12570 SW GLACIER LILY CIRCLE-1 AMJM
12570 SW GLACIER LILY CIRCLE
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- INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
T;gaud,Oregon 97223
R one: 639-,171
Type of Inspection
i
Date Requested _ � ��G- A.M. P.M.
AddPAddress _–� ✓ Permit #
/J. �/ -
OwnerLot # _—
I
j Builder
The following Bedding Codc tlefi•ciencies are required to be corrected:
i
--T- -- -
Presented to - — Approvee
Inspector
Disapproved
Date
CALL FOR REINSPPCTION
YES 0 NO
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WILDING DEPARTMENT, TIGARD �D
PLUMBING PERMIT
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
"i iLard. Such installations require inspection by the City inspector who shall be notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required •
for all contractors and sub-contt actors.
Job
iawner��lq�JcF�•4r'� prr,+�'J _- --_ Address c. � Ali
X? t Dat
NUMBER OF TOTAL ±
TYPE OF PERMIT MIMS FEE ON EACH AMOUNT I
FL€;3�EBMIA 1_ I
Sing!•Family-1 bath—each _—' / _ _ l 25.00
Oupl.tx -Fath 1 bath unit — 2g•00 �� ;i1;=•
Additional bathrooms—each �� 10.00
15.00
INDIVIDUAL F I X T U R E IiC B r'1 P i E I 1 C_1 F1
t to 50 Fixtures In 1 building—tach +� 3.00
51 to 100 Fixtureetin 1 bulldin -tach_ _ - — 2.50--
10 1
.50101 to 229—F Lx—lures In 1 buitdirn each 2.00
_201 or more Fixtures in 1 bulldinj,tach _- Y _— 1.50 -- •--
MISCEL1LANEOUS
Sewer—each additional 100 It. r _ ^—�10.00 — ~-
WatRr Service to bulldin _ / 6.00
Other (3 stir )•
_PERMIT _ •D O For Plumbing Inspection Phone 639.4171
State / G D Plumbing Contractor By
T •G�'
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INSPECTION NOTICE f
City :4 Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639-4171
Address �.�.��,;�i—�. .. �, �_ Permit
T•ipe of Inspection
The following Buil&ng Code deficiencies are required to be corrected: ____�y_:_x
t•
A
Presented :o —_ _ Inspector
Date ---'—
CAL L. FOR REIALSPEC77ON
0 YES [> NO
T0 Pertnit-___
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............
TOTAL.
tMATIr 4
CON FAA(""
T C)
Olt
p;1 a E
-At
H.:it input r mrig (BTU Per Hour)
Flu'. `I/L'
FLIFIL (JIL IF I G A'S II-r---ELECT 01111 P
I TE PA NO. IF r rf f r.1 No. FEE
�. :f: mi6vi; I , Il-f'
_0 OU
lo"",
100,00 L i-l' 11 F ove r i W!
5.00
2.00
V.
_ _ 3.0U_� y
tin 1, 3 1 If,
1000
INSPLCTOTS
CITY 13 U",16 11 I(JI'lSE Rr-oumrr) ref( AH C:01,JW.'V;I(W:; 0!, (:(,"i I H VWl!
APPRol/rD Ily DATE DATE
RECEIPT NO
714
Of Ap!)Iiurit
BUILDING PERM ITAPPLICATION TIGARD DATE_ ___ 19 3174
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND FPECIFICATIONS. OWNER PHONE
LOTNO.. Anyirt _
OWNER %)tllk 3 JOBADDRES_S 4.,i'u ,:jL! UlCALA.ki, Lliy Liii,1 Sumrror Lake
ARCHITECT
ENGINEER
BUILDER game ADDRESS 710,., SLI Srarldburg St. DESIGNER
STRUCTI-RE _M NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DANIAGF1_ W❑ DEMOLITION
E),RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT 0 GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY id-3 LAND USE ZONE �=71 U BLDG.TYPE aN FIRE ZONE--!—PLAN CHECK BY IN" HEAT-983 _
(;un trust single family dualling W/atteched garage. 3 bedtoams 2 Flatha.�
SEE I:QRRECTICIN !MEET ATTACII['D.
SEWER PERMIT k;:'jgQ ... 70,,,QL)
OCC.LOAD FLOOR LOAD 40 —HEIGHT 12 NO.STORIES 1 AREA 17`x` NO.BEDROOMS 3 VALUL64 000.
_ BUILDING DEPARTMENT SET BACKS FRONTO REAR LEFT SIDE 7 RIGHT SIDE
Permit 4i='•0a _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
1n7a0 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY A AREED THAT THE
.
Plan Check WORK WILL BE DONE IN ACCORDANCE NI i H THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH AL.I_ APPLICABLE CODES AND OREINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ X22•��� RESTRICTIVE COVENAt TS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS AQUI ,IDI 0 SEWER,PLUMBING AND HEATIIVG.
State Ta 4' 8,60 rtt f, it • G$?1 � 0 0(]
SDC - 400.PQ
Total3;3.1.•l U
PDC �0N .I. �1 •�Tr4PPLICANT OAG-EN
�— L•__. �.
By P1 R ,
-- -- - �LfH Receipt No. r _
Approved 7 ADDRENS PHONE
{
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
-.j✓ —' �G Permit No. of /, --�
Rough-In
Fixture —
Final
1%-- 1—fir plc!�_� —__--— — -
L«.� _ HEATING
// Contractor
Permit No. C Z 1p-�a y
— Gas or oil -- _--`_—.
Rough-in
Final
—� --- SEWER --- -----
��-- _--i Final
— DRIVEWAY W
Final
Storm Drainage
(Rain,Drain)Final
Sidevwlk
Curb&Street Final
Approach
—9:t G.D..PT.FINAL TEMPORARY CERTIFICATE OCCUP CY Fina,
CERTIFICATE OCCUPANCY c —
V / Landscaping
if Zoning Fin
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