12390 SW KNOLL DRIVE 1.2.390 SW .tNULL DRIVE
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Receipt 39607
r SEWER PERMIT N? VP49
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Unified Sewerage Agency _
of Washington County CITY OF Tigard DATE 9/30/81
OWNER : ,port zi &_Sarah Williams PKINF : 639-9034
OWNER 'S ADDRESS: 12390 hL Eno Ll- i)ri.ve
TYPE O�- INSTALLATION:
® SIDE SEWER EJ LINE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY:
C] NL6 ❑ EXISTING ® SINGLE FAMILY L] CO"MERCIAL
EXiST. (PRIOR TO 7- 1-70 ) ❑ MULT. RES. [j INDUSTRIAL
FIXTURE UNITS DWELLING UNITS 1
ADDRESS OF STRUCTURE : 12390 SW Knoll t)-ive _
Permit Conditions: The applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency..
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 cf the location of side sewer latera.15. if the sewer iG not located at
the measurement given, the installer shall prospect three feet in all directions from t'ne distancr and depth raven.
If not so IocatRd, the Installer shall purchase � 'Tap and Side Sewer' Permit at the currPn! charge and the -kgeicy
will install a lateral at the location sp^cified by Oe installer.
FEES:
PERMIT FEE. $ 35 .00
CONNECTION CHARGE 300. 00
LINE TAP INSTALLATION _ penny iebertz
ISSUED 3Y
01-HER
TOTA[ $ 335 .0'l
9/30/81.
T-rl- 30 AP('L. ICANT DA.rL
1
SEVVER PERMIT o
ADDRESS OF STRUCTURE 12390 SW Knoll Drive
TAX MAP _�2S1-1jjQ TAX LOT 1500 _ SYSTEM Fanno Creek
LOT —_ RLOCK OF
dwh 9/30;of 9/30/81
APPROVED BY DATE: ISSUED BY DATE
D . U . ' S J- _ _- RL_."ARKS PURIy & fi11 exiatinq sematic tank ver _St-'-e Code_
Min. 4" vine required.
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SEWER PERMIT Na
Unified Sewerage Agency
of Washiny:cn County CITY OF _ DATE:
OWNER : l Ur S4r4Iv� VV91(Ci0 _ PHONE :411- 10 3
OWNER 'S ADDRESS: lz-S4O 54) VV%.o<< `.
TYPE OF INSTALLATION:
Lp SIDE SEWER El LINE TAP AND SIDE SEW!.R ❑ LINE TAP
TYPE OF OCCUPANCY:
❑ NEW ❑ EXISTINGSINGLE FAMIL'! ❑ COMMERCIAL
EXIST. (PRIOR TO 7- 1-•70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UN ITS
ADDRESS OF STRUCTURE : _ bow—,
Permit Conditions: The applicant agreea to comply with ill rules and regulations of the, Unified Sewerage Agency.
When calling for i;ispection, please refer to the Permit NV Ver. The /,pplication expires in one hundred twgnty (120)
days. The amount paid will be lorfeited shtald expiration occur.
The Agency does not guarantee the accuracy of the location of -'de sewer laterals. If the sewer is not located at
the measurement given, the installer shall prospect three fe_;. 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 cur-ent charge and the Agency
will install a lateral at the location specified by the installer.
FEES:
FEPMIT FEE $
CONNECTION CHARGE
LINE AP INSTALLATION
ISSUED B Y +�_
OTHEr
oy TOTAL $----
APPL.ICANI DATE Y
SEWER PERMIT O
N
ADDRESS OF STRUCTURE. 1 3 q0_e.set) N0 • r��
TA/ MAP - �� TAX L O T
SYSTEM
LOT _BLOCK OF
A OVED BY DATE ISSUED BY DAIE�
D. H . ' S RENAR KSgi- 44--I]Laj' ed . 9 A Tek _ 464-
_
BUILDING PERMIT APPLICATION 10 Y TIGA.RD DATE _ (5"22-77 —, ,a !
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED BUILDERPHONE
OR AS SHOWN AN-) APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE __.
1p2 390 :i1J Knoll Ov.a LOT NO.
Y
OWNER iorence Ui"1iMhSJOB ADDRESS �.1�.li LK HuME ADDRESS _
ARCHITECT —'
BUILDCR rTtrna'T p• InCSL!jitJ ia_1 ADDRESS rNGINEERDESIGNER
STRUCTURE ❑NEW _LTREMOpEL �' ' ❑ADDITION Q%EPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
EIKESIDENCE ❑COMM ❑EDUC'TIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE&kLAB ❑FENCE
n ❑BOND ❑MOVING CONDITIONAL USE ❑DESIGN REVIEW ❑COU14CIL APPROVED L-1SIGNS
OCCUPANCY ' LAND USE ZONE__ BLDG.TYPE FIRE ZONE---__"LAN CHECK BY_ HEAT_==== _
Itt,a b homra romu.vt)ld bssument;. wailb puss nOW U8119 BXlV footinU t!r' t.hl,ur wall��
il►mdcnur trnscyment s1sU 4" thick & Now poach 6 Ratio install sum ouc°k rua r section Of
hw4riw sled install windou and slidiou door d. TI-1l a:.ding. Ulitsan ngu j'1umtji�-
r)ermi t.
S?�SS,.laS1AQ_—� F14.4fl_LQA.Q---__ — �+FiL .1�1Q�I�L1 .__. AREA
6UILOING DEPARTMENT SETBACKS FRONT QXitl�AR LEFT SIDE RIGHT SIDE
Permi1_.__74.OJ_ ----- _ -- �— --- - ----
THIS PERMIT IS ISSUED SUBJECT TO THE RFGULATIONS CONTAINED IN TFIF SCILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICA:iLF CODES AND ORDINANCES, AND IT IS HERI?BY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUTAt0taI ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PFAMIT DOES NOT WAIVE
w RESTRICTIVE COVENANTS. C'JNTRACTOR AND SUB CONTP.ACTORS TO HAVr: CURRENT CITY BUSINESS
State Tax 2.22 LICENSE. SEPARATE PERMI'-S REQUIRED FOR SEWER, PLUTABING AND HEAP ING.
rota) 22
By
Approved �' Receipt No
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aau Ia! i 11# pi III< � #
DATE INSP. TYPE INSPECTION REMARKS PLUMUING DATE
0% Contractor
`ll'7I JA) t T h y,/ _ Permit No. --_—
(�— £ cix Rough•in
L --
I ze
L—y,�Jf Fixture
���P �0(��� p2V� a�i Cl��_ Final _—
`�6'7� �r� Y► Q�` C�sN"�CJ —^ HEATING
4. �;t A t6 �2 Contr .:tor
7-0 L Permit No.
�A
-v <1PrAV VdP"S Gas or Oi _
Rou h-in
Final
-- ----__--- ----------- - SEWER
Final
DRIVEWAY
Final
;term Drainage
jApp,
ain Drain) Final
dewalk
urb&Street Final
_ _ oach
BLDG W1 FINAL TEMPORA-n—"!-- CERTIFICATE OCCUPANCCERTIFICATE OCCUPANCY nalandscaping
oning Final
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