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CITY OF TIGARD BLDG. DEPT.
12420 S.W. MAIN STREET
TIGARD, OREGON 97223
PHONE 639.4171
CONTRACTOR: a
Pursuant to Section(s) of the Uniform Building Code, the
following item(s) require correcting:
Date:.-1—6 Permit No.
Inspector —
CALL FOR REINSPECTION
CITY ? 28
BUILDING PERMIT APPLICATION OF b IC ARCS DATE__
THE UNDERSIGNED HEREBY APPLIES FOR A 'ERMIT FOR THE WORK HEREIN INDICATLD BUI1.t7FRPHONE
)R AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATION, ON'NEPPHONE -
LOT NO.
OWNER _ JOB ADDRESS' _ I.IdM_E ADDRESS _
- ARCHITECT
ENGINEER
BUILDER L ADDRESS � DESIGNER
STRUCTURE - ❑NEW ❑Rt'MODEL ❑ADDITION ❑ I-]
REPAIR []RENEWAL [:]FIRE DAMAGE ❑DEMOLITION
❑ RFSIDENCE ❑COMM ❑EDUTATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO 1•_;CARPORT UGARAGE ❑STORAGE❑SI-AB ❑FENCE
❑DOND ❑MOVING ❑CONDITIONAL USE ❑DE3.GN REVIEW ❑COUNCIL APPROVED OSIGNS
OCCUPANCY--.---LAND USE ZONE BLDG.TYPE-----FIRE ZONE-- PI AN CHECK BY _ HEAT
atlti,I. ; ,jr-A singis family dwellin;j w/altteched „ !Lat,,sw 1 Owdruorn )Sth.
l - FI. 119sus same, gel $1 �. US�omm�r f i� i.t) � L8116
',Iwwegr Permit. - 20117 Iw M70 00
- -- - fir40 ice.----
QG�.S4Ai�—__�1.QQt11�.s1Z_� HEICzHT____ .0 -N9152QHJE5- —.��-
BUILDING DEPARTNMGNT� SETBACKS FRONT REAR �d LEFT SIDE RIGHT SIDE
Pelmet 7►1r;tt.ro 0fl ----
-' — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THF. BUILDING CODE, ZONING
Plan Check 10.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THF
-- - - WORK WILL BE DONE IN ACCORDANCE WITH THE PI ANS AND SPECiFICATIONS AND IN COM;-k IANCE WITH
Sub-total � .• "10 ALL APPLICABLE CODI'S AND ORDINANCES. THE ISaIJANCF OF THIS PEFIMIT DOES jOT WAIVE
RFSTRtCTIVF COVENAN'S. CONTRACTOR AND SUR CO'4TRACTORS TO HAVE OURRENICITY B'JSINFSS
State Tax . 124 LICE�SE. SEPAHA7Ep,EFIIMITS REDUIREO FOR SFWFR, PLUMBING AND HEALING.
-- -- r" t„ - 4�i liJ E U u
Total 11.4164 por 13r
By pl.
---- ..—-- APP[IGANT QA AGENT
Approved I 1 Receipt No -�'7 '33
6��l
I
DATE IINSP. TYPE INSPECTION REMARKS PLUMBING nATIE
-------- -- ------
9� 21- &Pf
. Contractor
�' 74-79 /eP c r o Permit No.
9� U
Rough-in
-50 --- — Fixture--- ---•— -----
t— 61 K Final --+
HEATING
Contractor 11
— - — —�— - Permit
Gas or Oil
♦ -----
Rough-in --- ---
- — — —� Final
e —
SEWER
�_.. ------ ------- ---- Final — —
-- —_ DRIVEWAY -
�_ __ll Final
Storni Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. FINAL TtMPORARY CERTIFICATEOC UP -JJJ CY Final
CERTIFICATE OCCUPANCY — —._—.--
��
Landacepinp
Zoning Final