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Permit
CITY O TI �4RD ..,, BUILDING DIVISION PERMIT #:t 'D40" 100 jg 131,25 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639- 41710ii�P1)� � +� Inspection Requests (24 Hrs.): (503) 639 -4175 '__.. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / 37 ._ • /S CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE (5 ° -7766 CONTRACTOR: dae PHONE #: Inspection Request Scheduled For: Date: i —�� Pour Time: Code # Inspection Description Confirm # Contact # Message l n _ ' t &N��--■ Ps M C4 . Corrections /Comments /Instructions: ' cries cam. rz_ x/46.2 5 776V1 ‘7.04,tical . z�- , ASS _ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL a CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED i Inspector: / Date: 1--r) 4 Phone #: (503) 718- (