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City of Tigard
INSPECTION REQUEST
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for I
INSPECTION TIME: dG PERMIT NO. : - I
DATE : c3' DATE ISSUED :
OWNERS NAMV �_____��' Q' L_
CON'TRACTOR . -- ---- -
EST : , , '�l�ter❑ , V:suai4 , I_Uborctory fj
RESULT: Ap.,rcved LJ Pendi ig _
SKETCH.*
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ISRECTOR DA'i
NOTE � A.tach supplemental test data herr'to]
City of Tigard
INSPECTION REQUEST
f o r
INSPECTION TIME ' Z 2cj PERMIT NO,
DATE : DATE 'SSUED :---L—1
OWNERS NAMF 7`42
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C C,N r R A C,TOR
EST ' ,�,.,- --, , Wot9r0 , V.*suai,�, Laboratory F]
RESULT '. Ap,,roved X, ,-)ijappro�ad 0 , Pending Ei
SKETCH:
INSPECTOR DATE
NOTE * At!ccn supplemental test (iota hereto]
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i City of Tigard
INSPECTION REQUEST
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for
INSPECTION TIME : PERMIT NO.
i DATE . 6 ZZ IZt DATE ISSUED*— Z
OWNERS NAME . —
I ADDRESS :
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CONTRACTOR :—
TEST
ONTRACTOR :_TEST a r 'l , Water -1 , Visi-cl i , La'• .ratorl h
RESUL'r. Apprt;ved DisapproveH 1 P ndin9 `J 1
i SKETCH:
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INSPECTOR DATE
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[:NOTE : Attach supplemental test ,tato hereto]
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City of Tigard
INSPECTION REQUEST
for
i INSPECTION TIME . _ PERMIT
DATE . _ _L__ Z __ DATE ISSUED'___LL
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OWNERS NAME : ILL") __--
I ADDRESS : 32- ^�
I CONTRAC. If-, rt �-
J TEST � r Lj , Woter p , 1/isr Gl 0 , La'- ,ratorl (1
RESULT ' Approved , Disapproved 1 P-inding J
I SKETCH:
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I
INSPECTOR DATE
IOTE: Attach supplemental tees jof,; herer1
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : _ PERMIT NO. :
DATE : 6, 11,11'7-1 DATE ISSUED '. i
OWNERS NAME ' -- 7-, 122
CONTRACTOR
V:sual 14 I_a boratory r
RESULT* Ap,-,rovedX , :)i;awnved G end;ng p
SKETCH.'
INSPECTOR DATE
NOrF Atturn suppiemental test data kereta,
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PLIMBTNC PERMIT APPLICATION
Jurisdiction of
No. 1 Type o* .re F'ee Permit No. _� ?!'
Permit fee
Watt t Closets iToilets) S Permit Issue
Bath Tubs Approved by 1`
Lavatory acs as nBuilding Permt,. ,
,[ oiUwer _ -�' Receipt No. _W
D;..hwas in
n s i 'C en
oink3,�r�nar _ Locgtion c f Buil ' .n T/1 _
Sinks Bar
Sinks. S .o I-T- Automatic k-sFZshar WvR-
i isDosa
• Lsund-vrreya_�—_ Nae & Address of OwT,:� -
Drair.a locr
ains Area i,� _3� --
rairsi a .r i e;-a_tor
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Jilin rAins
/ utomaMi Weser NamAddress
oun a.ins. Drinking / y.�LtG• _
"aun .wins. o a
ZZ A A J 4 < Z---
Water' Service
iJ: Bu (Old o:_r;�� (Al t.r, Repair c_
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awr, ,rriinc���i{@—r@{—�
]'his`i mT c: mail and void if work .r c::r,atruci.i.:n
'. y -)r if cc.nstructicn or walk 15 ..
f,r a per±od -f 1 ,- + v • at any time after work i:: mmer.• ,
Ali plumbing firms rm:s 1. be licensed by the City �.f Tigard and p +. j $1,000 bond
4
nerPby ,(-rttfy that I rave -mad and examined this appi: .at. :.n and kr,rw the !:rn
be true and correct.. All provisions )f laws -nrl r.•rdinar, e-, govFrn.ng this tv
w Irk wi 1. be cnmpl: d with whether specified Yrrein (,r r.: '..,, '.he granting *'
pe-m)t does nr t pr,.; art p tr. give authority to r a' c,r c:+n-e i i-he pt c:`:ie�irns
.f any r the.r nt a t�, local law regulating cons t ri ...n r t lie c •rf�-rmance f
�nstr'acti:n.
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City of Tigard
INSPE=CTION REQUEST
for
INSPECTION TIME : �' ___. PERMIT NO. :
DATE : -�r /0.tt DATE ISSUED :—
OWNERS
SSUED :_OWNERS NAME .'
ADDRESS'
CONTRACTOR
TEST '. Air [1, Wotet- 0 , Visual D<, Laboratory p
RESULT : Approved �' , Disapproved ❑ , Pending []
SKETCH.'
I SPECTOR DATE
LNOTE : A,tach supplemental test data beret]
CITY OF TIGARD
1 242 S. W, Main Street
11GARD, OREGON 97123
APPLICATION FOR BUILDING PERMIT
New Construction X❑ Demolish ❑ Addition ❑ Remodel ❑ Move C
ZONING P-D DATE ISSUED 4-17-73 BUILDING PERMIT
DATE RECEIVED 4-10-73 BUILDING FEE $ _ 77.00 No.
BY FSPLAN CHECK $
OTHER .$ 10.00 VALUATION $ 20,278
TOTAL $ RECEIPT No. 7j�y- Z-
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT M 39 MAP M 281 11C CENSUS TRACT W-8 JOB N
Architect or Engineer T•De'
Address Phone
Owner T.D.C•
Address - - _ _ — - —_ Phone
Builder!
Address __-Phone
BUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ❑ Industrial E
OCCUPANCY GROUP I No. of Stories 1 Total Height 14,_ Area of Lot 1,216
Type of Constructir, XPOORWOOMODOWX V Floor Area B '- 1 1210 2
Set Backs: Front_ 11 Hack_ _20 L.Side_4-8 R.Side 4-9
Private Sewer Pipe Size King CittySewer— Septic Tank ❑
Water Service Pipe Size_ 3/411 Storm Sewer ❑ Ditch ❑ Drywell,J
Street and Garb Requirements Existina
Driveway width Iti _ No. of Perking Spaces— 2
'A'11ARATE PER14ITS REQUIREU FOR SEWER AND PLUMBING
SPECIAL INFORMATION
TRIS PEHM_1C'FOR MODEL ONLY--NOT TO BE OCCUPIED UP!PIL ALL RBQUIREMSNTB OF
THE CITY Or TIOARD HAYS BEEN CONPLLED WITH AND A LETTER FROM ORBOON
D.E.Q. AUTHORIZING SANITARY SBWEP ODMM.TION
ADDRESS ASSIGNED -1o�1o_&�YL.�7�lALury ark Dr.
FIELD CHECK HYM - --- _EC-- - ----DATE 4-16-7j
PERMIT' APPROVED BY 4i"k'�, l%A.
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard; Oregon, and that the building wil
nat be r,ccupird until a Certificate of occupancy has been issued by the City of
Tigard Building Inspector.
SLgnature v Apnlicant