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Inspections CITY OF TIGARD • BUILDING DIVISION PERMIT#:�1 -0,2o/3- 43 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 �' I.. • INSPECTION WORKSHEET FOR DATE: [l([erb3 TIME: a2; (0 PAGE: SITE ADDRESS: 13W B vt") CLASS OF WORK: SUBDIVISION: LOT#: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: /1/tc/13 Pour Time: Code # Inspection Description Confirm # Contact # Message k2( fart-bow goy. Corrections/Comments/Instructions: • • • • ❑ PASS ❑ PARTIAL APPROVAL , ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION . ❑ ADDITIONAL FEES ASSESSED Inspector: G%--/ Date: lI l/ [3 Phone #: (503) 718- 7O p ��— l 1 c � �