8175 SW DURHAM ROAD 1
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8175 SW DURHAM ROAD
r INSPECTION NOTICE
Ia2 L4--a l.c-) t j.o t~ �,e City of Tigard Building Department
J P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
1
Type of Inspection
Date Requested—9i(2'�rl2— Time _ A.M. P.M.
Aouress _APermit #
Owner — _ Lot #
i
Builder
The fuliowing Building Code deficiencies are required to be corrected:
Presented to _ _ Approved
Inspector
Disannroved
Date -4z2--%
CALL FOR REINSPECTION
❑ YES 0 No
SEWER PERMIT
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345`
Unified Sewerage AQertr —
of Washington County CITY SOF T1 gard DATESEpt,�'A 1987
OWNER,
OWNER' S ADDRESS, p,p_ , g 71ia1 �� pR 97fIF�
TYPE OF INSTALLATION, W~
® BUILDING SEWER ❑ LINE TAP AND BUILDING SEWER ❑ LINE TAP
TYPE OF OCCUPANCY,
❑ NEW ® EXISTING ❑ SINGLE FAMILY ❑ COMMERCIAL
❑ MILT . RES . ❑ INDUSTRIAL
FIXTURE UNITS ___ DWELLING UNIT; I.
ADD^ESS OF STRUCTURE , _ 8175 S.W. Durhaln Ra_ _
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified
Sewerage Agency. When calling for an Inspection, please refer to the Permit Number. The Permit
expires one hundred twenty (120) days from the date of issuance. The total amount paid (permit
fee. connection charge, line tap fee and/or other charge) will be forfeited if the permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. If the sewer
is not located at the measurement given, the installer shall prospect three feet in all directions
from the distance given. if not so located, the installer shall pur-hase a "Tap and Side Sewer"
Permit at the current charge and the Agency will install a lateral.
FEES:
PERMIT FEE
CONNECTION CHARGE 300.00
LINE TAP INSTALLATION
OTHER ISSUED 8y
TOTA 335.00
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DATA OF I S�UkNCj'
APPLICANT DATE OF EXt—PI RA1fON
SEWER PERMIT
ADDRESS OF STRUCTURE _8175 S.W �rham Rd
TAS MnF �l l�Cr - TAX LOTQUARTER
SECTION i� __.._.._...,..
LOT BLOCK OF -
DATEISSUEDUED BY
DAT OF
D . u . ' ; 1 REMARKS _ Min 9" Sewer septic tank must Ix, I.xui4<rl
with sane] or gravel . -`��