11220 SW FAIRHAVEN STREET-1 m r/-
rr
N
owl
N
O
Ln
E
nj
W
H•
ti
S
W
C
CD
I
1
+i
I
w 11220 SW FAIRHAVEN STREET �`
A 0 0 R E S S P E i'1 IT
PERMIT CHARGE none
COINNECTIOri FEE 6
PAID e Y _
TYPE OF BUILCING Jkp� _ DATE COt.''.cCTEG
r >' --
SERV CE RATE __ IPJSPF.C�fIOh FEE
Cg':TR CTOR —_ _ PAID BY _ DATE
SI7_E OF COIPJECTION ASS�S� MENT `�__ PAIO
BUILDING DEPARTMENT, TIGARD
PLUMBING PERMIT
-- , holder of a valid l.,lumbing contractors license s hereby
authorizes{ to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Owner__---_ _ Address___j7_.__�.
NUMBER OF TOTAL PERMIT NO,
TYPE OF PFRMIT ITEMS FEE ON EACH AMOUNT (Office Use Only)
Single Family-1 both-each w _ ^� 25.00 _
Du lex--Each 1 both unit _ _ 25.00 _
Additional bathrooms--each
Mobile Home Space-each _ ^15 00 _
INDIVIDUAL FIXTURE FEES
�1 to 50 Fixtures In 1 building-each — 3,00 rvV
51 to 100 Fixtureu In 1 building-each -
101 to 200 Fixtures In 1 buildin -each i _`- _ 2.00 _
201 or more Fixtures in 1 buildin --each_�� 1.50 _
MISCELLANEOUS _ _ -�
Building_Sevver_1st 50 ft. —_ —^- 10,00 - -
Sewer-each additional 100 1t. _ 10.00' _
Water Service to bulldir _ _ _ _ 5.00 --
Privo_te_Water Systems-each 100 ft. y� 10.00 -
Other-S acif I: - ._------ _ - -- --_--
PE_RMIT For Plumbing Inspection Phone 639-4171
3%State ��� Plumbing Contractor (3v
TOTAL RECEIPT NO. Issued By
CITY
BUILDING PERMIT APPLICATION of TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. r_-__
CWNER i;u„ iL`' JOBADDPESS 11220 :7U fairhayOIi HOME ADDRESS
ARCH ECT
_f� ENG'NEER
BUILDER i 11rV Li d9LLlulli ADDRESS V MDESIGNER
STRUCTURE ❑NEW 0RMODEL _❑ADDITION REPAIR ❑RENEWAL ❑FIRFDAMAGE _❑DEMOLITION
❑ RESIDENCE ❑COMM COEDUCATIONAL 0GOV'1_❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE L-]STORAGE❑SLAB [IFENCE
❑BOND_ OMOVING []CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY__i�i LAND USE 70NEL—j BLDG.TYPEIRE ZCNE1— PLAN CHECK BY � I HEAT j&-4
31n62ea faMily dW9,111214i W/a tachad Garage - 4 (40drU01111 - 3 Both.
�jjj_ pev I, oder - PmvQd axiVOwcry to be completed beeforw occupied.
F jui,Uation design to tie se. ufamcribed ant/ shmins on tirttwings by Do-j. hebattdr -
tower Permit ,' 1"l,1«��� � y�6�i5.D�l
gQS:.S.QAQ _X444-EiLSZAJ7._-_ �V) .---_H LC�I�L_'�� _N4$T�91 —_�1P. �1�_E;CT�i_NO.8�,�,ROOM$4_._y8L4�_ 1.
BUILDING DEPARTMENT SET BACKS FRONT 30 REAR 46 _ _LEf T SIDE L")fJ - RIGHT SIDE
Permit •t
- — TN15 PERMIT IS ISSUED Sl.'41FCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1� .y } REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS H REBY AGREED THAT THF.
----- WORK WILL BE DONE IN ACCORDANCE WITH TAE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total * �aQ ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tali fl.G;3 LJP61YSE. +EPATZ66ERMITS RFOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 334.16 POC lei $Lao. .
13Y P1 APaLNt
Approved C « t. sIdern Receipt No.1344
DATE INSP. TYPE INSPECTION REMARKS PLUMBING
DATE
Contrac+or' —
1�1 �� Permit No.
Fixture
Final
^� HEATING — --
__ Contractor —`
Permit No.
Gas or Oil `
-- — Roughan -- —--
Final
SEWER
Final i /C d--7 _
I
DRIVEWAY
12
J_;{onh Drainage -
- (Rain Drain)Final
S idewal k
—_ Curb&Street Final
Approach
BLDG. DEPT. FIN/1L TtW1P0RARY _ CERTIFICATE 0C_C_ PANCY
_ S CERTIFICATE OCCUPANCY Final
Lnndscaping
Zoning Final
{
i
33�
I�.
i
I
{
1
Y
3