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COMMUNITY DEVELOPMENY DEPARTMENT oaeraon �'d"Ft 11 Y 1=rrE' uF
13126 aav4 Hell Bbd,P.O.Box 23397,Tlpwd,Ungon 97223(603)839-4176 f)C:I lIr�diNl.'�J
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� C1FaTl�� IEi;aUl ( : 1i.::/141�li'' 1
f:,I'IC d�UllNE. ;".. . . i _ SW JORDAN WY
6UBD I V I SI LAN. . . « a BEDFORD C)LE IN I C�IJ I IJI�a
HLOC:K. . . . . . . . . . a LOT. . . . . . . . . . 45
CLASS OF WORK. :NEW
TYr4E OF USE. . . a 5F
(')CCUPPNCY GRP, a R3
OCCUPANCY !_t)At3 a 1 17 4
TENAMT NAME. . . a
■
i f'tem�,rt<� a PGITFI I
t
BEACON HAME S
F•O DO 1;468
BEAVERTUN OR 9';X7"5
Pholif #1
Guritr■cit or a ._�....._.._................ ._..........,.._._....�._._..._-..._.._.___._
HEALON HOMES �
FSC) BOX 1:366
BE AVER T ON OR 97075
Phone #a !.5P-4•-1999
Rog #. . a 719"792
occupwncy of the a Bove ref2erenr.:ed bmi Iditip i v here!by N vers, And vo rt i fi*a
the compliance with the 5taate Of Oregnrl Specialty Godes for tho group,
Occ�upjancy, end tine under which the referenued permit weae ika'..ied..
f"IF7i. pEPAR 1141:NT tv
Nlf 1144 .
X NG 911 I FTI..
P0f;i'T IN A.)Nf-:ir,tf.:l.ln1..19 PLACE
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INSPECTION NOTICE ..
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City of Tigard Building Dcpnxtment 0-
13325 Sid Ball Blvd. Tigard. Orogon 9722
Inspection Line (Rec-O-Phone: 639-4175 Business Ph a9-4171
i
Inspection:_____
Footing Plbg. Underelab Much. Rough-in Appy/Sdwlk
Found. Plbg. Top Out Gas Line /INALII
Post/Beam Struct. San. Sewer Framing \`ldq.
Poet/n.•xm Mech. Rain Drain Insulation
Plbg. Underfloor Water Line Gyp. Bd. -Ns*eh.
meRequested. I Z' (� � � Time: _-- ANnl1_/►'� F!t
mm,-siiw
Addiess: (?- l l �(aY -1/1 U—.�U P:trmit
Builder: -7K-33t( 1 '5-:0- ',jIrf _ -- -- ■
THE FOLLOWING CORRECTIONS ARE REQUIREDs
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Inspector: Date: (.
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
—,-Call For Reinsp.
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INSP'. ION NOTICE
city of Tigan Building Departz
13125 SW Hall Bled. Tigard, 'Dregon 9 3 'V •
Inspection Line (Rec-O-Phonc): 639--4175 Bueineae Phone: 639-4171
Inspection:_- -- -
I ,
Footiny Plbq. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out -'Gas Lina \ FINAL: t
Poet/Beam St.ruct. San. Sewer Framing` -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor. Water Line Gyp. Bd. -Mach. f
_6/ /� -
Date Requested? _
Permit #s
Address. ��_
--- /
` Builder.:
THE FOLLOWING cORREkmoNS ARE REQUIRED:
14'
1161
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Inepectorr._ nater .__._
APPROVED DISAPPROVED APPROVED sUBJECr i'o ABOVE
Call For Poinnry.
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INSPECTION NOTICE
City of 'Tigard Building Department Me
j 13125 SW Hall Blvd. Tigard, Oregon 90 7223
i
Inspection Line (Rec-O-Phone): 639-4175 HueineePhone. 9-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Anpr/Sdwlk "•''
1
Found. Plbg. Top ..:_*. Gas Line FINXL:
PnstjBearn Struct Sari. Sewer. Framing -Bldg. t ''
Post/Bean, Nech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Oyp. Bd. -Mech.
r
Date Requestedt_ `j/ d �•� Times AH FN
Address: n Permit Is G
Builder:
■
THE FOLLOWING CORRECTIONS ARP REQUIRED:
L
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$ Inspectorl `
.APPROVED DISAPPROVED _ APPROVED SUBJECT TO ABOVE
_C& l For Reinap. , 9d
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INSPI C ON NOTICE
City of Tigard Building Department
13125 SW Ball Blvd. Tislard, Orogn 97223
o
Iunpection Line (Rec-O-Phone): 539-4175 Buainece Phone: 639-4171
Footing Plbg. Underalab Mech. Rough-in
pppr/Sdwlk.
Found. Plbg. Top Opt Gas Lino
FINALS
poet/Beam ^tract. San. Sews:
Framing -Bldg.
nsulatiotl ) -Plumb.
Poet/seam Nech• Rain Drain
Plbg. Underfloor Nater Line
Gyp. Bd. -Neuh.
t
Time: _AN PN i
Date Requeeted:_�(L_ 2L--�--1 � -_
y. I
Permit #t__A-da +lJ
Addresg:
Buil,dor: ■
THE FOLLOWING CORRECTIONS ARE RB4UIRSDs
4
_ nate:
Inspectors �-'-�
APPROVED DISAPPROVED v_ APPROVED SUBJaCT TO ABOVE
Cal). For Relnep. .�
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INSPECTION NOTICE
i
City of Tigard Ruildi-ng Department -
'_3125 SSI Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 ,
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Insrect.on ,T_----
Foaling Plbg. Underelab Mech. Rough-i Appr/Sdwlk
Found. Ping. Top Out Gas Line FINAL: t 1
/—
Poat/Beam Struct. San. Sewer Framing -Bldg. ;
pvst/Beam Mech. Rain Drain Insulation -Plumb.
Pi~,. Underfloor water Line Gyp. Bd.
-Mach.
P ' PH F,
/lL o Requented:, _Time: — AM _
Addreai: 1r(dL� Permit
] THE FOLLOWING CORRECTIONS ARE REQUIRSD:
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Inape r.to:•
_ Date:
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APPROVED DISAPPROVED V APPROVED SUBJECT TO ABOVE }`
-Call For Reinsp.
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INSPECTION N(2!ICE
City of Tigard ruildi,� neper
gent
13125 Sit Bail Blvd. T-gard, Oiec�on 97223 :... ' .....
Inspection Line (Rec-t,-Phone): 6' 9-4175 Business Phone, 639-417.1 \
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Inspection: -. ------ -_;`
A r
Footing Plbg. Underslab Koch. Rough-inl PP /Sdwlk a. 1 •
Found. Plbt;. Top Out A Oas Ling
PINI S.:
Post/Beam Struct. San. Sewer aminq
-Bldg.
Poe -Plumb.Hoch. Rain Drain Insulation
P'.Yg. Underfloor Water Lina cyp. ad.
-Rech. Y"
pate Requestedt me
O � Tit AM PK .."
//
A 7'i t � L Permit
Add"
THE FOLLOWING CoP.AECTIONB ARE REQUIREDt
J+
Innpect0 1f - - Date•_��,__
APPROVED DROVED - APPROVED SUBJECT TO ABOVE { q
_Call For Reinsp•
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�d-4171
inspection:_ _ �\
Footing Plbg. Undereleb Mech. Rough-in qp /9f.fxrk ,
Found. Top Out Gas Line FINAL: ;
Poet/Beam Struct. San. Sewer Framing -F,ldg.
Poet/Beam Mech. Rain Drain Insulation -Plumh.
Plbg. Underfloor Water Line Gyp. Bd. -Hech.
1 i iPin
Date Ttequeeted: - �- Timsf _ �'` AH PH
Addreda:_ ? /� — Permit #fly'�
i�-�46
Builders )O � � �• � t�ir ?�; � w
THE FOLLOWING CORRECTIONS ARL REQUIRED: "1�1`ati
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Inspecto --_-- Date:
Y,
APPROVED fSAPPROVED APPIiI)VF.D SUBJECT TO AiiOVE
Call For Reinsp. , "
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INSPECTION NOITCE
city of Tigard Building department.
13125 SW Ball Plvd. Tigard, 7regon 97227 r
znapection Line (Rec-O-Phone): 639-4175 L'ueiner,s Phone: 639-4171
< Inspection:— ———
Footing Plbg. 1-iderslab�( Mach. Rougt} in Appr/5dwlk
t
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Si.ruct. San. Sewer /-���J�^�
-Bldg.
Post/Beam Hoch. Rain Drain Insulation --Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Hech.
Date Requested: _Time: AN PN
Address:_ L Permit
i
Builder:
I THE FOLLOWING CORRECTIONS ARE REQUT^.dD:
' ! Y J�• �{l'�//.�1.^/ �_ (.4..�� L1 �%I f V. I�,LS�'4•z�(.C.y-G'I
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Inspector: '' Date--
APPROVED
ate--APPROVED 1ISAPPROVED APPROVED SUBJECT TO ABOVE
Ca1L
For Reinsp.
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INSP$CTLON NOTICE
_ City of Tigard Building Department 01 ft
13125 Sq Hall Blvd. Tigard, regoo 97223
Inspection Line (Rec-O-Phone): 6.39-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk ,
Found. / Plbq. Top Out Gas Line FINAL: ,)
Pnet/Bea.a Struot. San. Sewer Framing -Bld-g.
Post/Beam Mech. Rain Drain Insulat -Plwnb.
Plbg. Underfloor Water Line Gyp. Bd. -Mecn.
Date Requested: /0 / 2— Time: __AM __PM
/-
J&A deer - ? '}� W _ Permit i:1�05._ k
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Date..
APPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
/ Call For Reinap.
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K INSPECTION NOTICE //r
City of Tigard Building Depart—dt }
` d
13125 SK Hall Blvd. Tigard, Oregon 97 2
Inspection Line (Rec.-0-Phone): 639-4175 Business Phone: 639-4171 " "• •
Footing Plbg. Under.ilab Me__.. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
:ost/Seam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb. a'
Plbg. Underfloor Water Line Gyp. Bd. -Mach.
Date ��Requestedt /_ r( -- Time: AM PM •
/1►dd etee: ��{- - �C �v11/\�
Ulu- Permit #t q.7— D
.,n Builder:�1Q. '- �4G�( � ) L�- l�� / - ' ■
THE FOLLOWING CORRECTIONS ARE REQUIRED=
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Inspector
APP,IOVED _-� DISAPPROVED -^, APPROVED SUBJECT TO ABOVE
__Call For Reinsp.
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INSPECTION NOTICE
ctty o. Tigard Building Department 0_1
13125 SW Ball Blvd. Tigard, orogen 9722,
Inspection Line (Rec-O-Phone): 639-4175 Business PL 6399-4171
Inepect•ion:
Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan Line FINAL: yy.
g
oet/Boom StruaF;. San. Sewer Framing -Bldg. R
Poet/P2dm Mech. Rain Drain
Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
P
Date Ra9uaeieds_��� �� Time: AM PM
Permit
� Builder:_ � i ■
rSt•. THE FOLLOWING CORRErCTIONI ARE REQUIRED:
Y � y
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1('
Inapectort_ ` _ Date: �.Z-' Jti t
APPROVED 4"'� ^
` DISAPPROVED APPROVED SUBJECT TO ABOVE „h
1 µ 1.
—<--Call For Reinep.
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INSPECTION NOTICE
City of Tigard Building Department
13125 rK Ball Blvd. Tigard, Oregon 97223 ✓ Iq
Inepe`tion Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
I Inspection•___ -- —--
Foo«ing Plbg. Underalau Mech. Rough-in Appr/Sdwl.k
s
Found. Plbg. Top Ou•_ Gra Tine FINAL:
s, I{
Poet/Beam Struct. San. Sewer Framing Bldg.
Poet/Beam Mech. Rain Drain Insulation -plumb.
IPlby aUnderfloor Water ?.ins Gyp. Dd. -Mech. s.
ate Request ds_ �` ---Time:
Builder:
s
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _.,_`�_.� _._, Date:__�� _� '
APPROVED _ DISAPPROVED APPROVED SUBJE(-r TO ABOVE I1
;all For Reinsp.
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INSPECTION NOTICE
City of Tigard 921ldiog Deparha'gnt
1:!125 81f Hall Blued. Tigard. Oregon 97223
inspection on Line Re+,-O-Phone)
s 639-4175 8
u
sineoe Phones 639-4171 +
�
Inspections —
Footing Plbg. Underslab Koch. Rough-in Appr/Sdwlk
9
Found. Plbg. Top Out ciao Line FINALS
I _
Post/Beam etruct. an. Se -Plumb.
wer J Framing -Bldg.
j
a Post/Beam Mach. in ra Insulatlon
Plbg. Underfloor i;Ner7L A
Gyp. Bd. -u
Date R 'gated: ��j 'r�-�— —T�s /� _---'PN
}
Address _ ����,-j��� —Permit 1 a
iBuilders_ /
THE FOLLOWING CORRECTLONS ARE REQUIRED$
i
��JC=,�� Dates J� >
Inspectors -----
JJJAPPROVED -_ DISAPPROVED -, APPROVED SUBJECT TO ABOVE
J���
Call For Reinop. 1
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INSPECTION NOTICE
city of Tigard B'uildi Department
1,3125 811 Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-4171
Inspectiont
ng Plbg. Underslab Mach. Rough-in Appr/sdwlk
1
Found. Plbg. Top out Gas Line FINAL:
a,
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Ral.n Drain Insulation -plum!).
Plbg. Underfloor water Line Gyp. Bd. -Mach.
AM�- PM
Date Requested:_ - 7 -1 - Time:
Permit ..
p C
r Builder:,
The FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspectors ✓ �f Date:
APPROVED �— DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Aoinep.
I,
MASTER PERMIT
CITY OF TICAPD
CIiYOF116>a1RD r"«MIT tl. . . . . . .
: M5T92--0060 t,,
COMMUNITY DEVELOPMENT DEPARTMENT offem
13125 SW HWI Mod. P.O.&+x 23307,T04 Or.gon 7, 1 4176 i:i G�L E I SS UE D: @5/26/9,-`
r�iTL ADDRESS. . . : #�� W JORDAN WY PARCEL_: 28116AD•-Pt._DS
`;UL1li I V I S I ON. . . . : BEDFORD GLEN
ZONING: "
4, BLOCK :
LOT. .
_ ---- BUILDING
REISSUE: DWELLING L1NiTS: 1 F'ASEI4ENT. . . . . . . . :0 sf
CLASS OF WORK. :NEW BEDRMS:3 BATHS:2 GARAGE. . . . . . . . . . :467 sf
TYI�'E OF USE. . . :SF
FLOOR AREAS------•~----•-- REQUIRED SETBACKS--_•_-.-._.__.__-
1 YPE OF CONST. :SN F I RST. . . . : 1$94 s f LEFT. . :5 ft R I GHT. :S ft
�ICCUPANCY GRP. :FR,3 !SECOND. . . -0 of FRONT. ft REAR. . 120 ft �
'-;TORIES. . . . . . . : 1 THIRD. . . . :0 S REQUIRED---------------------
HEIGHT. . . . . . . . :
_______________---HEiGHT. . . . . . . . : 1.-7 ft TOTAL-------; l894 s f GMOKE DETECTORS. :Y
F=LOOR LOAD. . . . 140 psf VALUE. . . . .: 95530 PARKING SPACES- 10
Remarks. PATH I
PLUMPING
'!INKS. . . . . . . . . . : 1 FLOOR DRAINf':. . BACKFLOW PRF_VNTRS. , :0
AVATOR�tS. . . . . a� WATER HEATERS. . . : L TRAPS. . . . . . . . . . . . . . aO i
IUB/SHOWERS. . . . :•3 LAUNDRY TRAYS. . . :Qi CATCH BASINS. . . . . . . :0
WATER CLOSETS. . a2 SEWER LINE (ft) - :0 GREASE TRAPS. . . . . . . ar'
DISHWASHERS. . . - '. I WATER LINE (ft ) . : 1nrb OTHER FIXTURES. . . . . :0
GARBAGE DIST'. . . : 1 RAIN DRAIN (ft) . :0
WASHING MACH. . . : 1 '.3F RnIN DRAINS. . . I
_.,--_.__-______-- MECHANICAL , __.___.______...._ _.___.._______.__..__ FEES
F=UEL TYPES--•__.-______...._.._ KNIT HT;.S. . :O type amov.cnt by date ^Qcpt
/GAS/ / / VENTS . . . . . s0 BPRT $ 421. 00 JLH 05/26/92 -
MAX INPUT:0 eTU VENT FANS. . :3 BPLC $ 2273. 65 JLH 04/07/92
FURN ( 1O0K : 1 HOODS. . . . . . : 1 BSPC $ 21. 05 JLH O5/26/92 -'
FURN ) =100K . . :0 WOODSTOVEG. :0 MPRT $ 36. 00 JLH 05/26/92
FLUOR FURN. . . . :0 CLO DRYERS. : 1 MISC $ 35. 00 JLH 05/26/92 -
'tGIL/CMF ( 3HL :0 OTHER LJNITS:O MPL.0 $ 9. 00 JLH 05/26/92
GAS OUTLETS: 1 MSPC $ 1. 80 JLH 05/26/92 -
Owner', --- -- - _._.._.__._._._._______.____...---_.______ APRT $ 132, 50 JLH 05/26/92
BEACON HOMES PSPC 4 6. 63 JLH 05/26/92 ,
PO BOX 1..36E ;
BEAVERTON OR 97075
j Phone #: 524--1199
Contractor: -- _- -••.-.. .._____..__.____.__._._
BEACON HOMES
PC) BOX 1369
BLiAVERTON OR 97075
Phone #: 524- 1999 _
Reg #. . : -70782 _.__._ __-•�- -936. 63 TOTAL
j This permit is issued subject to the rrgulations contained in the -- -~-- - REQUIRED INSPECTIONS _
Y Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Fireplace Insp
1 applicable lnws. All work will be dors in accordance with approved post/Be,Rm Stri.rct Gas Line Insp
plans. This permit will expire if work is not started within 180 Post/Bean Mechan Ins;'.clation Insp
days of issuance, or if work is suspended r,,. P-re than days. Plm/LIndslab Insp Gyp Board Insp
PLM/Underfloor Rain drain Insp
wermittee ,:1.gnat1.trP .; � e Z,.._ . ._.._.. lvle(.Jlanical In-,p ),Etter^ Line InsF_
pi.-mb -fop OLtt Appr/5dw1k Insp
Iwy ..red lay: F ramtnq r• _�, Mec,hanir�al Final
Cell for inspection - 639-4175
a_
i 10 00,1100"Pop"
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PERMIT. .F .LhlkSNGC32'T � TIFARDA1rb FFRMT1 #. . .
MST'3�::'-0460
CO/AM MY DEVELOPMENT DEPARTMENT aoes"
13124 OW Hd MAp.O.JIM 23 I.T+rd,Or"m",M(SM)&*Mi0 DALE T,tiSIJCD:
F•'faRL•F"L. : �ri116iaD
S I TE ADDRESr3. . . : SW JORDAN WY
SUBV I V I S I ON. . . . : BEDFORD C-?LEN 1 ON I NG
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . 15 �.
CLASS OF WORK. . a NEW BARSAGErDISF'O SALS. . 91 u
l TYPE Cry' USE., . . . :SF WASHING MACH. . . . . . . : 1 SACKFLOW V,RFVNTRS.'. ,
OCCIJPnNC'; GRP'. - :R3 FLOOR DRAINS. . . . . . . 90 TRAPii. . . . . . . . . . . . . . :0
WATER HEATERS. . . . . . : 1 CATCH BASTNEi. . . . . . . :0
F I X TUREG---.__.-----•----- LAUNDRY TI-MY S. . . . . . :0 SF' RP I N DRAINS. . . . . : 1
S I NKS. . . . . . . . . . 11 GREASE 'rRpw:.. . . . . . . .o
LAVATORIES. -. 3 OTHER FIXTURES. . . . . 10
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . . . :0
WATER CLOSETS. . :2 WATER LINE (ft ) . . . . 1 100 a
D16HWASHER S. . . . : 1 RAIN DRAIN (ft ) . . . . :0,
RemorIts : Pt-111-I I
i
OWNER:
BEACON HOMES BPRT $ 421. 00 JLH 05/P6/92
Po SOX 1368 BPLC $ 273. 6`.1 .JLH 04/07/92
D5PC f 21. 05 JL1-4 0 y/,.-".692 -
j BEAVERTON OR 97075 MPRT 36. 00 TLH 05/26/92 -
' ''htrrne ii:
1524-1999 MISC >Z 35. 00 JLH 05/26/92
r MPLC TLH 05/26/9: -
Pl,..k.mbing Cont•raftor:--- ---__:_____:.-- -_ MSF+C f 1. 82 JL.H 05/Z26 98' -
t PPRT $ 132. 50 JIM 05/,716/92
Name : :a �.i�- ----- - -l�-.a.a....�r ______ PSPC t E+. 63 ,TI. I! k75/c6/'1c
Address:•- --
7ip3_. Ph _
Req
REOU T RE P T i.6PECT I ON S
s This permit is issued gUb,jert to the
reg--i-dations contained in the Tigard Mttnir. ipal Foot/found Insp Rain drain Insp
Code, State of Ore. Specialty Codes arrd all past/Beam StrI.Ict Water I_in(a Insp
other' appli'cat,le IAVAIt' All' work will be dont Post/Hearn Mec),an Appr/5dwlk Insp
in ,accordance with approved plans. Tris Plm/undslab Insp Mpchani<_al Final
permit will expire if work is not star,tpd PLM/Underf,loor-' Plumb Finan
within 180 days of ifysuance, or if work is Mechanical Insrr Btk.ilding Final.
suspended for-, mor v thr%n 180 days. Plumb Top C)ut Erosinn Control.
Fr«zming Insp 'Crawl Drain
Fireplace Insp
C3as Line Inap
Insulation Insp
k._ ....yC _. »____ ___-___ . Gyp Board Ins`P
Authorised F'I rimhiny ContraC ,or Signature
Call for inspection E39.. 4175
Contractor Notes . _ _ _ _... _.__ .__ _ ___...._.—._--_
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(_;17 V- .OF T I C)AR"') — PECE I PT OF PAYMENT RECEIPT NO. :9P-227726
CHECK AMO(.INT 686. 63
NAME z BEACON HOOES CASH AMOUNT LA. 00
ADDRESS a PAYME=NT DATE : 05/26:92
SUP01VISION r
PURPOSE M PAYMENT AMOUNT PAIL) PURPOSE OF PAYMENT AMOUNT PAID
ETU-Tc DINC3 FEiii .421. 00 PLUMBING PERM 132. 1150
MECHANICAL PC" -.;6. 00 ST. BUILD PER 29. 48
-LAN CHECK F~E:.: 6 3 SEWER INSPECT 35. 1.10
i .OT 9 BEDFORD GLEN
a iF#, t:iW JORDAN WAY
A7S'y,-
1`QTAi._ AMOUNT PAIL) _. _ ._> 686. 63
1
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j unified SANITARY° 0�
sewerage
Or., SURFACE WATER NTH
F 15F N. First Ave.,Suits 270,Hillsboro, .,97124
503 648-8621
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PHONE 524-1 ?9y JUkI'Ai
I 1 IXIUFtE LOU1VALENT EIWLLLINb kr�,IIILNi 1HL
NITS ;� S icl<VICLr_ UNITS 0 0 UNIT1 0tRVItrE
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1NSF'LCTION 40.uu
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1 SUU I ui Hl.
SUB 1UlAL :'L+o .'jIj
IU1AL <ot, U."
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Permit Conditions: The applicant agrees to comply with all rules and regulations ,f the Unified Sewerage Agency. when calling
for an it
Issuance.
please
paid to the(permit fee,iconnection charger. The e�lineexpires
feeone
and/ordred rothereighty
charge)°willabe from
forfeiteddate
of
If the
—.a. permit expires.
The Agency does not guarantee the accuracy of the location of side sewer laterals. if the sewer is not located at the
measurement given, the installer shall prospt�t three feet in all directions from the distance given. it not so located, the
o
installer shall purchase a "Tap and Side Sewer" Permit at the current crerge and the Agency will install a lateral.
6/90 WHITE — USA, BLUE — Acc unting, GREEN —Inspection, YELLOW — customer