10800 SW 108TH COURT 4.1
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Address /09"00 Permit No. � � 3
Permit charge 220r2 t!.-
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Owner -zt/ /��� „��y ,�� Connection Fee
Paid by
;ype of building � h Date connected
Service rate Inspection t -e ,2 5, i
Contractor Paid by date
Size of connection Assessment Paid
BUILDING PERMIT APPLICATION cOF TIGARD DATE _ 3'1'7`'_ 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE W09K HEREIN INDICATED BUILDERPHONE- —
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT NO.— —
00 :iW
OWNER JOD ADDRESS _ HOME ADDRESS
- — ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
��
SIRUCTURE ' ❑NEW C3 REMODEL. ❑ADDITION_ ❑REPAIR ❑RENEWAL ` 1I1-1EDAM1.GK ❑DEMOLITION
❑ RESIDENCE ❑COMM OEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAH PORT ❑GARAGE ❑STORAGE 0SLAB !DFENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑':OUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE—:-'—BLDG.TYPE . -' FIRE ZONE--L PLAN CHECK
LILiSSLI�_• Jt 1i) ,+'% 5W 10Uth Ct. LQt d1l 0.11r—�—'1G.1 — ---
sawG7 Pcrmit iti'!934 •r#WgK CQtlrl, ;b6['j1J •swur i.nsn. ate_ -
OCG 14BD _E1.49P LOAD 0 N0.STORL:S_ 1_ AREAL 3;34 NO.BEDROOM__—VALL'E�li-i,n7f1_
BUILDING DEPARTMENT SET BACKS FRON13fj BSII REAR_ 1't LEFT SIDE N i RIGHT SIDE
Permit
THIS PEF,MIT ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING, CODE, ZONING
Plan Check I0• UIJ REGULATIONS ANU APP(ICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL RE DONE IN A(.:f)RDAI4CE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total 164. IT' ALL APPLICABLE CODES ANS ORDIN',,vt'ES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RE (RICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax L •lt� LICENSE. SEPARATE PERMITS r'iEGU1RED FOR SEWER, PLUMBING AND HEATING.
Total A.1h,V P400ce #1 $1000
B --
V APPL-ICANT OR AGENT
Approved ; Rer,e1pt No.
AD li~E55 f UN[
6"W;
1ATE INSP.I TYPE INSPECTION REMARKS PLUMBING DATE
- OK _� Contractor
ifs - Permit No. _�-�-3--_
Rough-in
Fixture
/ ' - --
o ,Q_ Final
HEATING
Contractor _
i
Pe-mit No.
Gas or Oil
Roy i in -- -- --- - A—
G Final ---
SEWER
--- ---- - _
Fin;,; —6t 6 —M-")
DRIVEWAY
Final
Storm Drainage
Rain Drains Final
Sidewalk
Curb&Street Final
AFFi,,n
proach ----- --- —
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCr
CERTIFICATE OCCUPANCY al
dscaping r
CToning Final `-
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SEXIER PERMITUN�l X3934
Unified Seweraga Agency
of Washington County CITY OF- T i(,o rc7 DATE 3-1-7:3
OWNL-R : _ /Men U: Drew — PHONE :
OWNER 'S ADDRESS:
TYPE OF INSTAL.LATJON:
X fX ,BUIL_DING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XQ:NEW x❑, SINGLE FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR 'f0 7- 1-70 ) ❑ MULT . RES. ❑ INDUST-2IAL
1.
FIXTURE UNITS DWELLING UNITS
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
SIDE SEWER INSTALLATION
1 SSUED BY
OTHER _.
TOTAL. $ 625.
APPLICANT DAT
13 le 17
lam__ GF T.
WiLL ei..3id FOR TH15. SEWER �'ERMIT N'U 1 .3934
FrG�411T, ,I
ADDRESS OF STRUCTURE lii''UU SW lLJJLh Ct.
TAX MAP_ TAX LOT SYSTEM fanno creek
LOT r= BLOCK OF _
APPROVED BY DATE ISSUED BY DATE
RE=MARKS
CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE_: I I ESTIMATED SALES PRICE $__``;
APPLICANT NAME �� ��,��,�,_� TELEPHONE
JOB ADDRESS /� ,Q GL L� �_,J vy C� BLDG. PERMIT #
AMOUNT OF FEE FOR S. D. C.____ ,
DESCRIPTIdN OF IMPROVEMENT
EXEMPTIONS -PER ORDINANCE #77-26
i
FEE RATES:
A. Single family dwelling unit under 560,000----------- 00 0�0�
B. Single family dwelling unit over $60,000.--------- $4.00
C. Mobile Home Court Space (New Development)-- -------- $150.00
D. multi-Family Duellings--por unit------------ - $240.00
i E. Commercial, Industrial & Institutional(Park. Space) $ 50.00 each
F. Single Family unit under $40,000- ----------------- $250. 00
r
CITY OF TIGARD
ORDINANCE #77-71
PARK SYSTEM DEVELOPMENT CHARGE
DATE : ,// 1- 1 ESTIMATED SALES PRICE
APPLICANT NAME � ti c . r. � TELEPHONE #
JOB ADDRESS "'--C :+ BLDG. PERMIT
AMOUNT OF FEE FOR P. D. C. /�_ —
DESCRIPTION OF 'IMPROVEMENT
EXEMPTIONS - PER ORDINANCE #77-71
x.
FEE RATES:
A. Single family dwelling unit under $40,000--------------- 7b. 00
0. Single Family dwelling unit over $40, 000.----- ---------$100. 00
C. Mobile Home Court Space (New D?.velopment)--------------$ 50. 00
D. Multi-Family d0ellings- -per unit------------------------ 60. 00
CONSTRUCTION t5 LOCATED ON S.E . >' N.W. SIDE OF S.W. PACIFIC
HIGHWAY . N.W . is Park District #I. S.E'. is Park Dis".rict #II .
N NEW�wjgwfw, MELAPWAM
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BUILDING PERMIT APPLICATION 1IT y TIGAAD DATE!_.._.�. 19_«. Na
OF �.
rAF LINDE RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE�--%. .y"
C.,F; AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHON � ` _
LOT NO _
JOB ADDRFGS L/ 1 �� iMOME ADDRESS - —
ARCHITECT 4:,j �
ENGINEER
ADDRESS /9t1 _. DESIGNER
-I�:'URE X%EW ❑REMODEL ❑ADDITION ❑RLPAIR ❑RENEWAL OF IRE DAMAGE ❑DEMOLITION
F. �IFNCE COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
]POND ❑MOVING ❑CONDITIONAL USE ❑D SIGN REVIEW ❑COUNCII. APPROVED _ ❑SIGNS
'.LU ANCY1 LAND USE ZONE—_ " BLDG TYPE- =FIRE ZONE _ PLAN CHECK, BY �—_ HEAT4lf G
- -
H�1QHT _._NQ,.�IQRIE�-_�__ARE3��� N4�@EQ S
BUILDING DEPARTMENT SET BACKS FRONT (O REAR r LEFT SIDE RIGHT SIDE
—.-- _—
- - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 20NING
Pian Check �- QL 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
`'uh total -- ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOFS NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
PIE, Tax ' t LICENSE SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 0
Hy
�{.�Irnved Receipt No
ADIMf SSHP ONE
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