11110 SW SUMMERFIELD DRIVE M w v w FU ! t
110 SW SUMMERFIELD DRIVE
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A00RESS C, PERMIT CHARGE _ none
0CR , ( � COVICCTIO�J FEE
— P A I O BY
TYPE OF BUILDI'�G ( T ���� 1_ DATE COr;':FCTEO
SEPv ICE RATE Ir.5PE.CTION FEE S �_
PAID DATE
CONTRACTOR BY_ _�_�.....SIZE OF OF CO;;�d_CTI0N SSEiSMENT _ �__ PAID
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BUILDING DLP !P FMLN C, TIGAHU I NO.
PLL' JIPA PERMIT
folder of a vaild piumbing conirac_u: Inc,.+ae is hereby
authorized to cause plumbing wcrk ash rein novo to he ln,;Ialled in ,iccordancc vJth 1` ' i"Inhirt', carie of
Tigard. Sneh installations reCiLi" inspection by the Ci!-; Injpector *-o slijil be rotif'-, not less than four
(4) hours prior to the time the Install ltions are ready for inspection. City of Tiy. ,1 13o . +1ess _ii.ensF required
for all contractors and sum�crtra:tors. ��nb�Q IJYJ�Lc��i 1�6-w-Z
owner�,//'�il ilf ��./���/� _— A !I e_sr _�� ��_?�-_ — ria tri—
T Nl;:•,hcR JF i
TOTE( I PERMIT NO.'S /L�
TY.`E OF CcAMIT _—_ I7E41i FEE ON EALti ( ,�h10Uvr ffice Use O�r'Yl I �l /mac,/
-- —�-----. --: !', Tri
DENTIAL __ _ -__— .4 ----
Single Family-11 bath—each 25.00
Du lex—Each 1 bath uni;
Additional bethro yms—each _ _ _ 10.00 --
Mobile Home S ace—ee._h — 15.00
INDIVIDUAL FIXTURE FIXTURE FEES J _ _ _
1 to 50 Fixtures ,n 1 building_each ! 3.00 _
51 to 100 Fixtures in 1 building—each _ 0 2.50
101 to 200 Fixtures in 1 building—each 2.00
201 or more Fix—ires in 1 builds —each — _'.50
(MISCELLANEOUS _
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Building Sewer-1st 50 `t. t� 10 Co Gtd —_
Sew---each additional 100 ft. 10.10
Water Service to building _ _ _ I 5.00 D
Private`Nater Systems—each 100 ft i 10.00
i Other (Specify):
i
PERMIT Far Plumbing Phone 6394191
0% state Plumbing Contractor 9y
TOTAL `_/L Q� T(� RECEIPT NO. Issued By
E3 CITY 1 r
IGARDDATE 1�`2 4/ to 7t,� �� �•���
BUILDING PERMIT APPLICATION of *�,_
3 1 a 1
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR fHE WORK HEREIN INDICATED BUILDERPHONE
')R AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE
I1: LOT NO._..— .wy
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OWNER + JOB ADDRESS t 111,0 aW :UW$1Vfi61u HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑RFM_nDEL ❑ADDITION [:]REPAIR _❑RENEWAL [:]FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT—❑GARAGE ❑STORAGE❑SLAB ❑FENCE
_❑BOND ❑MOVING ❑CONDITIONAL UGE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY.—.LAND USE ZONE_ t BLDG. 1YPE '! FIRE ZONE''_ PLAN CHE( U,"__ ^^� = HEAT�,'lGL_r_
-Lury Augi tment Uni t6 - 6 09droumss Fs tiaths.
----- . e-I buo of A- — _---- --- - _
s)swsr l3o i mit 17A'7J -� 44831i*00 6 a2, s�c�.ft.
-- - A Oil -2a -- 2 h3v i'! i 1x311 200.
-HS1_G!�L-- 40.STORIES --A-5-g-_-...-.—N4�AFDB49M�-.�VALUE
BUILDING DEPARTMENT - SET BACKS FRONT REAR LIFT SIDE RIGHT SIDE
Pel-mit ,:3(�, 10 _. --------
--' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check 106uu REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 11 IS HEREBY AGREED THAM THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLAP S AND SPECIFICATIONS AND IN CONIPLIANCF NTH
Sub total 393.00 ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PF.-.MIT DOES NOT WANE-.
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 1'O HAVE CURRENT CITY RUSINF!3S
`state Tax 1 ,r 32 LICI`ETy$E. SEPAGAT�,P5RIJ'S�.FIfOUIREO FOR SEWER, PI_UMBINI; AND HEATING,
11 JJ
Total A08,32 POO #2 — 480.00
ByP1 - ----------------
—. APPL(CANT OR ADEN T
— It
Approved 'L,. 4101d®tl Receipt No.
i
DATE IPSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
/ ` -Gw. Permit
Rough-in
Fixture
i HEATING
Contractor
Permit No.
Gas or Oil
Rough.n
Final _
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final
Sidewalk
Curb&Strest Final
APPrcach
1L.OG.DEPT.FINAL TCMPORP.RYCERTIFICATE OCCUPANCY Final `
CERTIFICATE OCCUPANCY c -
�-
Landscaping
Zoning Final
It,
BUILDING PLRMIT APPLICATION c^FY T1 ,ARD DATE_ _
,AF L :4M RSIGNE') HEREBY APPLIES FOR APE RMI' FOR 'THE WORK HEREIN INDICATED BUILDERPHON : Z '�_
,-FAS SHC)WN AND APPROVED IN THE ACCOMPA�'YING PLANS AND SPFCIF ICAI IONS. OWNER PHONE
LOT NO_�
JOB ADDRESS
ARCH ECT
ENGINEER
R ADDRESS DESIGNER
'oRE NEW _—OREMODEL— OADDITION� OREPAIR —ORENEWAL ❑FIRE DAMAGE ❑DEMOLITION
L-'-'II NCF 11-J,MM ❑EDUCATIONAL OGOV'T ORE LIGIOUSIJPATIO ❑CAR PORT OGARAGE OSTORAGF OSLAB ❑FENCE
!H'.`ND C.MOVING ❑CONDITIONAL JSE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
pKZ
�.L,rANCY�J- .LAND USE ZONE E_ �_� E ...
BLDG.TYPE FIRE ZON PLAN CHECK BY_ HEAT '
t
77
0A0_- _-- FJ.QQF.II.QAQ_ [—Y-__ HEI F L - __ :2_ I4RIES _Apj1�`?I_tjQ EDEMAS V_81
BUILDING 6 1 PA—Rf ME NT 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 HEREBY AGREED THAT THE
I- — -f WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
` Sut;lplal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVF COVENANTS. CnNTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITV BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
Sy -Pr'Vts _I.- , _ -_,____ _ __ _ APPI iCANT OR AGENT
AG proved — _ ( Receipt No. C
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ADDRESS
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