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15227 FW ALDEP,BROOK PALCE
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ner:..._ ........................................................................Permit No.......
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,�• Building Address............15227............W... ..... ................Alderbrook.....P1.....�......LoL. #4.1.Q... _. . .....
. Certificate is hereby given this................day of...p.u9.up.t............... 19....7.7. �
that said building may be occupied ands }�
pti ,r: that it complies with all requirements of
'�j f•: the Building Code for the City of Tigard, ` r'
C
as approved by the Tigard City 'Council. ��►
Building Inspector
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City of Tigard
INSPECTION REQUEST
f Or
INSPECTION TIME: L PERMIT NO. :--
DATE: DATE ISSUED
OWNERS NAME : ,
ADD fiE S S:
CON TIR A CTO R
TE ST : Air 0, Woter C) , Visual 0 , Lo il-ratory 0
qESULT' Approved /Disapproved C Pending
-SKETCH.
, PECTOR DATE
[:NOTF ' Attach supplemental test data beret.]
i
UNIFIED SEWERAGE AGENCY NO. ______11693_- ---_-._--
WASHINGTON COUNTY DATE
CITY ----
C'F ___ Tio__ ._ -ard - --- --
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: --- --- 1-:D-,EiI_- -
OWNER'S ADDRESS:
STREET
CITY STATE ZIP
BUILDING SITE: LOT- 410 �_ BLOCK __ ADDITION ---__- —�_
TAX LOT NO. —,_.__—_ TYPE OF OCCUPANCY - residence — —
ADDRESS -15227 SW Alderbrook_pl, ------
DWELLING UNITS FIXTURE UNITS -_
SURCHARGE IF APPLICABLE
PERMIT FEE _ 575-_______.. INSPECTION FEE _ 2_5_.___ "TOTAL DEPOSITED _ _600.
(NEW) (EXISTING) BUILDING SEWER SYSTEM -T-arna-Creek--__-___- __
The Applicant agrees to comply with :11 rules and regulations of the Unified Sewerage Agency.
APPI ICANT
G�'1 ----
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
INIF S17F -- - - _ INSTALLER
I
RECEIVED BY,,
(AGE OR ITS AGENT)
v' d,
COMMENTS: Bldg. #1344 ---- --- __ --------
g
9
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
BUILDING PERMIT APPLICATION cor TlGARD DATE_--
3-1t—'�'7 ,s___ 144
THE UNDERSIGNED HFREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF "2.39 "3101
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS .AND SPECIFICATIONS. OWNERPFIONF
LOT NO.-
OWNER
O.-OWNER Ion-ca JOB ADDRESS 1;,11T 1j; + lad>rbrook H6AC ADDRESS
ARCHITECT
Dome ENGINEER
BUILDER ADDRESS DESIGNER
SFhUCTURE K=NEW ❑REMODEL ^ ❑ADDITION ❑—IREPAI'A ❑RENEWAL t3FIRE DAMAGE ❑DEMOLITION
Q flESIDENCE OCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIUUS CJPATIO [:)CARPORT ❑GARAGE [:]STORAGE EDSLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONA.L USE 0DESIG11 REVIEW OCOUNCIL APPROVED ❑SIGNS
OC__CUPANCY._.L._—LAND USE ZONE ' BLDG.TYPE_ FIRE ZONE_ PLAN CHECK BY— —� HEAT_
1.11.0 ilk :tai re—Lesue aawsa as 1`.`x.1;9 SW 5ummWield Lane
frame duelling w,/rAttachad garage
USC LOAD—__-_ -_.F{QpR QA DHEIGHT NO.STORIES 1 AFt A h® NO,BEQBQOMS � yALVE` M •__
BUILDING DEPARTMENT 13
_�. SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 127.60 -- -- --- — — - •---
-- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check lag 00 REGULATIONS AND ALL. APPLICARLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WIL L BE DONE IN ACCORDANCE WITH TNF.PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOl WAIVE
RESTRICTIVF COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax Q•y l LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 141.1i
By
APOLICANT OR AGENT
Approved l! Receipt No. � � 1
.y�
ADDRESS NE
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1�
i
UATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
_T I/.11z1jl _ Permit No. n eo( ' S/— /l- 7:?
Rough
T' Fixture — ^
rV v—� Final
��77 _ HEATING
_ Contractor
_-- Permit No.
Gas or Oil
-- Rom' in ---
Final
SEWER
Final _
DRIVEWAY—
, Final
Storm Drainage,___
(Rain Drain) Final
Sidewa,k
Curb&Street Final
Approach
BLDG DEPT FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping J
`-� Zoning Final �/
ADDRESS__, PERMIT NO.
_ PERMIT CHARGE none
------------
OWNER, c
CONNECTION FEE x__75
PAID BY kO e
TYPE OF BUILDING �'Jy_ _ DATE CONNECTED
u.J
SERVICE RATE — ��0 INSPFCUON FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT _ PAID