11625 SW TERRACE TRAILS DRIVE 11.625 SW TERRACE TRAILS DRIVE
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ADORE
P E i'1 I T N __------.-
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PERMIT CHARGE. � � nonp
CONNECTION FEE -Z;�,,._,,._
OWNER
PAID BY
TYPE OF 8uIL01NG1%'-�.� �.�����r._. DATE CONNECTED
SERVICE RATE _ ._. ._ INSPECTION FEE
_ �._�.
C ON T R ACTOR
PAID E3 Y DATE
_.._... ----------- __......_. __.�
ASSESSMENT PAID
SIZE OF CONNECTION — p
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CITY Y OF TIGARD
OREGON
wr O�aner:.E`....haus................. ..............."............ .............Permit No... .. ....... ... . ...
f 1111
<.; 11625 SW Tc.rrece Trails
Building Acidress............... ........................ ...... ..................... ........".. ................_
r 31........ Januar .............. 4 ...7.
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Certificate Is hereby given this...... . day of.... Y , 1 � z
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.
• $uildin(t Inspector
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : 42y PERMIT NO.:
DATE: & ' DATE ISSUED: __L_L_
OWNERS NAME :
i
ADDRESS '
ICONTRACTOR : ---- --
TEST: Ai.TO, Water p , Visuait t Laboratory ❑
RESULT: Approved ' , Disapproved ❑ Pending t'j
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SKETCH'
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INSPECTOR DATE
COTE Attach supplemental test date hsrsto1
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City of Tigard I
INSPECTION REQUEST
fo r
INSPECTION TIME: PERMIT NO. :
DATE: o //st DATE ISSUED .'---L2-
OWNERS
SSUED :_L1_OWNERS NAME : ---
A D D R E S S: -------
I, CONTRACTOR :
ITEST ' Air ❑, Woter❑ , YteuaA , Laboratory 0
RESULT: Approved )14 Di eapproved C , Pending L]
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NSPECTOR r DATE
FNOT6 : Attach supplemental test data here}]
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City of Tigard
i NSPECT'ION REQUEST
for
0
INSPECTION TIME: _��TPERMIT k"10. :—
DATE .
l0. :DATE : _�.:: _ _ DATE ISSUED .__,L1
OWNERS NAME
ADDRESS: _. I to l z
CO NTRACTOR : —___.
Tr.ST : Air p, Water fJ , Visual m, Laboratory C]
RESULT: Approved) Qisapproved C Pendir:p p
SKETCH.
10
A L!�
INSPECTO DATE
i_NOTE Attach tupOemental test data bel Of
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BUILDING PERMIT APPLICATION "y TIGARD GATE 1U-4-76,OF
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF. _
I.J L;a(.;aL 1162) 5LI 7errvua Tro LOT NO.
OWNER JOB ADDRESS RF ,
ARCHITECT
�f}nll A.�jt, 13 ENGINEER
BUILDER_ ADDRESS DESIGNER _
5 RUCTURE F- [..)
ONEW 1 t❑REMODEL F-� ❑ADDITION ❑REPAIR Y URENEWAL _ ❑FIRE DAMAGE ❑DEMOLITION
1.J
❑ RESIDENCE COMM EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑-ATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
❑BUND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SiGNS
OCCUPANCY _LAND USE Z01JE_ DLDG.TYPE_ FIRE ZONE-4 PLAN CHECK BY.. — HEAT --
L,..,not. 2 story eir)(419 family dwollinc► w,/attect►,ad W.:rrauu 3 bmdroom ' Lti
+Complete 94A of dr0uiny on trueess requirod` garage, 441 baaument. .336 �
--- --- -- 2 1650 , 3 399000.
OCC• LC�L�_ __ ___F�.4GP t.2A2____� t JGHT __.N� SLQRIE�__ AREA NO.BEDROOMS VAL
BUILDING DEPARM�f�T 30 33 if" � � fi
- BET BACKS FRONT REAR LEFT SIDE RIGHT S JE •• _
-jai. _ _ —. ---- ---'—_ —.
Permit
THIS PERMIT IS ISSLlEO SUBJECT TO THE REGULATIONS CONTAINED IN THE BU11 DING CODE, TONING
Plan Check • REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IF IS HEREB ' AGREED THAT THE
— — WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANC IN COMPLIANCE WITH
Sub-total ALL APP�_ICABLF. CODES AND ORDINANCES. THE ISSUANCE OF THIS PERWV T DOES NOT WAIVE
•
RESTRICTIVE COVEN14NTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CI FIRFNT CITY BUSINESS
State Tax LICENSE. SEP14RATE PERMITS nFOU1RED FOR SEWER, PLUMBING AND HEATINt
Total -
By
------- - - -- - AI 'CANT OR AGENT
Approved Receilrl No
ioa S — — Hc:r�[
GATE INSP. TYPE INSPECTION W— REMARKS PLUMBING DATE
Contractor
Permit No. 33 "C'/)2/74 Rou h-in
Fixture_--_
��- p — Final ---- — ----.v
HEATING
YA11
� Contractor
Permit No.
Gas or Oil ------
Rou h m
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
_ (Rain Drain) Final _
_ Sidewalk —12-
_ Curb&Street Final
ADDrusch 11 - 12 -76Pjj
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
UNIFIED SEWERAGE AGI-:- NCY NO. �1Of►66
WASH I NG R..'N COUNTY DATE 10-4-76
CITY OF=- icar0____
APPLICATION FOR SFINFR CONNECT-ION PERMIT
OWNER: ._ Ed Gause
OWNER'S ADDRESS: .___
STREET
CITY STATE ZIP
BUILDING SITE: LOT_ 1 _- BLOCK ADDITION
TAX LOT NO. _____ TYPE OF OCCUPAP;;,ti residence
ADDRESS __ _1.1_f1�SW__7�rre_cQ._Trils
DWELLING UNITS 1 _ FIXTURE UNITS _
SURCHARGE IF APPLICABLE __ 50#_QO Oer�Dell.
PERMIT FEE ___57_5_._fM_ _._ INSPECTION FEE .-25..5QU- TOTAL DEPOSITED - 600.00
OI EW (EXISTING) BUILDING SEWER SYSTEM ._..---f_a_nno_Cree
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT___ _, � -__
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE ___.-___._ _�_ INSTALLER
RECEIVED BY--..--- -,.r�ti- - t — �'C'""------- — -- -
(AGENCY OR ITS AUN7) -"--
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COMMENTS:
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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