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OREGON
Owner: ___�i___y.L C__-_ _Permit
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Certiiicate is hereby given this -_ a ` day of zAIA R y� 1
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that said building may be occupied and that
it complies with all requirements of the
t Building Code for the City of Tigard, as A,.<
' r approved by the Tigard City Council.
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Building Inspector I "•
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SEWER PERMIT N? 13411
V
lJnifiedSewerageAgency CITY OF Tigard DATE 6=15-
of Washington County
PHONE : 639-31_01
OWNER : T n r -
OWNER 'S ADDRESS:
TYPE OF INSTALLATION:
BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑NEW ® SINGLE FAMILY ❑ COMMERCIAL.
❑EXIST . (PRIOR TO 7- 1-70 ) ❑ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS_ DWEL'_ ING 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 ( i20 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR .
FEES:
PERMIT FEE 25.
CON;4ECTION CHARGE 575.
SIDE SEWER INSTALLATION ISSU BY
OTHER ----
TOTtAL 600. —
LAI
APPLICANT DATE
SEWER PERMIT N" 13,111
ADDRESS OF STRUCTURE. ------- - ----
9190 SW 5utner 1i�t. --
TAX MAF--- TAX LOT ----.-- SYSTEM --!�P_r]no cel-UBk___
LOT 424, _ BLOC K -----.OF _ ---
_�
AIS ED BY DATE
APPROVED BY PATE
REMARKS bldg. J1518 "—'--
TA'
BUILDING PERMIT APPLICATION 11TTIGAID DATE Ei-15—'r7OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHUNE_11-19`011-01
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNERPHONE_
LOT NO._
OWNER JOB ADDRESS 9196 JL _:�11111111Q�F i r•;Zd tipMF ADt)RESS _..�—_
ARCHITECT
ENGINEER
BUILDERf�AlAalf3 ADDRESS _ DESIGNER _
STRUCTURE xf3kW 0REMODEL . ❑ADDITION OREPAIR — ❑RENEWAL _ ❑FIRE DAMAGE— ❑DEMOLITION
f3;4#SIDE._E ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PA TIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
QBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS-
F3�ari HEAT
OCCUPANCY 1 LAND USE ZONE �i ! .BLDG.TYPE 41i FIRE- ZONE--.4- PLAN I:HECK BY_
Lot #+424 Ind 400 re-issus 681111116' 88 9420 aU ,)UIP Grfisld Ure
/e�t f snt�na�i +�N ICY 8 2 bfidr1H19L_2_bHtti
�_--NO.STORI�,S ARLA —NQ3�Q.Eg4.u"c VALU - 29,500o
QQ-IQAl7 —._ -FLQQR LOAD.—.-- �IEIGHI ---- ,+ 67
-
th
BUILDING DEPARTMENT SET BACKS FRONT 12 REAR 1L LEFT SIDE - RIGHT SIDE "
Permit 127*N0
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check lie 00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREON AGREED THAT THE
WORK 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 BUSINESS
State Tax 4.11 LICENSE. SEPARATE PERMITS REGUIR�EpD1 F�p�R`SEWER�PmL�ULv18IND�AaD�NFlAT�AW.tie(�a
Total 1�01�11 CC 1 rTL k P S3U
_- APPLICANT OR ADEN! ice•.,\
Approved Receipt No.
i"
DATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _
f Permit No.
8`2-LJ I�) Rougtin —
I Fixture- —
Final
/C _ZJ' , HEATING —
(( — Contractor _
Permit No. -7.
Ga,.or Oil
nt> Roubin _-------
' l.�-?9 1 _--�_-- --- -- — Final --- _ — --
SEWER
Final
--DRIVEWAY
Final
—_—_ — Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
A roach
BLDG DEPT•FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final