15240 SW ALDERBROOK DRIVE-1 ow-
Ui
N
U)
F-�
C.
O
h
Q
ti
O
O
X-
I
i
1lbl.,,IflR(x)F IMIVC,
ADDRESS.. S���O J(�/ �Ze _ PER"IIT ND._/,S,Fa�5-
PERMIT CHARGE none
CONNECTION FEE
O W N E R '�-. --
PAID BY T D
TYPE OF BUILDING � DATE CONNECTED
SERVICE RATE INSPECTION FEE
CONTRACTOR
PAID BY - - DATE
ASSESSMFNT PAID
SI %.E OF CONNECTION
h
SEWER PERMIT NU3 15825
Unified Sewerage Agency ]
of Washington County CITY OF T i ga rrt DATE
OWNER: �z _n_r . PHONE :
OWNER 'S ADDRESS:
TYPE OF !NS"IALLATION:
x❑ BUILDING SEWER ❑ BUILDING SEWER AND SIDE ;EWER
TYPE OF OCCUPANCY:
xf] NEW f2 INGLE FAMILY �_� COMMERCIAL
❑ EXIST. (PRIOR TO i- 1-70 ) ❑ MOLT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS_.—1
ADDRESS OF
PERMIT CONDITIONS: THF .APPLICANT AGREES TO COMPL' WTTH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERACE AGENCY. WHEN CALL1IvG FOR INSPECTION,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES III ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEF $ 25.
CONNFCTIGN CHARGE b00.
SIDE SEWER INSTALLATION
ISSUED BY
OTHER
TOTAL $ fA25
.1
APPLICANT �--- -�-- � DATE
SEXIER PERMIT N • 15825
ADDRESS OF STRUCTURE 15240 SIJ Alderbraok Dr.
TAX MAP _ TAX LOT — SYSTEM fanno creek
LOT 1 BLOCK OF
APPROVED BY DATE ISSLIED BY DATE
D. U. 'S ,—I REMARKS bldg. #1973
.....,... »...r........,.—n..-........�...or,+..n—.�...,,.--•ewr�w.�r.-+..+.n*.n�+..r—....—..-...-,.........._.—......�•,. ....,..--....,�.•....�,..,..,.......ww�ww.+....+-..---•�..�...o---
1TY
BUILDING PERMf I APPLICATION roe TIGARD DATE. 3-20-70 1n73
r
THE: UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PIi7N�_ �_—
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS Own;ERPhC
LOT NO._
OWNER T . JOB ADDRESS .5240 SW Alderurook r,
_ lIjkliME ADDRESS
ARCHITECT
£idf1113 ENGt.4EER
BUILDER _ ADDRESS DESIGNER
pSTTRUCTURE "OfkW CJREMODEL y_^OADDITION ❑REPAIR ❑RENEWAL _ `j-IREDAMAGE UDEM�-OLITION
L AESIDENCE C31 IVA ❑EDUCATIONAL. ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑ST_Fil-GE❑SLAB []FENCE
QBOND, ❑MOVING ❑CONDITIONAL_USE ❑DESIGN REVIEW ❑COUNCIL APP',10VEU _ [:]SIGNS
stw _ I
OCCUPANCY__LANC USE ZONE-_ BI..DG.TYPE----FIRE ZONE_ PLAN CHECK BY�
A*1 mk 5-0 reii3sue of liat)13 SW tL1it►merf ield Lane 3 bvdraum 3 bwf.t°I
sewer permit 'IbIB25
411 20 2� peso 3 4-.:�(100.
OCA 14AD FL44R_L491L_�----- HEIGHT ___l�9,_ TQHIES_ �_E Jam, $QQ 13 VAL.4! —
• —
_ BUILDING DEPARTMENT SET_BACKS FRONT 10 REAR `-v LEFT SIDE RIGHT SIDE
Permit Tzz_._0U_�� --
—�1a. THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE q_IPI DING '.ODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREOY AGREL"i) THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total I ALL APPLICABLE CODES AND ORDINANCES. 'THE ISSUANCE OF THIS PEPMIT DOES NO1 WAIVE
RESIRICTIVE COVENANTS. CONT4ACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax ' LICENSE. SEPARATL�PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total ---------
.� i .LJ.L. Ir 4 , iIti
BY _ _ —--------�_�..
( �►( ,`CANT OR AGENT
Approved \. Receipt No. 1
DATE INSP. TYPE INSPECTION nEMARKS PLUMBING DATE r
(/ Contractor
f Sfb ptl L),�C� Permit No. � f /FS -78
�TZ_ .tet -ten{ten• (�-tt�.,c..,.,ct_ Rough-in
Z -cv , Fixture__
Final
--
.oJr ) ! .ai�c:Ls._��,�,� HEATING
_J �K G ,L - Contractor _
t*_t Permit No.
Gas or Oil
Rou h-in___—. _ —
__ _ Final
— —SEWER �
Final
DRIVEWAY
—..-�_�—_—_------ Final I
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG DEPT FINAL TEMPORARY CERTIF1 .ATE OCCUPANCY
CERTIFICATE OCCUPANCY Final —_
l Landscaping
�/ Zoning Final