11730 SW TIEDEMAN AVENUE 11730 SW TIEDEMAN AVENUE
v
C
N
b
N
H
•s
O
M
n
INSPECTION NOTICE
City of Tigard Building Department ;'. 30
12420 S.W. Main St.
Tigard,Oregon 97223 j
Phone: 639-4171
Type of Inspection –.&,�2LAI ;JI.-i�-�.----__. ___
(-U
Date Requested C-1 - � _ _ Time._ A.M. M.
i address I j 1. I , o w. r�` —�__-- Permit # ,L0 IiLj—�
Owner_ ` ti.kj.n.,aT r J Lot
i I 1
The following Building Code deficiencies are required to be corrected:
.� ."
--i—A2.z"e.:
Presented to —_ ._ — Approved
Inspector —�— L Disapproved
Date.
CALL FOR REINSPECTION
L J YES r] 140
as s,
SEWER PERMIT Ni? 257,►3
Unified Sewerage Agency DATE C S
of Washingion County CITY OF
OWNER : 1 �' . _ ,��'` _ _. P H 0 N EL
OWNER ' S ADDRESS
TYPE OF INSTALL.AfIONc
❑ SIDE SEWER ❑ LINE TAP .AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY:
❑ NEW t EXISTING A SINGLE FAMIL" [_] COMMERCIAL.
EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS____ — DWELLING UNITS
/, ' �'f�le' r
ADDRESS 01= STRUCTURE : �L_7 5/-) >���'��:�
Permit Conditions. The applicant agrees to compiy with all rules and regulations of the Unified SeNerage Agency,
When calling for Inspection, please refer to the Permit Number. The Application expires In one hundred twenty (120)
days. The amount paid will be forfeited shoule expiration occur.
The Agency does nat guarrintee the accuracy of the location of aide sewer laterals. If the sower Is root located at
the measurement given, it I installer shall prospect three feet In all directicris from the dislanco and depth given.
If not so located, the Installer shall purchase a 'Tap and Side Somir' Permit at the current chrrge and the Agency
will Install a lateral at the :ovation specified by the installer.
FEES c < <)
PERMIT FEE -
CONNECTION CHARGE
LINE TAP INSTALLATION d �
ISSUED BY i
OT ii R
TOTAL
APPLICANT DAT
SEWER PERMIT N« 25703
ADDRESS OF STRUCTURE
TAX MAP _ TAX LOT _ SYSTEM
LOT BLOCK OF —
—
APf OVED 'BY AT SSUED BY DATTFF
D . U . ' S _ R r:ro A F?K SLC-
2f�1
(---)f'-''" "I �