14425 SW 93RD AVENUE ff WE S• a
14425 3W 93RD AVENLiE
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BUILDING PERMIT APPLICATION TIGARD DATE-- -
THE UNDERSIGNED HEREBY APPLIES r OR P PFRMI f FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE —
LOT NO.
OWNER 'Aytuund Kalbere>r JOBADDRESS )��� y3Xd
Clack 97U 1 `-yARCHITECT
ENGINEER
• BUILDER Nevtune _ _ ADDRESS 13765 SE Axabler Rd. DESIGNER _
STRUCTURE ❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
Ej RESIDENCE ❑ COMM ❑ EDUCATIONAL_❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE.❑ SLABCI FENCE
OCCUPANCY _LAND USE ZONE _._Rhe`BLDG.TYPE _—FIRE FIRE ZONE___PLAN CHECK BY 80t HEAT-----
1eaeCal l WX 36' Fibers aee m%i mai )v01_per aPprnveci ,�lxtis• -
SEWER PERMITM_ — --- --- --
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES _-- AREA NO.BEDROOMS VALUE IU,OOU.
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE 1-0 RIGHT SIDE _2y
Farmlt HU•SU THIS PERMIT 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 52.33 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 DUES NOT WAIVE
50-total I32.0 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 3.22
SDC
Total 136.05 PDI.,M
APPI WANT ON AGENT
By rtt
Reoelpt No. -- PHOW
Approved BCN A['�'RFS'
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I�DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No. _!
Rough-in t?
Fixture —
Final
HEATING ---
-
Contractor
Permit No.
Gas or Oil
Final -
SEWER
Final
�_ -- DRIVEWAY
— —_----
Final
Storm Dreinagr,
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY final
CERTIFICATE OCCUPANCY
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LnndscaDing
Zoning Final
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MINIMA
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TF1(. U1�(>LI1jIGNeD HEFILLIY AP,'I_ILS I,U1l A ft ItN1I I F1111 I tIt. v'w%JItn :. .. •. •. • ••
OR C,S SHOWN ANO APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. ovrNcr�:Itorlt ZG ��/��
LOT NO. Z
o.vNEr� TT LZIl41�.�u7oe3 naoa :ss I `EL<<�)S �L), _.1� {ZC�• _ , ,E`I1/SOS
ARCw TECT
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SkQ� I3N-E-E:R
—
ST RUCTLIRE _- NEW ❑AOOITIf1N _ ❑nZPAIR QREVE'NaL ❑FIREOA.AAGErr��� [JOE-7-101-11� rnESILlr-jC[ ❑COMLA/ ❑EDUCATIONAL ❑GOV'T [:)RELIGIOUS[]PATIO ❑CAR PORT UGANAGE ❑STOiIAGE tJSLaB ❑FE
T-
-•—--_�__.—___._ --c='� --- •-----'"__.— ^�'-�
CCCVP.0;_Y�►._LANO USE ZONc -BLDG.TYPE -51f_ _ PLAN CHECK BYHEAT= — -
_�.�--- --F�('�4'}'=..�,�1� 1 '1' �'1 alra,,,�y n��_rstalrti 7 7 nu- y n•I"1�L-,f��F`,{'. .__
r
E U E R PERMIT
FLO R n.STORtFS AREA@EOROO
_ NO. ti15 VA I �y� (JtC�•
1s"��L9=p 9 IOAO H[IGHT —r._►1 - -
-_ 5111LOINGDEPARrMENT '
SET BACKS FRONT '� REAR � �� LEFT SIDE /d RIGHT 510E c.G
1t .i
THIS PERMIT 15 ISSUED SUBJECT TO THE RL:;ULATIOr`J5 CONTAINED IN THE BUILDING COBE, Z07
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT
r--- c WORK WILL BE DON[' IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL16.NCE I
$:17•:,fdl � �`_ ALL APPLICABLE CODES AND ORDINANCES. THE '?SUANCE OF THIS PERMIT DOES NOT W
---- r, RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSK
�;a[r• Tax 2 '� LICENSE. SEPARATE PERMITS REOUIRED FCR SEWER, PLUMBING AND HEATING.
Tural SDC —
r PDC
APPLICANT OR AGENT
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Appru:tri I '✓� Receipt No.
SM (SrOt-m
SDC
PDC $
SEWER C NNECTION $
SEWER IN PECTION $
SEWER SUR JARGE $
RCJULl . Approved U , u,sopproved U , Pending U
SKETCH:
INSPECTOR DATE
UNIFIED SEWERAGE AGENCY NO.
WASI] ! NGTON COUNTY DATE
C i T Y OF -- Tiaard ______- _
APPLICATION FOR SEWER COWAECTION PERMIT
4 J
OWNER: _ __ -- _ _ �_�__..__ —.. -- - --
OWNER'S ADDRESS
;TREET
CIT
_-Y ------
STATE ItP
BUILDING SITE: LOT._.__. __..__ BLOCK _.__ _--._______.._ ADDITION
TAX LOT N0. -_- . - _ TYPE OF OCCUPANCY residence
ADDRESS 14425 SW _93rd_Ave.
DWELLING UNITS. __ _. _ 1 _ FIXTURE UNITS _
SURCHARGE IF APPLICABLE
PERMIT FEE _ ...575..O.Q._. -_ INSPECTION FEE _25.00 TOTAL DEPOSITED _ __ 600.00
NEW (EXISTING) BUII..DING SEWER SYSTEM Fenno Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
-
APPLICANT F_f l�'y' �' I e5i- 'ctr—,ee
- -
SEWER PERMIT
THIS PERMIT AUTHORI7ES CONNECTION TO THE SEWER SYSTEM.
LINF SIZE _ INSTALLER _---_....._-______._
RECEIVED BY (AGENCY
►AGENCY 05,4'tS AGENTI
COMMENTS: _ _ Bldg. #1205
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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CITY -�-
BUILDING PERMIT APPLICATION OF TIC�ARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
AS S N ND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONF._,/_ �T"`
LOT NO..
OWNER JOB ADDRESS :SIJ 93rd Ave, HOME ADDRESS
ARCHIT CT
ENGINEER
BUILDER �--1 _ADDRESS— "" _[DESIGNER
STRUCTURE ❑NEW _ ❑REMODEL ❑.ADDITION Cl REPAIR ❑RENEWAL _ ❑FIRE DAMAGE ❑DEMOLITION
Cl RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO LICARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
OBOND ❑MOVING ❑CONDI FIONAL USE UDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
.CCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE__ PLAN CHECK BY __ HEAT__ .___
_ t r3 r h . e a,
chr>snbea las s,,.,tud. Street P i:iugL,° ted t i:._.1� u4.11 k;J
bNdtt
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Q �.LQO ._LQA0 ___IILUU7 �'`I NO.SIQFIIF,S -�/_AH BEQRQ4M5__ VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR O LEFT SIDE �� RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJEr'T TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT 1;: HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Stlb total AI_I_ APPLICABLE COIX'S AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING_
Total
By
APPI '(:ANT OR AGENT
Approved _ Receip, No.
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WAA
DATE INSP. TYPE INSPECTION REMARKS f PLUMBING DATE
Contractor _
Permit No.
D—I - T_� � in�jlx� Rough-in — —
\z-2o 71 {{ K F-xture
0! rFinal
DISRpFnoveib 2c ) _I HEATING —��V—
�L—�k �n 'r'. W 1l�r✓ ^� Contracts
d�c' I 1-",tv PLOK- _��—ST��LI >> Permit No !
AA �� —__— ��— — Gas or Oil
Rough in
Final
SEWER
Final
DRIVEWAY
Final
— — - _- Storm Drainage
_ (Rain Drain) Fina'
Sidewalk
Curb&Street Final
--
Approach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY / 1
CERTIFICATE OCCUPANCY Final
( Landscaping
Zoning Final
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Address / �5� 5- �n</:�d'��u.c� Permit No. / /0a �
Permit charge X 0 72 t!—
Owner _ / Li. �; � Connection fee
Paid by L 04r
Type of building _ �� Date connected
Service rate Inspection fee ASN
Contractor Paid by date
S.:ze of connection ` Assessment Paid
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