10865 SW PATHFINDER WAY cd
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O �I Y OF TIGIAR:I�
OREGON
j' % , O��mei. Geer a Neusserm01 +�
• .............................................................Perit No...........: ...
Building Address......�G965 S.W. Pathfinder Way
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24th October
Certificate is hereby given this................day of....-..........................., 19..........
that said building may be occupied and
a that it complies with all requirements of ;.
the B, limn, Code for the City of Tigard,
as approved by the Tigard City Council.
`O ir0"I Building Inspector „f
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIS /:,.._,(� � PER"AiT Nn. '
DATE: DATE ;SSJED:�
OWNERS NAME :
ADDRESS :
%v ,•,�'�
DaN T RA;TOR
TEST. Air C , Water 0 , Visual L, , :..aborato•y C
RESULT: t sap roved C Pe,Jing 3
S f,ETCM:
f
I, S ECTOR DATE
[OTE: Attach srpplemental toe' dare here,
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : L_LP_ _ PERMIT NO. : -.- --. .
DATE: J-12117,2L DATE ISSIJED._....:'_
OWNERS NAME : ��.__ -ZTT
ADDRESS : 6; Oz
CONTRACTOR :_!L - `�� ---- -- -
IKI
TEST' Air Cl, Water E, , Visual „ Laborator
I RESULT: ApprovedX, Disapproved D Pending (_;
SKETCH.
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INSPECTOR OATE
IOTE Attach eupplementu' telt 400 hmrr13
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ADDRESS
pel- PERMIT N 0. --
PERMIT CHARGE none
CONNECTION FEE
OWNER
_ --- P A I D B Y _
TYPE OF BUILDING
DATE CONNECTED
SERVICE RATE `, INSPECTIONS FEE _
PAIL) BY DAT
C U N T R,1 C T 0 R "N :�:-�.�:=5, '•spa`
11 ASSESSMEN1 PAID _ --_.--
SIZE OF CONNECTION ------�'�'
UNIFIED SEWERAGE AGFNi.'Y NO. -- 5052
WASHINGTON COUNTY DA !F _ ___--3—/0-75__---
CITY O F---- -- - -- ----
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: - __ George Heusser 649-4584
OWNER'S ADDRESS: 2590 S.I.J. 198th _ _ _^
STREET
- -A JUN k A l nh 3 - ---- --------D req an�-- -- _
CITY STATE ZIP
BUILDING SITE: LOTS- RXXX--. BLOCK ____ _ ADDITION _--Pathi'inder
TAX i_OT NO. . ____ TYPE OF OCCUPANCY __ r-esidenrm
ADDRESS 10B-6r,- 1-.--1-1.---Pathfinder--1Jay
DWELLING UNITS-- -- - 1 __ - --- _ FIXI URE UNITS —_ -- --- _ --
SURCHARGE IF APPLICABLE -__- 50 to [ferry Dell
PERMIT FEE 525 - -- INSPECTION FEE 25 TOIAL DEPOSITED -- 550 _ .—
(NEW) (EXISTING) BUH-DING SEWER SYSTEM __ ___ _ _F ►r�u___ -sBk—
T!�e Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT
SEU1'E ;"; PERMIT
THIS PERMIT AUTHORG-ES CONNECTI('.� TO THE SEWER SYSTEM.
LINE SIZE ----___ 4'; _ INSTALLER
RECEIVED i§Y_ ITC�-crcT)
COMViENTS: . op a
This AF plication and permit expires i , ninety (90) days. The amount paid will be forfeited
shiuld exp4ation occur.
..,..... ,+. .,:..,..:.,...,:-..:p-.o.4n....,-a�,.ww. yK,,,.gMye,•M9:.�lw.W.:.«..o... ..u..,,..n.,....o'M.'.�,..,vW,.w w.. ... 'SA►,!!iw )1QN f[n!Yd'R 'CAg11n'1iwr+e�wOrL. .►•v .-w._. i«» ..,.,,.. ».«.y a. a+.....
CITY OF
BUILDING PERMIT APPLICATION TIC ARD DATE _�"7_ N°
THE UNDERSIGNED HEREBY APPLIES FOR APE RMiT FOR THE WORK HEREIN INDICAT•_D
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATION+. OWNER f HONE
OWNER Nrmla�Alrr ADURESS liItSi�1.' "•'-'• - �P .ttl4't•: dUILDERPHONE
ENGINEER
BUIL[Eli ARCHITECT _ DESIGNER
STRUCTUR: KNEW 2�.EMODEL ❑ADDITION _ ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
ORESIDENLE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RE1..IGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
_❑BOND ❑MOV ING; ❑CONDITIONAL USE ❑DESIGN RCVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND I1SE 20IvE-BLDG.TYPE r!HE ZONE___ PLAN CHECK BY_ HEAT____�r1____
construct, I44A Wq• ft* split entry frame dwelling —
with getege 1r. basement acc•ard.i;ng to eaprcved pie(%$.40
OCC. LOAD4 ,.FLOOR LOAD 1b HEIGHT _ NO,STORIES 1 AREA x794 `'014111�tUE .1a 0 ouo
BUILDING DEI ARTMENT ,
SET BACKS FRONT REAR 4C1, LEFT SIDE r� RIGHT SIDE
Permit 1.-1,d•[30 --
THIS PERMIT IS ISSUED SUBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 76•aU REGULATIONS AND AL1. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE. WIFH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICA91-F CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT Dr..ES N01 WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURREAT CITY BUSINESS
1%State 3.57 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 229*�,2
By
---- APPLICANT OR AGENT
-- -
Approved Receipt No.
XMFES5 -- PH0 V�
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
,. Rough-in
v _ Fixture _
[. J.G 4•�� : ! < Final --
4 r HEATING
I _
Contractor JA'-';, _
soy �' G Permit No.JOS► ?ay
-7 Gas or Oil _
Rough-in
Finai
SEWER
Final --
sR7 �� �. DRIVEWAY -
9"75 Vt� __ Final
Storm Oraina a
(Rain Drain) Final
j Sidewalk
Curb&Street Final
_
Approach
SLOG.DEPT,FI>AL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final -
5' y Landscaping
Zoning Final
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