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INSPECTION REOUE T
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INSPECTION TIME : RMP (�f_.
` DATE: L DATE I SSU F C: .__ , �
OWNERS NAME : _. C -sc _
ADDRESS : i
TEST' MY U; Water C , Visual El , Laboratory L
RESULT. approvedO, , Disapproved ❑ , Pendmq
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for
INSPECTION TIME : 21 , PERNI:T
DATE: Z1 DATE
OWNERS NAME:
ADDRESS : -<. a
64'4l i'RACT0R : — ----
TEST: Air 0 , Water p , Visual [--I , j_a!,n,f,
RESULT' Approvrd)4-1 UiyQDproued
SKETCH:
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ADDRESS //1l- %11-0
PERMIT NO.
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PERMIT CHARGE none
_..__,_... . ._...�
OWNER ___ CONNECTION FEE -
P A I D BY --
TYPE OF BUILDING ..:(d^�+%Atc _ DATE CONNECTED ���. _
SERVICE RATE INSPECTION FEE _ „_.._..
CONTRACTOR ._.�,f's.�,zy;t�c'� PAID BY _ _, DATE
SIZE OF CONNECTION �' ASSESSMENT PAID
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City of Tigard
lNs,,,,E(;-nON REQUUJ
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INa"PECTION TIME'
PP I E Ja DATE
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CIT" OF
BUILDING PERMIT APPLICATION TIGARD DATE_---_ 19
Id° 0298
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOa fHE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN° AND SPECIFICATIONS OWNER PHONE --
1/31a S'/t/ jrunwuc�� 40�
OWNER___ _ _ —! ADDRESS BUILDER PHONE
ENGINEER
----,—AFJCHITECT DESIGNER
STRUCTURE ❑NEW0_ REMODEL EJ-ADDITION ❑REPAIR ❑RENEWAL []FIRE DAMAGE EISLA
0 RESIDENCE 000MM EJEDLICATIONAL EIGOV'T ORELIGIOUSOPATIO OCAR PORT ❑GARAGE 0 C
STORAGE SLA9 CFEIICE
❑BOND ❑MOVING LICONDITIONAL USE ODESIGN REVIEW EICOUNCIL APPROVED USIGN S
OCCUPANCY----LAND USE ZONE -2-07— BLDG. TYPE..-- FIRE ZONE—2- PLAN CHECK BY rrs HEAT_
construct 1685 sq. Pt. r-mme . .inp with attached g*ragt.
no nt accarAng, approved plana
3 bedrooms
- °#0 lb
OCG LOAD _ FLOOR LOAD ,HEIGHT NO.STORIES _ _ AREA D VALUE -�
BUILDING DEPARTMENT SET BACKS FRONT REAR ' LEF1 SIDE RIGHT SIDE
Permit .13600%. --- — -- -- _ —
C�•�i, THIS PFRMIT IS ISSUED SUBJF :T TO THE REGULATIOOS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINr LACES, AND IT IS HEREBY AGREED THAT TM:
WORK WILL BE DONE IN ACCORDANCF WITH THE PLANS AND a.'FLIFICATIONS 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 CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By re ------- ---_ _ --
-- APPLICANT OR AGENT
Approved l/!A Receipt No.
ADDRESS _ HO --
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DATE INSP. TYPE INSPECTION REMARK,• PLUMBING_ DATE
Contractor
Permit No.
7 -�•/ - f _ Rou h-in —
e.- L�<• � "'' ./.�i� Fixture _
Final
HEATING
Contractor ..—_-------
�N. SPermit No. -
3 Gas or Oil
Rough-in -
--- _� Final
S E W E R,6-.740. _—
�� "�� Final
DRIVEWAY -30 — - Dr --
ae Final
Storm Drainage _
- — _ (Rain Drain) Fina;
---- — _—_._—__—._._-------- ------- Sidewalk _
Curb&Street Final
SLOG.DEPT,FINAL TEMPORARY — Apliroach Q�
/�?' ✓� CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY
/ ]Flinal
L 1� Landscaping
Zoning Final — --` --
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