12480 SW 129TH AVENUE r m
12460 SW 129TH AVEMIE _.
N
y
4J
rn
N
ORE
3
c�
a�
N
9W
"N"i tilt ......
'+ .,,.,,X41111 i `)
PIP
no no
A
AA,
Vv 1,
cu 'T
Ln m Iv
in
1.MINN
4J fj
N tpm
fit
IF
Qj
L
IS=
C14
N
:3
cj Q)
T, -4
W.
C
-4
en
4.j
it
(Al
IS
4LJ
0 Ill-
0 odel
0 w
in cn u 10
tj
tj
.......... ------ ............ . ..... .........—I.—....
4 AN! %5w �1!0, 417
W / !I tt tit i
B ilding Department
No. 1
Residential Commercial ❑
New Installation Replace ❑ Addition ❑ Alteration ❑ Date
Licersed
Plumber Z_�/Lsr-( �Sr�_.k� Owner
Address �. <.aJ ��.����,.n P� ���. Job Address
Phon-i w _ Applicant
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
IITEM NO. FEE 'To TAIL _ 11 ENI _— NO. FEE TOTAL_ i
Fixtures-1 raps 7.50 Sewer:First 100 It. 30.00 -
Disiiw_asher 7.50 I - Each Addit.100 ft. -- 15.00
IGarbage Disposal_ 7.50 7.1-C, Ejector f Pump — 7.50
Water Heater / 7.50 7 >-C) Water.First 100 ft /� 20.00 --
Backflow Prevenler 7.50 Each Addit.2( )ft. 15.00 �� I
Storm&Rain Drain:First 100 ft_ 30.00 —
111
oe Each Addit.200 ft. _ t 5.00
Mobile Home Space 25.00
Other(Specify): Rain Drain-Sing!e Fam.Dwelling 15,00 - -
-- _---
PERMIT FEE i -------- ------- — !
STATE
Issued By -----------
TOTAL •/ Receipt No. _ - Applicant-- 11=�
I4
I
I
i
i
i
BUILDING- PERMIT APPLICATION TIGARD DATE_ 19 3Z 4257
/
.HE UNDEFiSIGNED HEREBY APPLIES FOR A PE"iMIT,-OR TH`_WORK HEREIN INDICATED BUILDER PHONE 2'r3-1 `
OR AS SHOWN AND APPROVED IN T' E ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _
LOT NO. 14 2 ne I].. c+d 3
OWNER .T W Tiraygon 81dr• 140[d ADDRESS i'i=.G `''r 129r.Ft
ar At'Pl�T1r�31'
Range 11051 S'. Division ?'t l. IrIY�Wu�li'r :,vavaon
BUILDER ADDRESS DESIGNER
STRUCTURE E*NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
173 RESIDENCE ❑ COMM ❑ EDUCATIONAL E1 GOV'T L RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB L FENCE
OCCUPANCY R.-3 _LAND USEZONE 1-7 BLDG.TYPE F "TT _FIRE ZONE— — PLAN CHECK BY _ I1 HEAT—
Conettuct 5in71e family d cllin<: w attaefleel (jarwae
"ee Cnrrectim Rheet atticthel — --
-
t
SEWER PERMIT'�_ _ 12
OCC.LOAD FLOOR LOAD 41) _HEIGHT _12 NO.STORIES_1 _— AREA 1324 NO.BEDROOMS VALUE'� + "
BUILDING DEPARTMENT SETBACKS FRONT :-'0 REAR I", LEFT SIDE 1' RIGHT SIDE
Permit 1'?�•tltl _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check "`I• WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
3tl'l.Up WITH ,,LL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORG TO HAVE CURRENT CITY BUSINESS
State tax
12*7
.14
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
I
Total 31 •2;f SDC— � . 11/ "-7/ Al e,r A/
I ;ifKl.tYtl
PDCN '� APPLICAN T OR AGENT
Receipt No. / !1' /r e 1 '. . 17 At_}t-
1
t k�".�,
Approved �hrh ✓ . } ADDRE88 -- —� PHONE
i
DATE INSP. TYPE INSPECTION REMARKS PLUM3ING DATIF
Contractor
/21AA_ C% " --------- --— Permit No .3�
�2-.211 i O•• -jr* %%.�..._.-t._--- ' Rough-in
Fixture --
/z-.tom -kLZ17 ----------- Final —
/_� M HEATING
Contractor
_ e Permit No. 2 769 -
----
Oil
Rough-in
Final --
--------------------— SEWER
— ----------- --- Final
DRIVEWAY ----_--
Finni
Storm Drainape
_ -'-- _— ^-- (Rein Drain)Final
Sidewalk
- - Curb&Street Final -
Approach
BLDG DEPT. FINAL TEMPORARY CERTIFICATL OCCUP*kNCY Final
CERTIFICATE OCCUPANCY _
LenJacaping
I
--- 7.onin9 Final
r �
BUILDING PERM Fr APPLICATION TIGARD DAT IE ` c• Is $,Z vocJP 7
THE UNDERSIGNED HEREBY APPLIES FOR A PERM IT FOR TI iE WORK IF-HEIN INDICATED BUILDER PHONE ZS3�
OR AS SHOV+IN AND APPROVED IN THE ACCOMPANYING DLANS ANQ SF'E!;IFICATIONS. OWNER.PHONE
J
{� .1;%G - r, -Im/ LOT N O.
O'fJrJER J �V ✓'� hn 814, JOB ADDRESS 12'6O .>012q+—" �•
_ A AiiYNMF;�F p
BUILDER S Q ^_ ADDRESS 1105q /IV L(DN �'±:_., . OE Ert_ f71"'a�ls0
STRUCTURE NEW ❑ REMODEL ❑ AODI_TION _ ❑ REPAIR ❑ RENEWAL _ ❑ FIRE DAMAGE ❑ DEtAJLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOLa ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORA'E ❑ SIAB❑ FENCE
&--CUPANCY ►' _LAND USE ZONE BLDG.TYPE �L �FIRE ZZONE PLAN CHECK BY — -HF-AT'---
';EWER PERMIT
HEAT---
SEWERPERMITk 0=3q Wle
OCC.LOAD FLOOR LOAD 4t) HEIG;IT I.2 NO.STORIES AREA /3„ZyfNO.BEDROOMS 3 VALU�f�SOO
BUILDING DEPAF TMENT SET BACKS FRONT ,20 REAR /je LEFT SIDE RIGHT SIOE
P!'rmit THIS PERMIT so v-SLIED SUBJECT TO THE REGULATIONS CONTAINED 114 THE SUILDi .i, CODE,ZOWNG
REGULATIONS AND !'.'.L APPLICABLE CODES AND ORDINANCES, AND 17 IS HERESY AGREED THAT THE
PlanCheckWORK WILL BE DONE 1,\i ACCORDANCE WITH THE PLANS AND SPECIF=ICATIONS ;.N7 IN COMPLIANCE
WITH ALL APPLICABLE CODCS AND ORDINANCES. THE I!,SUANCF OF THIS PERMIT DOFS NOT WAIV;
�Sub-total _�,��•Oo AESTRICTIVE COVENANTS. CONTNACTOR AND SUBCONTRACTORS 10 HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING,'.ND HEATING.
Statn Tax
Total - -- i 2 -__LL1 IC
pDG# APPLICANT OR AGE
By
Receipt No. _
Approved ADDRESS PHONE
s a c `B O O 6ev),
PDC - $ # Ago
SEWER CONNECTIONZJ _ P(7tTpQ, - �•'. .
SEWER INSPECTION $ _�
SEWER SURCHARGE 5
— i72o
10-Z-7- V a Z '�����i�.�'
--- 1 10"t(Af- 4v G4 4/ssv moo S' o /,2'9' f (JVD/` f' �`Yc(f ►' __
l2.�#So S � Iz� � fie- ;.o��l�l� . �e��•ao�Q .3
135
z3- x 30 700
3;(,::,, $Awl
oc
�, aG�
CITY OF TIGARD—12410 S.W.MAIN--TIGARD,OREGON 97223
- RECEIPT —
DATE:—ZZ=L-_�-� .�_ AMOUNT•. S/2 9.
NAME: ;�Y+_(.� ;1�4 '` .� 1 � CASH:
ADDRESS: ZZO— t 4
M.O.: _
f CF
FOR: _ ACCT. 0 PERMITS SURCHARGE AMOUNT
SEWER BILLINGS 40-364 $
BUSINESS LICENSE 05_&Al
PLUMBING PERMIT 05-332 $_ _
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333 —
SEWEP CONNECTION 40-363
SEWER INSPECTION 40-365
SYSTEM DEV. CHARGE 25-366
PARK DEV.CHARGE #1 30-367
PARK DEV. CHARGE #2 30-368 �------
ZOONNII��ING ADJUSTMENTS 05--362 _
/ TOTALS
RECEIVED BY --
PERMIT NUMS.IRS ASSIONED: —�
`Number _Amount Number Amount Number Amount
S ---- S -----_ S
RECEIPT #12092
2OO2
NAM
C17YOF MAW
WASHINGTON COUNTY,OREGON
i
BUILDING DEPARTMENT
PLAN CHECK APPLICATION Date a4c6ar2S 196?2
This is to certify that the following plans have been submitted
for plan check pursuant to the Oregon Structural Code and Fire
h Life Safety Code, 1979 Edition.
OwnerAA �-er-
,iob Address 8(� �[J 12
Lot N o. 192,
—a� �-
Owner/Applicant Address! -'f _�i(4 _
Phone No.Ilk
.2y�^-
Description: q&41'P'V-4
ice,
.h 1330 4 s'• _
City ard, Building DRpL.
B y :— _ !407 .�� —
12420 S.W. MAIN P.O. BOX 23397 TIGARD, OREGON 97223 PH: 639-4171 ---
LpRsEn�
N
V � �
a � �
• !tXLTWRCAD NLomwoAl MvvhtN)G VR.eM7-
o 441: IV �-- Roos
P- go
TT
L
w = _ r �� wpnoRr
�. x x
w ~ DEt7l_ t/ON 8jpIeES x Y
N
N
i
/ SJLAIt M4 PASS
-OA �
Jk11Y�. s
Sr�,sf��l
+RIVE
SCIA[
110 LA
N . i
ctarAr.. I r�rtLt
P ,C'3�►
r
ai. aN' �► � par � � w� �
Page Five
w w
6-3
U] E
H >
Q _
FN•r {�
O U
o
4
cn vo v F- `Y✓ /
TC7-
U 4
&I —
a \
U .a
�Url rr1 w
N w Uig y
cn F 5 0
ti >
v
3 -
F-4
c,
I
O
NO
—0 lu
U
H
o � C
fd •ri Gl •U) FI --.
N Q)
o
�° r- '-4 =
a o v ani d .�3�
g'v
x �
C4
51 O. U "h
'� n
O U .
v1
x