11645 SW 114TH PLACE-1 11645 SW 114TH PLACE
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City of Tigard I
INSPECTION REQUEST '
for
INSPECTION TIME: '� `''v PERMIT NG. :_� I
DATE: '` o r' DATE ISSUED
OWNERS NAME :
CONTRACTOR :
TEST : Air ❑, Water❑ , Visual,13< Laboratory ❑ i
RESULT: Approved 12/—,'
2 Disapproved ❑ rending ❑
SKETCH.
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INSPECTOR DATE
[OTE: Attach supplam•ntal toot data berlla]
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C�� Cl""Y OF TIGARD
OREGON
. .............. ............ ... . ....... ...
Permit No. 73-9D..........
BuilWng Address-444A.I.PY,........1.�4��...Piace. . . .. ....
. ..... .................. .................... ..............
Certificate is hereby given this....19 —day of.ARY!eTp.®F...........119_7.3...
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.
Building Inspector
LI'Mo..U I
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City of Tigard
INSPECTION REQUEST
for
'-,AIA L
INSPECTION TIMES PERMIT NO. . ..--
DATE .
O. . .. —DATE . ')ATF ISSUED' Z Z -
I OWNERS NAME '
I ADDRESS : I L4 O, 'l_ .
C+)N1 RA CTU R
i ES I Niter �� , as�� , Ln
RESUI.Y )provall
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SPECTO9 f1 ATE
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City of Tigard
f INSPECTION REQUEST
for
INSPECTION TIME * r ""� PERMIT NO. : ._�____ _
DATE . -7' /6 ?: DATE ISSUED
OWNERS NAME : ` �''_ �uGl,•� � ------------_�
I ADDRESS :CONTRACTOR :- -- ---__...
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TES1 � i :J , Water [] , Vise-al 9 , La rctcr; n —
RESIU T . Approved Disc+pproveH 1 �,nding ,J
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INSPECTOR DATE
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�'ity of Tigard
INSPECTION REQUEST
for
INSPECTION TIME' PE?K, NO. :--
DATE:
O. :_DATE: / DATE ISSUED :---L
OWNERS NAME :
i s
ADDRESS:
CONTRACTOR : ---
E ST : L.�, Water 0 , V; uai i.a boratory fJ
RESULT: ApilrovedA , :1,;appra�,ed iJ , Fendi ci p
S KETuN:
iLLS
INSPECTOR DATE
NOTE : Attoch suppiementat test duto hereto'
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PEPMIT NO. : --
DATE : 4�� // 7 DATE ISSUED :-
i _
OWNERS I,AME : '��frCn �✓ ___._
ADDRESS'. -
C N T Ft A r,70 R :
E ST ' , 'Nater 0 , V:sjal La , Laboratory
RESULT'. Avroved L7 , :)i,;appro\,ad t'endinq []
S KETCH.'
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N�TOR DATE
NOTE Attacn supme,nental test data beret
FENN WE W ' i
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City of Tigard
INSPECTION REQUEST
for
6 , `
114SPECTION TIME '. � �' PERMIT +0- : . -
DtTE : . / '7 DATE ISSUED :---i /
OWNERS NAME '
ADDRESS:
r O N'r R A C T 0 R : __----___ ----
;-J , Water[l , V;sual '.� , ;-cboratory ri
RESULT'. A%vroved W Di3approvad G , I'endiny C7
SKETCH.'
INSPECTOP DATE
NOTE : Attach supplemental teat data heret�l
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City of Tigard
INSPECTION RcQUEST
for
I N S P E C T 10 N 1"I M E : if--o 2 _ P E R M I T N 0. :
DATE . DATE ISSUED :---/.
OWNERS NAME -
A D D R E S SCONTRACTOR -
TEST : Air 0, Wotern_,_�V_i,,jal �nboratory E]RESULT '. Approved T , Disapproved ❑ Pending L]
S KETCH:
INSPECTOR DATE
COTE 4ttact, supplemental test data beret!]
City of Tigard
INSPECTION REOU EST
for
INSPECTION TIME '---- PERMIT
I DATE . ' / c,// . DATE ISSUED' _ �-1�
OWNERS NAME - ____L
I
ADDRESS '. .
Ct NI RACTO R —"
TEST LD 'dater '1 La ratorl !,
RESULT: Approved 1J , Disapproved j rr`tinding ;_,t
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!NSPECTOR DATE
I1�40TE Attain Supplemental test .: era hereto]
1
Addrose 11645 S.W. 114th Place . Permit No, 41141
Permit charge
Caner Homes Uy Douglas Connection fee 425
Paid by ��ra ; UM �ti
Type of building Resioence Date connected
Service rata w_ inspection fes
Contractor Homes by flouglas Raid by 5Inrn gets
Size of connection 4" Assessment paid
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Cit of Ti u. .A I
City g i
INSPECTION REQUEST
fr) r
INSPECTION TIME : t �O PERMIT NO. :
DATE .' 5 /30773 DATE ISSUED :_ Z
OWNERS NAME "
ADDRESS x/1(0 / `� i✓G rac..P�
CONTRACTOR . yg-L /—
TEST Air L] , Waterg, Visual p , Laboratory
RESULT: Approved V, Disapproved CJ , Pending Ll
SKETCH;
INSPECTOR DATE
COTE: Attach supplemental test data heret]
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : _—._._ _ PERMIT
DATE .' --// DATE ISSUED :_! _,_
OWNERS NAME ' ')I-A "at04
ADDRESS: "> 4,
CC"N*TRACTOR --
E S T : Water p , V:suai I(] , I_a boratory rj
RESULT ' fhp,,roved ('A Dijapprovad G Pendil,q p
SKETCH:
�3u. 73
INSPECTOR DATE
NOTE: Attach supplemental test data beret
City of Tigard I
INSPECTION REQUEST 1
for
INSPECTION TIME : _L'�• _ PERMIT
D AT E : _._ /� '/ z DATE ISSUED
1
OWNERS NAME : - - ---
CONTRAC,TOR
EST ' ,' ^ter Q , v: vuai V, Laboratory 0
RESULT i+p -raved 9 Oisupproved G , Pendioq Q
S KETC W
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---� 1173
1 SPECTOR DATE
NOTE llttor.h 4uppiementnl rnit data hert-t.1
PLUMBING PERMLT APPLICATIG,Ny�
Irrr _Sdiction of .�� 3 `"� 0/J
No. Type .! Fixture Fee Permit No. _yj_y'c�-P
Permit fee �y
2 Water Closets TcilF,'s ��, Permit lss.7i- .�
Ba Lh abs Zs e r. Approved by
avator W-.sE_Bsi _- Building Per•mi tl Yc
Shower _ _-_ _ Receipt No. -911-%-
1n D,shwanhiri
Inks i.tchen _
Sin s Cr inary� - __,_ Location of Bu 11 d t rig
Jin 6,
-
_ _At�m`atic DT. iwashei J.C) _—_-___....-•-•-----._.----------
-- L dr,;y_Tra} E Name & Addr,. , Ov,r,, - _--
Drains Floor
�
nslTr"._,--- -
Ra_n Drains •�-- - ._ - - --•- ------ - --••-•--
-wutomaLic Waster Name & Ada, • :.s t i . ,mt)f
Founta i n�s�soda
TtHot Wa t e^ anfiTt —
Ur,rtals Buildin (6#*w_N••wj ,Alter, Hepar. r
�..a 7715sins�ai•7--_
_ _. _ _
-iwr-. lotlem _.-- ` -�_ -------------
Sw.,mm n cK — _--- ---– � _.t;�.� _---------------�� –
_7�ink`�er ..tHm_._�_._
Trr1.s harmit by nrrer, i and void if work or ccnz;tr,..^ .7.c,d !. n t
-cmmen:vd within 60 ar if constructicn or w,.:k t.: ;. • at-.r. :ne l
! _ , a period i 12C V at inv time after work IL - nim ilr. -
All plumbing firms mus! licensed by the City of Tigard and pr.s'. a $1,000 bond,
I hereby certify that S have read and examin(-d this .a lel": : �i' .. n an,! V:,c w UJ.- _amc
to be true and correct. All provisions of laws 3n,! . r�!:r ar g-% r' r E; •!:t , tvt
cf w;r•k will be eomplior! with whether specified h-:, it r.- 1 , '.he granting :f :,
perm-. t dk e, n,:t prxsume to g_ve authority to vlolol r r.f . l•rcN t i i .ns
of any the r statj, r lo,al law regulating ccngtru: t r. n r;, t,:rmance t'
�ori.O.vucti- n.
7
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%-,i +y of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : -�'� PERMIT NO. :
DATE : 5//j/l DATE ISSUED :
OWNFpS NAME
ADDRESS'.
EST : ,,., -. , Wrterp , V:suai 1a , I_abarc ^ry {-j
RESUL* ,kp roved )I3uppro�ed Ci ending U
SKETCH:
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INSPECTOR DATE
NOTE: Attach supplemental test data hereto
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UNIFIED SEWERAGE AGENCY NO. 4841 -_
WASHINGTON COUNTY DATE 5-10-73
CITY O F--- --- - Ti _ --- --
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: ____ . Hosss by Douglas
OWNER'S ADDRESS: -- - --- - - ---- --- -
STREET
I ---
CITY-------------- -- - - _
STATE 21P
BUILDING SITE: LOT-___3-____ BLOCK ____._—_.__ ADDITION _114th P1soe
TAX LOT NO. __ _ TYPE OF OCCUPANCY Residence
ADDRESS _ __-__.�..___ i ►�_M. 114th YLae
DWELLING UNITS----.-----_ - 1 ___-_.. FIXTURE UNITS
SURCHARGE IF APPLICABLE
PERfJ,IT FEE--4?5 INSPECTION FEE - 25 TOTAL DEPOSITED kk 450_
' (NEW) (EXISTING) BUILDING SEWER SYSTEM 21.4"i_
E The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
f
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
n
LINE SIZE 4 --_-. INSTALLER .- rre
RECEIVED BY.__._..,_ L�,(/(
1 91NCY OR ITS AOENTI
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COMPAENTS it'.'�^ __ tt�/<(i- C.�iiGG�ti � ,�.'n�_ �i,,� �l si"
This Application and hermit expires in ninety (901 days. The amount paid will tie forfeited
should expiration occur.
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City of Tigard
I INSPECTION REQUEST
I for
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IINSPECTION TIME : •" 3` PERMIT NO. ' .�
DATE : S�/y��� DATE ISSUED' Z
OWNS :S NAME .ADDRESS :
CONTRACTOR :__
ITEST .-� r J, Water -; , Viai•GI , La'• .rator� to
RESULT; Approved 'k'1 , Disepproved 1 Phnding J —
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I INSr'ECTOR DATE
�._lTF Attnch supplemental fns} herOl.
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CITY OF TIGARD
17420 S. W. Mdn StrW
TIGARD, OREGON 1M 3
APPLICATION FOR BUILDING PERMIT
New Construction lxJ Demolish LJ Addition ❑ Remodel Q Move❑
ZONING R'7 DATE ISSUED 5'973 _ BUILDING PERMIT
Ii��p�7�
BUILDING FEE $ � No• . V:{.)
DArE RECEIVED
PLAN CHECK $-T---3�'�- -
BY---- `102.W VALUATIOI4 $ 17+582.40_
OTHER $ _
TOTAL SJ _ RECEIPT No. 72,1'L,
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNIS14ED WITH APPLICATION
I.$' 34 t C_
LOT N 3 MAP N M 2W CENSUS TRACT W-19 JOB I
Architect or Engineer__ �Bvasa Ly Ib+ as
Address Phone
Owner Nae
Address Phone
Builder low
Address __ _ Phone
BUILDING USE Single Res. Multi Res ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP I No. of Stories I _ Total Height4 15 Area of Lot846
Type of Construction FMWL&44F@ULA4W V Floor Area B 1 1189 2
Se* nacks: Front 20� Back_ 50_' L.Side 100 _ R.Side_101
Private Sewer Pipe :viae 4 Sewer uea r Septic Tank
Water Service Pipe Size_____j/j`. _ Storm Sewer X❑ Ditch ❑ Drywell❑
Street and Curb Requirements _jhdauf
Driveway Width 181 _No. of Parking Spaces Q
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMHTNG
SPECIAL INFORMATION
t
i ADDRESS ASSIGNED__11G4G�' B•W 1141i1s Plea�_�___ �,�
FIELD CHECK
PEP141T APPROVED BY r
It is understood that all work will conform with applicable codes anf ordinances
of. the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of OccupaAcy hAs b n.issue4 by the City of
Tigard Buildino Inspector,
�i—gnature o AppcanW
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