10310 SW KABLE STREET 1031C SW KABLE STREET
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INSPECTION NOTICE
C, v of Tigard Building Department
12420 S.W. Main St.
i ib.ird,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested e A.M. P.M.
Arldruss AA - Permit
Owner _.__A�. —__ __— Lot
Builder
The following Building Code deficiencies are i squired to be corrected:
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Presented to -41 A/ 6-A-'ppoved
Inspector 'a'11111Y� -I H Disapproved
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Date
7CALL FOR Rklk4ECTION
❑ YES 1-:1 NO
k :`EWER PERMIT
Unified Sewerage Agency Tip
_
of Washington County CITY OF
DATC �'-l�•F L
OWNER :
� e �. PHONE 6�9-2�a3
OWNER 'S ADDRESS: _ ID3JO Se V"Ie. 94 f
TYP OF INSTALLATION:
SIDE SEWER ❑ LINE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY:
❑ NEW ❑ EXISTING SINGLE FAMILY ❑ COMMERCIAL
X'EXIST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS-_Afw^&_Q�_
ADDRESS OF STRUCTURE : ___- ►PL --_ ��
Permit Conditions: The applicant agrees to comply with, all rules and regulations of the Unified Sewerage Agency.y�
When calling for inspection, please refer to the Permit Number. The Application expires in one hundred twenty (120)
days. The amount paid will be forfeited should expiration occur.
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 prospect three feet in all directions from the distance and depth given.
If not so located, the installer shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will install a lateral at the location specified by the installer.
FEESt
P E 3s
�0 ION CHARGE _ .
�d�:
50 E TAP INSTALLATION
0THF_R ~ ISSUED BY
TOTAL pry,
APPLICANT '-` --------- _
DATF
SEWER PERMIT
ADDRFSS OF STRUCTURE 10 310 $Fv Wk
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TAX MAP 51 -11 C — TAX LOTd �
----�Z_.-________.. SYSTEM Thi �/M/�
LOT BLOCK O F _
APPROVED BY �- DATE '� ---- ---
/� p ISSUED BY J 1 DATE
------ h� ___.. Ft E ro A R KS ##M M 1'�. 1'v1K,�7��1i f7►tt Pl�• $LTi�_'Fw M� qtr. CAKQ