15420 SW ALDERBROOK DRIVE 1
r
D
:1
D
J`
ti
e
15420 SW ALDERBROOK DRIVE
tKt�'x�S?laF�r?7raaa+wenn�r��11��'OU?�etr+��r;tir�,••,„+�i'�^,;r;, ..
BUILDING DEPARTMENT, TIGARD
PLUMBING PERVII
holder of a valid p;umbing contractors license Is hereby
authorized to cause plumbing work as herein noted to he installed in accordance with the plumbing k,de of
Tigard. Such installations require inspection by the City loviector who shall be notified not less than four
(4) hours prior to the time the installations arc ready for i;tspection. City o-i Tigarit Business License required
fo- all contractors and sub-contractors.
4j rc.
F
Owner_. �., tfa Addrers_�, r ' Date—' -- —
— il NUMBER OF TOTAL PERMIT NO.'S
TYPE OF PERMIT ITEMS FEE ON EACH AMOU14T (Cffice Use Only)
$IDEN71AL a ____
Single Family-1 beth—eac.t _ 25.00
Du lax—Each 1 bath unit 25.00___
Additional bathrooms--each _ 10.00
Mobile Home Space—each 16.00 i
INDIVIDUAL FIXTURE FEES! __.._
__..1 to 50 Fixtures In 1 building—esch ^3.00
51 to 100 Fixtures int building—each 2.50 _
_ 101 to 200 Fixtures in 1 building--each 2.00 T�
201 or more Fixtures in 1 building—each _1.50
MISCELLANEOUS
Building Sewer—tat 50 ft. 10.00 _ _ --
Sewer—each additional 100 ft. _ —_ _ 10.00
Water Service to building 5.00 _
Private Water Systems—each 100 ft. 10.00 _ ^^
Other (Specify):
PERMIT For Plumbing Inspection Phone 639-4171
3%St-tre _ Plumbing Contractor By ,
T01i,L -- i., RECEIPT NO. Issued By
I
|
r 0
OCC
ORECON
289
29 77
that said building may be occupied and
that it complies -%vith all requirements o
the Building Code for the City of Tigard,
as approved by the Tigard City 'M
Building Inspector
-- ^1 4.�- ° _ ° __ " 4=vul
' -^-
�
�
h
i
I
9 Cite of Tigard
INSPECTION RrQUEST
I ¢
I � or
i INSPECTION 'TIME : PERMIT NO. :
I DATE: Z- DATE ISSUED:_1.__L,
OWNERS NAME : % - L)- C.�
ADDRESS : �r% S `�2- ��i ,n��z�'iELn
CONTRACTOR :
TEST . Air ❑, Water ❑ , Visuai x, + Laboratory ❑
RESULT: Approved , Disapproved p Pendcn t
I
SKETCH:
I
I
I
I
I
I �
INSPECTOR DATE
COTE Attach supplement,.j test data hereto
I --
City of Tigard
INSPECTION REO VEST
for
INSPECTION TIME ' PERMIT NO. : .-..
DATE . OATE ISSUED-/ _L
OWNERS NAME :
ADDRESS :
CONTRACTOR
TEST* Air E), Wnter [w`_kV' QlT_r"_LQborof07V
RESULT: Approved Il;_, l_�DV;Sl: roved (J . Pendi-ig
pp J
SK
UQ�.-=- m
i -�
I /
VECTOR DATE
EN OTE Attach supplemental test data heret0l
UNIFIED SEWERAGE AGI NCY N0. __ 11644
WASHINGTON COUNTY DATE __ 2-8-77
CITY OF.__Tig&rd
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER'S
STREET
CITY STATE 21P
9UILDING SITE: LOT__3-9.2._--- BLOCK .__. ____ __ ADDITION
TAX LOT NO. ___—__.._____ TYPE OF OCCUPANCY .. .___ __ __ residence
ADDRESS . ____I—5420--aWLfllderbrl?ok...Or.
DWELLING UNITS I —. _—_______ FIXTURE UNITS
SURCHARGE �IF APPLICABLE ._----.--_-_. ------ _ _-- ----__-------_-_----_-.---
600.
PERMIT FEE ----5?5.'___— INSPECTION FEE �5�_ TOTAL DEPOSITED ..__. ..
(NE=W) (EXISTING) BUILDING SEWER SYSTEM
The Applicant agrees to comply with all rules and regulatiuns of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE _ _- _ ___ INSTALLER
RECEIVED B .
(AGENCY OR )TS AGENT) f 1'
C 0,MMEN IS:._. Bldg. #1'l89 [
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
,...,... �rr•wwvn-�..r—......................-....�w.+w.t..�r .. ..�,�rn�...�.w�+.r..,.v»-.........,-«•---`-.v+�.-�......;w.�w...w�+...w.�...��.-.
i BUILDING PERMIT APPLICATION CI Y TIGARD DATE ___ �`
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WGRK HEREIN INDICATED BUIL-DERPHONt-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
i:f 20 SW N1detbruuk Ur. LOT NO.
OWNER JOB ADDRESS HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER Y ADDRESS DESIGNER
SIRIICTURE QNFN CJ REMODEL ❑ADDITION C3 REPAIR ❑RENEWAL UFIREDAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM DEDUCATIONAL UGOV'T ORELIGIOUSUPATIO ❑CAR PORT ❑GARAGE ❑STORAGE USLAB []FENCE
❑BOND 0MOV ING 11coNDITIONAL USE UDESIGN REVIEW UCOUNCIL APPROVED USIGPJS�
+ tJ
UCCUPANCY--.__LAND USE ZONE ',BLDG_TYPE.
—FIRE 7.ONE__ PLAN CHECK BY HEAT
:`1JUf F.ve?In G- ').7 1.,,,i,L.i J .I JUmmc-, . , i• 1.G Ln(j filrl dtje 1.11'11Wr
+ farwil room ;; bnth V —�
__F.L44_tLLOAD -_---- HEIGHT NGS.-S..IORIES AREA (�EIO NQ.H_E.L?PQQMS •j VALUE i I]l
BUILDING DEPARTMENT SET BACKS FRONT ( REAR LEFT SIDE '-I t ; RIGHT SIDE r '
Permit 166.00 '— — —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check ]��(t(� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERESY AGREED THAT THF
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPFCIFICA'(IONS AND IN COKIPLIANCE WITH
Sub total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE CCVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY FI ISINESS
State Tax — u LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HFATING.
Total 1,28
13Y
APPI SCANT OR AGENT -------- --- -'-------.
API` oved ( --- Receipt No.
ADDRESS
r
L
3
i
DATE INSP, TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _
Permit No. �0 p 3S
Fixture
( ;- �_ Final
c _ HEATING
Contractor
Permit No. 7D 141, 717
Gas or Oil
Rough-in
Final
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb& Street Final
A teach
—�BL.DG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUP!.':CY Final
Landscaping
V _ / Zoning Final V
I
i
. l
Address 5 y�ei ��� yc�C�c�,�. ,�( Permit No.
Permit charge 22Q-?"7 _
OunEr �. , � . N Connection fee
Paid by
Type of building v�Ze-� Date connected
� v
Service rate �� Inspection fee a��
Contractor — Paid by date
Size of connection Assessment Paid