16590 SW ROYALTY PARKWAY OWN
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16590 SW ROYALTY PARKWAY'
�- KING CIT1
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SEINER PERMIT v� o
� N. 225,5
Uf
Unified Sewerage Agency
of Washington County CITY OF DATE
OWNER: i /- A ► /U P H 0 N E : �%— =';">/
OWNER 'S ADDRESS: �,� r !�� / / ( '~ �i i) If?-7:]
TYPE OF INSTALLATION:
❑ SIDE SEWER [LINE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY:
El NEW EXISTING EL-1-SINGLE FAMILY COMMERCIAL
❑ EXIST. (FRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS` DWELLING UNITS _
ADDRESS OF STRUCTURE :
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
When calling for inspection, please refer to the Permit Number. The Application expires in one hundred twenty (120)
dais. The amount paid will be forfeited should expiration occur,.
The Agency does not guarr-r!ee the accuracy of the location of side sewer laterals. If the sewer is not located at
the measurement given, the installer shall prospect three feet in all directions from the distance and dPr;!;i given.
If not so located, the instal(,.r shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will install a lateral at the location specified by the installer.
FEES:
PERMIT FEE $
CONNECTION CHARGE
LINE TAP INSTALLATION
ISSUED BY
OTHER
APPLICANT DATE
City o` i 0 a r d ��ec h a n i c a l Peri i�l i t I► 3 Fee ermit
PA,Gto-_____.___I
ti�ry Ins'allatioi' _ F1::place ❑ Relocation ❑ Addition D Alt-�rVion Ory State-__- .�
i TOTAL__ `l.
KIAT ING
CCINTR.ACTOR .►� ►ZAr�.- '�tJ12.1JA�.'�.____r_._- " ` ��.�5.�3-i�L1�
GHQ + ' WORK ADDRESS, C"n^ Q,W
PHONE �+S�.� P� ` r t-T- t_ ► 5. SZ—I -
-e:t___�__ APPLICA;IT
Heat Input Rating (BTU Per Ho
I UAL. OIL ❑ GAS U ELECT G OTJ-IER-
11 EM NO. FEE ITEM NO. FEE
.-or Issuance u` 1"armit� _ EE ABOVE Air Condition_Compressor 15 to 30 HP ^� 10.00 I
(Vary--up Cg- & incl.10_0,000_ BTU 4.00 v -� Air_Flartdlin_g 10,00_0 CFM� � � 3.00_
Naw_100,001 BTU's & over 5.00-��Air Handling Over 10,000 CFM 5.00
rlc^r Furnas _ 4.00_ Evaporative Cooler 3. 0
sYa!i • Floor • Suspended r _4.00 _Range Vert Fan 2.00Install Vents Only �- 2.00 Vent System
Reoair- Heat& Cooling �— 4.00 -_- Hood Commercial
Air Condition: Comprassor Under 3 HP _ _ 4.00- Cormnercial Duct System -_ 10.00
Air Condition Corn7ressor 3 to 15 HP 7.50
!NLPECTOR'S COMMENTS
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR Sun COii1raACTORS
/JIPROVED BYi , DATE ISSUEO BY DATE
^ECEIPT N0.
rr, Signature of Appli nt
10HI1 f. P,[jNHtIR01 Pil!NBING, INC,BL11LDING DEPARTMENT, TIGARD �
P 0. Box 129 PLUMBING PERMIT N0. �
NEN,BERG, HIGH 91131 holder of a valid plumbing contractors license is hereby-
authorized to cause plumbing work as herein noted to be installed in accordance witl the plumbing code of
Tigard. Such installations, require inspection by the City Inspector who shall be notified riot less than four
(4) hours prior to the tirne the installations are ready for inspection. C of Tigard Business License required
for all contractors and sub-contractors.
Owners _- Address/_C196 Otl- G tlE c. 00, Date �_D6
NUMOcP OF TOTAL PERMIT NO.'S
TYPE OF PERMIT _ ITEMS - FEE ON EACH AMOUNT (Office Uw Only)
SIN! Femlly�t beth—each —A 25.00
Duplex—Each 1 both tAidt —_ 25.00`
Additlontl bathrooms—each 10.00
Mobile H_om- a Spece_eech _ tg pp
INDIVIDUAL FIXTURE FEES
_
Ito 50 Flxturea In 1 building—each 3.00
61 to 100 Flr.turet fn 1 buiMing_eech
101 to 200 Fixtures In 1 bullding—each 2.00
201 or more rixturel in 1 buikiing—etch 1.50
MISCELLANEOUS
Bullding Sewer—tit 50 ft. __- 10.00 i
Sewer—each addlilonol 100 ft. — 10_00
Water Service to bulldlrV 6.00 J 0,•, '•,
Privet!water Syetemt—each 100 rt.� 10.00_
then (Sp"Ify
PERMIT C ) For Plumbing Insriection Phone 6394191 C
:% State Plumbing Contractor BV tj 1
RFCFIPT NO. Issued By
JILDING PERMIT APPLICATION KING CITY 1-"<< .'y 1290
THE UNDERSIGNED HE:-EPY APPLIES FOP A PERMIT FOR THE WORK I II:REIN INDIGATED B011-)LH PHONE 539-3101
OH AS SHOWN AND AP"ROVED IN THE ACCOMPANY' +G PLANS AIJD,lPF('IFICATIONS. i)WNFR PHONE_
Lor NO.- .—K City
20
OMNER ? ,inrf. `43srks JOBADDRESS '),,390 51,j wt�.ty N►drkwa,
— _ - -
ARCHITECT
ENGINEER
BUILDER T�1=�1. 08V• Cu• _ADDRESSl53n� i ° hath DESIGNER T•ls•( .
STRUCTURE tJ NEW ❑ REMODELY �P- ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE I❑ DEMOLITION
lU RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY —LAND USE ZONE T 7_BLDG.TYPE �s�ti FIRE ZONE PLAN CHECK BY --HEAT-IiB —
Ctj(jstruct single frimi?y dwelling w sattechad garage. 3 Hsdm ms z 8h tihsv
i"MECTION 5iiCILT ATTt1i�NCC . _ --
SEWER PERMIT N — Issuod, by U•5•A• garage :,lei Dg• �t•
OCC.LOAD FLOOR LOAD 40 HEIGHT 142 NO.STORIES I AREA 1117 NO.BEDROOMS i VALl 7 g 1bg0•
BUILDING DEPARTMENT SEI BACKS _FRONT 10 REAR__1 c1 LEFT SIDE :, RIGHT SIDE r"
Permit I° `�1•�fJ _�THIS PFRM1T IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
„ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
(!
Plan Check �• WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal <:71•ate RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
�; •7'•"i
State Tax
1 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC—
Total � r_7 5.7/ - - ----- ---- - - - - -
�— PDCM APPLICANT OR AGENT
Ry _.� P
`— Receipt No. --
_�-e�----_,��_----- ------ - -_ PHONE
ApprOved (�f I ADDRESS
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
00\
Contractor
00\ _ Permit No. a 03 .60 /0-/6`g»
!C-•1 `QO ��
P,S57 T e..� Hough-in --�
Fixture
Final
HEATING
Contractor n
r1'tl2-S,6 Acew►� G _ Permit No.
Gas or Oil
Rough-in - —^_^----
Final
:,JSEWER
Final
DRIVEWAY -- --_—_—i
Pinel
Storm Drainage
(Rain Drain)Final
Sidewal k
Curb&Street Final
Approach
BLDG. DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCx
CERTIFICATE OCCUPANCY !/� Final
Landscaping _--J
Zoning Final