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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Ph o : 6394171
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Type of Inspection
Date Requested Time --Time P.M.
Address _� 1 - -t
Pa mit
Owner -- —_ _.� Lot #
Builder
The following Building Code deficiencies are required to be corre;ted:
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Presented ton�Approved
Inspector r — XI llisapproved
n
Date
CALL ft R INSPECTION
YHt ❑ NO l
Building Permit No.
Locatiqn
Certification of Regis-
.ration
With the Builders L%;,ard
I, -T M_ MILC-CK 6((�R . ,ging business as (dba) ,
_-in 0 ,U I nC/ am registered under the provisions
of ORS Chapter 701 Oregon ,'lomebuilders Law) .
fly Builders Board Registration Number is 4
My registration is in M1 'orce and effect and expires on
Signature _ _
So 1.'L,
BUILDING PERMITAPPLICATIONTIGAaD DnrE_ t9-q7kk
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN IND ATED BUILDER PHONE
OR AJS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _
O'llNER�— '
LOT
JOB ADDRESS
ARCHITECT
ENGINEER Z
BU1LCER _ ADDRESS DESIGNER
ST", tCTU'l — NEW- Cl REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL Cl FIRE DAMAGE ❑ DFMOLITIOI,
P£SIL, VCE ❑COCOMMM ❑ EDUCATIONAL ClGOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ClGARAGE ❑ STORAGE ❑ SLAB❑ FENCI
LAND USE Z014E �-? f'D_BLOG.TYPE — & FIRE ZONE_-T -PLAN CHECK BY _Ly_k!HEAT` � _
SFWER PERMIT M 74/4�_-- --- —__—� 7`, ��?• --` -
OCC.LOAD FLOOR LOAD HEIGHTNO.STORIES Z AREA f NO.BEDROOMS VALUk Q�7�1
BUILDING DEPARTMENT
SETBACKS FRONT l � REAR LEFT SI DE RIGHT SIDE
_ _ ----
1'-rmlt THIS PERMIT IS ISSUED SUBJECT TO THE REGUL ,TIONS CONTA,..ED IN THE BUILDING CODE,701,W4,
^ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THI
[Plan Check i�y WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPL1ANC'
/ WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV'
RESTRICTIVE COVENANTS. CONTNACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY HUSI`:E''
;lath Tai/
A G LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
--
1 otal SDC r ._���� � q
PDC# APPLICANT OR AGENT
By
- - Receipt No.
ADDRESS — -!`- PHONE -
el
SOC - �� ��� ,By ! U V
PDC 5 o
SEWER CONNECTION _
SEWER INSPECTION
SEWER SURCHARGE S /
so .
BUILDING PERMIT APPLICATION TIGARD DATE_�j�smber 13 ,19 84 5022
THE UNDERSIGNED HEREB"APPLIES FOR A PF.11MIT FOR THE WORK HEREIP•, INDICATED BUILDER PHONE Uu!m 10
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANII SPECIF!CATiONS OWNER PHONE
LOT N0. 93r—
OWNER •ems 1L1.11talr_- JOB ADDRESS 16435 Sia (:oar Creek 1JIr. Mr Creek
ARCHITECT
BUILDER ADDRESS ..: . ENGINEEP
_, DESIGNER
STRUCTURE EINEW ❑ REMODEL ❑ ADDITION ❑ REPAIR_ 11-4ENEWAL _ ❑ FIRE DAMAGE ❑_DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T C_l RELIGIOUS i_7_P,,FIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABL:1 FENCE
OCCUPANCYK-3 _ LAND USE ZONE _R"7pU BLDG.TYPE _�(`__FIRE LONE F LAN CHECK BY _! HEAT
Construct single family dwellitn w/attached garage.
3 bathroom 3 bedroom
SEWER PERMIT# 27y00 Garage 630
OCC.LOAD I•LOOR LOAD _4U HEIGHT 20 NO.STORIES ' AREA 1531 NO.BEDROOMS 3 VALUE 56mWd•
BUILDING DEPARTMENT SETBACKS FRONT_ 1,) REAR 7 LEFT SIDE I RIGHT SIDE 12
Permit 30 I.Uu THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 195.€.i WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
Sub-total 496*65 WITH 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 12,04LICENSE.SEPARATf PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC—
total _5Uh.h9
BY C6 PDC# �5 i[tt/ APPL NT OR AGENT ,
--- 5 04J
Approved Recelpt No. ,.�t,Ali3 _
__,ETW ADDRESS —�--- --- — PHONE
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BATE IINSP. TYPE INSPECTION REMARKS PLUMBING DATr; `
��• Contract
Permit No. t �t�,K-3v,
Fixture - --
/� Final - -- —
A LrQ, � HEATING
ll``--�-� --- _�COnRBCt � � �CJ•
L1��%' - — J �• Permit No. 3
or Oil
'Rni,nh
- SEWE17 0
Fra!
— ---- ,—_DRIVEWAY -
------ -- Srorrti Drainage - -
j(Hain Drs nl Final
Sidewalk
Curb&Street Final
— Approach —
ki:DG. DEPT. FINAL � CERTIFICATE OCCUPANCY -
CERTIriCATE OCCUPANCY Fii inel
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_ - —' - Zoning Fina!
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