15297 SW ALDERBROOK PLACE r. �
1
w
n
N
10
V
la
Q
h
LT
�f
D
0
V
.d
1�
i
15297 SW A[DERbR00K PLACE;
s
i
City of Tigard
I
INSPECTION REQUEST
for
INSPECTION TIME : - ) ( :30 PERMIT NO. :
DATE: .,_L_.)27 DATE ISSUED:...�._L_.
OWNERS NAME .'
ADDRESS : 1.
CONTRACTOR :_-JA; arL ��
TES-T`, Air O, Water 0 , Visual , Laboi story ❑
RESULr.' Approved P , Disapproved O Peneony [j-
SKETCH.'SKETCH:
I
I
INSPECTOR DATE
NOTE Attach eu
pplemenfai toot data he ret]
i
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: A''`\ PERMIT NO. :--.---
DATE :
O. :—_.—.__...DATE : DAZE 133UED .,_1_L._.
OWNERS NAME : _-.----
ADDRESS:
C0NTRACTOR
TEST : Air L1, Water[] , Visual � , Laboratnty C]
9ESULT: Approved EJ Disapprov: d C Pending []
SKETCH: r ; r sr,-�f 40-
-� ->.f7L 74r Per
INSPECTOR ORATE
NOTE: Attach supplemental test data bereta�
iL _.__
i
II
City of Tigard
INSPECTION REQUEST'
nor
INSPECTION TIME' ^' , PERMIT
DATE . DATE ISSUED ._1_2
OWNERS NAME
ADDRESS: __4r7
'E ST Air CJ, WoterEl , Visual , Lab -olory n
gESULT: Approved ❑ Disapproved Pending
SKETCH: 5 /D�c�� 7, Br
a
INSPECTOR DATE
COTV Attach supplementnl test data hereto]
i
_ I
City of Tigard
INSPECTION REC�U E ; I
-for
INSPECTION TIME: PERMIT NO. :__ �_ I
DATE: ,�-2�1-IZZ� DATE ISSUED .---/—L—
OWNERS
SSUED .---[—L_OWNERS NAME : _
ADDRESS: -X - - ---- -- ._ -
CON TRACTOR :
;-EST : Air p, Water❑ , Visual p , Laboratory
RESULT: Approved Yd' Dislopprovad C Pending [j
SKETCH.
f
I
i
I
1 SPECTOR DATE i
COYH: Attach supplemental tet' data hereto
UNIFIED SEWERAGE AGENCY NO. .____1_1016
WASHINGTON COUNTY DATE
CITY OF____ TiglJrd
APPLICA'i-ION FOR SEWER CONNECTION PERMIT
OWN E R: ---- -- -- J.D-Cu ----- ---- ------ - -- - --
OWNER'S ADDRESS: - -------_-- -- -
- STREET -
CITU STATE ZIP
BUILDING SITE: LOT _._406 ._._ BLOCK —____ b7DITION
TAX LOT N0. _ ___.—___ __ TYPE OF OC:CUP, _ - residence
ADDRESS . . _--1-5%'.9.7_SW__Alderbrook. P1_. -
DWELLING UNITS- _._ .. _---____.1______.___.____------__ _-- FIXTURE UNITS --- ---__ _-_ -_
SURCHARGE IF APPLICABLE _ -_- ----.- ---�_---.---_____------------_-_ _ ---
PERMIT FEE _575.00-__ . .,_. INSPECTION FEE _25�M TOTAL DEPOSITED 600-.00 - --
(NEW) (EXISTING) BUILDING SC-WER SYSTEM _ Far= -CrBak---..--..-----.--- -------
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONN=CTION TO THE SEWER SYSTEM.
LINE SIZE _ .__.-_. __ _ _ ____ INSTALLER
R E C E I V E D B Y____
--` � _►_it
(AGENCY OR I7S AGEIVt)
COMMENTS: .____ _Bld.q• #1193....._-_ _
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
BUILDING PERMIT APPLICATION COF
IT TIGARD DATE __, 19
THF UNDERSIGNED HEREBY 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 I,d Atdarbraok '1�ME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE UNEW ❑REMODEL. ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
0 RESIDENCE ]COMM DEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB (]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY `_LAND USE ZONE BLDG,TYPE___ 15 FIRE ZONE 3 PLA14 CHECK BY_-_ _ HEAT y,GSP
^_ LOt 406 MkAV e:-o—irasUot creme eu 155b1 5U SummerfiCA Ln,
frame dwelling ofattached garage 2 bedroom 2 both
QCC,LOAQ F-LQQR LOADHEIGHT - NO.STQRIES 1_AREA 1490 No,5FjUBQQMS._2 VALSZE,I (327•
BUILDING DEPARTMENT SET BACKS FRONT 10 REAR 14 LEFT SIDE 1.I r 24' PIGHT SIDE 41 tart
Permit 2:.'d.,01) --- ------ -- =
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BIIIL.DING CODE, 7ONING
Plan Check 10100 REGULATIONS AND ALL APPLICABLF CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
--- WORK WILL BE DONE IN ACCORDANCE WITH THE.PLANS AND SPECIFICATIONS AND IN COMPLIA14CE WITH
Seib-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 3,93 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 13 4*93
By -- - _` ..- ------ ----
APPI ICANT OR AOE:NT
Approved —— ,? Receipt No.
ADD
i
d
9EMARKS PLUMBING DATE
uATE INSP. TYPE INSPECTION ----
- Contractor .
Permit No- C 7-,10
i Rou h-in
Fixture
77
-- Final_---- ---- ��
HEATING
i Contracinr
Permit No. J 2,22
-je eorUil
in ---- —,
cQ/ a ✓
Final
.� SEWER
/!Xnsf` Jl9i� t1Joc!/r� �� Final _` -- --- —
ra — — -DRIVEWAY-
_ Final— —
S
Storm Drainage
(Rain Drain) Final
Sidewalk_---
Curb&Stleet Final
— --- -- -- x.21- 7'7
BLDG DEPT FINAL TEMPORAPY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPAWY —•—-- — --'--
Landscaping
1�
Zoning Final
Address _ /.5'�9�;, x Permit No,
Permit charge L2-12
Owner Connection fee --
Paid by
Type of building Date r,onnected
Service rate
Insper:tion fee
Contractor _ Paid by date
Size of connecticn Assessment Paid
I
M
I