14435 SW HALL BLVD W
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14435 SW HALL BOULEVARD `11
INSPECTION NOTICE
Cix,,,of Tigard Building Department
12420 S.W. Main St.
Tige.rd,Oregon 97223
Phone. 9.19-4171
Type of Inspection
V
Date Requested Time A.M. P.M.
Address Permit *--ta
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector U Disapproved
Date 4&'-
CALL FOR REINSPECTION
0 YES EP Pdo
SEWER PERMIT N9
Unified Sewerag3 Agency ,_*_,ps�
of Washington County CITY OF _ A DATE �7-2'7
OWNER: PoLirf4'VA.1Ah ot&Its _ ' ��PHONE : _
OWNER 'S ADDRESS: tgg3,-�- SG_) E4CX'1I P,� 04 •
TYPE OF INSTALLATION:
❑ S;.&VEWER [] LINE TAP AND SIDE SEWER Q LINE TAP
TYPE"'Of."pCCUPANCY.
❑ NEW ` EXISTING SINGLE FAMILY ❑ COMMERCIAL
EXIST. (PRIOR TO 7- 1--70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS_
ADDRESS OF STRUCTURE : Ate_.
Permit Conditions: The appl'cant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
When calling for Inspection, please refer to the Permit Number. The Application expires in one hundred twenty (120)
days, The amount paid will he forfeited should expiration occur.
The Agency does not guarr,ntee the accuracy of the location of side sewer laterals. If the sewer is not located at
the measurement given, the installer shall prospect three feet in all directions from the distance and depth given.
If not so located, the Installer shall purchase a "Tap and Side Sewer' Permit at the current charge and the Agency
will install a lateral at the location specified by the installer.
FEES:
3O PERMIT FEE $
CONNECTION CHARGE
LINE TAP INSTALLATION _
OTHER
ISSUED BY
�
TOTAL s
APPLICANT DATE
SEWER PERMIT N�,
ADDRESS .OF STRUCTURE
TAX MAS � J -�� i TAX LOT C.. SYSTEM K"1101110
LOT BLOCK _ OF QM4'-VPk4 W
APPROVft' BY DATE ISSUED BY DfA f
D . U. ' S -- -- R E N A R K S _ �_�k(.'.E ' ..`t* 47-or _9 �&4-