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IN'PECT;ON NOTICE
Citv of Tigard Building Department 7
11420 S.W. Main St.
Ti-wd,Oregon 97223
Phone: 639.4171
Type of Inspection
Date Requested-__ ? 23 ` Tima A.M. _ P.M.
Addrass / C.Z_�/ ,� V .acy _Y.'�'� Permit
Owner ---_- -- ---_v— Lot
Builder
The following Building Code deficiencies are required to be corrected:
I
Presented to _ — � Approvru
Inspector _ 'A/l
- r �_ � Disapproved
Date
CALL FOR RE INSPECTln U
❑ YES 41 NO
BUILDING PERMIT APPLlCATIUN TIGARD DATE Je^r2U.'+ft�' 20 _ 19 1 4288
THL UNDERSIGNED HEREBY APPI...IES FOR A PERMIT FOR fHE WOF',!' HEREIN INDICATED BUILDER PHONE tai
CSR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
,-4 *)'-11. Co. LOTNO. 9 11111'.3OM0
OWNER i'1�1�T7.3 I>tlti'10:;11 ADDRESS liT`�?�1 7._. ",rant eo,irt; _- 7°C!7•rac+^_--
ARCHITECT
C,inco klnnlw s Inc. : ri ENtiril=K twrinan 6446-546f)
BUILDER - ADDRESS ST• 3 lox +14 � {f�.1.. _ Sit f_
STRUCTURE ( NEW CJ REMODEL rl enDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
L1 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAOK ❑_STORAGE ❑ SLAB❑ FENCE__
OCCUPANCY ! "' � LAND USE ZONE ---_BLDG.TYPE _.. FIRE ZONE PLAN CHE_CK BY HEAT Cast
(.'oristr.ict siagle fwWily i4011 ixt'T per. plans & code
le-iss*,io of ppra'ait i -)-wl We. )
SEWER PERMIT M r.
OCC.LOAD_ FLOOR LOAD y`' HEIGHT NO.STORIES ' AREA_ NG.BEDROOMS_I VALUE 4
FBUILDING DEPARTMENT SETBACKS FRONT r-%' REAR LEFT SIDE RIGHT SIDE
enII THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
2100 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANr II IS HEREBY AGREE..THAT 1HE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMrLIHNCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAiVE
Sub total _ ^_� 71.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 10124 LICENSE.SEPARATE PERMI I S REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC- '4(1C1
Total �� ' • ��
1 PDC# 1- 1 00.00 A-0-LZAN—TO R AGENT
By
Recelpf No
Approved t41a1 —v ;, J ADDRESS --PHONE —
DATC INSR TYPE INSPECTION
REMARKS
� - PLUMBING �3x. DATE
�6-- = -- _ Contractor
p
Permit No,
Rough-in Q
Fixture
CI•J � Final
HEATING
Contractor
Permit
No.
Gas or Oil
Final --
SEWER _ --
Final - /
I'IRIVEWAY
-- Final
-' Storm Dr einape
(Rain Drain)Finrsi
- — Sidewelk
--- i� i Curb&Street Final
^BLDG.DEPT. FINALTEMPORARY -- Approach _
IC'ERTI'ICATE OCCUPANCY CERTIFICATE OCCUPANCY
Anal
�L9ndsr -
- I �_ II 7.oninp Finel