14270 SW 97TH AVENUE-1 14270 SW 97TH AVENUE
INSPECTION NOTICE UCS' r`If �?43 �I
City of Tigaid Building Department
1242.0 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection=S �`—
.r
Time. A.M.. P.M.
Date Requested�=�— -
C-f _ _
Address I Permit
[1 --f`-- � -
7 Lot # _ -
Owner --— ---
Builder -- W---
The following Building Code deficiencies are
req re to be co ed:
/--^�•yf•..rte'.. � �-�'_•�-� �
y '?ate a. .•-,,.����-� -- `
_o
w
oresentad to T. Approved
Inspector ///U Disapproved
Date
CALL. FOR REINSPE-GMN
YES ( L*NO:.�
Uf4 SEWER PERMIT LN '.' 2s4Y
Unified Sewerage Agency 1 IGARD Oct. 14 , 19b_
of Washington County CITY OF � DATF
OWNER : —A.__,Iohn .1. & I,Pnnra Loill, _ _ PHONE , 639-1606
OWNER ' S ADDRESS : 14 CI SW �)7t11 Tigard. Orem?97223
TYPE OF INSTALLATION:
❑ SIDE SEWER ❑ LINE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY: a, /M"AI'�e f)%)MP S 4A r''�^r^+ opt R .
❑ NEW ❑ EXISTING ❑ SINGLE FAMILY ❑ COMMFRCIAL
® EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS one
ADDRESS OF STRUCTURE : Same as above _
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
Men calling for Inspection, please refer to the Permit Number. The Application expires in one hundred twenty (120)
days. Tile amount paid will be forfeited should expiration occur.
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 feat In all directions from the distance and depth given.
If not so located, the Installer shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will install a lateral at the location specified by the Installer.
FEES:
PERMIT FEE x 35.00
CONNECTION CHARGE _ 30(J.00 _
LINE TAP INSTALLATION dmf
ISSUED BY
OTHER pump Sta/Pressureline 3712.81
Surcharge
TOTAL E 705 81
LD
APPI_ CANT DATE
NOTICE:f`� GAYS FROM THE
ti[t i11C,SEVIER SERVICE
l':i>r.BEGINFOR If315PERMIT.
t SEWER PERMIT IN'' 2644
ADDRESS OF STRUCTURE 14270 S.W. 97th
TAX MAP —i 2S I I IBA�r t TAX LOT 120(? SYSTEM Fanno Creek System
(SW McDonald
LO1 -.ii I..nC K OF
FC _ 10/14/83 dmj 10/ 14/33
APPROVED HY DATE ISSUED 8Y EIATI
r
D . U. Is one KNARKS Misr 4" jlipe required. 811ima iluxSXX
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