8915 SW COMMERCIAL STREET-2 r �
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8915 SW COMMrRCIAL STREET
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Ir,apectiin
Date Requested =���
��� Time---A.M. P.M.
Address '_ t
Permit #
Owner
------ Lot #
Builder
The following Building Code deficiencies are required to ba-rgrreated:
�G
Presented to _
Approved
Inspector "
�- Disapproved
Dat,
CALL FOR REINSPECTION
C� YES [A NO
CITYOFTIGARD h1AaTER PERMIT
Cf1YOFTWARD f-Fril1IT N. . . �I'iST 0 0.511
COMMUNITY DEVELOPMENT DEPARTMENT ot"" r'R T II. PERMIT V. VIST90-0 319
13125 SW Hall Blvd. P.O.1 pox 23397,Tired,Oregon 97723(6D3)6394175 DATE I S S U E D s 10/09/90
SITE. WDDRE:i.•.. , ., : 8915 k_(jMMF::RC CAI... ST $421 PARCEL.: 2.il02Af•T".
SUBDIVISION. . . . : Z:01,11NCi.,
Etl_C:CK . . . . . . . . . . s 1O. . . . . . . . . . . . . .
_.".__..._.._._......._._"" __•_.__ _....._"_.._.....__"".." ._...
BUILDING ............._._..__.._..._."..._._.._...__._....._._._�_.............._. .._..._....._.._
REISSUE: DWELLING UNITS:1 BASEMEN'T.. . . . . . . . :0 S f
CL-ASS 01" WORK. l+L I)RMS10 BATHS:O GARAGE.. . . . . . . . . . :0 s (
TYP'E OF USE. . . sMH FLOOR AREA<a__..____._......__ REQUIRED -
TYr--'E= OF C0NF3I . -.511 1"'IRST. . . . s0 r>f LE:I'"T. . -.0 ft RIGHT. :(4 1
OC:CUP'ANC:Y GRP,. :R3 SECOND. . . :O sf FRONT'. :0 +'t REAR. . :O ft:
STORIES. . . . . . . ..! THIRD. . . . :0 S F;F.CIU7RED _.._._._._._...._...__..............
HE:IBHT. . . . . . . . . 0 ft TOTAL•---•-•---••10 Sf SMOKE: DETECTORS. :
F.L00R L.0AD. . . .. :0 psf VFII...I.IE::. . . . .. $: 0 r'ARKING 13r'(10E: . . :0
Rema-+.s: SET UF' FOR Mf.II'rIl_L:: HOME: PARK - FP1L-UMI+It4G, EL.ECTkICOL INCLUDED. N FEE J
?'b._ so.�-e�!�&sc.......s'' +c. s✓.....�........ ._ .£`... I...I.JI*I { hr(�' .._c.....,'.,r'_
SINKS. . . . . . . . . . ...0 I L.00R DRAINS. ,. . . :0 BACKFLOW I'REVNTRS. ,. :0
LAVATORIES...., „ ::0 WATE::R HEOI E"RS. . „ :0 TRAP'S. . . . ,. . . . ., . ., „ ,. „ ,:o
TUD/SHOWE'RS.. . ., . :0 LAUNDRY TRAYS— . :0 CATCH BASINS. . . . . . ., :0
WATER CLOSETS. . c0 13E::WE:R L.IN1= (ft) . :0 GREASE TRAP'S. . . . .. ., „ :0
D:I:SHWAFHERS. . . . :0 WATER LINE: (f•t) . :0 OTHER FIXTURES. . . . . ..0
GOR PAGE DIS(''. . . 2F; RAIN 1!PAIN (ft) . -.14
WASHING MACH. . . :W SF- RATH DRA:INS. . :O
_.._..._._.... ..__. ....._.._......._ I'I L C 14A N T(1-Al... _. ._. .__................_... ._.... _....._....._.... .. _. FEES ._.._...__.".."._._.....
F'URL.. 'tYF'Ec1_.._..___._._...__.___._. UNIT 1.1185. . :0 type a"10t.tr1't by elate recut:
VE:N1 S . . . . . :0 Br'R'T $ 89. P5
MAX INP'UT:O BTU VENT F'ANS. . :0 B 5F'C 1: r?1. 00 /
F'URN < :1.00K . . :0 HOODS. . . . . :, :0 111,1-�T t; 20. 00 /
F URN )-J.00K . . :C%1 WOODSTOVES. ;O 1,1 5P'C: $ 1. 00 /
FLOOR 1=URN. . • . r(I CLQ DRYS.-RS. : fd 1"'1=1R1 $ J.ra. 00 /
BO I I._/CMF' ( :3HF'c 0 OTHER UN I T S c H F-15PIC: $
GAS OUT LE l S:0 r'AYI*i 147. 00 DCR 10/09/90
Owner:
WILLIAM DAVIDSON
128130 SW PACIFIC HWY
TIGARD OR 97223
0WN►E:R/CC)N TRiACT0R
F't)01.1 a 11:
Rieq li. . : 041NF.Ft ___.._._._._._._.._.
147. 00 TOTAL
This permit is issued subject tc the regulations contained in the - - - - RE OUIRED INSP'ECTTONS "- -- -
Tigard Mur`^ipal Code, State of C e. Specialty Codes and all other root/fot.trld Ir1sp P'lm/Uslderfloo-r
applicable laws. All work will he done in accordance with approved f'IUmb Top OUt Crawl. D-r•sin
plans. This permit will e►pire if work is not started Within 168 Framing Insp F'tq Drain Bsm' t
days of issuance, or if work is suspended ore than 1 s. F i r e p l a r.e I n s p F'l u m b i 1.1 q Top Cl t i t
Sas I.. i.11 C. 1:Y1sp 1:'11_tmb F: i.na1
r:1 e r n1 J.t:t e ra i.q 1'1 a t 1.1 r�^a _ .._... -- -_.... at.. ._.. .. Water I..i.►•1 e
�^ f ..................._............
_......_.._..._..
� ,,,,,,�p� F':IUmb F•inaI
Call for inspection 639-•4175
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W=UlLw—AJmp%&ffiR� NMI
- I
r T TY OF T I GARD — RECEIPT Of' PAYMENT RECEIPT NO. a470- '20562n i
CHEcft:: AMOUNT a 147.00
NAME. s CASCADE MOBILE V I L.I.A CASH AMOUNT n ().0(.1
).0(.1
ADDRESS 0915 SW COMMERCIAL 'Ell' PAYMENT DATE a 1 01U9!?Cl `
:sur{ulvlSruN
T I BARD, OR 97223.— LOT #21
PUF;VOSE OF t-'AYMENT AMOUN"I' F Al D PURF7'0:3E Of' PAYMENT AMOLJN T PA I Ci
BUILDING PERM 170-03,19 J 25 PLUME-ifk(3 PERM_w 15.c.iC
i
9T. BUILD PER 5
I
F`'LACENENT PERM I l' r'OR A MOBILE' HOME. TO CASCADE PARK
I
T'(TVAI_ AMOLIN'T PAID _ 147.o0 I
_ -I,3 ..a/:+t�yli•M4`a.7v4r: .n!1@A'�.�!,�' �.ir�' {f
ru�7!}vl.�/lNV.f!wi.�.M)5.�.1.�-.�:I •'.�..:'.. wr:a .X►r;�•-+;Jr-j►„t,. _r ,. .1 I
e..aoN F
APPLICATION FOR TITLE
DIVISIONVINVIN INSPECTION DATE DEALER BATCHCODE
CI" AND REGISTRATION AND INITIALS TRANSACTION
NEW PLATE NUMBER STICKER NUMBE i PERMIT NUMBER MEMORAN:IUM RECEIPT NUMBER EXPIRE DATE
PRESENT PLATE NO
❑ G;5 ❑ DIESEL BODY STYLE YEAR MAKE EOUIPMENT NO. FLEET ACCOUNT NO TITLE FEE
❑ OTHER lCHAMPIlON
VEHICLE IDENTIFICATION NUMBER TITLE NUMBERWEIGHT OR LENGTH DMV FARM ID NO TITLE PENALTY FEE
M_4434-3L 12x60
NAME OF OWNER(PRINT LAST,FI ST,MIDDLE AND SIGN ON LINE 18 OR 19 BELOW) DATE OF RT RFGISTRATION FEE
1 DAVIDSON, WILLIAM G. ol
NAME OF JOINT OWNER(PRINT DIST,FIRST,MIDDLE AND 91014 ON LINE 19 OR 19 BELOW) OAll OFFBIFIIH ` REPLACEMENTIPLA
TRANSFER FEE
NAME OF JOINT OWNER OR LESSEE(PRINT LAST,FIRST,MIDDLE AND SIGN ON LINE 18 OR 19 BELOW) DATE OF BIRTH VIN FEE
t
OWNER'S RESIDENCE ADDRESS(HOUSE NUMBER.STREET) ADDRESS JOE DIFFERENT) TOTAL FEE
= SAME
18245 SW PACIFIC HWY SP 3
CITY,STATE,ZIP CODE COUNTY OF RESIDENCE wUNTY OF USE VEHICLE TYPE
TUALATIN, OR. 97062 WASHINGTON WASHINGTON
MOBILE HOME LOCATION(ACTUAL LOCATION OF MOBILE HOME) COUNTY WHERE MOBILE TITLE CODE
HOME IS LOCATED
SAME AS ABOVE WASHINGTON
OWNERS AGREE THAT TITLE ❑ INSURANCE CO NAME(NOL AGENT) POLICY NUMBS TRANS
WILL SHOW JOINT OWNERSHIP YES
-�� WITH AtGI T OF SURVIVORSHIP ❑ NO
11
SECURITY INTEREST HOLDER(BANK.FINANCE CO.ETC) ORIGIN
SL,SL 1UR�UiHOLDER ADDRESS(STREET,CITY,STATE.IIP CODE SURVIVOR
►i
SECONDARY INTEREST HOLDEN(BANK.FINANCE CO ETC) — N10TOR POWER
l SECONDARY INTEREST HOLDER ADDRESS(STRF[. !FFY,STATE.IIP CODE) _ PROCESSING
-I LESSOR'S NAME(PRINT LAST,FIRST,MIDDLE AND SIGN ON LINE 19 BELOW) EXEMPT
I I S1iOR S ADDRESS(STREET,CITY,S1ATE,IIP CODE) MISCELLANEOUS
TO APPLY FOR TITLE AND REGISTRATION IN OREGON THE OWNER MUST FILL IN AND CERTIFY BY SGNING 111E STATEMENTS BELOW IT 18 A CRIME UNDER ORS bAMAGE CODE '
+�2 078,TO CERTIFY THE TRUTH OF A STATEMENT WREN YOU KNOW THE STATEMENT IS NOT TRUE SUCH A CAIME IS PUNISHABLE H I A JAIL SENTENCE OF UP TO
I INE YEAR,A FINE OF$2500.OR BOTH
CERTIFICAMW
IF THIS APPLICATION COVERS A MOTOR VEHICLE THAT IS LESS THAN ODOMETER READING(NO TFNTH 1 DATE G' READING OF DIFT1REN FRO
8 YEARS OLD AND WHICH IS NOT OTHERWISE EXEMPT FROM ODOMETER U MILES LINES 18 OR 191
REOUIREMENIS, THE OWNER OR LESSEE MUST COMPLETE THIS
SECTION ❑ KILOMETERS
IHIS SECTION MUST BE COMPLETED ONI Y IF IF THIS VEHICLE IS LEAS"D. THE LESSOR IS CERTIFYING 10 THE INFORMATION IN THIS SECTION AND T-
I THIS..PPLICATION IS ALSO FOR REGISTRATION OR READING ABOVE IF THEOE IS NO LESSOR,THE OWNER IS CERTIFYING TO THIS SECTION AND THE READI
II THIS APPLICATION INVOLVES TRANSFER Of OPI_GON TITLE AND THE ABOVE IF THIS APPLICATION IS ALSO FOR REGISTRATION,THE OWNER AND THE LESSOR(IF THERE IS 01
VEHICLE IS LEASED OR THERE IS A SECURITY INTERST HOLDER ARE CERTIFYING TO THIS SECTION AND THE READING ABOVE
I CERTIFY THAT,TO THE BEST OF MY KNOWLEDGE.THE READING IS ACTUAL MILEAGE UNLtSSA0lY OF THE FOLLOWING ARE TRUE (CHECK THE BOXES THAI APPLY)
❑ THE ACTUAL MILEAGE IS MORE THAN 99.999 MILES/KILOMETEAS
❑ THE ODOMETER READING IS NOT ACTUAL MILEAGE AND SHOULD NOT BE RELIED UPON
❑ THE ODOMETER WAS ALTERED,SET BACK OR DISCONNECTED WHILE I HAVE HAD THE VEHICLE OR WHILE SOMEONE ELSE HAD POSSESSION OF IT
IF THE ODOMETER WAS ALTERED FOR REPAIR OR REPLACEMENT WHILE I HAVE HAD THE VEHICLE I ALSO CERTIFY THAT
❑ THE ODOMETER WAS RESET TO THE READING BEFORE THE SERVICE,OR
❑ IT WAS RESET TO SHOW .MILES/KILOMETERS. THE READING BEFORE THE REPAIR OR SERVICE WAS MILESIKIIOMETERS
If THIS MOTOR VEHICLE IS SUBJECT TO THE FINANCIAL RESPONSIBILITY LAW.I CERTIFY THAI 11 IS NOW COVERED BY THE LIABILITY INSURANCE POLICY LISTED ABOVE,AND THAT
I WILL CONTINUE TO COMPLY WITH THE INSURANCE REOUIREMENTS UNTIL THE REGISTRATION EXPIRES OR I SELL THE VEHICLE
MY PLACE OF DOMICILE(HOME)IS IN OREGON,OR I AM OTHERWISE FLIGIBLE OR REOVIRED TO REGISTER THE VEHICLE UNDER OREGON LAW(ORS 803,200.ORS 803 J901
I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS TRUE AND CORREC .
bIGNAtWIR11ER OR LE Eqq OWNE DATESTELEPHONE NUMBER(OPTIONAL)
� HOME
SI WORK
_
.NAI URE Of JOINT OWNER OR LESSOR AS SHOWN ABOVE DAT COUNTER DATE STAMPIINITIALS
1 MUbILE HUMS/MOBILE HOME ACCESSORY STRUCTURE
STATE OF OREGorr INSTALLATION PERMIT APPLICATION
DEPARTMENT OF COMMERCE 1NHEN APPROVED THIS APPLICATION IS YOUR PERMIT
7 BUILDING CODES DIVISIC,1Building must be Completed
according to city codes and
final inspection made before PERMIT NO:
occupancy.
CITY OF TIGARD COUNTY: ilki,444441I �
APPLICANT TO COMPLETE NUMBERED SPACES ONLY
A,idress of Propnsed Mobile Home Installation: y ounty ;,p
1. 8915 S• Via COMMEROIAL ST 11GARD AS.MINOTQ_1t{—.9722.',..
Directions to Mobile Home Installation:
2
Is Mobile Home On Private In a Mobile
3. W/In City limits s C-j No 4. Property [J Yes ] No 5. Home Park 0Z1 Yes ❑ No
Owner Phone No.
h. _DUDLEY Re AND EvELYNEMe RATTY _ — _ _ 61 -1 c)0
Dealer Installer Address City Phone No. 0�-1.r�2418�, Reg. No.
Sent,-S•-._MO®ILE HOME INOORP 1120 OLD SHERIDAN RD MQ INNOILIE OREGON
Accessory Installer Address City Phune No Bldr. 6-_d Reg. No.
8
SAMA_—_ —_—_—_. /y� I 5____
9 DescriEe Work: Install Mobile Home ❑ 10. Install Awning 9(X 11. Install Cabana
----_ ---- - - - - - fiX. G4 _--- - — Cl___ .hyo
•Date In'pectlon la Requested Manufacturer of Mobile Home Sire of Mobile Home
12 1 1
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
CORRECT. ALL PROVISIONS OF LAW AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH
WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT GIVE AUTHORITY TO VIOLATE OR
CANCEL THE PROVISIONS OF ANY OTHER STATE OP LOCAL LAW REGULA.'iING MOBILE HOME INSTALLATIONS.
or
Signature of Of—of (Date) , Signature of Dealerinstaller or(Accessory-Installer) (Datel
APPLICANT PLEASF DO NOT WRITE BELOW THIS LINE
70NING APPROVAL Required Yes ( ; No Received
Date
SANITATION APPROVAL Required [J Yes [_[ No Received Date
PARK LICENSE NUMBER OF APPROVED SPAI:E WHERE MH .
NUMBER PAFK SPACES WILL BE LOCATED
" CALL FOP INSPECTION PHON( NO rIFDO\NNS REQUIRED [] Yes I- No
SPECIAL CONDITIONS:
I 41 SINGLE WIDE (Inc. Tip-Out) $25 5. IVAW NG OR CARPORT $5
2 [-J DOUBLE WIDE E40 6. ELF,CTRICAL
3. [ ] EACH ADDITIONAL WIDTH . $15 7. PLUMBING ,Oo
4 F_I CABANA $15 B. L) MECHANICAL
TOTAL CK CASH M.O $ eJll0r d
APPLICATION
SDA E PERMIT L
APPROVED BY:
_ ISSUED: �'/fie F1 ��
ego
V
Part I Orlin copy - hita Part 2-Applicant (isnary Put 3 Inspector Blue Part a Auditor-Green Part 5-total Government-0-rod i
!1•ISIIO-t11
CITIi'G+I: T I GAIL
No. 4572
l / 12755 S.W. ASH
f
P.O,8OX 23397 Date
` rIGAFD. OR 97223
Name- -
Address --
Lot--- Block/Map - i --
r-
Permit M's TBldg. Plumb Cash Check
Sewer Other 010t,!C- Other Roc. By.
�- Acct No. _ Descriptlon — Amount
10.432 Building Permit Fees ,00
t 10-431-600 Plumbing Permit Fees -
ff 10-431.601 Mechanical Permit Fees
10.230.501 Slate Bldg, Tax
10.433 Plans Check Fee
10.435 Other Licenses & Permits
30.443 Sewer Connection
30-444 Sewer Inspection _
24.448 Street S st Dev. Charge -
25-449.610 Parks I Syst, Dev. Charge
i 25.449.620 Parks II Syst. Dev. Charge
31.450 Storm Drainage Syst. Dev. Charge
10.430 Business l ax --
10.434 Alarm Permit
10.227 -� Bail
10.455• Fines •Traffic/MisdlParki_ng__
10.230• _ CPTA Traffic/Misd/VIc. Asst.- - - - ^-
10-456 Indigent Defense
30-446.4_01- -3ewer_Service/USA_
f 30-446.402 Se" Service/City
31.447 Si- i Drainage -
40-475 _ Bancroft Prin. Pymt.
j 40-471 _ Bancroft Int. Pymt -
10.451 Other Charges for Services _
TOTAL �
DEPT.
wsa
I BUILDING DEPARTMENT, TIGARD
I > PLUMBING PERMIT �•
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be 'nstalled in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tiyerd Business License required
for all contractors and sub-contractors.
f n• r
Address j - ,� ��f�J c'��rr ',, _Date
NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS PEE ON NAd1 AMOUNT (Office Use Only)
R E 3 10 E N JjA_L_
Single Family-1 beth-tach 25.00
Ouplex-Each 1 bath unit ,25.00
Additional bathrooms_-each _ 10.00 -_
Mobile Home Space--tach 16,00 _
INOIVIOUAL FIXTURE FEES
1 to 50 Fixtures In 1 building-tech 1.00
51 to 100 Fi:.tures in 1 building-tach 2.50
101 to 200 Fixtures in 1 building-each _ 2,00_
_201 ar mnre F_irturef in 1 building-each 1.50
MIS_CELL_ANE0US
Budding Sewer-11, 60 ft. 10.00
Sewer-each rdditlonal 100 ft. 10.00
Water Service to building / !. _ 5•00
Private Water Systems-each 100 ft. 10,00 - -
Other ISpeOf ):
PERMIT for Plumbing lnsoection Phone 639-4171
1%State i a!' Plumbing Contractor By _ ��zvr✓'-ow I
TOrAL RECEIPT NO. Issued By
" 0 11t E I;0.`,1E/M03ILE HOME ACCkS : ;:Y Si '.I.1C;'►'Ur:E
STATE OF GRFGON INSTALLATION PERMIT APPLICATION
f , DEPARTMENT OF COMMERCE WHEN APPROVED THIS APPLICATION IS YOUR F-RN1IT
•' ,. , BUILDINCr CODES DIVISIONBuilding must be completed
according to city codes and
' PERMIT NO:
final inspection mado before
occupancy.
CITY OF TIGARD COUNTY:
APPLICANT 10 COMPLETE NUMBERED SPACES ONLY: .-.--- --- -
_ .- -
Cit County Zip
Address of Proposed Mobile Home Installation: y
Direction%to Mobile Home Installation: - -
2. - --
-_..J_ ----------------- - In a Mobile
Is Mobile Hc..-,e On Private
� y�� No 5. Home Park Yes C7 No
3. W/In Cit lirrtlts Yes- ❑ No J 4. Property------ 17Q Yes_( - - - --- — --- -
---y -- - ILL
f / �I�i� Q Phone No. _
Owner 4�r ) L� �•� `d 1 rt __
`y Address city Phone No. Bid,. Bd. Rep.No.
Dcs'e -In%taller Q "�
7. ��X.f/.r-Z2'p� � ��.� _. __ 7r 7t-1.�=?4'�:•.,� ��—!���--- Bldr.Bd. Reg .No. -
Access oryInstsIler t
Address City Phone No.
B. -
9. DescriE.e Work: Install Mobile Home 10. Install Awning or Carport -0 11. Install Cabana ❑
- -- - A4anu`edurer of Mobile Home Size of Moblle Home
•Date Inspection Wile
12. --
13.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
CORRECT All PROVISIONS OF LAW AND ORDI DANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITI
+ WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT GIVE AUTHORITY TO VIOLATE OF
CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING MOBILE HOME INSTALLATIONS.
or] Signe of Owner (bate) Signature of Dealer-Installer or(Accessory.Installer) (Cate)
APPLICANT PLEASE DO NOT WRITE BELOW THIS LINE:
Q
ZONING APPROVAL: Required ❑ Yes F3 Nu Date N� _
ed Date
SANITATION APPROVAL: Required (] Yes ❑ No Receiv
�fS _
PARK LICENSE NUMBER GF APPROVED SPACE WHERE MH ►�
NUMBER PARK SPACES WILL BE LOCATED
CALL FOR INSPECTION: PHONE NO.4,3 of^4t/7 / TIEDOWNS REQUIRED [ J Yes No
t_SPECIAL CONDITIONS _Et(,t/ .._ R _
`
I. `SINGLE WIDE (Inc. Tip-Out) $75 5. AWNING OR CARPORT $5
2. [] DOUBLE WIDE . . . . . . $40 6. (.] ELECTRICAL . . . . . --
b c^
3. EACH ADDITIONAL WIDTH . . . . . . $15 7. f� PLUMBING . . . . .
a. ( ] CABANA . . . . . . . . . $15 8. [] MECHANICAL . . . . .
TOTAL CK CASH M.040A
bATE PERMIT .
APPLICATION ISSUED: � ...• 3v 7
.1 PROVED BY:
Part t-CN/in Coov-Wsitt ^art 2-Applicant-Canary Part 3-Inspector-BIW Part 4 Auditor-Green Part S-Loral Govtinmtnt-C•o-
SP'436II.•[14
Address d l'� J+�' �/�>/'�F�'�rAL Permit No.
Name of Occurant �/A Permit charge -2 • pO
_ ConL.9ction fee_ 71"- s'A
Paid by
Date connected
Type of Building erem)e,Cf�,/ Inspection fee jD a'D
Service Rate_* /L EL Paid by _.Dafe
Contractor F'DF,e�-� �w ���'� Assesemeat Paid _
Size of connection
M
.I
n� ss w w w w w iw
PERMIT TO CONNECT
T
Tigard Sanitary District
PERMIT N° 7 Q DATE
b ,1..
PER511T IS GIVEN TO;� o
r
OF
TO CONNECT A �✓ .9�'�yf►'�' �=' ��' ..
TO THE SYSTEM O/FT/IGARD SANITARY DISTRICT
AT
THIS PERMIT MUST HE POSTF.O ON THE VESCRIRED PREMISES UNTIL CON
NECTION IS MADE ANO INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
.4,l` ` , �•� '1,aGG
PERMIT FEE PAID $.. ...........................'A! "Dfrq'IYIlI?I
CONNECTION INSPECTED AND APPROVED
Date Superinten ent
WORALMNALMO
..} )
�l ��I"
,1 r
3 41,C
Address � �,, 7�i.�Z�i�1�2Y Permit No.
Name of Occupant_ _ _— Permit charge
o d --
---.-. _- Paid by--.—_---___-- _
Date connected
Type of Buildin "T uwr _1Inspection fee__J._____
kG� Rale . Paid by . --- -- -- ._Date.—_—_ —_
L
Contractoa_ _ _. Assessment-, �_(�L Paid.
c
Size of connection--1
APPLICATION FOR SEWER SERVIuE
The undersigned agrees, in consideration of the sewer service connection by the
Tigard Sanitary District, to abide by and comply with the ordinances, regulations and rules of the Dist-
rict presently in effect or hereinafter enacted and to pay sewer service charges as the same may be im-
posed from time to time when due and befure such charges become delinquent.
I ful'y understand that all unpaid sewer service cha-ges becume a lien upon the
property served as stipulated in O. R. S. 224.220.
t
Connections to the District's system must be made by bonded contractors and/or
bonded and licensed plumbers.
---- --- Owner ---- ---
APPROVED BY
Superintendent
TIGARD S�LNITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
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Address 2 LS�s1w C�y�«f�- e�+ � Permit NO.
Name OlUcpant Z� Permit charge
Connection fee
Paid by /A
Date connected.
Inspection fee �U'�L��'ull /4 1 GY
Type of Building
Se.-vice Rate_? Paid by 64T_�4_61 __Datel.—-22
Contractor Assessment —PaidAlf,vtcl_
Size of connection
APPLICATION FOR SEWER SERVICE
The undersigned agrees, in consideration of the sewer service connection by the
Tigard Sanitar., District, to abide by and comply with the ordinances, regulations and rules of the Dist-
rict presently in effect or hereinafter enacted and to pay sewer service charges as the same may be im-
posed from time to time when due and before such charges become delinquent.
I fully understand that all unpaid sewer service charges become a lien upon the
property served as stipulated in O. R. S. 224.220.
Connections to the District's system must be made by bonded contractors and/or
bonded and licensed plumbers.
Owner
APPI4OVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S.W. Commercial St.
Tigard, Oregon
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PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N? 677 DATZ r'- .�r 3 • ( .�.
PERMIT IS GIVEN TO +r S
OF
TO CONNECT A _
TO THE SYSTEM-OF TIGARD SANITARY DISTRICT
AT �.
THIS PERMIT MUST BE POSTED ON THE DFACRIPED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN CODI-
PLETED.
PERMIT FEE PAID . TI(:ARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date
�tendent