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12255 SW 106TH DRIVE 12255 SW 106TH DRIVE 1 a� ti 0 r 0 1n U-) Ln N N .-1 RMIMAM ADDRESS �� � ; ��iQ� �Il i PERMIT NO. Svc PERMIT CHARGE none OWNER y_ CONNECTIONFEE ---�— _„ PAID BY TYPE Of BUILDING DATE CONNECTED SERVICE RATE _ INSPECTION FEE CONTRACTOR /� PAID BY DATE SIZE OF CONNECTION u '' ASSESSMENT _ PAID i s`� 5 CityTigard of � i SPECTI ON REQUEST for INSPECTION TIME: PERMIT NO. . DATV? - 4JP—S' DATE ISSUED _LL _ OWNERS M A NI . _PIP IuW47 c Z4o;ou sT,arr A D D R E S S ' 12,2 •S S— -r.&to; CONTRACTOR TEST: Air [D, Water[] , Vtsuol ❑ , Laborofory I C 4ESUL T: Approved Disapproved ❑ Pending SKETCH. I 1 1 I I I r�0T E. City of Tigard INSPECTION REQUEST for �e a _ ► f INSPECTION TIME: PERMIT NO. :- DATE.- u"- 1317a DATE ISSUED ., Z I OWNERS NAME , 3 ,0,L is _.. ADDRESS: /As_s' S CONTRACTOR : TEST .' Air ❑, Water EJ , Visual Laboratory ❑ RESULT* Aon•,7uodN Bier ,,r-, , n Pending ❑ SKETr.lC 70 I E I i w awa Or 1wwr w, W l I I City of Tigard INSPECTION REQUEST for I INSPECTION TIME: PERMIT NO. :— DATE: O. :DATE: DATE ISSUED .'—..-/ Z_ OWNERS NAME . ADDRESS: CONTRACTOR : _(CS _ Q �S�+�►_.____—_ TEST : Air U, Water[] , visual, Laboratory ❑ RESULT: Approved X, Disn, pr-ved 7 Pending ❑ SKETCH,- 4 s 7! INSPECTOR DATE [OTE: Attach iuPrOementnl telt data hereto CITY OF N° 0220 BUILDING PERMIT APPLICATION TIGARD DATE19_-- THE IJNDCRSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICT6?NS. OWNER PHONE _ lOt f:lyr WNER utA.1L�.la t.Li: Didustt ifias ADDRESS 4'• a'_,fa1.h a BUILDER PHONE 'jU .:isnua9 N Marm -IVIon ENGINEER allILDER ARCHITECT DESIGNER STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑--�IREPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION ❑_RESIDENCE_❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE f❑BOND ❑MOV ING C��USE—O XSJ9 ❑DESIGN REVIEW ❑COUNCIL APPROVEC _ ❑SIGNS --- — i'�— 1 NA OCCUPANCY--L—LAND USE ZONE—_ BLDG.TYPE_. _FIRE ZONE_ PLAN CHECK BY IIEA7 _ r:0rj8truct 1581. sq, rt. . frame t1welling attached yaArag end---- _��� bsoemnnt according to approved plans 3 bedrooms :z4 0 lb - CO C• LOAD FLOOR LOAD HEIGHTNO.STORIES AREA_ VALUE i BUILDING DEPARTMENT — --���i �s 0 SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE —�— Permit 130.0(1 _ —_--___ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check 65,on 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 Recording ALL A:PLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS, CONYRACTOR AND SUB CONI RACTORS TO HAVE CURRENT CITY BUSINESS 1%State 1. 30 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING. Total 146. 30 By — --- _ _._ APPLICANT ON AGENT Approved Receipt No. ADOnE55-- —_�__ MioNE IN v v v ■0► v v ■r DATE INSP. TYPE INSPECTICN REMARKS PLUMBING DATE ------ Contracto 1 `Ja� — �/' Permit No. l 7sv 3 -7- Rough-in �e��DItiG �Vl 6,L, Fixture Final S_�''-� f✓a-�.7r-, ____ �� HEATING --__ Permit No. a Gas or Oil Rough-in Final SEWER — ---- — --__ — Final DRIVEWAY Final Storm Drainage _— _ (Rain Drain) Final Sidewalk f Curb&Steet Final _ — Approach _ BLDG.DEPT FINA� TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Landscaping v Zoning Final l i c /1-7 UNIFIED SEWERAGE AGENCY NO. 5064 WASHINGTON COUNTY OATF _ 3-26-75 CITY OF Tigard APPLICATION FOR SLVVER CONNECTION PERMIT OWNER: _ .-XMXMXXKNX Futuristic Ind. _— OWNER'S ADDRE:3S: ---�7 �- .�.-�el�uialn_-St., - -- 5's IFET ----- Pas�Ytlar�rl --- -- _arTAe art_ - ---- - - - --- 97223 ZIP - -- BUILDING SITE: LOT.--I BLOCK - ---- ADDITION -Cly-desdale TAX LOT NO. — __ __ TYPE OF OCCUPANCY ADDRESS - ---I:2-255 S.A ._ 106th DWELLING UNITS - --1-- --_____-____ FIXTURE UNITS SURCHARGE IF APPLICABLE -- _- - _ - _ - —__ pi PERMIT FEE 525 . -___ INSPECTION FEE 25_ TOTAL DEPOSITED __ 550 — f e (NEW) (EXISTING) BUILDING SEWER SYSTEM _— Fanno Creek The Applicant agrees to comply with all rules and reguations of the Unified Sewerage Agency. SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE SIZE Orr INSTALL7R RECEIVED BY-- -.-{_�r8n }�ui hta -paid (AG Y—OR IIS AGENT) COMMENTS This Application and permit expires in ninety (90) days. The arnount paid will be forfeited should expiration occur.