11535 SW HAZELWOOD LOOP 11535 SW HAZEL,WWD LOOP
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PERMIT
A D D R E
_ PERMIT CHARGE none _.
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CONNECTION FEE
O W N F R
PAID B Y
�— DATE CONNECTED ----- --
TY PE. OF
5 INSPECTION FEE S ---------
SERVICE RATE _r__`�
PAID BY _ _ GATE _.
C014TRACT0R _ PAID
A55E51MENT — --
SIZE OF CONNECTION
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City of Tigard
INSPECTION REQUEST
for
Ute,
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INSPECTION TIME: PERMIT NO. :_�
DAT E: ../.,LrY DATE ISSUED -. I
OWNERS NAME :
ADDRESS:
CONTRACTOR : _____
T'C ST : Air C�, Water[] , Visual rJ" , L.r.norntory ❑
RESULT: A,v,oved Disapproved C' Pending ❑
SKETCH:
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IN ECTOR DATE
NOTE : Attach supplemental tett date bi►et] I
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SEVVER PERMIT M li'll 4
N
Unified Sewerage Agency4-5-7?
of Washington County CITY OF— Tigard DATE ._A
O W N E R t K._ip_Ho_mes _ _- � P H lN E 649-2654
-.
OWNER' S ADDRESSt
TYPE OF INSTALLATIONt t
i
BUILDING SEWER BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCYi
MNFW SINGLE FAMILY ❑ COMMF-RCIAL
❑EXIST . (PRICR TL -I-70 ) ❑ MULT. RES. INDUSTRIAL
FIXTURE UNITS__ __,-__ DWELI. ING UNITS 1
PERMIT CONDITIONSt THE APPLICANT AGREES TO COMPLY WI-A ALL RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPLCTION, PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION
EXPIRES IN ONE—HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL
BE FORFF_ITED SHOULD EXPIRATION OCCUR .
FEESt
PERMIT FEE $ 25'— ---
CONNECTION CHARGE ___ 575.
� I
SIDE SEVER INSTALLATION
I SSUED�'' Y j
OTHER
TOTAL $ _ 600.
APPLICANT DATE
SEWER PERMIT Nv ' 12114
ADDRESS OF SI RUCTURE _. _1153 _-5_W_Nazelw7odLoop __ �_•-_� _.___
TAX TAX LOT_--,--.. r'YS'T EM -_ Fanno Creek_
LOT __._.95 .—.- BLOCK ------ --- -; ;-��;;-�:�- 'E• ,� ' �_'
DATE
APPROVED BYar� DATE I 55UED BY
1751
REMARKS _ 81"�g• _ ___.__.._-- _. __..
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C� BUILDING PERMIT APPLICATION 1ITTIGARD DATE 4 .1 S,179
OF .49086ws
THE UNDERSIGNED HEREBY APPLIES FOH APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHON
AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIFICATIONS. OWNERPHONF
.OT NO.
OWNER & rtuflue JOB ADDRESS L1"'I _qy &V&J1j HOMEA�7URESS
ARCHI7EC:T
ENGINEER
BUILDER `lE31'1H ADDRESS ___DESIGNER ��M
STRUCTURE _MN W0_REMODEL _ ❑AD_:I_TION _ W
❑REPAIR PRENEAL - ❑ 1_I
FIRE DAMAGE_ DEMOLITION
❑ PleSIDENCE _❑,OMM ❑EDUCATIONAL ❑GOV'T!❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB OF--NCE
�0BUND ❑MOVING ❑CONDITIONAL USE _ ❑DESIGN REVIEW ❑COUNCIL APPROVED [-]SIGNS J_
q"' — J�` FIRE ZONE_— .'!,PLAN CHECK BY, 4 tf HL AT .++
OCCUPANCY LAND USE ZONE BLDG.TYPE _— —
carrote o.inl;19 family d 11ingw gttych.qsl garnGe --
garnqu 552 sq, fte basement 948 sq. fte
--FID-QR LOAD HEIGHTS°__ NO STORIES '� AREA.1+��'e8"o•BEDR -Gn --VALUE �.�•,2�G..
UII_DING DEPARTMENT SET BACKS— aONT, REAR _LEFT SIDE lr; RIGHT SIOk y:
Permit � lliS?•11!`a
THIS PERMIT IS ISSUED SJBJECT TO THE RE;ULANIONS CONTAINED IN TIRE BUILDING CODE, ZONING
Plan Check 10,ov REGULATIONS AND ALL APPLICI-.eLE CODES AND OEDINANCES, AND IT IS HEREBY AGREED THAT THE
— WORK WILL BE DONE IN ACCORDANCE WITH THE PLA%S AND SPECIFICATIONS AND IN COMIPLIANCF WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES THc ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SJ8 CONTRACTORS TO HAVE CT.'RRENT CITY BUSINESS
State Tax 5*3 7 1 ICFNSF. SEPARATE PERMITS REQUIRED FOR SE:P1ER, 1L.UMBING AND HFATINC.
Total _ -- 1840T
By __. :pjp �ANT OR AGENT -_- - -
Approved �t.0 f7,,,v ;,I Nn
1'i G,N*
= tr.
UATE INSP. TYPE INSPECTION FIEFAARKS PLUMBING
/p DATE
��L��• .0 Contractor
Permit No. C'7 S
Rough in
Fixture
Final
HEATING
'71 U27 07C— / —�-- Contractor
�3 9 etNulcJt y..f�a"�-- — —_ Permit No 33 `� 7
fi--- --�-
Gas or Oil
g i.. Rough in
-- — n,^ ��. .! ' Final
( (J - - — - ----
-- ------- -- -- _— __— SEWER
--- — — ---------- _ Final _
— _ DRIVEWAY _--
-- Final
Storm Drama c
JOCCUPANCY
ain Drain) Final
ewalkrh&S+rect FinalBLDG DEPTFINAL TEMPORARY— broach � — ,DCERTIFICATCLiRTIFICATE pCCUPANCYalndscaping
ning Final