12770 SW KATHERINE STREET 12776 SW jkATHERINE STREET
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: --/ PERMIT NO. :_._.__M_
DATE: J DATE ISSUE :,__/--Z- _
OWNERS NAME : Wroezl rac ZT _ - - ---
A►DDRESS: 16?71>ew_l..ec .. -- _
CONTRACTOR :
TEST ' Air 0, Watertj visual p , Lcboroicw r�
RESULT: Approvb , Disapproved O , Fending C7
SKETCH.
I
__A!fP1fCT0R DATE:
FrTE ; Attach supplemental test data beret fl
City of 'Tigard
INSPECTION REQUEST
f r
INSPECTION TIME: PERMIT NO. : —
DA,rE: 71'2 79- TEISSUED .
OWNERS NAME :
ADDRESS: 5 '�
CONTRACTOR :
TIE-$T : Air [1, Water r
..j , Vleija[V, Laboratory [3
RESULT . approved' , Disapproved EJ Pending
SKETCH. /to ; -7 Sc
ANSPF�# OR DATE'
50TE Attach supplemental test data beret Qj
City of Tigard
sfL:c,,nON REQUE-l' T
for
!N8PLCTION TIMF' _2,,'04),OM T
D61 E: C)AM
OV,'NF,7t-.R NAME '
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City of Tigard
FINSPECTION REQUEST
for
ter..—�,�•i v v c.,. v�� /� f�'j'�C���f�.
SPECTION TIME: PERMIT NO. :
DATE: 3 IA,',l ?> DATE ISSUED : Z Z
fNER$ NAME : ' -: 5,e?rA
ADDRESS: . /AZ
INTRACTOR : e�GU.f..___`��1!SVxFZ,
-ST : Air CJ, Water❑ , Visual* Laboratory p
-SUL.T. Approved ❑ , Disapproved o , Pending []
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I
INSPECTOR DATE
Q: Attach supplemental test data beretaaj
UL
City of Tigard
' fJNSP'ECTION REQUEST
for
INSPECTION TIME :—,— --=- — PERMIT NO.:
DATE: Z let,L-5,_ DATE ISSUED:._.L-I
OWNERS NAME :
ADDRESS : ���• I'tic�'y,�-
CONTRACTOR j6�4L-e!f"r—t—
TEST".
TEST. Air ❑, Water u , Visual, Laboratory C�
I RESULT: Approved ❑ , Disapprol d Pending p
SKETCH:
I
INSPECTOR DATE
ENOTEI Attach suppl-+mental test data herst:01
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City of Tigard
INSPECTION REQUEST
for
(.�'�,P-�.�-�-�
I �
{ INSPECTION TIME : /� PERMIT NO.:
I DATE: /''`/�'S" DATE ISSUED:_—L-L.
OWNERS NAME :
ADDRESS : --
DDRESS :
CONTRACTOR :
ITEST: Air ❑, Water Q , Visual ly, laboratory ❑
RESULT. Approved 0 Disapproved Pending L7
SKETCH:
0
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INSPECTOR DATE
COTE : Attach supplemental test data heret]
ea .� � .� nes wet eet eS
I
City of Tigard
I
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. : --
DATE: —l—
0. : __DATE: —1 � DATE ISSUED:_._/_',
OWNERS NAME :
11:� �70
ADDRESS : eV
CONTRACTOR : — — —
I
TEST. Air 0, Water Visual, Laboratory ❑
I RESULT: Approved Disapproved ❑ Pending U
e KETCH:
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I INSPECTOR OATE
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[NOTE : Attach suppl4mentol test data hers,]
.,.Y+*nYaew`,ailWryv"W,.'+"7�«..+•rww•.w..,».. ..r.'"W 'u+«' �`�"ip`!f+'4lrf�:i°n�M�li•MW�W +�'�"'1•»++wwwm�a':wwa
l �•,� �� CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE 1�•�`: ._�.�. N° 0117
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYj.Ij1Saji?�AN�St�NR," � SIGA �OPIS.� QWNRI�ONE _
Herbert F'. Mori s3et' T22
NER 94�DRESS BUILDER PHONE
S,t'ifllkli ENGINEER
$111LL?EH
_- ARCHITECT DESIGNER
STR'JI'T11^c ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIrR-iEDAMAGE CIDEMOL'IION
C3R'cS'DENCE ❑rrC-1OMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPATIO F]CAR PORT ❑ L_.I
GARAGE STORAGE CISLAB ❑rENf c
_ OBOND OMOVING OCONOITIONAL USE ❑DESIGN REVIEW C1 COUNCIL APPROVED [:]SIGNS
OCCUPANCY_.W._._LAND USE ZONE—=, -, BLDG.TYPE___-_FIRE ZONE PLAN CHECK.BY___ 'I!` HEAT_—_.__._
Now Singlo Family Rwnidence tf) be curia tructad ac.x3rdirlg
ptery i, ._
mttochad 4 rig• - No Basement-Wood rtrame
♦Al�yy t
Lb.
QAC, LOAOFLOOR LOAD _— HEIGHT NO.STORIES AREA VALUE
r_ BUILDING DEPAPT RENT SET BACKS FRONT e, HEAR— 31-9 _EFT SIDE 16-1 RIGHT SIDE k'3?
Permit ',�Ei.()Q
THIS PERMIT IS ;3Z;L'E0 'qUBJECT TO !HE REGULATIONS CONTAINED IN THE BUILDING CODE, ?ONING
Plan Check 10,or REGULATIONS AND ALL AI•PLICABI E CODES AND ORDINANCE AND IT IS HEREBY AGREFO THo",r THE
WORK WILL BE nONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE ivITH
Recording 4.Of ALL APPLICABLE CODES tlNrl ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
® RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
19G State LICENSE. SEPARATE I'ERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total- -� •
BY
-- - --- APPLICANT ()" AGENT
Approved RuTipt Nu
ADDRESS
JwmwALwA= ew = ar .E
DATE INS' TYPE INSPECTION —, REMARKS— PLU�Mj7BING�/� �I DATE
6� -;1rt2 S.,';Y.s^ s7 Contractor
/` Permit No.r cY
= 7S
Rough-in
14_----- I To l[_j St"7 uti7-I L rz_ Fixture
al"ys. _j7La--_ , L.►-LL t1At[:K Final
HEATING
"ePho- " o w&? Contractor .w
� Prm
eit
/-a;7- p Ak•A4�I�r tom,-t),c�1I?v 2r vuij �/ _�/�---
-�; Gas or Oil -----.
J ?S Get e__-5 1�/S i v', I=11pyGor.--ce Rou h-in — - ---
�- � _ArDJft%, l be Final — -- - _
a 7`�'�S O N dCv1Z SEWER
71 Ll L'+ 1 —--- ----_ F i nal
DRIVEWAY
-` Final
A_ Storm Draina
(R;;n Drain` Final
Sidcwalk
- Curb&Street Final
BLDG.DEPT,FINAL _ TEMPORARY CERTIFICATE OCCUPANCY —
CERTIFICATE OCCUPANCY Final _
La tdscaping
Zoning F'nal
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UNIFIED SEWERAGE AGENCY NO. 5021
WASHINGTON COUNTY DATE --11-15-76
CI I-Y OF-_----- Tilj;ird
f .PPLICATION FOR SEWER CONNECT ION PERMIT
OWNER: Herbert E. Morissatte
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'7WNER'S ADDRESS: ifa
STREET
-ITV STATE ZIP
BUILDING SITE: LOT__-9.j_ ____._ BLOCK __- _._ ADDI1 ION 13e11ijuod I.1-
TAX LOT NO. __-__.__—_ ____ TYPE OF OCCUPANCY _ Residence_
ADDRESS _ -__. 12770 S.W.- -KatLazine -Street
.
DWELLING UNITS FIXTURE UNITS _
SURCHARGE IF APPLICABLE -
PERMIT FEE 525 -- -_ INSPECTION FEE - 2S___-_- TOTAL DEPOSITED _._5.5D
(NEW) (EXISTING) BUILDING SEWER SYSTEM Fannn Creek- _-.-. -- --
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPI.ICAN T�e ���i'f _l_ ?'' C-C-
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE _._.___...._. 411_ __. INSTALLER
RECEIVED BY__ ._a��2, c;sd� City. of Tigard
NCV OR ITS AGENT)
COMMENTS: d.uil.ding..pormit # 0117
This Application and permit expires in ninety (90) days. The amount paid will he forfeited
should expiration occur.
/0 - 99
ADDRESS �l)_�/� PERMIT NO.
PERpji ( CHARGE none
OWNER CONNECTION FEE
PAID BY
TYPE OF BUILDING DATE CONNECTED _
SERVICE RATE I�!Yn��� INSPECTION FEE
CONTRACTOR PAID BY ,,tip DATE
SIZE OF CONNECTION 4�� ASSESSMENT �� PAID
ELL� �
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