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15745 5W ALDERBROOK CIRCLE
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c aoDREss f PF RMI1 NO._ ' --E-
PERMIT
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PERMIT CHARGE none
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CO%NEC T IO'a s' EE Ole,
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PAID EY
DVE CONNECTED
TYPE OF BUILDING _
'
% INSPECTION FEE
SEP,VICE RATE � l �
PAID 8 Y _,____ __ DATE
CONTRACTOR PAID
5IZE OF CONNECTION ASSESSt1E:NT -
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SEWER PERMIT N 15872
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Unified Sewerage Agency Tigard 4-21-78
of Washington County CITY Y OF _ DATE __
OWNER: �,n r _._ PHONE :
OWNER ' S ADDRESS s
TYPE OF INSTA!.L_ATION:
BUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
XO NEW XMSTNGLE FAMILY ❑ COMMERCIAL.
❑ EXIST. (PRIOR 1.0 7-• 1 -70 ) ❑ M!)L T. RES. L] INDUSTRIAL
FIXTURE UNITSDWELLING UNITS l
ADDRESS OF STRUCTURE : 25745 SW Alderbrook Cir.
?ERVIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGLii_ATIONS OF THE UNIFIED SEWERArE AGENCY. WHEN CALLING FOR INSPECTION ,
PEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
F!JNDRED AND TWENTY ( 120 ) DAYS. 1'Hc AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE 25.
CONNECTION CHARGE 600.
SIDE SEWFR INSTALLATION 8. Grcene
ISSUED BY
OTHER _
TOTAL 625. -
< ._ APPLIC.ANT DATE
SEWER PERMIT �" 45872
ADDRESS OF STRJ!CTURE 15745 5W Alderbrook Cir.
TAX MAP _ TAX LOT SYSTEM fanno cr,�nk
LCIT 472 BLOCK _ OF
APPROVED BY DATE ISSUED WY DATE
#2049
D . U . ' E� 1 _ REMARKS bldg.
No '1041
BUILDING PERMIT APPLICATION c`TY TIGARD DATE—
OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATION OWNER PHQNE-_
LOT NO. -
OWNER s 1. JOB_ADDRESS_ �'< — _ HOME ADDRESS
ARCHITECT —--
BUIL.DER :'6 fN@_ ADDRESS ENGINEER
-- 1 _DESIGNER _
STRUCTURE ?1 ANEW ❑REMODEL `OADDITION �—J
0REPAIR CRFNEW_AL ❑FIRE DAMAGE ❑DEMOLITION
❑RESIDENCE ❑CCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS OPATIO []CAR PORT ❑GARAGE ❑STORAGE SLAB r JF ENCS
_ ❑BOND _—OMOVING — ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNC!L APPROVED ❑SIGNS —
OCCUPANCY_ LAND USE ZONE i •Z BLDG.TYPE._ h FIRE ZONE Pt AN CHECK BY
-- = .:
i fa t 9 q b 1, ---
��eLta�tral� c_ ar:Api � tl�at.,ir . �► :� t,t.tl:
413 000.
(J(X-LQA� ��,QQ�I LS:.4Q . ._..!aCI HEI�aHT 2U _ NS.�T.QRI�S;_— A���i)Ial,?ND.BED�QOMS :—YLJ 1E
BUILDING DEPARTMENT _ rF • 1'� ft'f' y
----- SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check � — REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCE:;, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICAI IONS AND IN COMPLIANCE WITH
SubtotalLID ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE GF THIS PFRMIT DOES NOT WAIVE
RESTRICTIVE COVFNANTS. CONTRACTOR AND SUB CONTRACTORS 1'0 HAVE CURRENT CITY BUSINESS
State Taxr LICENSE. SEPARATE PERMITS REOUIRED F-OR SEWER,taPLUMBING AND NFATING.
1'
Total i;.E , � .t� Lr 440J.--- - - •U:C. h2 $1000
By
-- — {T--- APPL117ANT OR AGENT
Approved Receipt No.
-- •A—fb ss — r —--—
f
A
DATE: INSP.— TYFL* INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No. /w
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REWER
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Final
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(Rein Drain)Flnnl
S��iawolk
Curb&Street Final
-- ------- —.—�^ Approach
SLOG. DEPT.FINAL TEMPORARY CERTIFKATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landu:aping
Zoning Final