15200 SW ALDERBROOK COURT i
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15200 SW .ALDERBROOK COURT
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Y OF T10��V", 43
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.Permit No..
1.26G
U�,ner:......T.D.C. IJ
1 1200 5W Alderbrook Ct.... .Lot X 400
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$ Building Address........ Ou y
;.. •, given this. ..�.n..... gay of_......!�8..
... 1. 7 7 ,{n
Certificate is h�I eb/ g :
that said building may be occupied and
that it complies with all requirements of
\. ,•� the Building Code for the City of Tigard, <,
as approved by the Tigard City Council. rip . fi
�. Buihing Insperior i
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Chy oI Tigard
INSPECTION REQUEST
for
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INSPECTION TIME: PERMIT NO. :
DATE: 1i L: ,L17 DATE ISSUED '.-".__ _ I
OWNERS NAME : L J�- - —
ADDRESS. f 40e-' (Ld I
CONTRACTOR : __ _----
TEST : Air Ll, Water[] , Visual [ Lubora!ory p
4ESUL.T: Approved ❑ , w Disapproved C Pending [1 ,
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SKETCH:
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INSPECTOR DATE
COTE: Attach supp!ementat test data beret�7
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City of Tigard
INSPECTION REQUEST '
far
INSPECTION TIME: PERMIT NO. : -._—..
DATE: 1.� ?.? DATE ISSUED .
OWNERS NAME
A D D R E S S.
_ I
' EST : Air [J, Woter Cj vieuaI ❑ , I abnrotory ❑
'RESULT: Approved Disapproved C Pending ❑
SKETCH.
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I(�, PECTOR DATE
NOTE. Attor.h .tupplementnl test drtn beoeta' I
UNIFIED SEWERAGE AGENCY NO. — 11618
WASHINGTON COUNTY DATE - 1-26-77
C I T Y 0 F___JA_g_q r-d
APPLICATION FOR SEINER CONNECTION PERMIT
OWNER: ___________Tk_D.-C-
OWNER'S ADDRESS:
STREET
--------- _ -- -------- -- -- — --__..
CITY STATE
ZIP
BUILDING SITE: LOT_____4..QQ --- BLOCK ADDITION
TAX LOT NO. TYPE OF OCCUPANCY res.i.darim—
ADDRESS
DWELLING UNITS---.---.l FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERMIT FEE - INSPECTION FEE __2_5,.___ TOTAL DEPOSITED
LtJ_LWj_ (EXISTING) BUILDING SEWER SYSTEM
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT_
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION 10 THE SEWER SYSTEM.
LINE SIZE INSTALLER
Y4..<.-e �e
RECEIVEDI;kGFNCY 0 n/ S AGENT)
CONIME NTS: Bldg.- #1266
This Application and permit expires in one hundred and twenty (120) days.
The amount p-jid will be forfeited should expiration occur.
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4i1' BUILDING PERMIT APPLICATION c0F TIG ARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HE9EIN INDICATED BUIL•DERPHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE-
n r1.OT NO.
OWNER u JOB ADDRESS 15200 .1 Al' a L)ruok HOME ADDRESS
RRCHITECT
ENGINEER
BUILDER ADDRESS — — DESIGNER _
STHUCTLIRE__, EW_ _❑REMODEL ❑ADDITION ❑REPAIR 1JRENEWAL _ [:]FIRE DAMAGE i❑DEMOLITION
USESIUENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE C3 DESIGN REVIEW ❑COUNCIL 1,PPROVED ❑SIGNS
c —
�UPANCY—_—LAND USE ZONE I.� FLOG.TYPE ' ' FIRE ZONE L PLAN CHECK BY E ` HEAT '
Lot n tWO 111 ,tTtorcoy mirrgla family re—iaeua, Hamel as 10J-L't3a :,Wl�rt,�c7 t
t b%dr€om, 1 bath Frame dwelling a/atteahed %;srag+e
C)C�C _LOAQHEIGHT bO.ST_QRIES AREA 1448 NO BEDROQM5__/'__YALUE Lf_� 7T�•
DEPARTMENT jflE.� t„ I,
BIIILDING
SET BACKS FRONT GEAR LEFT SIDE RIGHT SIDE
Permit .�,:'7.L.Qu � -- �.-.---------_
HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE FLANS 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 SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4,11 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 141.1 .
By
nNt OR AGENT
Approved Receipt No. ^`ti
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UATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
77 �xJ 4- A -ya _-- —� Contractor c^
/�� fie✓ _ t- C;eti1 Permit No, 0 / 3LS-/vl-7J
Rough-in I
J — Fixture _
Final _
7 — HEATING
/// /7 ,-� ,� — Contractor
63-a-
Permit No.
Gas or Oil -
-- - - R ough in
Final _
SEWER
Final
DRIVEWAY -
Final
Storm Drainage
_ (Rain Drain) Final _
— -- .- ---- Sidewalk
_ Curb &Sueet Final
— ----- — — _
Approach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -
Landscaping
Zoning Final -�
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Address _4-�� ' Permit No.
-- Permit charge
Owner -.,�. h ra Connection fee
Paid by
Type of building Date connected
Service rate Inspection fee
Contractor _ paid by date
Size of connection Assessment paid '