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15440 SW ALDERBROOK DRIVE
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OF' OCIV
CITY OF �Ti(.�ARD C�.
ORE(FON
Ottiner:........... ..T.... ............... ............................ ............Permit
Building Address.......15440 SW Alderbroor .__..La.t., ri_ <3'�
........................................
` !I Certificate is hereby given this.... 4........day of....Auu.u.st.............., 19.....7.7
! that said building may be occupied and
that it complies with all requirements of
x` the Building Code for the City 0'i 'Tigard,
t> as approved by the Tigard City Council.
Building Inspector
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City o Tigard
iNSPECTION REQUEST
for
41 C
IINSPECTION TIME * `�' ` r' PERMIT NO. : _
DATE: • 1z DATE IS SUED:
OWNERS NAME '
ADDRESS : _Lj..r 11
CONTRACTOR
TEST. Air 0, Water 7 , Visual,(, laboratory []
RESULT: Approved 13 Disapproved Pending F
SKETCH.
OCT
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INSPECTOR DATE
ICN07E : Attach supplemental tett data hotel",,]
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City
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., ity of Tig � rd
INSPECTION REOUEST
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INSPECTOR DATE
[NOTE . Attuch supplemental tett dote heret7
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UNIFIED SEWERAGE AGI-NCY NO.
WASHINGTON COO N
.I-
WASHINGTON DA I L 1-26-77
CITY OF Tigard
APPLICATION
FOR SEWER CONNECTION PERMIT
---
OWNER:
L:NNEFt'S ADDRESS:
_- - STREEt
_ _ F
CIt Y 1
BUILDING SITE: LOT-3.91-- BLOCK —._ ADDITION
rssidence
TAX LOT NO, _ TYPE OF OCCUPANCY
ADDRESS .-_..._154.4Q_.SW-Alder broak_ar -- - ---
DWELLING UNI1 S -.____ -1---. ---
FIXTURE UNITS _--
SURCHARGE IF r',PPLICABLE -_ _---_----- ---- -"�— --_--
PERMIT FEE---.-- 600•
575- • INSPECTION FEE 25—• --- TOTAL DEPOSITED _.
-.- .-------
(NEW) (EXISTING) BUILDING SEWER SYSTEM __--F-atxaa-Creak-_The Applicant agrees tD comply with all rules and regulations of the Unified Sewerage Agency.
SEWER PERMIT
THIS PFRMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
UNE SIZE - -- — INSTALLER -- -
RECEIVED BY.�_-�`�-�-s(AGENCY
c-, AGENT)�
COMMENTS:
i his Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
l
..._........�,*.,...,�^,-........._.,..,..,,.... .--ter..... •...__..._...�«.,. _ -•-•-"�'„s.ei-
BUILDING PERMIT APPLICATION 1oF TIGARID DATE_ 1-26-77
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE`
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
T —
V{ Q LOT NO —
OWNER JOB ADDRESS"'*_ 6 _SW k t•dorbruuf-, HOM_ E ADDRESS
ARCHITECT
ENGINEF.P
BUILDER 11 r 1 ADDRESS DESIGNE-. t�-�77
ttS^^T�7RUCTURE_ ONEW ��r--11 O REMODEL _LJ_ADDIT'ION OREPAIR ❑RENEWAL LJFIRE DAMAGE 1 [!DEMOLITION
LJRF_SIDENCE []COMM [!EDUCATIONAL ❑GOV'T CIRELIGIOUSOPATIO [:]CARPORT GARAGE ❑STORAGEOSLAB ❑FENCE
�DBOND ❑MO'/ING ❑CONDITIONAL USE ❑DESIGN REVIEW QCOUNCIL APPROVED ❑-IGNS ^�
Q�UPANCY______LAND USE ZONE—_ bLDG.TYPE '' FIRE ZONC"—' PLAN CHECK BY_ HEAT
1 t ft a duelling w/ettaffiChed gsraga 3 hedrucom
....CS LQAD FLQOR I QAD _T-1��1St�L—AAAA—� �IQRlF.,�'� Aai�A•' 11 1{3 NO.BE-DR _Qm1 __ —VALUE 000,
BUILDING DEPARTMENT SETBACKS FRONT ( v REAR LEFT SIDE _ ft_ IIIGHT SIDE A#g
ot
Perin t 166.UQ
-- THIS PERMI' IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COt`5, ZONING
Plan Check .101011 REGULATIONS AND At L APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREE[? THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI.IANCE WI TH
Sub-total ALL APPI_ICAHI E CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
AAA A- RESTRICTIVE COVFNANTS. CONTRACTOR AND SUB CONTRACTonS TO HAVE CURRENT CITY BUSINESS
StateTax 5.29 LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
TotalBy
_—. ___ APR&_CANT OP Al3ENT
Approved Receijil No
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DATE INSP, TYPE INSPECTION REMARKS1 PLUMBING DATE
-Z Qontractor
JL�- Permit No.
'Al Rough-in
Fixture
Final
04
HEATING
2,Y Contractor
TO Permit No. lt7/
Gas or Oil
-5—ou 9ti I r
Final
SEWER
Final
DRIVEWAY
Final
S^,orm Drainaqe----
(Rain Drain) Final
Sidewalk
Curb & Street Final
Approach
BLDG DEPT. FINAL TENIVORARY CEHI IFICATE OCCUPANCY
CERTIFICI TE OCCUPANCY Final
Landscaping
Zoning Final
Is.
ADDRESSK/() eU-tt-ttt7,4 A( PERMIT N0.
PERMIT CHARGE none
_ 1 ,� � CONNECTION FEE
OWNER �
PAID BY -. - (
TYPE OF BUILDING ��_ DATE G"4&G-TE-fl
SERVICE RATE ,�} INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID