11880 SW 113TH PLACE 118F'.O SW 113TH ?LACE
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CITY OF TIOARD C},
•� :. OREGON
Owner:.........H.e.r.b...M.o.rIAP—Ptte.................................Permit No.. 1172
113th P1 `
Building Address.....I. Q80 I.......... W 5........................ .......................................................
Certificate is hereby given June
........day of................................. 19..... .. ,,
that said building may be occupied and
that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
...................._
Building Inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: Lti'/� PERMIT NO. :-
DATE:
O. :DATE: Z /A9177 DATE ISSUED :._._.1_L--
OWNERS NAME :-- u o —
ADDRESS:
CONTRACTOR :
TEST : Air ❑, Water❑ , visual 0 , Laboratory O
9USULT: Approved Disapproved Pending ❑
SKETCH:
INSPECTOR DATE
COTE: Attoch $WlOms"tol test data bereta] I
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City of Tigard
IfVSPECTION REQUEST
I for
INSPECTION TIME : " I PERMIT NO. :
DATE:< < DATE ISSUED.
OWNERS NAME . �'tc .!/S,5 , (-
ADDRESS : 3 `- �C - - --
ICONTRACTOR : 5- ��= • ___
TEST: Air ❑, coater ❑ , VisuclI , Laboratory ❑
RESULT. Approved)i , Disapproved ❑ , Pending !J
I SKETCH:
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I INSPECTOR _ DATE
COTE Attach supplemental toot data hereto
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City of Tigard
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INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
DATE: ._.__1=.iL__ DATE ISSUED'.
OWNERS NAME .
I ADDRESS :
CONTRACTOR : --- ------- ---
ITEST. Ai► I_l, Water (1-,--Visual Cl , Laboratory ❑
RESULT. Approved , Disapproved ❑ , Pending J
SKETCH:
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INSPECTOR DATE
r44 TF A t I a r h supplemental test doto horst
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UNIFIED SEWERAGE AGS NCY NO. __-_ 11002 -WASHINGTON COUNTY DATE 11-22-76 ----- __—
CITY OF___Tigard
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: -_Herb P1orissette —_____ ___ - -
OWNER'S ADDRESS: - - -- ----_ —._ ----------
- STREET
CITY STATE
- -- -
BUILDING SITE: LOT___ 1'' _ BLOCK ADDITION
TAX LOT N0. .______ -_-_-. TYPE OF OCCUPANCY _ __ ___ r' sidenre �y
ADDRESS h-,P 1. _ --- -- ------
D W E L L I N G UNITS FIXTURE UNITS ---..-- --
SURCHARGE IF APPLICABLE_____________.__:__ -.-.__
PERM T FEE 575. 00 _ _ _ INSPECTION FEE ?5..00 TOTAL DEPOSI TED 600 �0-- ---
(NEW) (EXISTING) BUILDING SEWER SYSTEM . F'3nno CrF r;k
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT ` < �j i l_ ,.. , .t_
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE f INSTALLER
RECEIVED BY. ,4, '1 -
IIAGENCY OR ITS ff5ENTI
COMMENTS: ��rj'�• 1.177. -15n. r30 Laron [jeights
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will he forfeited should expiration occur.
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BUILDING PERMIT APPLICATION C1TYOF TIGARD DATE 11-22-76 1172
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED SUILDERPHONE 246"8803
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHON97
LOT NO.
OWNER tri eset't e JOB ADDRESS SU 113th P.f HOME ADDRESS
ARCHITECT
BUILDERENGINEER
} ADDRESS DESIGNER �L• Tslish
STRUCTURE GNEW ❑REMODEL [I ADDITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
U RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS[]PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑POND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_.L__LAND USE ZONE F<-i BLDG. TYPE Ll FIRE ZONE. _ PLAN CHECK BY—x"11-' _i_ HEAT__„
uanyt eift la family du elliri(j a/attachtw gars n j� p;!i >sha,,w ; _.! i;,.> ; .3
bedrrom Z bath car.ogG 46 3 taq, ft. sheets 1-2-3
OCC.LOAD FLOO LOAD (t_� HEIGHT `? _Ns?_6TQfl1F.;i. . AREA NO.BEDROOMS 3 VALUE 31 E Ntl„
BUILDING DEPARTMENT SET BACKS FRONT " REAR LEFT SIDE RIGHT SIDE 16
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check 66 1w;0 REGULATIONS AND ALL APPLICABLE COC,ES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
-'- WORK WILL BE DONE IN ACCORDANCE WIYH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINlWCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTGR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 97 LICENSE. SEPARATE PERMITS REOUIrED FOR SEWER, PLUMBING AND HEATING.
Total A 2M, 47
BY
APPLICANT OR AGENT
Approved Receipt No.
ADDRESS - ------._-._ ON— -- -
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
11-�' Fixture _
Final_
/- �- HEATING
Contractor
qvr� Permit No.
VN"� Gas or Oil '
Rough-in
Final
- -- - -- a_ SEWER
Final
DRIVEWAY
Final
_ Storm Diainage
(Rain Dlain) Final
Sidewalk LC
Curb&Street Final
Approach
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
l Zoning Final �'
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Mpw Installation 121*epinre ❑ Reloeat!on ❑ Addition ❑ Alteration ❑ --
TOTAL
CONTRACTOR OWNED Herb 'Marti �:t�ty:_____.�� _.
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WORK ADDRESS .11-I t-
761 - 1070
-761 - 1070 Port 1lima , nt! 11723(AI'PLICANT Laurer Mol_111t__
Hem input ^nting UITU Per !-:nur1 1511 UvwDEU Vent Sip.n s r flue "iie 4 __.._.
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^� Address ,//X�10 �,�J//3 C!�L1 Permit No.
Permit charge 22
Owner ,�_s_�_11►� ;z�n t/� Connection fee �'SJ
Paid by /fi"
Type of building 2 .0 Date connected
Service rate T-- Inspection fee ,
Contractor `1 Paid by date
Size of connection Assessment Paid