12220 SW 127TH AVENUE 12220 SW 127TH AVENUE
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City of Tigard
INSPECTION REQUEST �
for
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INSPECTION TIME: `•�'�� _ PERMIT NO. :_._
DATE: _4 /z /7-21 DATE ISSUED :_ / /
OWNERS NAME '—
ADDRESS.'
AME :ADDRESS:
CONTRACTOR . _''E
TEST : Air ❑, Woter[I ,, Visual 0 , Laboratory []
RESULT: Approved Ll , Disapproved O Pending p
3 KETCH:
INSPECT t?R DATE
LNOTE Attach supplemento, talt dat •, hrrt•tu �
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City of Tigard
INSPECTION REQUEST
for
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INSPECTION TIME: PERMIT NO. : ZSR 3c. �
DATE: 3/'9/73 DATE ISSUED : mss
OWNERS NAME :_ I. ,,—
ADDRESS:ADDRESS:
CONTRACTOR :
TEST : Air p, Water❑ , Visual EI -Laboratory ❑
RESULT* Approved Ll-,bisapproved r7 Pending p
SKETCH:
14
INSPECTOR DATE
NOTE: At+ach supplemental test data beret]
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. :
DATE : . 3 P41�" DATE ISSUED:�7..�
OWNERS NAME : ._��;
ADDRESS . _ /x�v-vc yrs, /027 K.—,, 7
CONTRACTOR
TERT. Air [I , Water [] , Visual [7, Laboratory F]
�'ESULT. Approved 0-, Disapproved ❑ Pending L]
I SKETCH.
tiv i �cJ� �'C;c..✓.
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INSPECTOR DATE
ICNlif Attnch sup[ If-men InI tP9t data here td
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ADDRESS _1,U-2Q 1W. Jil'I!"- PEHMIT N0.
Alps `
PERMIT CHARGE none
OWNERN _ CONNECTION FEE �a5�
_ PAID BY � �124ua
TYPE OF BUILDINGDATE CONNECTED
SERVICE HATE INSPECTION FEE
CONTRACTOR PAID BY DATE _..
SIZE OF CONNECTION �__ �� _�_� ASSESSMENT PAID _
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I City of Tigard
INSPECTION REQUEST
I for
INSPECTION TIME * PERMIT NO. :
DATE : .--71.w/73 DATE ISSUED:-i) iAl73
OWNERS NAME : —
ADDRESS : �' /� lr •. __
I
CONTRACTOR :
I TEST. Air O, Water
�p , Visual�aboratoryp
RESULT. Approved !�', Disapproved ❑ Pending L)
SKETCH:
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INSPECTOR DATE
I [,TE ; ,attach supplemental test data hereto
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City of Tigard
INSPECTIONi
REQUEST
for i
INSPECTION TIME: PERMIT
DATE: /T_> DATE ISSUED : � I
OWNERS NAME : --
ADDRESS: 0? I
CONTRACTOR
TEST * Air 0, Watery;Visual a Laboratory ❑ I
RESULT. Approved 0 Disapproved ❑ Pending 11SKETCH. ..�
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INSPECTOR DATE I
I NOTF Aft orh aupplf rnent^I toot data hereto i
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City of Tigard
INSPECTION REQUEST f
for
INSPECTION TIME: r� PERMIT NO. :—
DATfE: 5-ff4-J _ D
A
TE ISSUED .___LL
OWNERS NAME :-
ADDRESS: 4i:
AME :ADDRESS: 4i: oo
CONTRACTOR : IW
TEST : Ai► ❑, Water[] , viauatx, Laboratory p
REW.lL''" Anne w—idDiev, .)r yid 73 Pending ❑
SKETCH:
4 � _
PLUMBING PERNyT 'PPL :A ION
Jurisdiction of
]Jo. Type of. Fixture 'ee� Penriit No. 3 -:0'-
e)0 Permit fee --:)6�
Water ClosetsToilets -2.0 d Permit Issued - ,r
Bath Tubs "(100 Approved by >
LavatoryWash Basin _ 4 Building Per �� 34.
Shower '' o Receipt No.
Sinks, Dishwas,-ng - _
Sinks LX1t,chen
Sinks OL nary _ Location of Building
Sinks.—Bar —
Sinks Slo
Automatic Dishwasher
_
Laundry Trays� Nacre & Addre s f')l Own,-I, -
rains, Floor
Drains Area —�-
rJr'airiS. Re r• era or' �!� Lt .r_; gin
-Ram Drainsn �0
Automatic Washer 7 e, rla�ye x ddress of Plumber
Fountains ins rirl iri
Fountains .soda -
Ho t Water Tank
Water Service
Urinals Bu„.lding -M►ry New) (A -^
a cTi= asins - dr n;; .a - `
':4 Lawn Sprinkler System
SwimmiriPool
--sprinkler System - -”
This permit becomes null and void if work or construction authorized is riot
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 120 days at any time after work is commenced.
All plumbing firms must be licensed by the City of Tigard and post a $1,000 bond.
I hereby certify that I have read and examined this application and know. the same
to be true and correct. All provisions of laws and ordinances governing this type
of work will be complied with whether specified herein or not, the granting of a
permit does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction cr the performance of
construction.
Sign tre of A Ii -^3nf
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City of Tigard
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INSPECTION REOUEST
for
INSPECTION TIME : / -::�<' PERMIT X10..
DATE: 3 t �2-3 DATE ISSUED'- L_lf
OWNERS NAME: ---
ADDRESS'
ICONTRACTOR :— S Oy�5-0ti (:�'v„;s
TEST:Air O, W-ter p , Visual a, Laboratory p
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RESULT: Approved P1 Disapproved D Pending L]
I SKETCH*
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INSPECTOR DATE
I [NOTE : Atlnch supplemsntol feet dote hereto
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! City of Tigard
INSPECT10" N REQUEST
I for
INSPECTION TIME : "Q"' PERMIT NO. : 73 3L
DATE: 3 L71 ;3 DATE ISSUED: —PI ,1
OWNERS NAME :
ADDRESS : -
CONTRACTOR :.
DDRESS :CONTRACTOR :. --- ---------- --- ----
I TEST. Air 0 , Water�/, O
Visual ❑ , Laboratory []
RESULT'. Approvedisapproved O Pending L7
I SKETCH'.
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PECTOR DATE
ICNOTE : Attach supplemental test data heret:01
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i City of Tigard
INSPECTION' REQUEST
for
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i INSPECTION TIME : "LOS) PERMIT NO. : X3-26
I DATE: __' I'll . DATE ISSUED: v
OWNERS NAME : 431QLniA,t `1C�c«CdjatAL
I ADDRESS :
1 CONTRACTOR
! TEST. Air El , Water [j , Visual CJ , Laboratory L7
IRESULT: Approved E71 Disapproved 0 Pending []
i SKETCH:
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rNSiPECTOR DATE
�N0TIF Attach supplemental test data here t]
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UNIFIED SEWERAGE AGENCY N(I 4S03
WASHINGTON COUP '-'Y
CITY OF-.-- T t.6al•k' -----
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: -- —
OWNER'S ADDRESS:, 7603 s B Powell Blvd.
STREET
Portland
CITY STATE ZIP
BUILDING SITE: LOT ____ BLOCK . -_...., ADDITION Bellwood 11
TAX LOT NO. TYPE OF OCCUPANCY Aeaidonoe
t
loy4 - Bellwood II - Addresc penaing
ADDRESS _�� _ I
DWELLING UNITS. _
_l�—_.__._.__.__.._____�.___ FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE 425 INSPECTION FEE 25 TOTAL DEPOSITED .. .45o
(NEW) (EXISTING) BUILDING SEWER SYSTEM Tigard
The Applicant aq ues to comply with all rules and regal tions of Ur' ewerige Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SiZE I INSTALLER J. W. Brayson
RECEIVED HY Li +1 I
/ I ENC�)p TS A-4NTI
COMMENTS:
This Application Ind permit expires in ninety 190) da The mnrnmt hill will lir I,uloIlerl
should expiration occur.
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CITY OF TIGARD
12420 S. W Main S►rMf
TIGARD, OREGON 97223
APPLICATION FOR BUILDING PERMIT
New Consttuction Q Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING R-7 DATE ISSUED 2-28-73 BUILDING PERMIT
BUILDING FEE $ typ,pp No. . .,...
DATE RECEIVED 2-15-j� . 1,_ _4;Ki _
BY FS PLAN CHECK $ lin-cYi VALUATION $ 20,572
- OTHER $
RECEIPT No. /1S 63'
TOTAL $ 1 un m
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT #95 cr'j 1,, �-tAAP M_2Sl 4AA CENSUS TRACT W JOB M
Architect or Engineer ng r1ny - ---
Address por tn„d nra:nn _ —� Phone
Owner Brovso❑ lluilder Inc ---
Address 4-')'� S.g, HreBew- Phone 777-3,15u
'------
Builder same _
Address -__--- -__-_---
Phone
,;ame -- --
BUILDING USE :;ingle Res. ❑ Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP_`—_- No. of Stories�I _ Total Height li_ Area of Lot 75Wj
Type of Condtructj on LxAjVMAAaxasXXAW V Floor Area B` -- 1 13yu
Set packs: Front 2c Back a L.Side 11 - R.Side 12 _'�
Privato Sewer Pipe Size_,! r Seweu."gyp, Tiast� (
ptic Tank U
Water Service Pipe Size j/4" Storm Sewer x❑ Ditch ❑ Drywe]1 ❑
Street and Curb Requirements under construction
Driveway Width 1d' No. of Parkinq Spaces__ ,2
SEPARATE PERMITi REQUIRED FOR SEWER AND PLUMBING
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SPECIAL INFORMATION
No OCCUPANCY UNTIL REld1IlSED BY CITY
ADDRESS ASSIGNED —_—lUt 1;_.-Allwood ,jl -.Addrequ yggdlt%
FIELD CHECK BY __ ____DATE. � .
PERMIT APPROVED By,
I�. in understood that all work will conform with applicabl code n ordinances;
cf the State of Oreqon and the City of Tigard Drug n, and l `t the building wilt
not be occupied until a Certificate of Occu cy -trLR ed by the City of
Tigard Building Inspector.
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5 gnature Acca _
Avoid Verbal Messages A-1
CITY OF TIGARD
To:
— _. _ —___— ------ • > jam.
Subject: Date