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13470 SW CRESMER DRIVE ,'
City of Tigard 3-13
INSPECTION REQUEST
for
IINSPECTION, TIME :.Z-;W PERMITJ NO. : ------
DATE *
O. : --_—_____DATE : DATE ISSI ED:._._.L_L_
OWNERS NAME I . _.��
ADDRESS .-
D R E S S � .__
IC �NTRACTOR � e l on rLM� e� �x
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ITEST . Air ❑, Wafer [] , Visual ❑ , Laboratory ❑
RESULT. Approved Disapproved ❑ , Pending p
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigar-', Oregon 97223
Ph;nc 639.4171
Addross
Pormit #_
Type of Inspection -- —• -- _ '
Tho following Building Code deficiencies are required to be corrected: -may
Presented to-._ Into-ctor
Date
'ALL FOR RF_ AGOECTION
❑ YES ❑ NO
BUILDING PERMITAPPI-ICATIONTIGARD MATE �s t.;(; 3474
THE UNDFRSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK 'IEREIN INDICATFn BUILDER PHONE 777-397t)
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER F TONE 63 TJ- .t c
_
OWNER f rank Rogers JOBADDRESS 13470 SW Creamer Drive tWX LOT NO.
ARCHITECT
ENGINEER
BUILDER Professional `i9mode1.ADDRESS,'j404 SE 72nd Avg DESIGNER Prof. Relli
STRUCTURE ❑ NEW C7 REMODEL In ADDITION ❑ REPAIR ❑ RENEWAL El r`IRE DAMAGE ❑ DEMOLITION
Cd RESIDENCE Ci COMM Ci EDUOATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO 0 CARPORT ❑ GARAGE ❑ STORAGE ❑ BLAB❑ FENCE
OCCUPANCY P-3 LANDUSEZONE t' —BLDG.TYPE FIRE ZONE-7131-AN CHECK BY _ dtiEAT a®C.'
_ Lonstruct s on & family �n�� sl�t_i� -max . ��_ n.511� family duel Wig.
SEWER PERMIT#
OCC.LOAD FLOOR LOAD 41J HEIGHT 13 NO.STORIES AREA 1"'?(1 NO.BEDROOMS 1 VALUE
CGUILDING DEPARTMENT SET BACKS FRONT_ �- - REAR LEFT SIDE RIGHT SIDE
Permit �rll a.fIO THIS PERMIT IS ISSUED SUBJECT TO THE REC'- ... IONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES ASD ONDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check ,7.;-)0 WORK 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
18ub•total 172. 5O RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING ANO HEATING.
tat3 Tax 4.60
Total 1?177.10 SDG
PDC# APPLICANT Oji AGSM
By P
-- C t, Receipt No '71 7
Approved __-. - ------ PH--t-0-=- —
DATE INSP. TYPE INSPECTION _—REMARKS _ PLUMBING DATE
!Y•i _ S./ p Contractor _—..._._
Permit No.
Fixture
Final —
✓ f°, `� HEATING
Contractor
Permit No ;-/I q/ s _/p Sa
Gas or Oil lJJ
----- Rough4n —
Fir&!
3lsn £R
Final— --
DRIVEWAY
Final --
_—_ Storm Dralnagr
(Rain Drain)Final
Sidevwlk
--_ Curb G Street Fhwl
Approach
SDG- DEPT. FINAL TEMPORARY CERTIFICATE OCCUPytdCY
CERTIFICATE OCCUPANCY J�`) Final
N I .ndscaping
Zoning Final
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PERK" T` LC'T, ,
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Tigard strict
PERMITl�° 1 DATE /�— / 6 —
11FIRMIT IS GIVEN TO
OF
TO CONNE('T A _ _--�--- ---_—._ ---
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS CON-
NEVTION 1SI 1
MADE AND INSPECTION THE
FDESCRIBED E
ONNECTION PREMISES UNTIL
AS BEEN
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J. TIC
SANITARY DISTRICT
PE�:�tiT FEE PAID 3...... ...(. i....,�..........
''�- e>��� BY ' jam'�f...r.17�:•t'R'��- ..____._._..
f: ;NNECTION INSPECTED AND APPROVED
Superintendent
Add r.e:,s i ;3C/7,Q Permit No =�� Y ---
_�. Permit charge_,_-_�'1
OwnerConnection fee_ 3 7,1 15
Paid
Type of bu_1ding 4 Date connected____��- i �n
Service rate Inspection fee_ ye..._
Contractor _,,, Paid by___. Date
Size of connection 211 _ Assessment �_�_„_Pa..i.d�