11475 SW HAZELWOOD LOOP / ] .475 HA''.E;LWC)Jll LCXDI'
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CITY OF TIG- ARD
OREGON
Owner:....B.ay.d.-Th.urn.to.n........................ ....... ........Permit Ne-13.35
Building Address........1,149.5...SW...Hf3-z q1w-PP PAP-- -#9 77- - -
of..JAw9.p. ......... ......
Certificate is hereby given tbi.s.......5...... day p,t_ 1�)
that said building may be occupied and
that it colliplies with all requirements of
the Building Cole for the City of Tigard,
as approved uy the Tigard City Council.
............�-.< ..... ......................
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LOding Inspector
AG N A
A d d r e s s _ �)S, cv_� J ,��
Permit No.
— _-- - Permit charge
Owner
Connection fee
,— Paid by
Type of building _ :�.�,, Date connected
Service rate Inspection fee
Contractor Acid by nate
Size of connection Assessment Paid
H -11 --77 sc� y
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cITY OF TIGARD Ivey
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ORECON
Bob Smith1079
I4 ON%ner:... ...... ...... .... .
...................
Ncrmit No........... ... ...._
sl 11475 5W Hazelwood Loop
BuildingAddress....I...... . . .. ........ ... .. _.. . ...... .. ..... ............................
3 .A ri.1.......... .. 19..7.7. T
Certificate is hereby given this of.......
that said building may be occupied and
that it complies with ali requirements of
tlhe Building Code for the City of Tigard,
ns approved by the Tigard City Council.
1;' j'q Building Inspector
/I
City of Tigard
INSPECTION iREQ' ,IES T
for h
INSPECTION TIME: ::: ;� PERMIT NO. :.__
DATE: DATE ISSUED
OWNERS NAME
ADDRESS:
CONTRACTOR :
'EST : .kir D, :Motsr,6, Visual 6, Laborato• r
/
RESULT' Appi-w!advo , Disapproved 7 , Fending []
SKETCH:
�NSFJECTOR DATE
COTE : Attach supplement: ! Tett do°c hereto
NEW
it
UNIFIED SLWF- RAGE AGLENCY N0. 10649
Y
DATE 9--21-76
NASHINGTON COUN
CITY OF-.--- _Tigard
APPLICATION 1-013 SEWER CONNECTION PERMIT
OWNER: . .....
OWNER'S ADDRESS:
STREET
CITY STATE ZIP
BUILDING ;ITE: LOT---- BLOCK ADDITION
TAX I OT NO. TYPE OF OCCUPANCY . -esldaarae
A D D R L ISS _._11475 5'J- H a x e w o o d—Lp-
DWELLING UNITS-------.----, rIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE INSPECTION FEE 25.0ri- TOTAL DEPOSITED
CUES') (EXISTING) BUII DING; SEWER SYSTEM
1h Applicant agree,- to comply with ali rules and regulations of the Unified Sewerage Agency.
APPLICANT
"`£ J� - - - _ �``�� —. _......
MAJER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE INSTALLER
RECEIVED BY.
(AGENCY OR I'M'AGENTI
COMMI'NTS: Bldg, -1079
This Application and permit expires in one hundred and twenty (120) days,
The amount paid will be forfeited should expiratii. occur.
MA
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APPROVED k, .jt ;Ji, --.-""TION
PERMIT k) . ,�D J9_ SI 1�,�. . i G�. ,.qw
RY - _ --TITLE_ DATES�?L-I �j
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BUILDING PERMIT APPLICATION Co Y TIGARD DATE_ t��' '127' —, 1s A
THE UNDi_RSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK. HEREIN INDICATED 8I)1LDERPIIONE_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE ---
1 f LOT NO.�_—
W
ONER i JOB ADDRES�1 Q f 5 SW ha zallrood DOME ADDRESS
ARCHITECT
ENGINEER
BUILDER
_ADDRESS DESIGNED
STRUCTURE ANEW _ ❑REMODEL ❑ADDI'TION [I REPAIR _ ❑RENEWAL ❑FIRE DAMAGE 1„1DEMGLITION
QRFSIDENCE ❑COMM ❑EDUCATIONAL CGCIV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [-]FENCE
❑BOND ❑MOVING ❑CONC:TIONAL USE C1 DESIGN REJIFW ❑COUNCIL APPROVED ❑SIC:NS
OCTLJ
CUPANCY____ LAND USE Z,)NE _BLDG.TYPE .—FIRE ZONE_ PL AN CHECK BY_ HEA1____�
uc;E�►t. ewx my tp111�A y dwwalXan4 w,/sttrchuc; r;iaraege 4 bearuom 3 both
__ i9fA�ttl�flQEi.b1�,L°vW �"' •Q.
ft. ---
NOMIQB 11 246 NO, f&?)a.49MS 4. VALUE-35 QUUu
BUILDING DEPARTMENT �+ :T"'' * fol
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
-- THIS PERMIT IS ISSUED SUBJECT TO THF REUULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check LO*00 REGULATIONS AND ALI- APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AUREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total ALL A°PLICABLF CODES AND ORDJNANCES, THE ISSUANCE OF THIS PFRMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax Qo".JL LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 156o56
By
- - - — ---
- --- --- n PPI.ICAN1 OR AGENT
Approved Receipt No
ADDAFS3 - PHCSNE
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