15292 SW ALDERBROOK PLACE-1 1
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15292 SW ALUER$ROOK [LACE
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OF 0
CI`I Y OF TIGARD Ne
,� v OREGON
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l Tualatin Deve�o melt Co. 202
0��rler:.......... ........ . ............. ................... ................Permit No...' .. . I ” `f
'J �0.t... 41.x....... ...............
Building Address............,........ y #.............. 1!�........
t fl g 15292 SWthlsd.E5tho day
1, Certificate is hereby given ... y u. .
that said building may be occupied and 1 ;
that it complies with all requirements of ij
.j the Building Code for the City of Tigard,
as approved by the Tigard City Council.
.... . ..,i".P. - --................
t '
• ♦ Building Inspector
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City Of Tigard ` �f
INSPECTION REQUEST
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INSPECTION TIME: PERMIT NO. :-
DATE:
O. :-DATE: / /2//77 DATE ISSUED _- Z
OWNERS NAME :_
ADDRESS'. , tell
CONTRACTOR : ,if-2 512- _�
rE ST : Air U, Water❑ , Visual ❑ , Loborat try p
9ESULT: Approved 1` Disapproved C Fending C-)
SKETCH:
� I
INOYDECTOR~� DATE
FYOTE . Attach supplemental test data berets]
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«Neo- 11' i� SEWERAGE AGENCY NO. _ 11025'
"'!ASHH\jG-r0N COUNTY DA [E
C. -I-Y OF Tigard
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: _ T.D.G.
OWNER'S ADDRESS: - - -- ---_..__ T_.
STREET
CITU STAtE IP
BUILDING SITE: LOT_417 —_ BLOCK ADDITION
TAX LOT NO TYPE OF OCCUPANCY ___ residence
ADDRESS ___-_.-_1,5 92 al.l 1derbrook P1. ----- -
DWELLING UNITS -..-. 1 FIXTURE UNITS
SURCHARGE IF APPLICABLE _-___---___ -- -_ _—_ --- -
PERMIT FEE . 575.00-- INSPECTION FEE -?S•OOTOTAL DEPOSITED 600.00
(NEW) (EXISTING) BUILDING SEWER SYSTEM janno Crook
The Applicant agrees to comply with till rules and regulations of the Unified Sewerage Agency.
APPI ICANT`��1___' _RA��—'titT��---- _- --
SEWER PERMIT
THIS PERMIT AUTHORISES CONNECTION TO THE SEWER SYSTEM,
LINE SIZE -- - -- -._.-__-- I N ST A L L F R
RECEIVED BY_ �_._..�
(AGENCY OR ITS AGENT)
COMMENTS Bldg.This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
BUILDING PERMIT APPLICATION c0F TIG�RD DATE t''-15-7b t9 1712
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _.. _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE .�
LOT NO_
OWNERS!OB ADDRESS :3iW A�.t71iirbroak HOME ADDRE_ -- --
ARCHITECT
ENGINEER
BUILDER �l'' _ ADDRESS DESIGNER
STRUCTU'IE []NEW _❑REMODEL OADDITION —O_REPAIR_ ❑RENE_WAI_ ❑FIRE DAMAGE []DEMOLITION
❑RESIDENCE ❑COMM []EDUCATIONAL DGOWT DRELIGIOUSOPATIO []CAR PORT ❑GARAGE []STORAGE[]SLAB ❑FERICE
�LIBOND [I MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW []COUNCIL APPPOVED []SIGNS
OCCUPANCY —L.AND USE ZONE—_— -) B1 G.TYPE-2——WFIRE ZONE!— PLAN CHECK RY__ ,_ HEAT'
KIK xx l I re—issupt some as 15634 5W 5UM09rfibid L 5(110
---._-- _._ (welling ;j/sttached gess e. 2 bedroom 2 beth _
lSZL�I--- N9�93LU_—_—AREA .., No,BED�S?QA� .--- Yl►_Ll 44itj7•
BUILDING DEPART MENI SET BACKS F90NT - _ REAR LEFT SIDE RIGHT SIDE 1 '"
Permit ilk.
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
— - WORK WIL L 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 `.(l• LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By -----
APPLICANT OR AGFNT
Approved R^ceyf No.
AD0�95 1'FIC)NE
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DATE'VNSP. TYPE INSPECTION REMARKS PLUMBING DATE
F
oro, et) 7 ��01 .y - _ 7J
,r"/- ✓ti!« i�
Rough-in243
`� ..�.� � _ Fixture _
lrs� 4? .I�e�l� _ Final
'
Contractor
Qf - 'ni
Ajtc Permit No.
/ Gas or Oil ---- - - - —
J='7
Rough-in -- - -- -
_� _ Final
- -- — ---_SEWER _.. JL1q ""-1-77
- _ Final _
DRIVEWAY
Final
—. Storm DrainaageW_ -
(Rain Drain) Fina
Sideway
Curb&Street Final
A roach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFIUATE OCCUPANCY Final
Landscaping
Zoning Final �J
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ADDRESS ,1�"" i!i�1 ,L B.pe»-�c( .�. PERMIT NO.
PERMIT CHARGE none
( I CONNECTION FEE
PAID BY
TYPE OF BUILDING ._ LS�.c _� s �rtL� _ DATE CONNECTED
SERVICE RATE _.� � tro�--- INSPECTION FEE
CONTRACTOR —__ \� PAID BY _i DATE
SIZE OF CONNECTION ASSESSMENI _ PAID