11615 SW TERRACE TRAILS DRIVE F
11615 SW TERRACE TRAILS DRIVE
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ADDRESS PERMIT N 0.___.,/C7 C• ; �� _�_�.__.�.;
PERMIT CHARGE ncone
OItNER CONNECTION FEE
��— PAID BY
TYPE OF BUILDING _ s ` C:d,_._.� DATE CONNECTED
SERVICE RATE ���' _ I►JSPECTION FEE �? S �
CONTRACTOR _� PAID BY __.___------ D A T E
SIZE OF CONNECTION - _ ASSESSMENT _ PAID
3 3
I S 7 7
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�%k ' CITY OF TIGARID Cy ;► >� !
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Owner.......
Ed Gause _ .............. ...... .._ .Permit N��. 1023
11615 5W Terrace Trails
BuildingAddress......................................................... ............. . .........
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Certificate is hereby given this........ .......da of.-..P...-..... .. . •14. 7? '
that said building may be occupied and ("
that it complies with all requirements of
tI the Building Code for the City of Tigard, �E
as approved by the Tigard City Council. y
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Building inspector
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City of Tigard
INSPECTION REQUEST
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INSPECTION TIME '_ PERMIT NO.: --
DATE:
O.: _.DATE: "0'0121 2�- DATE ISSUED:__L�
OWNS nS NAME : 6'W..
ADDRESS : ✓/ �� 7..rrpc 4'7'"� !�CONTRACTOR :...
TEST . Air ❑, Water ❑ , ✓isual d', Laboratory ❑
RESULT', Approved I� , Disapproved 0 , Pending [j
SKETCH:
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INSPECTOR DATE
cNOTE . Aftach supplemental toot data heret]
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City of Tigard
INSPECTION RFQU FS T
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INSPECTION TIME: _ PERMIT 14U. :
DATE: '._ DATE ISSUED '
OWNERS NAME --
ADDRESS: 61 5
CONTRACTOR .-
rEST : Air p, Woter❑�11
alD , Laboratory p
RESULT: Approved Disapproved C Pending p
SKETCH:
/4-SPtCTOR DATE
L6rE: Attach supplemental fest data beret
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BUILDING PERMIT APPLICATION C Y TiGAR® DATE�YgY t_26 19__'I(,;._ 123
:�39-61f 55
THE UNDERSIGNED HEREBY APPLIES FGA APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
i 7 LOT NO,
',NNER d GQNau moist JOB ADDRESSIlt'l!,' 5W T« -rece Tra*116AE ADDRESS
— ARCHITECT
batme ENGINEER
BUILDER —_�ADDRESS —__ r-1 DESIGNER —�
!¢3T((RUCTURE LJNEW ❑ ❑
REMODEL ❑ADDITION REPAIR EIRENEWAL ❑FIRE DAMAGE_ ❑DEMOLITION
lJti�• '. DENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS I_JPAT10 ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
UBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROJED ❑GIGNS
OCI;UPANCY I LAND USE ZONE R_7_BLDG,TYPE-_` FIRE ZONE 3 PLAN CHECK BY— CTU HEAT "a
CurIr3L. 2 stoxy dwelling/ w/y®rswe 3 bedroom 3 beth
e� s mss°°
QCT LOAD FLOOR LOAD HEIGHT �NO,$rQB.�$ _ EA 30260. 3 VALUE42��t�d_•
BUILDING DEPA^TMENT SET BACKS FRONTW L� REAR LEFT SIDE RIGHT SIDE
Permit 161,60
THIS PERMIT IS ISSUED SUBJECT TO 7I4E REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check _ 40.00 REGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREFO THAT THE
WORK WILL BE DONE IN ACCORDAP•;r;E WITH THE PLANS ONO SPFCIFICATIONS AND IN COMPLIANCE WITH
riUlJ-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- - RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State.TAX LICENSE. SEPARATE PERMITS RFOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 209,09
BY
- __--_ nPPi "-4%NT OR AGENT - - __- ----------__...
Approved iJ Receipt No
waQQ� 7 76
S��w� �- �"°�"' ��►3�7� ray
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UNIFIED SEWERAGE AGENCY NO.
WASHINGTON COUNTY DATE 26. 1976 _
CITY OF__ Ticard
APPLICATION F=OR SEWER CONNECTION PERMIT
OWNER: ---=_____-__ Ed Cause
OWNER'S ADDRESS: --- ----- -- -- - - - - ------ -
STREET
CITY STATE ZIP
BUILDING SITE: I.OT BLOCK . _._.-__- ADDITION
TAX LOT NO. _—_. ____.____ -_ TYPE OF OCCUPANCY __.Residence__
ADDRESS __ 11615 SW Terrace Trails
DWELLING UNITS 1 FIXTURE UNITS
SURCHARGL IF APPL_ICABLE.�-_____ 50. 00 Derby Dell
PERMIT FEE -__55.00 __ INSPECTION FEE __25 00 TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYSTEM _. FannQ_-..Cze_ek_—._.__
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
L I`
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYS tEM.
LINE: SIZE --------- INSTALLER
RECEIVED BY
--
(AGENCY OR ITS NT)
COMMENTS: Bldg.. wL 1023
This Application and permit expires in one hundred and twenty (120) days.
The amount paid ,will be forfeited should expiration orcur.
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