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INSPECTION NOTICE
City of Tigard Building Department
{
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171 1
Type of Inspection
Date Requested_ �%�� Time_ A.M._ P.M.
Address _ t7_Q Gl. G.— Permit
Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to - _ L] Approved
Inspector +� 'I _ �7131eepproved
Date
CALL FOR REINSPECTION
/ ] YES ❑ NO
I
f INSPECT-ION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
[ T PF a 639-4171
Type of Inspection
Date Recuested Time -- A.M. P.M.
/ r f 1 � -
Address �.L-1�:\ j � Permit
')wner__— Lot $p
guilder
The following Building Code deficiencies are required to be corrected:
I
Presented to
_ Approved
Inspector I Disapproved
Date
CALL FOR REINSPECTION
[� YES NO
1
BIJILDI:IG PER MITAPPLICATION TIGARD DATE- )b ^ •g LIL 4839 1
r E UNDERSIGNED HEREPY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
tLOT N0._�
_ i y
OWNER Jay Miller JOB ADDRESS 774U SW l;und ; . fivGtU Parer. T
ARCHITECT
ENGINEER
BUILDER same —ADDRESS SQL J}px 2�2y I _�� DESIGNER W — _�y�
STRUCTURE El NEW 0 REMODEL ❑ ADDITION A❑ REPAIR G RENEWAL O FIRE DAMAGE ❑ DEMOLITION
19 RESIDENCE ❑ COMM Cl EDUCATIONAL U, GOVT ❑ RELIGIOUS L PATIO ❑ CARPORT IJ GARAGE L] STORAGE ❑ SLABCi FENCE
OCCUPANCY--t_3 _ LAND USE ZONE >R-12 BLDG.TYPE) + FIRE.ZONE —PLAN CHECK BY AC F• HEAT
_ Gu_1U-t- J t_ it • tjj�,,ily dyellijA;z wl ittacheu Ii•� _
_ne-Issue YE Ptr alt d/i136 ------ter—feu 3 Math __�
SEWER PERMITN 2.6536 _ �..era�e 4 J 7
OCC.LOAD FLOOR LOAD 4-) HEIGHT I'/ NO.STORIES AREA lit NO BEDROOMS 4 VALU=
r� BUILDING DEPARTMENT SETBACKS FRONT o„Nw► REAR LEFT SIDE RIGHT SIDE
�ermit 355,1)U THIS PERMIT IS ISSUED SUBJECT TO THE REGULA-IONS CONTAINED IN THE BJILDING CODE. ZONING !
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND ITIS HFREdY AGREED 1 HAT THE
Plan Check 4U.L►l) WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 3g5.U0 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
i4.?L) LICENSE.SEPARATE PERMITS;,FOUIRED FOR SEWER,PLiIMBING AND HEATING
State Tax
SDC— ,�U�).,a, _
Total '�►�)'e•1t) tl 15u.UU (�--
PDCM APPLICANT OR AGENT —
By L' t 25Uaflu
Recelpt No.
Approved Bird I ADDRF83 � � PHONE
DATE INSP. TYPIC INSPECTION REMARKS PLOMAIN 3 r � I p/r,Tt —
Perinit NO,
Fmal
all HfiAlIt%C
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BLDG. •1..' t L IEWUNARY CffRTIRICATE OCCUPANCY
CER?IFICATE OCCrIPANCY Final
Land.-:•,�„p
'Zoning Final