9790 SW PEMBROOK STREET F
9790 SW PEMBRXK STREET
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CITY'� � •rte {��
ITY OF TIC�A�R.t �
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k1 i3milding Address. ...P.7.9.0. 5W pembrook. St...... L,o.t 7-14
Cet•tificate i:� hereby thia....17........rlay of Mdreh........ .......... 15178..
i that s„'r1 building may 1w occupied and j
that It complier with all of
the Buildings Code. [m, the city of
a6 approved by thrr, "l'it;,,rd City co-.111cil.
¢.i w>C J �'«w�U ► ww�' �i"4.r t� '�oq.>• J «.u3wulFFI (icy a;r9(1y� �`
I r ;��4�J .,l ,. . �'w�.+-,4; _� ,. . r� '�'` y � +{ .. J t t y�r'•�i r' `�✓, ' v,;.t 4��-i'� 'qM. �'
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Address .% n Permit 57� ^d o.
Permit charge )
Owner �lC�/y ��-�,�s7 Connection fee
Paid by b L LIC 4 %177t�
Type of building ?c e L Cate connected
Service rata Inspection fee -2
Contractor Paid by date
Size of connection Assessment Paid
R's 8- o
BUILDING DEPAf;TMENT, TIGARD N�
PLUMBING PERMIT lr •
C-A�tAI. �'�u-� 1 ►a +_ mf�.C�1�r1;nLL;-�OL`holder of a valid plumbing contractors license Is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing codf! of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owner_�n11� �%•�L�- _ _�/_y1�i4c_f_-'_Q-`_•�__� Address_._l��.l_' _--i_.—' et n
_
-�~ NUMRER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EA:H AMOUNT (Office Uso Only)
-8.9,S.1 PSN TLAl
Side Family_t bath.-each �._ _-. 25.00 _
Duplex-Each 1 bath unit _—__ ._ 25.00
Additional bathrooms-earh _ _---___ 10.00
Mobile Home Sp., h. — _ 15.00
_INDIVIDUAL FIGURE FEES
1 to 50 Fixtures 1 building—eNgh — __3.00
51 to 100 Fixtures In 1 building each —` y _._ 250
101 to 200 Fixtures In 1 building-each 2•00.__
201 or more Fixturas in 1 building-- ej+ch — —_ 1.50
M_ I S C E_L L A N E O U S
Buildingw
5Per--1st 50 ft_ ----- 1000 —
<; _Sewer-each additional 100 ft.
Water Service to building —_ � 5.00
-- ---- ------
Prlvate WatcrS stan,s-each 100 ft_ —^— _-_- __. 10.00
_.l' _ --
Other (Specify): -
PERMIT_ / 'tom For Plumbing ln-p��rriorr Phone 63.9 4171
—336 State u o Plumbing Contractor By —'
TOTAL —_ r . Ni1 FIECEIPT NO. Issued+By
.. .. .;.,ye•pa'e,:,�,r.r..toury..,..N^.e"�!!ryNw.,� ..�..^+^��re•^'r' ^,s�'+'�"
By-24-77
BUILDING PERMIT APPLICATION 1 FY TIGARA DATE- _ t9 � �_f 7 ,n
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNERPHONIT
LOT NO._ -- --
t,lovLerly 7'iU ;i1J ►�Amt�r�
OWNER D ADORE.F,S HOME ADDRESS
JO
ARCHITECT
---�- IscQ��-mki Pox A].?(' NUht.a rri ENGINEER
STRUCTURE_ nNEW ❑REMODEL BUILDER ADDRESS ADDITION ❑REPAIR ❑R_E_NEWALIGNER❑FIREDAMAGE ❑DEMOLII"ION
J RESIDENCE ❑COMM ❑EDUCATIONAL- ❑GOV'T C3 RELIGIOUS❑PATIO DCAR PORT []GARAGE �❑STORAGE❑SLAB ❑FENCE
❑BOND [:]MOVING ❑CONDITIONAL.USE ❑DESIGN REVIEW []COUNCIL APPROVED (:]SIGNS
OCCU N Y 3 AND USE 20NE BLDG.TYPE-- FIRE Z NE.=.._._ PLAN CHECK BY HEAT
r ; C�lflt9 d�I f L't -W . )� H. -- � I
-- 1 LC?flLt 49 L,,,u.
QCC. LOAD __, FLO LO HEIGHT 20'9•ST013IES.__*jLjy0A _._ NQ,PEDR300MS VALUE,dtL_...
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
IJt� 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 TNF
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 PERKP T :')ES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT r.iTY BUSINESS
State Tax -�T LLGb)l t MPARATR ftXWTS "tout PIED,"ps sottR.!RLUMBING AND HFATIN3.
Total ilark tldL I: i i ' 100.
By - R --
ANT OAGENT
Approved Rer_eipt No.
-PHONE
.Wu.�...r.w....w....,_,1..—....1......�.........4....rr..wa�...:.....-..,.s.•.......s.t—.w�.y.,......�..w......d.wY�r..u....,.... _. .._... ..a..r...w.,aau.a._.s.w..e.,..,w.w......»„ ........ _.
UA1E INSP. TYPE INSPECTION REMARKS r — PLUMBING� _ DATE
-�`f'r�, 5b V contractor
L0- 'J U ,�t �ti — — Permit No.
Rough-in
Fixture —
/�'y`���- � — Final ___ _
HEATING -
Contractor
---_ Permit No. 136 .7 /0—/1-
Gas or Oil
Rough in
F inal
SEWER
Final _
DRIVEWAY
---- -- - - - - Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street F final
F\pproach_ _
BLDG DEPT. =INAL TEMPORARY CERTIK;LATE OCCUPANCY
CERTIFICATE OCCUPANCY Final —
Landscaping
C. �orung Final
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; . SEINER PERMIT N9 13498
u
Unified Sewerage Agency CITY OF Ti Gard DATE 8-24-77 i
of Washington County i
PHONE : 981-6770
O W N E R : _y1 i_VV_e.r_1 X_
oust.
OWNER ' S ADDRESS: —
TYPE OF INSTALLATION:
XQ)3UILDING FEWER ❑BUILD'ING SEWER AND SIDE `_EWER
TYPE OF OCCUPANCY:
X& SINGLE FAMILY [� 'cnMMERCIAL.
JC�D�E W
❑EXIST . (PRIOR Tv 7- 1-70 ) ❑ MULT . RES. IIlDUSTRIAL
FIXTURE UNITS _
DWELLING UNITS 1 -
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 —
TOTAL $ —-- 625•
DATE
j APPLICANT
SEWER PERMIT M 13498
9790 SW Pembrook St.
ADDRESS OF STRUCTURE
_______� TAX LOT ---- SYSTEM c
SYSTEM fanno reek
TAX MAP
LOT ___ 14 BLOCK OF-_ `
APPROVED BY DATE
ISSUED BY DATE
REMARKS [41d0 X1659 _
L1TY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE : �� J �� 7 °7� _ ESTIMATED SALES PRICE -
APPLICANT NAME ��.L�1_•P C�s,1�� TELEPHONE Z'
JOB ADDRESS ) :7() (9i�, i��.ti.,j, i� - _ BLOC. PERMIT m / i
AMOUNT OF FEE FOR C. D. C. 3o o
DESCRIPTION OF IMPROVEMENT_____ � � _ �-m �
i
EXFh1PTIONS -PER ORDINANCE #77-26
FEE RATES:
A. Single family dwelling ;snit under $60, 000- ---------C $100.0
P. . Single family dwelling alit over $60, f)00.--------- -1 r,TT,-D0
C;. Mobile Home Court Space (New Development)------- $150. 00
D. Multi-Family Uewitings--per unit------------------- $240.00
E . Commercial. , Industrial & Institut.ional (Park. Space) $ 50. 00 each
F. Single family unit under $40, 000. ------------------ SS250. 00
CITY OF TIGARD
ORDINANCE #77-71
PARK SYSTEM DCVELOPMENT CHARGE
DATE : 7'' ESTIMATED SALES PRICE
APPLICANT NAME (- )n 0M_1t-,_t TELEPHONE #__ 6 77 O
JOB ADDRESS 0--, '') q p C?��a_,,, Q.=. - (e_ BLDG. PERMIT # `•�9
AMOUNT OF FEE FOR P. D. C .
DESCRIE'TION OF IMPROVEMENT
EXEMPTIONS - PER ORDINANCE #77-71
FEE RATES:
A. Single family dwelling unit under $40, 000. --------------$ 75. 00
B. Single family dwelling unit over $40, 000.------------- �"�
f. Mobilo Home Court Space (New Development)--------------$ =�u•00
D. Multi-Family dwellings--per unit------------------------$ 60. 00
CONSTRUCT70N IS LOCATED ON \,/' S.W. N.E . SIDE OF S.W. PACIFIC
HIGHWAY . N. E . is Park District #I . S.W. is Park District, #II .
ITY
31JILD!NG PERMIT APPLICATION CIF TIGARD DATE—�.a _-__. 19.-_11• Np
{V LI'gDt H�IGrNE D HEREBY APPLIES FOR A PEOMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE__94_j'1(L-__
;•F AS SH,)WN ANDi�PPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE-
./
HONE- .•J
/ q7af D S. W. Pembnook S . HOME A LOT NO. ',� Ot�_
F# //1/ �� I J1 J09 ADDRESS ARCHITECT
M ENGINEER
R U_�a_veA--ty Con.6t. Co. ADDRESS Rx I Bt'x tit
412C HubbaAa DESIGNER
^ _
URE LJEW�OREMODEL ❑NDDITION LIRLPAIRr�-1 ORENEWAL `1FIREDAMAGE CISLAB
X4 ' 'DINCE 01-010M_ElEOUCATIO-NAL CJGOV•T DRELIGIOLISOPATIO CICARPORT nGARAGE ❑STORAGE LJSLAB ❑FENCE
-1HOND I_JMOVING _ GCONDITIONAL USE JDDLSIGN REVIEW_ ❑COUNCIL APPROVED ❑SIGNS
:._L'FANCY � L aNC USE ZONE__ - BLDG.TYPP' _FIRE ZONE- PLAN CAECK BY—�_ HEAT�_�LkL��—
00,
G�
F 1 VQp_L41A�- -----H IC+HT - $3� -..NQ I4RIE _._.L�fi€�� _wL•@Ei2R49. '. 1lE�LS�E.
BUILDING UEPARIMENT SET BACKS, f RONT--LO 1 REAR a�.� iLEFT SIDE 151 RIGHT SIDEml t
THIS PERMIT IS ISSI!FD SUBJECT TO THe REGULA'IONS CONTAINED IN THE BUILDING CODE, ZONING
r'lan Check — 'y pGy REGULATIONS AND ALL APPLICABLE COLIES ANC ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WIT11 THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
`>Ub total ALL APPI ICABLE CODES AND ORDINANCEF. THE ISSUANCE OF THIS PERMIT DOES NOT WANE
--- ---- -- - RLSTRICIIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Iale Tax l a�'f LICENSE SLPARATE PFRMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
'T mal G►aventy ConeZ. Co.
-- --- --
by
... APPL(CANT OR AGE NI'
,'Approved Receipt No.
ADD �r—�Ftf—tr-��i—'iric�'i-77 Y`�iU1V�7�IIT7Y
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