11100 SW SUMMERFIELD DRIVE ■
11100 SW SUMMERFIELD DRIVE
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ADDRESS /DU �tQ/. PERMIT NO._____ / 71V J'
PERMIT CHARGE none
OWNER �! CON"1ECTION EEE
-- PAID BY _
TYPE OF BUILDING /niE ;�-S=----- DATE CONNECTED
SERVICE RATE ��7 � INSPECTION FEE
CONTRACTOR _ PAID BY DATE _
SIZE OF CO'1':ECTION AS r'SSMENT ____ PAID
�II �
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BUILDING DEQ.: ; :HENT, TIS;AHD ' L)
PLUM !NG r c:1'rilT 1 ,
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�/,(/JxcY1� __-- , o (jet of a valid pl-incl„nr, c( ,e'at ;:;.s icttns9 s hereby
authorized to cause piurnbing ,rocrk a: herein rr,*t 'o he ;istdtl::d i-i accorHn: t. Ai, plumbino, ccrjr of
Tigard. Such installations —. ,.juire inspectiot. by t`,e City Inspector who SFA 1 :* i113'i' ' 110t les visci tour
(4) hours prior to the time the ;:.OaHatiors -,i:. :'a�iy for inspection. City of Tigan; , r',_ _nse !vquired
for all contractors and sub-contactors.
Ov+rnekAri�re55 Ap _ _dd: '�rr��� — '/�
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NUNISER OF ( ?OTi,L PEP.MIT NO.'S 1
lTYPE OF PEP.MIT i,rrAS FF ON EACH — AMOUNT (Q'+^e Use Only) i
_E Dl T 1 A L --- — : — - �t -—•--—--- � / /.i� Gs'�lGCG�
Single Fernily-1 beth—each— ------ !— - -- -- 25.00
_ --
Diolex—E:h , bath uni: --
Additional bathroorns—each �_-- — { 10.00
�—••pile:Nome Space—each _ i ---- t5.00 1 —_— ---�
°;rl _0iVIOJAL FIXTURE FEES
1 to 50 Fixture-- ;n 1 building—each _ 0.00
51 to 100 Fixtures in 1 building—each 2.50
101 to 200 Fixturct ;n 1 building—each i 2.00
201 or more Fixtures in 1 buiiding—each 1.50
( MISCELLANEOUS
Building Sewer—ist 50 ft. _ ✓ 10.00
Sew—each xlditionai 100 ft. 10.00
_ _
—�—}----
Water Service to bui,dtc -----�— 5.00
Private Water Systems—earn 100 f:. _+_--10.00
Other (Specify): _
i PERMIT p Qp , For Plurnb%ng 111wectiorl Phone 6394191
% State• r JD, d G C Plumbing ConWctor By
TOTAL a(k,
0.0 RECEIPT NO. Issued By
BUILDING PERMIT APPLICATION SOF TIGARCJ DATE_��__-_ 1__t�r? 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHON,,63��—M11 I
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE_—
Drive TOT NQ t.�..
O_WNERTIlAISaLiCY flrltt_ LQ, JOB ADDRESSI.1.191.j ��f ;;n0.7(�jMyrfield HOME ADDRESS i
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑RI'MODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRED.IMAGE ❑DEMOLITION
[I RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STC9AGE❑SLAB ❑FENCE
OBOiJC ❑MON ING []CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY--LAND USE ZONE HPI Its- BLDG.TYPE •-0y --FIRE ZONE; PLAN CHECK BY-1.Tw, HEAT
-------- -- ^ A gry Aoartmoot 0 lltti til- iia+It a_'attt• — E� lc�ttsl�.
__. 52w ar Permit rr17479+ - S403'440
OCG. LOAQ ___F_I. R LO/3Q Qu IIEI.GHT `'0 ,1!L1�STORIES _AREA �� � NO.BEDR_QQMS 1� VA U1 _41� A re l °
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDF RIGHT SIDE
Permit #,GE3r•.
- --- THIS PERMIT IS ISSUED SUBJECT TO THF RFGULArIONS CONTAINED IN THE 1UILDING CODE, TUNING
Plan Check 214*Ofj 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 COMPL IANCE WITH
SUV-total I ,�'�IJt1 ALL APPLICABLE CODES AND ORDINANCES. TILE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES'
State Tax 1 j„ �! LICENSE. SEPARATE PERMITS REOUIRFD FOR SEWER, PLUMBING AND HEATING
Total tz °ie 12
BY
APPt It-ANT OR AGE N1
Approved i,lnidin Receipt No. / '' r
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor —
Fermit No. 6
>/�G- 7I. n� 7�0..\._ ,y ham\ ------ --
I II a �� b —----- Rough-in
_ � ���� ---- -- - _-`_- Fixture
�a4h-Et xetr�A ��..�,. Final
/�� •,� HCP TING -
Contractor
Permit No.
Gas or OI!
Rough-in
Final
SEWER
- Final
DRIVEWAY
— � — Final
StorM Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.IIEPT.FINAL TEMPORARY- CERTIFICATE OCC.UPAN Final
CER'i'IF'ICATE OCCUPANCY r-_ /�y --���
[L.ndscaping
Zoning Final
JJILDING PLRMIT APPLICATION colFv TIC ,AAD DATE— ----, t8' _. N°,
.; F LINUF RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN IN BUILDERPHpN _"f �����..
H
LIR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS A14D SPFCIF ICATIONS. OWNER PHONE
•. ., ,, LOT NO.—Ilt-
JOB ADDRESS(tARCHITECTF �-_
ENGINEER
ADDRESS _ DESIGNER _
URE
I/ <W ❑REMODEL ❑ADDITION ❑REPAIR
r ; M _r--_❑RENEWAL ❑FIRr DAMAGE []DEMOLITION
K1INCE ❑CnM—CEDUCATIOND
_AL _ GOVT ❑ U
REGIOUSDPATIO LJCARPORT ❑GARAGE- ❑STOHAGE(]SLAB ❑FENCE
-IHOND [:3 MOVING ❑CONDITIONAL USi ❑DESIGN REVIEW - LJCOUNCIL APPROVED EISIQJS _
-� PLAN CHECK BY—_ HEAT
l AND USE ZONE�J---BLDG.TYPE .��f IRE ZONE.g.,a, -� _,--� _
IL
',AD I 1 0DH_L48a- -q-10- C�`ISS-EI2B-Q11�
ROILDING ULPA.RTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS 4EREBY AGREED THAT THE
-- — WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL APPLICABLE COL ES AND ORDINANCES. THE ISSUANCE OF THIS 'ERMIT GOES NOT WAIVE
---- --- - — RLSTRICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
!dale Tax — / 7_ / LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
by -- - -- —-- -- ---
APPI ICANT [)p AG 1
Apprnved Receipt No.
- HHOON-E-_