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INSPECTION NOTICE
City of Tigard Building )epartment
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639 4171
Address ------ Permit
Type of Inspection
The following Building Code deficiencies are required to be corrected:
Presented to In,pect-wr
Date
G4LL. FOR REI1lSR'ECT70N
YES 0 No
MILWAUKIE PLUMBli�u �iy11_niNG DEP'',RTMENT, TIGARD N?
P. 0. BOX 393 PLUMBING PERMIT
CKAMAS QRMON 9101;�+_.___._�_, holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code Of
i igard. SL',--h installations require inspecti.On by the City Inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Ti and Business L cense required '
for all crntractors and sub-contractors. JobY
O',vner _.�'' _' _ Adcres�.3_rl 2U__ Date J�
—NUMHEII OF TO-rAL
TYPE OF PER`AIT ITEMS FEE ON EACH AMOUNT
Suety�amtly-1 bop—each 25.00
Duplex—Each I ha;; unit _ 25.00
Additional bathrooms—+each _ _10.00
Mobile Home S ace-_eich __ _ — — 15.00
INDIVIDUAL FIXTURE9(COMMERCIA
Ito 50 Fixtures in 1 iildin —each — 3.00 _ �';'•.
51 to 100 Fixtures in 1 I Ilding—each _ _ 2.50 -,�!
101 to 200 Fixtures in 1 bi ding—tach --- „2,00
201 or mere Fixtures in 1 building—each _ 1.50
NIISCELLANEOUS
Sewer—each additional 100 ft. _ _._ 10.00 �—
Wat?r Service to building— +_ -------_ _ 5.00 _ r 0
Other S eciF ------- _—^— --
PERMIT n For Plumbing Inspection Phone 6394171
4 o State —7 ''''3— Plumbing Contractor Bye
TOTA1 29 AFf FIAT Mn I'mip(t RV t' '
BUILDING PERMIT APPLICATION TISPRD DATE _ ? -.-_,ts__u� 3735
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR FHE WORK HEREIN INDICATED BUII.rER PHONE 292-35f"'
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWN=R PHONE
LOT NO. Z1_NlQrninr� N� '..1
OWNER Uedgtdood Homes JOBADDRESS 13270 Sw CI7_.m!A ey Rid_(atJ 1.(l l9 Ft
ARCHITECT
ENGINEER
BUILDER Seml3 ADDRESS 9055 SLI SIGNER Lledgwoon
STRUCTURE -❑ NEW ❑ REMODEL LX ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
LVAESIDENCE ❑ COMM ❑ EDUCATIONAL 1-1 GOVT_❑_RELIGIOUS ❑ PATIO 17 CARPORT E GARAGF_❑ STORAGE ❑ SLABL_] FENCE
OCCUPANCY LAND USE ZONE _ pn BLDG.TYPE _ :�N _FIHE ZONE_ PLAN CHECK BY _dWh HEAT —
Add 1of m:-.ramie over y�ar_agbedroom to dWe119.f1y�_jnder canatruction
Non—habitable space.
SEWER PERMITM
OCC.LOAD __ FLOOR LOAD GO_ HEIGHT 1.3 NO.STORIES 2 AREA 663 NO.BEDROOMS -- VALU4 tj10 00.
BUILDING DEPARTMENT SET BACKS FRONT SE F PLA"MAR LEFT SIDE _RIGH1 SIDE
Permit $40.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS C(`h'TAINED IN 1HE BUILDING CODE, 70NING
REGULATIONS AND ALL APPLICAL _E CODFS AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan C_ Teck 20.00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI'ANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOTS iVOi 'NAIVE
Sub-total E 0.on RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE Ctlr;,tNT CITY BUSINESS
LICENSE.SEPARATE"ERFAITS REQUIRED FOR SEWER,PLUMBING AND HFA I iNG.
State Tax A 1.60
— -- SDC -
Total $61,60
PDCq A PLICAhTORJ,GENT
By _�1:
Receipt No.
A-proved duh ADDRESS PHONE
`iia
BUILDING PERMIT APPLICATION TIGARD DATE_--_��t = . -,19�! 3343
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOTNO. 21—i arnxl�u_
OWNER W►3f,jget.j-,ci(j jj�,M 16 JOBAD_DRESS 132 s-r_b..Lflj1gii)L 1jdgs CUrt —.—
ARCHITECT
ENGINEER
BUILDER Sams ADDRESS 90J-'•, FAJ bt00t/tIt101711 HLOYDESIGNER 6ludg wood__ -
STRUCTURE — LA NEW ❑ REMCDEL ❑ ADDITION- ❑ REPAIR _ ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
URESIDENCE ❑ COMM EI EDUCATIONAL -_l GOVT ❑ RELIGIOUS ❑ PATIO C7 CARPORT ❑ GARAGE ❑ STORAGE LJ SLAB❑ FENCE
OCCUPANCY -LAND USEZONE i!17ACJ BLDG.TYPE `}I�`FIRE ZONE " _PLAN CHECK eY . U"'H HEAT Gas
LClr.137[iUL SLI'•IGL_E AMILY-UWELLIN16 U TH ATTACHCCI I;ANAGE -- _
';rF CORRECTION SHEET ATTACHED _ 4 Cedrocim .
- 5 Llaths
SEWER PERMIT f .� - r- J.0 r:'
OCC.LOAD FLOOR LOAD 4O HEIGHT `` NO.STORIES ] AREA Lt� I? NO.BEDROOMS 4 VALUc 09,30
BUILDING DEPARTMENT SETBACKS FRONT A 'SEAR 21 LEFT SIDE ' 1.7 RIGHT SIDE 6
Permit 7.00 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND If IS HEREBY AGREED THAT THE
Plan Check 11 113. . 'l WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECT. ICATIONS AND IN COMPLIANCE
WITH ALL APPLIC19LE CODES AND ORDINANCES. THE ISSUANCE OF THIS P FPkAIT DOES NOT WAIVE
Subtotal :U RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CUP' ENT CITY BUSINESS
LICENSE.SVARATE PERMITS REQUIRED FOR srWER,PLUMBING AND HEATING.
State tax 9.Uu
soc— 400.nn
Total 's49'
"— PDC# )' 10J. ' APPLICANT OA AGENT_
By
Receipt No. e
Approved [AIH AD- D�E-se PHONE
I
DATE INSP. TYPE INSPECTION REMARKS PLUMBING
jD TE
Contrac
� a ,.�� � �Permit No. /=(o _____�4�
�
Rough-in
tiGs�l
-- { Fixture
S-iti=
Final
HEATING
Contractor
/ ��� Permit No.
Am RA w Q W.w.�C_s7C— —
Gas or 011
Rough-In
Final
�- • SEWER
--- Finds c
-` DRIVEWAY
- Final
Storm Drainage
(Rein Drain)Final
S idewal k
' Curb S Street Final
V--�--` Approach
N.DG_DEPT. FINAL TEMPORARY CERTIFICATE OCCUPINCY Final
CERTIFICATE OCCUPANCY --
/ /J Landscaping
Zoning Final