11580 SW GLENWOOD COURT-1 ll5t0 SW GLENWOOD COURT
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ADDRESS 'Yo
PERMIT NO.
PENMIT CHARGE acne
OWNER e, CONNECTION FEE
PAID 15f
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE INSPECTIUN FEE
CONITRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID
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f CITY OF TIGARD
OREGON
t. }'c�rmit No..:............ .....
Bob Smith
Owner:...... ......................................................
< � 11580 SW Glcnwood Ct.
BuddingAd(lress........ ... .. .................. . ....... ....... ................. ........................... 1
Certificate is hereby given this... ....... .da of..Fe.bruary . _.. 1p...7.?
�f 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.
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r... . .. .. ��'.. .
l Building Inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTICA TIME -.—C4 PERMIT NO. : —
DATE: —_L2' 2 _ DATE ISSUED:— L-�
OWNERS NAME '. -
ADDRESS :
AME : _ADDRESS :
CONTRACTOR :--
TEST'.
ONTRACT0RTEST. Air D, Water ❑ , uiavolk, laboratory ❑
RESULT: Approved 0 Disapproved Pending �-j
SKETCH'.
I
INSPECTOR oATE
COTF Attnr,h supplemental ttst data hereto
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�reeee�
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I f Tigard
ord
City o g
t��SPECTION REQUEST
for
` INSPECTION TIME : 02'0 PERMIT NO. : --
DATE :
O. : ____DATE : %7 DATE SSUED: ._1-L
II OWNERS NAME
C G.M.7 R A C T 0 R : —
I
TEST. Air 0, Water ❑ , Viaual*�, Laboratory ❑
RESULT: Approved Disapproved 0 ,
Pending rj
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I
I
I
INSPECTOR DATE
NO?F Attach supplementoI feet data heretoi
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City of Tigard
INSPECTION REQUEST �
for '
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INSPECTION TIME: �'
INS PERMIT NO. :
DATE: -:;� /6 DATE ISSUED —L-2— f
�- ''�-
OWNERS NAME ' ���' 7 H- , I
ADDRESS:
CONTRACTOR :
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BEST* Air U, Water[] , Vlsual*, Laboratory (]
9ESUL.T. Approved Disapproved C Pending ❑
SKETCH,
i
INSPECTOR DATE
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CNOTE : Attach supplemental test data berets] ///
rill � �w �' !■f � � �
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NC, :
DATE: &l/21416 DATE ISSUED: I
OWNERS NAME .
AUDRESS: -&mL
CONTRACTOR :
TEST : Air [] Water( •ual Q", Laboratory p
Approved fB� diaa
RESULT: A roved C Pending PP , PP , Q []
SKETCH:
INS F ECTOR DATE
EM')1E : Attach suPplemeritnl test dato beret01
U N I F ! ;.:U SEWERAGE AGENCY N 0. __ 10 6 5 0
WAS! ! NGTON COUNTY DATE 9-21-76
C i V Y 0 F__.___.__ Tigard
4PPI-ICATION FOR SEWER CONNECTION PERMIT
OWNER: Bob Smith
OWNER'S ADDRESS: ----_____
STREET
CITU - _ STATE /IP
BUILDING SITE: LOT_-.-_.—_-. .__ BLOCK __—_________ ADDITION
TAX LOT NO. TYPE OF OCCUPANCY residence
U
ADDRESS g 1!x C t, _
DWELLING UNITS__ _. -_.._______1____..______ _ FlX'I'I.JhE UNII-S
SURCHARGE IF APPLICABLE _________.._.______—_
PERMIT FEE 575. 00 !_ INSPECTION FEE _ 25. 00 TOTAL DF_.POSITF-D __ 00. 00- _
(NEW) (EXISTING) BUILDING SEWER SYSTEM ______ I-enno Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT.
SEWER PERMIT V
THIS PERMIT AUTHORI7_.FS CONNECTION TO 1HE SEWER SYSTEM_
LINE SIZE - INSTALLER
RECFIVED BY
(AGENCY OR ITS AGE
COMMENTS: _ ? do. _'� y 080
This Application and permit expires in one hundred and twenty (120) days.
The arnount paid will be forfeited should expiration occur.
ffwxwxwj
BUILDING PERMIT APPLICATION 1Q Y TIG.J"AD DATE `-21-76
�-'9 -2715
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED PUILDER PHONE-
Oil AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIO:: OWNER PHONF
0 LOT NO.
OWNER`F ob Silloth $OE1ADDRFb31dMW •'w ("'loE"it,lood rJ.HOME ADORES',_ _
ARCHI't LCT —
n;,t; ENGINEER
BUILDCR - ADDRESS DESIGNER
STRUCTURE ONEW O REMODEL ❑ADDITION _❑REPAIR ❑RENEWAL []FIRE DAMAGE _[]DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑ L
SAB ❑FENCE
�12BOND ❑MOVING ❑CONDITIONAL USE []DESIGN REVIEW DJOUNCIL APPROVED ❑SIGNS
OCCUPANCY 1 LAND USE ZONE —7 —BLDG.TYPE FIRi-ZONE PLAN CHECK Br f...; ' HEAT
,nnt. sim..le:, 8 '- slily dLaR?' ling w/atteahutj �l1XE);;�. 4 be:,froam 4 htatb --- --
St(C.LOAD f QgLO,4l) HEIG�L NO.5TQgIES AREA 1248 NO.BEDROOMS 4 VAL.0 —0.900
BUILDING DEPARTMENT SET BACKS FRONT 20 T REARS F LEFT SIDE I r 0 RIGHT SIDE 311'
Permit ��''• `� • —+_ - _ — -- --
Q® "-- THIS PERMIT' IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
+
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HF9EBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUNAIENT CITY BUSINESS
State. Tax ' 4.74 LICENSE. SEPARATE PERMI FS REQUIRED FOI', Z;FWER, PLJMBING AND HEATING.
Total 62 a 76 —_
By
�-- AC 'CANT OR AGENT
Appiovec * t Receipt No. j
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