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1.0530 S.W. Century Oak Drive ! S
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of Tigard
INSPECTION REQUEST
for
N, �;PFCTMN TIME . PERMIT NC
DATEA.'r E i S S U E D
OWNERS I'NAME :
EST e r 0 c" -,j b,7►0 t')r
RESUL ;uppt.;,,id
SKETCH:
-3
WPECTOR DATE
50TE Attach supe omental test nate harrt 103
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City of Tlgc ,r
d
INSPECTION REOUEST
for
NSPECtION TIME : y _ r'ERMI r NO. . ..--
DATE '
n. . . _DATE : I i,�2167L 'BATF ISSUED'__Z1—
I OWNERS 'NAME ' •/-� �
IADDRESS : .,�'� " � >� , E
IRESU' ,r Approtiea ui.�c�,prova� 1 �nd�r J
SKETCH:
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INSPErTOR DA E
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City of Tigard
INSPECTION REQUEST
f o r
Oz-�
INSPECTION TIME ' ZP--. ln? PERMIT NC,. :---
DATE
DATE ISSUED :
OWNERS NAME :
ADD RES S '
J.W-4
CON R
E ST : ;Voter p , V:suaql Laboratory
RESULT: Ap.-,roVAd .)i3approved 0 , Pending [j
,SKETCH.*
PECTOR DAVE
-NnTE: Attach supplemental test data beret 91
City of Tigard
INSPECTION REQUEST
for-
.
INSPECTION TIME: �` a PERMIT
DATE: DATE ISSUED
OWNERS NAME :..,Z:- 9:�—o
ADDRESS: ,3 ---
CONTRACT'O R
EST ' , W,:tar ❑ , V:suai 'j , 1_aboratory ❑
RESULT- * �,p roved )iaupproved G , Pending ❑
SKETCH.'
INSPECTOR DATE
NOTE: Attach supplemental test data hereto
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Cit of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: L PERMIT
DATE: 7/�3//!, DATE ISSUED
0 Y N E RS NAME ' --
ADDRESS'. - /C
AME :ADDRESS: /C
CONTRACTOR -
i E S'T ' ,air U, Water 0 , V,suai '] , 1-aborahry fj
RESUL ' Ap.-roved U , rliauppr nedNe
!ending Q
SKETCH:
INSPECTOR DATE
NOTE Attach s.rwemental feet data hereta]
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City of Tigard
INSPECTION ;REQUEST
for
INSPECTION TIME: _ PERMIT NO. :—
DATE . 7 /ia/ DATE ISSUED
OWNERS NAME ' ---,-
ADDRESS '
AME : -_._ADDRESS: --
CONTRACTOR : -- —_- --- --
EST : Lir I.r, Water[] , Visual 0 , I_aborntory r
RESULT: Approved 0 )isopprovadA Pending p
SKETCH.'
t1 ,-� �G�Lc.e.d.1/ �'"`'�LCO (D"'`i �a.[ �r ,�-G1u•....reg
7I-At 7-Y
INSPECTOR DATE
NOTE: Attach supplemental test data beret a]
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT
DATE , Z1zS/;73 DATE ISSUED :_—,i
OWNERS NAME : _ 7��- c _
ADDRESS: .
CONTRACTnR
TEST : Aif , 'JVater❑ , visual U , I_a boratory 0
RESULT: Apo rovad Disapproved G Pending p
SKETCH.'
, LS1 ;> 3
NSPECTOR DATE
NOTE' Attach supplemental test data hereto]
amity of Tigard
INSPECTION REQUEST
for-
INSPECTION
or-INSPECTION TIME . �• PERMIT
DATE : DATE ISSUED *
OWNERS NAME
ADDRESS '
CON'rRACTOR : _ D.
V;suaf j , Laboratory r3
RESULT' Ap,,roved4 , Diaappro�ed G bending p
SKETCH.* Zo
✓IN3PEUTOR
DATE
NOTE: A•tocrn suppiemental test data berets
PLUMB, Nu F&RIv-, r
'PFI-TCATION
No. TYPe )f Fixturr-
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71
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_Pr n er em -----------------
This permit become- rul-
commenced within 6cl �!.&J.n authorized is not
,_r w.-,:,k Is suspended rr abandoned
for a perllr:d -f "J.20 days i '
ays '-',re afterw' A,,rk is - -mmer�c-t�.d a
All Plumbing firms must be li:�rvied bv the City :f Tigard and post a $10000 bond.
I hereby certify teat I ::evP
-'ad and examl-nei -his appli,:at4cz and know the same
to be true and correct, Al.1
:f '.AwS and :-rdinanc'
es 9-Vern'ng this typ
of work will be complied with whethe, SPLOcifled herc.-in cr nctz, the granting of a
permit does nt presume tc -31,til-: �', ,- -,�- -1,-1� - cancel the prcvisions
cf any other 8tat�- 7r lc`al te
_'9ula+Ir,9 ::-'-structI,_n 'r the performance of
-onst
1-ucti-n,
i
i
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. : .__.__-_ _
DATE: DATE ISSUED'__./_L_
OWNERS NAME : —
' ADDRESS :
CONTRACTOR :
TEST .4 r j, Water Lr] , %lisralld, La' ratory rl
I RESULT. Approve Disapprcved 1 FNnding
I SKETCH:
I
I
I
I SPECTOR DATE
ICNO"IE : Attach supplemental test iota hereto
CITY OF TIGARD
12420 S. W. NI.In Shwt
TIGARD, OREGON 97427
APPLICATION FOR BUILDING PERMIT
New Construetic.i 40 Demolish F-1 Addition Remodel ❑ Move❑
ZONING P-D _ DATE ISSUF;t (f '�"7� BUILDING PERMIT
DATE RECEIVED 44-?1 BUILDING FEE $ ba.0Q No.
''3-116
BY !S PLAN CHECK $._1Lli�_ --- --
-- OTHER $ VALUATION $ 15,02.00
TOTAL $ RECEIPT No.
TWO SETS OF ?LANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT 38 MAP # 2S1 LIDD CENSUS TRACT W- JOB 1
Architect or Engineer Tualatin Development CO-
Address _
O.Address _ __I53pp N-Y' >> h Ave,,_ -_ Phone
—Phone
Bui.]der earns _r — ---
Address
BUILDING USE Single Res. lfl Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP I No. of Stories 1 __ Total Height 14 Area of Lot 4wlu
Type of Construction V Floor Area By_- 1 1040 2` ---
Set Racks: Front_`_ Back_24___ L.Side_4R.Siie_ 4
Private Sewer Pipe Size )a- Sewer usa_ _ Septic Tank
water Service Pipe Size__3/4- Storm Sewer ❑ Ditch ❑ Drywell❑
Street and Curb Requirements—__ 14istiva_ --
Driveway Width - __.__-__jaL__u_ __No. of. Parking Spaces
SEPARATE PERMITS REQUIRED FOR SEWS AND PLUMBING
SPECIAL INFORMATION
ADDRESS AS SIGNCD 10530 S.W. Cantury Oak[ Dr.
FIELD CHECK BY sC DATE 6-4-T3
PERMIT APPROVED BY� � Y
It is understood that al.l work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
Signature Ap-p)icant