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INSPECTION NOTICE
,ity of Tigard Building Department
12420 S.W. Mair,St.
Tigard,Oregon 9722.3
Phone: 639-4171
Type of Inspection _ xy-
Date Requested /��— `� _c-�3 _ Time. 1—A.M. P.M.
Address � '� '�_ �, <;�_ cs�c� Permit
Owner — . - - — _ Lot
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BuilderThe tollowing Building Code deficiencies are required to be corrected-
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Presented to /Approved
Inspector --_ --- I LJ Disapproved
Date
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CALL FOR REINSPECTION
❑ YES /NO j
BUILDING F LWIT APPLICATION TI"RD GATE--�e,l,taw r L tis " 4605
THE(INDERS1 J!,I D HEREBY APPLIES FOR A PERMIT FOR 1HL WORK HEREIN INUICATFD BUILDER PHONE 2 7-14Qa
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFWATIONS. OWNER PHONE
OWNER Cer.tliry 41 Ho•witOBADDRESS 1333S SN Rrittany_0r. _ _ Jc)b 28,9 _
�— — ARCHITECT
ENGINEER
BUILDER _� _ _ ADDRESS_. 7412 SW Bvt. till, Hyy,DESIGNER — —_ ----1
STRUCTURE CI NEW ❑ REMODEL L7 ADDITION C1 REPAIR ❑ RENEWAL LJ FIRE DAMAGE ❑ DEMOLITIq_q
1-3 RESIDENCE ❑ COMM C] EDUCATION<L 1-1 G_OWT ❑ RELIGIOUS ❑ PATIO_O CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY .—..---:- ' .LAND USE ZONE _T11 _BLDG.TYPE =4I�__.FIRE 7_ONEA PLAN CHECK BY 1'+} HEAT,�'j_
��_anstruct `AnE;l�t Fa%il�r Owelling W/21ttddhed Lara ge. — _ -----
SEWER PERMIT# 2t,43364
OCO.LOAD FLOOR LOAD 4i --HEIGHT 20+ NO.STORIES 2 AREA 12 ' NO.BEDROOMS VALUE
-- --- ---- —
BUILDING DEPARTMENT SET BACKS FRONT REAF LEFT SIDE RIGHT SIDE '
--- a,4.
Permit w9,k 000 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 1 ff4,• WORK WILL BE DONE IN ACCORDANCE WITH THE PLAN£ AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE 1!;SUANCE OF THIS PERMIT DOTS NOT WAIVE
Subtotal_ 4H 1,c;0 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTaACTURS TO HAVE CURRENT CITY BUSINESS
�— LICENSE.SEPARATE PERMITS REOWRED FOR SEWER,PLUTABING AND HEATING.
State Tax 1 1,fr%.
Total 41'3.41' SDG—
— PDCM APPLICANT OR AGENT
By
Approved
4 Receipt No. ADDFl[SS - — -- ------ -- PHONE
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DAT 11P INSP. TYPE INSPECTION REMARKS PLUMBING DATE
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