11285 SW 78TH AVENUE 11285 EW 78TH AVENUE —'
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BUILDING DEPARTMENT, TICW-n �r�
i r PLUMBING PERMIT •
Yet-��/a.•.y _ � holder of a valid plumbing contractors licenso is hereby
authorised to cause plumbing work as herein noted to be installed in accordance with the plumbing code o
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four i
(4) hours prior to the time the installations are ready for inspection. City of Tigard Busin;.'ss License required f
for all contractors and Sub—Contractor .
Own er,.,;" r1 —__ �_'.,�'� .�_ ddres,l '_�- '�1' A Date_
_ NUMIF.R OF TOTAL PhRA111T NO.'S
TYFE OF P CM11T ITEMS FEEONEACH
—
� A41UUNT (Office Ute Only;
Simla Familx-1 be-h—eeach 25.00
f)upiex`Each 1 bath unit _ _ _ 25.00
Additional bathrooms-each —�`—^ — 10.000
Mlonil3 '•Iome.Space.-each ----- 15.00
INDMOLI_AL_FIX_TURE FEES
Ito 50 Fixtures in 1 buildin -each —� —9.00
—51 to 10(1 Fix_ures in 1 huildingZeach_ ,— _ 2.50 S
101 ;0 200 FlxtureLin 1 builti! _ __.__-____. -_ 2.00
207 of more Fixtures in 1 build ny--e:ch 1.50 __
MISCELLANEOUS
Sewer-�lst 50ft. _ 10.00 _
_ J
r Sewer-each id-iitional 100_ft. — ----�- 10_00
Waver 5arvicg to building 5.00
Private Water 3 sterns-each 100 ft,-� ,—__— _ _ 10.00
_PERMIT__— --- — _ For Plumbing In.;o-'ction Phone 639.4111
"o Si to Plumbing Curttraetor By
CI AL RECEIPT Nr). Issued By
ff W IN
WSW
r.._..
5 1� 2001
BUILDING PERMIT APPLICATION rOF TIGARD DATE 4-5"7k' 226—?86"
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE. �.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHON ''* '' . "`
LOT NO.—
OWNER i hi j,ia11ghfiar JOB ADDRESS 11285 SU 70th HOME ADDRESS
ARCHITECT
I :.f-ICit�nuoad L oasts C )XDDRESS RFa 2 � ol: a74-1 ' f at�Q--'1t1illENGIN
EER
B'IILDCRER
:: ❑ L,.I
TRUCTURE 4EMW
REMODEL ❑ADDITION ❑REPAIR RENEWAL. 0-IRE DAMAGE ❑DEMOLITION
❑AE Si DE NCE' 000MM ❑EDUCAT IONAL OGOV'T 0REL.IGIOUSDPATi0 ❑CARPORT ❑GARAGF ❑STORnGECSLAB CFENCE
❑BCND CMOVING []CONDITIONAL USE C3 DESIGN REVIEW ❑COUNCIL APPROVED SIGNS
OCCUPANCY__`' - LAND USE ZONE. ��!? -BLDG.TYPE_c' I .FIRE ZONE 'J� PLAN CHECK BY___° 1 HEAT._ k'
9i:1t;�1. family tlGtOl�.. n'�i / tte►r.he. �;r�xgr,�e 3 bl�I r,jom usth t;r: i,�go —
sower permit 11! 1146
REA Q=?N1Q-H UROOMS 3, __YALUL'�+32811! L
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 66 LEFT SIDE 9 RIGHT SIDE 0 �Permit 136.00
136.00
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20:4ING
Plan Check 6U,00 RFGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT 15 HEREBY AGREED THAT THE
---- VVOnK WII L BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb•total 2U4e00 ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT UOES NOT WAIVE
RESTRICTIVE. COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY R1tSINESS
Statex TeX ;►.4 _ LIt;ENSE:SE�PAJA7E,QE�RMITS REQUIRED FOR SEWER. PLUMBING AND HEATING.
Total0 ,4G
BY
------ APPLiCANi OR AGcNI
'Approved -Ity Receipt No.
.i
DATE INSP. TYPE INSPECTION REMARKS PLUMIING DATE
Contractor
�4r, Q Permit No. ,k�
Roughin
Fixture
— — 2- O1, Final
A�uI / 1 — HEATING
/V 0 Diu ri iContractor — —
�,, J Permit No.
5 � Otudr — Gas or Oil —
Rough-in
Final -- --
0 SEWER
,— _ d�LCiCX tiss CJ�Gu C D.np �t Final
DRIVEWAY
ti nel"�^t �Ch a Final —�
_ Gtr 1Cp/1Je cr(�C! 3 Storm Drainage
�s•Cv ^ Rain Drain)Final
:t �y � U :iidewelk
—d `—�— 2 a Curb.&Streat Final
►osT xn- o _ ,Approach
BLDG. t 1 AL TEMPORARY CERTIFICATE OCCUPANCY Incl
CERTIFICATE OCCUPANCY
_andscaping
Toning F'viei
/o/9 o �D, -/9 i��?---�rt�
J p.
r
Uf
SEINER PERMITW
nfied Sewerage Agency
of Washington County CITY OF _ Ti i rr rri DATE A__ 7R
OWNER ; PHONE :
OWNER ' S ADDRESS:
TYPE OF INSTALLATION:
xQ BUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XDANEW xIL-1>6INGLE FAMILY ❑ COMMERCIAL
❑ EXIST. (PRIOR TO 7-1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS_
ADDRESS OF b T R u T URE :
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. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE 600,
SIDE SEWER INSTALLATION
ISSUED BY
OTHER _
TOTA $_ 6-S,_
APPLICANT DATE
�UNI F1DRr,, ,,' SEWER PERMITN° 15646
ADDRESS OF STRUCTURE 11285 SW 78th
TAX MAP _ TAX LOT SYSTEM _f annn rr�,�lc
LOT BLOCK OF
APPROVED BY DATE ISSUED -''Y DATE
D. U. ' S 1 REMARKS ____ bldg. #2001
CITY OF TIGARD
ORDINANCE #77-71
PARK SYSTEM OF-VELOPMENT CHARGE
DATE : -� /:S /�
ESTIMATED SALES PRICE $ /, 1,(J
APPLICANT NAME '��A.j TELEPHONE
JOB ADDRESS / I;�- �'� �' `� � BLDG• PERF1IT
AMOUNT OF FEE FOR P. D. C. Jya
DESCRIPTION OF IMPROVEMENT_
EXEMPTIONS - PER ORDINANCE #77-71
FEE RATES:
A. Single family dwelling unit under $40,000.-------------$
B. Single family dwelling unit over $40,000.------ _!____4$100.
C. Mobile Home Court Space (New Development)------- _$ 50.00
D. Multi-Family dwellings--per unit------------------------ 60.00
CONSTRUCTION IS LOCATED ON S.E . Y' N.W. SIDE OF S.W. PACIFIC
HIGHWAY. N.W . is Park District #I . S . is Park District #II.
CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTE11 DEVELOPMENT CHARGE
DATE : ��/. �1 E5 T MATED SALES PR ICE ; /00
APPLICANT NAME TELEPHONE
JOB ADDRESS BLDG. PERMIT L
AMOUNT OF FEE FOR S. D. C.
DESCRIPTION OF IMPROVEMENT
EXEMPTIIINS -PER ORDINANCE: -1177-2.6
FEE RATES:
A. Single family dwelling unit under 5K,000---------- (,300.00,?
H. Single family dwelling unit over $60,000.--------- 5400. 00
C. Mabile Flame Court Space (Naw Development)---------- 3150.00
D. Multi-Family Dwellings--per unit------------------- Sa240.00
E . Commercial , Industrial & Institutional(Park. Space) $ 50.00 eaclr
F. Single family unit under $40,000. -------- ------ 3250. 00
ITY
3WILDING PERMIT APPLICATION `"oF TIG AAD DATE 1_-����_�,_.__, 19� N°
2.1-4
!F kINM HSI GNED I-!LREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE41612-!ZV3V
:-F, AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO
-F.4-PJC+LL. k-E"CI-4 Cie- Jc7B ADDRESS /�� S(.ti..� i�"'�S - HOME ADDRESS
ARCHITECT
t✓ ENGINEER '
4 w ,u: (� ADORE Ox �f7�1- �a1Kf« DESIGNER �rr� ✓-- L.� A�,.t c4
R (E�l?.L.v_ CQ__L_LG_L_Q�_._ 4 T _S1 r/ f--�. --�_
".,RF NEW 0 REMODEL ❑ADDITION —�OHEPAIR - ` ®RENEWAL ❑FIRE DAMAGE- ❑DEMOLITION
IR __^
NCE cnmm ❑EDUCATIONAL ❑GOVT 0RELIGIOUS0PATIO ❑CARPORT ❑GARAGE ❑STORAGE[]SLAB ❑FENCE
1H'`ND 0MOVING O -ONDITIONAL USE _❑DLSIGN REVIEW []COUNCIL APPROVED ❑SIGNS
L'�:.N Y � I SNC 'SE 20NE BLDG.TYPE_ FIRE ZONE PLAN CHECK BY _ - HEAT
Ap ___. _._... FL�'Q.Fi l.4AD. _v_-_. _ H LG►�_L_ __ ._;iIQiES__ -.AF�.d__/�Z!NQ�@EpROOMS 7 VALUE
/o Q
BUILD,.IG UEPARTMENT SET FACKS FRONT REAR W LFFT SIDE / I.& RIGHTSIDE
-F-= THIS 'ERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Flan Check e^ 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 COMPLIANCE WITH
-uta 101at _ � �QQ ALL %PPLICABLE CODES AND ORnINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
i
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
`tate Tax LICENSE. SEPARATE PERMITS Rf-OUIRED'FOR SEWER, PLUMBING ANO HEATING.
Total �, !j/1`..
_._ A PL ICA '1 OR AGE
hY , I �ti s'4�,�iCa�ckv T
-4pptoved Receipt No
� nD[ipF55' HON
qk7l �
i
._ _. .- ._._-- ,.... -..._..—�:.a..- ..• .. rte:;'17s";,;."!_ _�-=•".""""..._.-.,.-_+.wa...,aa•.-�o•«a_�m'a'ar+Ic.
of Ti clarc� �'��tcht�r�ic(�I E'��rcili� \��
ns;dli�tion Re;i!aa l r.el cation _J %+ci;i tion i_� Alts ration
l
SQMER
SET PLUMBING & HEATING fOTAL_ _
CC;'.TRACIOR 17005- OWNER
ADnRESS
BEAVERTON, OREGON WOK DDRESS '� Fs-
PHONE
R
APPLICANT .�.
Heat Input Rating (F''TU Per Hour)_ O' 0� Vent Size —_ -_ Flue
FUEL OIL ❑ CAS J� ELECI l ] jj OTHER
ITEM/ NO. FEE ITEM NO. FE
For lssuance of Perms; Air Condition Compressor 15 to 30 HP 10.1
New Under 100,000 BTU 4.00 Air Fi,indling 10,000 CFM 31
r;-w• 1(1U,000 BTU & over Y_— - - - �, 1 - 5.00 '• Air I leu filing Over 10,000 CFM 51
Floor Furnace _ an4.00 Eva;rorrrve Confer
l4'ail Floo 5lspded--v� �W -� � � - 4.OU ranyc Vent Fan
Install Vents Onl, 7.00 Ven, System I
Repair • Heat & Cc oling 4.00 Hnnri Commercial 3 i
Air Condition Compress o' Under 3 HP 4.00 Conirrierc ial Duc Sv c,em 110
Air Condition Compri tisor 3 to 15 HP 7.50 -
INSPECTOR'S COMMENTS
CITY BUSINESS LICENSE REOUIRLD FOR ALL CONTRACTORS OR SIi,+ CGNTRAC'FURS —
APPROVED BY,---. .____ __-- --•— DATE - - -----.____ ISSUEC BY
-.-- DATE
RF'CE IPT NG.
A
DDRESS 1 5' '%��_ VERiIIT N0._
n'-Ri',IT CHARGE none
J'NER CU�I�JFI�TION FEE eel
.._. PAID BY --
IYPE OF BUILDING DATE CONNECTED
SERVICE RATE / r�� . INSPECTION FEE _ ,7.5',
CONTRACTOR PAID BY DATE
SI7E OF CONNECTION __ A)5ESSIIENT PAID