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INSPECTIGN NGTIC�
City of Tigard Buildint7 Department
1242C S.W.Me n St.
C Tigard,Oregon 97223
Phone: 839-4171
Type of Inspection
Date Requested -J�a Time A.M. P.M.
Address �,_ — ,� _ "cam �-!} _ Permit #--y�—
Owner -----w•._ _ Lot #. 27
CBuiider
The following Building C(Av deficiencies; are required to be corrected:-
- ----- _ ---- —
r
Prese-ited to `� Approved
Inspector jj4' _ `- _ __. I Disi pproved
Date �- �� {
CALL I%'OR REINSPECTIO 1
� YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested ;2 Time--4K— A.M. P.M.
Address Permit '11112—
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to
EJ Approved
Inspector Disapproved
Date 3 -r
CALL FOR REINSPECTION
G� YES F-1 NO
VENDOR
ADDRESS -"
CITY, STATE, ZIP M—'- C'NOF TWA RD
DATE P.O. # V
WASHINGTOrJ COUP41Y ORF('�ON
CHECK ONE: I have received the following. Please make REQUISITION
payment. (Forward to Accounting.)
Received:
Date Initials '-
I have ordered the following. Please issue OTHER INFORMATION:+ .�
a confirming purchase order. (Forward to
QAdministrative Secretary.)
I have researched the following. Please
issue a Purchase Order. (Forward to
Administrative Secretary,.)
I want to buy the following. Please research.
Return price information to this office.
(Forward to Administrative Secretary.)
ACCOUNT # QUANTITY DESCRIPTION (Please explain thoroughly) UNIT PRICE TOTAL PRICE
;gPo a
TOTAL AMOUNT DUE $
DEPARTMENT HEAD APPROVAL:
FINANCE DIRECTOR APPROVAL:
(for 600 Accounts over $2,500, and all 700 accounts
DISTRIBUTION: White - Pur. Coord. or Accounting
Yellow- Department Copy
Y, f4jechaulical Permit NO.
Now Ins.tallafioll Replacu U lloluc�tloll Additimi Alteration rl DAIT:
HC-AT1146
CONTRACTOR ! OWNE11...
I-Icat Input liatinu(BTU Pel Floud Vent Size —,!4�- vv.,� si,
Furm Oil-Ll GAS E:t-LCrl-1 01HER . ......
ITENI -ENq. HE NO. FEE
Fear lr,sLlince of Permit SEE 13ELOW Each X- l-, Unit or Duct Systern 7.50
qjf,w-Lqjc��A 6.00 Cor17 7.50_
uvt!r
021!,Llj�,LLA V)I 1, Fpch 4.50
)Jew
Woodburnlnq_§tovo 4504.50
Wall-Floor- Surponfled sor up & Ind.3 T 6*06
X(Ai !_gVt(, For.
3.1 to 15.H.P. 11.00
Re it jlei!CqoljM____.
CITY BUSINESS LJCEIIISE.jlEQ ALU 6Y AU- LUlq I kAL 10145 OR SU13-CONTFIACTOF45
KES
WO-TOTA-1.
% STAT*r:._ Issued Lly
�7.oq
BUILDING PERMIT APPLICATION TIGARD DATE.-- 2,3'1982_. 4112
THE UNDERSIGNED HEREBY APPLIE`-. FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE 645-4C 37_
OR AS SHOWN AND AFPROVED IN THE ACCOMPANYING PANS AND SPECIFICATIONS OWNER PHONE_.-._.g' ` �.
LOT NO. __-g9-
OWNERS.W.
3 ti JOB ADDRESS 13225 . . Genesis
Lata,:A7i=k 4�II�-d
-�W.--..__-- --_--ARCHITECT --
ENGINF,ER
BUILDER `' ADDRESS _ DESIGNER
STRUCTURE EX NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGF ❑ DEMOLITION
IM RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT O GARAGE ❑ STORAGE_ ❑ SLAB FENCE
OCCUPANCY �"3 LAND USE ZONE R-7 BLDG.TYPE- N FIRE ZONE PLAN CHECK BY - HEAT 4" '
ometruat sLagla family amlliaq all per plans a ockle rWquiralaantm
—- >PltmllbLng a Nechaniaal permits requLred
SEWER PERMIT 0 2333 ftza" 460 IYq. ft.
OCC.LOAD FLOOR LOAD __ HEIGHT 21 NO.STORIES 2 AREA 2182 NO.BEDROOMS _— VALUE 82.000
BUILDING DEPARTMENT SET BACKS FRONT 20 FEAR 361 LEFT SIDE 16' RIGHT SIDE is,
Permit _ 00
THIS PERMIT 18 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
246.3 REGULATIONS AND ALL APPLICABLE, CODES AND ORDINANCES, AND IT IS HEREBY AGREED 1 HAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE. PLANS AND SPECIFICATIONS AND IN r,OMPLIANCE
625'.35 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
S.:b•total_ RESTRICTIVE COVENANTS. COP'TRACTOR AND SUB CONTRACTORS TO H!WE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 25.41
SDC- 4 0.(7()
Total 650.36
PDC# ., 140^0O APPLICANT ORAaENt
By
Approved _� M� Receipt No. ADDRESS - — — ----PHONE
A
DATE INSP.i TYPE INSPECTION REMARKS PLUMBING DATE
Contractor , ,. _- 3L
"Zi
Permit No. 1� („ w6
Rough-in
��Ji Fixture
Ff ��. cfGli Z Final
--
�_�' `� Y Contractor
Permit No.
8,"*lr OII
Rough-in
-- � Final _
--- SEWER
— ----- Final
DRIVEWAY
Final
Storm Drainage
Main Ornin)Final
Sidewalk
Curb k Street Final
__ Appreech ------
BLDG. D4PT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Lendu.,,ping
Zonina Final
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