11950 SW HAZELWOOD LOOP-1 P
11950 SVS PALTLWOOD LOOP
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A d d r a s s //3w SZ) zl-��- Permit No. �.
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Permit charge 22 C �7
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Pr 7 Connection f ee
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P2id by
Type of building Date connected _
Service rate � ' Inspect-' ,in fee
C,7ntr,,r�tor Paid by pate
Size of connection Assessment _ paid
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4 J�� CITY OF T IGARD
OREGON
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OAA-ner:......... -...........�h.t .. . I_........... .. Permit No.....1128 _ ;t
Building Address.......... 11950 ��J..Hazglwo- Lu. p. ..................
•, Certificate is hereby givon this...20....... day of....�a.rpb ................ 19.....?.7
that said building may be occupied and 'J
that it complies ti•ith all requirements of J
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_• the Building Code for the City of Tigard,
as approved by the Tigard City Council. ?
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+.+ Building nspector 1; `
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City of Tigard
INSPECTION REQUEST
for
IIVSPECTION TIME: ii , al PERMl1` NO. :.
DATE: -0, %��rDATE ISSUED _ Z Z
OWNERS NAME :
CONTRACTOR :
TEST : Air [), Water[] , Vieual o/l Laboratory p
gESULT: A proved Disapproved C
G ,� PP , Pending U
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INSPECTOR DATE
COTE : Attach supplemental test data beret
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City of Tlyor+d
INSPECTION REQUEST
for
INSPECTION TIME: 42 PERMIT' NO. .-_
DATE: ''6 DAT ISSU D "_ I�_
OWNERS NAME : —
ADDRESS:
AME :ADDRESS:
CONTRACTOR : - --
TEST : Air G, Watsr[1 , ,Vieual [3 , Laboratory o
RESULT: Approved GY, Qieapprovrd 1-7 , ?ending [)
SKETCH:
1
INS �CTOR DATE
FOTE.' Attoch •upplementol fest dots hereto]
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UNIFIED SEWERAGE AGENCY NO 10615
WASH I I� GTON COUNTY DA FE 10-13-76_ _
CITY OF Tigard -
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: --� J.L. kib� Light
OWNFR'S ADDRESS:
STREET
CITY --------- ------._._______.
STATE _..
Z 1;'
BUILDING SITE: LOT_ -- BLOCK _____ ADDITION —
TAX LOT N0. _-_______ _ TYPE OF OCCUPANCY rpGi riecen
ADDRESS _. 11950 SW Haaelwood Lp.
DWELLING UNITS_--_.--l----------_-____ FIXTURE UNITS
SURCHARGE IF APPLICABLE .._._--_---
PERMIT FEE __.__575. 00 _ INSPECTION FEE .25.00 TOTAL DEPOSITED 600. 00
(NEW) (EXISTING) BUILDING SEWER SYSTEM Fenno Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT-r; —,
SEINER PERMIT
I
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SY!:;TEM.
LINE SIZE -. _ .-- INSTALLER ---__--
RECEIVED B Y—
!AGENCY OR ITS AGENT! -
V
COMMENTS: Bldg. ;1128
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
LIGHT Construction Co.
15890 S.W. Colony Drive Tigard, Oregon 97223 Phone 6398560
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APPROVFD FOR CA TR-�'R CITY OF TIGARD�'�
p 0 SITE ADDRES-S --b Wit:
Y TITLE DATE-/
i.....,,,w„r,,,.,nr"y�r..,wwM,,,, .,r,,,R,=,,,r!"'rr' ��*"....q'.^a.•'w°.*A��►."'*q.w..".ry.*,�•' TV-
BUILDING PERMIT APPLICATION 11 Y TIGARD DATE '0 .1'3-~'�__, 19�___
THE UNDERSIGNED HFREBY APPLIES FOA APERMIT FOR THE WORK HEREIN INDICATED 13UILDERPHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPAN` ING PLANS AND SPECIFICATIONS. OWNEr?PHONE___ _
LOT NO.
OWNER _��• Light, JOB ADDRESS 0.950 SW 4azelwood 46IMEADDRESS
ARCHITECT
aENGINEER
BUILDER e 1 _ADDRESS DE-IGNER
ST11RUCTURE UNEW 0REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
CwIRESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑POND ❑MOVING ❑COND'TIONAL USE ❑'DESIGN REVIEW []COUNCIL.APPROVED ❑SIGNS
OCCUPANCY_-.L..._LAND USE ZONE BLDG.TYPE f IRE ZONE_j_ PLAN CHECK BY_ >`t;j EIEA1S3s
c;{ volts single family 1lwfP>.1ling w/attalhl.iwo ,rage 3 bedroom 2 bath
garage !,00 raq.Pt.
� . LQAU FLQQB L._ OAD-- _ HEIGHT_—_., N0.STDRIES 1.1___AREA153 NO.yEDRQOMS 3 VALUE 37s800.
BUILDING DEPARTMENT SET BACKS FRONT20
REAR 37 LEFT SIDE 1) RIGHT SIDE 1Q
Permit 510:iG
THIS PERMIT IS ISSUED SUBJECT TO TETE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 10 011 REGULATIONS AND ALL APPLICABLE CODES. AND ORDINANCES, ANL IT iS HEREBY AGREeD THAT THE
——- WORK WILL BE DONE IN ACCORDANCE WI fH 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 4e 0;j LICENSE. SEPARATE PERMITS REOUIRFO FGA SEWER, PLUMBING AND HEATING.
Total 16Z 0 a7
Byr-------
_ --- - - - APPL.ICANT OR AGENT
Approved Rviceipl N
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Z413120 - --- -- - Lonti,:,clar
- I ��,�ti _ Permit_No (06'5 0 0.1
yRough-in —
27
��Q Fixture
Final
HEATING
l _ Contractor
Permit No.
Gas or Oil
Rough- n
Final
— -- ---�—_ .� — SEWER
Final__—..___ —
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
-- _ ---. —� — - - Sidewalk L,C• ;t-
Curb&Street Final
A roach __._.� - G .Z -�•-7
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
( Landscaping
Zoning Final
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