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9485 SW SUMMERFIELD DRIVE-1 N M t N U 9483 Shy SUMMERFIELD DRIVE 1 c+ v W •,I w N v; E E 7 cn cn L') m 'CC Q� w ,w 1�olu rili-is S 9 4 PL,9MTT "JO. PERMIT CHARGE none OWNER CONNECTION FEE PAID BY it TY11c". OF BUILDING DATE CONNECTED SEPUICE RATE INSPECTION FEE CONTRACrOR PAID BY DATE SIZE OF ('0NNECTION A5SE50ENT PAID I!jC,BUILDING DEPARTI,IENT, TIGARD l ( 1:9 PLUMBING PERMITNO. holder of a valid plymbing contractors license is hereby authorized to cause plumbing work as herein noted to be installed in actor-:ance with the plumbing code of Tigard. Such installation. requir,; inspection by the City Inspector who shall be notified not less than four (4) hours prior to the time, the installations are ready forV ction. City of Tigard Business License required for all co tractors and sub-contractors. d , OwneK _"a:2 (�!_ -ti= �. _A_ldress4 �. r �11d���1 ✓ Date� �7_ TYPE OF PERMIT hUMr'CN OF TOR L. U PERMIT ITEMS FEE ON EACH NO.'S I AMOUNT (Office Use Only) Sinplrr Family-1 hath-each . L') _Duplex-F.och 1 bath unit 25.00 6 -- -- Additlonel bethroo�s�eaah `- — � 25.00 �— ;v Mobile Home SPfl10.00ce-oath _ '---- INDIVIDUAL FIXTURE FEES _ 1500 1 to 50 Flxturos In 1 buildin -each --- I -- � — 3.00 _ 51 to 100 Fixtures in 1 buildin -each 10f to 2(10 Fixtures in 1 buildin�,.,;;i - '?-50 ---- -__— is 201 or_more Fixtures in 1 building-ea-.h 2.U0 MISCELLANEOUS 6211ding Sewor-1st ri0 ft. -- Sewe;-each add'•+anal 100 ft, 10.00 i Water SsrVire to building- - 10.00 _ Private Water Systems-ee�h '00 5.00 —— f t. Other (Soecif ----- 10,00 _ l _PERMIT 6,0 For Plumbing twection Phone 679.4191 An State / U — i Plumbing Contractor Hy TOTAL RECEIPT NO. IssuFJ P.y I f - SEINER PERMIT M, 12179 4 :V .Unfied Sewerage Agency of Washington County CITY OF Tiqard DATE --- 5-31-77 OWNER : _ T .D.C . __--- -- PHONE : 6;39=3101 OWNER ' S ADDRESS: TYPE OF INSTALLATION: U BUILDING SEWER ❑BUILDING SEWER AND SIDE SEWER TYPE OF OCCUPANCY: X❑NEW OX SINGLE FAMILY ❑ CCIMME__RCIAL ❑EXIST . (PRIOR TO 7- 1-70 ) ❑ MUL-T . RES. ❑ INDU`;TRIAL FIXTURE UNITSDWE=LLING UNITS _ PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY wires 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 . FEcS: PERMIT FEE 25. CONNECTION CHARGE 575. SIDE SEWER INSTALLATION ISSUED /BY OTHER TOTAL 600, APPLICANT DATE SEWER, PERMIT N" 12179 ADDRESS OF STRUCTURE ra4t". -`ll SLlmmerf i P1 d f1r. �—.-- TAX MAP I AX LOT __. SYSTEMU_ pa__i;_ruek LOT 378 BLOCK OF — -- APPROVED BY DATE ISSUED BY DATE REMARKS Bldg. y1474 _ TTY OF T I CARD GRDlFti'ANCE X77-26 STREET SY`_'TEM DEVELOPMENT CHARGE DATE • jr ESTIMATED SALES PRICE APPLICANT NAME ._ (� ` . TELEPHONE r _-35- j / JOS ADDRESS PERMIT AMOUNT OF FEE FOR S. D. C . DESCRIPTION OF IMPROVEMENT EXEMPTIONS -PER ORDIN,AW.E L77-26� FEE RATES: A. Single family dwelling unit under $60, 000. --------- S300. 00 B. Single family dwelling unit over $60, 000. --------- $400. 00 C. Mobile Home Court Space (New Development)----------- x,150. 00 D. Multi-Family Dewllings--per unit------------------- $12�,0. 00 E . Commercial , Industrial & Institutional ( Park. Space) $ 50. 00 cacti F. Single family unit under $40, 000. ----------------- $250. 00 BUILDING PERMIT APFLiCATION r FY TIGARD DATE__+ �L" �, +� I�'4 THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE_ '_)39—"3101 OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE T ( LOT NO. WN OER I .L . r JOB ADDItE_gS ')4b5_ jl .9UiTttiA631f eld 1401M9 ADDRES5 ARCHITECT 8�nr ct ENGINEER BUIL.7ER ADDRESS DFSIGNER _ STRU'TURE _ Q NEW ❑REMn_^_L ❑ADDITION — ❑REPAIR ❑RE_NEW_AL _❑FIRE DAMAGE_ ❑DEMOLITION ©RESIDENCE ❑COMM ❑EOUCATIOVAL. ❑GOV'T ❑RELIGIOUS❑PATIO❑CAR PORT ❑GAHAGE ❑STORAGE❑SLAB ❑FENCE ❑BOND ❑MOV ING -- UCONDITIONAL USE ❑DESIGN REVIEW LJCOUNCIL APPROVED ❑SIGNS CCUPANCYj__LAND USE ZOP'E Rw7 BLDG.TYPE ado FIRE ZONES PLAN CHOCK BY__ tytld i HEA-;;Jas 1 titmen 3 ',u th S?GS 1.SZ9Q—___ FJ.40RNO, -TQHIES Z JFljrk4gQ_ NQ.NjaR 9M.5.� BUILDING DEPARTMENT gET BACKS FRONT YREAR 311 LEFT SIDE _RIGHT SIDE 5 Permit 184,LIQ - -- -- --THIS PERMIT IS ISSLIED SUBJF".v 70 THE REGULASIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check 92,00 REGULATIONS AND AL1. "P(I 'ACLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE `— WORK WILL RE DUNE IN AG:'0I1,, ,MCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Sub-total ALL APPLICABLE CODES ANU jRDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUFIRENT CITY BUSINESS State Tax d,28 LICENSE. SEPARA71 PERMITS FIEUUIRED FOR SEWER, PLUMBING AND HEATING. To al 284.26 :yet.r fn 0sVelopmw,_ ih> ry:: , #Op.i. ; By — -- '— - -- AP C,iNI ON AGENT Approved Hecelpt No. I y7 I DATE INSP. TYPE 11`45PECTiON _s REMARKS w PLUMBING - _�— DATE -IS '11xy Contractor _ Permit No. U Z h 8n 2 Rough in p- 12-q1 Fixture ti, Final HEATIP-G 1-I -11 _ Contractor z /0—Iz O/C t* Gev� ac-�� G Permit No Q�' k.4-CA- Gas or Oil _ 4 ot,-^ L X -nn e-w >¢ Rou h-in _ Qq Final SEWER ---- - z0-��( r Final IL._ Q �,.� DRIVEWAY-- - -- --- C d,.tfL1tAJL Lk" Eu_lS.l�— Final _ A "ice&rj Storm Drainage — ���'�c3 �d (Rain Drain) Final — -- Sidewalk Curb&Street Final _ _ Approach BLDG DEPT. FINAL IEMPORARY CERTIFICATE OCCUPANCY CERTIF ICATE OCCUPA14CY Final r Landscaping Zoning Final e I— CITY QI' BUIL iG PERMIT APPLICATION TIGA0 t THE UNDO-ilSIGNED HEREBY APPLIES FOn A PERMIT FCn THE WORK FIEREIN INDICATED Oil AS SHOWN AND APPROVED IN THE ACCOIMPANYING PLANS AND SPECIFICATIONS. OW`JER PNONE-!�"rq C+.'1^IEn L "I jJ 25SLj M,ntQ ��nulLnrn.P!iaNC — T r_NGINr-Ert �' 11y!moi h'rz �� Anc;!IITI:CT D,!StGNCn rrsTn;.^TVnE Lityw ❑m:moDCL ❑ADDITION CJREPA!R ❑RENEWAL [:]FtnEDAMAcr- ❑DEN'OUTION ❑COQ+`1•.1 ❑EDUCATIONAL CIGOV'T ❑nELIG10USC:IPATIO ❑CAnPOnT ❑GARAGE GSTORAGE CISLAG ❑+=ONCE -j."C !D ❑SICVING CCONDITIONALUSE ❑GCSIGNnwirw ❑COUNCILAPPnOVED ❑SIGNS '(Cl.' ��1D U�'701 _nl-DG.TYPE_ _F!nE ZON53 Pt.AN CHECK OY _ HEAT 1 n.%I7_ r-1-00n LOAn HFIGI1T NO.STOrilrs % AnrA VALUE -- ilUtL']I 16 0I-"AIlT'A!-"IC —, fI1C1NT i,r.All LEFT STD!` ��U nIGIIT SI Or _---- —` SGT nACk.. — — -fHls PEnrai—. IS ISSUED SUBJECT TO TIIE nEGULATIONS CONTA!NED !.NJ THE nUILO!NG CODE, ZONING Pl::n :f._; �� IIEGULATIONS AND ALL APPLICAnLE CODES ANO 0-. D:..ANCES, AND IT IS HEnEDY AGIIEED TI4AT THE Y.OnK WILL Or DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND I!J COMPLIANCE WITH He-orc! n l i ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCC OF THIS PEnVlT DOES NOT WAIVE nESTR:CTIVE COVENANTS. CONTRACTOn AND Sun CONTnACTOIIS TO HAVE CUnnENT CITY 6USINCSS LICENSE. SLPAnATE PL•RMITS nEQUIRED FOR SM'En, PLUNIIJING AND HEATING. Tari - J Lzz 1 1- APPLICANT O G:-'- !•,(+uUrc:-. ie Receipt No. ���f�' AU+ � \ PHONL .� 5-7 \3� `4 \J ©f Tvoa d Mechar;eat PermitNew Installation Replace 77 ne!ocation r' Addition r Alteration —' TOTAL77 CONTRACTOR /%d��.�9�� �L.'c�c 0».��c f Ci" ,OWNER S/V-1572E _ %i e 4 WORK ADDRESS � S':Gti:��� � ?HONE Heat Input Rating (Bri Per Flour) /d` Vent d Size_f � " Flue Size FUEL OIL ❑ GAS ELECT ❑ OTHER ITEM NO. FEE ITEM NO. FEE For issuance of Permit ( 3.00 Boilers Over 50 HP 75.0C New- Under 100,M0 BT!! ' 4.00 Air Handling 10,000 CFM 3.CC New- Over 100,000 BTU 5.00 ! :fir Hand!i Over 10,000 CFM i 5.0C Floor Furnace 4.00 Evaporative Cooler 3.0C Wal! - Floo• - Suspended 4.00 ' :fent Fan ' 2,0C nstall Vents 2X0 l Vent System 3.0C Repair- Heat & Cooling 4.00 Hood I 3.00 3oi!en Under 3 HP 4.00 1 Domestic Incinerator 1 5.^C Boi!ers 3 to 15 HP 7.50 Comm. Incinerator 20.0' Boilers 15 to 30 HP 10.00 Other Not Listed 3.00 Boilers 301 to 50 HP 115.00 '+ INSPLCTOR'S COMMEVM- CITY BUSINESS LICENSE REQUIRED FOR-ALL CONTRACTOP.S OR SUE-CONTRACTORS APPROVED BY_i DATE ISSUED BY DATE RECEIPT NO. 2; /,{�� y I1, 774 Si,naturs o!Applicant