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For
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
i igard, Oregon 97223
Phone 63P•4175
Type of Inspection
Y,Q F
Date Requested Time A.M. —_�_._ P.M.
r�✓ C
Address +� (� + Permit
Owner _ �1?"",�` �"'.f'vQCy, Lot # _
Builder
The following Building Code deficiencies are required to be corrected: '
01.0 A-AV
I
Presented to __ i4-orproved
Inspec Y_S;6 Disapproved
Date
CALL FOR REINSPECTION
O yea O No
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CITY OF TIGARD 639.4171 FU4 1USPEIII.'I.Lo , 5793
BUILDiNG PERMIT i DATE
TAX MAP __.LOT NO. �_ SUBDIVISION', :'
OWNER-1#0n .,ori.ssettc :;W Avon St.
JOB ADDRESS ._ _
BUILDER 1'.Q. 1.ux.15t524TPortlittllc U�` 7 --.--._ . ._ STATE REG NO. -_ ��1:i3 EXP.DATE
BUILDER'S PHONZ44mbgW
ARCHITECT___ _ _- PHONE _.OTHER --
STRUCTURE I ! NEW L! REMODEL ADDITION REPAIR MOVE D OTHER I DEMOLITION
RESIDENCE COMM 1 EDUCATION IND RELIGIOUS ACCESSORY GARAGE OTHER ❑ FENCE
OCCUPANCY LAND USE ZONE �!.�LBLDG TYPE -L"--FIRE ZONE PLAN CHECK BY t''�1" H�E\A,T+ �'
S
SEWER PERMIT N
2L..2h i 1dulguru c�.iay�7 Lath r
OCC.LOAD FLOOR LOAD 40 HEIGHT 1r' NO STORIES_i AREA'"() NO.BEDROOMS" VALUES" JU('
BUILDING DEPARTMENT SETBACKS FRONT REAR _ L'9T SIDE) RIGHT SIDE J
Pe_rmil— )bt,.UU THIS PERMIT ;a ;SSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AOD ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check — � WORK WILL dE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WIl'H ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF ThIS PERMIT DOES NOT WAIVE
Pi.Ck.Fire U- i RESTRICTIVE COVENANT'S. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
AX PERMIrrS.$.FIPARATEPERMItSREOUIREDFORSEWER,PLUMBIC AND HEATING.
! State Tax �U I,
SDC- 5UU.Of) / �.
4b3.34 � — _. . _ ._ _. -. _
r — PDC# L[11.SU.UU PP NT A ENT
Total — - -
Prepd. _ 114uIU0 _
Bal.Due —- 383.321 Receipt No. PHONE
/t a r ADDRESS �-� -
— - -
` Issued By __Approved By
DATE- INSP. TYPE INSPECTION REMARKS PLUMBING DATE
� 1r� Permit
o >�vrWl,t4 0 r l U 9� /0 8L
Id ---
PPermit No �..�
Rough-in — -
-t_i (r • Fixture
Firal
xv
/e HEATING
10,i Contractor
744
Permit No
Gas or Oil —�`-
------_�. Rough in I
Final
SEWER
Final ----
DRIVEWAY
Final
_-- -����--" —�- — -- Storm Drainage
(Rain Drainl Final
- --�-- — —'� 5i0walk
A
Curt)8 Street Final
Approach
BLDG.DEPT.FINAL TEMPGIARY CERTIFICATE OCCUPANCY F na
CERTFICATE OCCUPANCY
V / Landsceoing
r - Y / Zoning Final
1
CITYOFTIVARD No. 10259
12755 S.'A. ASH / 66
P.O BOX 23397 Date t J�
HGARD,OR 97223
Name
Address ---- --------- ---
Lot- -_ Block/Map Subdivision/Addressu�- —
Permit Ws BidgPlumb Cash Check
Sewer O her Other Rec. By ,
Acct. No. sc tion Amount
10.432 Building Permit Fees ^_ i
10-431-600 Plumbing Permit Fees _
10.431.601 Mechanical Permit Fees_
10-230.501 State Bldg. Tax -77-777-
10-433
10.433 Plans Check Fee
30-443_ Sewer Connection ✓
30.444_ Sewer Inspection _
51-448 Street Syst. Dev. Charge
52.449-610 Parks I Syst. Dev. Charge _
52-449-620 Parks II Syst. Dev. Charge _ �-
31.450 Storm Drainage Syst. Dev. Charge
10.430 Business Tax
10-434 Alarm Permit
10-227 Bail -
10.455- Fines-Traffic/MisdlParking - -
1100230- CPTA Traffic/Mlsdryic. Asst,
10.458^ Indigent Defense
30-122.401 Sewer Servlce/USA -��
30.122.402 Sewer Service/City 30% _
V-13 - Sewer SevicelClly Maint. — - —�
30-125 T Unmatched
31-124 Storm Drainage
40.475 Bancroft Prin. Pymt.
40-471 antro 1 Int. ,'f—mt.
L TOTAL
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