9585 SW MURDOCK STREET I ill�r. w
9585 SW MURllOCK STREET _
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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
A.M.—P-IV-
Date Requested IL-2 4 — 1
V-e-, ,/, Permit
Address
Permit
4-
1
'Lot
Owner
Builder
The following Building Code deficiencies are required to be corrected:
Presented I-) Approved
Disapproveo
Inspector
Dats
CALLFOR REINSPECTION
F-1 YES .k;-1 NO
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City- of Tigard
INSPECTION REO LES T
for '
INSPECTION TIME: PERMIT NO. : _ f
DATE : . G /- Z-75_ DATE ISSUED :-- I Z `
OWNERS NAME : _
ADDRESS: �: �d- 64 _1C
CONTRACTOR :
TES ST : Air 0, Water p , Visual , Laboratory p
RESULT: Approved Disapproved p Pending p
SKETCH; A
INSPECTOR DATE
[NOTE.' Attach iuprlemenint test i(Va heretj
liq"41
UNIFIED SEWERAGE AGENCY NO. _- 5075
WASHINGTON COUNTY DATE _—_4418-75
CIIY OF--- —_Tigard
APPLICATION FOR SEWER CONNECTION PERMIT
OWNER: __.- ____ R.C. Hardman
OWNER'S ADDRESS: ------ --_ - _9585 S.W. Murdock Street
STREET 97223
Tigard Oregon
CITY STATE ZIP
BUILDING SITE: LOT__. _--____ BLOCK __.- __-_- ADDITION _.__....--_—___--
TAX LOT NO. -- -_-__ ---- TYPE OF OCCUPANCY -- _- ----__.-_.._--_---------- _r
ADDRESS _ -_ -_ 9585 S.W. (burdock Street_ _ -_-___.--_--.—
DWELLING UNITS - _----__ FIXTURE UNITS
SURCHARGE IF APPLICABLE _._ ----- -._--_-_-_ ._ _-----___---_------
PERMIT FEE _ -300 - - INSPECTION FEE 21_5- ------ TOTAL DEPOSITED __ 325
(NEW) (EXISTING) BUILDING SEWER SYSTEM ___- --__ Fanno Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANTt -. 4CL( __._ ... -- ----
SEWER PERMIT
THIS PERMIT AUTHORIZ, CONNECTION TO THE SEWER SYSTEM.
LINE SIZE __ _ INSTALLER
RECEIVED _-
(AGENCY OR ITS AGENT)
COMMENTS: . _ sewer permit only -__sewer made available first of 1975
This Application and permit expires in ninety (90) days. The amount paid will be forfeited
should expiration occur.
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A D D R E S at, PERMIT NO.
PERMIT CHARGE none
OWNER ���� � CONNECTION FEE
PAID BY _
TYPE OF BUILDING DATE CONNECTED _
SERVICE RATE �j�4 INSPECTION FEE
CONTRACTOR n�,r.+rtR.+ PAID B Y _ `,�}+ DATE
SIZE OF CONNECTION �`' ASSESSMENT __ PAID