11595 SW HAZELWOOD LOOP I
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PERMIT
ADDRESS
PERf'"11T CHARGE none
C 0 N N E C T 10 N
01..INFR
PAID BY
I.YPE OF Blilt-DING DATE CONNECTED
INSPECTION FEE
SERVICE RAZE
CONTRACTOR PAID BY D AT E
SIZE OF COW.CTION ASSESSMENT PAID
:? -/0 -77
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C.,ITY OF TIGARDOREGON
Bob Smith
r ................Permit No......936.......ONner:.............................. .................. .......... .
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Buila,ng Addr�.qs_.... ......�.1.$9�...SW...Hazelwoad...Loop......................_............ ,.
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Certificate
Is hereby given ththnt said building of-February.
..occu /led and
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Kph*
K that it complies with all requirements of !'
the Building Code for the City of Tigard,
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as approved by the Tigq rd City Council. = t,
Building %spector ......................... r ,�.
A
City of Tigard
INSPECTION REQUEST
for
INSPECTION 'TIME: 2 PERMIT NO. :--
DATE:
O. :_—DATE: _.L2-L-7(- DATE 13SUED :-._L!_-
OWNERS NAME : ---_---- i
ADDRESS:
CONTRACTOR :
TEST : Air 0, Water Vi axial Ci , Laboratory ❑ I
RESULT' 'approved El , Disapproved ❑+ , Pending El I
SKETCH;
i d I
t
RPECTOR DATE
F-rTE Attoch supplementnl dota beret
CITY QF
BUILUNG PERMIT APPLICATION TIGARD DATE-2:__� ,9-2-6-N°
THE UNDERSIGNED HEREBY APPLIES FOR APERMI f FOR THE WORK HEREIN INDICATED
OR AS SHOWN ANC APPROVED IN THF. ACCOMPA YING P �`{� ND PE( ICAT 0 OWNER PHC;JE_ __--
OWNER �O ADDRE�/ �J� �Oros�p_�Y_
ILDEFI PHONE
ENGINEER
STRUCTURE NEW Q REMODEL ❑ADDITION UREPAIR ❑RENEWAL ❑FIRE DAMAGE []DEMOLITION
RESIDENCE ❑COMN ❑EDUCATIONAL 0GOV'T DRELIGIOUSOPATIO ❑CARPORT EIGARAGE ❑STORAGE[SLAB ❑FENCE
rOBOND ❑MOVING_ ❑CONDITIONAL USE _— 0DESIGN f+C`r'i7W OCOUNCIL APPROVED ❑JIGNS
OCCUPANCY--Ir LAND USE ZONE _BLDG.TYPE s!____—FIRE ZONE PLAN CHECK BY � HEAT_
__���-' ---- � ---�- -�r� 1 _._ate..�I %��•/�, _
Xt
— � tl Pte.,•. ,
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES_— AREA VALUES J�_�_
BUILDING DEPARTMENTr
--- SET BACKS FRONT >10_ REAR b_, LEFT SIDE _ RIGHT SID _ -�-
Permit to r/�---- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPI 'CABLE CODjS AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS ANO SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CON"RACTORS TO HAVE CURRENT CITY BUSINESS
Stats — 1-17( LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PL.'JMBING AND HEATING.
Total
By
APPLICANT OR AGENT
Approved _ �+ Receipt No,
ADORF!'M - -- -- — ---P'FjUNE —. - --
7/i 9/b
UN1I= IIID SEWERAGE AGENCY No __ 9596
WASHINGTON COUNTY DATE 76L-
C I l Y OF T i g a r d
APPLICATION FOR S1 VVIR CONNECTION PERMIT
OWNER: - Bob
OWNER'S ADDRESS:
CITY STATE
BUIL KING SITE: LOT___- 13LOCK --__ ADDITION - — --
TAX LOT NO. . _._ __ - TYPE OF OCCUPANCY reef derlce
ADDRESS _11595 SLS Hazelwood Loop
DWELLING UNI v 1___.___1__-- __- . -- FIXTURE UNITS
SURCHARGE IF APPLICABLE__ _ _ .- -- .- - ---
PERMIT FEF 575._00 INSPECTION FEE _25.00 --OTAE_ DEPOSITED 000. 00
;NEW) (EXISTING) BUILDING SEWER SYSTEM Fanno -C-reek _
The Applicant agrees to rumply with all rules and regulations of the U ufied Sewerage Agency.
APPLICANT14__ — _44✓�
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION T, THE SEWER SYSTEM.
LINE SIZE --- _ INSTALLER
RECEIVED BY. . `.
(AGENCY OR ITS' GENT)
` COMMENTS: bldg. #0936
This Application and permit expire', in ninety (90) days. The amount paid will be forfeited
should expiration occur.
C1� CITY OF )uly lei 19 N° 0 9 36
BUILDING PERMIT APPLICATION TIGARD DATE
THE UNDERSIGNED HEREBY A°PL.IES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE ---
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
V11N_ER,_ -
ADDRESS 11595 r't"' Ofizalaood t-"P P BUILDER PHCNE
ENGINEER DESIGNER _
RLJILDEB _ ;'Ti''tIntl ARCHITECT __ ----
STRUC1URE 0AEW ❑REMODEL. ❑ADDITION___ ❑REPAIR ❑RENEWS-AIL ❑FIRE DAMAGE []DEMOLITION�-RESIDENCE ❑CJMM_DEDUCATIONAL ❑GOV'T OFIFLIGIQUSC�PATIO ❑CAR PORT UGA9AGE 0 STORA3E EISLAB_- C�FEN�E
❑BOND lJh'OVING ❑CONDITIONAL USE []DESIGN REVIEW []COUNCIL APPROVED [,SIGNS
_— — L TW _ HEAT
�' FIRE ZONE_ PLAN CHECK BY
OCCUPANCY 1 LAND USE ZONE BLDG.TYPE �1M$rl �� tlstlrUlalfl t,l/attAt't'16[S rj�k'dr91q�
CL -trULt Uns �2 story dws111nrj)
Re-lssus from Job Lot j41-F144 _
_. v,� uE360 500.
FLOOR LOAD
HEIGHT NO.STORIES AREA
OCC LOAb _ 0 1 �
BUILDING DEPARTMENT SET BACKS FRONT PEAR LEFT SIDE RIGHT SIDE 1�
Permit
THIS PERMIT IS ISSUED SUBJECT 'f0 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANDSPECh ICATIONS AND IN COMPLIANCE WITH
Reco`ding ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
1`16 Stats
LICENSE. SEPoRATF PERMITS REOUIRED FOR SEWER, PLUMBING AND HFATING.
Total
By SANT OR AGEN1
Approved Recx,ihl No
— A D .55
i
DATE INSP. TYPE INECTION REMARKS PLUMBING DATE
Contractof
� r
oo// 2 � Permit No. — 71L�
6.7G �Gc- A rst Rough-in _ --
{_�� _ _ Fixture_
3 76 l✓ /Lcn* ��_., -.. _ Final
-
(� G _ �� �,� _HEATING
-T� _J C Contractor
��/sh6 4 Gcf hr 101-5 �'6 /1 "t,v. _Jf1veA Permit No. — 7/-z O6
K p lm,r to -+ ON b n Gas or Oilbu_ �Y
s..,Y,,g ar Eee ►.o'. all *!,C0 fluu9h-
i n ----_- -`-
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Final
--- - ---
-- -- - - ---- SEWER
Final _
DRIVEWAY —
Final
Storm Drainage
�- — _-�-- Rain Drain) Final
Sidewalk
Curb&Street Final
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
(\ Zoning Final
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