11383 SW LAKEWOOD COURT 11383 SW ;SAKI NCYOD �'-'`URT
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Address Formit No.
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_ --- Permit charge
CWne' `7� Connection fee
Paid by -L
Type of building uw Date connected
Servi,'3 rate S Inspection fee
Contractor Paid by _ date
Size o' connection _ r AssessmF.nt _ Paid
in.
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OF
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t� CITY OF TIGARD
OREGON
�1.9ht............................ ................Peri,it ?v0.. 10,73........ �3
11383 SW Lakewood
Building Address..........
Certificate is hereby given this...28........day of....Ma.rch................4 19.....77
L _ that said building may be occupied and
( <:. that it complies %rith all :-�yuirements of +
3 the Building Code for the City of 'Tigard,
as approved by the Tigard City Council.
/ • ,i Building Inspector a�
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City of Tigard
.-' NS T
� PEC ► loN BEQUEST
for
INSPECTION TIME: PERMW NO. .
DATE: .,,_?/iVY2 - DATE. ISSUED :—
OWNERS
SSUED :_NERS NAME _ _ -
ADDRESS: —/
CONTkACTOR :
-E S T : Air 0, Water Wisual�el Laboratory r3
RESULT: Approved , Disapproved C , Pending Ej
SKETCH,
I
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INSPECTOR DATE
IrTE Attach supplemental test data bereto�
CitY of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. : --.---
DATE
O. :
i OATEN2
DATE ISSUED:----,-- /
OWNERS NAME : 171"
ADDRESS : -���-_
CONTRACTOR . _
TE4T: Air 0, Water ❑ , il1sual Labaretory p
MRESULT.' Approved L7 Disa rov0d�
PP , Pending i-i
SKETCH:
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I
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INSPECTOR DATE
50TE . Attach Supplement-0 toot data hereto J
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w tom
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City of Tigard
INSPECTION REQUEST
for
_ Z-�
iINSPECTION TIME : 3 '�4) PERMIT NO. :
DATE: DATE ISSUED: L._L
OWNERS NAME . `' - _
ADr,RES : �Z `S_ c.cJ ,
I CONTRACTOR
TEST* Air 0, Water ff;"yttualt-"oratory p
RESULT: Approved tY', Disapproved O Pending r]
SKETCH'.
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INSPECTOR DATE
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CIO[
UNI - IL-A) SUVERAG E AGENCY NO. . 10644
WASHINGTON COON'ry DALE —Se t. 1.6x_1976
C;II Y OI Tigard
APPLICATION FOR SEWER CONNI4, TION PERMIT
OWNER: __ __ J• L. Light Const.
14525 S.W. 150th
OWNER'S ADDRESS- ----.-
-. — — — —
STREET 97223
Tigard Oregon
CITU - - ST-AT E ZtP
BUILDING SITE: I.OT i2 BLOCK AUDITION .--Englewood Subd._
TAX LOT NO. -TYPE OF OCCUPANCY
ADDRESS _-- --113fla_ .W. 1..9 k_�L�Q_4 _ t• __. _. -- --.�-- _
DWELLING UNITS__ FIXTURE
SURCHARGE IF APPLICABLE--_ --. _____ - .. _-_-___ -_------- --------� .-- --
PERMIT FEE ___-_-___a — INSPECTION FEE - —25 'TOTAL DEPOSITED
(h1E.11Y1. (EXISTING) BUILDING SEWER SYSTEM ____- _ - Fanno Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT_ -- -- =f -
SL WLR PERMIT
(HIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
411Somerset Plbg. &,, Heatinr,
LINE SIZE _-- .. _-- .- -_ INSTALLER
RECEIVED
[z.t.
IAQNI V�//H ITS AGENT)
COMMENTS:__ -_ _ buildin.g._ paimi.t 107.3 .-___.---
This Applicatirn and permii ,ries in one hundred and twenty (120) days.
The a.nount paid will be forfeited should expiration occur.
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BUILDING PERMIT APPLICATION �o Y TIGARD DATE1)QlQt• 1 19�G ?3
THE UNDERSIGNED HEREBY APPLIES FOR APE RM IT FOR THE WORK HEREIN INDICA FED BUILDER PHONE.-U39-25"
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PL/,NS AND SFECIFICATIJNS. oWNER'Tr*�Mvtp ---
:-7T NO —
OWNER s A
JOB DDRESS i• • i 1 IE ADDRESS
ARCH I'fECT
ENGINEER
BUILDER :3ADDRESS
SIRUy�,
CTURE UNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ IRESIDENCE ❑COMM ❑EDCATIONAL GOV'T ❑RELIGIOUS❑PATIO ❑
❑CARPORT ❑GARAGE STORAGE❑ [:]FENCE
FENCE
LJROND ❑MOVING []CONDITIONAL USE []DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY— LAND USE ZONE sc-7 BLDG. I YPE FIRE ZONE PLAN CHECK.BY- {!.' _ HEATS _
y�T5C�1t family dwelling W/at.".sghed garage ---- - - ------- -
QSQJ.S28Q— -- F144R LOAD -_ HEIGHT �y Ng.,STORIES— _ AREA �V9�b�12HQ9��2 ._ Vim' Ll1E 1�c..-
-.-.- -
BUILDING DEPARTMENT SETBACKS FROPPOf REAR 3.1 LEFT SIDE_ 7 RIGHT SIDE 7 _
Permit 1:)l•00
—'- 10.00 THIS PERMIT IS IS 1LIED SUBJECT 1'0 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, 4ND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCEF THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REOUIRL.) FOR SEWER, PLUMBING AND PFATING.
Total
By
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A (CANT OR AGENT
Approved Ri.ceipt No.
-- , ADDRESS
6 176
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