15620 SW ALDERBROOK DRIVE-1 Y
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15620 SW ALDERBROOK DRIVE `
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CITY OF `T IGARD
C OREGON
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1133
t)wnel :._...T.': ... .... ........................... ...... .....................Permit No......... ..........
15620 SW Alderbrook }�-
. Building Add.•ess..................... ..... Lot #384
Dr.
Certificate is hereby given this Augus ;•� ;��•i y g .......day of................t.............., 19.......:
i that said building may be occupied and
_3 that it complies with all requirements of « �s
the Building Code for the City of Tigard,
4 as approver by the Tigard City Council. y
r. Building lnspector
'�'►'\U M^ t./ 4+.� �_> l i:� 1«0• 1 °.:.:• i i '�..�° (., ° �. t"� - ."f\
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I City of Tigard
INS►PECTiON REQUEST
for
' INSPECTION TIME ��'�� PERMIT NO. -
DATE: DATE ISSUED:__L—c.._
OWNERS NAME : .
C0NTRA(.;T0R 4_' —M)-
TEST'
)-TEST' Air LY, Water p , Visuali, Laboratory LQ
RESULT: Approved Disapproved U Pending J
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SKETCH'.
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I NSPECTOR DATE
CUTE Attach supplemental Yost doto hereto,
City of Tigard
bNSPECTION REQUEST
f o r
INSPECTION TIME PERMIT NO. :
DATE: DATL ISSUED —
OWNERS NAME
ADDRESS:
C 0 N T R A C TO R
"EST : Air 0, WaterEl V al 0 , Laboratory jj-
9ESULT'. Approved t� Disupprovecl Pending C)
S KETC H.
1 `� Ca ��
PECTOR )ATE
[–NOTE .' Attach supplemental test data hereto]
3- i
UNIFIED SEWERAGE AGENCY NO.
WASHINGTON COUNTY DATE -8-77
CITY
APPLICATION FOR SEWER CONNECTION PERMIT
T.D.C.
OWNER'S ADD RESS: .-_.._- - - ---------- - - -- -- - - --
STREET
CITY StATE ZIP
BUILDING SITE: LOT 3A4 BLOCK _ ADDITION
residence
TAX LOT NO. _ _ _ TYPE OF OCCUPANCY
1°,620 SW Alderbrook Dr.
ADDRESS _�._..'_�._.—------------ - - -- _ — 1
f�
DWELLING UNITSFIXTURE UNITS -_____
SURCHARGE IF APPLICABLE — .._-_-.___— __-- .
PERMIT FEE - 575'____— INF ECTION FEE -_25• TOTAL DEPOSITED __600. _
(NEW) (EXISTING) BUILDING SEWER SYSTEM - Fanno Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
i�
A P P I_I CANT 1 ' �-/�!4 l c°'
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SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE ..___._._._.. .___._ _ INSTALLER ____.__
REi':EIVED BY f! - - _
(AGENCY O TS AGENT) G
COMMENTS: ._ Bldg. _#1333_ __
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration or,Cur.
BUILDING PERMIT APPLICATION 11 Y TIGARD DATE t9____ 1333 1
n
THE UNDERSI( .r.J HERLBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILnIERPHON'r
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNLRPHONE
T. .i„ 15620 SU A1de.broak E r• LOT NO_�
OWNER .LOB ADDRESS HOME.ADDRESS
ARCHITECT_--
iENGINEE13
BUILDER3dyllil�t ADDRESS _ _ DESIGNER
y
STRUCTURE LJNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RcNE.WAI ❑FIRE DAMAGE ❑DEMOLITION
0AESIDENCE [:]COMM [:]EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO `JCARPOPT [:]GARAGE ❑STORAGE❑SLAB [:]FENCE
❑BOND ❑MOVING ❑CONCITIONAL USE ODESIGN REVIEW ❑COUNCIL. APPROVED ❑SIGNS
OCCUPANCY_ .L LANG USE ZONE' 1 __.BLDG.TYPE ^-FIRE ZONE_ PLAN CHECK BY � HEAT_____
cLut g',:-U4 ;+1k: 15 re—isswura samo au 15581 SW SlumM`srf i f.( Ld Lane
Frwrn�� dIAW1TYi1u_ 1L'�a3C`tf]U •._ira�� ._ 2 bIDt1Tt�QfA bOtrl a +$x9 k 00 sq. ft.
OCC.LOAD ____— F1-QQH_LOADf,.l —}_I.EJ_GL�L__2U _N_QJT I'cS 1_ABEA I 9 NO.BEDROOM " YALUE �_ '•
BUILDING DEPARTMENT SET BACKS FRONT 13 REAR 11 LEFT SIDE Q IF
-k')Tr RIGHT SIDE'i—T
Perm t 136.ESE'
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Cherk 10*GE, REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLAAS AND SPECIFICATIONS AND IN CQMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSOANCF- OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 49 30 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
total 1130. )o
By
— APPLICANT OP AGENT --�-- -—
ApprovedReceipt No.
ADLM'SS .�E
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ATE
GATE INSP. TYPE INSPECTION v_ REMARKS PLUMBING p
T ( '
— Eontroro.7-2
Q ';=' �j1-/�"
Rough-in
_ Fixture
Z _ Final
Yz;,Z Ado
HEATING --- - — -
Contractor
Y� - F.., Permit No. 7 �-77
Gas or Oil
V
Rough-in
_ Final
SEWER —
_, _ Final
DRIVEWAY -17
-
�G ,5-
--- Final
Storm Ureinage _ —
ficin Dr,in) Final
Sidewalk _ C S-> - 77
Curb_a Street.Final
Approach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
l Landscaping
/ �� Zoning Final `/
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ADDRESS�� bio PERMIT NO.
PERMIT CHARGE. _ none
OWNER c� �° CONNECTION i EElJ�
PAID BY
TYPE OF BUILDING DATE CONNECTED _
SERVICE RATE INSPEC?ION FEE
�j�
CONTRACTOR PAID BY _ _ DATE
SIZE OF CONNECTION ASSESSMENT __ PAID �_