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INSPECTION NOTICE
City of Tigard Building Departmer t
12420 S.IN.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection ITJ/ CzF h';
Date Requested/0�R& _ _ � Time_ A.M.3 J P.M.
Address Permit
Owner
#.----
- -- _
Owner ( Un �i '7�- y�, f C'�i C�-- Lot #__....
BuNder -----
The following Building Code deficiencies are required to be corrected:
Az-
Presented to _ Aplrroved
Inspector - 4111sapproved
Da'n �----- -- AC" `i f-"_:7 --
CALL FOR REINSPECTION
IT YES ❑ 140
is t�
SEWER PERMIT N 25414
fUnifled Sewerage Agency
�W
of Vl/ashlnrjton County CITY OF DAT E
�,A�
OWNER 4� '� 21./x. PHONE r to,�Iv --- 99C)
OWNER 'S ADDRESSr
TYPE OF INSTALLATIONS
❑ SIDE StWER ❑ LINE TAP AND SIDE SEWED ❑ LINE TAP
TYPE OF OCCUPANCYr
❑ NE ❑ EXISTING ` SINGLE FAMILY [] COMMERCIAL
JEXI.ST. ( PRIOR TO 7- 1-70 ) ❑ MULT. RES. / ❑ INDUSTRIAL
�T FIXTURE UNI DWELLING UNITS A r
ADDRESS OF STRUCTURE
Permit Gonditions: The applicant agrees to comply with all rultu and regulations of the Unified Sewerage Agency,
When calling for Insp!+ction, please refer to the Permit Number, The Application expires In one hundred twenty (120)
days. The amount paid will be forfeited should expiration occur.
The Agency oes not guarantee the accuracy of the location of side sewer laterals. If the sewer Is not located at
the measurement given, the Installer shall prospect three feet In all directions from the distance and depth given.
If not so located, the Installer shall purcnass a 'Tap and Side Sewer' Permit at the current charge and the Agency
will Install a lateral at the location specified by the Installer.
FEESr
PERMIT FEE
CONNECTION CHARGE
LINE TAP INSTALLATION r _
ISSUED BY
OTHER
OG-
TOTAL.
w
SEINER PERIM11' N1 26414
ADDRESS OF STRUCTURE
TAX MAP � � <! -D _ TAX LOT SYSTEM -*C.x-i
LOT BLOCK _ OF
A D 9Y DATE ISS 9Y AT
D. U . ' S �� REMARKS
f f
@UII_DING PERMIT APPLICATION TIGARD DATE _i r_��7_-_-,tg_;,;j 4554
TAE UNDERSIGNED HEREBY APPLIES FOR A PE14MIT FOR THE WORK HEREIN INDICATED BUILDER PHO"IEA � -.' %7
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPE�,r ICA I IONS OWNER PHONE �_-_ -
OWNER {. j lI:t, JOB ADDRESS ! 1185 SA �;ar , . LOT NO._ T'�251�2G'�.?
- - _XL 1500
G14,IstonP (471.121NG NIEERT -- w_--
BUILDER breckwood Ilowes ADDRESS 45�32nd ')r. Sults NS3 DESIGNER_
STRUCTURE [)(NEW ❑ REMODEL - ❑ ADDITION_- ❑ REPAIR _❑ RENEWAL_ _❑_FIRF_DAMAGE ❑ DEMOLITION
Eil RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT C❑ GARAGE ❑ STORAGE ❑ SLAB0 FENCE
OCCUPANCY �;�_LAND USE ZONE . E[-Z BLDG.TYPE .__.:�',__.FIRE ZONE_..PLAN CHECK BY A
— __XnL__HEAT--GAUL---
Gonsttyact "i-ir le Fardly ')welli.0 w/attached ;.arm,e.
t �epairin:c houat+ that burned)
-_._---- -- 3 tied 2 8ii%Lli
SEWER PERMIT# _ ;qra,,e 564
OSC.LOAD _ FLOOR LOAD 4G HEIGHT 2'.) _ Nr.).,STORIES I AREA IOU NO.BEDROOMS t_ VALUE r' '
BUILDING DEPARTMENT SET BACV5 .�FRONT ' REAR r
LEFT SIDE 51-0 RIGHT SIDE
Permit THIS PERMIT IS ISSUFD SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check
REGULA ION`= AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS HEREBY AGREED THAT THE
59 .7 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
Sub total 4`a 1•7o RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CON TRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 11.92 LICENSE SEPAPATE PERMI fS REQUIRED FOR SEWER.PLUMBING AND HEATING.
Total 503.62 SDC- A011
PDC# w APPLICANT URACiE1QT ��•1i� I'.� 16 (C t'' V(C.{__'i!__
��proved
crl 1_ ll(.1i Receipt No. ADDREt3t3 � _'UI'c 1 �J --- 'r� ` �t_r
i
1
i,
DATE INSP. TYPE INSPECTION REMARKS 11 PLUMBING DATE
ry Contractor
000' 4— 1ri[Lie'9 a Permit
_ Q Arugh•ir
/ fixture
( J.43 --�1��_ _ ffne: ----- _—T
16— rB{M//�/ eHEATING
Contractor
F `----- _ Permit No. V
10 -3
,'rnQ ., 1/ Gasgo
in
_1.LIL�1. �I Rough- il
i n
s---- -------.— ,__ Final _
SEWER
— -------_ —�—_— _�_. ---------- Final —
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Find
Sidewalk
Curb a Street Final
Approach _
tJ1.DG.DEPT.FINAL--'-"7- TEMPORARY CERTIFICATE OCCUPANCY l
(CERTIFICATE OCCUPANCY Final
Landacapinji
IIIZnning Final
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