11540 SW GLENWOOD COURT-1 11540 SW GLENWDOD COURT
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City of Tigard
NSPECTION REQUEST
for
PERMIT NO. :_ —
DATE: —6-L7'76 DATE ISSURD ._ . I Z
OWNERS NAME :
ADD R E S S
CONTRACTOR : - ' `-` s-------
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RESUI-T: Approvsd')� , Disapproved ❑ Pending Ll i
SKETCH, ��2trt4 a4 np
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INSPECTOR DATE
City of Tigard
for
INSPECTION TIME: �r'Z .. PERMIT 1-40,
DATE : DATE IS°Ur.t)
OWNERS NAME :
ADDRESS:
CONTRACTOR
TE ST : Air Cj, Woter [J , visual L9 , L,)'
"ESl1LTApproved giinpproved
SKETCH;
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CITY 0P 33
26 7C NP 07.
BUILDING PERMIT APPLICATION TIG�4RD DA,rE— 19
THE UNDERSIGN,'D HEREBY APPLIES FOP. APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE
,mith . �5,,+J ., . :jjunwoud Ct, 297 -,L71b
YNER ADDRESS BUILLER PHONE
Bub Smith guilders ENGINEER �r
$L�LDER _ �iITE�T DESICNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIREnAMAGE ❑DEMr-01L.ItION
ORESIDENCE ❑COI, ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑FAT10 LICARPORT ❑GARAGE ❑STORAGE❑SLAB CFENCE
❑BOND ❑MOVING ❑C:ONDITIONAL USL ❑_DESIGN REVIEW _ ❑COUNCIL APPROVED ❑SIGNS _
OCCUt6NCY I LAND USF ZONE--.BLDG.TYPE 9� FIRE ZONE—i PIAN CHECK BY_ It HEAT_.
To construct ono '.uryr frame dw alling wi th dayll.ght basement, incluu
attached garage according to approved plans.
vs,a
ss o. mss, d bedroom -
OCC.LOAD FLOOR LOAD HEIGHT _ NO,STORIES AREA VALUE
1
BUILDING DEPARTMENT SET BACKS FRONT REAR :�2 LEFT SIDE 1RIGHT SIDE
Per it ---1-.t".'
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Cherk REGULATIONS AND ALL APPLICABLE CODES ANn ORDINANCES, AND IT IC 4EREBY AGREED THAT THE
WORK.WILL RE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording All APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-" RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE C09RENT CITY BUSINESS
�96State ' a LICENSE SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total G 5 ' • '`
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By
------- -- APPLICANT OR AGENT
Approved Receipt No
-- ADURESS -
V
DATE INSP. Trk INSPECTION REMARKS PLUMBING DATE
Contractor
r'etrnit No. o511 33 �!17
1442 Rough in
.2 L-L Fixture
Final
4-7 1?
1- 76 HEATING
6) Contractor
Permit No.
Gas or Oil al
Rough-in
Final
---SEWER,-/
Final
DRIVEWAY, -,2-,
.11
-Final
S,ormDrainage
(Rain Drainj Final
Sidewalk 4
Curb&Street Final
Approach 6
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
A CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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ADDRESS PERMIT N0._
_ PERMU CHARGE none
OUNER M CONNECTION FEE
PAID BY __� .•— ..___._.._
TYPE OF BUILDING ;st <. DATE CONNECTED
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SERVICE RATE _ INSPECTION FEES
CONTRACTOR :y`-� -- ,� -�-� PAID 0Y _.. DATE
SIZE OF CONNECTION `{� ASSESSMENT PAID
'7 - 11
ILA
'41 / :� ��
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