10195 SW HILLVIEW STREET-1 10195 3W HILL VIEW STREET
xwjLMKL'kN
INItIN noTzcs
City of Tigard
Building Departste!nY.
13125 Sp Hall Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone)s 633-4175 Bunineee Phone: 639-4171
Inspections ----__—�_ - - - ------ ---
Footing Plbg. Underalab Mech. Rough-in Appr/r.swl.k
Found. Plbq. Top Out Gas Line FINAL:
Pos,c./9eam Strsct. Sart. Sewer Framing -Bldg.
Poet/Deem Such. Rain Drain Insulation -Plumb.
P1bq. Ir,derfloor hater Line Gyp. Bd. -Meeh.
dates Requeeteds_ J� �'�- c TLMe. �I' - AM PM
Addreea:t / 4.,ti i� P�rml\' `. uJ/��/"
THE WA."MING CORRECTIONS ARG REQUIRED:
Innix*sl.,r+ t:�. _� _ __. Dates _
l PP ,VE1l — DISAPPROVED _— APPROVED SUBJECT TO ABOVE
-call For Reinsp.
/ � COPY TO:
APPLICATION — STREET IMRROVEM'�NT/EXCA.VATI(7N LZq (wl-urL)-FILE
YELLOORDINANCE NO. 74-14 (PINK)- THERE.
(PINK)-OTHER AGENCY
(INSTRUCTIONS ON SEPARATE SHEET) y ' (BLUE)-APPLICANT
APPLICATION NO.: -----
APPROVED _
NOT APPROVED ❑ 9Il,ARI). l)RH,C:ON FEC AMT.: RL)L )
�..I I'N' IIALL RECEIPT NO.: �1=-r►L'='`-4 ---
PENDING FEE. PMT. E3
Bti
PENDING SECURITY 13PUBLIC WORKS DFPART-MEA T _ _ _ _ _ _ _ _ - - - -
PENDING AGENCY "OK" ❑ Appkcatlon and Progress Re(:,rd MAINTENANCE BOND iF� ----
PENf)ING INFORMATION 1:3FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED
ANNUAL
EXPIRATIONDAIe:
----
PENDING VARIAN—E ❑
4ftt��'�-'� �_ BATE ISSUED: _L7___La�-L — - BY. ��_
PERMIT N O. -tsi. ----
(1) �+PPL.ICATION IS HEREBY MADE 1 0 EXCAVATE EOR AND INSTALL
AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
lackamal , Or. 77'7-2608
APPLICAIVT _]''A1 ire mechanical Inc. 11338 S.E.5EVal1t.V1•ek• C T PHONE— p
NAME ADDRESS 777- 608
_ �• lley View. Cla.ckamaopOr._�___- -_
m i1 P;c hanical Inc. 11' '+F� O.E.�iE• - CITY PHONE
CONTRiaCTOR_� NAME
ADDRESS 639-5484
C11fYord Cabe 10195 •'x• iiinvi.ew St. T.i ard , Gregon
PLANS BY_' NA E ADDRESS CIT�I PHONE -
ESTIMATED IC•.PROVEMEN7 TOTAL_ VALUATION ( COS,-): $ ---!L-00*DO00
DOLLARS
——
.._ --
ver
jr��NOR
SEWER CONNECTION
CITY OF TICA RD PERMIT
CnYO
04 r4FARD #. . . . . . . SWR91-0133
COMMUNITY DEVELOPMENT DEPARTMENT C411010H
13126 SW HWI Blvd P.O.Bw 23397.'TOW,Oregon 07223(603)1539-4176 ITJI�iSUED! 06/26/91
ADDHE SS. i 019"1 is W H I LL. t/I EW z3 r PARCEL. 2SI02CC-121201110
GUED I V I S I ON. . . . F"RELEON HEIGHTS N0. 2 ZONING- R-3. 75
S L()CK.. . . . . . . . . LOT. . . . . . . . . . . . . :;R3
TENANT NAME. . . . .
USP NO. . . . . . . . . . F'IXTUR;.: UN7,T5. . .
CLASS OF WOrK. . . :NEW DWELL.I NG UN I T! . . - i
I YPE., OF' USE. . . . . ..SF NO. OF BUILDINGS: I
I NS I-ALL 'TYPE....: SLJSWR TMPEESV ';LJRF'A(.E. . -
Own er-2 FEES
CLIFF- SHARON typo a III o;-t r)t by date I-ecolt
101195 SW HILL ST FIRMT $ 1500. 00 JLH 06/26/91 —
TNSP $ 33. 00 JLH 06/26/ 1! —
[ IGARD OR 91223"
W10TIe #.-
Contrac,tort
CONTRACTOR NOT ON FILE
c ti o n e # $ 1335. it,0 TOTAL.
REQUIRED INSPECTIONS,
This Applicant agrees to comply iiith all the rules and regulations Sevier- Inspection
of the Unified Sewage Agency. Thf hermit expires 120 days from -----------
the date issukd. The total Mont paid will be forfeited if the
'permit expires, The Agency does not guarantee the accuracy of the
side sewer laterals, If the sewer is not located at the measurement -------
uiviin., the installer shall prospect S feet in all directions from
the aistance given. If not to located. the installer shall purchase
'74c and Side Sewero Permit and tht Poprry will install R lateral,
tl3s&Eed Syr,
CEkll fot, inspection 63-9-4175
CITY OF TIGARD RECEIPT OF r-'AYt`-FN'r' RECEIPT NO. 91-21473P
(.,'HECK A110UN7 a 15350. 00
NAME CASE, CLIFF CPSIA AM'.)UNT 0. 00
ADDRESS e 10195 SW HILL VIEW ST PAYMENT DATE 06/26/91
SIJBD I V I S i ON
IGARD, OR 97283
PURPOSE Or PAYMENT AMOON r r,,p-I i) PURPOSE OF PAYMENT AMOUN'l' PAID
SE'WFR USA 1500. 00 SEWER INSPECT .20.
AMOUNT PAID