11575 SW TERRACE TRAILS DRIVE 11575 SW TERRACE TRAILS DRIVE
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Q���rler:......... Permitrl :�
...... ................... .............. No... 1012_
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Building Address................. 11575 SW Terrace Trails
%•' Certificate is hereby given this........1.....Aay of....Apri l ... ............ 19..7..7... y
that said building may be occupied and
(: that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
/ +1 Building inspector fir`
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�s C••'�,''�.fi'�"� 1, �-'� �/ ' ' �'�
t�`� ��',°YM; /. .. .. '�i�:''�L?F,a. / ••. s. �A';•r�. i.;�?MV3...� /.�'S`�• ,:ri..•vo, :•T•�`'"�N'•.. „1'^k'�• ,f�ir•� " '��'�. .��a
Address �/./:a;�S` 'z �_z_. 1r�L. C.• _ Permit No. , ZOL: �
Permit charge 2201;� t,
owner —T -- / � Connection n n e c ;i o n fee �-
Paid by
Type of building Date connected
Service rate _ � (� Inspection fee ?
Contractor Paid by _ date
Size of connection Assessment Paid
3 --9-7 -7 3 300 - .��
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City of Tigard
INSPECTION REOUEST
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for
INSPECTION TIME : PERMIT NO.: _
DATE:. DATE ISSUED:__LL
OWNERS NAME '
ADDRESS . '� ti-' -C
CONTRACTOR
TEST' Air O, Water G , Visual 0 , Laboratory p
RESULT: Approved fJ Disapprovod C7 , Pending p
SKETCH: [�
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V ,
INSPECTOR DATE
ICOTE : Attach supplemental fool data herelo�
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City of Tigard
INSPECTION REQUEST
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for �
INSPECTION TIME: —� 2) PERMIT NO. :
DATE://.,7./ DATE ISSUED '--L-
OWNERS
SSUED :..._L_OWNERS NAME : yam—
ADDRESS: //-2-25
CONTRACTOR : -
TE ST
ONTRACTOR : _TEST : Air ❑, Woter❑ , isual ❑ , Laboratory p I
RESULT: Approved a Disapproved C , Pending L)
SKETCH:
i
I SP'ECTOR DATE
CNOTE: Attach Supplemental tet data ber0to]
I
BUILDING PERMIT APPLICATION CITY TIGARD DATE u u ' 76A _ 1112
THE UNDERSIGNED HEREBY APPLIES FOR APE RM IT `OR THE WORK HEREIN INDICATED BUILDER PHONgk4 -364 3
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNEIZPHONE _
OWNER
Ler a:V ktAl ey 11575 Terrace 1 Tradia Cir. LOT NO.
JOB ADDRESS HOME ADDRESS
BalTtG ARCHITECT
BU.LDER ADDRESS ENGINEER
DESIGNER
STRUCTURE "11NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑TIRE DAMAGE ❑DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL ❑GON'T ORELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
RE
I AOND- ❑MOVING ❑CONDITIONAL.USE ❑DESIGN REVIEW_ ❑COUNCIL APPROVED ❑SIGNS
Q499tANCY Y _LAND USE ZONE BLDGTYPE FIRE ZONE PLAN CHECK BY
HEAT
---- ❑r,c�t x1t,■ at�ry c�ur�l3in���mttaohrd T�lyftl 4 bedroom 3 d Lath ----�^
-- Tax MaR 3E 3—__Tsx Lot 36QO -
--- —arms 624 -
QCC ISLQ _ FLOOR I.O�_GQ EIGF�T_---_ ___NO.STORIES 2 ?A23 4�? ;� y
- ALFA __—LVO BEDJ3QOMS _ VALUE f
BUILDING DEPARTMCNT SET BACKS FRONT250 REAR 490 LEFT SIDE y! RIGHT SIDE '!
Permit 163,00 -�— — _�- _- ------
"-`-" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 100011 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORN. WILL BE DONE IN ACCORDANCE WITH T-HE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 5019 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total Z j��lfy
By
ceipt No. - ° ICANT f�R AGENT
Re
Approved - ( ------- —
A D ESS
o
017 b
317
/001ft�� 96W
Ll-97 je
�Y
.....,..._....................._rc.».............,..-. �..-...._.. ..-.,,..,. - �.. .. . .... .. .. ........ � � .,.. .. ._ ....._...-- ''—'1 T'tfi!tfr'• ---,--;-zsrrr+----;m'R
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' 1,71:7
UNIFIED SEWERAGE AGENCY NO.
WASHINGTON COUNTY DATE _Augt1nj17. 1976
CITY OF Turd
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: _.._ Larry_Kell9y—__ _-
GAINER'S ADDRESS:
EET
cITv -
- lIP
BUILDING SITE: LOT-..-- BLOCK ._-._ _ ADDITION
Tax fiap 3CA
TAX LOT NO. _ 3600 TYPE OF OCCUPANCY ._ residonce
ADDRESS 11575 SW Terrace Trails Dr.
DWELLING UNITS-___— 1 FIXTJRE UNITS
SURCHARGE IF APPLICABLE _ 50.00 Derry Dell
PERMIT FEE 575. 0 INSPE=CTION FEE 25.00 TOTAL DEPOSITED _ 600. 170
(aEYY) (EXISTING) BUILDING SEWER SYSTEM __funno Creek
The Applicant agrees to comF ly with all rules and regulations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION 10 THE SEWER SYSTEM
LINE SIZE - INSTALLER
RECEIVED BY------
IAGENCY oR ITS AGENT)
COMMENTS:
r31 dg. X1012
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
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