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12091 SW LINCOLN AVENUE s �ww WwWrw wie, ■ a 12091 SW LINCOLN AVENUE 1 c .-I 0 C 3 '-1 Q� N 1 / 7.r: ^•: t?•�� C +ti' 'V. 1 Sf% }�/, f ±.: / y Nr�Y!b� V`"W 7c,14=. O4�'� �1 ��� �1 +`.Y��_) � 1 �i4�+ ..1 •�++ 1':1 �'°,�f (? *:..► t:' 6 * (^1 ^ t1'a l':I4aln4.'1 •``✓,/ OF occ A/ LI ry OF T'IGARD C .:C MOEGON j � Steve SPie9el Permit No....1.40$.......... Owner:... ..... ...... ............................................. ... ........... 12091 SW L.incolr St. 4.., +.; C Building Address.......... ..... 19....7.7. Certificate is hereby given this.....15....—day of. August ... .. . C f that said building may be occupied and t' that it complies with all requirements of •.,� the Building Code foi- the City of Tigard, �� r " � as approved by the Tigard City Council. ,: \ ............. . {:'..7...✓.. ............... , j � Building Inspector' nspector < ;�/�`-'�tc�-af���j�f`����-��` r�rk '�1���ir%1'ti �v,%'—�'9�`�tu��� , ?n�w .. •✓.i, r. I City of Tigard INSPECTION REOUEST for 3 c� INSPECTION TIME :_ , PERMIT NO. ' -- DATE: DATE ISSUE(" �L_L OWNERS NAME ' / - -----ADDRESS : — — CONTRACTOR TEST. Air O, Wvter lk)�, Visual rJ , Labor story D RES!.-LT. Approved 1�f , Disapprove. L, -ending c3 SKETCH: 1 IZoR3 1111 I llo`I � 1_ y l 0400 ,, 1 I INSPECTOR DATE OTE: Attach fupplemeotal ioit data herato� i i r 1i I I I I ^o '.i r` a� �? rooCD t r � Oa 41 Or r- J �p � 1 t] J t9 O •-� I � Q C.) n 00 t:s c7 U C7 L' r (] O l7 7 � lJ U rn t 1 I- cyo ai ni 0 .- U ri N - - E I d vi Ll SI to n U I U h- LO ooi V I U4+ L r� r I Q f AA to . O h 1 fin j Wu u r_ o 4 O u I 11 uj A IL. cu � C N vi v v o 4� Lo 6. w o1 rtf V t ui N L 1 N N N L t' F: , IL >_ 4j $ x w j 'o o o -r- .O to H x x x +.• ul U L- L• .r, ro c. 4 LL V. it L.! F 1 1 h 1 ] t] b J [n V U ZZ m : pp L: 3 � t LL �'. u v: t7 Z ? t7 n r:• ;:� t1 {� i�l (j SEWER PERMIT QSj Uf Ml 1213 2 Unified Sewerage Agency of Washington Caunty CITY OF Tigard D,4TE _4_ k- 7_— OWNER : Steve Segel _ PHONE : 246 0538 OWN ADDriE:SS: 12091 SW Lincoln _ — TYP,. L INSTALLATION: ❑BUILDING SEWER []BUILDING SEWF_R AND SIDE SEWER TYPE OF OCCUPANCY, ❑NEW ❑ SINGLE FAMILY © COMMERCIAL_ ❑EXIST . (PRIOR TO 7-1--70 ) ❑ MULT . RES . ❑ INDUSTRIAL FIXTURE UNITS _ DWELLING UNITS 1 PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND RF_GULATIONS 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 AMOUivi PAID WILL BE FORFEITED SHOULD EXPIRATION OCCUR . FEES: PERMIT Ff-r ®® 575. 00 CONNF_CTION CHARGE SIDE SEWER INSTALLATION \ ISSUED BY OTHER Ins. 25�_��_ TOTAL $ 5600. 00 APPLICANT DATE SEWER PERMIT N:' 12132 ADDRESS OF STRUCTURE —JS201 51,1_L.1n_i�L11n�_Ii --- TAX MAP TAX LOT 5 S 11, M L 0 T BLOCK —OF APPROVED BY DATE ISSUED BY Dt,TE. REMARKS — v 1 ,y = W V) I z '11 JI I 2F=- r >w O V ry V 2 � a2 (- W \ N 7:u U d �� 1 C-c Owp <, Q n z " O O z > V1 D a z W W I a a Q zZa=ucF �w z � ui QO z > z <7Wu W a 3 7 w LL ( W W '] VLLHZ Cl N O m v w a Q z Q O ¢ a r U vj Q Q m w r Wa �jO2 -� Y l O -e LLI Z a u u - 1 4 a: 0 (� Z w u F. d Cl LL Nzaz ' I -{ Q w V 2 J C) Cl a ✓ Z W ❑ R, n N F O l u Z U cr C) a w � pa � w u' °w- H w a 'c� D = Q cr W ` I W n j, Q Y Q Q �] W oz =X_ P, L 1 Q C) C N Q ! µl p U D: I Ln 0 n a h 2 u w Owu � d ] w 3 z ¢ 0. t_7 U. Q � c � .� FW r Q} N jU a < p O �', 7 p 0 `, w O O V � � C1 n w � � 20 a u N d > a � ' Cl :01 , u O Z a� 1 N a a W 1 �1 �J LL } N W 1 p Z C) Q 2 w O a W z F- 0 u, Oawu2 w 1 Q o 0 u E Cl w z yZOw > Q � I a 0 °a w a °o ! ul ao v, awcau y w a C) 4 v a > a coi x LL F zp �> w - Q o z 1 N oaJ _ N O m y' Z C � ul W aya � H D v 1 u a —�� a 4A cc v a 3 e¢ ° C1._ Qu Q F w u z O n �" T ) H a F 7 M r LU Cl Q >' n R O U I W I 5 OI 7 O ! CL Q / I U I s d u ul CJcr o t ' 111 a > C1 u v • UI OrCL FI p nO' tr t C(1 U1U u i c0 1- CITY OF TIGARD ORDINANCE #77-26 STREET SYSTEM DEVELCIMENT CHARGE �d DATE :_._— ._ E5TIMATEO SALTS PRICE APPLICANT NAME_ L4_ � TELEPHONE JOB ADDRESS L.,� !� q I �� u/ �� BLDG. PERMIT #_ oc AMOUN1 OF FEE i OR S. D. C. v DESCRIPTION OF IMPROVEMENT EXEMPTIINS -PER ORDINANCE `77-26w_ FEE RATES: a A. Single family dwelling unit under $60,000---------- 5300.00 B. Single family dwelling unit over $60, 000. - ------ -- 5400. 00 C. Mobila Home Cnurt Spare (New DevelnPment)----------- $150. 00 D. Multi-Family Dewllings--per unit-------------------- 540.00 E. Commercial , Industrial & Institutional (Park. Space) b 50. 00 each F. Single family unit under 540, 000- ----------------- $250. 00 1 Address C.'�,�-� < , s� Permit No. Permit charge _-.a�2 7 Owner Lam, _�, o o � Connection fee ®c Paid by Type of building Date connected Service rate Inspection fee Contractor Paid by date Size of connection Assessment Paid