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11600 SW HAZELWOOD LOOP-1 h 1 {.•� � ' AI 11600 l ,J e �I A� IV y • 0 11 • 40 e t ADDRE PERMIT NO. PERMIT CHARGE nris OWNER CONNECTION FFE Pi IU GY IYPE OF BUILDING DATE CONIN► CTFD ` ERVICE RATE INSPECTION FEE CON rRAC*TOR P"' Jo BY DATE SIZE OF CONNECTION ASSESSMENT PA I f) 1 -2 "N C 1GARD CITY O Y t, OREGON = ) �� ArtLutZ ... . .._.Permit No..JQ38 Owner:............. . ... . ......... ...... .. .. 11SWHaz®1WordLoop,•..Buildhi Address...-....... .. ... ... . ........ w a .t : ' certificate is hereby given this................day of._.....3A.npgry......., 19..7.7.... R ) beoccupied and that said building g ma >S a uiof ' that it complies with all r q the Building Code for the Citi- of Tigard, 1 as approved by the Tigard City Cc�ur,cil. r ' 1 � Building Inspector /.J �• �_, ► (y <► `; • s �.TU!y' i• � �iw���,/�iy�s. 1 r .•y,� � n l,, •s `: .�-• ly a 'i'� ta••1 \} � r i City of Tigard I INSPECTION REQUEST for INSPECTION TIME: 6?- 22:a PERMIT NO. :---- DATE: .,/'/j O. :.^._ _ i DATE: .//j DATE ISSUED :_._t_L_ OWNERS NAME : 2 , -2!!� CA , ADDRESS: CONTRACTOR : TEST : Air p, Wot;,El Vi•;,ol p , Laboratory ❑ I RESULT: Aporoved D' . Disapproved E , Pending [] SKETCH: I I 1 i I I Cla- r DATE 50TE Attach supplemental test data hereto- I I UNIFIED S1:-.VV1­ 13A(-`j' E AGENCY NO. 10621 WASH I NGT 0 N COU NTY DATE -- 2/7176 CITY OF-...--,--- APPLICATION FOR SEWER CONNECTION PERMIT " C)k'VN[-R: . rt I OWNER'S ADDRFI,,Iq: STREET CITY STATE ZIP BUILDING SITE: LOT.-_...___._..__-.___ BLOCK ADDITION TAX 1-0 F NO. -- - TYPE OF OCCUPANCY r9sidence 11600 SW 11,3zelwood Loop ADDRESS ------- DWELLING UNITS I FIXTURE SURCHARGE IF APPI-ICAF31-F PERMIT Ft--:E 575, 00 -- INSPECTION FEE 25. 00, TOTAL DEPOSITED _ 600,00 (NEW) ([XISTINC) BUILDING SEWER SYSTFM The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency. APPLICANT SFVVF-R PERMIT THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM. LINE SIZE . INSTALLER P R E C E I V F D BY (AGENCY OR �"GENTI COMMENTS: — E16-. V: Icj?F This Application and permit expires in one hundred and uventy (120) days. The amount paid will be forfeited shouli expiration occur, �,�r,K�„�.., �y'Tn..�GT�` t+1►jYva�IF'"J!�1""�yw''M„"'�+' C 1138 BUILDING PERMIT APPLICATION OF TlGARD DAT F�s_'�- - Iq---' THE UNDERSIGNED HEREBY APPLIES FOR APERMII FOR 1HF WORK HEREIN INDICATED OLO 'NO.WNER -+DNF RPHONF _ OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS lO. = + t OWNER i'Y`4 LI��_._.. JOB AUDRF:iS ilbG,t� `JW F'la?Et I.tJl�lad I,�QME ADDF:ESS .�. --- A4CHITCCT ENGINEER FC?It1t3 ADC)RESS _ DESIGNER _ BUILDF.Ft__� []FIR DAMAGE _ ❑DEMOLITION STRUCTURE �`©NEW QREMODEL -1 ❑ADDITION ❑REPAIR_ ORFNEWAL _ P��HT ❑GARAGE OSTORAGE SLAB OfENCE — LJRESIDENCE ❑COMM EDUCA',IONAL _OV_ TT ORELIGIOUSOPATIO ❑CAR OO ►�nOND MOVING L.]CONDITIONAL USE ODESIGN REVIEW [-]COUNCIL APPROVED_— ❑SIGNS P7CCUPAN Y— L LANO USE ZONE. BLDG.TYPE FIRE ZONE PLAN CHECK BY_ Urw NEAT. Cunst single family dwbllillg w/4t1_ackied garage^=With patio 3 bedroom 2 bath garage 490 eq. 1f t. _ I nAD-_--- FLC?QL��QAD HEIGHL� SND. AREA 1623 NO BEDe ODMS ,� ` S1i BUILDING DEPARTMENT 61 SET BACKS FRONT 209 20LEFT SIDE ' � RIr:HT SIDS Permit 145*00 THIS PERMIT IS ISSUED SIIBJE(*,T CO THE REGULATIONS CONTAINED IN THC BUI'_DING CODE, ZONING Plan Check 72•A REGULATIONS AND ALL APPLICABLE CODES AND r)RDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL CTE DONE IN ACCORDANCE WITH, THE PLANS AND SPECIFICATIONS/,ND IN COMPLIANCE WITH Sub total ALL APPLICABLF CODES AND ORDINANCES. 'THF ISSUANCE OF THIS PERMIT DOES NOT WAIVE RFSTRICIAVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS State Tax 6*5 2_– LICENSE. SEPARATE PERMITS REOU RED FOR SEWER, PLUMBING AND HEATING. Total 124,02 By APPI 11 ANI OR AGENT Approved N{- — -- Ap(JHl.SS myw.z b(, T6 10 1 12/-)� i I CITY OF TICARD MECHANICAL PERMIT DATE-- - - -- PERMIT N0. _ }IECEIFT NO. - BY -_ -- _--- ----_- -- -_ _- - FEE -- l. Permit shall he obtained prior to commencement of installation. 2, Pehnit shall be obtained for all appliances which are to become a' fixture to the building. 3, Relocation, replacements, alterations,. or changes to burners and duct work require permits . 4. A7.1 work to be concealed must be Inspected before cover up. New Installation ._� Replace -�" Relocations Addi - on ❑ 'Alteration _ CONTR. 014NERj- 1 WORK ADDRESS#�4��2�u.'da� 17005 N. W. CORNELI. RD. _ APPLICANT TELEPHONE N0. TEL; NO.- ____ --_�-- - -- F1'RNACE - rL4NUFAC'1'URER ---------_�_�� PHONE NO.. -- • Size I+'liia size HEAT Input ra:Ling (Btu Per` Hour) Vent CASK] ELECT [] OTHER __._-_- --- FUEL OIL �_� ---_--� �. -- TOTAL SQ. FT. Top Floor l��'�, Main Floor � Basement GENERAL . _-----1TF,M NO. FEEf ITEM NO. For issuance. 'Of. Permit x.00 Boilers Over 11ew - Under 100000 Btu 4.00 Air _Handling 1( J00 CF'M New - Over 100,000 Btu Air Nand- 1�ng�:�er 10,U0_ 0 CFM _ Floor Furnace _ .00 Eva _orative Cooler —l�r - Sl- e _ .00 Vent Fin Install Ven-mss�__ •� Venr�ys fair - Heat & �.:oo73n� x+.00 ---Ho—OCL Boilers Under 3�HP--_ _ 4.00 Domes ic,I-nc�-erator Boilers o 15 Nom____ 7.50 Comm. Incinerator _ - 1 to ers l-j 30 10.00 Other io�I,is£e_�� to 11 --l-6-50-140 e r s 30- TNSPECTOR' S COMMENTS APPROVED BY _ __ DATE ISSUED BY �___VJ DATE