15335 SW ALDERBROOK DRIVE to
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15335 SW ALDERBROOK DRIVE
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OF OC, :
CITY of TIGARD C
OREGON F0
i . Owner:.............D.C...... .. .................................... .. ..—Pern,'t No.J. 4.§...........
BuildingAddress.. 1523" SW Alderbrook Dr.•......Lo.t.. 419......................
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r� Certificate is hereby given this...... ..15.day of. A.u.9 ................. 19..?�...
that said building may be occupied and
that it complies with all requirements of 4>•�
the Building Code for the City of Tigard,
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as approved by the Tigard City Council. w
c." Building Inspector
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City of Tigard
INSPECTION REQUEST
E for
IINSPECTION TIME : �"`—r1— PERMIT NO. :
DATE: s 12`127 DATE 'ISSUED ._.;
OWNERS NAME . —
ADDRESS ' -!'
AME .ADDRESS ' _'
ONTRACTOR '_ i : "r�_f �
TEST. Air U , Water « , Visual Laboratory
RESULT: Approved Disappro,led 0 , Pending
ISKETCH:
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INSPECTOR DATE
CN�TE , A11rch supplementolett det•1, he►etol
it
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City o , Tigard
INSPECTION REQUES,, I
for I
_ I
INSPECTION TIME * __ _ PERMIT NO,
DATE : � 1,19227 DATE ISSUED .'— I I j
OWNERS NAME : _-_—.-_._. f
ADDRESS:
C O N r R A C TO R . _.__
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"EST : Air C.7, Woter�❑�, Visuai p , Loborotory p
gESULT: Approved [� , Disapproved C Pending p
SKETCH.
IN PECT0 DATE
OTE Attach supplenmsntnl lest data bureto7
3 1It�_-7
UNIFIED SEWERAGE AGENCY NO.
WASHINGTON COUNTY DATE —7- _
CITY OF-- T i Q a r d -_-
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: _ - _ _T.D._Q .
OWNER'S ADDRESS: - - - - - ----
STREET
CITY STATE ZIP
BUILDING SITE: LOT 408 BLOCK ____. _ ADDITION --_
TAX LOT NO. _ —,-.. — TYPE OF OCCUPANCY residence
/-53-if.6
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ADDRESS !!N? SW Alderbroo : _
DWELLING UNITS_- -_--1 _-_- -.-- --- -- FIXTURE UNIIS
SURCHARGE IF APPLICABLE --
PERMIT FEE __-5?.-5--.— INSPECTION FEE _2 TOTAL DEPOSITED 600. 00
(NEW) (EXISTING) BUILDING SEWER SYSTEM Fanno Creek _
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT��
l
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE ------_-_ - INSTALLER -_—
/1 0
RECEIVED BY
�_
(AGENCY Py ITS AGENT)
COMMENTS: Bldg. #1346
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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1TY
BUILDING PERMIT APPLICATION Cor TIGARD DATE. '" 4' _ _, 19146
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONU___.,_ !ni
OR AS SHOWN AND APPROVED IN THE AGC.p ' ,kA . ,"ICATIONS. OWNER PHONE
OWNER JIJu NDDRESS T
-- _ HOME ADDRESS _
ARCHITECT ^'
BUILDER rr _ ADL HESS ENGINEEh
DESIGNER
CI
STRUCTURE ❑NEW u REMODEL ❑ADDITION ❑REPAIR _❑REN_E_WAL. ❑FIRE DAMAGE_❑DEMOLITION
❑ RESIDENCE_❑COMM ❑EDUCATIONAL ❑GOV'1 ❑RELIGIOUS❑PATIO [-]CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING— ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS —
OCCUPANCY LAND USE ZONE_..._. BLDG.TYPE FIRE ZONE____ PLAN CHECK HEAT_,^
:..,�..�tltr C,1 a bath
NO,STORIES AREA 1-'' �DROOMS VALUE +
BUILDING DEPARTMENT 13 —+
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permlt ---
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAIP:ED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREDY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE.PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALI. 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 LICENSE, SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HFATING.
Total
By
-- --- APPLICANT OFI AGFNT
Approved Receipt No.
ADDRESS �-- PI Ici1VF
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E
UP TE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
"'� Contractor
Xr/7/-2 Perm;t No, r ,.7 �G 03 Y—/5- 77
Rou h•in
C z Fixture
Final
�7 -S —T ��� -- V HEATING —
r Contractor —
S Permit No, 7G(o 7
Gas or Oil
-- --- Rou h-i r ---
— ---- ---
Final
--- --
SEWER
--- -- — —_ Final -
- — ------ — DRIVEWAY
Final _
------ --- ---- — --- -_-- - — --- Storm Drainage _ -
--__ -- (Rain Drain) Final
Sidewalk
Curb&Street Firfal
—` A roarh C 2v--7
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
`✓ Zoning Final
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ADDRESS_/.;;- %.35T��; _��2. d4 PERMIT NO.
PERMIT CHARGE none
OWNER . CONNECTION FEE
� � • c'' ---
PAID BY
TYPE OF BUILDING /Zto DATE CONNECTED
SERVICE RATE i5���) INSPECTION FEE
CONTRACTOR PAID BY DATE �f
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S?ZE OF CONNECTION ASSESSMENT _ PAID
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