11685 SW HAZELWOOD LOOP-1 L
11685 SW HAZELWOOD LOOP
b.
c �
C�
3
k.
Address //�,��-' ._. -.,�...,� ;� Permit No.
a
Permit charge 22 C' 2
Owner ( � Connection fee �� —
Paid by
Type of building 1_ 14�� Date connected
Service rate _ jInspection fee
Contractor �^ Paid by bate
Size of connection Assessment paid
3
I
I
If Tigard
i
City a g
I INSPECTION REQUEST
E for
IINSPECTION TIME :_.L� __.__ PERMIT NO :
DATE' // 012-1 DATE ISSUED:—L.—L--
OWNERS NAME .
ADDRESS : /J( � .t. ��.•� ' r'._
TEST: Air [7, Water p , Visual ❑ , Laboratory ❑
I RESULT. Approved Ea< Disapproved O , Pending J
I SKETCH:
1
I
I
I
I SPECTOR DATE
ENOTE : At�ach suppiemental test data herstol
I
� . >� ` .
o0
o
LT,X-- ct a0
y w 0
"-
In U Q.
N V_
O wm -j v - - - — --
Z , 91 0
CP
�� •� ami � Q:a a
c - O ~ C Q
0 % c ry
0 8 �
C" n
N —
4-
0 O
E o c
C] c
CL c Q
�2 f0 a u1 In O In ri N N
? O CJ N
fy F- A _ �' t.7 w W 5�Q7 E G
_
Fy a o c c C
y. N LL
iiTO
W
:2 I O Q li— r
C] t: -0 L- z a x
C7 -� c c c
i� CL cl O
M Cl 4 U
W
D N C N O ti tL
fin U-
^j til u u
,J b CJl L iC O C u n v u _
0 F- LL ¢ 19 rc U�
CNC 1� O
Qul .� 7
.O w J w ; n c n S v C7
on In
N
o
`n
,x w ~I ro o t'
In
O cn K x x ;
.� W U �- ro y > i w m �[ LL LL 11 it '� n`. m
I pro _ N E -1 g T' N
r_I m v _• o 0 0 w 14 N Fd
�7 \ r4.1
z p In ra C..) ^ _LW of U
N .�(v
i
City of Tigard
I
INSPECTION REQUEST
for `
INSPECTION TIME: PERMIT NO. :
DATE: ._ '-z3 DATE ISSUED
OWNERS NAME :
ADDRESS:
CONTRACTOR : ___ _--
'EST : Air 0, W'ater[l Visual Laboratory L7
RESULT: Approved , Di�tappr^:5d [M Pending [I
SKETCH- C'
2 ?
' NSPECTOR DATE
CNOTH: Attach supplementnl test data beret 01
UNIFIED SEWERAGE AGI---NCY NO. 1 06to
WASHINGTON COUNTY DA I'F August 16, 1.97,6—
CITY OF
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: . YYXXXU V. 1',"avne HELLIcl,,'SON
0\VNFR'S ADDRFS& 302 N.E. 18
_______iTREFT
Mllsboro 97123
CITY
ZIP
BUILDING SITE: LOT._A93___ BI.00K ,------- ADDITION . Englewood Subd.
TAX LOT NO. TYPE OF OCCUPANCY residence
ADDRESS 11685 S.W.--Hazlewood Loop.
DWELLING UNITS FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE INSPECTION FEE25 600
-_ ____ TOTAL DEPOSITED
_NEVI (EXISTING) BUILDING SEWER S"(STEM ___.,Fanno Creek
The Applicant agrees to comply with all rules and regulations Of the Unified Sewerage Agency.
APP L I CAN
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE - 14" ---_— INSTALLER _._, Tualatin Valley Plbg,
RFCEIVED BY. n
(AGENCY OR ITS AGENT)
L
COMMENTS:, building pengitl000
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
1�
0
0
r
/_A7'/ 0
/�uuS G /"l. f;.ti/ /5-7l
ty
11645 1,A,71I H/nop Leos
L 07- 0 3 !;Pf 6( , IV,- P s v 6 '/V/S a/'.' �
V. Ick r^'/
APPROVED FOR Cor.STRuc-riON
CITY Oi I,, .r,D
FFP'N,IT NO. Sim
Rj. TITLE Q DA1 EF�� ''�
u "0
r
N^
1
..... _.y:r..+.,-.....i+p,�'..:.MIWwwI..VM.tY..+w+w�uV"..,yiM+rVM•.rr.�w:..nwn+..wlyaw�.s..r,
BUILDING PERMIT APPLICATION CO FY TIGARD OATS " ' _ 1976 f+'
THE UNDER`.IL;NED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13UILDERPH0NI6A:`__ 1f.r__
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE _
tf ry p qy�^ QQ ,,�,,,��•,, LOT NO.
OWNER ayne Slell.�.C�C9G'n JOB ADDRESSU(k.`1 y• _ L: ,'.I.1'.)t F(' Ii@h71T DURESS
ARCHII ECT
BUILDER Salo() ADDRESS ENGINEER
�c-� _ DESIGNER-
SLR
ESIGNER
STRUCTURE LJ NEW 0 REMODEL OADDIITION r,❑REPAIR ❑RENEWAL (jFIRE DAMAGE ❑DEMOLITION
11 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T t_.I,RELIGIOUSI)PATIO ❑CAR PORT OGARAGE ❑STORAGE OSLAH FENCE
IJBONU ❑MOVING _❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED_ ❑SIGNS
OCCUPANGYLAND USE ZONE _BLDG.TYPE —FIRE ZONE_""7 PLAN CHECK BY Cri VA— HEAT — "1.1`' —_
_-- Cotte w t Werk tard1y ttvelllaw; witil. aattac hf� 'O
--- -- —T---T
Q"—LOAD FLOOR LOAD _ HEIG JyQ STORIES AREA —_AQ
BUILDING DEPARTMENT r "
- SET BACKS FRONT REAR LEFT SIDE R
� IGHT SIDE
Permit 133000 ___ --- - - — -----------
y — THIS PERMIT it; ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check loom REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, P.ND IT IS HEREBY AGREED THAT THE
-` WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4*29 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEA1lNG.
Total —��--
Approved liv(vipt No
AOICANT OR A61 FiT
AD R SS PRUNE
---
. ..... ...._. ...._. _........._ .. ...... ...._...-._..,.-�„:...,„a..ry,,.,.,w.—.. _..:. ..�_......�+iso:.,.o�...a.,.,.....r.u...r.-a--... .W..�....,..._i......+.wu.�..►r
d
74 4 .�G Cl7r e,<
UJ C) CD S C5 0 0 C 0 co
wm C-i CV m m In 66
C) LL. c,4 CN
w
%
CL w
LL
U.
u
O cc
0 0 0
sT C-1 ..Ll'
al
w 0 0
0
Ln
0 CYV VC
JJ
cu u '.
> C:
CL 0 c — 0
0 LU c c m m > z
z x LL U)
S -EI C C E E(0a cu E
o 0 m fn
Q
N m Q Q uj > > S G U 0 0 cc LM
U-)
3 0- 0
D D c cr-
CL >
w q 0 r3 0 o C) c! Uc7 � cr-
'a ui m m 4 df- — — z
0 ui F-
LL 0
cc
w
C5
0 0 < w
cr
0 <
Er
w
0. r2
(n in
m uj z
< co C:
E- 2�o 0 o- Y
o o 0 0- CL
0-6 LO m Lo V)
0 0 CU LLJ co
,P 0 m t 2 (D —
TZ u 0 0 rr z
F- @u to 0 — ., — 0 Z
L) -0 C 0 C 0 0 V) w
-J o w T LC) C
< 0. M C
- w E D 0 > D > 0-
4-J s cr U- L) 03 0 —
cr z LL.1 cr W
Z 0 0 w 4' CL
CU 0 r CL. w
0 m v a
W 0 0 0 0 z
(r cr, m m En
LL zl z G- c < fr