11670 SW FAIRVIEW LANE 1
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116•/0 SW FAIRVIED LANE
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OF OCN ter
G� CITY OF TIGARD
h OREGON
1220 tt
Owner:.........Ed.. Gau&,.e.................................. ...............Permit No................
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11670 SW Fairview Lane
. ; Building Address....................... �
4October
F Certificate is hereby given this............. ..day of................................, 19........
�. that sa building may be occupied and ;j , 44
4 r that it complies with all requirements of
the Futl in rode for the City of Tigard,
as approved by the Tigard City Council. ► y
-��-t ......../ . . ............................. .....
Building Inspector >
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ADDRESS-Z2, � �= Z-y`t_.-J iti- PERMIT N0.
PERMIT CHARCE none
OWNER - -�_ CONNECTION F .E J 75" "
PAID BY
TYPE_ UV BUILDING �il.e,�� DATE CONNECTED a _
N.r
SERVICE RATE !% INSPECTION FEE _� S
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION _�__ ASSESSMENT PAID
f�l
City of Tigard
�. SPECTION REQUEST
for
-� 1�4t H � s(pf-ec"W-K-
INSPECTION TIME: ' 62 PERMIT NO. : ---
DATE: a1/^ 7 DATE ISSUED :.._L_L_
OWNERS NAME : FP ----
ADDRESS: 4")Q SU..(, Erl-If� V1F�t'-
CONTRACTOR : .-----------_-
'TEST : Air 0, Woter❑ , Visual Laboratory p
RESULT: Approved , Disapproved 11 , Pending C�
SKETCH:
1
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INSPECTOR DATE
[NOTE Attoch jupplemental test dote beret]
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City of Tigard
INSPECTION REQUEST
0
for
INSPECTION TIME: PERMIT NO. . _
DATE: _-9- /e/77 DATE ISSUED .r.l_.Z -
OWNERS NAME : !!�� �,z.�
ADDRESS'. L��c! ✓ ___.
C;ONT?AcmR
'E S T : Ai► J, Woter 0 , Visual 0 , l aboratory p
RESULT: A
pproved [�/, ' Disapproved l= , pending [i
SKETCH:
I
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INSPECTOR DATE
�N0TE A t I h eu1)p!emer+to! Istat slots herto�
4
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Cit of Tigard
gard
INSPECTION REQUEST �
for
IOPECTION TIME: yn PERMIT NO. : _
DATE: ,.-) /`f/77 DATE ISSUED .__lam
OWNERS NAME : _ � A' 4�*V r,F
C O N T R A C T O F : --_ -----__— —
TEST . Ai► LJ, Water[] , vieuat,v', LaboratoryC]
RESUI' : Appro,ed ❑ , Diaapproved ,p( , Pending ❑
r RETCH: f-777
J4 L L a/Wja 01 s rR ►C i Tv77
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INSPECTOR DATE
COTE: Attach supplemental tett data bereto]
V •I
City of Tigard
INSPECTION REOUEST
for
i
INSPECTION TIME : PERMIT NO. :
CATE: ,L64772 DATE ISSUED'.__1__L
OWNCRS NAME —
ADDF'LSS : Z&7 U
CCNTRh::-rOR : ___
TEST. A40, Water ri , visual G' , Labora+ory C
RESULT'. Approve+ Disapproved O , Pending Q
SKETCH:
NSP TOR TOR DATE
COTE: Attach supplemental test dote beret-0
UNIFIED SEWERAGE AGENCY NO. ___11034
,
WASHINGTON COUNTY DATE ___1-3-77 �
CITY O F__ Iise r d. - - - -- -
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: _--- _._ -l<d_
OWNER'S ADDRESS: - --- _ --------- -- - -
STREET
CITY STATE ZIP
BUILDING SITE: LOT _-_- - --____ BLOCK .----------- ADDITION
TAX LOT N0. _ _ - _ - _ TYPE OF OCCUPANCY residence
ADDRESS . - 11.670- SW Fairview- Lane
DWELLING UNITS- 1 - -- ----- - --- - FIXTURE UNITS -- -
SURCHAPGE IF APPLICABLE
PERMIT FEE
_5_7-5._00 _ INSPECTION FEE 25.00 TOTAL DEPOSITED - 600.f13
(L (EXISTING) BUILDING SEWER SYSTEM _- _Fanno
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT —. _.._ _-__ _ �8'�•�----- --- -
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE - --.-- - - --. INSTALLER
RECEIVED BY__._ -T -NT
(AGENCY OR It ENT)
i
COMMENTS:_ _Bldg' X1220 !
This Application and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
CIT __-- I
BUILDING PERMIT APPLICATION ofY TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERP4ONE_-_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNFRPHONE _
LOT NO.
�� 4t laaa00 Sir. fairview La
OWNER JOE'ADDRESSME ADDRESS
ARCHITECT —
41'1Es ENGINEER
BUILDER ��-11 ADDRESS DESIGNER _
STRUCTURE `�:JNEW 17 REMODEL ❑ADDITION —❑REPAIR ❑RENEWAL ❑FIRE OAMAGF ❑[EMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSUPATIO ❑CARPORT ❑GARAGE ❑STOh,,GEUSLAB LUFENCE
❑BOND ❑MOVING ❑CONDITIONAL USE EI DESIGN REVIEW DCOUNCIL APPROVCD []SIGNS
UPANCY_ LAND USE ZONE _BLDG.TYPE FIRE ZONE__ PLAN CHECK BY HEAT
OA", single family gstK f.;4. — .19C act (4B 1'Et L1 (l@I' �IL.7 G ,•, �.
+.t0 2 1 a 073499 900.
9 LOAD __-.ELQ4PLOAD _ IG
HEF1_ NO,STQRIES ABEA._ NO.BEDROOM-a= VALUE _
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 2n LEFT SIDE 7 A f• pp RIGHT SIDE 7 E h rc
Permit
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- -- --------
93
c` THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check `I 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 WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
State TaX .tSl LICENSE. SEPARATE PERMITS REOUIRFD FOR SEWER, PLUMBING AND HEATING,
Total 286.91
By -- - --- - - ------ - -
--- - -- i---- APr "ANT OR AGENT
Approved Receipt No ; i
kiss PHONE ---- .
VW>Mn.awe.. .. . u:snf/:w....w1.:aIn.i.NyY11.a+aJavaii.-JrIN._..uiW.�Ya.Wr:..rtAuw�aYw ..ww.:..AA. ... ..6YYYMRILii.�}411WlYiMi�I+loli.hw.i.�uYefMr. :• .•-•"-MIIn. -
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DATE INSP. TYPEINSPECTION
_-�_� REMARKS
r —7-- PLUMBING DATE
Contractor
t atm �/ CrTtic. Rou$h_in
a 3-7
77 Q p� FixtureLt
Final
110
HEATING --
n Contractor
—I 4�.6, Permit No. �41 3 3
(�� '`�'�� (Zn t fit,► Gas or Oil.
-----------
Ck-
ough in _
Final
SEWER�_v1fLJi_�
4
sa '� Final
_ DRIVEWAY —
Final
— _ Storm Draina e
(Rain Drain) Final
_ Sidewalk
Curb&Street Final _
BLDG DEPT.FINAL 1EMPORARV A roach _ L_ 2
CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY
Final
I andscaping
Zoning Final
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