11710 SW FAIRVIEW LANE (
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INSPECTION TIME: —,dPL_ PERMIT N0. :-z!&2Z
DATE: .-s1_-s1_ DATE ISSUED :_ 1_L
OWNERS NAME :
ADDRESS: co_�4. . �. %-s�, . 1_,�• !
CONTRACTOR :
"EST : Air M, WoforCO , visual ❑ , Laboratory v
^ESULT: Ap;roved 1 , Disoppt,;rwd ❑ %,,ding v
SKETCH: aet �•..�.- -•f
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INSNc'.'TOR DATE I
COTE Attach supplemental test data beret I
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BUILDING DEPARTMENT, TIGARD NQ 2571
J' PLUMBING PERMIT I
__ !1-O� J �• ►'N-� `__ holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection bN, 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 Busine! • License rcqu;red
for all contractors and sub-contractors
Job
Owner_ !�) 't'` _ - — -- Address. �l7 f ca � f�t�e :ykkr Date__
NUM13ER OFTOTAL
TYPE OF PERMIT ITEMS FEE ON EACH /WIOUNT
S_ln le Femlly-1 beth–each__ —Y.___ 25.00
Duplex,–Each 1 bath unit —25.00 ^�
Additional bathrooms—each _ 10.0_0
Mobile Home Space–each w – 15.00
INDIVIDUAL FIXTURES COMNER " — _
1 to 50 Fixtures in 1 building–each _ _ 3•00
61 to 100 Fixtures In 1 building–each __ 2.60
101 to 200 Fixtures in 1 building--each !_ 2.00
_201 or more Fixture, in 1 building--each _ _ 1.60 _
MISCELLANEOUS
Sewer--each additional 100 ft.
Water Service to__lja_lny -- –� W+u� – –5.00
If
_Other ecify):
PERMIT �'�• _ For Plumbing/nsnectiou Phone 639-4171
_l%State Plumbing Contractor By�..
TOTAL _ 0 RECEIPT R"1. I,eued By
.a•.ne.I..•,..S:yy.,, 'n.rPAii._s'y1EJff.�Y kaia�.Lu.vii.u:wa,...:..L�5<Wy1.kA:l ���d.t4'r4 ....;,.u..i.�.xa:A'I,M�ilr.ei..{.a 45tp:znlvirelad�:n..wuun:JywHlr�rtw7LLtli7r Aho«.aiyiY:.t.
n
AcJ Jr r Permit No. 1�/�5'
Permit charge vr7
_�� _ e
Owner ,�_ Connection fee �7S
^i el
Paid bye-'
Type of building '/�-t.o Date connected
Sprvice rate Inspection fee �e:;�-
Contractor i Paid by Date
Size of connection Assessment paid
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City of Tigard
INSPECTION REQUES �
for
I tSPECTION TIME. a PERMIT NU. : .___-__�. i
DATE : 6 /FS/11 DATE. ISSUE[.) .._._._L_ Z I .
,NNERS NAME :
ADDRESS: 11WO L
N T R A C TO R : ___
ST : Air [3, Water 0 Visual 0 , Labnrotory pFSULT: Approved 1 Disapproved C Pending Li
�KETCH
INS4P �OR DATE
[NOTE: Attach supplemental test data beret aj
w w w w
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City of Tigard
t INSPECTION REQUEST
,At /t- for ,
INSPECTION TIME :l/ 1 PER'111T NO. '. ------
DATE '
O. : _T—_--
DATE: //<il� . DATE ISSUED.—!--/—
OWNERS
SSUED._!--/ _OWNERS NAME :
ADDRESS :
CONTRACTOR :__
TEST: Air O, Water [� , Vfsu��l Laboratory p
r(ESUL,T: "Vproved Uisopvroved [7 Pend,7g i
SKETCH:
INSPECTOR DATE
COTE : Oicich supplemental test doto hereto]
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—�_____-__- � ��.1.ti K L 1.\ I•I:I U`.ItA�Aft LOAN
MAP
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Shutairr�r Luculiuir of
IN1f'R0VFMF'NT ON AND NOUNDARIL-S OF•
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STA71 ()l= OREGON
1 Surveyed: 1,'_'.ti ' ,
Y certify that I surveyed the following described property and that I find the improvements situate they
on the premises in question and that the
y do not or encroach
certificate is made at the request and for the exclusive use of the client the eon to be.
construction purposes, property lying adjacent thereto. This
is not to be used for
Surveyor
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QF
VINrf.NT ON NIS pERMIi'
'RUC110N ,AS APPROYAI OF
9.155.
REQUBY
I ED ' '`.
s ,T I
❑ MEMORANDUM
❑ SITE VISIT
JAMES G. PIERSON, INC. ❑ PHONE MEMO
CONSULTING ENGINEERS CONFERENCE MEMO
PORTLAND OREGON! ❑ TRANSMITTAL
() J- -lwl 10044v61
� 1171
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Tot) C D Go,1.:ii .-CfZLJCQAJ Project _ k��,i.f�s-�.Y�-- V i?At�Njs Y- /
r'''' v T J� `\C--�R 12 C`n - -- c> FJI.I I-ANF• 1I(AmIL�
Date
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_. ��� w\�� c��G ���� n b�`�Z P►-�oNE C.r�►�yE1LSATlr,-A of
T\J� o��� -, Luc•�.ci1L �v�\+c�\-\ �a�� = .:rt �C� iO
By:
Jam s G. P erson , Inc.
� SEWER PERMIT
LJ)
N" 12125
Unified Sewerage Agency
of Washington County CITY OF Tigard DATE 4-14-77_
OWNER : Ed Gause PHONEr
OWNER ' S ADDRESS: _
TYPE OF INSTALLATION:
®BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
Q NEW ® SINGLE FAMILY ❑ COMMERLIAL
❑EXIST . (PRIOR TO 7-1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE E 25.
CONNECTION CHARGE 575,
il.
SIDE SEWER INSTALLATION
ISSUED
OTHER _
TOTAL 600.
APPLICANT DATE
SEWER PERMIT N° 12125
ADDRESS OF STRUCTURE 11710 SU reirview Lane ___
TAX MAP TAX LOT SYSTEM Fenno Creel._._._,
LOT 21 BLOCK OF
APPROVED BY DATE ISSUED B DATE
REMARKS Bldg. #1397 _+
i
BUILDING PERMIT APPLICATION cOF TIGARD DATE 4"14"7' _.19 1397
THE UNDERSIGNED HE13EBY APPLIES FOR APERMIT FOR THE WORK. HEREIN INDICATED BUILDER PHONE —
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE__
LOT NO. _-.._ —
OWNER I C CaUll 113 JOB W j IppME ADDRESS _
ARCHITECT
ENGINEL:R
BUILDER i't,n ed ADDRESS DESIGNER__
STRUCTURE E NEW ❑_ REMODEL El ADDITION ❑REPAIR�-1 ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
L3 RESIDENCE ❑COMM ❑EDUCATIONAL. ❑_GOV"i_❑RELIGIOUS❑PATIO OCAR PORT ❑GARAGE ❑STORAGE❑SLAB -[:]FENCE
OBOND _❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _—
OCC'JPANgYL L LAND USE ZONE_ F?.! BLDG.TYPE 5N FIRE ZONE PLAN CHECK BY CtU HEAT _
L.unst,, singlo family dwelling w/attached garage 5 bodto" 3 both
Lot 41 Motet inspection required on lower foundation before deck covoriny
ann�ieei� �, a>mnt,_1LL1_ , t-t._ aJ11a a ., -tt.. --- —
_ BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 11 LEFT SIDE _ RIGHT SIDE g
Permit 189,00
THIS PERMI— IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Pian Check 94.50 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALI APPLICABLE CODES ANC ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- — RFSTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State.Tax 8051 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWED, PLUMBING AND HEATING.
-- yatem ggVelopmont Lharr; * 300eU'
Total 292*01
By _ AP IC NT OR AGEN1 - --
Approved R�reipl No. _�
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
_[RContractor
Permit No.
0
ugh-in
w E:rZ Fixture
C Final
_T6
HEATING
1 2" Contractor
All
Permit No.
Gas or Oil
Rough-in
Final
'qEWER
Final
DRIVEWAYt.,_13 -
,4
finaL.
Storm
-
D
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in
a
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(Rain Drain) Final
Sidewalk
?7
Curb&Street Final
BLDG DEPT.FINAL TEMPORARY A roach 6-13
E rIFICATE OCCUPANCYCERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final