12790 SW KATHERINE STREET 12790 SW KATHERINE STREET
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City of Tigard
INSPECTION REQU ES"r
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for
INSPECTION TIME: PERMIT NO. :. I
LATE: __222L/_
_22 ''/_7- '''E ISSUED '—
OWNERS NAME :___�r���!ss�' _ —
ADDRE 3 S: 0�1 ..►
CONTRACTOR : __
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TE ST : Ait %.a, !Nater❑ , Visual K Laborciory ❑
RESULT: Approved , Disapproved 11 Pending []
SKETCH.
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INSIPV 0,R DATE
[NOTE: Attach supplemental teat data bareta�
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City sof Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO..:
DATES /�'/ SEDATE ISSUE,p:-_ -
OWNERS NAME :
ADDRESS : - -
CONTRACTOR :__-__- __-_.__.____- _-_
TEST: Air O, Water , Visua�0 , Laboratu, v p
RESULT: Approved , Disapproved ❑ , Pending [j
SKETCH:
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NV SPE.CTOR DATE
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OTE : Attach supplemental feet data here -0
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CITY or
BUILDING PERMIT APPLICATION TIGARD DATE— -- A�- ---__-. 19 0207
THE UNDERSIGNED hF!REBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 244-13AVU
OR AS SHOWN AND -1PPROVED IN THE ACCOMPAAYING PLANS AND SPEgjf j t1 iqtffia OWNER P�;ONE
OV NER .�__ ! • L$a$g'Z$� ADDRESS l'e l +U .�I�W• ft$ �18�rirGi BUILDER PHONE
as Nhove ENGINEER
BUILD, j _ ARCHITECT _ DESIGNER
STRUCTURE _ ONEW [1,REMODEL ❑ADDITION ❑REPAIR ❑_RENEWAL 0,-IRE DAMAGE `,f-1
DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T L._JRELIGIOUS OrATIO ❑C.AR POR`f ❑GARAGE ❑STORAGE OSLAB ❑FENCE
OBOND OMOVING ❑CONDITIONAL USE ❑DESIGN RE /IEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY —_-LAND USE ZONE,.----Bi nG.TYPE i FIRE ZON PLAN CHECK BY_ Pf'B HEAT- 'a'
`"a roily rresidenc.sa tip ba (.-Uii1,�tVk6CtYd SCL4.k rdLag to plare
attoQhed gaaarriqu—nu beseawnt - coact frame.
1492 30*000
CC LOAD FLOOR LOAD — HEIGHT —� ^NO.S1 ORIES AREA VA'.UE
BUILDsNG DEPARTMENT
SETBACKS FRONT + REAR LEFT SIDE 18 RIGHT SIDE
Permit — �-�--
"' — THIS PFRMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINE') IN THE BUILDING CODE, -ONING
Plan Check REGULATIONS AND ALL APPLICABI E C07ES AND ORDINANCES, ANC, IT IS HEREBY AGREED THAT THE
-— W TRK WILL BE DONE IN ACCORDANi.E M,ITH"HE PLANS AND SPECIFICATIONS AND IN COMPO aNCE WITH
Recording ALL. APPLICABLE CODES AND OP tOINANCi-S. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— —`—'-' RESTRICTIVE COVENAN"IS. CONTP.ACTOR AND SUB CONTRACTORS ''O HAVE CURRENT CITY BUSINESS
196 State LICENSE. SEPARATE PERMITS REIJUIRED FOR SEWER, PLUMBING ANO HEATING.
Total
By ----
.__.- AAP LICA T OR AGFN1 - --
Approved- Receipt No
AbORFSS ---- ---- PHONE
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
7./r Permit No.
Fixture
Final
HEATING 70
Contractors
Qermit No. a
ti9.,h,af a"- — Gas or Oil —
,c.ccr,l Rough i n. — ------- ----
SEWER 7�
F nal
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
. — --- --- -- -- — A broach
BLDG DEPT. FINAL. TEMPORARY ERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY -------
Landscaping
Zoning Find
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UNIFIED SEWERAGE AGENCY NO. -_ 5057
WASHINGTON COUNTY DATE
CITY OF_--- - -_ Tigard
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: Herbert E. morissetteo Bldr. - 244-1300
OWNER'S ADDRESS: _-8905 S.W. Dolph
STREET
Portland Oregon
CITY STATE ZIP
BUILDING SITE: LOT 92 - BLOCK ADDITION
Bellwood II
TAX LOT NO. TYPE OF OCC''JPANCY -_residence _
ADDRESS _127.9Q_ ,1Js__�S_atherinA_ 5trset
DWELLING UNITS _ L-- _____ FIXTURE UNITS
SURCHARGE IF APPLICABLE -- ------- __ -- _--____
PERMIT FEE 525 - -_. !NSPECTION FEE .25___ _._ TOTAL. DEPOSITED 5.50__-
INEW) (EXISTING) BUILDING SEINER SY'S;-EM __- Fanno_ (:Tee
The Applicant agrees to comply with all rules and regulations of the Unified Sewgragc� Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AI,!! HORIZES CONNECTION TO THE SEWER SYSTEM.
LINE S17F 411 INSTALLER
RECEIVED Bti' ct i a-c-4-f ./
A _
GENCY OR ITS AGENT)
COOMENTS: $150_ tq_Leron Heights ..building_ permit 0207
This Application and permit expires in ninety (90) days. The amount paid will be forfeited
should expiration occur.
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ADDRESS7.1(`� PERMIT N0•-
P E R I1 I T CHARGE none
OWNER � "ONNECTION FEE
PAID BY
T'fPE OF BUII.OINi; DATE CONNF.:CTED
SERVIt:E 'TATE _ r IN5PECTION FEE
CONTRAC i'OR b � PAID BY DATE
SI7_E OF CONNECTION _ ��� _, ASSESSMENT _ _ PAID _��
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