10870 SW 115TH AVENUE-1 10870 SW 115TH AVENUE
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CITY OF Ya .
OREGON
t 0«ner:........8ab...Smith......... .. ............... . _.__ .1 ermit No. .. .......1��2II. �.
f' Building Address....108.7.0...SL1 .115th......... .
Certificate is hereby given this........1.5....day of......August ...... 19.. .7.7. y
;I �D
that said building may be occupied and
that it complies with all requirements of . '
the Building Code for the City of Tigard,
x + as approved by the Tigard City Council
....................
,. Bulding Inspector
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City of Tigard
i NSP'ECTION REQUEST
for
IN'PECTION TIME: PERMIT NO. :---.—
DATE: DATE ISSUED
OWNERS NAME : - 1
ADDRESS: ;LG5
CONTRACTOR : _
rEST : Air ❑, Water 0 , Visual ❑ , Laboratory ❑
RESULT: Approvsd� Disapproved C Pending ❑
SKETCH.
i
�IPECTOR DATE r
COTE: Attach supplemental test data beret]
City of Tigard
INSPECTION REOUE T
for
e
IINSPECTION TIME : PERMIT NO. :
DATE: DATE 1 SSUEL:—Z-�!
OWNERS NAME .
ADDRESS : ���
i CONTRACTOR
I
TEST . Air L7, Water (1 , Viaual Cl , Laboratory p
RESULT. Approved 7 , Disapproved ❑ , Pending ❑
SKETCH. -�.�-
y2
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IN Cf6R DATF.
[NOTE Atlach sopplemental teat doto heretol
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City of Ti;nrd
INSPECTION REQUEST
el
for
INSPECTION TIME: _142 -W, PERMIT NO. : .._.___..._
DATE ' _1;dFzzAz DATE ISSUED .___ 1
OWNERS NAME :
ADDRESS:
CONTRACTOR :
TEST : Air 0, Woter, ' , Yfsual p , L aborotory L]
RESULT: Approved 9 Disapproved C , Pending Cl
SKETCH:
IN ECTOR DATE
COTE: Attach eupplementol toot d -to beretp�
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BUi LUi 064 bEPT F1LC,
�4
ox. -heron :;art n
Public .,arcs
City 0f ii aro
1220 S. , ; .ain
igard , Oregon ')?223
;..ay 3, 1177
;A �: Encroachment of Lr-t 201, in the Lnrlewood Sub-Division
Lear ix. l:artin,
it has came to our CAtention, thro,.); h the survey, that our
foundation for , ob E,205 is encroaching upon the utility
ease^ient by 2 and half feet -
'VJe would like to reeuest permission to continue the house
in its rresent conditic.n.
Thank You,
:Ancerely,
,ob G . Smith _-- uileer, Inc .
8'i25 S- b:idea Lane
F ortland, Oregon G'T223
rSCjnr.
APPROVED FOR CONSTRUCTION
CITY OF TIGARD
BY__/ _DAT! /.'/7 7
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7c)
IVESii
f 4� SEWER PERMIT M
121 44
Unified Sewerage Agency,
cf Washington County CITY OF Tigard _ _ DATE 4-22-77
Ot NER t Bob Smith _ PHONE :___ 644-894 5_
OWNER 'S ADDVESS: __
TYPE OF ; NSrA;_LATION:
®BUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
O NEW ® SINGLE FAMILY [:] COMMERCIAL
j ❑EXIST. (PRIOR TO 7-1-70 ) MULT . RES. [] INDUSTRIAL
FIXTURE UNITS___ _ DWELLING UNITS _ 1
PERMIT CONDITIONS: THE APPLICANT .AGREES TO _ON'PI_Y WITH ALL RULEG
AND REGULATIONS OF THE UNIFIED SEWERAGE t,JENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT Nt".BER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 1.20 ) GAYS. THE AMOUNT PAID WILL
b E FORFEITED SHOULD EXPIRATION OCCUR.
FEESt
PERMIT FEE $ 25,
ZONNECTION CHARGE 575,
SIDE SEWER INSTALLATION
iSSUEDIBY
OTHER
TOTAL s 600.
PPLICANT PATE
SEWER PERMIT N`: 12142
ADDRESS OF STRUCTURE 10870 SW 1]S h _
TAX MAP TAX LOT SYSTEM _Fanno Creek
LOT 205 BLOCK _ OF _
44
APPROVED BY DATE IS ED BY DATE
REMARKS Bldg. #1420
BUILDING PERMIT APPLICATION "'Y TIGARD DATE_ 4"22-
e THE UNDERSIGNED HEREBY APPLIES FOR APE RM IT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNERPHONE �.
LOT NO.
OWNER t' JOB ADDRESS 10870 .541 11jth � HOME ADDRESS _
ARCHITECT
.r�PtiL' ENGINEER
BUILDER ADDRESS DESIGNER _
STRUCTURE XONEW ❑IIEMODEL ❑ADDITION_ ❑REPAIR ❑RENEWAL ❑FIFE DAMAGE ❑DEMOLITION
'-[:)"RESIDENCE ❑COMM DEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PONT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑COI:CITIONAL USE ❑DESIGN REVIEW ❑CGUNCIL APPROVED ❑SIGNS
OCCUPANCY------LAND USE ZONE. -BLDG.TYPE FIRE ZONE_ PLAN C-IECK BY— HEAT__—
Cur.rsi., single family dvIlllnIj w/attachQd giraga Loo ,t2
3 badroom 2 beth
QcLO _EW_QR:.OAS__—_..NEJStE1T _ p --Y4 .$_T_ORIES AREA��f� NO,BEDROOMS VA8 3 4 UU.
BUILDING DEPARTMEi IT SET"ACKS FRONT 2'l REAR 0�. LEFT SIDE fJ RIGHT SIDE
Permit +2• _ —. .
THIS PERMIT IS ISSUED SUBJECT TO THE R'GULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPI.ICABLE CODES AND ORDINANCES, AND IT +J HEREBY AGREED THAT THE
– WORK WILL BE. DONE IN A(..CORDANCE WITH THE PLANS AAD SPECIFICA(IONS AND IN r:JMPLIANCE WITH
Subtotal ALL APPLICABLE CODES ANL ORnINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
REtSTRICTVIE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Slate .ax p; LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUM41NG AND HEATING
Total � y'�"►trJti : llcalt�ptnc~ra��. f��I��'�;
By
APPI (CANT OR AGENI -.
Approved Fieceipt No. )
AAO.•R 55
W WA!Nf rw in
DATE INSP. TYPE INSPECTION REMARKS F _''Y.BING DATE
/ ' S0 -- ��,�...�, v ice,...,, c•• ..� �,� �
]PermitNo.
Contractor
/Je
Rough in _
Fixture
Final_
f HILATING
Contractor
Permit No.
Gas or Oil
Rou h-rn
_ SEWER
Final -
a— --- DRIVEWAY/
OF
— — - — — Final 00_
Storm Drainage _
(Rain Drain) Final
Sidewalk
Curb&Street Final
A roach 6--,�/-77
BLDG DEPT.FINAL TEMPORARY CERTIFICATE.OCCUPANCY lFinal
CEPTIFICAI'E OCCUPANCY
Landscaping
Zoning Final
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CITY OF TIGARD
ORDINANCE r77-26
STREET SYSTEM DEVFI.OPPIENT CHARGE
DATE : 4-22-77
_ FSTl��AiEU SALES Pr? ICE
APPLICANT NAME Bob Smi*, j TELEPHONE ; 644-8955
308 ADDRESSJ�1l6th __...__ _______.--- -_---- _SLDG. PERMIT __ --14.2Q
AMOUNT OF FEE FOR S. D.
DESCRIPTION OF IMPROVEMENT__ 3_inole_f!Rilydwelling_
EXEMPTIJNS -PER ORDINANCE '#77-26
FEE RATES:
A. Single family dwelling unit under ;60, 000. --------- $300. 00
J. Single family dwelling unit over $50, 000.--------- S400. 00
C. Mobile Home Court Space (New Oevel_:)pment)---------- 5150. 00
D. Multi-Family Deullings---per unit------------------- $240. 00
E. Commercial , Industrial. h Institutional (Par.k. Space) 5 50. 00 Ezch
F. Single family unit under $40, 000- ------------------ 6250. 00
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AddressBJ,70 '" Permit No,
Permit charge 22 0,17 e—
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Owner sa ��->/ .�„�..- ConnP:�tion fee h
P a i d b y ____ /�-U-�
Type of building Date connect'.-ed
Service rate Inspection fee �S
Contractor Paid by Date
Size of connection Assessment paid
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