9385 SW NORTH DAKOTA STREET 9385 SW NORTH DAKOTA STREET
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BUILDING PERMIT APPLICATION 'or Y TIGARD DATE
THE UNDERSIGNED HEREBY APDL!LS FOR APE RMIT FOR THE WORK HEREIN INDICATED BUIL DER PHONF
OR AS SHOWN AND APPFOVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT NO.
OWNER)I-) �} JOB ADDRESS " A`�' J t!1 HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑REMnDEL ❑ADDITION' ❑REPAIR _❑RENEWAL — ❑FIRE DAMAGE -- ❑DEMOLItION
❑ RESIDENCE ❑COMM_L�DUCATICNAL ❑GOV'T [:]RE,!'-E,!'- OUS❑PATIO ❑CAR PORT ❑ CI
GARAGE ❑STORAGE ISLAB ❑FENCE
❑BOND []MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY____.LAND USE ZONE—_-.. BLDG.TYPE _—FIRE ZONE PLAN CHECK BY_ HEAT_. _
Q (;,LOAD — FLOOR LOAD
BUILDING DEPARTMENT SET BACKS FRONT_ —_ REAR LEFT SIDE, RIGHT SIDE —
Permit
THIS PERMIT 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 DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIAP CE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CUNTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax, LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By - --- ----
APPL CANT OR A(i NT
Apuruved Receipt No.
Address Permit No.
Permit charge
Owner C�t�L� Connection fee
Paid by
'(ype of building ? ___ Date connected
,r Z�Zy
Service rate Inspection fee
C.)ntrjc+ur _ Paid by Date
Size of connection — Assessment paid
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CITY Y OFTIC��RD � rC �
OREGON
Owrjer:..... ..Ladd..Arn.oti. .. ...... ....... ........ ... ..... ..F'c�l
Building Address.............. 9365 . SW .Ncvlrth Dakota. Ave. .
of Certificate is hereby 19 '
given a}• ......M.��ch.......... .... ....7..7.
that said building may be occupied and
that it complies kith all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
= ?' �
Building Inspector �s l
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11 TIGARD DATE 151
BUILDING PERMIT Ak (CATION OF FIUILnER PHONE—
THE
HONE —
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
IN THE ACOWNER PHON�
OR AS SHOWN AND APPROVED -
ACCOMPANYING PLANS AND SPECIFICATIONS. LOT NO.--
OWNER L.aiijd ArnoJOB ADDRESS 9385 SW Dakota AN&b I CME ADDRESS
ARCHITECT
ENGINEER
DESIGNER
ADDRESS
BUILDER -----'— �1
STRUCTURE 'L.INEW ❑REMODEL OADDITION r❑REPAIR _L RENEWAL ❑FIRE DAMAGE _ DEMOLITION
E ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGEOSLAB ❑FENCE
RESIDENC _
I�OND ❑MOVINGr ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPR( L_1SIGNS
_ MLAN CHECK TW HEAT---
Q�CUPANCY_..=--_LAND US'ZONE_ _BLDG.TYPE ){� FIREeZTNaE P3ub ject to approved trues gssi
Const, single family dwelling w/atta&.ed garage
design* 3bedrllrarn :' bath
Ids-rays 5 err. •
__ 11uU3 ,75�*
HEIGFIT
NO STORM$. ARE . NO BEDROOMS -_
Q
QG�LS)AQ __F.L�BISZAL2-. ______,- A --
iE Q REAR 20 LEFTSuns �y_ RIGHT SIDE
��
BUILDING DEPARTMENT SET BACKS FRONT � --
Permit 3 0
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
�lJ.�� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE KITH THE PFIC
LAN5 AND SPECIO.TIONS AND IN COMPLIANCE WITH
$Ub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
--
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITU BUSINESS
State Tax �•8:� LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total ��•
By y APP. 11 N, OR AGFNT —
Receipt No.,/ !
APpro��
-
AD[tgESS
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _
Permit No.
_
lRough,in
Cj Fixture
rawFinal
HEATING
Contractor b
Permit No.
Gas or Oil
Rough-in r
_ Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&street Final
_ Approach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
1 Zoning Final
Il!
UNIFIED SEWERAGE AGENCY NO. __-- 10662 _v
WASHINGTON COUNTY f)ATE __ - 9-30-76 `-
C I T Y O F Ti3as_r!___- -- — --- --
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: _ Ladd Arenoti
OWNER'S ADDRESS: _-- - -- -
S'i RE ET
CITY STATE ZIP
BUILDING SITE: LOT - BLOCK ___-__ _ —___ ADDITION
TAX LOT NO. --- _ TYPE OF OCCUPANCY - __ residence —
A D D R E SS _ _ ._9-n5_ 5.W-.1a kata_Av.e
DWELLING UNITS __ _—.- 1 __---�___ FIXTURE UNITS
SURCHARGE IF APPLICABLE -_—_-____ _- ------ —
PERMIT FEE _r,75.-GD --.— INSPECTION FEE2-9-..Dn—_ TOTAL DEPOSITED 600.00
(N (EXISTING) BUILDING SEWER SYSTEM __-.—_F.3nna._ C.tsek - ---
The Applicant agrees to comply with all rulesandof the Unified Sewerage Agency.
APPLIC —T
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE'.-- _ INSTALLER - -
RECEIVED BY. `z`--t _
IAGENCY OR IYS, ENt)
COMMENTS:- - BLDg. ;;-1101 ---
This Application and permit expires in gyne hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: _ u `� PERMIT NO. :
DATE: zi� DATE ISSUED :--/
OWNERS NAME : ---
ADDRESS:
AME :ADDRESS: ./loe
CONTRACTOR : L s.1
TEST : Air 0, WaterZ , Visual (f, Laboratory p
RESULT: Approved Disapproved O , fending CJ
SKETCH; � I
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INSPE.c�,_, 0 DATE I
NOTE: Attcc� supplement,if test
,I
- U11-DING PLRMIT APPLICATION �oF TlGjkRD DATE_._—__--_— Nq
oNDF RSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER Pt-,ONE—
AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIF ICAT IONS. OWNER PHONF6.Q^f 73y!
LOT NO
_HOME ADDHEISS
ARCHITECT
ENGINEER
.R ADDRESS DESIGNER
-1C:IURE O%EW RFMODEi. ❑ADDITION ORkPAIR ORENEWAL ❑FIRE DAMAGE ODEMOLITION
,' I''DFNCE OcOI,AM OEUUCATIONAL OGOV'T ORELIGIOUSOPAT10 OCARPORT OGARAGE ❑STORAGE❑SLAB ❑FENCE
OMOVING OCONDITIONAI USE _L..IDLSIGN REVIEW OCOUNCIL APPROVED OSIGNS —
t AND USE ZONE—A- BLDG.TYPE --O%._FIRE ZONEt2- PIAN CHECK BY HEAT _�-
NO,@EDRD52MSynl
_ BUILDING DEPARTMENT SET BACKS FRONT REAR _LEFT SIDE RIGHT SIDEvtmIt
_
- - - THIS PERMIT 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 THt.( 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
---- - RESTRICTIVF COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Ows Tax-5,, _ 'Z� LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Tntal
APPL IC OP AGE NT
App lived Receipt No 3 f�J �cc� J9
AD(1RE55
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