11750 SW 113TH PLACE -gww.
11750 SW 113TH PLACE
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C 11 Y OF TIGARD lvC'
r> OREGON
S ; Herb f"or.... a -, T 1199
Building Address... 11750 SW 113th. P1.
�i' Certificate is hereby gi�'en this.....2.0.... ..day of May jo 77
that said building may be oceup;ed and
ci. that it complies with all requirements of
a the Building Code for the City of Tigard,
as approved by the Tigard City Council.
Building inspcctor`.,.C..... .... ►!t �,�
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City of Tigard
INSPECTION REQUEST
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INSPECTION TIME: 9' PERMIT NO. :.
DATE: » DATE ISSUED .
OWNERS NAME : � �
ADCRESS: ZZ;7-5'6 S,141 113
CONTRACTOR
TEST : Air C7, Wafw ❑ , Visual t l_abr.ratory (]
RESULT . Approved Disapproved C , Pending (]
SKETCH.*
INSPECTOR DATE
[OTE: Attach supplemental lees dare berera]
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City of Tigard
INSPECTION REQUEST
far
INSPECTION TIME: PERMIT NO. :_.__
DATE: _3 1/// 727 DATE ISSUED .—.-L Z
OWNERS NAME : _Zl/ , 6
ADDRESS: 117,5o
CONTRACTOR :
TEST : Air Q, Wnter❑ , Visual ❑ , Laboratory D
RESULT: Approved 0 Disapproved C , Fending ❑
SKETCH.
SPECTOR DATE
[OTE: Attach supplemental test data beret]
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UNIFIED SEWERAGE AGENCY NO. ____11022 _ -_-�-
VVASI] INGTGN COUNTY DATE 12-15-76
CITY OF____T.kerd
APPLICATION FOR SF=1lUFR CONNFCTION PERMIT
OWNER: . H.Hrh MorissELte_ __-_.- -v___..,__.--__----._s..__-- --_
OWNER'S ADDRESS: .----------- —__— -------- — - ----- ------- --
STREET
CITY STATE ZIP
BUILDING SITE: 1.OT__ _ BLOCK - _ ADDITION
TAX LOT NO. ___ _ TYPE OF OCCUPANCY residence
ADDRESS -----. 11750 SW .113th P1.
DWELLING UNITS 1 _ FIXTURE UNITS
SURCHARGE IF APPLICABLE - --- _ _-- _ ------ _ - --_- ._
PERMIT FEE _-_.-575. 00 -.. INSPECTION FEE ._25..DIl TOTAL DEPOSITED 6on.00
(NEW) (EXISTING) BUILDING SEWER SYSTEM __ ..- Fanno Creek
The /applicant agrees to comply with all rules and regulations)of 0'e Unified Sewerage Agency.
—7—
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE . . INSTALLER
RECEIVED B Y -�--
IAGENCY OR ITS
COMMENTS: Bldg. #1199 Paid to Leron Heights $150. 00
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeiteJ should expiration occur.
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BUILDING PERMIT APPLICATIONcoF TIGARD DATE__�2~l�J�'�
THE UNDERSIGNED HEREBY APPLIES FC t APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONK
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING P, NS AND SPECIFICATIONS. OWNER PHONa_s. -1 — �
1 1
113tt1 PlLOT NO._——�
OWNEF�*r� (��Oi i.e®attt� JOE AUDREssl- `rJW . HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER $++ IRO ADDRESS DESIGNER Y __
SSIRUCIURE NEW []REMODEL ❑Ar,DITION ❑REPAIR^ ❑RENEWAL ❑FIRE DAMAGE EJDEMOLITION
U.RESIDENCE ❑COMM [:]EDUCATIONAL ❑GOVT ❑RELIGIOUS❑PATIO OCARPORT []GARAGE ❑STORAGE❑SLAH []FENCE
❑POND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVEr) [:]SIGNS
QCCUPANCY I.AND USE ZONE t-- BLDG.TYPE will FIRE ZONE' PLAN CHECK BY-_Zrt HE'.AT_,,._,.,-_-__^
"onet. singg f•sMilY dwalling w/gttached �4arsgs wages 112 3 bedraotu ';ath
Typal Sparrow
tier. �,10!
�CSr.�1�QA2 — FLOOR LOAD 4,0 ___DIGHT 20 NO,STQKI-U 1 AREA 11.34 NO.BEDROOMS `3 'VALUE28 III 350
BUILDING DEPARTMENT SET BACKS FRONT ZO REAR 7- "LEFT SIDE B RIGHT SIDE 715"
Permit 124-QQj
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check l��o� REGULATIONS AND ALL APPI_ICABtE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PF .SiT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HA.4 CUKPENI' CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND IiEATING.
Total
BY -- - -.
_ AP �CANt OR A4f.N1
Approved 1 W Ri,ueyt No, \I 1�
—� ADDRESS I'HDNE
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DATE INSP, TYPE INSPECTION REMARKS FPe�rmiit
UMBING DATE
-��� M`675
�1 - f _ Rough-in _
Fixture
/ HEATING
7 ontractor
Permit No. .�' - — .,i y
Gas or Oil
Rout_in
e= /. J' Final ---- - - - -
- _ ¢ , SEWE9
Final
_57 Z DRIVEWAY
Fina'
Storm Drainage
(Rain Drain) Final
Sidewalk
_ Curb&Street Final
Approach l r !1-IV-77
BLDG DEPT.FINAL. TEMPOMARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
C Zoning Final `
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Ci y of 9F cifird Mechanical !Icrmft i Permit
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New Installation XJXReplace ED Relocation ❑ Addition ❑ Altere,ion ❑ ---
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CONTRACTOR OWNE9 8 Herb `'lorriSSQ_tc _.,
An,nn-'rs 609 SE 134th Avenue WORK ArDDRESS 117ga SN 113th
1'I-I0N'E 7t;1 -1070 Pert apc:_ OR 9723bAPPLICANT Laurey Mehiia
Hent Input Rntin� (13TU Per 1-lour) 8.O ,000btt.t Vent Size 5' r Flue s4e 4 I'
FurL OIL ❑ GASX12XXELECT ❑ OTHrR
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address _1/�.5� �{,,� /�� �--� Permit No.
Permit charge
)Wner � �J7c.`2y�oe Connection fee
Paid by ; -10(
Type of buildingL� Date connected
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ervice rate /sj'4 Inspection fee �5 �—
.ontrector Paid by date
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Size of connection Assessment Paid
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