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H r ryCZ� CITY OF TIGA R ,
/\�1]�{`aii OREGON
rR iOwner: Permit No.
Building Address---3Z G U t=w !� 4_r
,� r �
Certificate is hereby given this _ --.— day of C If
that said building may be occupied and that
it complies with all requirements of the
y ; Building Code for the City of Tigard, ash
approved by the Tigard City Council. f
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---— �'
Building Inspector
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Address Permit No. /.21-3 rf
Parini t charge 22 r y? tf
Owner Connection fees
Paid b
Type of huilding lZ-r Date connected
Service rate / S Inspection fee
,'ontractor Paid by _ date
Size of connection Assessment Paid
`1/7 7
BUILDING PERMIT APPLICATION "yaF TIGAR® DATE- 4-21-77
THF UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREI:i INDICA-i ED BUILDER PHON7="r�
OR AS SHOWN AND APPROVED IN SHE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF
LOT NO.--
U
O. wU Kurt Oall 9260 511 V .+r w Terrsc,-1
OWNER JOB ADDRESS HOME ALIDRESS
rY ARCHITECT
Gs Hsuu ENGINEER
BUILDER ADDRESS �— DESIGNER
t�
STRUCTURE_ [INEW ❑REMODEL. _❑ADDITION C3 REPAIR ❑RENEWAL V ❑FIR^ DAMAGE []DEMOLITION
ET-FIESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑REL.IGIOUS❑PATIO ❑CAR PORT ❑GARAGE 0 STORAGE❑SLAB ❑FENCE
013OND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY.,I LANU USE ZONE—t — BLDG.TYPE `'I` FIRE ZONE 'PLAN CHECK BY lst "!_ HEAT
c m it•. singlo family dw illin(W W/attachad garage split
;+q_bsdrn .►19► 3 bath garagra Ljn_-s&1. ft-
40
t.d0 2G 2 27C,2
OCC.LOAD F_L QQBJ QAC_—_- HEIGHT NO STORIES VALUE
BUILDING DEPk�RTMENT r ,YG
SET BACKS FRONT 2 REAR _ LEF f SIDE ' RI(,NT SIDE
Permit
-- - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check REGULATIONS AND ALL APPLI,-ABLE CODES AND ORDINANCES, AND IT IS HEREBY AGRCED THAT THE
WORK WILI. HE 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
-- — — RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax g.23 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total :316."Ati +1 ti t cim 0evelupmon t Lha rge 14l)a On
APPLICANT OR AGENT
Approved � H rc 1p1 No. i
` tW vi ADOR� /UN
i
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
•��/�/�/%��7� r 9Z J-4 -P�I�e—t� — Contractor p
Permit No 2 y- 7
6 z g 3) u p Rau h-in --- ---
l
17 J� f ,ii"'t Fixture ---
-20-11 V91 1 v 11
, a - Final - - —
1..20-1� HEArING
Contractor
Pcrmit No. q0�
L)X--�c'�s 1—
tYSSU Gas or Oil
z2orpa- `,.7r_ +� - ROU h i - -- --
Final --------—,
SEWER --—2-0-U - tiQ�., Final
DRIVEWAY
-----
e Final —- ---- - --
Ipproach ain Drain) Final
dewalkurb8�Street Final t�.a AL0e-ck-riot
BLDG, DEPT F L TEMPORARY CERTI IF CATEOCCUPANCERTIFICATE OCCUPANCYnalandscapingoning Final
4 S
,. _ SEWER PERMIT �U
` 12137
E" Unified Sewerage Agency
of Washington County CITY OF___Tia�ar-d__,___ DATE
OWNER :
Kurt Ball PHONE : 620-0435
OWNLR 'S ADDRESS: _
TYPE OF INSTALLATION:
[E BUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCYs
Qt EW O SINGLE FAMILY [:] COMMERCIAL
[:]LXIST . (PR10R TO 7- 1--70 ) MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
PERMIT CONDITIONSe 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 . THIS APPLICATION
EXPIRES IN ONE-HUNnREO AND TWV;TY ( :20 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD 'EXPIRATION OCCUR.
FEES
PERMIT FEE 25,
CONNECTION CHARGE 575. _
SIDE SEWER INSTALLATION
ISSU BY
OTHER
TOTAL S 6nn_ _
A ��'020(1 4
APPLICANT DATE
SEWER PERMIT N° 121. 3?
ADDRESS OF STRUCTURE 9260 SW ViRw TRrrnrp _
TAX MAP- TAX LOT SYSTEM Fanno Creek
LOT _ BLOCK OF
Ar'PRCJVED BY DATE I SStJED BY DA i-E
REMARKS___ Bldn. #1413
CITY OF TI"ARD
DEDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE.
DATE : ` = 7 ESTIMATED SALES P`ICE
APPLICANT NAME)'dit1N TELEPHONE ' _ _M
PERMIT
AMOUNT OF FEE FOR S. D. C. 46� p d '
DESCRIPTION OF IMPROVEMENT40,
,�'�� ����__ 270 t�•t o�_�
�.
EXEMPTIONS -PER ORDINANCE ;477-26
FEE RATES: CAf
A. Single family dwelling unit under $60, 000-- ------ 5300. 00
P. Single family dwelling unit over $60, 000. --------- S400. 00
C. Mobile Home Court Space (New Development)----------- $150. 00
D. multi-Family Dawllings--per unit-------------- --- $240.00
E . Commercial , industrial & Institutional(Park. Space) $ 50. 00 each
F. Single family unit under $40, 000- ----------------- $250. 00
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