15202 SW ALDERBROOK PLACE-1 H
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157.02 SW ALUERBROOK PLACE
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City of Tigard
P
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
I DATE: /9/ Z%DATE ISSUED:_1_L_
OWNERS NA",4E : --
ADDRErS :
i CONTRACTOP : Ail'Ot
TEST: Air 0, Water ❑ , Vieuai It , Laboratory ❑
RESULT. Approved 0 Disapproved Cl , Pending [J
SKETCH'
I
I a
i
INSPECTOR DATE
I [NriTf Attoch supplemental test data hereto
City of Tigo d
INSPECTION REOUEST
for
INSPECTION TIME :, PERMIT NO. : _
GATE: __`' �L..� DATE ISSUED' L
OWNEV.
CONTRACTOR :--.—..—
TEST'
ONTRACTOR :--__.._TEST: Air 0, Winer [J , Vieual ❑ , Laboratory []
RESULT: Approvvi W, disapproved ❑ Pending 1-1
e
SKETCH:
INSF�IfOTOR DATE +
[OTE: Atteeb aupplamental feet date Meret3
SEWER PERMIT
r V? O 1
Unified 5ew_r,jya Agency
ofV,ashingtonCounty CITY OF, Tigard__ DATE _ 3-25-77
06NLR: ._ Tualatin ha�elp wnt_f'n_ PHONE : 639-3101
OWNER ' S ADDRESS: __ _
TYPE OF INSTALLATION:
[�BUILDING SEWER [ ]BUILDING SEWER AND SIDE SEWER
G
TYPE OF OCCUPANCY: !
[ NEW U4l SINGLE FAMILY [] COMMERCIAL
❑EXIST . (PRIOR TO 7 - 1-70 ) ❑ MULT . PES. ❑ INDUSTRIAL
t
FIXTURE UNITS_ DWEI. LING UNITS _ 1
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES `
i
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 4
BE FORFEITED SHOULD EXPIRATION OCCUR.
FEES:
PERMIT FEE $r
CONNECTION CHARGE 575•
SIDE SEWER INSTALLATION
ISSUED BY"
OTHER Inspection Fee _ 25.
_ TOTAL $ 600.
APPLICANT DATE
SEWER PERMIT N?
ADDRESS OF STRUCTURE 15202 SW Aldecbrook P1.
TAX MAP TAX LUT _ SYSTEM Fanno Creek
I.OT 4 � BLOCK OF Summerfield
- -- – � ed � e G -.1 a t
APPROVED BY DATE ISSUiz!5 BY Y4 DATE
REMARKS_-B1.dg-u- ,41 ';.r,A —_ -
,�V BUILDING PERMIT APPLICATION 1OF
1T TIG ARD DATE 3—L;i-77 .Z �
THE UNDERSIGNED HERF-BY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER _ JOB ADDRESS 7.5202 51J Alger b ruck Homs ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRCSS r, DESIGNER i
S'TRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR ORENEWAL ❑FIRE DAMAGE ❑PEMt—OL.1"TION
Cj RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑REL IGIOUS❑PATIO ❑CAR PORT ❑GARP.GF ❑STORAGE❑SLAB OFENCE
❑BOND ❑MOVING _ ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED LJ SIGNSu`�a
OCCUPANCY LAND USE ZONE—_—__BL.UG.TYPE.---FIRE ZONE i PLAN CHECK BY et HEAT
ritfJl'Iry !'t . . .s+... i}+; aa 102kN :. ea',` ,reIlnloaf Terracig —
framQ dwLlllny wZattachi.)d 6araav
0Q. LOAD FLQQR LOAD 403
__HfjGHT 1{ NQ�.T IE$--- .� AREA��+ '=- N�Q��R�QfY1S— VALUE _ 4 •
BUILDING DEPARTMENTSET BACKS FRONT , REAR LEFT SIDE L11 RIGHT SIDE
Permit 1l?.1?Q --- _`
- --' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check Itls UQ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sul) total ALL APPI'CABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- —-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax ;v 1.I. LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEALING.
Total ISi1�.1
By
------- --- ! APP ANT OR AGENT
An•,oved —1 ,y„ Receipt No.
A17 5�5
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i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
d %
t 't�� �*•�`_ _ Contractor
-7 - Permit No. ) ' r..
Rough-in
�—
1-1 J �� —_�_— _ Fixture _
• Final
.�� 20— — HEATING
�� Contractor
_ Permit No. j j _ 7
57'-P - Gas or Oil --
��r rov H1611 Rou hin
r _ Final -- ---------J
SEWER
-�� — Final ^�
DRIVEWAY L y_ 7
-- Final
_ — Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
— —..—_--_
Approach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
`- Zoning Final `i
Address / Z 4 O ��i� Permit No. -
Permit charge 0 i,7
- o
Owner Connection fee �5
• IBJ
��•�� n�t� n�� n,..a ,� Paid by
Type of building Date Gonne^ted
Service rate _ `� Inspection fee I
Contractor ---
Paid by Date
Size of connection �� Assessment paid