9425 SW INEZ STREET 9425 SW INEZ STREET
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ADDRESS PERMIT N0.
PERMIT CHARGE none
OWNER CONNECTION FEE
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PAID BY
TYPE OF BUILDING DATE CONNECTED
SERVICE RATE __/ __� _
INSPEC7ION FEE
7�4
CONTRACTOR _ ____„ PAID BY DATE
SIZE OF CONNECTION __ ASSESSMENT _ PAID �__--
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Builclillg Address..9425.....•.. Inez......... .................................... ... ..... ... ... ......
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Certificate ig hereby given this.... ........day of...•N.o-y-ember........., 19�h.... + t. •._
rl. I that raid building may be occupied and :t ,
that it co—npiies Frith all requirements cif
the Building Code for the City of Tigard,
a, approved by the Tigard City Council. ��t,� •
............ ... .... .....
Building lrspeclot
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City of Tigard
INSPECTION REO U E ST
for
INSPECTION TIME :()akl",, PERMIT NO. :
I DATE: _�- %-' Z DATE ISSUED:--/--/—
OWNERS NAME '
�_
AD C R E S S : `5c-t� �e-y —�--c�- ;L 5
CONTRACTOR :_4TIE
TEST. Air O, Water ❑ , Visual,w , Lc.boratory o
RESULT. Approved Disapproved Q Pending p
I SKETCH:
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INSPECTOR 'DATE
I NOTE Arta:h supplemental tg,et dare hereto]
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Of Tigard
INSPECTION REQU ES T
for
INSPECTION TIME: PERMIT NO. :
DATE: DATE ISSUED :-I--Z_ I
OWNERS NAME ,' ---
ADDRESS:
AME :ADDRESS:
CONTRACTOR :
TEST : Air O, Water❑ Visual (j , LaboratoryC3
RESULT: Approved E.7 Disapproved O Pending
SKETCH.
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INSPECTQ DATE
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UNIFIED ',;,EWERA.GE AGENCY No. ..---
WASHINGTON COUNTY DATE Duly �9� 1s7�_
C I T Y C.r c 119v! d --- ---- -- -- -- ----
APPLICATION FOR SEWER CONNECTION PERMIT
R: Gaor a
0 W N E --- -- - -
OWNER'S ADDRESS: --
STREET
__ - ----- ZIP
_
-- -- -----. -. STATE
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CITY T pT
U�Ix DANE 215 -1�AB- --- BLOCK --- --- — ADDITION -
TAX LOT NO. _._7 --- ---- TYPE OF OCC!I'AN - reaidenc®
ADDRESS 9425 SW Inez_ ---- --
DWELLING UNITS - --- _ 1 - - -___-_ FIXTURE UNITS ----- - —
SURCHARGE IF APPLICABLE — --
PL-RMIT FEE --5?5•
00_.__ INSPECTION FEE 25,00 TOTAL_ DEPOSITED -600-M -
�N wW (EX6 LNG) BUILDING SEWER SYSTEM _ F-anna-_C-riwk - - - --- ---.___
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
PPLICANT - -- --
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM,
LINE SIZE __ INSTALLER - - - - -
RECEIVED BY- ---- -.- -- --
(AGENCY OR ITS AGENTI
COMMENTS: bldg-.- 09Bfl-This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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CITY OF 9A-yr 29 Is� N� 0968
BUILDING PERMIT APPLICATION TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMiT FOR THE WORK HEREIN INDICATED OWNER PHONE #>39-83`
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. 6=J11 I
q47 e.w Ines BUILDER PHONE
QWNER ADDRESS - ----
ENGINEER DESIGNER
i��1.1,l.,t�• r��--D11ntR'• ��--11 gRCHITECT _ --^^- 1-1 — -
STRUCTURE R IJNEW l J REMODEL DADDiT10N ❑REPAIR `,RENEWAL ❑FIRE DAMAGE rr--11 []DEMOLITION
Q RESIDENCE ❑COMM ❑EDUCATIONAL _❑GOV'T ❑RELIGIOUSCIPATIO ❑CAR PUTT OGAPAGE ❑STORAGE LJSLAB ❑FENCE
aCIBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW LJCOUNCIL APPROVED
SIGNS
R..7
OCCUPANCY�..—.LAND USE ZONE BLDG.TYPE ' FIRE ZONE_ PLAN CHECK BY HEAT'
t V 2 story d8wellinl� 3 i;:erlraam 3 t�sttt
Tax ,igip 251 11AB Lot 77 6001 main bapament6 2'
t;s—issue or 565 placttsft 1—?']
v b 00 s 5 a •
HEIGHT NO.STORIES AREA VALUE
QC,,LOAD FLOOR LOAD _ 2,� 49 (
REAR LEFT SIDE RIGHT SIDE
BUILDING DEPARTMENT SET BACKS FRONT _
Permit 142,00
THIS PERMIT IS ISSUED !SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
rID ORDINANCES, ANTHE
Plan Check 0, 0 LKWILLIONS AND LL BE DONEINALACCORDAN E WITH THE P ANS AND SPECIIFIDCATIONS AND N COMPLIIANCEIT IS HEREBY AGREEDTWITH
APPLICABLE CODES A
WOR
Recording ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCI' OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State 4,b6 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By -AN T OR AGFiJ1 / ?eol
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Approved Receipt No. DRESS
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DATE INSP. TYWINSPECTION REMARKS PLUMBING DATE
Q _ FIContractor �/S�'�
6 Permit No. d! 3
(� Rough-in
JJ Fixture
�yt�l.�.rc���,�u i•�exy Final
HEATING
Contractor /
/ Permit No.
Gas or Oil
Rough-in
Final
SEWER
_ Final
DRIVEWAY 1G 9.99.7(,
Final
Storm Drainage
(Rain Drain) Final
Sidewalk L G
Curb&Street Final
_ _ TtFinal
oach _ C. Q A9 7 G
BLDG,DEPT FINAL^ TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY scaping
ng Final
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