15405 SW ALDERBROOK DRIVE _.__....
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CITY OF TIGARD
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ON% r:................. ............................... .. ............. ......Permit No........1155
15405 SW Alderbrook Dr.Lqt,.#.3.2,A.........
• Building Address.................... ............. ..... .......... ... .... .......
Certificate is hereby given this...2.5........day of....MPY...................... 10'T?.....
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.
Building Inspector
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City of Tigard
INSPECTION (REQUEST
for
INSPECTION TIME: t PERMIT NO. :
MATE. 1-7 DATE ISSUED .�1�
OWNERS NAME :
ADDRESS:
CONTRACTOR :
J
TE ST : Air p, Watery , Visual , Laboratory p
RESULT: Approved Disapproved C' , Pending p
SKETCH:
I
INSPECTOR DATE
EOTV Attueh supplementnl tett doto be►etal
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City of Tigard �
INSPECTION REOUEST
for
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City of Tigard
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INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :— I
DATE : DATE ISSUED I
OWNERS NAME .' — --1 -
ADDRESS: .�� f3-�G -- — --
CONTRACTOR : __ --
T E ST ! Air ❑, Water[] , Visual [3 , Laboratory []
RESULT. ApprovedDisapproved C�, ending []
SKETCH: I
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1N PE%.TOR DATE I
NOTE : Attach supplemental tee) data dereta] I
ly
UN r r_, _ - AGENCY NO. 10693 __. --- --
UNI IED S�tB17-- p *AGE
VIJASH I NGTON `. UNTY DATE
CITY O F T i�_ d _ -- --- --
APPLICATION FOR SEWER CONNECTION PERMIT
U\11NER: ._- - __�I���C •_ --- —
OWNER'S ADDRESS: --------"--- -_-.._
STREET
BUILDING SITE: LOT _326— BLOCK ADDITION
residence
_— TYPE OF OCCUPANCY
TAX LOT N0. _- ---- -
ADDRESS 15/,05 _ _SW- Alderbrook Dr. -
DWELLING UNITS --- 1 FIXTURE UNI I-S - --
SURCHARGE IF APPLICABLE - —
500. 00
PERMIT FEE -535--UQ - INSPFCTION FEE X5. 00 TOFAL DF"OSITED _
Fanno Creenk
- -
(NEW) (EXISTING) BUILDINGSEWER SYSTEM -----------��_ --
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agen.
APPLICANT
SEWER PERMIT
(HIS PERMIT- AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE -_ INSTALLER
RECEIVED BY --
(AGENCY OR IT7 AGENT)
COMMENTS:
This Application and permit expires in one hundred and twenty (120) clays.
The amount paid will be forfeited should expiration occur.
•.•-__...-__^-•,i—.- •.i-•-+r-r.�e•-r- ^"w°7.•.mc►�u+r.�c-_._4i. --.1. ',-.,.,,,,u�-.•r1++Ml/r,rw.a�wv--raJ+R.;er_r-^"K"!r-tlR �J MR-
11T j �..t..76 .:
BUILDING PERMIT APPLICATION of TIGARD DkTE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_— _.
LOT NO.—
OWNER I �- _ JOB ADDRESS 15405 SU AlderbrOnk (40ME ADDRESS _
ARCHITECT
ENGINEER
BUILDER >SmQB ADDRESS DESIGNER _ r _
STRUCTURE )ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑ O
FIRE DAMAGE DEMCLITION
URESIDENCE [:]COMM ❑EDUCATII1O--ttNAI. ❑GOV'T ❑RELIGIOUSOPATIO ❑CARPORTOGARAGE CI STORAGEEISLAB ❑FENCE
MONO []MOVING MOVING CONDITIONAL USE DESIGN REVIEW DCOUNCIL APPROVED ❑SIGNS
QCCCCUPANCY___.LAND USE ZONE BLDG.TYPE FIRE ZONE— PLAN CHECK BY HEAT___
Ut 326 '1odvxJ rontein :;..F * re-iesue, some as 10235 5tl Grt onleatf Terreacu _.._.
Frame owell.ttig u/'ettaached fleraa@rA 2 bedroom, 2 Math
QM129Q FLOOR LOAD_ HEIGHT NO.STORIES� ARLA �C NO.BEDROQMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT ICI REAR 1.3 LEFT SIDE RIGHT SIDE
.� 14.�
Permit :; `:0 -
Plan Check 10*00
THIS PERMIT IS ISSUED SUBJFCT TO 'THE PEGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
3EGLILA11ONi• ".ND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HER!'6Y AGREED THAT THE
WORK WILL B1- DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCF OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4• LICENSE. SEPARATE PERMITS REOUIRED FOR SEWEF., PLUMBING AND HEATING.
Total 168o62
By
APPLICANT OR AGEN1
Approved Receipt No. ( "
-- - -- - --
/TDD�55 vi+0�raE
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•V.s...Re V.vMuwri.r
U� ATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
- �s�Izz -- Contractor _
10G/ Pei mit No.
_ — Rough-in
Fixture
F nal _
HEATING
Contractor
��-� Permit No. —_ �t /"�a ' 7
Gas or Oil
CA"LA_ ..,_� ! y Rou h•in _ — —
_ —T ` �tu�+�rinal ---
SEWER
Final
DRIVEWAY
Final
Stonn Drainage-------- --
_ _ VAi
Drain) Final _
_ L L .�'f-7�7
eet Final
__ __ ----- L L 1--27BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCYCERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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F A DD R E S° 1 ,;.e_G S• c— �..t PERMIT NO. z
PERMIT CHARGE
OWNER ��, CONNECTION 'r'EE �_
PAID BY
TYPE OF BUILDING „ ,'.�v DATE CONNECTED
SERVICE RATL INSPECTION FEE
PAID B YDATE
CONTRACTOR _ ni\ ___...OF CONNECTION �T ASSESSMENT ,�_ PAID ��