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12133 SW 125TH AVENUE-1 12133 SW 125TH AVENUE _. , a a c� C� II 1 lni � 1 O lu F 1 (15" F•a J I jy U W CLQte b ow � E+ rr w _ _ 1 M I t JEW •+MM+`.-r.,.g.,.e.vrrmu.w:+au�,......�...ar.rr'waq�w „YWVs'q6a,.,,u,M#.,■•,.,,rr^^��^-^nAlr�,i.Q+l'M+116A�'�w�.^w^vr,.�'>7»rv��"'�^^+vM"'p" i ciTr or BUILDING PERMIT APPLICATION TIGARD DATE 7W2 0345 Tr,E UNDERSIGNED HEREBY APPLIES FOR APEPMIT FOR The WORK HEREIN INDICATED OP AS SHOWN AND APPROVED IN TI.E ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE OWNER �Jnder ADDRESS :12133 S,IJ, 125th _ BUILDER PHONE Charles Schroader ENGINEER EUILUER AFIQHITECT DESIGNER STRUCTURE ❑NEW 0REMODEL_ ❑ADDITION ❑REPAIR ❑RFNEWAL ❑FIRE DAMAGE ❑DEMOLITION ❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PAJ10 ❑CAR PJR--T ❑GARAGE [I STORAGE.❑ CSLA ❑FENCE ❑BOND ❑MOVING OCONDITIONAL USE ❑DESIGN REVIEW :_.1000NCIL PPPROVED ❑SIGNS OCCUPANCY- LAND USE ZONE —BLDG.TYPE,_ FIRE ZONE_ PL.N CHECK BY _ HEAT- 12 x 2U owning — .:.. LOAD _- FLOOR LOAD HEIGHT _T NO.SIORIES AREA VALUE j3u BUILDING DEPARTMENT SET b_.CKS FRONT _REAR LEFT SIDE v RIGHT SIDE Permit 6. —� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check REGULATIONS APID ALL APPLICA3LF CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL RE DONE RI ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH 1 Recording ALL APPLICABLE CODE, AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE .106 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 9USINESS 196 Stets LICENSE. SEPARATE PERMITS REOUIRFD FOR SEWER, PLUMBING AND HEATING. Total j rr).06 BV a -- APPLICANT On AGENT Approved :era Receipt No, —• ._ .A 5S -- - i,o i rd --------- DATE INSP TYPE INSPECTION REMARKS PLUMBING DAIi l Contractor p I c 1permit No. Rough-in -------- Fixture Final HEATING Contractor Permit No. Gas or Oil Rough in Final SEWER Final DRIVEWAY Final Storm Drainage (Rain Drain) Final Sidewalk Curb&Street Final BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY] CERTIFICATE OCCUPANCY Final Landscaping Zoning Final w PR k,Tii � - xC AiV 'V OON Cwr�er.....Tual ...... No...?.3:.136........ Building Address.-. ....... ........... CertILIL-4te is hereby give tI&...L12th.day144, of•.•.I{wy�1��* �3• that aid building may be occupied and that it complies with all requirements of the B"ng Code for the City Of Tigard, as a,pprn�d by the 'I'igarcI City Council. i NMI V.. City of Tigard INSPECTION REQUEST for INSPECTION TIME '. - 3� PERMIT NC. : ___.___— D AT E : 73 DATE ISSUED OWNERS NAME : - ADDRESS: -- CONTRACTOR : � �-- ---TE ST : , °Nater 0 , V:suai !_aboratory 0 RESULT Avroved , Dijapprorad G , Pending [] S KETCH: INSPECTOR DATE NOTE: Attach supplemental teat data her etaa tai.. r. • . `�• •� , r"'� ' +• ., 1,..3...l..�.� :.!'�. i UFAMMUS A re or wt tw Eni I i I Of I-igard INSPECTION REQUEST ,-f G r %� . !NSPECTION TIME . ,___. PERMIT NC. . DATE: l DATE ISSUED.—,_! OWNERS NAME : - — �-- ` A 0 D R E S S: 0N'rRAr.TOR EST tarp , `J' �a .r '.c]b^rat,)r; r7i r i RESULT* !,p--rUvecl J6 ...c;ppr3-.cd G ,.etidi.tc; ❑ -- I SKETCH: t INSPECTOR DATE LNJTE : Attach suppiementa' tact uata hereto 1 I cit of Tigard� INSPECTION REOUET for (NSPEC-TiGNPERMIT DATE : Z' 7 DATE i SSUED ___�:..1-- I OWNERS NAME ' T I ADGRESS : I CONTRACTOR :__ - - --- TEST > t J , Water r] , wisrcl 0 , Lo'• .ratory n RESULT: Approved U , Disapproved )e F'nnding IV SKETCH: Lcr 4a*.rpt 1w o�T�►�� GiT� �'��'"'ltss I - '- ? _7z I INSPECTOR DATE ILNOTE : Attoch nlementol test j ota heret] 1 1!;t.F, A„c. Permit No. �4t1►_,l1 Permit charge Ch ier Connection fee 425 Paid by Tie oi' ►;ulldir►g F7osirJenr.n _ Date connected 7-23-73 service rate --3. 00 per month Ins pection fee ___2_5, 00 Contractor �—L,4alatin Oeveijp +n . ►.r,, Paid by Date_ am F:.__, Size of coruiec:tion 411Assessment Paid City of Tigard INSPECTION REQUEST for INSPECTION TIME* �� PERMIT NO. : DATE :ZA*_,2!t DATE ISSUED : i OWNERS NAME : D C . �'�'7 3 �� ADDRESS: � � -OW-X_.+ CONTRACTOR : TEST : , ---' , 'Water X V:suai �_ab)rctory 17j RESULT: Ap.�roved .1iiapproved G e,idi ,g D SKETCH: 3 INSPECTOR DATE —NOTE AttaCn sunpiemental test data he�et� I Cy Tigard of Ti and INSPECTION REOUEST for INSPECTION TIME :__________ PERMIT NO.: DATE: _2 LZ-2L?--? DATE ISSUED: = OWNERS NAME . IAC' ADDRESS : — CONTRACTOR :--- M �'•- --� ITEST . Air O, WaterA, Visual , Laboratory [] RESULT. Approved Dip, proved L7 , Pending p I SKETCH: I I I I I I IN3P ECTOR DATE IOTE: Attach supplemental test data hereto] 1 !! B�m Al City of Tigard INSPECTION REQUEST for INSPECTION TIME : ����� _ PERMIT NO. : DATE : Z DATE ISSUED : i I OWNERS NAMEL-- ADDRESS IZ1_3�_ CONTRACTOR EST : i%ii- ice, Water Q , V;: ual f] , Laboratory Q RESULT ' kaporoved �.�upprovad G !'endi�ig Q SKETCH*. INSPECTOR DATE -NOTE Attach PmeninI to,t dn'n LPrt,t UNIFIED SEWERAGE AGENCY N0. --- 4 �'6 WASHINGTON COUNTY DATE JU1e cl'(' CIT Y UF- APPLICATION FOR SEWER CONNECTION PERMIT OWNER. vJwc!cl . Ca., Inc. OWNER'S ADDRESS Ui) 5-W•_11uth STREET QE'e� CITY STATE- ZIP BUILDING SITE: LOT BLOCK AI)0ITION TAX LOT NO. TYPE OF OCCUPANCY 1i e. ADDRESS 1�1'S d•w• 1251-11 Av, . DWELLING UNITS i _ FIXTURE UNITS SURCHARGE IF APPLICABLE PERMIT FEE 1,c.. INSPECTION FEE i�: TOTAL DEPOSITED 4,,r (NEW) 1,E�XI ;TIN(3) BUILDING SEWER SYSTEM , ,.,,r.-., The Appin.,lnt tyrer,s if, comply with all rules and regulations of the Unified Sewotxjtr Agency. i APPLICANT / �, s SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER S`rSTEM LINE SIZE " INSTALLER iieka m, r RECEIVED BYXGENCY�RL[ 1�Lc IT. AGENT) i. COMMFNTS TIm Application „m] )Irwin t expirw; in nme'V (90) days. Tho, imoijnt I •,nl w !i hr' lol It ltral should Nxl�lration orrin. CITY OF T iGGARD 121:0 S. W. Main Street TIGARD, OREGON 97423 APPLICATION FOR BUILDING PERMIT New Construction L.J Demolish ❑ Addi ; ,nn ❑ Remudel ❑ Move ❑ ZONING_ u_l DA:E ISSUED u-27-(j BUILDING PERMIT DATE RECEIVED BUILDING FEE $• It UU Nt �v lv6 BY PLAN CHECK $ 3d-;)j OTHER $ VALUATIO14 $ TOTAL $ 11;, 0 RECEIPT No. TWO SETS OF PLANS AND PLOT PLANS MUST DE FURNISHED WITH APPLICATION LOT M -)`) MAP p�29.1 jBB CENSUS TRACT W-1, JOB N Architect or Engineer__ Tualatin ev in n nt ' Address___ r+,-1p#�e rl r__ Phone Owner UL,e Address -`-_ -- Phone Builder lder_____ --- r NN - - ------ Address BUILDING USE Single Res. ❑X Multi Res, ❑ Comm. ❑ Industrial❑ OCCUPANCY GROUP 1 No. of Stories- i— Total Height , Area of Lots Type of Construction XffX,ADMOLXX1AXXgLU V Floor Area B 1 2 Set !lacks: e'ront`#'jeIi hack 10-IjIL.Side— ,I R.Side-- Private, Sewer Pipe ' ize "' Sewer ­a Taaru Sai,tic 'rank ❑ Water Service Pipe Size- - „r Storm Sewer © pitch ❑ Urywell ❑ Street and Curb Requirements`_ Qom, Driveway Width - _ No, of Parking Space3__ SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED S.W. 12)th Ave, FIELD CHECK BY ATE --- -- ---- -- L-tel-1 PERMIT APPROVED BY,. tpU' � IIt is understood that all work will conform with applicable coo3s and ordinances of the State of Oreqnn and the City of Tigard, Oregon, and that the building will not be occupied until a Certificate of Oce'tlpaacy,Fras been issued by the City of TigAxd Building Inspector. Sijnat,jre o Applicant