11670 SW 114TH PLACE-1 11670 5W 114TH PLACE
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
-7
Date Requested J / Time---- A.M. P.M.
Add 3SS Permit #
Owner Lot
Builder
The following Building Code, deficiencies are required to be corrected:
Presented to FfApprovel
Inspector
Disapproved
Dote
CALL FOR REINSPECTION
E] YES 0 NO
y
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection --
Date Requested & _ z 4 V l Time ._ _ A.M. P.M.
Address i'/�4 > iV - ------- Permit #--- — - --
Owner _ Lot # _
Builder
The following Building Code deficiencies are required to be corrected:
r
Presented to _ Approved
Inspector
Disapproved
_ G
Date _ 3
CALL FOR REINSPECTION
[n'-YES ❑ NO
Address 114ti, Plane Permit No,-1572
Permit charge_ _
Owner Connection fee 400.00
Paid hy_
Type of hui lding_� ��Hn� Date connected 7-19-72
5t-rvice rate Inspection fee 25.00
Contractor A llAn I'a►tereon_ Paid b Date
Size of c(intaection_ Wl Assessment.—Paid
_
i
PERMIT TO CONNECT
Tigard Sanitary District I
PERMIT N? 15"i 7 DATE
PERMIT IB GIVEN TOOF
TO CONNECT A f
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $... ............................TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date Superintenccrt V