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15475 SW ALDSRBROOK DRIVE
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W Main St.
Tigard,Oregon 97223
Phone: 639.'171
Type of Inspection
Date 1equested �_ ?— C�.i_. Time_ A.M. P.M.
Address —�•"�.`l._Z,.�_��. - �as� Permit
Lot # —
Builder
The follo,ring Building Code deficiencies are required to be corrected:
' / r
,4�,L
Presented to
Approved
Inspector _` / I -- U Disapproved
Date
CALL, FOR REINSPECTION
YES 0 NO
0 :•+
0 F 0
c � � /Vic
ARD
C� CITY OF TIG
OREGON
1166
Tualatin Development CO-
Owner....... ............................. . ..... . . . ....... .. „permit No.
15475 SU Alderbrook Dr. Lot #371
BuildingAddress... I...................... .. .... ................. . ........ ...... .I......7 7
5th.... (lay of..May ......... 19.........
en this........... ......................
Certificate is hereby given
that said buildi!-,g may be occupied and
that it complies with all requirements of
Z. ll the Buildin,z Code for the City of Tigard,
as approvee by the Tigard City Council.
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Building inspector
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City Cf Tigard
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INSPECTION REOUEST
for
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INSPECTION TIME :—jz-i PERMIT NO. : __
DATE: / /.5/ i 7 DATE ISSUED.'--Z—L—
OWNERS NAME :
ADDRESS :
l�
CONTRACTOR : f_j�N►�-?Tac►w�
TEST. Air ❑, Water p , visual X, Laboroto►y p
RESULT: Approved Disapproved []
Pending
SKETCH:
INSPECTOR DATE
[NOTE Attach supplemental test data hereto
City of Tigard
INSPECTION REQUEST
for '
INSPEC' ION TIME: PERMIT NO. :---
DATE:
O. : --DATE: Z e Z DATE ISSUED / / I
OWNERS NAME :
ADDRESS: -
—
CONTRACTOR :
T'E'ST: Air p, Waterw, Visual, Laboratory C]
f?ESULT: Approved,&, Disapproved C Pending p
S KETCW.:
Lr 2
INSPECTOR DATE I
[NOTE: Attach supplemental test data Beret] I
/sry,d�
UNIFIED SEWERAGE AGIFN!CY No. ___ 10699
WASHINGTON COUNTY DATE
CITY OF Tigard - --- -- --- ----- --
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER:
OWNER'S ADDRESS: ._ --- ------- — -
STREET
CITY STATE
BUILDING SITE: LOT_-_;.71 BLOCK —___ ADDITION
TAX LOT N0. - - -.- -- -- _ TYPE OF OCCUPANCY ___ residence
ADDRESS _- 15475 SU Alderbrook Dr.
DWELLING UNITSFIXTURE UNITS -_--
SURCHARGE IF ---
PERMIT FEE INSPECTION FEE TOTAL DEPOSITED . 6Q11. UO
LNEEW) (EXISTING) BUILDING SEWER SYSTEM
The Applicant agrees to comply with all rules and regulations o; the Unified Sewerage Agency.
APPLICAJ-MC - �—
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE _- INSTALLER
RECEIVED BY
-- IAGEN UR 17S AGENT) --
Bldg. ;1166
COMMENTS:--..------------ .._._ ----
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
3' lUILDING PERMIT APPLICATION coy 'r1GAkD DATE 21M1�-7h ' ' 66
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FORTHt WORK HEREIN INDICATED BUILDER PHONE_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYIN41PLANS AND SPECIFICATIONS OWNER PHON- -
i LOT NO.—.
OWNER . ,. . JOB ADDR.:SS. ,jCIa 5k,j i�1lrieE'f' rook "ME ADDRESS
ARCHITECT
ENG INEER
BUILDER -y V 10' _ ADDRESS DESIGNER
STRUCTURE LIN W ❑REMODEL ❑ADDITION_- C3 REPAIR -- ❑PFNEWAL -❑FIRE DAMAGE []DEMOLITIONE'RESIOENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑S,ORAGE OSLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑Gr_SIGN REVIEW ❑COUNCIL.APPROVED ❑SIGNS
OCCUPANC%,' __LAND USE ZONE_ BLDG, TYPE FIRE ZONE_ PLAN CHECK BY ___ -HEAT
371. Ilk: x11 H,cl-jesue, some as 155131 `u Summer t i eld L+nns
viyInaA 1-I1>-r,llinij U.fa;tacked 4er'ane 2 beftyam 2 bath ---------
!CC OAU _�j,Q4Q�,f�.�D -- HEIGHT _ ___ NO.STURI 5 �_�1REA 1490, `7 A` U ` 7 8 2 ,�
BUILD+NG DEPARTMENT SET e4CKS FRONT REAR
^�,Q _ �.Z LEFT SIDE 4'LY � RIGHT SIDE
Permit -
- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUII-DING CODE, ZONING
°Ian Check 1C).W REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- - WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. ',HE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
- - RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTO'/S TO HAVE CURRENT CITY BUSINESS
State Tax 3.93 LICENSE SEPARATL PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By _ ------ -- ----- --
_ A111" (CANT OR AGENT
Approved � Rerell�l N(l
ADOR - —�—PONE — -
e
DATE INSP, 7 YPE INSPECTION REMARKSL,.r
LUMBING DATE
_ r
Perm�t No,
/� c• ����_S !►. HEAD G
Contractor
Permit No.
Gas or Oil -
-.—� —_
Rough-in — ---
Final
-- -- -- SEWER 4.
_ Final
DRIVEWAY �— /„G
Final
Storm Drainage
(Rain Drain) Final _
rinal
L L �-� ' 7
treet FinalDG DEPT I!NAL TEMPORARY CERTIFICATE OC'JPANCY
CERTIFICATE OCCUPANCY ing
inal
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Address 5=4�_2S--G r�1��t7 .C��zoz►-hD�i � Permit No. Z
Permit charge 22 C.,3 12 e-
0 W n e r
-0Wner �° Connection fee
Paid by ._/• L �°
Type of building ?_��, ,� "ei_�,� Date connected
Sery ; ce rate Inspection fee
C,j,,�ractor �T Paid by D� to
Size of connection Asbessment _� w paid