13410 SW HOWARD DRIVE -LT J Iw.J W, 4J LJ 4 1 Ilr L. 4J 1J R '
b
•
r
I
k
P
1
INSPBCTIOK—I70TIC1� �v
city of Tigard Building Departoent
131.25 taw Hall Blvd. Tigard, Oregon 97223
Inspection Line {Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:__ __�.- -- ---
Footing Plbg. Underslao Hoch. Rough.-in Apr/Sdwlk
Round. Plbg. Top Out Gas Lia" VI ALs
Poet/Beam Struet. an. bower ) Fras, -ng -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -Plumb.
Plbg. Underfloor Neter Line / Gyp. Bd. -Kec:h.
Date Requested.— ! _.�TiiimeesAH
Address: L
Builder:_ ------
THF. FOLLOWING CORRECTIONS ARE REQUIRED:
lb
Inspectors___— --_— _T--- Dat(.:
-- _..APPROVED �— DISAPPROVED _J[ APPROVED V11AJR(:1T TO ABOVE
_ Cal] For Reinsp.
W
SEWER CONNECTION
CR
TIGARD 'CrTY OF TWARD PERMIT
OFIWA
COMMUNITY DEVELOPMENT DEPARTMENT 0MOKIN PERMIT -0. . . . . . .
1312648W Hell Blvd. P.O.Bw 23397,T19",Or69Dn 97223(sW)6394175
PARCEL:
SITE ADDRESS. . . 1--'410 SW HOWARD DR ZONINGING. R--C,E,
SUBDIVISIoj\j. . . . WOODCREST -
SLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :5 -------------------------
TEMAN*r NAME. . . . . : f~ IXTURE UNITS. . . *
USA NO. . . . . . . . . . DWEI-L I NG UNI I TS. - - I
CLADS OF WORK. . . :ADD NO. OF SUILDINGS: 1
VYVIE OF' USE. . . . . :SF IMPERV SUP FACE. . :
IN(:'-'TALL T\/PE. . . . :BOG"
Remarks : connet existing SFD to pv.blic sewer. Septic tank int.tst be p'-kmPeci 8"(1
filled. Filled septic,
tank m+-kst be inspected by City.
FEES
(..jwner* 'A M a 1A 11 t by dace re'–pt
JOHNSON type
4840 C DORRONGE WAY PRMT i 1900. 00 SCR 08/13/91 0
INSP 4> 35. 00 Bcp 08/ 13/91 0
CARPENTE R I A CA 93013
Phone #-
Contractor—
CONTRACTOR NOT ON FILE
1935. 00 TOTAL.
Rep REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer InspPut ion
of Unified Sewage Agencl. I The permit expires 120 days from Septic Tank Fill
the the
issued. The tutaj amount paid will be forfeited if the
permit expirps, The Agency does not guarantee the accuracy of the
side sewer Aterals. if the sewer is not located at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tao and Side Sewer" Permit and the Agency will install a lateral,
Call for inspection 63c-4175
fi
CITY OF TIGARD RECEIPT OF PAYMEN'll- R E CE I PT NO. a 91-216270
CHECK AMOUNT a 19:x"5. LAO
NAME JOHNSON, CHERYL CASH AMOUNT 01160
ADDRESS s 4.840C DOPRANCE WAY r.,i)ymEi\rr DATE s 08 17/91
SUBDIVISION
CARPINTERIA, (.-,A 9301.1---
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OFPAYMENT AMOUNT PAID
1900. 00 SEl,%lFR INSPFC-r 35. 00
SEWER Pf-J?MIT
13410 SW HOWARD DR, TIGARD, OR
TOTAL AMOUNT PAID 35. 00
w
�Jc �
(ifs t. f ave_ Z�v 5 A a rc
7'
a re 5Kl 'e e/