Loading...
12193 SW 125TH AVENUE 12193 SW 125TH AVENUE r•. 1 W Q I f, If� I \� S L . U n r Cr 0 - a vi o Cl 21II U 114 I rrr) aq M 3�t o cn t� o� N .-1 MA► r $ t I City of Tigard INSPECTION REQUEST for IN8PEwTI0N T:,1E: z: M'''%— PERMIT NO. :_ I DATE: aL* :,T/ tea, DATE ISSUED ^.WNEr,; ►AMEN �2 _'` ����__.. CONTRACTOR : TEST : Ai, vi sup; r] , L j'o-otory C RESULT: Approved I-isapp.oved 7 Pendi17 � I SKETCH: 01 I i r' INSPECTOR DATE I �Noi : : Attach supplemental tett data bet r t] I i I ADDRESS I�Ig� d�•.- � s r�_G<< <� PERMIT NO. _ 4 j1 PERMIT CHARGE none OWNER CONNECTION FEE -�-, —"" PAID 8y TYPE OF 811ILCING DATE CONNECT D SERVICE RATE , X67 INSPECTION FEE _ 1. NTRACTOR PAID .9yDATE _ SIZE OF CONNECTION .��� ' ASSESSMENT _._. PAID wW llt City of Tigard INSPECTION REQUEST for iNSPECTION TIME —:_ PERMIT NO. : i DATE: ����'� DATE ISSUED".wL.- L OWNERS NAME : Joh /0x "�js , ---- ADDRESS :ADDRESS : CONTRACTOR :...�---� �r I TEST. Air O, water (] , Visual [] , Laboratory [] RESULT. Approved O Disapproved O , Pending 0 SKETCH. I I I I I INSPECTOR DA'T'E I [NOTE Attar,h supplemental test data herel] It I♦ � J i City of Tigard INSPECTION REQUEST for INSPECTION TIME: PERMIT NO. . __ DATE: 7 V DATE ISSUED '.— OWNERS SSUED :_OWNERS NAME ADDRESS' �s, /93 �,� (aS CONTRACTOR P I TEST : Air 0, Water❑ Vieualx, Laboratory ❑ I RESULT. ApproverlDisapproved O Pending ❑ SKETCH: I I I INSPECTOR DATE L01E Attach ,upplemontal test data beret 01 t IE I I City of Tigard INSPECTiON REQUEST s Tor INSPECTION TIM::: PERMIT NO. :—,--- DATE: --Z-1__ DATE ISSUED OWNERS NAME : f /.;2• 4.3 5w /.2-1 CONTRACTOR : - TEST : Air ❑, %later C7 , Visual p , Laboratory ❑ RESULT: Approved N, , D;iapproved 11 , Pending ❑ SKETCH: A, INSPECTOR DATE 5019: Attach tupplet"Intal toot data bereta7 N ��0 IN PLUMBING PERMIT APPLICATION Jurisdiction of No. Type of Fixture Fee Permit No. 7y- -f Permit fee __� c", a If ,o•--� ��U Water Closets_ Toilets a _ Permit Issue _ Eath 7tiubs — _ _ Approved by _ Lav_atory-(W aFh Basin _ �" Building Permi. _ hewer-- ------ ,� Receipt: No. J_o � Sin�cs�Dshwashing��_ _^ _Sinks Kitchen s Sinki.na -_- -� Ord Location of Building `- - -Sinks, Bar---------___--- - --- -Sinks S1oP_ Automatic, Dishwasher _Lawn- dry TrdVs__.----_—_ _ __.__ Name & Address of Owners' , fs&2•e__ Drains, F .00'r-------- ---- - ---------------_-_--_---__��._ ..�__ DrainArea s Drains. Refrigerator. _-- —=- __--_ -- 1— _Rain Drains ' Automatic Washer - �`� Name & Address of Plumber ------------- inking ____________inkng -Fountains. Soda Hot Water Tank ----- ,�> Water _ Se—rv.ice.. Sizze Urinals --_- Building or New)_ Alter�Re� _ air or- atns -�arbc ---- ------ Tns�aTI ������T.;���s��L - -__ _ Lawn_�Spri:ik��r• System- ------- ----�_..___.—._--------�--- -- --- _ Swimming_Poc�°.L _ __. Sprinkler •Syi_Iem This permit becomes null and voie. if work or corscrustion authorized is not commenced within 60 days, or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. All plumbing firms must be licens,�?d by the City of Tigard and post a $1,000 bond. I hereby certify that I have road ar�d examined this application and know the same s to be true and correct. All provisions of laws and ordinances gover^'.ng this type of work will be complied with whether specified herein or not, the g,.snting o ' a permit does not presume to give authority to violate or cancel the provisions ' of any other state or local law reguaatirg construction or the performance of construction. '� Signature of Applicaq:,) as � to liar � I� to � e1r UNIPEU SEWERAGE AGENCY N() 4916 WASHINGTON COUNTY !)AV'L _ . 1- 3-73 CITY O F ___.__Liber d -- APPLICATION FOR SEWER CONNECTION PERMIT OWNER: -- . John Lneuar OWNER'S ADDRESS: 3921 SU­ Dgkota STREET T ige r d CITY STATE_ z1P BUILDING SITE: LOT__35.__ BLOCK —__-__ ADDITION Brookway TAX LOT NO. —_--- ____— TYPE OF OCCUPANCY Residence ADDRESS - -._ 12193 S,Jd..__125th_Ave. DWELLING UNITS -- ------1---- -- FIXTURE UNITS SURCHARGE IF APPLICABLE ----.-. - --- _.- ---------...___ _-._ PERMIT FEE -4W ---- - INSPECTION FEE ___25_ TOTAL DEPOSITED .J►��___ - (EXISTING) BUILDING SEWER SYSTEM __ __ Tis}&"-- ----- �I The Applicant agrees to comply with all rules and regulat:,)ns of the Unified Sewerage Agency. i APPLICANT �4 4�• �-�'�'� - ----- SEWER PERMIT i THIS PERMIT AUTHORIZES CONNECTION TO Thi: SEWER SYSTEM. LINE SIZE -.__ - -- qr .. _ _ INSTALLER _ J ` RECEIVED BY- - �����`- C � `--) AGENCY OR ITS AGENT) 1 I Qt t�COMME�JTS � I ` This Application and hermit expires in ninety 190) days. The amount Maid will be for feited should expiratirm orrur. CITY OF TIG RD + 12120 S. W. N41n Strost TIGARD, OREGON 97221 APPLICATION FOR BUILDING ^ERMI7 New Construction © Demolish ❑ Addition ElRemodel ❑ Move❑ ZONING R-7 DATE ISSUED 11-14-7R BUILDING PERMIT DATE RECEIVED BUILDING ftE $ 74.00 No. PLAN CHECK $ :7.00 73-256 BY _ VALUATIOCJ $ 19,674 _ OTHER $ 4.00 recording TOTAL $ . (4 state RECEIPT No. � tt5.YO— It i j y� TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT M 35 MAP A 2S1 3BB CENSUS TRACT W-19 JOB N Architect or Engineer L. M. Bruinier Addre9s 1304 S.W. Bertha Phone .0h6-3022 r I Owner John LoeWer Address 3921 S.W. Dakota St. —,------Phone 246-4395_,_ Builder same Address _ --Phone BUILDING USE Single Res. x❑ Multi Res. ❑ Comm.- ❑ Industrial❑ OCCUPANCY GROUP I _ No, of Stories 1 Total Height`_ 16_ Area of Logo _ Type of Constru ,tion IXXEIXXXXXXXIMX V Floor Area e _-1 12'L2 2 Set Backs: Front 221 Back 521 L.Side—_ 7 R.Side_ tt Private Sewer Pipe Size 411 5ewerusa Tioard Septic 'rank ❑ Water Service Pipe Size-_ 3/411 Storm Sewer © Ditch ❑ Drywell❑ Street and Curb Requirements ExistinQq ___— Driveway Width 101 _ —�No. of Parkinq Space SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION i ADDRESS ASSIGNED` 1219' S L 12Sih Aug- FIELD ue FIELD CHECK BY----_ _ ----�8 -DATE 44--W-713------ PERMIT APPROVED BY > jj,,_.,_ aTt is understood that all work will conform with applicable codes n dinances of the State of Oregon and the City of Tigard, Oregon, and that the building will not be occupied until a Certificate of Occupancy ilas been issued by the City of Tigard Building Inspector. �gnatl`reoApplicant _ _ EXHIBIT "A" CITY OF TIGARD Residential Structure Occupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residential structure (a) on the following described lands prior to the recording of an occupancy permit releasing the restriction in the Deed Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: (The City will issue a release as soon as a final inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: Tax flap 251 388, lot 35, Brockway Subdivision ADDRESS OF PROPERTY: 12193 S.W. 125th Ave. NAME Of OWNERS John Loewar ADDRESS OF OWNUs 3921 S.W. Dakota St. IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this _ day of OWNER: t APP rrROVED: e P4 t Bu ng Official City of Tigard STPI . OF OREGON County of Washington ss' 19 13 Personally appeared before me the above named LC' c� W e %, and acknowledged the foregoing instrument to be voluntary act and deed. N y o ar u c for rPo My Com lesion Expizess N i iial Titom%gCN. ►hi«. M '..rord.A ►a.rb,. . X55 I YA26 i as STATE OF OREGpN sc County nl Wa+klnYton 1 k,lilt � 11tr.D rRecordar RI Cot* +al.r rountV� dna,°w dtn0ort11V E`cctlors a was p rants+ for Inetrumenht�k of r>rord% that tha wNlretordtsd In recetvod and No. otn+ty of +old C and fool altlecdnlrect"' "t hand Wetness my RO cwd �NE 90 P1 Reeved+ !� peDuty y 1200"1 EXHIBIT "A" CITY OF TIGAPO Residential Structure Occupany Restriction KNOW ALL MEN BY THESE PRESENTS, that occupancy of residential structure (e) on the following described lands prior to the recording ot an occupancy permit releasing the :netriction ir. the Deed Records of Washington County, Oregon, is prohibited by the ordinance of the City of Tigard, Oregon: (The City will issue a release as soon as a fiesl inspection determines that the construction is satisfactorily completed) DESCRIPTION OF PROPERTY: r —Let,lay 5ubdlviaion ADDRESS OF PROPERTY: NAME OF OWNER: ADORES° OF OWNER: IN WITNESS WHEREOF, the undersigned has caused this restriction to be executed this day of , 19_ OWNER; a�— APPROVED: Title Byt 13U it Of fr ,city of Tigard STATE OF OREGON ) e County of Washington ) 19 Personally appeared before as the above named and acknowledged the foregoing instrument to bF voluntary act and deed. Ao ary Public or Oregon My Commission Expires: e w City of Tigard INSPEC i ICON REQUEST for INSPECTION TIME: l� �e'J PERMIT NO. : DATE: e-Y123 SATE ISSUED :- _L_L_ I OWNERS NAME ' _��''/,,qj ►f - - ADDRESS: !QZf..3 J74,' 1J _E � CONTRACTOR : _ . TEST '. Air ❑, W-tsr❑ , Visual f , Laboratory ❑ RESULT: Approved , Disapproved O , Pending ❑ ° SKETCH. I I i 3 INSPECTOR DATE I079: Attarh Supplemental toot data beret] I 1