11920 SW 113TH PLACE i
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C1 1 Y OF 1 IGARD
Code Enforcement Action RequesL
Complainant: 7-1
Address:
enone No. : -----
Date Receivedt�E
Complaint:
9usiness Tax Open Storage of iwP*-Q �
aMti
Noxious Vegatation
Noise ���
Hazard Dog (Animal)
Sign 1 Filling (Sensitive Lands)
----, -•-- Other _-
5i?y �Y
Explanation:
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Location:
Tax Map: Tax Lot:
Action: v
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Cod Officer: _
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Address 01 / Permit No.
Permit charge 22 p?2 e_
Owner �j j� 9f Connection fee 5 j�
Paid by
Type of building � � _ Date connected
Service rate �S Insiection fee
Contrector - Paid by date _
Size of connection Assessment Paid
Y-11 -77 ' F -7 7c -3U
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� ' \ x.11 Y OF TIGARD
f OREGON
'i Owner:...H-erb Mor_issette ....Permit No....... . 1174 ... �.�
BuildingAddress.......11920 SW..,113th..•Plac9.......... ... ........ . . '
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Certificate is hereby given this......1........day of APri.1. . . .......... 1: 7.7....
`; UI that Said building may be occupied and
that it complies with all requirements of � W
the Building Code for the City of Tigard,
I as approved by the Tigard City Council. n
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Q'./.1.wr.....!��,�.1•..4..7 t-...........................
$uildinR inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME . '�' {' PERMIT NO. :
DATE: /2y/77 DATE ISSUED: / L
OWNERS NAME :
ADDRESS :
CONTRACTOR :-....
TEST' Air 0, Water [3 , Visual, Laboratory ❑
RESULT: Approved , Disapproved O Pending (]
SKETCH:
INSPECTOR DATE
COTE Attach supplemen►a, test doto hereto,
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City ty 9 of Tigard
a rd
INSPECTION PEOUEST
I for
INSPECTION TIME ;-) `? PERMIT NO. :
DATE: i. /VLJL DATE ISSUED.—I J—
OWNERS NAME :
ADDRESS : /l —
CONTRACTOR :_ .�� L —
TEST. Air [], Water p , Visual, Laboratory ❑
RESULT: Approved Disapproved ❑ , Pending [!
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KETCH:
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INSPECTOR DATE
ICNOTE Attach supplemental teef da*n heretul
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME". PERMIT No. :
DATE' ---,L--/--- DATE ISSUED —__ / I
OWNERS NAME :
ADDRESS: // �,� �✓ // 3f��Q,
CONTRACTOR :
TEST : Air 0, WoterE] , Visual 0 , Laboratory p
RESULT : Approved U Disapproved C' , Pending p
SKETCH:
AINSPfECTOR DATE
[NOTE: Attach supplemental test data beret]
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UNIFIED SEWERAGE AGENCY NO.
WASHINGTON COUNTY DATE
CITY OF
APPLICATION FOR SEWER CONNECTION PERMIT
Herb flori530tt'3
OWNER:
OWNER'S ADDRESS: —ZIP
BUILDING SITE: LOT ----
BLOCK ADDITION
TAX LOT NO. TYPE OF OCCUPANCY residence
ADDRESS - .-------- ---- "13'tb--PI
DWELLING UNITS- FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE - 575-00-- INSPECTION FEE I OTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYSTEM -.—
The Applicant agrees to comply with all rules and regul I ations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE INSTALLER
RECEIVED BY.
- jjnG[-NCY OR JIS AGFNV
Flog. " 1174
COMMENTS:
This Application and pefinit expires in one hundred and twenty (120) days,
The amount paid will lie forfeited should expitation occur.
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BUILDING PERMIT APPLICATION cOF TIGARD DATE 11224*76 1174
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 24LI—aI303
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE_
LOT NO.
OWNERtiert' JOB ADDRESS 192U yl,l 1130 Pl- HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER 0EIR10 ADDRESS DESIGNER
STRUCTURE jNEW-- ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑FIE LIGIOUS❑PATIO [:]CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE _7 BLDG TYPE JIN FIRE ZONE 3 PLAN CHECK BY HEAT
n Lnn;.a Family dusliing m/mittachwd �a� a%d _s 3 tz®dry IZtT :a tl l y -,
------- - rte 510 •n& .i't a - --- -
QCC,LOAD _______F_t MB LOAD __HEIQ�jt- 1? NO.STORIES __AREA1 9 NO.BEDROQMS - VALUES E`!3r""1•
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 40 LEFT SIDE H RIGHT SIDE
Permit 124.00
�— rry THIS PERMIT IS ISSUED SUBJECT TO THE. REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check YL.[TIS REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANT. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY nUSINESS
State Tax 5,y@ Ags LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING
Total _ 191*!:,a
By
-- APPLICANT 017 AGENT
Approvers r,, Receipt No.
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
7d °
Contractor
Permit No. 0,7--70
Rough-in
Fixture
Final
HEATING
Lt3 Yr tLl 1, + Contiactor
S'?7 0 1- aret G_- _ Permit No, i'.'f ��/ �•1�,,�/7�
t Gas or Oil
Rou h in
Final --
SEWER ��.
Final _
DRIVEWAY
anal
Storm Drainage
(Rain Drain) Final
Sidewal l,
Curb&Street Fina' _
--- __ A roachL 3`el-7l
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
( Landscaping /
` `` Zoning Final 1
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