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City of Tigard
INSPECTION REQUEST
for.
'NSPECTION TIMEAV-47MC PERMI NO
DATEAF -22-,"A3 DATE ISSUED
OWNERS NAME ' r- Q• C.,
A O D R E S S 07 Za
C�)N I R A C T tj R
P.5 r , &-ter ;X, Lr'
RESJL.T -J.-xpproied -1
SKETCH:
17
INSPECTOR DATE
TE Attach ;Ljpplementol test -j otv merst
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : 3' PERMIT NO.
DATE .— %�3 DATE ISSUED :iZ
ODWW RS NAME '
ADDRESS: 'J. r'-- ..- vm�rk.�ct� � 0
CONTRACTOR : ----:7�C.— - ------
EST : = WoferIll V:Su aiikil", -aborato;yr_j
RESUL '. Ap.-roved 7iauppro�ed G ;pending
SKETCH.'
INSPECTOR DATE
NOTE: Attach supplemental test data heretol
I
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City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME : PERMIT NO. : .___
i
DATE - /k /,&*- DATE ISSUED' Z
OWNERS NAME :
ADDRESS • 6Aizll Op —
I CONTRACTOR :-_
ITESTI -j , 'wnter �� , �r;t G1 , La rctor; r-t
RESULT Approved ftp Disapprover+ 1 -nding D
I SKETCH:
1'NSPECTOR DATE
COTE Attach supplemental test d a'c heret1
I
City �of Tigard
i
INSPECTION REQUEST
for
INSPECTION "TIME' PERMIT NC. :
DATE: Lr -1Z.3 DATE ISSUED : i L__
OWNERS NAME : - --
A
ME : — __
CONTRACTOR : /�—Z.;)�C,
TE ST : Air IJ, Water p , V:sual )(, 1_a boratory o
RESULT: Aporoved)e, :?isapproved G Per'4ing p
SKETCH.'
r
I SPECTOR DATE
NOTE: Attach supplemental teat data Hereto]
i
I
City of Tigard
INSPECTION REQUEST
f c r-
lop
INSPECTION TIME : _. PERMIT Nd. : —__
DATE : / / DATE ISSUED : i
OWNERS NAME '.
ADDRESS : _
CONTRACTnR : I5-q40EST '. ':surer , v:suai 11, Laboratory
RESULT: Aporoved )lisupproval ❑ , 17endhiq p
SKETCH.*
7S
INSPECTOR DATE
_NOTE: Attach supplemental test data beret a]
1
N&IIAV qW 41F
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PLUMBTNG PERMIT APPLICATION
Ji.risdiction of
0. Type Type of Fixture Fee PerTiit No. _]3 -
Permit fee ,_
d: WinWater Closets ('1'oi.lets J Pemit Issued- 7-fib.
Doth Tubs Approved by
a'r or as as � Building Perm 17S'h ����
ower Receipt Nu. �+laz
-Tcs �Dishwas En_ _
In s tchen
sinks. r riarXLoc*t�n of B��dinf /
--sinks, r d -------
Si.nks, o� �
4,LLL1___e
u t oma U c Lti s—iw—a-.-
s p osla_
--Laundry �1`ra_s Name & AddrE is of Owner
raiais Floort 2A
_
ra ns. Area -
ains let
'ra or
�tPa �L 3
ria n Dratns -- -c- -
utoma �c-WasFer Name & Addres of Plumber
7oun_Ta7.'ns 17-nen
tains Soda
_ of Waler Ta ik o
Water Cervice 'S ie , -I ' -- _.._.
Urinals Bui Old or Alter. Repair or
a c a sin s-- aY-Trc a _ ------
a.wn r i ers em _ v .�✓r_u �1 .t'—^
Pool b Fier - �--'-
a rj.nkl erSys- em -- -
This permit becomes null and voiu if work or construction authorized is not
commenced within 60 days, or if construction or work is suspended or abandoned
for a period of 120 days at any time after work is commenced.
All plumb tng firms must be licensed by the City of Tigard and past a $1.,000 bond.
I hereby certify that I have read and examined this application ,mid know the same
�o be true and correct. All provisions of laws and ordinances governing this type
of work will be complied with whether specified herein cr not, the grar_ting of a
permit does not presume to give authority to violate or cancel the provisions
of any other state or local law regulating construction or the performance of
construction.
d6ac.L
Sif,—at Applicant "T'
i
City of Tigard
INSPLCTiON REQUEST
for
9G a,-i��,�/'�o-✓
INSPECTION TIME: /L,fe22 PERMIT NO. :--
DATE:
C :—_DATE: 6 R-2/73 DATE ISSOEU :__L..L,_
OWNERS NAME :7" (2 _
ADDRESS: . 73
CONTRACTOR
TEST : ,�:i Wsite`r 1 , V:sual !J , L.abora4ory p
RESULT' Apnroved Disapproved 0 , Pend,nq CJ
SKETCH;
I PE(J'TOR DATE
_NOTE Attach suvpieme-Ital tort dn'c lip,reto�
CITY OF TIGARD
12420 S. 'N• Main SOW
TIGARD, ORaLON ""3
APPLICATION FOR BUILDING PERMIT
New Construction ❑X Demolish ❑ Addition ❑ Remodel ❑ Move Ll
ZONING M= P-D DATE ISSUED 6 15.73 _ BUILDING PERMIT
4_30„73 BUILDING FEE $ 77-UO
No.
DATE RECEIVED
PLAN CHECK $ 10.00
By _F�_ VALUATION $ 20,278
OTHER $ RECEIPT No. SC.yJ
TOTAL $ A7.rci R - -&
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
CENSUS TRACT W-8 JOB N
LOT A_73 MAP M 231 1M
Architect or Engineer -----
Address_ 15 S.W. 116th ve. Tigard O�yBon _-LPhone-r_ _ -------
owner
Address _ .--Phone-
Builder
—_Phone-Builder
Addreus Phone__`- _
BUILDING USE Single Res. o Multi Res. ❑ Comm. ❑ Industrial ❑
OCCUPANT:'! GROUP I No. of Stories 1 Total Height 17'_ Area of Lot-VW—
Type
ot 00 _Type of Consu action 0-m-WWWWWbuda V Floor Area B 1jj%?§ - Z
Set Backs: Front 15 Backs_ L.Side 2p—, R.:,'!, a 10
Private Sewer Pipe Size 4" Sewer usa,29= Septic Tank ❑
water Service Pipe Size 4" Storm Sewer c❑ aitch ❑ Drywell ❑
Street and Curb Requirements_ axLatiu8 -----_ -- ---
Driveway Width 186 _ -yNo. of Parking Spaces 2
SEPARATE•. PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDRESS ASSIGNED 15940 S.N. Century Oak Dr.
FIELD CHECK BY, _ �. __M DATE 6-
A5-7;
PERMIT APPROVED By
It :s understood that all work w`.11 conform with applicable codles an ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building wil:
not be occupied until a Certificate of. Occupancy has been ia,suedft-he City of
'Tigard B-iiding Inspector. -
Sxgnature o� pplicant