12571 SW MAIN STREET L
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APPROVED FOR
CITY OF TiGARD
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12571 SW MAIN STREET
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CITY T!G A R D Date
f SIGN PERMIT APPLICATION OF
The applicant hereby applies for a permit for the work indicated or m djown In thft SOCOMPOying Pi"end
specifications.
SIGN LOCATION ADDRESS:
CAM,
APPLICANT: Owner` Ls�ee Authorized Repraerrtstlw .-
l� .� . ► ,�� f _ 77
NAME/COMPANY _
_ - - - - - -Wall . �...— Projecting ._ �::=-.-Odw
PROPOSED SIGN:
F tqnding �� c� _ HEIGNT .L.�----- 'WALL AREA =_
SIGN DIMENSIONS 1�tAREA
_ COST _ ZONING DISTRICT —ILLUMINATION
PROPERTY FRONT E _ COLOR
MATERIAL - d --------
COPY
EXISTING SIGNS: Freestanding Wall _�L-- Projecting -- Other•
j COMMENTS: ` '`� � �
d axle dewing and plot
All sign permits must be accompinlWhy fhb airs been oomplsUd
plan. If work authoriz�ed under A sign Pwn* It sl"a
within ninety days after dw WOW"Of.dwp"It. perm
iall
PLANNING DEPARTMENT become null and void.
Permit Fee in, CC
1.
Approved ✓k ,V 1.111"''' pplican s ignature
i ecei t o.
Renewal Date � ress '
IV Aw
�I
SIGN PERMIT APPLICATION OF TIGA►RD Date No.The applicant hereby applies for a permit for the work indicated or as shown in the accompanying plans and
specifn,ations.
SIGN LOCATION ADDRESS: 12.571 sW Bain St. ------.--
Glenn
teven, Authorized Representative
APPLICANT: Owner ss _
-- . �ETL'TFTfdNRYt't.i.NIc; —_. Tel. --_
NAME/COMPANY - -- _ _ _ _ _ - - - -- - _ _. �- - -
PROPOSED SIGN:- - Freestanding _ Wall Z Projecting Other
AREA HEIGHT
SIGN DIMENSION ' 1 � 1 a`1• ' ' --I' WALL AREA
S '
PROPERTY FRONTAGE COST ZONING DISTRICT ____ILLUMINATION ----
W00a COLOR ellow
MATERIAL -- — _DRB —
COPY ate plans -- --
EXISTING SIGNS: Freestanding Wall XX Projecting Other ------- ----- ----
COMMENTS
_e All sign permits must be accompanied by a scale drawing an.+ plot
plan. If work authorized under a sign permit has not been completed
within ninety days after the issuance of the permit, the permit shall
PLANNING DEPARTMENTbecome null and vpid. `
Permit Fee
IU.uc� � ...
Approved u VB App Icant's Signature
Recut-.moo.-- I I1 `'l I -- (..! -_
Telephone
Renewal Date ___ --__ - ► drrm
BUILDING PERMfi- APPLICATION T IGARD
GATE-_���.��- —.19
THE UNDERSIGNED HERE.HY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
n LOT NO.
OYINERA ' /L"/J08 ADDRESS �. 3-ZL,�y L'�'� ��/ J ARCHITECT
ENGINEER
BUILPER ADDRESS DESIGNER
STRUCTURE ❑ REMOCFI_ ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FiRE DAMAGE ❑ DE►AOLs
❑ RESIDENCE COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PA'10 E] GkR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ F8
0CZUPANCY `�/-LANG USE ZONE ! BLOG.TYPE N CHECK BY HEAT
SEWER PERMIT N --
CCC.LOAD FLOOR LOAD 5--- HEIGHT43 J NO.STORIES L AREA NO.BEDROOMS,�"' VAIUE
BUILDING DEPARTMENT SET BACKS FRONT LEFT SIDE RIGHT SIDE
rPl,,,
mlt THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZOt
_ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED TYAT
Cheek (�g WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLI,IWITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W
b total 3 ,S3 RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSII
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stats • � 7
SDC—
Total —
PDC# APPLICANT OR AGENT
By
Receipt No. ADDRESS PRONE
A v -
SSD(' --- $
SDC __ - .
PDC -'
SEWER CONNECTION $
SEWER INSPECTION $ ,a
�
SEWER SURCHARGE_ �S
C^^I^'eqts :
t! 7
L
,AUIInING RECEIPT
NAME: DATE _.
Y U G171 4*
ACCT. N DESCRIPTION AMOUNT
-- �-
10-132 euiluing Permit fees S
10-431-600 Plumbing Permit Fees
10-431-601 Mechanical Permit Fees :
10-230-501 State Building Tax
10--433 Plans Check Fee
30-443 Sewer Cornection (20X) S _
30-202 Sewer Connection (80x) f _
30-444 Sewer Inspection f
51-448 Street System Dev, Charge (SDC) f
52-449-610 Parks I System Oey. Charge (PDC) f
52-449-620 Parks II System DQv. Charge (PDC) f _
31-450 Storm Drainage System DQv. Chrg (SSDC) _
10-230-505 TRFD (95x) —
r, 10-478 TRFD (5x) s
10-234-506 Washington County Fire 01 (95X) f __
10-478 Washington County Fire 01 (5x)
10-220 Amart/Wedgewood f
TOTAL 6(�L-'_(J -
(be/1214P)
- -` r f ➢ i
,( 1
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Address �7 �� !/'►a'`�'' P rmit No.
Name of Occupant/ �Permit charge_ 1
Connection fee ZZO c)
Paid by �^-
__ Date connected 13
I
Type of Building z Inspection fee6
Service Rate — Paid byDate — '�
Contracto , -t--)' , 0'X ^ '�Assessment� Paid
Size of connection*
f
s# s• s
APPLICATION FOR SEWER SERVICE
( 1
The undersigned agrees, in consideration of the sewer service connection by the
Tigard Sanitary District, to abide by and comply with the ordinances, regulations and rules of the Dist-
rict presently in effect or hereinafter enacted and to pay sewer service charges as the same may be im-
posed from time to time when due and before such charges become delinquent.
I fully understand that all unpaid sewer service charges become a lien upon the
property served as stipulated in O. R. S. 224.220.
Connections to the District's system must be made by bonded contractors and/or
bonded and licensed plumbers.
Owner
/ APPROVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S.W. Commercial St.
Tigard, Oregon
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■ee +� �a w.r .. e. ,.d .R
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N° 664 DATE
PERMIT IS GIVEN TO
rr
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT 7 s
1r THIS �
AT
CON-
NECTIONMIT MUST BE poSTFD ON S NF H4
MADE AND INSPECTION OFCONNECTION EAS BEFNIL
COM-
PLETED.
PERMIT FEF. PAID ..... .........................fIGARD SANITARY DISTRICT
CONNECTION INSPECTED AND APPROVED
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