11711 SW QUEEN ELIZABETH STREET 1
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11711 SW QUEEN ELIZABETH
--KING CITY
a>f t� � st♦ ar w
for inspections call 639-41i5
BUILDING PERMIT APPLICATION KING CITY DATE— jet*Wmr 4 19 8:) 135
THE UNDERSIGNCD HEREI3Y APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 620`5056
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER Subr. lleuri 5wi.th JOB ADDRESS11725 Su limen Elizabeth LOT NO.
----��-- --- __ ARCHITECT l�r�••id tinrSran
BUILDER Willi= Hrl ENGINEER
�' ADDRESS DESIGNER_
STRUCTURE _❑ NEW _CI REMODEL O ADDITION 11 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
ElRESIDENCE 91 COMM ElEDUCATIONAL ElGOV'T ❑ RELIGIOU_�__E1 PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB El FENCE
OCCUPANCY LAND USE ZONE _BLDG.TYPE —FIRE ZONE_ _ PLAN CHECK BY F.w HEAT---
Finish exterior of structure & r�rouz�da, pour toatitTss, wall.s.LanW 4 _repjjjv dams�ed
walk. Wr"ae rolls w%windows_& doors. g4n&e front office " iadicated._ by _
additional drawings. See Permit /1.343 Ylumbin8 permit requfrea.
SEWER FIERMITM
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS uVALUJ-'-00"
BUILDING DEPARTMENT SETBACKS FRONT REAP LEFT SIDE RIGHT SIDE
Permit ll. ) _
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 67,g;� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH 1HE PLANS AND SPEC'FICATIONS AND IN COMPLIANCE
Subtotal 176.yj WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE GF THIS PERMIT DOES NOT WAIVE
_�, R_STRICTIVE COVENANT. CONTRACTOR AND SUB CaNTH,4C70RS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE.SEPARATE PEPMITS REOUIRED FOR SEWER,PLUMPING AND HEATING.
Total 1132.85
SDC—
Uy ;`iu PDCM APPL�CANTORAGENT'
EW Receipt No
.Approved PHONF
DATE JINSPI T rpg INSPECTION REMARKS PLUMBING DATE
_ Contractor—n IA,"A y
Permit No.
Rough.In
1 Ct:�7 Fixture I
Final
HEATING
Contractor
Permit No.
Gas nr Oil
Final
SEWER
Final
DRIVEWAY
Storm Drei tap
(Pain Drain)Final
Sldevmlk
Curb&Street Final
Approach
OLD03 DEPT. FINAL TEMPORARY CERTIVICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
LendscapInp
Zoning Final
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(Ity of 1>>ng City
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Q� September 9. 19b�
,)eano Smith \
King City jenturist 61 inic
15735 6• d. 116th ,ive .
Kine, "Icy, uregon )7224
gear lair. Smith:
The King City Architectural heview %.;or►imittee have
aPproved the final plans submitted by ,avid lilorgan
and instructed ;:ar. 4alden of the Gity of Tigard to
release the building permit to you.
The Committee have discujoed this project at many
meetings and are of the unanimous opinion that occu-
pancy and operation of the facility would not be con-
sidered desirable until tree entire re -modelling is
fully completed, with an empriasis on landscaping, part-
ing spaces and exterior painting and r.�furbishirl6.
Yours truly,
George dhittier, Chm. '
Architectural iteview Committee
CC . King City Archtectural committee .
File.
Lid wvalden, City of Vigard. ' !
�r
"it dental clinic ��
BUILDING PERMIT APPLICATION KING CITY DATE ---_-_,19-- - til
43
THE UNDERSIGNED HEREBY APPLIES FORA PERMIT FOR l HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER ..me in Sidra,l JOBADDRESS t 11 I 1 S.: c}utsen i.lixabetkk
ENGIiNEERTBUILDER Ale" _ ADDRESS CESIGNER
STRUC.r
URE ❑ NEW �tl REMODEL CI ADDITION L�7 REPAIR ❑ RENEWAL _ El FIRE DAMAGE- Ll DEMOLITION
0 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIC ❑ CARPORT ❑ GARAGE 0 STORAGE Ll SLAB FENCE
OCCUPANCY ____ LAND USE ZONE BLDG.TYPE _—FIRE FIRE ZONE PLAN CHECK BY __ HEAT_____
------- — --1allren1l: modification of existf.c�`31dg. Allpe.r; cads regeiireme®nts
sal al)prmred planes.
SEWER PERMIT _ Ylwnb_iw, h rbech. Permits Requtred. u,o%
OCC.LOAD FLOOR LOAD 40 _ HEIGHT IG NO.STORIES I — AREA 332gU00.NO.BEDROOMS _ VALUE 1599001).
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 11u,5u THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE 3UILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS H.:REBY AGREED THAT'HE
Plan Check 93 1'd. WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFI_'ATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 178843 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. l uk,,4J ✓��f L
State Tax 4.42
— SDC- `n
Total _ _I82.85 PDCM �/ f aZ, APPL A T AGENt c l �... 1 _- •v '- —��..-
By cz-
Receipt No. —
Approvod E*f1 ADDRESS PHONE
DATE INSP. E 1 SPECTION REMARKS PLU BI—NC; DATE
o
Permit No. C 3 _ A
rL' i Rough-In 1- Lf 14 55
r _ nixture X152 ^ �3 y z
-� Final
/ /L - --- HEATING
Contractor
Permlt No.
C Gat or oil
7Flna --
SEWER
Filial
—` — -- J DRIVEWAY
Final
— — Storm Drainage .�;W �-
- -- (Rain Drain)Final
- -- Sidewalk _'� t,-,d P--
- J Curb f,Street Final t
Approach
SLOG. DEPT. FINAL TEMPORARY CEF7l'IFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -- —
Landscaping
+ Zoning Final
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CITYOF T1 ARD N0. 5802
12755 S.W. ASH l
I P.O.HOX 23397' Data � ld. S S
TIGARD, OR 97223
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Name
r
Address
Lot BlocklMaP Subdivision/Address J
Permit M's Bldg. Plumb Cash Check
Sewer
Other _ Other Rea B I;
Ip
�7escrl tion Amount
Acct. No.
10.432 Building Permit Fees
10.431 600 Plumbing Permit Fees
10.431-601 Mechanical Permit Fees '
10-230.501 1 State Bldg. Tax
4 10.433 Plans Check Fee -
t 10-435 at Licenses & Permits
1 30.443 _ Sewer Connection —
IF 30.444 Sewer Inspection _
24.446 Street Syst. Dev.Charge J —
f 25 449 810 Parks I Syst Dev. Charge
I 25-449-620 Parks II Syst. Dev. Charge ---_-
31.450 Storm Drainage S st. Dev. Chtlrge
10.430 Business Tax
10-434 Alarm Permit
10.227 _ Ball _-
10.455- Fines-TrafficlMisdlParking
I 10.230- CPTA TrafficlMlsdlVic. Asst.
I
10.456 Indent Defense
30-446-401 Sewer ServicelUSA — —
30.446.402 Sower Service/City
31-447 Storm Drainage
40 475 Bancroft Prin. P mt.
40.471 _ Bancroft Int Pymt. -
10-451 Other Charges for Services
t — TOTAL
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�- DEPT.
0
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