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.15480 SW ALDERBRCOK CIRCLE
CITY OF TIGARD Plumbing Permit
Building Departme,A No.
Residet itial [] Co nmercial
New Installation Rr;place Addition Alteration
Date
Licensed
Plumber 1 12 Owner u r I
Address t tmx_4�_ Job Address ligat) =.i.
Phone Applicant
CITY BUSINESS LICENSE REQUIRED FOR ALL, CONTRACTORS AND SUB-CONTRACTORS
ITEM NO. FEETO,TAL ITEM NO. FEE TOTAL
Fixtures-Traps 7.50 Sewer.Fit st 100 ft. 30-00
Dishwasher 7.50 Each Addit.100 ft. 15.00
Garbage Disposal 7.50 Ejector Pump 7.50
Wnter Heater 7.50 Water:First.1 00 ft. 20.00
Backtiow Pro jenter 7.50 Each Addit 200C. 15.00
Slorm&Rain Drain:First 100 ft,
Each Addit.-200 ft. 15,00
Mobile Home Space 25.00
Other(Specify): Rain Drain-Single Fam.Dwelling o 'W 15.00
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PERMIT FFE Comments
Issued By:
STATE
Receipt No. Applicant
TOTAL j' "nature
For Plumbing Inspection Phone 639-4171
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Owner:.T. 44.................................................................Permit No. 14 ..
75. .... ... '
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Building Address..........154.80.....SW...................A.1derbrook..............C.....r#.... ...........Lot..... ...........................
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Certificate is hereby given this.... 4 ....clay of.... , lg•,7,7,,, r,' ��
�; •, ; r that said building may be occupied and I4;
that it complies with all requirements of
the Building Code for the City of Tigard, :
as approved by the Tigard City Council. I �
Buil ling NspectorWig
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ItDDR EaS .�/5��� � ' :�� �- PERMTT NO. ..... ., ._ �_.r. I
PERMIT CHARGE �« _ � norm _
so
O'JNf R CONNECTION FEE
PAID BY
TYPE OF :IUI1.UING DATE CONNFETCD
1
Sf:RVICE AATE � S_� ..__... __,.. INSPECTION FETE ��S °!u
CONTPAr ron � PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID +
213, / '
City of 'Tigard
INSPECTION RrEQUES T
for
IN$PECTIGN TIME: PERMIT NO. :—
DATE: -9
O. :—
DATE: tj Z 11 DATE ISSUED :,L1_
OWNERS NAME :
ADDRESS: i' �a
CONTRACTOR : _ _ 1 -_� 2' - --- - ------
TEST :
----FEST : Air p, Water[] , visual ❑ , Laboratory p
r
RESULT: Approved Disapproved C Pending
SKETCH.
�L
INSPECTOR DATE
NOTE: Attach supplemental test data berets I
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City of Tigard
INSPECTION REQUEST-
for
EQUESTfor
SPECTION TIME: PERMIT NO. :
DATE 2,12? DATE: ISSUED :
NNERS NAME :
ADDRESS: ._ I
N r R A C T 0 R ' 'G ti — `l tial., ce►ti.-4
ST .' Air C), Wote► El , Visual [3 , Laboratory n I
IFSULT. Approved-Q,_ Disapproved L' , Pending D
(ETCH,
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INSPE TOR DATE: � I
fE: Attach supplemental test data beret]
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SEWER PERMIT .-
Uf W
NI? 12180
Unified Sewerage Agency
of Washington County CITY OF Ti ga rd _ - DATE 5-31-77
OWNER: --T.D. Gr — _- _ PHONE : 639-3101
OWNEf; , S ADDRESS:
TYPE OF INSTALLATION:
U BUILDING SEWER J BUILDING SEWER AND SIDE SEWEP
TYPE OF OCCUPANCY:
❑NEW (❑ SINGL.E FAMILY ❑ COMMERCIAL
❑EXIST . (PRIOR TO -7- 1--70 ) ❑ MULI . RES. ❑ INDUSTRIAL
FIXTURE UNITS_ _ DWELLING UNITS
PERMIT CONDITIONS: THE APPLICANT AGREES TU COMPLY WITH ALL RULES
AND RECUL.ATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERNII'f NUMBER. THIS APPLICATION
EXPIRES IN ONE—HUNDRED AND TWENTY 1 12 ) DAYS . THE AMOUNT PAID WILL
BE FORFEITED SHOULD E'(PIRATION OCCUR.
FEES:
PERMIT FEE $ 25.
CONNECTION CHARGE 575,
SIDE SEWER ?NSTAL.L-ATIONISSUED BY
OTHER
TOTAL s 600.
APPLICQ-NT DATE
SEWER PERMIT NV 12180 �
ADDRESS OF STRUCTURE 15480SW91.�es�l_D-.(Zk_G-lLIiE�_________-. -_.
TAX MAP — TAX LOT SYSTEM Fanno Creek
L 0 T ----4 4 3.. _,•. B l-0 C K ------ OF-
APPROVED
-- - OF-APPROVED BY PATE: ISSUED BY DATE
REMARKS Bldg. F1475
1TY
BUILDING PERMIT APPLICATION Coy TIGARD DATE �—P� Is
THE UNDERSIGNED HER ECY APPLES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILCiER PHONE_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNLRPHONE_._
,� ; LOT VO —
OWNER T ' JOB ADDRESS lb46O SU Aldo t:bro a�"-HC•NIE'A'bDRESS
-- ARCHITECT ----
ENGINEER
BUILDERr 1c" ADDRESS � DESIGNER T
STRUCTURE ,'041lE_W ❑REMODEL_ ❑_ADDITION []REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCE ❑ ^COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO l_;CAR PORT 0GAR1,GE ❑STORAGE❑SLAB ❑FENCE
❑BOND OMOV:NG ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY-I-LANDUSE ZONE t`» BLDG.TYPE aU FIREZONE- PLAN CHECK HEAT- _
Lot ,44; fim r,3-iesua same as 15581 ' L: 5ummer.field Lane — - -
r rame dwellinW w/attArhrrd I.4eraqu 2 bedroom 2 buth --
Q"-LQP-,Q—_ FL99►31Q312-- HEIGHT --_-NQaST4_�f€�_1 1490
-APIA!!. NQ_Elf Qf3QQM1---'7-yAL.QJ 0-
BUILDING DEPARTMENTSET BACKS FRONT f f'� REAR 1 S LEFT SIDE f Li" RIGHT SIDE �d f 1pn
Permit 136,00 -- — — -- ------THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check �(]�l�f{ REGULATIONS AND AL-'- APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- -- - WORK WILL BE DONE IN ACCORDANCE W17H 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 SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4.36 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 1A,36 Tit Cevc�lopmoni c:hertds 300.00
BY — --— - -
.�---.---- APP CANT OR AG@NI
Approved "W Recelrt No. J
ADWSS
„�.-.w.;�....:sur.Iwtwie.�W/ea.....,w,.wy.:,_�• .u..e„u..w...
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/ c `--- _—! -- I Contractor
_ I F_ermit No.
'I-22-11 U/t1 t3 1 rl Rough-in
Fixture —
_ Final _
HEATING
Contractor
---- -- Permit No. 31
h
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
---- _�.�_----- Final
Storm Drainage
(Rain Drain) Final
Sidewalk
— --__._—,—_— � Curb& Street Final
_ A roach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCLIPAIICY
CERTIFICATE OCCUPANCY Final
Landscaping
oning Final