15655 SW ALDERBROOK DRIVE 1
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15655 SW ALDERBROOK DRIVE
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CIT Y OF TIGARD
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Owne. ..............T..D.C.............. L�_t 356
#. . . Permit No.. 1J.�1 ........ ry�(;
Building Address........ .....15688 5W Alder.broo.k..qr,........".. .... . ............ ;,
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. R Certificate is hereby given this.... 4........day of......MRY. 19.....7.7.
that said building may be occupied and .
that it complies with all requirements of
the Building Code for the City of Tigard,
. ¢;• as approved by the Tigard City Council. 4z.
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} Building Inspertnr
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City of Tigard
INSPECTION REQUEST
for
IN PECTION TI ME PERMIT NO. : --
DATE:
O. : —_DATE: DATE ISSUED.'
__L_L
OWNERS NAME '. �—
ADDRESS : _
CONTRACT 0 R :._�'+r
TEST. Air El, Water visual, Laboratory p
RESULT: approved. , Disapproved p , Pending J
SKETCH:
INSPECTOR DATE
[OTE . Attach supplemental test data hereto] /
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UNIFIED SEWERAGE AGENCY NO. 11015.
WASHING-FON COUNTY DATE _____12-7-76
CITY OF—_11.2ard
APPLICATION FOR SEWER CONNF-CTION PERMIT
T.D. C .
OWNER: -
OWNER'S ADDRESS:
STREET
CITY STATE ZIP
BUILDING SITE: LOT-* BLOCK ADDITION
residence
TAX LOT NO. TYPE OF OCCUPANCY
ADDRESS . 51.1 11d�?rhroqk- Dr.
DWELLING UNITS FIX IURE UNITS .---
SURCHARGE IF APPLICABLE -----.-
PERMIT FEE .__.575 INSPECTION FEE --2-5,aa TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYS-TEM
The Applicant agrees to comply with all rules and teguldtions of the Unified Sewerage Agency.
APP LI CAN
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION To THE SEWER SYS-TEM.
LINE SI?F INSTALLER
RECEIVED BY
-(iGENCY OR 0SAGENti
COMMFNIS:-.
This Application and permit expires in one hundred and twenty (120) days.
The allIOUnt paid will be forfeited should expiration occur.
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CIT
BUILDING PERMIT APPLICATION Y TIC AICD DATE—
IAF
THE UNDERSIGNED HEREBY APPLIES FOR .A PERMIT FOR THE WORK HEREIN INDICATED BUILDE:RPHONL-, _
Oil AS SHOWN AND APPROVED iN THE A!,COMPANYING PLANS AND SPECIFICATIONS OWNER PHONE----.,_. _
T,L1.L. `11 Aldorbrook Cir. LOT NO. __,—
OWNEb )OB ADDRESS HOME ADDRESS
ARCHITECT
BUILDERENGINEER
f-1 ADDRESS
--�S DESIGNER _
ffSTRUCTURE ONEW ❑REMODEL _ L.IAOOITION ❑REPAIR DRENEWAL []FIRE DAMAGE []DEMOLITION
WP.ESIDENCE ❑COMM []EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE—❑STORAGE❑SLAA []FENCE0-13OND ❑MOVINGV 000NDITIONAL USE ❑DESIGN REVIEW— ❑COUNCIL APPPOVED ❑SIGNSW —
OCCUPANCY. LAND USE ZONE--BLDG.TYPE FIRE ZONE__— PLAN CHECK
Lot 356 Plalk XV 22-itewe. Samu i, , 1558hl •, 5 Irnfi fic4a Lau, _
F�. nra swelling wlet tesct ed rsrsuv 2boOroum
OCC.LOAD — FLOOFl LOAD -----__ HEIQIiT__ NO.STQ${ S AR,� jJ9.BEOROOMS� j
BUILDING DEPARTMENT 9LT BACKS FRONT 10 REAR 14 LEFT SIDE 4 i f'II RIGHT SIDE
Permit 122.*0�] —_ v--=- - — — -----THIS PERMIT IS ISSL'EO SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1Ws d0 REGULATIONS AND .ALL APPLICABLE CODES AND ORr-IRANCES, AN") IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLAITS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THI ISSUANCE Or THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CGNTRACTOR AND SLID CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax a*93 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total 13.,d,9'
Bv
— APP/ ICANT OR AGENT
Approved Receipt No
PI 1(.NF
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FsATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
—_ —
Contractor
�s
Permit No. J'
Rough m
�- - Fixture -_— —
d Final
HEATING
:Contractor
- , 1 .d Permit No_/
Gas or Oil
0-71
Rough-in
�•i.�.w�IL esu c. _C - o.s �� Final _
76 SEWER
Final
DRIVEWAY
Final
Storm Drainage
_— — (Rain Drain) Final
Sidewalk
Curb&Street Final
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
l , Landscaping
V Zoning Final V
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�_ � Permit No. �� �'
Address � � � � � ��t ' .'
Permit charge
Connection fee
Owner
Paid by
^� Date connected of building >f _
Inspection
Service rate fee v� _
Contractor
Raid by Date
Size of connection Assessment Paid