15195 SW 98TH AVENUE A A A A A A A A
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15195 SW 98TH AVENUE -
SEWER
CONNECTION
xxxx PERMIT
639-4171 PERMIT 1k. . . . . . . : SWR90-0063
PRIM. PERMIT #. : SW1.90-0063
:?ATE ISSUED: 02/09/90
SITE ADDRESS. . . : 15195 SW 9':TH AV PARCEL: 2S111CA-00400
SUBDIVISION. . . . : ALDERBROOK FARM Z014ING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :10
TENANT NAME. . . . . :
USA NO. . . . . . . . . . :39194 FIXTURE UNITS. . . :
CLASS OF WORK. . . :ADD DWELLING UNITS. . :1
TYPE or USE. . . . . :SF NO. OF BUILDINGS:
INSTALL TYPE. - . . :BJSWR IMPERV SURFACE. . : :of
Remarks: 7onnect house exieting (prior to 1970) , septic tank must be pumper; and
filled. Irsh•)ction of tank required lifter filling with gravel.
Owner: -----------------------------------
---------------- FEES --------------
PATRICIA OTTOMAN type amount by date recpt
15135 SW 98TH PRMT $ 300.00
INSP $ 35.00
TIGARD OR 97224 PAYM $ 335.00 JLH 02/07/90
Phone M:
Contractor: -----------•---------------- -
JACK BRISTOL
BRISTOL HOMES
P 0 BOX 84
WEST LINN OR 97068 ----____---.-------------------------
Phone #: 503-638-6640 $ 335.00 TOTAL
Reg #. . : 999
------- REQUIRED INSPECTIONS ---------
This Applicant agreed to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 120 days from _
the date issued. The total .mount paid will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterals. If the sewer is n-t- located at the measurement _
givan, the installer shall prospect 3 tees in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side ewer" Permit and the Agency will install a lateral. - -�
1•,:?rmittee Signatuze:
Issued By:
Call for inspection - 039-4175
sll► i>� ss +� �Ir W IWXW
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 /
Tigard, Oregon 97223
Phone. C19-4175 \
Type of Inspection
Date Requested Time____ A.M. ^ P.M.
Address — .LLQ L �' - ----- Permit
Owner _____—_—__ Lot #!
Builder —_ __The following Building Code deficiencias are required to be corrected:
Presented to -_ _ __—_—____._ Approved
Inspector �� _ Disapprovd
Date
CALL FOR REINSPECTION
❑ YEi ❑ IVO
C11YOF TIFARD
CITY OF 116 tETION COMMUNITY DEVELOPMENT DEPARTMENT OREGON13125 SW 14a11Blvd. P.O.Box23397,Tigard,Oregon 97223(DW)63"175 CO
xxxs -- PET- -- - ---. -----
639-4171 PERMIT #. . . . • . • : SWR90-0063
PRIM. PPRMIT #. : SWR93-0063
DATE ISSUED: 02/07/90
ITE ADDRESS. . . : 15195 SW 98TH AV PARCEL: ?S111CA-00400
UBDIVISION. . . . : ALDERBROOK FARM ZONING: R-7
LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :10
------------------•--------------------------------.---•----------------.--------------
tENANT NAME. . . . . :
OSA NO. . . . . . . . . . :39194 FIXTURE UNITS. . . :
GLASS OF WORK. . . :ADD DWELLING UNITS. . :1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS:
INSTALI TYPE. . . . :BUSWR IMPERV SURFACE. . : :of
Remarks: Connect existing home to sewer
Owner: ---------------------------------- ---------------- F,ES --------------
PATRICIA OTTOMAN type amount by date recpt
15195 SW 98TH PRMT $ 300.00
INSP $ 35.00
IGARD OR 972.24 PAYM $ 335.00 JLH G2/07/90 /r �•� )�
hone #:
.ontractor: ------------------------------
ACK BRISTOL
RISTOL HOMES
0 BOX 84
ST LINN OR 97068 ------------------------------------
�one #: 503-638-6640 $ 335.00 TOTAL
eg #. . : 999
------- -1EQUIRED INSPECTIONS -------
� hls App , icant agrees to comply with all the rules and regulations Sewer inspection
of the Unified Sewage Agency. The permit expires 120 days from
the date issued. The total amount paid will be forfeited if the
Oermit expires. The Agency does not guarantee the accuracy of. the
IIde sewer laterals. If the sewer is not located at the measurement
lven, the installer shall prospect 3 f6Lt in all directions from
he distance given. if not so located, the installer shall purchase
"rap and Side Sewer" Permit and the Agency will instal a lateral.
ermittee Signature:
eeued By:
Call for inspection - 639-4175
CM OF' TIGARD PECETTI OF PAYWINT PEC NOt 001072"1
I
CHEG' AMOUNT y ''n UO
NAME: BRTSTOL HOMES, CASH AMOUNT z .00
ADDRESS: PAYMEN—, DATE, 047-0*7-90
TIUARD, OR 9722-', PLG0 NO"ADDRt
15195
F-MOrl OF" PAMENT r,MOUNT PAID PURPOSE OF PA'MENT AMOUNT PAID
'-;EWER USA "00.00 SEWET INGF ECIGN 75.DO
Tf'-'TAL AMOUNT PAID 00
CIS OF TIG A RD
RUILDINC wilmI'T
C, PE:WMI'T No.
COMMUNITY DEVELOPMENT DEPARTMENT OREGON
131?SSW Hall Blvd..P.O.Box 13397.Tigard,Oregon 97223,(503)6394175 -Am DATE: ISSIM:W: 7/10/89
CITY OF TIC
P A 1 M P M, 4*79
J()B ADDRESS : 1519.5 SW 9811-4 AVF-_
'TAX MAP/L-(:)*r 2 L5111.(,Ad.'10 0 SUB LT' : BK :
I AN.) IJ".-iE:: 1�,q.5
1»-07, SIZE: : SETBACKS
FAONT : REAP
WOPK (CLASS : DEMOLI'VION DWEL.L . (JN:L'rS : 1_F:F-T: A I Gpt I'T'
IJSI:—:' *TYPE: ACCIESSORY Bl-.D,*,. NO. EIEMPOOMI:l : EX'T .WALL CONST :
GONST . 'rypu:, - NO. HIA'THS : N: S : r--. : W
OCIL.11P .CIR. P. : M1 PPO'T .(317FEWINUS :
tJl--' .LOAD N S K W
'rLYTAL APE'A:
NO. STOPIES : 1. 154' : ROOF CONST: FJF4E PEA�
HEAC44,T : 2ND : AIP&A SE:PAW? RA'TE.D :
3PD: OCC UP- SF:PAR?
MI*_.ZZANINE:7 k3ASE:.ri "T
PLOUN LOAD: U A P A(.',F'. SPRIKI—R7 AL.APM?
Fl OW((IPM) WTUk"I"?
WEAL—iYPE
PLAN BY :
,'!:--MAPKS :
DI;:.M(A ISH DAM 114F.'ISSLIF.: OF NO.
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R I NO , ln9 'TUTAI 11111:11-5 75
This permit is issued subject to the regulations contained In Title 14 PIECEIPI' NO .
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances• and it is hereby 1141EQUI1TEM
agreed that the work will be done in accordance with the plans and F I NAI
specifications and In compliance with all applicable codes and
ordinances The issuance of this permit does not wAlvo restrictive
covenants Contractor and Subcontractors shall have cut-rent city
business tax permits This permit will expire and become null and
void if work Is riot started within 180 days,or If work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all r fired inspections are requested and approved
r it inspections
Permitt ignatu
-r
issued By
SEPARATE PERMITS REWIRED FOR WORK OTHER THAN DESCRIBED ABOVE
SEWER PERMIT
UfUnfied E&werage Agency
CITY TY OF
of Washington County _ — DATE
O W N E RPHONE :
OWNER' S ADDRESS: �47 rA('
TYPE OF INSTALLATION:
❑ BUILDING SEWER ❑ LINE TAP AND BUILDING SEWER, ❑ LINE TAP
TYPE G.= OCCUPANCY :
❑ NEW /EXISTING SINGLE FAMILY ❑ COMMERCIAL
❑ '14ULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS DWrLLING UNITS
ADDRESS OF STRUCTURE :
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified
Sewerage Agency. When calling far an inspection, please refer to the Permit Number. The Permit
expires one hundred twenty (120) days from the date of ;ssuarce. The total amount paid (permit
fee, connection charge, line tap fee --.1r,, 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 locatcJ at the measurement gi,,, the installer shall. prospect three feet in all directions
from the distance given. if r.ct so located, the installer ;.;hall purchase r "Tap and Side Sewer"
Permit at the current charge and the Agency will install a lateral.
FFE3:
PERMIT 1-EE
CONNECTION CHARGE
LINE TAP INSTALLATION
ISSUED BY
OTHER
TOTAL —
DATE OF ISSUANCE
APPLICANT DATE OF EXPIRATION
SEINER PERMIT
ADDRESS OF STRUCTURE
TAX MAP -i i, TAXLOT QUARTER
-- -- - SECTION
LOT _ BLOCK OF
f-PPROVEO BY DATE ISSUED BY DATE OF ISSUANCE
D . U. ' S REMARKS
CITY OF TIFA / U 9C)
C"YOFTWARD PLAN CHECK APPLICATION
COMo�AUNiTY UEVLt.OPMEi1T DEPAIITMEN � � PLAN CHECK N
131n5w.1f,acvK1.P.0-ua.z�vr.r:g,ad.o .ern.( �n)Gl9�ors --
PFRMIT 11
DpTi_ ISSUED �-
JOB ADDRESS: % ` /y' '� t - Gf[f TAX MAP/SOT ='.ti///C (( D/Me)
SUB. l-09 : LAND SSC:
- VAl_l1A l"ION: _ -�- _- ----�-
OWNEk - SPECIAL NOTES
NAME: l(_�L_t C%�? ��- r. hEISSUE OF: - _ -
A['ORCSS: LAST REISSUE: ---- - ---
_ 4_000 PLAIN/
SE.NSIIIVE LAND:
PHONE: ---------------
APPROVALS RE UUIRED
CONTRACTOR_ PLANNING:
NAME: ENGINEERING: -
ADDRESS: �' FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
BUILDERS BOARD N: EXP DATE: LIST/SUBCONTRACTORS:
---- -- ----- BUS TAX:
ARCH/CN_GINEERCALCULATIONS:
NAME: _ TRUSS DETAILS:
ADDRESS: OTHER: - ------_.--
PHONE: -^------- .
C:OMtIENTS
SUBCONTRACTORS: PLUMB': , MEC[I
PERMIT H ACCT N DESCRIPTION AMOUNT AMOUNT PD. BA[ . Dkjt.
10--432 00 Buf.ldiny Permit Fees - —
10-431 00 Plumbing Permit Fees
10--431 01 Mechanical Permit Fees
1.0-230 01 State Building Tax (5X)
Fluildirx3 - --- - -�
Plumbing
Mech
10-433 00 Plans Check Fee -Building
Plumbing
Mech
30-202 00 Sewer Connection
30--444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC)
52-449 00 Parks System Dev Charge (PDC) -
31-450 00 Storm Drainage Syst Dev Chrg (SSDC) - -
10-2.30 OG [ ire 10 VAL
REC b
ArPilcnrui rGnnT-%! I-- ---- - ------�--- ---�_._--_-_
Received By • ';k_--_.._.___.... Date Received: --
cri/3587P/18P i
J; ZADING/EROSION CO DIM, 1_ HON
GENERi,i,CONTRACTOR NAME&ADDRESS: CASEfILE NO.:
PERMIT•NO.:
APPLICANTNAME AND ADDRESS:
EXCAVATION CONTRACTOR
NAME& ADDRESS: — -- _
OWNER NAME AND ADDRESS:
TELEPHONE 141JMBI-RS: —
APPLICANT: PROPER'T'Y DESCRIPTION:
OWNNER�_ STREET ADDRESS AIJD CROSS STREETILOC:ATED
r;F^qRAL C'OMIRACTOR: _
EXCAVATION CONTRACTOR: _
SIIV)OB_ — —
LEGAL DESCRIPTION:
24 HR/AFTER HOURS EMERGENCY TAX LOT NO.:
CONTACT PERSON,TITLE,TELEPHONE: 1/4 SECTION_
—_ SITE SIZE,ACRES:_ _
DISTURBED/WORK AREA,ACRES:
LOCATION&ADDRESS WHERE SPOILS
LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAINS TO:(CIRCLE ONE)
(NOTE:PERMITS MAY BE RFQUTRED) CATCH-BASIN DITCH PIPE CREEK
(CIRCLEONE) PRIVATEPROPERTY
PUBLIC RIGHT OF WAY
EROSION/SL'DIMrNTATION CONTROL (ESl MEASiIRI?S
MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS
DURING CONSTRUCTION: FOLLOWING CONSTRUCTION:
SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE
STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE ; 'PORARY ES''
PERIMETER RUNOFF COPlTROL, FACILITIES
CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS
COVER PRACTICES ENSURE OFEI.ATION OF PERMANT FACILITIES
CONSTRUCI'ION SEQUENCE OTHER
OTHER �_�� .--• —`
PIAN FOR EROSION CONTROL PREPARED AND SUBMITTED M ACCORDANCE Willa TECHNICAL.GUIDANCE HANDBOOK'.
EROSION CONTROL PLAN DRAWING,AS REQUIRED,HAS PLAN CONSTRUCTION NOTES COMPLETE,INCLUDING FMER(;ENCY
PHONE.NUMBER, SCIIEDULRISTAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES,AND
APPLICABLE STANDARD NOTES.
1 llt%VI?READ AND WILL COMPLY WITH THE ABOVE AND W 1.CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY
TO CONTAIN SEDIMENT ON TIIE CONSTRUCTION SITE.
OWNER SIGNATURE � APPLICANT SIGNATURE
0M- CIAL USE ONLY.
RECEI['T DATI: ACCEPTED
FEE NUMBER RECEIVED BY