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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4 i i3
Type of I nspLction _ .f j ' -- —
Date R quested _ Time_ A.M.—P.M.
Addrer.s — -5 44' 6z2,0 OA A Permit
Owner fiJ2 J6.1/1Lot #
BuilderQ —.._—
The following uilding Crae deficien s are required to be corrected:
Presented to __ _ �pproved
Inspector - J Disapproved
Date --
"ALL H'O REINSPECTION
❑ YES 0 NO
CITY OF
TIFA
RD
�IJII_.D] . : RI 91:T
CIT AIM PERMIT NO . F3UE3912A2
COMMUNITY DEVELOPMENT DEPARTMFNT OfE00N
13125 S W.Hell Blvd.P.O,Dox 23397,Tigard,Oregon 97223,(503)639-4175 I:)A TE:: T S SLJE:D: f.E/ :1./(19
JOW AD014ESS : 1()22,5 SW HI IO(7KSIDE. PI...
TAX MAP/L..O1' r S1.r EIB8J.G Sub : L'T' : BK :
LAND USE: RA .5
SIZE:: VAI...UAI'I(3N: lli 200 5E'Tk3AC:KS
FRONT : RE::AR:
WORK CLASS : AL'TC'RATION DWELL.UNITS : LEFT : RJ,. yI+T :
USE: I'YPE: : SINGI...E: FAMII...Y NO. BEDROOMS : I:::X'l .WAI...i... C:ONL-i'T' :
(:ONS1' . 1'YPE: : VN NO. I THS : N: S : IK : W
OC OUP .('.,RP. : R3 PIPUT . OPE:N:I:NGS :
O('('UP.LOAD N: S : E W
10'TAL.. AREA: :1.96
NO. STORIES : 1 1E.y'T' : GKA3F (::ONG T• : C FIRE. 1-
2E'T"7
HE.:1 GHl* : 1.2 2ND: ARE A SE::PAP? RATED:
BASEMEN-1-7 :3RD: (3C:(:IJP. SE::PAF27 RATED:
MEZZANINE'? BASEM"T
FLOOR I...OAD . F IRE". 5:PRKI-1:4'7 ALARM?
F LOW t CPM DE'T'EC:T7
—.
'I...AN (:34FI:K BY : 1:)Q r
REMARKS :
Add rtiof •t,r) exi.1nti.nyl iiiih 1d REISSUE OF NO.
I...AST REISSUE-
FEES :
EISSUEFEES :
W 9.1.a.kE:a:l.y L'--.dgatr PE1:1MI'T 1111.0 . ()(1
N
E :LU".'c'.:'.'► viw Elronk%i.de F:1I PLAN REVIEW *6. '5()
R t.igard or 97223 F:I:RE DEPT
I+K)NE ( °103) 6,39-3789 S'TA'TE: TAX is 5
UTHE P
C
O 1)FVE:L.L)PME'N'T CHAPGES :
N '.SDC:(S'T'ORM)
TSDC:I S TRE:E'T'1
R
A PI:)C:( 1
T PPEPAID < >
O
N
--. TOTAL: $17 .00
This permit is issued subject to the regulations contained in Title 14 RE:L"E:I131' NO.
of the TMC, State of Oregon Specialty Codes,zoning regulations --•--•-•—»-----•-••»-••—-,• ••—» •._..•.__
and all other applicable codes and ordinances, and it Is hereby REQU-IRED INSPE:CI'10145
agreed that the work will be done in accordance with the plans and FRAM T:NG
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not walve restrictive FINAL..
covenants. Contractor and subs antractors shall have current city
business tax permits. This permit will expire and become null and
void If work Is not started within 180 days,or If work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Signature
Issued By -- _
rAL.1... FOR '1 t•Iril irl'ION 639-41,73
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
r ddress �0 x S $�W r t3lt4- `✓ A Permit No.1,�
Name of Occupant Permit charge_
A f r Connection fee
Paid by
_ Date connected 6 Ce.
Type of Buildinq -_Al. � '� _ Inspection fee f Q
L �
Service Rate• --- Paid by 144. ; Date
(( �� f --- ----
Contractor 2"( :}U"k Assessment Paid
Size of connection �k'�
APPLICATION FOR SEWER SERVICE
The undersigned agrees, in consideration of the sewer service connectir-n by the
Tigard Sanitary District, to abide by and comply with the ordinances, regulations and rules of the Dist-
rict presently in effect or hereinafter enacted and to pay sewer service charges as the same may be im-
posed from time to time when due and before such charges become delinquent.
I fully understand that all vii,aid sewer service charges become a lien upon the
property served as stipulated in O. R. S. 224.22C.
Connections to the District's sys'.em must be made by bonded contractors and,/or
bonded and licensed plumbers.
_ Owner-- _�---
APPROVED BY
Superintendent
TIGARD SANITARY DISTRICT
8841 S. W. Commercial St.
Tigard, Oregon
PERMIT TO CONNECT
Tia,a rd
PERMIT N? 69694 DATE
PERMIT IS GIVEN TO .,_ .,," ,'
,r
TO CONNECT A '�� •.. a.TY
TO THE SYSTEM OF TIGAR•D SANITARY DISTRICT
AT /a `.S.kAj- �.jvt -�r �'�.. G j.J_k'._t� t'.� �1-• G
THIS PERMIT MUST BE POSTED ON THE PREMISES UNTIL CON-
NECTION IS MADE AND IN14PECTION OF CONNECTION HAS BEEN CI►AI-
PLETED.
d
PERMIT FEE PAID $........�......................TIGARD SANITART DISTRICT
By rit—
CONNECTION INSPECTED AND APPROVED
Date � �� p"tendent �_