14110 SW 97TH AVENUE 14110 SW 97TH AVENUE
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BUILDING PERMIT APPLICATION TIGARD DAI"E__'x 1.2
19 84 5060 I
i
THE UNDERSIGNED HEREBY APPLIES FOR A f 1..RMIT FOR THE WORK FIEREltI .NDICATEP BUILDER PHONE _
OH AS SHOWN AND APPROVED IN THE.ACG(,'t✓,PANYING Pt.ANS/,'If)SPECIFICATIONS. OWNER PHONE 630-2511 i
LOT NCL---10'
OWNER Uteri Wa(idgll JOB ADDRESS 14 1 W SW )itis 25fw11;A
- — --- — --- APCHITECT -` ---_—�
ENG NEER f
BUILDER `gar.._ Ar.)DRESS DESIGNER
STRUCTURE LJ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR EJ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE ❑ SLAB FENCE
OCCUPANCY -------LAND USE ZONE . R94-4 BLDG.TYPE —FIRE ZONE —PLAN CHECK BY l9GB. __HEAT—
.__ _. --�
_ Repcsie_ approac. 5)—IUD cu. yds. of Dirt Pill onyaope.q (see plan)
pwaer responsible for keeping streets clean of mwi.
SEWER PERMIT# _
OCC.LOAD FLOOR I OAD HEIGHT _ NO.STORIES AREA NO.BEDROOMS VALUE _
BUILDING DEPARTME JT SET BACKS FRON1 PEAR LEFT SIDE RIGHT SIDE
Permit I5.00 _ THIS PIFRMIT 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
IS.(Ii7 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total--- __ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
State Tax _
bU LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total
IS.btJ SDC—
APP'
PD(JN LIC'ANT OR AGENT
By C2
R melpt No. _._.
Approved BCR ADDRESS PHONE
_-
DATE I?JSP.1TYPE INSPECTION REMARKS PLUMBING DATE
Pur
mit No.
IRU..gh-in
r.x. re
11 Final
HrATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
t'RIVEWAY
rFinel
Pinel
Stnrrr of air vo
(Rain^r21.n)Final
Si ievmlk
Curb&Street Final
_ Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
I
CERTI;n,CATEOCCfJ;'At4CY r,n.i
Land%,:-pi--.q
Zontr, ins'
e �
BUILDING PERMIT APPLICATION TIGAr` D DATE2- 19��
THE UNDERSIG 4ED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
I-OT NO. J 0'?
_
—y�' NER "�t/�/s'1 `�/AD FL JOBADDRESS I_��/I i� '"1 1 S1— I AA,
-� ARCHITECT
ENGINEER
BUILDER 1! ADDRESS _ DESIGNER
_STRUCTURE ❑ NEW ❑ REMODEL__❑_AODITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITIOt,
❑ RESIDENCE ❑ COA':vt ❑ EDUCATIONAL i) GOVT Cl RELIGIOUS Cl PATIO ❑ CAR PORT ❑ GARAGE G STORAGE Cl fLAB❑ FENC
OCCUPANCY LAND USE ZONE BLDG.TYPE _PLP N CHECK SY 1 HEAT
� > !_ U• vy t T�1 lel" F t�, r_-
I'�r�l'1J6"'►'Y l��,EL- Pt �nl� �c?�yr�lEci _ E5^•L€!RLr r' r
SEWER PERMIT --
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS VALUe
BUILDING DEPARTMENT SET BACKS FRONT REA,9 LEFT SIDE RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZOWN
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED FY.AT TP
Mr—hack WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AF0 SPECIFICATIONS AND IN COYAPLIA14C
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
Subtotal `' RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES
LICENSE,SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
;State Tax
-- SDCToull
--
P[c# APPLICAN T OR AGENT
BY
-- --- Receipt No. -- - —
ApproveA 1 4. ADDRESS PHONE
SSUC --- $
SUC
POC -
1
SEWER CONNECTION
SEWER INSPECTION $ —
c,EWER SU,i. HARGE S
Cnmmonta ;
dw WM. 2 S IIBA
APPROVED FOR CONIQ,,TRUC'r!ON
CITY OF TIGAPID
PE RMrr NO.
i E ir)L)R j li I I C7
CANCELLED TAX LOTS
BY TITU DATE 102,loa,(;Io 60, 702,
300,302,
"o,v
19 02-3055e
200
.............................
4500 4 600 50 200 104 103 1 10
52 Ac. .74 Ac. 7,34c
7' .31
X800 7415''
10730 –
q -, 4700 tn.
0 120
IAL 3 220 10006
NT N 880 ig'5f"W n 105
50 47Ac.
sq, ------- — —30-5
301 aa
J,5 AC N 89*54'W 252.19 109
-- i-00
Ac
• 101
I(;5A(
al
so-
05. 7551 28
S 890 54't 525 A 83
— CS-5931 -- 15
106,
904C 1 10 0
91 4c
L
100
814C
SEE MAP
2S I IIAH
107
59AC
.A OL
004 Ch.
12100
IN! NF N:,
SEWER PERMIT
Nt 27965
Unifl*d Svwera"A99mv
Of Wast ln►.jt County C I TY OF _ - -`� L -�f' DATE !
i
OWNER: -Gv�_ L ��.��n�� AI- �� _ PHONE `? 7-
OWNER'S ADCRESS _
TYPE OF INSTALLATION:
BUILDING SEWER ❑ LINE TAP AND BUILDING SEWER n LING: TAP
"TYPE OF OCCUPANCY:
❑ NEW JLN E:XISTING L�j SINGLE FAMILY ❑ COMMEkOTAL
❑ MULT. RES. ❑ INDUSTRIAL.
FIXTURE UNITS - DWELLING UNITS __/ w
ADDRESS OF STRUCTURE , -/// //U
Permit Conditions: The applicant agrees to comply with all rules and regulationsTf the Unified
Sewerage Agency When callbg for an inspection, please refer to the Permit Number. The Permit
expires one hundred twenty '120) days from the date of issuance. The total amount paid (permit
fee, connection charge, line tap fee and/or other charge) will be forfeited if the permit expires.
The agency does not guarantee 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 3iven. If not so located, the installer shall purchase a "rap and Side Sewer"
Permit at the current charge and thn. Agency wil'i install a lateral.
FEES:
PERMIT FEE
e-f
CONIIECTION CHARGE
LINE TAP INSTALLATION
OTHER
I55UED BY
de
TOTAL
APPLICANT DATE
NOTICE:- DAYS FROM THI
ABOVE SEWER SERVICE
CHARGE WILL BEGINFORTHISPERMIT. SEWER PERMIT NV 27965
ADDRESS OF STRUCTURE I_���GT SGC• �7� t -Z�C3�.t� r
TAX MAP TAX LOT 10aQUARTER
SECTION
LOQ" .._..r._ _ BLOCK OF
U
P VE D BY DATE r I SSLIT D BY DATE OF I SSUANC I
f
D . U . ' S ._ R E P A R K S