9165 SW SUMMERFIELD COURT 9165 SW SUMMERFIELD COURT
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+ CITY OF TIGARD C
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+ OREGON �
Owner:. .J...D.C................... tt
_. . ...................................Permit No. 1417
3 Dtrilding Address.....91.65..SW..Sum.merf- e.1 d...C.t.. ... Lot...#4.26..... ......... ,r
k (_certificate is hereby given this. .,.. .day of. Augus.t.... ._ ...... 19..7.7 +'
;j 4 hat said building may he occupied and *�
I that it coinhlies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council. ) �'
Bwlding Inspector ._
\`,y
�' I
City of Tigard
INSPECTION REQUE� T
for
INSPECTION TIME .' -62 PERMIT NO. : ---...
DATE.* -5–// 1/ '? DATE ISSUED .–..–L–Z—
OWNERS NAME :
ADDRESS.*
CONTRACTOR :
rEST '. Air El, Water[] , Visual [3 , 1 abnrotory 0
9ESULT'. Approved LKI
Disapproved [7 Pending [j
SKETCH.
INSPF OR D;NTE
[NOTE: Attach SUPPItmental test doto beret
IMI'
I
lONii E. (?EI..►199UT P(!)!�[3if(G 1f,,C BUILDING ULPAK 11AL-IV I , I IUAIAU
NO.
PLUMBING PERMIT
NEW11"Ci;, CiiU'v;i J1132 hilder Of a Valid plumbing contracturs hCenSe is hereby
authorized to cause plumbing work as herein rioted to be installed in accurdanre with the plumbilig code Of
Tigard. Such installations require inspection by tlls. 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.
/ ' r ,
Owne _1>__1 16�—__— Add ress. �_. Dat(!--
� SIL Date—
NUMnFn OF OTAL PERMIT NO.'S
TYPE OF PERMIT 11 LMS FEE ON EACH AMOUNT (Ulfice Usti 0(110
RESiDENTIA A___• -_ -
_ Sinnla Fnmily-1 bnth-each ^_ 25.00 -,;, ,5. C)o _
Duplax-Each 1 buth uni; 25.00
_Additionnl bothrooms-each �— 10=00 _�CI �� CJ ^
Mobilo Horne Space-each 15.00
INDIVIDUAL FIXTURE FEES
1 to 50 Fixtures in 1 build;rg-each__ - �_ 3.00
51 to 100 Fixtures in 1 building-each __ 2.50
101 to 200 Fixtures in 1 building-each 2.00
201 or more Fixtures in 1 buildmU-each 1.50
MISCELLANEOUS
Ouilding Sowor-1st 50 ft. 10.00 — �-
Sewer-coch additional 100 ft. 10.00
Water Service to built in 5.00
Private Water Systems-each 100 ft. 10.00_
Other 1Specify):
_-
PERMIT ,�Tj.C,C For Plumbing inspection Phoma 639-4191
96 State_ �`, nom- Plumbing Contractor By
TOTAL RECEIPT NO. Issued By
SEWER PERMITy -7
Uf N" 12140
Unified Sewerage Agemy
of Washington Couidy CITY" OF _ Ti.gerd DATE 4-31-77 _
OWNER: T.D.C. PHONE :. 639-3101
OWNER ' S ADDRESS __----
TYPE OF INSTALLATION:
OX BUILDiNG SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XONEW El SINGLE FAMILY COMMERCIAL.
❑EXIST . (PPIOR TO 7- 1-70 ) MULT , RES. INDUSTRIAL
FIXTURE UNI"S DWELLING UNITS 1 _
PERMIT CONDITIONS : THE APPLICANT AGREES TO COMPLY WITH ALL. RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE $ 25•
575.
CONNECTION CHARGE
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL $ 600.
l APPLICANT DATE
SEWER PERMIT N V 12140
ADDRESS OF STRUCTURE 9190 SW_ Summerfield Ct. —
TAX MAP _ FAX LOT____ SYSTEM Far.no Creek
LOT 424 BL(jOF �_—
APPROVED BY DATE ISSUED /BY M DATE
REMARKS__ Aldo .4 417 __
i
CITY OF TIGARD
ORDINANCE #77-26
STREET SYSTEM DEVELOPMENT CHARGE
DATE : 4721-77 ESTIMATED SALES PRICE $ .. _49.�:[�.0_.___.. _.
APPLICANT NAME_ T.D.C. _ ^TE�EPHONE
JOB ADORFSS 9190 SW Summerfield Ct. -9LDG. PERMjT la _
AMOUNT OF FEE FOR S. 0. C . $300.
DESCRIPTION OF IMPROVEMENT _ _-__-sin gle family dWd ina
EXE111PTIjNS -PER ORDINANCE #77-26
FEE RATES:
A. Single family dwelling unit under $60, 000. --------- $300. 00
P. S.inr,'.e family dwelling unit over $60, 000. --------- 8400. 00
C. Mobile Home Court Space (Nnw Develapment.)------------ 51. 50. 00
D. Multi-Family Oevllings--per unit-------------------- $240. 00
E. Commercial , Industrial h Institutional (Park. Space) $ 50. 00 E :--(_h
F. Single family unit under $40, 000. ------------------ $250. 00
BUILDING PERMIT APPLICATION 11TTIGARL) DATE 1417
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF
OR AS SHOWN AND APPROVED IN THE ACXOMPANY1 PLANS� AND�SPE( F IC4TIOhJS. /OWNER PHONE
1iGs— �- '- -C- P 7 LOT NO.__
OWNER JOB ADDRESS ",P `J 4J J�ililfl3elY I' 3•+;'td L: HOME ADDRESS
ARCFIITE T
to F3tilE ENGINEER
BUILDER xx �ADDRESS _DESIGNERI _
STRUCTURE 'ONEW ❑ MO
REODEL ADDITION ❑REPAIRO
_ ❑RENEWAL. FIREDAMAGE ❑DEMOLITION
ry
LJrl-EISIDENCE ❑COMM ❑EDUCATIONAL OGOV'T ORELIGIOUS OPATIO ❑CARPORT OGARAGE OSTORAGEOSLAB ❑FENCE
L1BON0 DMUVING OCONDITIONAL USE ODESIGN REVIEW OCOUNCIL APPROVED OSIGNS
OCCUPANCY_L LAND USE ZONE- 1 BLDG.TYPE FIRE ZONE PLAN CHECK By.----- HEAT
4 4 16 tk �;� r -s ael:+l� taaala ar, 1 4!0365 S _-
frame dwelling w/attllchdd %'jursys 2 Usdroom abatll __--
(Z".LOAD FLOOF3yt]i4J? -H1lit_ NO.STORIES
BUILDING DEPARTMENT 1 — -
- SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 1 Z1e�!� ------ ------- -- —_ — ---�.._-.-- ---_.
THIS
MIT I
ED SUBJECT
THE
S CONTAINED IN
NING
Plan Check 10000 REGUI ATIONSSAND UAL APPI ICAB o CODESANDORDIINANCES, AND IT IS HEREBYDAGRE ED THATTHEWORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT
DOES NOT WAIVE.
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY PUSINESS
State Tax _ 3e 93 LICENSE. SEPARATE PERMITS REQUIRED FOR .EWER PLUMBING AND HEATING.
Total 134*93
BV
APPI,ICANT OR AGENT -
Approved Receipt No. 1
-- --•.r...wwn...«.•.u.n....wo:+.w.we.:.•.iY.�..ar.-- - - - w.wW.r....
i
i�
DATE INSP. TYPE INSPECTION REMARKS
TContract-r
PLUMBING , DATE
Permit
-
No. fi=t �3/ 3
Rough-in
_ Fixture
v Final
�T* HEATING
Contractor
Permit No.
Gas or Oil
— Rough in�_-- _
Final
SEWER
- Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final _.
Sidewalk
Curb&Street Final
_
Approach
BLDG DEFT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY --
Landscaping
C ( Zoning Final
I
1 0 - 0 1 -
-!C PERMIT APPLICATION 1-1GAIlD c No
THE 1 - - D f r E ,
� � L tJtiOL-RSIG,ICD HCRLOY A. PLIES FOR A PCRMIT FOR THC 4'.ORIC H�R�IN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCIDIMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
ADDnESS Q LQp �� a J',c�c�� r'�nUll DFR PHorIE
�— ENGINEER
t"t 12,E11 /►nCIIITFCT UF;IGNFn
STnI:r.TljRE L;+rjrw ❑nCMOnEL ❑ADDITION ❑nr-PAin ❑RENEWAL ❑F!t-nEDAMAGE ❑DEMOLITION
iDTN'CE ❑CON'Ll L0EDUCATIONAL OGOV'T []RELIGIOUS❑PATIO ❑CAR POr..T ❑GARAGE C FORAGE❑BEAD ❑FENCE
"QV?NG_ CllCONOMONAL USE ❑DESIG + RI=VIEW ❑COUNCIL APPROVED ❑SIGNS _
- _ AND t.!.^.F 70NF ` DI DG TYPE lFmc 70Nk,,L PLAN CHECK OY � HEAT 10
if Drt 4Q-41
��12 Vie— ►�CC���C� n c�S l0 ��t.� vlP�l 1t"
�- if
_
il--- FI-N)Dn LOAf1--- FIrIGitT NO.STnni['S t Af�EA4-�b 1C1 VAI.I)r @
- _ --- — ---
--- i,U`•; tl:riei DI-VAII1'A1'K r
F------=- -, -- _ c'-T RACKS FlIONT a r rArl� LEFT SIOlf nlGI IT SIOr-_
PEnN.tIT IS ISSUED SUBJECT TO THE-REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
nr-GULAT!ONS ANO ALL APPLICABLE CODES AND OnDINANCES, AND IT IS HE-nEBY AGREED TI4AT THE
YNORK WILL BE DONE IN ACCORDANCE WITH TI lE PLANS AND SPECIFICATIONS AND IN COMPLIANCE :11TH
� w I ALL APPLICABLE CODES AND ORDINANCES. THE !SLUANCE OF THIS PEWAIT DOES NOT WAIVE
5ESTRICTIVE COVENANTS. CC►N'fnACTOn AND SUB CONTRACTORS TO HAVE CUnRENT CITY BUSINESS
S – I LICENSE. SZPArIATE PLFINIITS nEOUinED FOR SEWER, PLUMBING AND HEATING.
Tet.:;
—i�
ri y
{Ap:)ioved Rc . APPCICAtiT OR AGct
ccipt Nr
C j ADU iL SS PHCNL
Uty of �"c ?�'�ec(TQF1{ca ?ermt a � Permlt S3•�o
i , .i
�..,� Fes
New Installation 13;' Replace ❑ 9elocation ❑ Addition ❑ Aiteration ❑ -- TOTAL
COtvTRACTOR -.iy'L�»4-�
O'A►NER �Uls �C
't'
ADDRESS 3� �► �- ,� `�
WORK ADDRESS ,=�.y �� -T.
?HONE 2=:r= -
AlPLICANT
Vent Site a r'ue Size
Heat input Rating {BTU Per H r! � --
FUEL OIL E: GAS til ELECT `�' OTHER
ITEM ll0. FEE fTEM NO. FEE
3.00 Boilers Over 50 HP 25.0C
For Issuance of Permit r
New- Under 100.000 BTU ! i 4.00 Air Handling 10,000 CFM 3.0
5 0Q Air HandlingOver 10,000 CFM 5.0cNew- Over 100 OC.. BTU 3.00
Floor Furnace 4.00 Evaporative Cooler
0 1 1 2.
nr
Wal! • Floor - Suspended 4.0Vent Fan 3.0C
Install Vents 2.00 i Vent S stem
4.00 1 Hood i 3.0C
Repair- Heat & Coolin 11 5_rx
Boilers Under 3 HP 4.00 Domestic lncineratm
Boilers 3 to 15 HP 7.50 ;1 Comm. Incinerator 20A
Boilers 15 to 30 HP 10.00 Other Not Listed 3.(X
Boilers 30 to 50 i;? 15.00
INSPECTOR'S COMMENTS
CITY BUS!!tiIESS LICENSE REQUIRED FOR-ALL CONTRACTOI'.S OR SUB-CONTRACTORS
APPROVED BY DATE 'SSUED BY DA-r---
RECEIPT NO.
i
i
/ 59,
Address
Permit No. / 2 �/U
Permit charge
Owner ' Connection fee -,- 2S--
Paid
2S-
Paid by
Type of building Date connected
Service rate � ��� Inspection fee
Contractor Pald by date
Size of connection Assessment Paid
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