15618 SW SUMMERFIELD LANE 15618 SW SUMMERF;ELD LANE
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uE51�lI f CHARGE none _
_�----_ - _ COIJNECTION FEE -> �;y
OWNER � C-- ,.� __.___ -
PAID BY
TYPE OF HUILDING 4____ __._ DATE CONNECTED �.
J3/ INSPECTION FEE
SERV I rF NATE
PAID B Y _ ______.__---._______ DATE
CONTRACTOR — _ --
ASSESSMENT _ PAID
SIZE OF CONNECTION — `, \3 JL
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OREGON !,
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T.•0.C. .... . ... ........ .. ..... .................. ..... .....Permit No. . .934........ �S ►�.
Building Address..... ....15618.•. W .SUMMRr.f1old Ln...... .
Certificate is hereby given this........9
... ..day of... DecFmber..... 76
that said building may be occupied and
` 1 that it complies with all requirements of >>'
the Building Code for the City of 7i ard,
as approved by the Tigard City Council.
it Bulidl _ 1,. pector
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City of Tigard
INSPECTION REQUEST
for
C:���_4 GSR:?
!N8PECTION TIME: Ci 2zi PERMIT NO. :—
OAT E: _1 6'� DATE II S S U E D :__L1� j
OWNERS NAME :ADDRESS:CONTRACTOR : --!
TEST : Ai; 0, Water[] , Visual I$ , Loh:,rotory [3 I
RESULT: Approved 14 Disapproved CT ,�Pending El
SKETCH: I
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INSPECTOR DATE
COTE Attach supplemental rest data heret]
UNIFIED SEWERAGE AGENCY NO. 10631
WASHINGTON COUNTY DATE ------9-14
CITY OF rd
APPLICATION FOR SEWER CONNECTION PERMIT
OWN EH: .______ — Tualatin Development Co.
OWNER'S ADDRESS: .
STREET
- -- ---- ----
CITY STAT __.. ZIP
BUILDING SITE: LOT X65___ BLOCK - ADDITION
TAX LOT NO. TYPE OF OCCUPANCY _ residence
ADDRESS __ 15618 SW Summerfield Lane
DWELLING UNITS_—__1___ FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE 575.00 _ INSPECTION FEE _ 57500_______.__ TOTAL DEPOSITED ___
(NEW) (EXISTING) BUILDING SEWER SYSTEML4KN� C i-cV <
The Applicant agrees to comply with ; II rules and regulations of the Unified Sewerage Agenc/.
APPE_ICANT ��--r��-��,
SEWER PERMIT
"THIS PE=RMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE _-_----------- INSTALLER
R E C E I V F D BY�._7
(AGENCY OR ITSGni ENT)
COMMENTS: . Bldg. 0934
$25. 00 Insp. fee paid_July 16, 1976
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
C; f T prd Mechanical Permit J4Q��-�'
1 2,,,/ 1 Fee
—
New oo'
New Instation `1Replace a Relocation _ Addition 01 Altera'„on
TOTAL
CONTRACTORRs� �"',�� t�-t.fm— OJWNER tJ D
AMPESS P.O. 'BOX �S L.�••�c' AMPS . QR.tte WORK ADdRESS .w .
?HONE �,��n — d �-� APPLICANT
Heat !nput Rating 1911 J ;'7LECT
� Vent Sin � F•.ue Size,_
FUEL OIL Ci CAS n 9THER
ITEM NO. FEE 1TEh" NO. FEE
For Issuance of Permit 3.00 3uilut Over 50 N? 25.00
New- Under 100.000 BT'J _ I 4.00 Air Handlir-g 10.000 CFM 3.CZ
New- Over 100,000 BT'J i 5.00 Air Handlina Over 10,000 CFM 5.0c
cfoor Furnace 4.00 Eygporative Cooler i 3.00
Wa!! - "lour - Suspended 4.00 Vent Fan 1 2.(_K
lnstaii V snts 2.001 Vent System 3.0C
Repair- Hen: & Cooling 4.00 Hood �•x
Boilers Under 3 HP 4.00 Domestic Incinerator S.00
Boilers 3 to 15 HP 7.50 comm. Incinerator %m-«
Boilers 15 to 30 HP 10.00 Other Not Listed 3.0(
30ilers 30 to 50 HP 15.00
INSPECTOR'S COMMENTS-
CITY BUSINESS L!C IRED FOR-ALL CONTRX—OPS OR SU°-CONTRACTORS
APP �"►Fn ay ���� DATE !SSUcD BY DATE_
RECEIPT NO.
TTI Si'!nitur!! of A :G9n i
x..
I
JOHN E. REINHARDT PIUIa'9K, IN. BUILDING DEPARTMENT, TIGAHD 110. �
PLUMBING PERMIT �� •Z'
P. n. aox Its - -------
__ NEMiaE(C. ngfrm 27137 holder of a valid plumbing contractors license is hereby
authorized to cau-.e 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 o' Tigard Business I-icense required
for all contractors and sub-contractors. JVD f 3U�;' /.5'6. / K
t 2. '>✓ >_ sa.�.S� L 2� 'u--ti ''�.L.LA--_,�Daie_—L_'.°�L� -
awnnt' — Add res._.. —_
NUM13Fn OF 'TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT (Office Use Only'
2.5.00
Singlo FomilY-1 both—each
du Ip ex_Each 1 bath unit _ _ 25_00 --- —
Addltlonol bothrooms—each ✓ 10.00 0
Mobile Home S4lce—each _ 15.00 —�
INDIVIDUAL_FIXTUnE FEES _ - --
1 to 50 Fixtures in 1 building7oach 3.00 wr�
51 to 100 Fixtures in 1 builtlinpiench _ 2.50
101 to 200 Fixtures In 1 building—each _ _ —2_00 ---
201 or more Fixtures in 1 building—ench 1150
MISC_EI.LANEOUS --
Duilding_Sower—lit 50 ft. _ 10.00 —
Sewer—each additional 100 ft. 10.00 _
Water Service to bullding__— _ __ 6,00
_Private Wow Systema—each 100 ft. �. �� 10.00
Other (Specify): _ _
PERMIT —,S• C�C� For Plumbing inspection Phorte 6394191
�:i% State Ct�— Plumbing Contractor 13y -
TOTAL 3 RECEIPT NO. Imed By --- �_ ---- I
L 1 -1 Y or. I
BUIL �G rF"cRMIT rkr,r1i Ir.AT10N TIGARID -
T:4E UNDERSIGNED HE(1Et3Y APPLIES FJR A PERMIT FOR THE WORK FIE RElN INDICATED
on AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPEC!F!CATIONS. OWNER PHONE
OV!"::R Tst�,., i '���«, r ��. ADDRESS fl77j iJ �' +-,` '--� "" BUILDt=n'PHONE li -�IOI
ENGINEEn
BL:tLF?ER Sc.r, t rr--11 ARCHITECT rr�� ;--1DESIGNER
STRUCTURE ®NEW t-�❑REMODEL OADDITION ElnEPAIR ❑RENEV.AL DFI-E DAMAGE ❑DEMOLITION
2rRESIDENC[ ❑rC-OMM QEDUCATIONAL ❑GOV'T ❑RELIGIOUS I_IPATIO ❑CAnPORT t-7GARAGE ❑STORAGEOSLAB ❑FENCE
l IROti0 DMOVING ❑CONDITIONAL USE ODESIGNRrVIEW ❑COUNCILAPPF,CVED ❑SIGrlS
_ _LAND U..E 7.OtJE _O,DG.TYPE FIRE ZONE1— PLAN CHECK BY—Cv<� HEAT Cssl
7..�r � —
OCC. LOAQ FLOOR LOAD HEIGHT NO.S T ORIES AREA VALUE r4 i,)4 �
BLiLt::NG OLPARTmEN f ,
__ SET BACKS ;IIONr REAR s LEFT,,IDr RIGHT SIDE
Permit y. pr7 ----------_-- --- _—_ -- ---
•M .Jss�c I THIS PE-RILIIT 1: ISSUED SUC:ECT TO TILE nr-GULATIONS CONTA r Tr,: BUILDING CODE, ZONING
REGULATIONS AND AI-I" APPL'CAIILE CODES AND ORDINANCES, - S HEREBY AGREED THAT THE
WORK WILL BF DONE_ IN ACCOI1Dr r.CE WI II THE PLANS AND� Et ,ONS AND IN COMPLIANCE V',ITH
}recording � ALL APPLICABLE CODCS AND ORDINANCES. THE ISSUANCE !HIS PERMIT DOES NOT WAIVE
nESTRiCTIVE COVENANTS. COM1'fIAC1*On AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
LICENSE. SEF.'1IIATE PEP%IITS REQUIRED FOR SEWER, PLUMBING AND HEEAT.NG.
� Total r
t
�—
Rcccipt Na. APPLICANT OR AGENT
�ARlnoved 1� i.l
A00R S PrtQry
i 5"3 -7
:�':xzn m*ksw•v:�s.ma+x*.+:�w!.oa�`�NMIk!",�M. �4w
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cl ) OF "
3�5 BUILDING PERMIT APPLICATION TIGARD ookTENO 0934
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN 'THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE----
Q1�INER I *U*L. ADDRESS ct # .:6L ;�L"J✓fU'ftWf."f�1sic
_
-- — — -- ��01 " r �lL' - .PHONE
ENGINEER
RU LUQ•_ ARCHITECT DESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL DFIRE DAMAGE. DDEMOI_ITION
QRESIDEi;CE ❑COMM CIFOUCATIONAL CIGOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGECSLAB ❑FENCE
❑BI ❑MOVING JCONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG,TYPE FIRE ZONE PLAN CHECK BY, HEAT _
Z;.4 10065 7)V3 H ,qK afid f'r. J(535 05355 77—TT "
STV dwelling v/attached garage 2 bedraam, 2 bath
Qom.LOAD FLUrIR LOAD HEIGHT NO.STORIES AR&& VALUE
BUILDING DEPARTMENT—�
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 00 — �— __ -- — ---
l fill
PFRMI, IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check • REGULATIONS AND ALL APPLICABLE CODES AND 0r71NANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILI BE DONE IN ACCORDANCE WITH i HF P' 4NS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. 14E ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RES.RICTIVE COVENANTS- CON 'RACTOR AND SIB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%vtate 3.75 LICENSE. SEPARATE PERMITS RI OL:'RED FOR SEWER, PLUMBING AND HEATING.
Total 12.8,75
By
�--- Af 'CANT OR AGENT
Approved �; (, (� !. RPcPihl No.
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _
07&
Permit— - — Permit No. U�s�` �a C� �I7�(re
Rou h-in
Fixture
0 Final -_— —
HEATING
d..4�.y+-r 0 Contractor
Permit No.
<. kG Gas or Oil
-- i _ -- --
-0-c•wt r Rough-in
Final _
-�_-----
-- Final
-- ------- -----
DRIVEWAYt-
Final
-- —_-- --� — - Storm Drainage _ —
(Rain Drain) i inal -
- Sidewalk
Curb_&_Street Final _
- -------- ----- -- ._
Approach L�•• �j.. �, i .�G
BLDG.DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
�j CERTIFICATE OCCUPANCY
, , 1/" Landscaping
(/�`� / Zoning Final I —
r
f.__J-'._ c-3rd Mechanical tll^+AI Ptrmlr N'9 Permit
J Fee—_
New Ins:alia+ion _ Re:,lace ❑ Relocation ® Addition �" Altl:ration Stxte
IOTA
CONTRACTOR GLrt I —_ O'NNERYB�'�MB� GVt.•LEIV_ 1> 1N�---
y• GG J 1/M AA"2. 413
Ar,nREssS S. L LV C VR GT 1 _ PC,&�L�1_1�_L)i WORK ADDRESS�.S�1
PHONE A t'oU (0 U APPLICANT POWER-AtiNr
Heat Input Rating (BTU Per Hour) _ Vent Size Flue Size
FUEL OIL ❑ CAS ❑ ELECT OTHER
.. ITEM NO. FEE ITEM 3. FEE
For Issuanre of Permit _ — _3.00 i_Air Condition Compressor 15 to 30 HP 10.0C
New - Under 100,000 BTU 4.00 Air Handling 10,000 CFM
New•_1QU,000 ETU & over —^_—_ 5.00 Air Handling Over 10,000 CFM
Floor Furnace _4.00 Evi,porative Cooler _ - 3.00
Wall - Floor •Suspended — 4.00 Ra Ige Vent Fan 2.0r
Install Vents Only _ _ _✓_2._00 V_e ot System___ _ 3.0C..
Repair • Heat& Cooling —� 4.OQ _ Hood Commercial 301
Air Conditirn Compressor Under 3 HP _ _ W4.Q0 Co nmerriAl DTIC System 10.00.
.':
-Alf Condition Cornpressor 3 to 15 HP 7.50
INSPECTOR'S COMIMENTS.,__.,__
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRAC'MRS OP SUB CONTRACTORS
APPROVED BY DATE .� IS:. u BY GATE
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