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15606 SW SUMMERFIELD LANE 1-'-,0-06 SW SUMMERFIELD LANE i m L' ro J •n N •�1 4_ N N E E O Q to qti PERMIT f-HARGE OWNER T� � � _ CONNECTION FEE PAID BY ' TYPE OF BUIL:: :NGDATE CONNECTED SERVICE RATE Q INSPECTION FEE CONTRACTOR --- �---��"'-`-'PAID BY DATE SIZE OF CONNECTION ASSESSMENT __ PAID �F i \ C, s 1 {; O OC 'I'C'Y OF TIGARD /? G OREGON 926 P rmit o _ •D.C. .. .... Owner....... ............... _-. 15606 SW Sumt{.�r'Pield Ln. ... .. ......... .. . y� _.. ...... \' Building Address................... ..... .... December .........., 19..7f,-- g �+ ' `• l Certificate is hereby iven this...9.. .. .. day of.._. .. .. .` that said building may be occupied and . .�� that it complies xit.h all requirements of the Building Code for the City of Tigard, as approved by the Tigard C ty Council. � Building inspector L:, ;rte ��•_i - ' - City of Tigard INSPECTION REQUEST for INSPECTION TIME'. ._._ PERMIT NO. :— _ DATE: DATE ISSUED :_. L.L. OWNERS NAME : ( pC _... _�-_-- ADDRESS: CONTRACTOR : rE ST . Ai► r), Woter❑ , Visualo, Lr boratory ❑ RESULT: Approved ,Z Disapproved C Pending p SKETCH. INSPECTOR DATE ENME : Attach supplemental lest data beret] lass UNIFIED SEVI ERAGE AGENCY NO. __ -_` 9 WAS Hil T 0 N COUNTY DATE 9-16-7E - -- � CITY OF-- Tigard APPLICATION FOR SEWER CONNECTION PERMIT E i� I OWNER: -- T u a l a t i11_D OWNER'S ADDRESS: —__._.__ - STRCET -------- CITY ---- -- STATE ZIP- . 1 BU!LDING SITE: LOT_364____ BLOCK —..---- ADDITION TAX LOT NO. —_-._-_.__ TYPE OF OCCUPANCY _resi.d-encs ADDRESS _L_ane i DWELLING UNITS _ 1 -- ----___- - - _-- FIXTURE UNITS SURCHAI.GE Ir- APPLICABLE PERMIT FEE _.._57-5_, UQ_ -__- INSPECTION FEE -_.-__-__ TOTAL DEPOSITED __ 57,5.,arj_. ( FW_ (EXiSTING) BUILDING SEWER SYSTEM _ 1 h(_1�_�____�►.���' �_ The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. APPLICANT SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE E1/-[ _. __._ INSTALLER /� _._ RECEIVED BY__..�.-`�'.-.-.-. (AWNCY OR ITS AGENT) COMMENTSBldg. "0926 --- $25. 00 $25.00 Insp. fee paid July 13, 1976 This Application and permit expires in one hundred and twerp (120) days. The amount paid will be forfeited should expiration occur. PL"BING, INC. BUILDING UCi'AIiTMENT, 1-I6ARU i P. 0. BOX 119 PLUMBING NO. PEC3�y1tT I/ NEWEERG, GREGON 91131 - _^ holder of a valid plumbing contractors license is hereby authorized to rause plumbing work as herein noted to be installed in accordance with the 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 time the installations are ready for inspection. City of Tigard Business License required for all contractors and sub-contractors. 'e,, 7' Addressttflll ��: NUMBEROF TOTAL— PERMIT NO.'S TYPE OF PERMIT ITEMS FEE ON EACH &V`1OUNT (Office Use Only) single Fomily"-1 both—ench ✓ 25.00 0�5 • c'C� Duplex--Eech 1 bath unit_ 25.00 _ Additionol bathrooms—nach 10,00 V _ _MoVe Home 5 ace—each_ _ 15.00 ^�r INDIVIDUAL FIXTURE FEES 1 to 50 Fixtures in 1 oailding—coch _ — 1.00 61 to 100 Fixtures in 1 building—each _ _ 2.50 101 to 200 Fixtures In 1 building_2ach 2.00 201 nr more Fixtures_in 1 bulldh —each 1.50 MISCELLANEOUS Building Sewer--1st 50 ft. 10.00 Sewer—each additional 100 It. 10.00 _ Water 5erylce to building 5.00 Private Water Systems—each 100 ft. 10.00 Other (S rcif _: L r PERMIT i5'00 For Plumbing lnsF.rctiorf Phoney 6394191 _3%. state -��� Plumbing Contractor By TOTAL 7 r RECEIPT NO. Issued By CiTy Y Cr :'GARu City of Tigard Mechanical Permit Permit _ $3.00 New installation TI� Replace ❑ Relocation ❑ Ac.dition ❑ AltEr ation ❑ ---- — /� TOTAL O' R� 0NTRACTO *„f_�LA� {•-' aj-JA,CL L OWNER llft�i � `+MR6S WORK AD i`c PHONE `A � APPLICANT_ Heat Input Ratirg (BTU Per Hyr) -Inn Vent Size ti Flue Size _ FUEL OIL ❑ GAS l ELECT ❑ OTHER - ITEM NO. FEE ITEM NO. FEE For Issuance of Permit ' 3.00 Boilers Over 50 HP 25.00 New - Under 100,000 BTU 4.00 1 Air Hand!ing 1n,000 CFM 3.00 New - Over 100,000 BTU _ 5.00 Air Handling Over 10,000 CFN1 I 5.00 F!oor Furnace 4.00 Eva orative Cooler 3.00 Nal! - Floor - Suspended ( 4.00 Vert Fan 2.00 Install Vents 2.00 Vent Svstem 3,00 Repair - Heat & Cooiing 4.0 Hood 3.00 Boilers Under 3 HP 4.00 Domestic Incinerator 5.00 Boilers 3 to 15 HP 7.50 Comm. incinerator 1 -)0.()0 Boilers 15 to 30 HP 10.00 Jther Not Listed 3.00 Boilers 30 to 516 HP ! 15.00 INSPECTOR'S COKIMEN-Z CITY BUSINESS LIC- QUIRED FOR-ALL CONTRACTORS OR SUB-CONTRACTORS APPROVED BY—.Z-- DATE _ ISSUED BYDATE RECEIPT NO. t n. -'-- --� Signature of Appl' nt �C City of Tigard for INSPECTION TIME :,.._.__. PERMI''' DATE: _/-- DATE ISSUED.— CWNERS NAME : ADDRESS : CONTRACTOR TEST. Air O , Water Visual,( , Lahoratory G Diaa grooved ❑ RC.�ULT: Approved Dp SKETCH: ,v v D � , so JrE:rT0R DATE (7Tf ; Attoah supplementul tett dato 1114-17.1, S CITY OR �-Tp 0926 BUILDING PERMIT APPLICATION TIGARD �I DATE 19_ THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.. T.C►.0 . Lot f,> 3u4 Sumf�gr f jwlr9 n639-3)01 OWNER _ ADDRESS IBER PHONE ENGINEER BUILDER ARCHIT DESIGNER STRUCTURE _ ONEW ❑REMODEL–� LJ ADDITION ❑REPAIR - ❑RENEWAL ❑FIAEDAMAGE ❑DEMOLITION C1 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB _❑FENCE —❑BOND DMOVING ❑CONDIT'IGNAL USE ❑DESIGN REVIEW ❑COUNCIL A. - LOVED USIGNS OCCUPANCY_. LAND USE ZONE-BLDG. BLDG.TYPE FIRE ZONE__ PLAN CHECK Y HEAT j o b j;" � �'it, b� � 4�Z/ A91i�� IF t.. Ott " 1 tSY ^, Id R e c" W g u r a g e 2 b*6,uom 2 bath OCAD FLOOR LOAD HEIGHT NO.STORIES AREA 1c,04 VALUE �P��Id• BUILDING DEPARTMENT SET BACKS FRONT �'�1 REAR _ L_.EFT SIDE RIGHT SIDE Permit L 12.00 THIS PERMIT IS ISSUED SUBJECT TO THE. REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check Moo REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Recording ALL APPLICABLE CODES AND ORDINANCES. THI ISSUANCE OF 1141S PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR ANC SUE CONTRACTORS TO HAVE CURRENT CITY BUSINESS 1%State 366 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWS i, P1 '-'"'.dING AND HEATING. t n&ptj­ Total 12�� )6 By - - ----- --- ------ __ AP -ANT OR AGENT Approved Receipt No. ADDRESS ��_� DATE I NSP.1 TYPe INSPECTION REMARKS PLUMBING DATE Contractor -07-Ab Permit No. .7V Rough-in Fixture Final HEATING Contractor Permit No. Gas or Oilp& _92yjLh-in Final SEWER Final DRIVEWAY Final Storm Drainage (Rain Drain) Final _— Sidewalk Curb&Street Final -----TCER1 CERTIFICATE OCCUPANCY Approa h BLDG.DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY Final Landscaping Zoning Final CITY or- BUIL fBUIL 1G PERMI-T Al"PU10"ATION TIGARD L N° 'j� - r THE UNDERSIGNED HEREGY APPLIES FOR APE Ri411T FOR THE WORK FIE REIN INDICATED OR AS SHOWN AND APPROVED IN T14E ACCOMPANYING PUMS AND SPECIFICATICN' OWNE'l PHONE _ I rnr.:l nSl� � Girrs�arw.- -- !;;v ADOFIr-ss lof 'X54' Rllll-nFn'PtIONF �?4- S,t� ;• ENGINELR j)ujI -0 AR('HITECT nrsIGNFR STRUCTURE ANEW ❑REMODEL ❑ADDITION ORFPAIR ❑RENEWAL ❑TIRE DAMAGE []DEMOLITION -RR--ESIDFNCE ❑COMM ❑EDUCATIONAL OGOV'T ❑RELIGIOUSOPATIO OCA111PORT OGARAGE OS-(OIlAGEOSLAB ❑FENCE l_[ROVO OMOVING ❑CONDITIONAL USE El DESIGN REVIEW ❑COUNCIL Ai'PROVED ❑SIGNS BLDG.TYI'r -_- _FIRE ZONC�!L PLAN CHECK RY______- OCC. LOAD FLOOR LOAD HEIGF-IT NO.STORIES i AREA /7Q4 VALUE Zq, )156 ~ BUILDING DEPARTNIEN( SET BACKS FRONT �� REAR LEFT SIDE RIGHT SIDE + -.Js..6 THIS PERMIT IS ISSUED SUBIECl TO TI1E REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING nc r•k..� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE 'PJORK :":ILL BE DONT IN ACCORDA%CE WITH THE PLANS AND SPECIFICATIONS AND IN ('01.1PLIANCE WITH Recording ALL APPL'.,ABLE CODESAND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE 1 RESTRICTIVE COVENANTS. COPITIIACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS n State LICENSE. SEPAIIATE PEHMITS REOUIIICD FOR SEWER, PLUMBING AND HEATING. Total --` APPLICANT 07 AGENT 1 Approved I � Receipt No. ADDRESS PHONE