10680 SW HIGHLAND DRIVE-1 1
- �7 1'L'
EXISTING
� rt n /r,1G;-fit :
' iC 15 TI N G � �� �\ 12u _ �nt.!v L —LT—LL,
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Ln
M O V E WINDOW A i / N / V , >,n .�►4n S
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EXISTING `DENTS — — — — ,� 1
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-
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I
16 - 2 I /_-/j r•,t i 4. `�
�I�s ` A�- 1 FRONT ELEVATION
cONc. � � A
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1 r I I Q ,A y ,� ,..�3,.1�, 1 /4 = 1 -- 0
ADDITION —, -- - - - � �°
14'---6" X 15'-10 it % SIS
I I ( I fr.,�( .35 vv l" r Cr✓� rG �'
3068 -_- - I I 1 I I ',► I I 1 -
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s,v,.a- I r XI STl G III I I J 1 12
GARAGE
------,� -__-_- --- �13
Lj
"
„- - I - --- - - 3 -6 - -- 4 - -- --- �� - 2'-1 O -
OVFRIHIANG
'
3' 9ROM
FLOOR PLAN 356 SQ. FT.
� OBJ N D A TI Uri r� LAN
1 / ,
4 1 , _ O � _ � _ ,� - I
1 , �- 1 /
4050 AL SL
8" DIA VEN�i S
�•
8,-0', O.C. 2_ X. 8 RAFTE'�S O.C.
3 TAB ROOFING 1
' OVER ROOFING FELT ( EXISTING ; ADDITION ,
OVER 1 /2" SHEATHING-- _ �.IASILITY- The City of Tigard Orag or Its
LEFT SIDE ELEVA7 ON employ
---_ - - ------ - — ---------- t. _� -,e far
1 /4 - ��--- discre��ancys which may appear hereon.
- _.
•� 14 -10" SPAN ----- --- - _ 16' 2" SPAN - -. _ -.,...-.... .. .....__. .,... .-.- ._, ...... --. --,... .,. ..,.
2 X 10 VV/10 SC?. IN. SCREENED VENTS
32" U.C.
�, .�Pyl-vr�4 fv�:�05wlrytil4d D�
2 X 8 JOISTS 0 CENTERS --\
�'
- 2 X 6 HEADERS (DOUBLED)
I 2 X 4 HEADERS (DOUBLED) -
R 33 INSULATION (10" FIBER GLASS)
I -- - -- - - �u��IUUU�l1�1U1,�11�1UVU�lJU1�1ClUUU�III' _�
3" CONC. POUR OVER EXISTING -,-)NC. --- -- —N
I I REINFORCE WITH 6 X6 10 j10 'N.W.F. 1 /2" SHEETROCK.- R-11 INSULATION
I RESULTING FLOOR LEVEL I (3 1 /2 FIBERGLASS
EXISTING TO MAICH HOUSE FLOOR LEVEL - EXISTING 4 X 10 BEAM I
-
STRUCTURE 100' - — —�
HEIGHT 16'- 0" TREATED 2 X 4 - T1 --11 SIDING 7_ 2 X 4 STUDS 16" O.C.
I TREATED 2 X 6 LEDGER TO MATCH
1 - EXISTING WhLKWA'r 3/8" DIA. LAG BOLTS EXISTING TREATED ? X 4 SILL \
ADDITION 2'- 0" O.C. INTO CONC. 8 0 OVER CONCRETE
3" NOTCH FOUNDATION - x--- 2 X 4 STUDS 16" O.C. �- U �,� 1 I �'� D E I A 1 1
'� - 4 ,X 6 BEAM FOR BEAM - - - -
- o 48 O.C. 1 O"
„ �, 1 /2" PARTICLE BOARD -
7 _ 0 -,� - , - : OVER 1 1 /8" PLYWOOD
241 T&G �. 2 X 4 TREATED SILL
6 O' ---
-- - - - - T
u a -, I* t�
S.W. HIGHLAND DRIVE Typ
• SECTION C TI O N B _i a I ° 9565 S. W. 69th
10680 S.W. HIGHLAND DRIVE 1 /2" = 1 '-0" 4, `�..- .--- - 18 Portland, Oregon 97223 (503) 245-0329
TIGARD OR. 97224 �- FINISH GRADE -- ----- -- - - - -
i 77 ME
I DAHLGRFN ADDITION 2 r�-�h �� 356 SQ. FT.
PLOT PLAN � � � 6 FOU(vDATION
E
- DRAWN BY: TCF_ DAr�: 16 MAY 91 FILE: DAHL.D WG
1 '= 20'--0" - S
�1 ---- L- 12" X 6" FOOTINGC T 10 N A A APP BY OA 1E:
- ---- - -- --- --- - - -- W/ KEYWAY ,
1 /201 = 1 '--0" SCALE: 1 4 1 --0 NUMBER: REV.
SHEET: 0
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NOTE: I F THIS MICROFILMED 1 2 - _ 3 4 5 6 7 8 9 10 ( 1 12
DRAWING IS LESS CLEAR THAN
MIS NOT ICE;-'IT 15 DUE TO
a
THE QUALITY OF THE ORIGINAL _
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10680 SW HIGHLAND DRTVN
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INSPECTION NOT:Lr7
City at Tigard Wilding Departsient
13325 SW Bail Bled. Ti%ucd, Oregon 97221
Inopectic:. Line (Rec-O-Phone): 639-4.15 Bustness Phoie: 63i-4171
i
Inspection:, 1(�
Footing Plbg. Uuderslab Her_h. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINAL:
Post/Beam Struct. San. Sewer. Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. ed. -Hoch.
Date Requested:_ -2 Tame: �_AM PN
Address:_ L 0 �! Perrmit
Builder:_
THE FOLLOWING CCRRECTt6N6 ARE REQUIRED:
Inspector �� �_---- -- Date:1�_�
AFPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
INSPECTION NOTICE
City of Tigard Building Departeent
13175 Bw Nall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phones 634-4171
Inspections --
Footing Plbg. Underelab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/!seam Struct. San. Bower Framing Bldg.
P-s,'/Seam Hoch. Rein Drain Insulation -Plumb.
Plbg. Underfloor Neter Line Gyp. Bd. -Hoch.
Date Requesteds_ Z�) O ` __—Ti.. AM PH
Address s_ ll��(!�/`y`U
Builder:__
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: / LC�K_—�_ _ Date:_(
APPROVED _— DISAPPROVED APPROVED SUBJECT TO ABOVE
`.-
Call For Rai.nep.
MECHANICAL
PERMIT
CPTYOF TIFARD Cf1YOF11iia1pD p'E.R[4iT #. . . . . . . : MEC91-0228
COMMUNI(Y DEVELOPMENT DEPARTMENT o11ea►on
13126 SW HMI Blvd. P.O.Ba 23397,T;pwd,Ow-URP4 03 q"75 DATE ISSUED: 1 / 1/91
SITE ADDRESS. . . : 10680 SW HIGHLAND DR PARCEL: 2S 1 1 ODD-0;800
SUBDIVISION. . . . : SUMMERFIELD 1\10. 4 ZONING: R-7BLOCK. . . . . . LOT. . . . . . . . . . . . .
. 158_._._.-__.__..__..__..__---__.___.______
CLASS-OF-WORK.. :ADDY FLOOR FURN. . . . : EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HL'ATERS. . : VENT FAN,. . . :
GCCUPANCY GRP. - : R_`: VENTS W/0 APPL: VENT SYSTEMS:
STORIES. . . . . . . . . I BOILERS/COMPRESSORS HOOLS. . . . . . . .
FUEL TYPES---_______..___... 0 HF'. . . . : DOMES. INCIN:
. /WOD/ / / 3-15 HP. . . . : COMML. INCIN:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
FIRE DAMPERS?_ : : 0-50 HP. . . . : WOODSTOVE13. . : :1
GAS PRESSURE. . . : 504, CLO DRYE:RS. . :
NO. OF UNITS ---`- - -' - ' AIR HANDLING UNIT) OTHER UNITS. :
FURN ( 100K STU: (- 10000 c:fm: GAS OUTLETS. :
FURN ) =100K BTU: > 10000 C..f m :
kemar^ks : Install NEW wood bt.lr,nind stove.
Owner: ___ ____---
` __--__-__---_-_ FEES
ROY F. AND VALLDAHLGREN type amount by date r-ecpt
10680 SW HIGHLAND DR PRM f $ 25. 00 BCR 10/01/91 -
5PCT $ 1. 2,5 SCR 10/01/91 -
TIGARD OR 97c"24-3507
t�hone #:
Contractor:
BY OWNER
---------------------------------------
Phone #: $ 26. 25 TOTAL
Reg #. .
--------. RE:GIUIRED INSPECTIONS ----_--
This permit is issued subject to the regulations rentained in the Final Inspect ion
Tigard Municipal Code, State of Ore. Specialty Codes and all other -
applicable laws, All work will be done in accordance with --.-
approved plans. this permit will expire if work is not started --
within 180 days of issuance, or if work is suspended for more
than 180 days.
r-er-mittee SignatureJ*ssi-ted By:
:
Call for inspection _ 639--4175;
ivCITY OF TI BARD - RECEIPT OF PAYMENT RECEIPT NO. t 91—c 1 irJO
CHECK OMOUN T 261 F-15
NAME. t DAHLUREN, ROY F. CASH AMOUNT s 0.00
ADDRESS t 10680 SW HIGHLAND DRIVE PAY►�ENT DATE a 10/01/91
SUBDIVISION a
TIGARD, OR 97pl 4-
PURPOSE OF r,nYMFNT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
MECHANICAL PL 25 ST. BUILD PER i.tis
try
�1
MECHANICAL PERMIT I'+;
TOTAL AMOUNT PAID
P I+;
IK SPECTION NOMI-0
City of Tigard Building Departzant 1r��
1312S BA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone)s 639-4175 Business Phones 639-4171
Inspections_
Footing Plbg. Jnder.l.b Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Line f Gyp. Rd. -Mech.
Date Requ:astede ,C( Times _)�._AM FM
Address: U Permit is
Builders ���z�.--
THIS FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector —__ ._ Dates
sII�APPROVED DISAPPROVED APPROVED SUBjXcT TO ABOVE
___Call For Reinap.
INSPECTION NOTIM
City of Tigard Building Depart
13125 SO Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-41.75 Business Phons: 639-41.01
Inspection:
(lootirg Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Fouod, Plbg. Top Out Gas Line FINAL:
Post/Beam Strsct. San. Bower Framing -Bldg.
Post/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater. Line Gyp. Bd. -Hoch.
_ 3d
Date Requestod: G - �Time: AM PM
Addreae:
i�
Buildert
TRE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: Datet_ :
APPROVED DTSAPPROVEp APPROVED SUBJECT TO ABOVE,
--- _
__Call Por Rei:.ep.
`'J
C TY OF TIFA RDC" 0 BUILDING PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT 01� PERMIT #. . . . . . . : BUP91-0169
13125 BW HWI Blvd PS).Box 23W7,Tigoid,Oregon 97 (5W)63"i76 ;77
- 6139 1:7-1 DATE !SSUEBs 077e3709t
SITE. ADDRESS. . . : 10680 SW HIGHLAND DR PARCEL: 2SIlODD-05800
SUBDIVISION. . . . : SUMMERFIELD NO. 4 ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 158
----------------------------------------------------------------------------------
REISSUE: FLOOR AREAS------'---- EXTERIOR WALL CONSTRUCTION—
CLASS OF WORK. :ADD FIRST. . . . : 195 Sf N: S: E: W:
TYPE OF USE. . . :SF SECOND. . . : Sf PROTECT OPENINGS?----------
TYPE: OF CONST. :5N THIRD. . . . : Sf N: S: E: W:
OCCUPANCY GRP. :R3 TOTAL------: 195 sf ROOF CONST: FIRE RET?:
OCCUPANCY LOAD: BASEMENT. : Sf AREA SEP. RATED:
sTOR. : 1 HT. : 15 ft GARAGE. . . : s OCCU SEP. RATED:
B5MT?-. MEZZ?: REDD SETBACKS-------- REQUIRED-------------------
FLOOR
ETBACKS---------
FLOOR LOAD. . . . :40 psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET. . :
DWELLING UNITS: 1 FRNT: ft REAR: ft FIR ALRM: HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE. $ 8970
Remarks : addition onto family room
Owner: FEES --------------
ROY F. AND VAL L DAHLGREN type amount by date reept
10680 SW HIGHLAND DR PRMT $ 74. 50 JLH 07/23/91
PLCK $ 48. 43 JLH 07/23/91
TIGARD OR 97224-3507 5PCT $ 3. 73 JLH 07/23/91
PI-ione #:
BY OWNER
Phone #: $ 126. 66 TOTAL
Reg
REQUIRED INSPECTIONS ---------
This permit is issued siiuJiLi .0 'ht regulationg contained in the Foot/foi-ind lnsp
Tigard Municipal Code, State of Ure. Specialty C0es and all other Fr-aming I n s p
applicable laws. All work will be done in accordan,7# with Inslilation I n s p
approved plans. This permit will expire if work is not started Gyp Board Insp
within 188 days of issuance, or if work is suspended for more Final Inspection
than IN days.
F='e r j.t t F. e S i q n a t 1-t r e :
Tss,Aed Py :
Call f c r inspection -- 639-4175
CITY OF TIGAR '
Ci — RECCE I�T OF ,PIIYMF�N"I' k .. �,. —^ µ
� C.CF a r' r NC?„ a 91 •r_1`4t6 t
�
CHECK AMOUNT' 126. fab NAMEa DAI•i1..r7REN, ROY CHECK
AMOUNT eld. ��
raDURE:�ist ¢ 10680 13W WJEfiIILAN[J DR CASH
DATE: a 07/23/91
;HBD I V I S I ON
7'1fiAr2IJY (IN 97224—
PURPOF E YOF PAYMENT AMOUNT 1-44I.D PURPOSE OF PAYME.N1 AMOUNT PAID
F�UIL.I7INC� BERM
74. 50 PLAN CNF.�.CK FE= 4
5. 43
Sr. BUILD PER 3. 73
�OTFl1... AMOUNT PAID — — — _> 126. E1fs
441,
City of Tigard
INSPECTION REQUEST
for
A o6
/+.it s �- r
INSPECTION TIME: PERMIT NO. :
DATE: 5r DATE ISSUED :
OWNERS NAME :
ADDRESS: _
L,' 7
CONTRACTOR : —
TEST : Air 0, Water[ , Visuolw,, Laboratory 0 �
RESULT: Approv-d � , Disapproved CI Pending p
I
SKETCH.
I
I
I
I
INSPECTOR DATE
COTE ' Attach supPiementnl test data 't+retaa]
Boa aqe s w w w w w w
City of Tigard
INSPECTION REQUES 1
for
IINSPECTION TIME :_ PERMIT
j DATE: DATE ISSUED.—A-'--.L'—
OWNERS
SSUED._.OWNERS NAME :
ADDRESS :
!
CONTRACTOR : L_���'4------------_-
TEST; Air O, Water VleuaK, Laboroto!-�
RESULT: Approve Disapproved PP , D
SKETCH:
S
I � r
IN'tPEC OR DATE
rNOT[ Attach su
pplemtnti,' letft uCsln h#r,Sv1
- ...»n'.,.pTA''M!+[e+e...,�ww+vayr+w.u!sws7�cnvn n.Fe.gw.,v++'aP'Mo^•..M*+ +w. .r..+'f,°'n� 4Nl MM R pow,*.Ph
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE Mar.-h 4 19 N° 0695
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED �.+J,'L-,t
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE �—
OWNER 6alatin ...UVfdioI}fI1C .,t i"'O ADDRESS 10680 SOL]* High&&nd I)r. BUILDERPHONE
ENGINEER
same V^i a TS13??
DALLJ,QER ARCHITECT DESIGNER
ST-RUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV-T DAELIGIOUS❑PATIO ❑CARPOR�-T ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW UCOUNCIL APPROVED ❑SIGNS
7 .5 rfF� C�a�
OCCUPANCY I LAND USE ZONE _BLDG.TYPE FIRE ZONE__ PLAN CHECK BY HEAT
Construct 1.248 sq, ft. from* dwelling with attached garmige according
to approved plasms, No Unasmaant.
--- 2 bedrooms —
_—
740 lb -- — --I7 -- �TJU
OCC, LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
--- - J �-- k�T J
-_ BUILDING DEPARTMENT SET BACKS FRONT HEAR LEFT SIDE RIGHT SIDE
Permit —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COOF, 7r+;dING
Plan Check 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
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1 State_ LICENSE. SfO (AOFCtiQfIStJu� �C1 FOR SEWER, PLUMBING AND HEATING.
Total �j
-- ------ / APPLICANT OR AGENT
Approved Receipt No. / p.' «� �'�~'�+
ADDRESS HON F
— --- —
k
w;
DATE INS?. TY E INSPECTION REMARKS. PLUMBING DATE
ontrector 1 •-�+-� �1"/�
�-
2-7 �, _ — Permit No. D
2 Z- j U2_3 _ Rou�,h-in
y:37.7b �,/ Fixture
Final
HEATING
Contractor
Permit No. -X-
Gas
Gas or OiI ' /O.Z
Rough-=n
�Final _
SEWERS-22 Z
_ Final _
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk LG S--13 -7�
Curb&Street Final _
Approach
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
G CERTIFICATE OCCUPANCY Final
pf Z Landscaping
Zoning Final
,
•i1�2p s7��
i s
s
119U�
F;XHIBIT "A"
CITY OF TIGARD
Residential Structure Occupancy Ruatriction
Y,NOW ALL hU;N BY M113E PRESEIN S, That occupancy of residential
structure (s) on the following dosuribed lands prior to the recording
of nn occupancy permit raleasing the restric�ion in the Deec. Rc•^ords
of Washington County, Oregon, is prohibited by tho ordinance of the
City of TiGard, Oregon:
DESCRIPTION OF PROPERTY: Swnmerfield - Lot 1 L
As recorded in Book ^3 y , Paye �`, Plat recori.s of Washington
County, Oregon.
ADDRESS OF PROPERTY: jtnl As ' e
NAME OF OVUE; : �T��1�,-1._ i �,..�� I�:or .-t- 6'n
ADDRLI73 OF OWNER: I
IN WITNESS WIMUOF, the undersigned has cuuccd this restriction
to be executed this (N day of yjy,,e __ 19�•
7
5
;Tualatin poo o,-rent
�,Ve j
APPROVED: Dy: ?� !;'�: 1� ('�.
t Tule
y.
uilding Official "` !o......................
.......'m.:.......A.M.PIS
City of Turd
Pr ,
.......................................—. Deputy
STATE OF OREGON
County of Washington ) r + 19 '-Y,
ham' personally appeared before me the above nrcud _
and acknowled3ed the foresoin3 instrumen o be
volantary net and deed. _
14'ot4Xry Public or 0 cion
.TA.�.._ ...__.
IC,
STATE OF OREGON � *` '�
County of Washtrgton
1, Roger Thomsss t, Director of Records
and Elections and E.-Offido Recorder o1 Com
veyances for said county, da hereby certify
that the within Instrument of wilting wcs
received and recorded in book of records
Na
of said County
Witness my hand and seal affixed.
ROGER TNOMSSE14, Director of
Retards S EMctions
Deputy
�� 10 sopN�j�
EMIBI'i "A"
CITY OF TICARD
Residential Structure Occupancy Re+triction
KNOW ALL MSU BY TH—SE PRF.SEhiS, That occupancy of residential
structure (s) on ti.:e following described lands prior to the recording
of an occur,ney permit releasing the rectriccion in the DeeL Raccrds
of Washington County, Oregon, is prohibited by the ordinance of the
City of Tigard, Oregon:
DESCRIPTION 0: PROPrUUY: Summerfield - Lot _(
As recorded in Jock Page ? Plat records of Washington
County, Orogon.
ADDRESS OF PROPERTYs
NAME OF OWNER:
ADDMSS OF OWNER: J r�C -
IN WITNESS UU-;REOF, the undersigned has c;uused this .restriction
to be .xecuted this y tti day of
MNER:
t
Tunl.n.tin !; fir'. nTent 'n-% 1 r.r..
Name
APPROVED: Dye �, l`�� y�2
T;•;,le
By: _
Building Offi2ial
City of Tigard
STATE OF OREGON ) 6s
County of Washington ) , 19 ,
�) Personally appeared before we theabove named
and acknowlei,ged the foregoing instrume tubo
voluntc,ry act and deed
et�uyi,y�
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CITY OF TIGARD
11440 S. W, Main Sfr"t
TIGARD, OREGON 97149
APPLICATION FOR BUILDTNG PERMIT
t7ew Construction
Demolish ❑ Addition ❑- Remodel - Move❑
DATE ISSUED BUILDING PERMIT
'1,0141 NG _ - � - No.
---- --- BUILDING FEL' $_f1�JiJ-
DATE RECEIVEDIla l �+ -----..__- �
PLAN CHECK $ /r%, � �� //r• 1S• �' �
BY (� r VALUATION $ J rVS
OTHERh r",.l„l $
RECEIPT No.
TOTAL/
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT
MAP # CENSUS TRACT _ JOB #_�f _ __
#_ I`7 _ -- ----_�_-
Architect or
Phone-C,3"-il
Address1!5'-5 2ca ��. .._�� ._-..•_-_ _tie��._- - ---
Phone_-__
euilder���
Phone
—__.
BUILDING USE Single Res. —.__.-----
!_^ n' Multi Res. ❑ Comm. 11Industrial
;r
OCCUPANCY GROUP Area of T,ot No. of Stories _ Total Height _-
Type of Construction I II III IVo Floor Area B,__.__ 1A,_q z_�_--
Back .,I L.Si.de LI^ R.Side
Set Sacks:
Front _.- �, ., - tic - -
n -A. SepTank
Sewer LJ
Private Lewer Pipe Size .— J o
II Storm Sewer Ditch ❑ Drywell
Water Service Pipe Sizet�
Street and Curb
. of Parking Spaces___?,-------- _
Driveway WidthNo
wj�J` -- -
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
J
ADDRESS ASSIGNED(7G -(J
FIELD CHECK
DATF. Z�_
BY_ —..___ -_--------•- --- _�___---•-----..
PERMIT APPROVED B�!/7
It is understood thr•' all work will conform with applicable codes and ordinance
of the State of Oregon and the City of Tigard, Oregon, and that the building wi
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Tnspector.
Suture of Applicant --_.__--------