IN .OMPLIANCE WITH
Subtotal 267,QC AL1. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERM1- DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CnNTRACTORS TO HAVE CLRRENT CITY B113INESS
State Tax ��] LICENSE. SEPARATE PERMITS REOUJRFD FOR SFWER, PLLMRING AND HEATING
Total 274o17 QLU..,
By
_..----_.— AP L1CA
'� Ni OR
Approver) a`w _ Receipt No,
DATE Iris r. T E INSPECT1014 REMARKS PLUMBING DATE -
-�-- Contractor
Permit No.
�-
Rough-in
Fixture - -
�P�_ r inel
I57 '. L.: ��----- HEATING
V ` Contractor
Permit No. 1,-1,7,2 }�
Gas or OII
-- - Rough-in --
---- Final
SEWER
Final ,S eLLr J.l✓. (,11 17
DRIVEWAY
Final
.gam f �/.✓---1 L�C�G`_�L��r'�/ ����i-L�i A� .—_. ----
!Y Storm Drainage
pin Drain)Final
J� Sidewalk
-
Curb,%Street Finat
Approach _
QLLt)G.DEPT.FINAL TEMPORARY— CERTIFICATE OCCUPANCY Final R
CERTIFICATE OCCUPANCY — --- --- -
Landscaping
Zoning Final �� �_
S ECYTE 1 ttE:2!i ff
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• 1588"7
Unified Sewerage Agency
of Washington County CITY (ll ________Lj_L1Jl:, l _�_____ DATE 5-4-78
OWNER s I Q y MilPHONE :_
OWNER 'S ADDRESSs
HYPE OF INSTALLATIONs
OUILDING SEWER ❑ BUILDTNG SEWER AND SIDE SEWER
TYPE OF' OCCUPANCYs
�fVEW x>UPSINGLE FA44ILY ❑ COMMERCIAL
[❑ EXIST. (PRIOR TO 7— i—�.. ; ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS�y_____„ D!'iELLING UNITS, 1
ADDRESS OF STRUCTURE : 9890 SlJ Kimberly Dr.
PERMIT CONDITIONSs THE APPLICANT AGREES TO C)MPI_Y WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES iN ONE—
HUNDRED ,AND TWENTY ( 120 ) DAYS. Tf!E AMOUNT PAID WILT_ BE FORFEITED SHOULD
EXPIRATION OCCUR,
FEESs
PERMIT FEE $ 25.
CONNECTION CHARGE 600.
SIDE SEWER iNSIALI_ATION 3. graene
ISSUED BY���
OTHER
TOTi,L
APPLICANT DAiF
z
MSEWER PERMIT � 5aa�7
ADDRESS OF STRUCTURE 9890 5'J Kimberly Dr.
TAX MAP TAX LOT SYSTEM fenno creek
LOT i0 BLOCK OF
E._ 1j alden �5-4-78 -��t--, ���Cc`:Lt.�=��— �
APPROVED BY DATE ISSUED BY ✓ DATE
REMARKS bldg . 2072
� s
I
78
��JILDiNG PERMIT APPLICA iION 1I' TIC,A.RD DATE_ 41. a S-_� , X97- N° _
(l►JDF HSiGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HF RF IN INDICATED BUILDER PHONF6-�G -0 S �8
aS c <t)WN AND APPROVED IN THE ACCOMPANYING PLANS AND S►'Amr'A013ftSS
CAI IONS. OWNER PHoyF��sLS
I / • LOT NO.
JOB ADDRESS aE(C^ ! _ goUje) l Ci FO�
ARCHITECT ,I
ENGINEER
ADDRESS _ _�. DF-SIGNER A( I4t/
_❑REMOD-L 0ADDITION �QPILPAIR ORENE'WAL [3FIREDAMAGE _[..]DEMOLITION
r�r f ❑ r;MM ❑_EDUCATIONAL ❑GOV'T l_JRFLIGIOUS(3PATIO CAR PORTT OGARAGE O STORAGE COSLAB ❑FENCE
�1MnVIN ❑CONDITIONAL USF. _ ❑DESIGN REVIEW []COUNCIL APPROVED �rJf'GNS
L4ND USE ZONE !�_ -CBLl1G,TYPE '!sf IRE 7CINE.- _ PLAN CHECK FY_ HEAT �-
as Ant
F ?DHL9L�P__ ___►�FICbT ___-__N-9-11-QBIE ARF �� _g--.►y4A.B DRS�.Q►�15 + __
-- BUILpING DEFARTMJF.NrYyT SET BACK, FRONT G REAR (p +LEFT 5!nE�_� NIGHT SIDE 4'�'
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check !'� r7� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 17 IS HEREBY AGREED THAT THF
-- — --- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE LN17H
i Sub total / ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- (:2 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACT PRS TO HAVE CURRENT CITY BUSINESS
`itelp T �7 /�, LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBINu AND HEATING.
Intal12,
ILL-
4Y
Approved �� ��kZ"" eceipt No.
111111 '-"--w-i ` - �- HON
-- - _ ----- ADLiHE55
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