11335 SW 121ST AVENUE 11335 SW 121ST AVENUE
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SEWER PERMIT 33426
Unified Sewerage Agency C I TYDATE
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of Washington County
OWNER:Michael Cook PHONE : 684_9282
OWNER' S ADDRESSt_ 113 .'.i_ gW 191st Tigara nu
TYPE OF INSTALLATION,
® BbILDING SEWER ❑ LINE '-AP AND BUILDING SEWER ❑ LINE TAP
FYPE OF OCCUPANCY
Q NEW n EXISTING ❑ SINGLE FAMILY ❑ COMMERCIAL
❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UN-141-C, 1 ��
11335 SW 121st 97223
ADDRESS OF STRUCTURE . -
Permit Conditions: The a;)nlicant agrees .. �somRly_with al; rules an �sgu�a!#IIrtT o he Unified
Sewerage Agency. When tailing for an i,ispection, pTcS9€"'rr?EF-lo the Permit Number. The Permit
expires one hundred twenty (120) days from the date of issuance. The total amount paid (permit
fee, coyrection cha-ge, 11ne tap fee and/or other charge) will be forfeited if the permit expires.
The Agency dijes not guarantee the accuracy of the location of side sewer laterals. if the sewer
is not loceted at the measurement given, the installer shall, prospect three feet in all directions
from the distance give% If not so located, the installer shall purchase a "Tap and Side Sewer"
Permit at lye current charge and the Agency will install a lateral.
FEESt
PERMIT FEE s_ 35 . 00
CONNECIION CHARGE 300.00
LINE TAP INSTALLATION <2.1
-- T
ISSUED RY -
OTHER
TOTAL s _ 335 . 00 "-"'DATE OF I �- SUANCr
) r ,� P � -
/, APPLICANT DATE OF EXPIRATION
V
SEWER 13EFiMIT
ADDRESS OF STRUCTURE _ 1.11,35 SW 121st 9722:3___
TAX MAP 151-34CB TAk 1_0I �Q� _ QUARTER
SECTION -- -
LOT BLOCK OF
BCR
APPROVED BY DATE ISSUED BY r DATE OF ISSUANCE
D. U. ' S 1 REMARKS 4" min. pipe req-1 . Septic !.ank to be pumped fr 1
filled w/gravol , inspection required try city. I
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February 13 , 1987
i
Mr . William R. Halvorson ttr . T )m ', iI I e r 'iu.i? ir
12555 SP: Summercrest Dr . 1478 N. Sherwo,-A
Tigard, OR 9722:3 Sherwood , OR 97140
Re : Tax Lot 205, :.5134 CS
Michael and Nancy Cook
Gentlemen:
The undersigned agree to release any claim to an
easement to maintain their dra4nfield over tax
lot 200 when the sewer line ha been b ,ou-ht to
our rear lot line at no exrense to us .
Very truly yours,
`71d n c -) ("Cr
Michael cook
Nancy Cook
I
ANDERSON & DM MAN
ATTORNEYS AT LAW
TIGARD PRorcesIONAI CENTER
8665 B.W. CENTER ,7TREE1
P. O. BOX 23006, TIOARO. OREGON 97223
TEuPHCwE (603) 629.1121
OCRRYOK N. DITTMAN
ROGER r. ANDERSON
December 23, 1986
William R. Halt' son
12555 SW Summfcrest Drive
Tigard, OR -,07223
Tom M1.1
r guilder
1478 . Sherwood Blvd.
She ood, OR 97140
b,6 Tax Lot 205 1S134CB
Michael and Nancy Cook
Gentlemen:
Since I wrote to you on behalf of Mr. and Mrs. MacLean lin December
15, 1986, I have been contacted by Mr. and Mrs. Cook, who own tilts lot
abutting the MacLean property on the north. They advise that HLV t1le
MneLean's drainfield, their drainfield was also in.3talled by Mr. Halvot-son
on tax lot 200, now being platted as Millview.
As their situation arose similarly, the Cooka also clalm easpmrnt
rights to maintain their drainfield on tax lot 200,and they would agree
to resolve the matter on the same basis as has been proposed by the Mac1,o)u1s
In my letter to you dated December 15, 1986.
Very truly yours,
ANDERSON & DIT MAN
DHD:sr DL-rrvck H. Di 1 tmn:i
11arr1s-McMon,igJv Assucintos
Mr. and Mrs. Michael Cook ,,,
Mr, and Mrs. Robert M.I(,T.(-an
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CITY UI TIGARD MECHANICAL PERMI.T
I'�•r u1 i c U �—i'���Z
CLLy of 'l•ibard
I J l 25 SW Hall Blvd. CITY f IIIC[ AMT
P.O, o�3 39 7 (/ Table IIA Medw0cal gods
Tigard OR 97223
1539-4175 1) Permit Fee -0- -0- 110.00
2) Supplemental Permit 3.00
i) Furnace to 100,000 BTU
incl. ducts& vents 6.00
2) Furnace 100,000 BTU +
Name or oeveiopm.nt Incl, ducts& vents 7.50
`0 c►t 3) Floor Furnace
Address incl. vent 6.00
Address Tax Lot btep o. 4) Suspended heater, wall heater
La Block Subdivision or floor mounted heater 6.00
5) Vent.not incl. in
Name ( or name of twai(1,,,) applibnce permit 3.00
Mailing Address mons 6) Repair of heating, refrig.,
Owner cooling, absorption unit 6.00
CnyIState np 7) Boiler or romp to 3HP
u1 f =a = absorp. unit to 100,000 BTU 6.00
f Name 8) Boiler or comp to 3HP-15HP
absorp. unit to 500,000 BTU 11.00
Mailing Address Phone 9) Boiler or comp 15-30 HP 1
absorp. unit 4r-1 million 15.00 -
Contractor pA,(Stste Mp 10) Botler or comp 30-50 HP
absorp. unit 1-1.75 million 22.50
State Registration No. City Bus. Tax No. 11) Boiler or comp 50 HP
absorp. unit 1,750,000 BTU 31.50
1 Mreby acknowlerr
dr that I have read this appllcallon that the Information 12) Air handling unit to
given is coect, Mal I am the owner or aAtwlred agent of the ownx, that 10,01 CFM 4.50
plans submitted are In compliance with State laws, that ! am registered with
the Suss Builders' Board, that the number given is correct. (If exempt 13) Air handling unit
from State r Istralilive reason belowi•
A on pease g 10,000 CFM + _ 7.50
14) Non portable
_evaporate cooler
15) Vent fan connected
to a single duct 3.00
16) Ventilation system not
Signature (owner or agent) Date included in appliance permit 4.50---
17)
.50 -_17) Hood served by
Describe work Q additionp alterationO repairQ mechanical exhaust _ 4,50
to be done residential ❑ non-residential 0 18) Domestic type
Existing use of incinerator 7.50
building or property ,/4 .._� 19) Commercial or industrial
Proposed use of typr incinerator .10.00
building or property 20) Other I.e., woodstove,water
dryers,oic SC}
Type of fuel — olt❑ healer, solar, clothes 4,50 natural gas LPG0 electric❑ _ _
NOTICE
21) Gas piping one to four outlets 2.00
THIS PERMIT BECOMES NULL AND VOID IF WORK OR 22) More than 4-per outlet
CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN BUN-TOTAL
180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED 4% SURCHARGe
OR ABANDONED FOR A PERIOD OF 1180 DAYS AT ANY - - -
TIME AFTER WORK IS COMMENCF.G PLAN REVIEW 25%Of eU0-TOTAL
_ TOTAL
Special Conditions --__--__---•-- _-- .._ __----
Dalo 1!1!i11t)rl /o//
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INSPECTION NOTICE
City of '1 igard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
'vpe of Inspection __ ►� CY;}'� �R� _- -_-- _--_--_-_ _
Date Requested - -2 L Time
Address S�%) L2- -<- t _�VP-_ Permit
Owner � C_ _�. —� _ lot
BuilderThe following Building Code deficiencies arb required to be correcteu:
ALAI T
Presented to _ Approved
Inspector Disapproved
Dete -- -- -.�o - - 8 ts'
CALL FOR REMSPECTION
❑ YES A-1 NO