12665 SW 136TH COURT ADDRESS.
12(05 SW 13(ip (zl f
c
V)
r
J _
c 1:lrecords\micro(ImVargclsV)uildirig.doc
w
J
;
)
\ \ k § k k 0) C) &
m 4 4 4 + 4 - -
2m
£ \ \ ( § ( § (
I §
0
}k
�
�
C) § { ƒ
LAI
X £
0 <
§
Cl) ®
10 /
9 .
Cio M /
V CL
� 2 = § § �
�
@
In o to
§ \§
�
/
m a
2
/ k t / CL` m o a
C2 C 2 k
R \ \ C) o \ R a
* § _ ° C e ) § a
U') s \ k l'-
V) m V) m m m m
SEWER CONNECTION
T T V
CITY OF TIGARD PE:Rtv1IT #.. . .1.. . : SWR95-0143
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED; 04/06/95
13125 SW Hall Blvd.Tigard,Orapon 97223.8199 (503)639-4171
PARCEL: 2S 104BD-0121600
SI'lL i�i;DRE3S. . . . 12665 SW 1, GT14 CT
SUBDIVISION. . . . : OBRS HEIGHTS ZDNING: R--7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . .
TENANT NAME. . . . . ..EVAN E. WHITAI-1,ER
USA NO. . . . . . . . . . . FIXTURE UNITS. , . .
CLASS OF WORT'.. . . :NEW DWELL I NG UN I TS. . :
YP'E. OF USE. . . . :OF NO. OF BUILD 1 NGS: 1
NSTALL TYPE. . . . :I_TP IK'ERV '-,URr-ACE:. . : .; s F
emarks : Connect to sewer later-al. No SOF' neecled as right of wciy work done
i-l-evio!Isly.
FEES
:::VAN WHITAKNER tYpe amol-int by ciate r^ecru*
12665 SW 136TH COURT PRMT 4 2-=00. 00 JDA 04/05/95 95 263795
I IJ Sr' 35. 0111 JDA 04/06/95 _.-
TIGARD OR 972 '
Phone #:
Conti-act or^: - - _...__.._... .....__.._._....__.__....__.._.__...... __--_--___._.__
MII_I_ER & SONS
.r 5 Box 62
;HERWOOD OR 97140
2`u5. 01Zr TOTAL
e- #. . . 03644
----- -- REQUIRED INSPECTIONS _._........._.._._.
'his Applicant agrees to comply with all the rules , regulations Sewer, In ss Pect i on
:f the Unified Sewage Agency. The permit expire, 180 days frcm Seprt is Tank Fill
tie date issued. The total amount paid will be forfeited if the
?rsit expires, The Agency does not guarantee the accuracy of the
-zde saver laterals. If the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
�,e distance given. If not so located, the installer shall purchase
"Tap and Side Sewer" Permit and the Agency will install a lateral.
e r•m i t t e e S i ;n,-i t -1 r-e
fly :
Call for inspection - 639-4175
n.
cc
r•-
Ln
J
CO
W
J
A - ACTIVE
ScA c ?ate SCUI&e
WALTER LAWSON
11055 Z W. Clay • Sherwood, OR 97140
Phone 682-0133
Da
Service ford Pa-A�
-� -
Address -- —
City -r` '0,=3 - Kor3e
In i � VislsFor� ntng Se is Tk —
For/��r
l'e i g ain Line � 26 a
� - �f I a
iii
F�3�C ea ruse Trap/26 i-
For Extra Labor J
a
Ce
f-
-� TbAVy r o O
i
W Amount Paid _ -—___— Balance Due �—
J
Due Date
Signature — - ---- --- - -- - --
Please make check out to present driver
Three percent per month interest charged on bills if not pad in 30 days
Not responsible for septic tank, drain field curbing or driveway damage
l,:
a Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 /
Jobsite Address:
Subdivision: Lot# Office Use Only
Contact Date ! ! Initials
Valuation: Result
Planck/Rec #
New Construction Only: (Square Footage) Permit #
House: _ Garage: Reissue of
Map & TL #
Zone
Corner Lot? Y (N� Flag Lot? Y N Plat #
Owner:
D t Lc'rjL Approvals Required
}=�,tc,,,, �(.
�� Planning Setbacks Solar
Address: l G G.�._�tu. /.1(� 14, Planning
Other
Items R.eguired
Phone: �a� Q- 3 --��r-�.Z
Subcontra:.tors _
Contractor: ,&q- �i�y� �i - [�, Truss Details
Address: �� ',G�. 1�9.t.����7.-x I��, Other _
Notes - - - —
Phone: 5 i L --
)
Contractor's License # &k -- 'I 7 —
�(attach copy of current Orego 1�)
Contact Name: j 1p,, V 1C.. -)14 LO�cv
Contact Phone. (____ ) ) 4,, ,�fi-, /•,5(a e2
Subcontractors, Arch itect/Engineer:
N Plumbing: _ Cunc't. �f� g 42
_ Address: _
ti Mechanical: 0 ; �1
(atta^h copy of current OR Contractor's License)
r Phone:
�
JOB DESCRIPTION:
Applica t°Signature Applicant Phone number
Received by _ /LC,Z t__ Date Received:
pormit # Account Deszription Amount Amt. Pd. Bal. Due -
F
Bldg. Permit (BUILD) _
Plumb. Permit (PLUMB)
Mech. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA) DO
Sewer Inspection (SWIP:SP)
Parks Dev Charge (PKSDC) -_
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT) _
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAL)LL
Water Quantity (WQUANT)
Fire Life Safety (FLS)
F-
_,
Erosion Cntrl Permit (ERPRMT)
w Erosion Planck/USA (ERPLAN) _A�^
J
Erosion Planck/COT (EROSN)
TOTALS:
c�
rri
rn
D j n
Nrn
I � I of•�' ''�'�, `� '�� I I `
co
I-• I I �I
�
f
I�! � I
I � r I �L
ml I p`, I ,7
I I n ! rri'
3: I I + U) _ -
i -
v
f N
00 (U II ♦
co
giOD
'
' j I � � �• i l I I I� �
I j I I;P I 1
}--
I 51 zs' — ?' o,
•i
1I,,
----------
.1
--
E� T. ANIT Y �
g Amo ti M