11670 SW TERRACE TRAILS DRIVE r
11670 SW TERRACE TRAILS DRIVE
V
r
w
UUM
19-
Address permit No.
Permit change 0 12 '= -
Connection fee
OureT D ✓ p_ A �c
Paid by
�, �_„ ��� _, E Date connected
Type of building � -
Service rate Inspection fee
..�.���
Contractor _
Paid by __ Date
Sire of connection Assessment paid
� _j -i7 `� � 3 cry. _ (, •',
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: !4-`z� PERIMI T NO. :
DATE: f V-U7K DATE ISSUED :---Ll-
OWNERS
SSUED :___1_L_.OWNERS NAME :—/j-e,/3
ADDRESS:
C:"NTRACTOR : ._
TE ST : Air 0, Water[] , Visual Laboratory I]
RESULT: Approved U Disepproved Lh Pending (]
SKETCH; jooe
01
+F
INSPECTOR f 'DATE
50711' Attach supplemental test data be►eto7
ly
City of Tigard
INSPECTION REQUEST
far
IN3PE.CT10N T!,ME ?FRMIT N0. : --
DATE: - DATE ISSUED :--L.-L-
OWN E RS NAME : --- --
ADCRr SS . --
CONTRACTOR --
T':ST : Air C , Wcte- - , VlaUai i `.Sanatory [�
RESULT' Approved C Divpproved Penlinl ❑
SKETCH:
INSPECTOR DATE
COTE: Attach suppiernental test data h4, tIj _
."tr•�^�'++p�'A�A?�+,'3'R. 17'"x' ,..
CITY OP
BUILDING PEWIT APPLICATION TIC ARD DATE August I--
— 19 N° 0 99 ;
'THE UNDER.,'GNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE __.
QWNER Samuel E Idlan Cunt. ADDRESS 11670 5W Terrace Tratilti,BUILDER PHONE
ENGINEER
BUILDER ARCHITECT DESIGNER
STl4UCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REx.11R DFIENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RILIGIOUSOPATIO ❑CARPORI ❑GARAGE GSTOHAGEEISLAB [:]FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW CCOUNCIL APPROVED OSIGNS
OCCUPANCY LAND USE ZONE--_—BLDG.TYPE FIRE ZONE____ PLAN CHECK BY-_____ HEAT_
4'rlca warage attachad I f]rddIYOiA ;"r u4th
osear4ont 1100 aflort, garage 445 !q. fto -- - ----
.39,,30
OCC,LOAD FLOOR LOAD HEIGHT_ NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR 26 LEFT SIDE RIGHT SIDE 71
Permit 137•QO -
-" .r� ;�r THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDI�„ CODE, ZONING
Plan Check •' 7EGULATIONS AND ALL APPLirABLE CODES AND ORDINANCE, AND IT IS HEREBY Ak REEV THAT THE.
WORK WILL BE DONE IN ACCORDANCE W1TH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State !•I' LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total 42.
`..'
By
Ar+111 NT OR AGENT
Approved --- Receipt No
ADDRESS PHONE
REMARKS PLUMBING DATE
DATE INSP. TYPE INSPECTION
Contractor_____
Permit No. _
3
Rough in
Fixture _ _
c
f Final _
IIEATING
Contractor _
Permit No.
5 y/ Al
Gas or Oil
Roughh-in
Final _
SEWER
Final _ T
` DRIVEWAY .0 C
r Final
Storm Draina e
(Rain Drain) Final
-- �� it -?3• ":
Sidewalk
Curb&Street Final
Approach
i,
BLDG.DEPT.FINAL- TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final _
Landscaping
C ( Zoning Final C
UNIFIED s1W1_RAGEAGENCY NO. __10609____-__
W;N S�� I 1 V V 1 O 1 V COUNTY DATE August 12. 1976
CITY OF Tigard _
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: Samuels & Eldien Const.
OWNER'S
STREET
CI rY STATE ZIP
BB JILDING ITE: I,OT __----_ BLOCK . _ ADDITION
-IF;)( 12"r :z S / - 3 C p residence
TAX LOT NO. TYPE OF OCCUPANCY
ADDRESS
DWELLING UNITS._-.' _-__—_1__,_____ _______-___ FIXTURE UNITS _.__._-._�—_____—__
SURCHARGE IF '
APPLICABLE __-__—_--_—_.- -___-__
5
PERMIT FEE _ INSPECTION FEE ___25'd0 TOTAL DEPOSITED -- _
(NEW) (EXISTING) BUILDING SEWER 5YSTFPII ..-_ Fenno Creek`
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
A P P I_I C A N T I-Ar',.�-� � �✓`�/V1— -- — ---
SEWFR PER1\AIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LI"r ''> 7_E . ----- INSTALLER
RECEIVED BY
(AGENCY OR ITS AGENT) +
COMMENTS: - _-B1d9• -;'10996
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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