15452 SW SUMMERFIELD LANE 15452 SW SUMMERFIELD LANE
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1196
.....Permit No...... 1197 I :`
Building Address. 154521.54.66-.. �I_ mm,e, f. e.J,d ..l.Gne..... .. .... ..
. : 1/y�.4.........day of....-.rla_y..................... . 7
Certificate is hereby Niven this...2
that said building may be occupied and
that it complies with all requirements of (`
the Building Code for the City of Tigard, 1
t as approved by the Tigard City Council. .:
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Building Inspector n t;,.
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1111,11111,
IONN E. REC�6,�RD1 PIGI`18illi, 14 BUILDING DEPAKTMEN1 , TIGAI'I NO,
P. 0. CQY 119 PLUMBING PERMIT - -�
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N�1'IGLf;, 0l;EGS;� 9]132 �� holder of a valid plumbing contractors license is herebtr
uuthorized to cause plumbing work as ;ierein noted to be installed in accordance with thz plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the tine, the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-c:ontractots.
Own �fC� tP l���� �U'—�<rl• _Addres
NUMBER OF TOTAL PERMIT N0.5
TYPE OF PERMIT �^ ITEMS FEE ON EACH AMOUNT (office Use Only)
Single Fomll -1 both-each 25.00
Duplex-Each 1 bath unit 25_00
Additional bathrooms-each �� _-- 10.00
Mobile Home Space-each _—_ -__ 15.00
IMdIVIDUAL FIXTURE FEES
_1 to 50 Fixtures in 1 building-each r 3.00
_51 to 100 Fixtures in 1 building-each _ 2.50 ---
101 to 200 Fixtures in 1 building-oach 2.00
201 or more Fixtures in 1 building-each _ 1.50 _
MISCELLANEOUS
_Building Sowor-1st 50 It. _ _ 10.00
Server-each additio .al 100 ft. _ 10.00 _�-_,•„ _
_Water Service to building _ —_ — 5,00
Private Water Symms-each 1(v ft. �— _ le 00
Other ftccify)•
_PERMIT i '> > For r'lurnbiny Inspection Phone 639.4191
;)% State j - 3 S Plumbip3 Contractor By e _
TOTAL ,,l(,, 3,`�l RECEIPT NO, issued Ey
1 �
City of Tigard
INSPECTION REQUES
for
" PECTION TIME: , _Z.__ PERMIT NO. :__._
DATE: ^i �/��7� DATE ISSUED .--- /
OWNERS NAME :- • L , _
ADDRESS: "D 5_373 1,5 5�'SZ 5'4_
CONTRACTOR '
'r'E ST : Air p, Water[] , oval 0 , Laboratory
RESULT ' Approved 13'/Disapproved C Pending Ll
SKETCH. /
I $PECTOR DATE
NOTE' Attach supplemental test data beret]
-74
UNIFIED
UNIFIED SEWERAGE AGENCY NO. _e. 11020
WASHINGTON COUNTY DATE
CITY OF,_ iTard.-_- -- - - ----
APPLICATION FOR SEWER CONNECT-ION PHIMIT
OWNER: _ — T.Q.C. -------- -- —
OWNER'S ADDRESS: _ _ —_ - _-- _-- --- --- -
STREET
- ---CITY ----- --- - -- STATE ZIP
BUILDING SITE: LOT--_.37_3--__ BLOCK __-.-__—__ ADDITION ---- --
TAX LOT N0. ___.- ___.— TYPE OF OCCUPANCY -._-________ residence
ADDRESS -_ --_-.._15452SLL-SLmmer.ffeld_.Lana_ ---- _ ----- -- _,____—
DWELLING UNITS ------- 1----------------------- ----- FIXTURE UNITS __------------
SURCHARGE IF APPLICABLE ___-. -
PERMIT FEE 5?5.00_ _ INSPECTION FEE — ----- TOTAL DEPOSITEp ._600.170_ _
Fanno Crook
(NEW) (EXISTING) BUILDING SEWER SYSTEM
The Applicant agr?es to comply with all rules and regulations of the Unified Sewer;,ge Ayercy.
APPLICANT _ _ ly� k�__------------_._._.---
1,
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE -- -- .-.---._- - INSTALLER .._. _-------___---------_� ------
RECEIVED BY-
COMMENT;;. .
Y_COMMENT;;: 81d9. #119?
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
CITY t'
BUILDING PERMIT APPLICATION oF TIGARD DATE TONT 3�'�f7 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13111LOERPHONE-__
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE --
LOT NO -
OWNER ZZ..*G JOB ADDRESS 1� - �-I 1J10M9Irf iQ114101.1�'AADRESS
---Y-- _ ARCH'TEC:T -- -
ENGINEER
BUILDER .� ''IYt{_ ADDRESS❑ G
t DESIGNER 1-11J
STRUCTURE ONEW
REMODEL CADDITION REPAIR ❑RENEWAL ❑ C
FIRE DAMAGE DEMOLITION
.QjqESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T 0 RELIGIOUS DPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:)FENCE
OBOND ❑MOVING 000ND,TIONAL I)SE ❑DIcSIGN REVIEW ❑COUNCIL APPROVED [ISI GNS
21PANCY--_-_LAND USE ZONP,.,_BLDG.TYPE__ FIRE ZONE_... PLAN 'HECK,BY HEAT_-_--_-___
i.,at 4373 model jortain Pe_j*auEa,, s..r,4& 10235 5,' Gr+3kJnle,-lf Tvirace
----Zrwe11in(j U/ �1
k4tached , �;I:� _-- ! hisor+loy, be4:h
fti --- --
QX_LQAQ -__ELQPLLIXA_0__._ —lyUQAT-- -- -- �I11S2.fiI�ZE1F.,� AREA I`J1lei NO.8.�12�4SZA9�?_.VALUE 38s bi
- BUILDING DEPARtMENT SE T BACKS FRONT 11 REAR LEFT SIDE r RIGHT C:DE
Permit ,,h.i);
THIS PG-RMI-I IS ISS11En SUN•IF..CT TU THE RFGUI AIIONS CONTAINFO IN THE BUILDING f.CtDC. ZONING
Plan Check TCI• REGLILATIONS AND AI L APPLICABLE CODES AND 11RDINANC.1 AND IT IS HEREBY %GREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal AIL APPLICABLE CODES AND ORDINANCES. THE ISSUANCC OF THIS PERMIT DOES NOT WAIVE
—"-' —' RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUpRFNT CITY BUSINESS
State Ta/ i'•C1 LICENSE. SEPARATE PERMUS 14EQUIRED FOR SEWER, PI UAIBING AND HEArING.
Total
By --____ _—._ ----- -- --- -- -- - --
---- APPI,ICA'V1 OR AGENT
Approved �(, Receipt No �
A_60 WE 95 � iii-�---- ---
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DATE INSP. TYPE INSPECTION PEMARKS PLUMBING DATE
Contractor
_ 7J —_ Permit No.—L-1 � 3s ,
—_ Fixture —
/L�� c46) J - - Final - -- _
y/5 ;7 i HEATING
Contractor --__
Permit No.
S/S�7? ''�-f - — --- ---- Gas or OilRough-in _
Final _
.�- ---- ------ __�__-_-- -----SEWER -� jQ /- '��. •' •-
Final
-- __ DRIVEWAY
Final
----- —— _ ��--
�- --�- Storm Dro n rZ_
-- (Rain Drain) Final —
Sidewalk
— Curb&Street Final
_ A roach _
BLDG DEPT, FINAL TEMPORAPY CERTIFICATE OCCUPANCY Final
Landscaping OCCUPANCY --
Landscaping (�
(, Zoning Final
BUIL PERMT APPLICATION - TIGARD 74.
THE UhDEttbIGNED :-I[REOY J1PI=L!ES FOR APERM!T FOR THE WaRlt !lEfIL-IN IND'C1lTCC
Ofl AS SHOWN A�'O /YrrROVEo IN TF4� lICCOPar,�ivYING PLANS AND SPECIF1CnT10N�. OwNcn PHONE-4
rn•JrJr_�j> P� Annr r-r-S S �,�j s��,t�'jv/ ' 1(Ln�=mr!IONr_
ENGINFcn
RUIL? 17--5�4 ' AnCta!TGCT DFSIGNEH
sTnuLTunr_ XNrat QnrMOOEL QAnDIT1ON ❑1lrrnln ❑nE,vrwr-�t,L Qr-Inc DAMAGE ❑aEMOLITION
M_misinr-NC_E_Q_MMM Q_ EDUCATIONAL QGOV'T QnE_L_!Gious CPAT!O QCA!) POnT_L..JGAnAGL- Q STO!IAGE 0SLAB OFENCE
L-111QtJD. QAIOVINr, QCONDITIONAL USE QDESIGN REVIEW L_1COUNCiL APMOVED ElSIG;VS
Or--UPANCYV-1-AND Ll''E 7ONF OLOG TYPE � .FIRE 20N-e,7— PLAN CHECK OY
/
11Pf' L,AAp f 1-gt7R Lf1AD HEIGIiT N_O-_S_TOR_ S / AREA Xj/O
111JI1-UING DfPAI1fMCN—f—�
- SET1ACS FHONT,{ —
, 2rn11LEFTR!G_1T S_taE
r=• -tft _ 40 — _ _j
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11-1IS PCnMIT IS ISSUED SUBJECT TO T!IC nEGULATIONS C ACD IN THC BUILDING CODE, ZONING
�C REGULATIONS AND ALL APPLICA!ILE CODES A?SD OnMNANLLS AND IT IS fiEnE11Y AGREED THAT THE
'.lOnK WILL BE DONE IN ACCOnDANCE WITH THE PLANS AND SPCC!FIC'LTIOrlS AND 1% Ci?h:rL!ANCE YJITII
!!Crorcling ALL AI'PLICAOLE CODES AND ORDINANCE.'. TILE ISSUANCE OF THIS PER1.11T DOCS N.OT �%A. VE
RESTRICTIVE COVENANTS. COPITIIACI.On AND SUP CONTRACTORS TO NAVE CURRf- JT CITY BUSINESS
P'."state I 4 Ge LICENSE. SEPAFIATE MINIM REQUIRED FOR SE-WEh, PLUMBING AND HATING.
Tota!
fly or
—'— f APPLICANT Oft AGt;-,rr
Li%�t�'c Receipt No.
AUUfIL55 !•HUrI_
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ADDRESS. Z ;_VS .2 ,,,�,,,r Tr�rL.�2- PERMIT NO.
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PERMIT CHARGE none
OWNER � CONNECTION FEE
PAID BY 4L-e '
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE ��� INSPECIION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
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