11820 SW 113TH PLACE 11820 SW 113TH PLACE
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CITY OF TIGARD
OREGON .
Morissette
Owner: Permit N��.
Building Address.
11620 SW 113th P1.........•
14th I.
Certificate is hereby given this........ NovF�mber 77 t
Y �' ........day of............:................. .,
that said building may be occupieta and
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<� r that it complies with all requirements of
• the Building Code for the City of Tigard,
as approved by the Tigard City Council.
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i City Of Tigard
INSPECTION REQUEST
for
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INSPECTION TI ME : _. PERMIT NO. :
DATE: -'> 642-22 DATE ISSUED:_.L�
OWNERS NAME : 1)1tt`L1S5'F % 7E-
A D D R E SS : 'c' �7L
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CONTRACTOR ,'
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TEST' Air ❑, Water ❑ , Visual /, Laboratory ❑
RESU!..'T: Approved ft , Disapproved ❑ , Pendin
SKETCH:
INSPECTOR DATE
COTE . Attach supplemental test date hetet]
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City of Tigard
INSPECTION PEGUEST
for
INSPIXT"C TIME . _ PERMIT NO : _.
DATE: L_1._??DATE ISSUED: / 1_
OWNERS ;SAME
ADDRESS
I CONTRACTOR :_._._._...._.
TEST. Air [y , water (j , Visuul CI , Laboratory Cl
RESULT. Approved 2L--8iMj proud 40 W, Pending i I
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SPECTOR DATE
I [OTE . Attach supplementol test dato hersij
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City of Tigard,
"�Y
INSPECTION REQUEST
for
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/i INSOCTOR DATE
CNOTE Attech suppItmen toI tett duto heret-,]
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UNIFIED SEWERAGE AGENCY NO. 11Q03
WASHINGTON COUNT)( DATE 11-22-76
CITY
APPLICA,riON FOR SEWER CONNECTION PERMIT
OWNER: __Ji-o t 9
OWNER'S ADDRESS: -------
S T RE ET
E ZIP
1 B
BUILDING SITE: LOT--..-- BLOCK ADDITION
TAX LOT NO. TYPE OF OCCUPANCY
ADDRESS ---
11820 SW 113th P1.
DWELLING UNITS-- --..-- . . ------ ----- FIXTURE UNITS ..----
SURCHARGE IF APPLICABLE
PERMIT FEE- 375. —0— INSPECTION FEE TOTAL DEPOSITED
(NEW) (EXISTING) BUILDING SEWER SYSTEM
The Applicant agrees to comply with all rules and regulations of the Unific-c! Sewerage Agency.
APPLICAN
SEWER PERMIT
THIS PERMIT AUTHORIZI:S CONNECTION I'D THE SEWER SYSTEM.
LINE SIZE _ INSTALLER
RECEIVED BY
(AG.ACY OR ITS AC
,,yFN n
COMMENTS:_ _Bldg6, ;'1171 I150, 00 Lerqn_Hei�hts,
This Application and permit expires in one hundred and twenty (12n) days.
The amount paid will be forfeited should expiration occur.
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BUILDING PERMIT APPLICATION 'OF TIt�AR� DATE '�1-22 96 1171
THE UNDER';IGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERr'HON% 2Q��81�QI
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHON17
p LOT NO
OWNERtiOVIJ I OriHSilttO JOBADDRESS1I8;e0 SW 113th Ni• HOME ADDRESS
ARCHITECT
BUILDERDRESS 0--101IR ADENGINEER
_i DESIGNER L. • �
STRUCTURE ,UNEW QREMODEL E_IADDITION ❑REPAIR _--❑RENEWAL ❑FIttR,,EDAMAGE ❑DEMOOLITION
.RESIDENCE ❑COMM ❑EDUCATIONAL. ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE LJ';TORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
QCCUPANCY I LAND USE ZONE fid E _BLDG.TYPE 714 FIRE ZONE 1j P'�AN CHECK BY— TU HEAT. 'US
curls,t. sin Ilii fa*i2y dti011ing u/fire place &garswu* per Plans $hyat
The"Grin"
"aUruam 2 Uatl,_ Slabrage 420 w;q, f t w
UCc;, LOA-[Z - FLOO"DAD J 1GHT l� NO.SjORIES� __-AREA"04 NO.BEDRQ;)MS 3 _VALUE309 Ug0*
_ BUIL.OING DEPARTMr.NT SET BACKS FRONT 20 REAR 43 LEF1 SIDE k?I RIGHTSIDE 19
— —
Permit A100 --- — -- ------- --- -
- — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check t..00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE V-ITH
Sub total ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT 'ITV BUSINESS
State Tax M®J TENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING
Total VMS
S
By
— APP"C;ANT OR AGENT
LA proved i tl.J Receipt No.
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ljU^TE INSP, TYPE INSPECTION REMARKS PLUMBING MATE
Permit No. D
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irRough-in _
Fixture
Final _
I it 67A HEATING
Co-tractor
y< __ Permit No. 1, 3, .JI
I !2nv��� yri Gas or Oil
Fou h-in
Final
_ SEWER j-10 .77
Final
DRIVEWAY
Final
Storm Drainage —
___ (Rain Drain► Final
Sidewalk —
Curb&Street Final
Approach L G 3 -a q.7 j
BLDG DEPT. FINAL _ TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
CLandscaping —�
Zoning F;nal �. f
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Address _ %$ V k,z«' ,/ /a��.Q Permit No.
J Permit charge
n u n e r �, c. , 1 ., ,j l Connection fee
Paid by VC-L .,-
Type cf buildingpate connected _
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Service rate inspection fee
Contractor Paid by date
Size of connection r- � � -- ---- _ ._
Assessment Paid