10135 SW HILLVIEW STREET-1 k'
1
le
f
�A ..
11
i
!1
>.t
�NSPB+'TTON Ndt:CE _01_
City of Tigard Buildinq Dopartnent
13125 sV Ball Blvd. Tigard, Oregon 97221
InepectLon Line (Rec-O-Phone): 639-417r Business Phonal 639-4171
Ina;.^.tion:.___ —�.---- — --
F-oting Plbg. Underslab Mach. Rough-in Appr/Sdwlk
Faune. Plbc,,�Out Gas Line FINALz
Post/Beam Stl .ct. San. Sewer Framing -Bldg.
Post/Beam Hoch. Rain DraJn Insulation -Plumb.
Plbg. Underfioor Water Line Gyp. Bd. -Mech.
rl►M PN
Date Requested:
�_� �
Add roan 7 �._� ,cy/'�i.�si timet Pwt:'di 1-2/—
Hu
!l/Hu ilder: _-
THN FOLI.O4I14G CORRECTIONS ARE REQUIRED:
IflBItt3CLOrt
APPROVED DiSAPPROVEL APPROVED SUBJECT TO ABOVE
Call For Reinsp.
SEWER CONNECTION
CITYOFTIVARD G?YOF R61ARD PERMIT
COMMUNrrY DEVELOPMENT DEPARTMENT anovn I-RIvl I T #. . . . . . . a 5WR91--01-3b
f
13126 SW HW1 Blvd. P.O.Bout 23307,Tigard,(Xagu^07223 (603)F.3r*-4176
ST E: ADDREE39. . . : 10135 UW HILL VIEW ST PARCEL: 2S102CC:-0R'200
G(IDD I V I S I ON. . F RELEON HEIGHTS t40. ZON 11,4G: P—:t. 5
S1-CICK. . . . . . . . . . . LOT. . . . . . . . . . . . ..25
TE:NNNT NAME. . . . . s
LISA IBJ. . . . . . . . . . : FIXTURE UNITS. . . '
(:LASS OF WORK. . . :NEW DWELL I NG ON I TS. . : I
TYPE- OF' USE- - :SF NO. OF RLIILDING9: 1
INSTALL TYI'-rE. . . . r tit. 5WR I MPERV SURFPCE. . : : s f
+,,temar,kaa
Owners ___._____.__.._.._._._.___..._.._..._.__...._ ._._. .._._ __...__.__ ______.____. _____. FEES
nxOSANNE GARY DU1=F'Y type amo+_tnt by date
101.35 SW HILL. VIEW PRMT $ 1500. 00 JLH 06/27/91 _
1 NGP t ?5. 00 JLH 06/27/91 .•..
1'ONTRACTOR Nr;f ON F 11_.r_
Phone 4: f 1.`i?5. 00 TOTAL.
Rat;
REOUIRED INSPECTIONS
This Applicant agrees to c�rply with all the rules and regulations Sewer InsF�et t i.t,n •_,._,_•_.._,_,_.,__,,.
of the 1,)rified sewage Agency. The persit expires 120 days fro*
the daip issued. The total aro:.nt paid will he forfeited if the
perrit expires. The Agency dret not guarantee the accuracy of the
ride sewer laterals. If the sewer is not located at trtie reasurerent __ ______._ _..__..._._____.___ ____........___._._.._.__
rven. the installer shall arospect 3 feet in all directions fro* __....w_.._.._.__..._. ._.. ___ __.._ ._.._............._..___....
I •he dis'.enrt riven. If not so located} the installer shall purchase _,,._.,_•.___�__.,, �._,___ _____. _._�__._.. _.__...
}
"Tan and Side SRNkr" Pereit and the Ag4ncy will install a lateral,
ler,mitttteffe
c.s i-I eC1 Ry : .. ..._...._
Gill for- insLient^tion — 239•-41'75
CITY OF VIGnPD RECEIPT OF PAYMENT RECEIPT NO. :91-214762
CHECK AMOUNT 15:S05. 00
, NAME r —Y, ROSANNE & GARY CASH AMOUNT 0. 00
ADDRFSE-ii 61! ;5 SW HILLVIEW PAYMENT DATE. 06/26/91
SUBDIVISION
TIGARD, 04 978P3--
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMF61T AMOUNT PA I D
1 1500. 00 SEWER INSPECT 35. 00
6v
SEWER PERM f T/CONTRACTOR IS NO*r YET DECIDED UPON.
TO-rot- AMOUNT PAID 17535. 00