15205 SW ALDERBROOK COURT I
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15205 SW ALDERBROOK COURT
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. � T'Y OF TIGARD 4'VC� >
' OREGON
:. ...Permit No........12.6.7.......
41 0��ner:. ....T.D.C........ ............... ..I........................ t , 1
Alderbrook Ct. 1_o t.. .#3`-'9......
Building Address.
15"05...SW.. .......... ..... ................
'
19 ...7.7.
given this._... 20......day of....�u.ne....... .......... .
Certificate is hereby g _. °
that raid buiMing may be occupied and
'� that : complies with all reyuireme.�tc of ` 3>
the Building Code for the City of Ti.,,,
y
rr as approved by the Tigard City CotmctL
e
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Building inspector
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City of Tigard
INSPECTION REQUEST
T
for
INSPECTION TIME: � o PERMIT NO. :
DATE: y1 1r 0_/ -f DATA: ISSUED '_i_L__
0*4ERS NAMEADDRESS* t f - )-«
CONTRACTOR : ' X114�rZ71) C/a�we
TEST : Air p, Water[] , Visuai�61, Laboratory p
9ESULT: Approved Disapproved [7 Pending p
S KETCH: -'It C1611 ti,E 7-
INSPECTOR DATE
[NOTE : Attach supplemental tett data herety,
UNIFIED SEWERAGE AGENCY NO.
WASHINGTON COUNTY DATE 1-26-77
CITY
APPLICATION FOR SEWER CONNECTION PERMIT
T.D,C.
OWN'
OWNER'S ADDRESS:
STREET
CITY STATE ZIP
BUILDING SITE: LOT -399 BLOCK, ADDITION
TAX LOT NO. TYPE OF OCCUPANCY
ADDRESS ----15205 SW-.A-lderbraok----Ct.
DWELLING UNITS FIXTURE UNITS
SURCHARGE IF APPI-ICABLF
PERMIT FEE INSPECTION FEE TOTAL DEPOSITED —600.
IN E,V) (EXISTING) BUILDING SEWER SYSTEM ---"ni-io
The Appl:cant agrees to comply with all ruluS and regulations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE ';I?E INSTALLER
F,E C E I V E D B Y
(AGENCYffl ITS AGENT)
COMMENTS: Bldg. #1267
This Application and permit expires ire one hundred and twenty (120) days.
Thle amount paid will be forfeited should expiration occo:
wv+•x���p(.Iq� OWN., �MwHnnr•�wwr+wMn�Yl`�'�gM'F"11�""
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BUILDING PERMIT APPLICATION 1 OF TIGARD DATE 1-2f)-77_ 1� 1267 `
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _—
LOT NO._.---._
OWNER JOB ADDRESS15205 SW AldiirbruuK U DME ADDRESS
ARCHITECT
ENGINEER
BUILDER lllr ADDRESS _ _DESIGNER
STRUCTURE 'Q- NEW ❑REMODEL ❑ADDIITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE DEMI-O-ILITION
`" UJAESIDENCE DCCOMM ❑EDUCATIONAL ❑GOV'T ORELIGI OUS❑PATIO ❑CAR PORT nGARAGE [-]STORAGE OSLAB []FENCE
L
BOND JMOVIIic000NDITIONAL. USE DDESIGN REVIEW JCOUNCIL APPROVED L-JSIGNS
OCCUPANCY I LANG USE ZONE ,r .BLDG.TYPE-' __FIRE ZONE— PLAN CHECK BY'-) � HEAT A
i.ot :399 MKAXII r' p-iusua, earns as 10365 SW 4ighland Ur.
! rapiv dualling w/ittachrad ga',:age 2 bedroom 2 bath
-No..$2QBm5-1--AREA 1222N0.BEDROS�MS yauE27,II50,
BUILDING DEPARTMENT— a� c a
SET BACKS FRONT REAR � ` LEFT SIDE RIGHT,IDE
Permit 1 .leOu
-- - THIS PERMIT IS ISSUED SUBJECTTO THE PEGULATIONS CONTAINED IN 114E BUILDING CODE, ZONING
Plan Check rluego REGULATIONS ANn ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT THE
-- "--"— WORK WILL BE DONE IN.ACCORDANCE WI TH THE PLANS AND SPECIFICA TIONS AND IN COMPLIANCE WITH
Sub total Al 1. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CCNTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State.Tax 3e93 LICFNSE. SEPARATE PERMI iS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total l:t4e3
By
AP J�WANT OR AGENT
Approved Receipt No.
UATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Zl�
t5 Rough-in_C. O�-
31,�17-7 a-6 _I/—' Fixture
Final
HEATING
AQ A) Contractor
Permit No
la
Gas or Oil
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Appi oach
BLDG DEPT FINAL TFmPnRARY CCRTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY ]Final
Landscaping
Zoning Final
i
y IS
Address ( (,-�- , �.r „ �/_ Permit No.
_ Permit charge
Owner Connection fee
,^ Paid by 1,
_.—..
Type of building _., Date connected
Service rate1_
Inspection fee --
Contractor Paid by date
Size of connection Ass ssment Paid