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11735 SW 114TH PLACE 11735 SW 114TH PLACE M � LN 4� �1 f r� H O a �I � o W to f 0 too w w rn �. a I Cv cl H F� H E4 cq r�1 c - I -mum S- ADDRESS // 7 �t l `� I A PERMIT NO. U$ 7y PERMIT CHARGE OWNER CONNECTION FEE U 7� PAID BY TYPE OF HIJILDING I DATE CONNECTED SERVICE RATE , INSPECTION FEE CON 1 R A C T 0 R ' PAID BY DATE SIZE OF CONNECTION `�� ASSESSMENT PAID City of Tigard INSPECTION REQUEST for icy INSPECTION TIME: �` PERMIT NO. : DATE: ._ Ll DATE ISSUED :—I--Z-- OWNERS SSUED :_—L1-_OWNERS NAME : ADDRESS: /ZY --- CONTRACTOR : ��y��'� TEST ' Air ❑, Woter❑ , Visualo�l.aboratory p RESULT: Approved ( , Disapproved ❑ Pending p f SKETCH. I 141, I I I I INSPECTOR DATE COTE: Attoth suppls,mental test doto berets i City of Tigard INSPECTION REQUEST for- INSPECTION TIME : PERMIT NC. : DATE. FL?073 DATE ISSUED .'--.--./ =' OWNERS NAME : ADDRESS: Zt,7-95 -- CON TRACTOR EST : �.., . , 'Nater[] , V:Sualj� , Laboratory I�j RESULT' ikp roved , :)isupproved ❑ i-endioq [] SKETCH. �.tf• �kt:)T 2r0- -1 INSPECTOR DATE NOTE . Attach supplemental test data t:�v (t J H r w-BRAM!� City of Tigard INSPECTION REQUEST {or INSPECTION TIME . /Z) '02 PERMIT NO. : DATE : _ DATE ISSUED OWNERS NAME ADDRESS: G G N T R A C T O R : _._-___ i EST : ,%!,- i_—, , Watery , V:aual Gl , Laboratory [j RESULT: Ap,-,roved , Oiaapproved ❑ !'endingy SKETCH: NSPECTOR DATE NOTE. Attach supplemental teat data bereta� ,I I City of Tigard INSPECTION REQUEST for INSPECTION TIME : PERMIT NO. : . I DATE ' -3Z7 "-3 DATE ISSUED- - Z L_ I OWNERS NAME . �t�0K) ! ADDRESS : —�__-- ICJ O N T R A C T O R : ----��_--------- __�_� I1'ES'l r Lj, Water N/is161 -1 , Lc , rcio n I RESULT: Approved , Diwpproved _1 � P--ndirg ;] SKETCH: I I I 9 ISPECTOR DATE ICOTE : Attach supplemental test Jett heret] 1 I city 9 of Tigard and INSPECTION REQUEST for IINSPECTION TIME :1�� � -- PERMIT NO DATE: - i 1k- DATE ISSUED'. --� OWNERS NAME : , ^' I ADDRESS : 1! 23`- - CONTRACTOR --- I Water Lc rc+.or; r1 TEST r J, r] , ` is ut �7 RESULT: Approved Disapproved 1 ��,nding J SKETCH: -�-. I I i —17SDATEDATE (_w)IF At1nch `13plementr,l test ,; u'c her0 t] City of igard ` INSPECTION REQUEST for I INSPECTION TIME : _ PERMIT NO. . DATE: 7lAGI>3 DATE ISSUED:-.Ll-- OWNERS NAME . ZrK- ! '°" Z-, ,f ADDRESS : '` I CONTRACTOR -- - -- i TEST. Air ❑, Water ❑ , Visual, Laboratory ❑ RESULT: App•oved Disapproved L7 Pending ❑ I SKETCH. i I F 1 1 , I`1 I 4 Cr INSPECTOR DATE CNOTE : Attach supplemental test data hereto] �yy UNIFIED SEWERAGE AGENCY No WASHINGTON COUNTY IIA T E CI T Y OF________ ___T:j{a►rd _ APPLICATION FOR SEWER CONNECTION PERMIT OWNER _ _-__._--_ )QU&IA A_DWAL.. ..-- OWNER'S ADDRESS 13V &V- Bull eTllt[T fT71T[ - 2�• BUILDING SITE LOT__,__ ..-- ELUCK __..__. ADDITION �U411.P3k9t______!_ TAX LOT NO _. T YF: nF OCCUPANCY ADDRESS 1&73S...i AI&.U40 Place DWELLING UNITS__--.__.. FIXTURE UNITS SURCHARGE IF APPLICABLE .,___ —.____. PERMIT FEE . - INSPECTION FEE -.43 TOTAL DEPOSITED (NEWT (EXISTING) BUILDING SEWER SYSTEM n i The Applicant agrees to comply with all rules and reg tions of the Unified Sewerage Agency. APPI WANT SEWER PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE SIZE 4INSTALLER RECEIVE;) 0Y G 11^ MMM�nnCNCY QN ITS AOikNTI COMMENTS days Au"M a' `/3/SB X4,01 b;'" This Application and permit expires in ninety 1401 days. The amount paui will ne forfelled should expiration occur. CITY OF TIGARD 17170 S. W. AMIn SIP&A T:CARD, ORsaON 91 APPLICATION FOR BUILDING. PER,IT New Construction LXJ Demolish ❑ Addition ❑ Remodel ❑ Move ❑ ZONING R-7 DATE ISSUED 7-16-73 BUI!.Dt!aG PERMIT DATE RECEIVED u-0-73 BUILDING FEE $_ 59we _ No73v159 BY FS PLAN CHECK $� OTHER $ 10,00 VALUATION $ TOTAL $ 9y.00 RECEIPT No. TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION LOT 1 7 MAP 1 CENSUS TRACT _ JOB 1 Architect or Engineer Address _ Phone Owne r JokAgIas Cot,st. OG.f Nomad L. Address_ I!I ] Sl'l;� g,y, EuLl MEn, __Phone Builder Address Phone BUILDING USE Single Res. E2 Multi Res. ❑ Comm. ❑ Industrial OCCUPANCY GROUP 1 No. of Stories 1 Total Height lu Area of Lot Type of Construction V Floor Area B - 1 1656 2_--__ Set Becks: Front s Back 15 _ L.Side`5 R.Side- 5 ((_�� Private Sewer Pipe Size 4" Seweru6a Tigard Septic Tank water Service Pipe Size 4" Storm Sewer © Ditch ❑ urywe11 ❑ Street and Curb Requirements eXL&cina Driveway Width_ 10' No. of Parking Spaces 2 SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING SPECIAL INFORMATION ADDRESS ASSIGNED 11735 S.W. 114th llace FIELD CHECK NY 6C _ 4 _ _DATE`J.1,; PPRNIT APPROVED BYE It is understood that all work will conform with applicable codes and ordinances of the State of Oregon and the City of Ti , Oregon, .an: that the building wil not be occupied until a Certificate of O,rEu nc es is by the City of Tigrrd Building Inspector. / nature of AppliAnt r r r r r r r ►'[O tl�p s. 119' Ul Lj bE "hod 3 -/ 5-8