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NOTE : IF THIS MICROFILMED - ------ +�.
DRAWING IS LESS CLEAR THAN
THIS NOTICE , IT 1 S DUE TO
THF QUALITY OF THE ORIGINAL
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9250 SW INEZ STREET
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f Tigard
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City o g
INSPECTION REQUEST
for
IINSPECTION TIME '.--- PERMIT NO. :
I DATE '. C171-222- DATE ISSUED'--L-
OWNERS NAME : -7-----
ADDRESS : --' ------
TEST .1 r J , Water 1] , Visl-al , La', .ratory (-1
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RESULT: Approved ❑ ,!Disapproved 1 Ptindiog�
SKETCH:
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I INSPECTOR DATE
rNOTE : Attach supplemeltol test (1ara hereto
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City of Tigard
i INSPECTION REQUEST
I for
IINSPECTION- ' I TIME :2-__ PERMIT
I DATE: zY 12,0193 DATE ISSUED:--I-L!" "
OWNERS NAME .
I ADDRESS : _ ��50
CONTRACTOR :-
TEST. Air L7 , Water �4 , Visual, ., Laboratory ❑
RESULT. Approved , Disapproved ❑ Pending []
I SKETCH:
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INSPECTOR DATE
iCOTF : Attach supplemental test data here,]
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Cit of 'Tigard
i y
INSPECTION REQUEST
for
I INSPECTION TIME : �* 1 `'-- PERMIT NO. : _ —
DATE : —.1 73 DATE ISSUED'___-.l L--
OWNERS NAME : � X—``
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ADDRESS : -- t'
CONT RACTOR :— -G'- L
La rotor; ;'1
TEST r J , 'Nater Lr] ,
RESULT: Approved DisrpproveH 1 F :ndi7g ,..1
SKETCH:
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–INSPECTOR DATE
COTE. Attach supplemental test •f Oto herd
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City of Tigard
INSPECTION REQUEST
for
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INSPECTION TIME: 3,'n' PERMIT NO. :—
�
DATE: 5" I Z� DATE ISSUED :--- / _
OWNERS NAME : ' 1+."As4
ADDRESS: . ` ----- —
CONTRACTOR :
EST : --,, Water0 , V'suai 1..1 , 1-aboratory 0
RESUL.i. * kp roved J , .')isupp►o�ed G !.endina f]
SKETCH:
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INSPECTOR DATE I
NOTEAttach suppiemental test data hereto I
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MUMMMU
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Address ')250 S.W. Inez Street. permit No. 47x0
Permit charge
Owner Walter A. Adolf Connection fee 425
Paid by Marvin Penrose
Type of building Residence Date connected 4-3-73
Service rete 3.00 per month Inspectic- fee %'_5.00
Contractor Marvin Ilenrose Paid by same Date
Size of connection �' Assessment Paid
i
.GtJL, C6Uc��
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME*. PERMIT NO. :-Y-7--Le-
DATE:
0. : Y7f e-DATE: 3 /JrY/1 DATE ISSUED :. -AZL- '
OWNERS NAME
ADDRESS: ---
C 0 N T R A C TO R : ----_—_--
TEST : Air ❑, Water[] Visual -dr,-,Laboratory ❑
RESULT: Approved ; ,""'Disapproved O , Pending ❑
SKETCH:
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c INSPECTOR DATE
J
FNOTF. ' Attach supplemental teat data beret]
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City of 'Tigard
INSPECTION REQUEST
for
INSPECTION TIME: 9 '00 PERMIT NO. :
DATE: 9 e"I Z- DATE It-'SUED:.
OWNERS NAME :
ADDRESS:
CONTRACTOR .
TEST . Air I_], WoterEl Visual laboratory o
RESULT' Approved-f:f , Disapproved 0 Pending p
SKETCH:
100T t=o 4 fz 0
INSPECTOR DATE
LNOTE Attach supplemental test data beret
CITY OF TIGAM MMUCAL P M V
APE PERMIT W). , �irJ RISC E I PT NO. �Z ZI?
Pert &hall be obtained prior to coswmenc*sent f f installation.
Permit shall be obtained for all appliances which are to b cOOW
a fixture to the building.
�.
Relocation, replaceasen`.s• alterations, or changes to burners and
duct work require permits.
v. All work to be concealed must be inspected before cover up.
Ow Installation U Replace ❑ Relocation ❑ motion E] Alteration U
mm. J,r tug u.� 1` . �.
WORK ADDRESS u ;+k.i .As
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APPLICANT _ .ae�•r:�
TELEPI M NO.
'ACE - M+AKTACT TTP TELEPHONE NO.
{EAT Input gyrating (Btu Per
i� Hour) Vent Size Fltje Size
OIL U GAS❑ ELECT 13 OMR
At. 90. FT. Top Floor Main
XNERAL
ITTV a NO. FF.F. _ ITEM ric. FRE
Is s e f P • x' 'svwr ,
ew - ver 100,
u r an
>o IzlacejiDorative Cooler
eroo.nnmon
en
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ore r mcec
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�r•neera�� __,ere 3 a
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RFS p r . L .
APPRCYED BY IRATE _ IF-SUED BY UATF.
aiKnRt.tirw ! Applicari•
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u% Jurisdio i " 4
Type of Fixture Fee Per"It No. 3-
Permit fee ---
Water Closets (Toilets) z Pemit Issue .
a th Tub s Approved by
ava ash sin Building Perm?j-cY
ML bower Receipt Yo. 7(g(f 7
S. Dishwai
luc en a
S �
Trna Location of Building _
s Bar W_....,�K a 2. —
s o
oma cDishwasher
U88 _
aundry ra s Name do Address of Owner arU ILM ,
+gins loor �, -aZ,I
�a -na Area
Drains Refrigerator
Rain Drains
_,/ u oma c as er Name & Address of Plumber _LdIdAirlto
oun a ns1Drinking
.
oun a na �off_
:2:'To-t Water Tank
Water ervice Size
..Urinals Building Old or New Alter Re air or
Catch-Basins - 7ar nsa
Lawn Sprin ers em r
aw mm n Poo e r
rinkler System
'his permit becomes null and 4Ad if work or construction authorized is not
:ommenced within 60 days, or if :onstriicti.on or work .is suspended or abandoned
or a period of 120 days at any time after work is commenced.
►11 plumbing firms must be licensed by the City of Tigard and post a $1,000 bond,
i
hereby certify that I have read and examined this application and know the same
;o 'ae true and correct. A]..1 provisions of laws and ordinances governing this type
)f work will be complied with whether specified herein or not, the granting of a
►ermit does not presume to give authority to violate or cancel the provisions
)f any other state or local .law regulating construction or the performance of
:onstructioa.
Signature of AFS l is 3
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City of Tigard
INSPECTION REQUEST
for
✓._cry_ ,.�fJj � _ --��,�,
INSPECTION TIME: Z'/-Ic- PERMIT N0. : c
DATE: 2 /is// , DATE ISSUED :
OWNERS NAME :
ADDRESS:
CONTRACTOR
TEST : Air ❑, Water(] , Visual Laboratory p
RESULT: Approved LT , Disapproved ❑ Pending p
SKETCH:
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INSPECTOR DATE I
NOTE: Attach supplemental test data beretfl I
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UNIFIED SEWERAGE AGENCY No 4790 _.,_..
WASHINGTON COUNTY
T14pra
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER �.Lr�• AlrNewMM 4!• __..__ _.....__ _ __...---
OWNER'S ADDRESS
BUILDING SITE LOT_.__. ._._ BLOCK.__w.____ ADDITION
TAX LOT NO _._. .,___ _ _... _._ TYPE OF OCCUPANCY __~!•__..__.._._-..---________
ADDRESS __ .-..�. _!a!a �!t !4•.
DWELLING UNITS _..___._.�.1_�� FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE 409 INSPECTION FEES ._....__ TOTAL DEPOSITED
INEWI I[XISTING) 9'.11LDING SEWER SYSTEM So" _
The Applicant preys to comply with all rule• and reWla nM of t nifind Sewerage Agency.
40
APPLICAN
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM
LINE SIZE �� INSTALLER oma
RECEIVED BY
f 011 I►a hOf NTr ___.. ... __..__._... _.
COMMENTS
this Aoollratron and permit expl►ef in ninety (901 days The amount paid will be IMleited
sht)t,lrl expvatton Occur
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CITY OF' TIGARD
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T19ARP. 0a80(m tn»
API'I.i"ATION FOR HUILDIW; PFFtMIT
New Construction LN, Demoiiah ❑ Addition L� Remodel ❑ Move
DATE ISSUED1 :� BUILDING PERMIT
I,A7t PtCLIVED BUILDING FF.t $ No.
lUY PLAN CHECK S 4 4�^p Z-3-QtL—,
__- VALUATION $
OTHER S 2'4&L�
-� _-- TOTALS T� A-Z RCCEIPT No 9T �y
TW) SETS or PLANS AND PIAT PLANS MUST BE FURNISHED WITH APPLICATION
L0 1 !� ------- 14A 11 1.2?-A_l- /I CENSUS TRACT _W JOB 1
Ar'•nitect or Engineer
A.tdrema ----__-_._.__-._—._.__.__ Phone Name
w+ner t
A d d r e m x Phone
hui 1 1II'r I
A,f:reqs
1+ iLI (vt; USF Single Res. Multi Res. ❑ Comm. ❑ Industria
PnwcY GROUP - -- NO, of Storie! j- 'Total Height s ' Area of Lot. mAll-
Typf- f onntruction I II III I'/ ( Floor Area 8 1
Front .2t, Back--4v— L.Side ' R.Side
F'rlvatr Sewer Pipe Site ---! Sewer`r- Septic Tank LJ
-,at- ';e'rvlce Pipe Size`_24- � Storm Sewer ® Ditch ❑ DryweII ❑
r.
t r..r' and (.'urt) Requirements
wiritn -17No. of Parking Spaces__2—
SEPARATE PERMITS REQUIRED FOR SE:WFR AND PLUMBING
SPECIAL INFORMATION
i
+,I , 1
t . ._DATED
PERMIT APPROVED 3Y
It 1r understond that all work will conform with applicable codes and ordinances
of the �7tatr of Oregon and the City of Tigard, Oregon and that the buildinq wi1j
not be occupled until a Certificate of Occu cy a sen issued by the City of
Tiqard Huildinq Inspector. Lpe
re o ApP Dant _