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15288 SW ALDERBRUOK PLACE
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> -- ,`�~ CITY OF TIGA�RD C
_ OREGON
F R F + Owner:. .........T.D.C...... Lot...7t.416........... .....Permit No........1208 .
i Building Address. .. .
.....15288...SW Alderbroo.k...Pl...................... .. '"
Certificate is hereby given this....../.*v.day of....MAY....................... 10.37
that said building may be occupied and ".
that it complies with- all requirements of �'• .
_ the Building Code for the City of Tigard, i
as approved by the Tigard City Council. •_,; ) ,,;i
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Building Inspector �� I
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City of Tigard
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INSPECTION REOUEST
I for
I -NSPECTION TIME : PERMIT NO.:
DATE: 11? 17" . DATE ISSUED'. Z
OWNERS NAME '. -Z � — _ �-----
1 ADDRESS : .r , " -2"'6
CONTRACTOR :------------
TEST'.
ONTRACTOR : ---- -.-- —
E , . Air ❑ Water Visual ❑ , ...aboratory [,
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RESULT: Approved U Disapproved LJ Pending rj
SKETCH:
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I INSPECTOR DATE
iCOTE Attach supplemental test data heret]
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I City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : %ti ' _ PERMIT NO. :
DATE: / -- DATE ISSUED'.__.Ll_
OWNERS NAME .
ADDRESS :
CONTRACTOR
TEST' Air 0, Water [] Visual O , Laboratory O
RESULT: Approv ad 0 Disapproved Cl Pending U
SKETCH:
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INSPECTOR DATE
COTE Attach supplamtnfal foti dafo ht►ato]
Y
U N I T~ f E D SEWERAGE AGENCY NO.
WASHINGTON COIJN-*fY
CITY OF __ - Tir rd
APPI__ICAI ION FOR SEWER CONNECTION PERMIT
OWNER: .
OWNER'S ADDRESS:
_ - STREET
CITY STATE
BUILDING SITE: LOT- BLOCK ADDI-TION
TAX LOT NO. _ _____-- TYPE OF OCCUPANCY
residence
ADDRESS - 15288_ I,f�1�.Q.tb»LoaL�Pl�_
DWELLING UNITS------ 1- - FIXTURE UNITS
SURCHARGE IF APPLICABLE ._ -- - ---
PERMIT FEEINSPECTION FEE 25.-(1D-- TOTAL DEPOSITED .__
600. Q0
(NEW) (EXISTING) BUILDING SEWER SYSTEM Fenno geek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT_ � �. �I`�Irt"�`C.v'-- --
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SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION 10 THE SEWER SYSTEM.
LINE SIZE INSTALLER —
REC IVSD BY. -
(AGENCY OR ITS AGENT)
�,UMNIENTs: Bldg.- #1208 _-._--
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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BUILDING PERMIT APPLICATION cOF TIGARD DATE__ ' -?r7f)
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHGNE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE_---
pp LOT NO.—_-
OWNER L•w w JOB ADDRESS' 'j c Ub j .c i{lderbrrlak 'l�Cfi�E ADDRESS
ARCHITECT
Sf1I ENGINEER
BUILDER �}.� ADDRESS DESIGNER
STRUCTURE LJNEW ❑REMODEL ❑ADDITION ❑REPAIR [:)RENEWAL ❑FIRRE DAMAGE ❑DEMOLITION
0 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T EIRELIGIOUS1_:PAT10 ❑CAR PORT ❑GARAGE LJ STORAGE❑SLAB []FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ODESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
QCCUPANCY LAND USE ZONE BLDG.TYPE _FIRE ZONE PLAN CHEC "' HEAT –_
Lot #416M1 MOO Ria-iosunt novel 00 1.5u1.3 SW SuMme id La-
Frame
a-Frame dwelling w/uttechad r., ,a 2 Usdrioumg 2,�bath
OCC,LOAD ---FLOOR L_QLA,JL-----_-HEIGHT - - NO-STORIES ` AREA _._.__.___"NL-ftFDROQM1------VALUE �, r���`•
BUILDING DEPARTM - SETBACKS FRONT REAH LEFT SIDE r RIGHT SIDE
Permit
-'–"---v -- THIS PERMIT 15 ISSUED SUBJECT TO THE RL'GULATIONS CONTAINED IN THE BUILDING COOF, ZONING
Plan Check ,,tie UW REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL.BE DONE IN ACCORDANCE WITH TAE PLANS AND SPECIFICATIONS ANON COMPLIANCE WITH
Subtotal 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 µw 92 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total t~ 9
BY --- — —
' — --- -- -- APDIICANT OR AGENT
Approved Receipt No.
— ADDRESS
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DATE INSP• TYPE INSPECTION REMARKS PLUMBING DATE
Cot,tractor
7.
Permit No.
42-:& 7— 2L Rough-in
Q3 Fixture
Final
HEATING
Contractor
;el Z Permit No. + -2
I as or Oil
Rough-in
Final
SEWER
---
Final DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
TEMPORARY CERTIFICATE OCC]UPANCY
BLDG DEPT FINAL CERTIFICATE OCCUPANCY Final
Landscaping
Owl Zoning Final
.......... .......
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Address !.Se � �,�✓�' c1 ��h,.p � � Permit No. _ z/c2 P
Permit charge
Miner _�� �� Connection fee
Paid by J' C
Type of building Ccv Date connected
Service re .2 �� � inspection fee
Contractor Paid h%, Date
ISizc of conrect:jn _ Assessment paid
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