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INSPLCTIC"i NOTICE
City of Tivard Building Department
12420 S.W. Main St.
Tigdrd, Oregon 97223
Phone 639-4171
Typr of Inspection
7_
Date Requested � Time _ —_ _P.M.
Address Permit
Owner----- 17v`��'�/� Lot #__
i
Builder
The following Building Code deficiencies are required to be .orrected:
Presented toC — Approved
Inspector i
_JL — — — Disapproved_5 `
Date
i
CALL, FOR REWSPEC??OW i
❑ YES V�NO
I
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time- A.M. P.M.
Address X/
ZIAIL�/G 4--Permit
Owner Lot
Builder &14
The following Building Code deficiencil are required to be corrected:
ems.-
Presorted to Approyea
Inspector Disapproved
Date
CA,",T, FOR RENSPECTION
0 YES L1 NO
CITYOF TIOARD No. 1411
12755 S.W. ASH
P-0-BOX 23391
'ItiARD,OR 97223 Date1�1Z"
Lc.
Block/M,
SubdivisianlAddress
Permit M's Bldg. Plumb �` C^
Cash Check o
Sewer — �`— Othe"
Other Rec. B
Acct, No. Description
10.432 Building Permit Fees — Amount
10.431.800 Plumbing Permit Fees — G
10.431.601 Mechanical Permit Fees
10.230•b01 State Bldp. ;n�
10 433 Plans Chock Fee
10.435_ Other Licenses 8 Permits— Uu
30.443 Sewer ronnect!on -- --
30-444 Sewer InADection —
24-448 _ Street�_Dev. Charge
25.449.610 Parks I S�Dev. Charge _ D
25.449-620 Parks 11 Syst Dev. Charge ----
31.450 Storm Orainsge Syst. Dev. Charge U
10.430 Business Tax
10.434 Alarm Permit
10.227 Ball_
10.455 Fines -TrafficlMisdlParking
10.230• — CPTA TratfJc/Misd/Vic. Asst.
10.456 Indigent Defense -
30-446-,01 Sewer Defense
30.446.402 Sewer Service/City —
31.447 Storm Drainage
40.475 Bancroft Prin, Pymt.
4_0.471Bancroft Int. P
10.451 Other Charges for Services
TOTAL
DEPT.
BUILDING PERMIT APPLICATION TIGARD DATE.-1"aC*WWr 11 18�, 5120
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREI V INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _.
LOTNO. 46 -_._—__—_
OWNER al Mi11#Y JOBADDRESS 7961 SW Chuv:hill Way _ Road Paris 11
ARCHITECT
ms GNGINCCR
BUILDER Sa
ADDRESS il.b._Box 2319 1 DESIGr R
STRUCTURE D(NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWA_L 1 1 F_IREDAMAGE ❑ DEMOLITION '
11 RLMDENCE f_] COMM L.I EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE i.? STORAGE ❑ SLAB -1 FEN_G.
OCCUPANCY =1 LAND USE ZONE — !!�R BLDG.TYPE_i 51*IRE ZONE---PLAN CHECK BY —IP'_HEAT__1:>r►►+i
Wnstruct single_fsmily avellin w/attached garage.
— RE-Issue of Permit 0474U See Lot Line Adjesttment
3 "throo9m 3 bed;oom `--�
SEWER PERMIT# 28212 _-`;arap 449
OCC.LOAD FLOOR LOAD 413 HEIGHT 21 NO.STORIES 2 AREA 1748 NO.BEDROOMS VALUb9*000.
BUILDING DEPARTMENT SETBACKS FRONT j(? REAR 69, LEFT SIDE 5 RIGHT SIDE j
Permit 340.00 1 THIS PERMIT IS ISSUED SUBJECT TO T;�!-: REGULATIONS CONTAINED IN THE BUILDING CODE. ;CONING
REGULATIONS AND ALL APPLICABLE CODES ANG ORDINANCE,, AND IT IS HEREBY AGREED THAT THE
Plan Check 4U.UC% WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMP'_IANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub total _ 38U.0(a PIESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUiINF.SS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWF A,PLUMBING AND HEATING.
State Tax - 13.6U LICENSE.
Total 93.6u
SDC—
— Z 1 150.00 TOR
PDC# APPLICANA�--
by t:c ..550: 250.(►U
Approved ,� E,Tk - - Receipt No. I( ADDRESS --— - PHONE -
IWMIFALM
E, 11 NSP. TYPE INSPECTION REMARKS PLUMBING DATE
Cnn
rector q
A-A Jj A. Final
4—
HEATING
%�JG - --!�!%tl� JL _� __ ---- - C-).'t-actur
Pe
--mum -Ila 17!11_N_O. 6?,e2—:IN
Gas o-f,.1
Rough
F,nal
SEWER
DRIVEWAY
Fin:.l
Storm D,vinagr
(Pain Drain)Final
Sidewalk
'Curb&Street F;; I
Approach
EILD.G. 0 MAL-- _T_ TEMPORARY T CERTIFICATE' OCCUPANCY__�__,
CERTIFICATE OCCUPANCY Final
j,Lands--aping
AZonir•. Final