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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
i Type of Inspection ._ -----
i 1
Date Requested_//wh' 7 Time- AAM
Address __ 11 ,339 5'0 e"__#*P,co("AV ZO r� _ Permit
Owner /'„m0 Y►'T — _ Lot #
Builder — �—
The following Building Code deficiencies are required to be corrected:
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Preserved to _- _.._— -- / I Appro and i
Inspector r/'S, I Dismo oved
` Date
I CALL FOR REINP3MMON
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f ❑ YES It NO
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BUILDING PERMIT APPLICATIONTIGARD DATE 3 /23/ � 'g ? 4052
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 3r;'7-6- 1�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
OWNER Arley T,7"lint. JOBADDRESS 7.1338 S;l Cottonwood LOTNO.22$ �-nF(Tleil Q
ARCHITECT Cf1�30x?•• ICC;C?
BUILDER ADDRESS AI�fyVr+ ENGINEER
- _ ---- ---- - -- - DESIGNER 620-9870
STRUCTURE ❑ NEW D REMODEL Q ADDITION ❑ REPAIR ❑ RENEWAL .0 FIRE DAMAGE ❑ DEMOLITION
RESIDE"!CE ❑ COMM ❑ EDUCATIONAL O GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE U STORAGE ❑ SLAB❑ FENCE
OCCUPANCY i _LAND USE ZONE _"-7 BLDG.TYPE — r � FIRE ZONE PLAN CHECK SY ci}:a11 HEAT T."•
-- (:rVr,tn,,ce. 17edraar Addition anO ry cI:,(,l,lr•. to exipt:incl rinnle fpir•}ily
SEWER PERMITH
OCC,LOAD FLOOR LOAD HEIGHT ] NO.STORIES 1 AREA ' NO.BEDROOMS 1 VALUE
BUILDING DEPARTMENT
SETBACKS FRONT •-- REAR ! LEFT SIDE RIGHT SIDE
PerI
--_ ---_-
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREQLY AGREED THAT THE
PlaWORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub ._ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUM91NG AND HEATING.
StaTotal SDC--DC# APPLICANTORANENTByRecelpt No.AppADORE PHONE
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
wo %' Permit No.
Rough-in
_ Fixture
7 S 19,;z `c Final _
HEATING
Contractor
Permit No.
Gat or Oil
Rnu n —
Final ---- '
SEWER
Final
DRIVEWAY
F i nal
Storm DreinW
(Rain Drain)Final
Sidewalk
Curb&Street Final
P pproach
SLOG. DEPT.FINAL TEMPORARY I CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPAM--Y
Landscaping
I i— IIZoni%Final
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OF OC
'ITY OF T IGARD IV(
OREGON
Owner:...........MQ.n.agsam..Kam.e.a................ .. ....... ......Ar'mit No. 14�iL
Building Address..11.3313...SLI...C.at.ton.woo.d...Lene.........
. Jte is hereby given thrs......� ... day 119..... ..... 19...7.7..Certifica
that said building may be occupied and #
that it complies with all requirements of
the Building Code for the City of Tigard,
as approved by the Tigard City Council.
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A
Building Inspector •. %
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Adrlr�ao., //33�_� _�zLac _:. r� . Przm.it No.
Permit r,Ft:.I r. [jc7
Cnnnuctinn fro cJ -2 s
P-Ad by
T y p r)f' !,'..i-:! d. rrr; � Date corinec:tr'd .._._
n rcirtc) Paid
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SEWER PERMIT /
N" 12191
Unified Sewerage Agency CITY OF T; :!-- DATE — -iz-,3_27.__
of Washington County ----
OWNER: monogram Hones PH _ L pS___
OWNER ' S ADDRESS= — -- - ---
TYPE OF INSTALLATION:
BUILDING SEWER ❑EUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCYt
Q NEW a SINGLE FAMILY COMMERCIAL
❑EXIST . (PRIOR TO 7- 1-70 ) LJ MULT . RES. ❑ INDUSTRIAL
FIXTURE UNITS
DWELLING UNITS 1 —
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALI_ RULES
AND REGULATIONS OF THE UNIFIED SEWERAGE AGENCY . WHEN CALLING FOR
INSPECTION, PLEASE REFER TO THE PERMIT NUMBER . THIS APPLIC4TION
EXPIRES IN ONE-HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT P4ID WILL
BE FORFEITED SHOULD EXPIRATION OCCUR .
FEES:
25.
PERMIT FEE -- —'
575.
CONNECTION CHARGE —
SIDE SEWER INSTALLATION — '- ISSUED-
OTHER - '—
TOTAL _ 600.
APPLICANT DATE
SEWER PERMIT N V 12191
ADDRESS OF STRUCTURE 11338 SW Cottonwood Lane
TAX MAP —
TAX LOT SYSTEMFanno creek
- _
LO'i _22-6— BLOCK - OF -'�
APPROVED BY
BATE ISSUE BY DATE
REMARKS__ bldg. 1491 —
�Q CITY a-•1y-77
BUILDING PERMIT APPLICATION of TIG ARD DATE __" 19,
.
THE UNDERSIGNED HEREBY APPLIES FOR APE RM IT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPFCIFICATIONS. )WNERPHONE " �• —
LOT NO.,.�
OWNER flunoWrsm Itumu JOB ADDRESSLut' tW14 ojir3 HOMEADDRESS _
ARCHITECT
ENGINEER
BUILDER c;..:ak: ADDRESS DESIGNER__ _
STRUCTURE '"QNEW ❑REMODEL ❑.ADDIIIION ❑REPAIR ❑RENEWAL (:]FIRE LIAMAGE ❑DEMOLITION
a gESIDENCE ❑COMM ❑EDUCATIONAL._ ❑GOWT ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE EI STCIRAGE L�-r—�,ILSLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED U:'IGNS
OCCUPANCY LANE)USE ZONE H-7 _BLDG.TYPE y FINE ZONE. MEAN CHECK B� Ntw_ HEAT,__._._
'.ot !, 226 const.rUCt single Osmily dualling wfatteched garage ; bedroom 2 bstj
';._LOAQ__ __ FLQ.QAJ.QA!?_ O_!_..._�iE1SikLl'.�_�C1—NO.STORIES 1 AREA lA34_L11Q_HDH4QM,S_A YAL._V_E 36,51)
l BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 75 LEFT SIDE 70__RIGHT SIDE 10 --
Permit 14H-1 Oa
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check i CL_CICI REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL. BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC:TIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 4,74 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING ANO HEATING,
Total 162*7,, Systr;m Llevelopment Charge $300.00
By
APF AN1 OR 1GENt
Approved Receipt No. ;
ADD SS PFI Ur�t
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DATE INSP. TYPE INSPECTION RF.r49ARKS PLUMBING DATE
�rL Contractor
- — Permit No.
_ Rou h-in _
Fixture
Final
11 2 1 -C>yf1 I — HEATING
9- 7 Contractor
Permit No.
-- —_— _. Gas or Oil
—Y— _ Rough-in
---- Final
SEWER — —
— ------- — - Final - —
DRIVEWAY
—_ __ ---- _ --- Final
Storm Drainage --
--- (Rain Dain{ Final
— ---- ----------- --- — Side_alk— —.
Curb&Street F,
A roach
BLDG DEPT. FINAL. TEMPORARN CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
( Zoning Final
f
f of f lard Mechanical PtImit M Permit_ .- _
i 1 0 Fee._
J New Installation Replace Relocation ❑ Addition i.-I Alteration 1J .4x" State------,-�
TOTAL
CO^.TRACTOROWNER-_!/ ,O' 9�+L'/(� 22� � /►
ADnRESS_l��_ _ �i_ _L..E-G� t�tCQ y31 , WORK ADUP��S
PHCINE ! _—_ APPLICANT . • 'AZ q -
Ic-
Heat Input Rating (B i U Per Hour) Vent Size _ Flue Size!
FUEL OIL ❑ GAS ❑ ELECT OTHER --
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit �_- - -=:00 Air Condition Compressor 15 to 30 HP 10.00
New• Under 100,000 BTU 4.00 Air Handling 10,000 CFM_ _- 3.00
5.00 Air Handling Over 10,000 CFM 5.00
New 100,000 BTU&over -- — --- 3.00
_-
4.00 Evaporative Cooler
l _ Floor Furnace -- ----- 2.00
4.00 Range Vent Fan
Well- Floot -Suspended `� 3.00
2.00 Vent System
- Install 'Jens Only — —'- 3 00
---- 4.00 Hood Commercial _
�•'r Repair - Heat& Coolina — - --- -
tL 10.00
Air Condition Compres-.r.r Under 3 HP ___ 4.00 Commercial Duct S,;stem
Air Gonditian Compressor 3 to 15 HP�- 7.50
INSPECTOR'S COMMENTS_--------------------
s� CITY BUSINESS ENSE REOUIRED FOR ALL CONTRACTORS OR SUB CONTRACTORS
! APPROVED BY DATE _ — ISSUED BY- DATE _
s RFCFIPT N0. _. _
774 Signature o1 Applicant
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