15280 SW 100TH AVENUE-1 15280 SW 100TH AVENUE ..�
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of inspection �'�`----
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Date Requested_�...�— - � — Time —_A.M. P.M, i
Add v., --�' -r s��--���� i �c-,' Permit
Owner— _____- _—___-_ Lot #
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The following 'duilding Code deficiencies ars requirad to be corrected:
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plM►MltNl to �. ..1�___ ------ Approved --
Inll(o�atty -- --�.—----- l� Disapproved
Date ---------�'= - "
CALL FOF REIA�SPEMON
❑ Y1 lyF�'{NO
. SEWER PERMIT �; ,, 27197
yo Unified Sewerage Agency
of Washington County C I Y OF �'�-�(( L)A�T I
OWNER : -C �. PHONf
OWNER ' S A U D r.FSS:
TYPE OF INSTALLATION:
N SIDE SEWER [� L.INE TAP AND SIDE SEWER ❑ LINE TAP
TYPE OF OCCUPANCY:
❑ NEW ❑ EXISTING ❑ SINGLE FAMILY ❑ COMMERCIAL
[� EXIS7 . (PRIOR TO 7- 1 -70 ) ❑ INDUSTRIAL
MALT , RES. [,
FIXTURE UNITS_____ DWELLING UNITS I
ADDRESS OF STRUCTURE : s��6 c�, ,o' lL� -
---
Permit Conditions: Toe applicant agrees to comply with all rules and regulations of the Unified Sewerage A,.iency,
When c.,'ling for inspection, please refer to the Permit Number. The Applicat`on expires in one hundred twenty 020)
days. The amount paid will be to:leited should expiration occur.
The Ayer+cy Moes not guarantee the accuracy of the location of side sewer laterals If the saner is not located at
the mea3u'ement given, the installer shall prospect three feel in all directions from the distance and depth given.
If not so located, the installer shall purchase a 'Tap and Side Sewer' Permit at the current charge and the Agency
will ir:stall a lateral at the location specified by the installer.
FLLS:
PLOMIT FEE ' " "
CONNECTION CHARGE —
LINE TAP INSTALLATION _ ISSUED BY
OT .IER -
TOTAL E _
APPLICANT — DATE
SEWER PERMIT v11 27197
ADDRESS OF STRUCTURE I� - ,YUO ,�SLc�' ze �
TAX MAF'' � � " �C� TAX LOT SYSTEM
L O ToI' __BLOCK OF
APPROVED BY DATE ISSUED BY DATI -�
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,low: OAppl.Only �By Appt.but if no aniejer use LKBX OLKBX r- Lota%;on: CDoor 0R4;I
Re&�nn ScIl.;oo
v!session/ e14 Arca iile.
.C,di,ys after recording.of 1�eW , #?
le7401 I
BATHS:M Up/ On Showers -1I z smtmemv le. % Terms: r'iCas� 171c,&,tor rL1.41Y
n ?. App.Total Sq.Ft. /
!.Nin Up Up Downl Root" SIZES App.Mn.Fl.Sq.Ft. Yr., 1,0-1-r740 le.plo -T_ Other:_.-
171-1 Style: DRonch-OSplil C)Tri DEng � e lron� c- r ol
_Entr :K:e,2 X 7' 10':t 'r Is:
Lining Sm/P/" 02S OCCod !ewer Cc nmclecl
Fir OB;lw 9-Cr•r oral
_7 Stwc;c Sys Unknown
Dining Rm./O' i(,"x.47 JoCcinterrp-Other r,� 'A,' Ceb!poo! XSvp6c 'icink, Tave%S
turn L c3an 14.111,-,a
Kitchen Exterior: ;NSidin2 OBrick OA Fey ;9 town
Eat Space i� Al?;4clv-,7. DShk.[]Asb.-Other C_"eld'l- Shrubs ;&Ittres Piq-maril
Family Rm./. _7 mp.OShake 0ShqI. Sprinkler Sys. [3 lighting 'T
7 A T_co f: r4-c o Loan
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L'tiii,y Sm. X 0131t-up-Other IXo(i
,V, a o, 1,"re::-
1, 0 S;dvwolks 0 Curbs OvIed7
Forty Rm Est. X Heat: ;:Fcitccef Air OGravity Flow Perin
v 0 15 It x Type L nI
v Atm. X CAei;iint 08a%e Bid, DElple, 5CC�L ffuncclvered Assumption fro$ (3
MrAshoa X 0H,N Tankl Floors: WN S_-up, S�D n Payoff rec.s
pet: V,':vY in %LFi
-"Fell X Oil Co. RD' F1 Sims Additional Eficut,1117iltices
C1X Filepitsce tj__1Iv OKit OFAm I Va.e- Heater. S.xlec. Payments$,,-loo Iz,el e r_j_ �
02sint.00ther 0G&, (]0ther-c-als.rz Cz#
Owed To
Bedrooms X Insulation: ftD-Hpad Personal Prop,Includ.-od: Owner h.S.- Ocorittct XD,:?d
x "j`,`M%fr.Bedroom X, Built-Im OfRange 00ven OHood
rHADAcc)untEAp1*l`nrd0Ye!.';
t x /I/ Sedciorn
ODiSP016111%Exh.Fan 1304htvshr. .61cpos:, City But
Bedroom X Other Walter 0 _j Schfiril Rus AYC--. OND
hc)oIj: it or 1"7 le/ /I Kinder itirteri
1,-, 8 lk Jr.H 1. roo,e^fe�laiel Blk$!;�" Parr;r c; a I 1k# If JQN'O:
SPkC'I/,.L. 110 ORIAA f
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lee:,
C14ECK APPROPRIATE BOXES
CATALC)G SECTION LAND SIZE FEAIURES FIRM
A NO Worth Reol. 0 R LO'Lake O%-•."Resi. 0 1.1 I'AH-tolobile Ho.--s 0 ST-L-Stande,cl Lot ca-age h 1 colt tit ID $1
A Ni-Norlhaiist A set. R%IV E A.W P esi. 0 H H13 House goats 0 LO-L-Latio Lot CJ I-C at Branch Phone
0 R SE Aciuthw Ratio 0 R VC.Vancouvor Real. 0 1 1 C.Income 0 S.M.L.SmAl Lot 2-C or SAL ES REPFIESEN1 ATIVE-
0 R GFI-Grthorn ArW. 0 R OE-Out at A!es E.Resi. C3 C I C-Commercial A A rift 0 C.cpt. f.omo_
0 S I'AL..MiNvoultio Flat. 0 R OW•Oul of At to W.Rosl.O 8 1 C-Business Oppe. 1 0
r3 Ft OZ.O,tqcsn City Rai. 0 T CT-TwnhsF-.Tundoo
0 F-Farn.Sri,,
V4 do 0,do mot A.own land adjoining the lknd herein lisirld, M
(If sold looporty is irtcoriocily det-cticii-d,%iollio? 1-4y evp,e-sly authorises itietnt
tub%.# too
quently to write heron,at attach hereto,the miracl legal description tht, III. Seller rates that the lot site of the het-rin 0vd P'(IPU-
.SiGN.* OYes :7�No e
A 1`^ 7_99 subject to public it-at,tel virrifir-
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