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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oreno,a 97223
hone: 639-4171
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Type of Inspection — - - -��-//- -- -- -
Date Requested_ '' / _ 'f'ime A.M. —011<—P.M.
Address ^ _ v 'C� Permit #.------- --_--__
owner-- --- - ` - Lot # `----
Builder
The following Building Code deficiencies are required to be corrected:
i
Presented to r] Approved
Inspector _ _., ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES C5 NO
Address '� .a //r��c< r" rrf _- �r �� Permit Ido.
F,,vrinit charge
Owner ;, �'; c i - r�� >� ,�"�, _,�_ Connection fee r� '
Type of building _ , /_,� Date connected
Service rate Inspection fee
Contractor _ Pa;u by Date
Si,zo of curioection Asse.sment paid
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134.
Mona ram.... ..... . 1tiw
ON% ger:. .... .. �..
ss....-..1...1352 SW Zrgnwgod Luop
.�uild�ng �d�.r . . .. . ... r
... ®t.rua. 9....7.1. 0;,
Certificate is hfr�:�3icen this.....11......day of. r.Y 1
that said building nay be occupied and
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that it complies ,N-ith all requirements of
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the Building Code for the City of Tigard, r
" - approved b y the Tigard City Council.
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :
DATE: DATE ISSUED '. L1_
OWNERS NAME :
ADDRESS:
C0NTAACTO R : ���<%���_-- --- _----.. �_...�
TEST : Air 0, Water(] , Vitivalx, Laboratory Cl
9ESULT: Approved , Disapproved 17 Pending
SKETCH.
INSPECTOR DATE
[NOTE . Attach supplemental telt data hereto
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11 I
City of Tigard
I
INSPECTION REQUEST
for I
INSPECTION TIME: __ PERMIT NO. :
DATE: ,� /is/IG DATE ISSUED :-1_L
OWNERS NAME : —
ADDRESS:
AME : _ADDRESS:
CONTRACTOR :
TEST : Air p, Watery, Visual (�] , Laboratory n I
RESULT. Approved 3 , Disapproved C , Pc-ndin9 0
SKETCH.
I
SPECTOR DATE
COTE' Attach supplemental teat data bereto�
P�RM-aURKMa
U\11 F I E D S I, VV E R A G E AGENCY NO. -
WAS I-3 I N G TON COUNTY DATE 20-14-763
—�--
CI-TY Tined
APPLICATION FOR SEWER CONNECT-ION PERMIT
OWNER: ms__44am es — -
OWNER'S ADDRESS: —_—.-_^ -----------
STREET
---- CITY — --- — STATE LIF
BUILDING SITE: LLT______ _ BLCCK _ _ __ _ ADDITION
TAX LOT N0. ------- _ TYPE OF OCCUPANCY _ _residence
ADDRESS L_r o p -
DWELLiNG UNITS --__.1_..___-- _-__ ____..__- __ FIXTURE UNITS -------
SURCHARGE IF APPLICABLE —_ _ --- - -
PERMIT FEE 575. 00 INSPECTION FEE _25. 00 TOTAL DEPOSITED _.._600.00
(NEW) (EXISTING) BUILDING SEWER SYSTEM __ Fanno Creek
4
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT
SEWER PERMIT
THIS PERMIT AUTHORIZES CONNECTION TO THE 5114ER SYSTEM.
I_IIVt'S1�E _ INSTALLER _
RECEIVED BY._
(AGENCY OR ITS AGENT)
COMMENTS:`Bldg.i;=1134
This Anplication and permit expires in one hundred and twenty (120) days.
The amount paid will be forfeited should expiration occur.
11TY TIGARD DATE 101-14-76 _ , 19 1 , 34
BUILDING PERMIT APPLICATION '0F
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE--
LOT NO.
i' c.irioyram Iirlmus 11352 SU Ironwood i.S,
OWNER JOB ADDRESS HOME ADDRESS
ARCHI'T'ECT
ENGINEER
BUILDER EIAiTIF, ADDRESS �r-t_� DESIGNER j
S1�RUCTURE—�'ONEW UREMODEL. CDADDITION0REPAIR��I� DRENEWrrA��L ❑FIRE DAMAGE []DEMOLITION
RESIDENCE ❑COMM ❑EDUCATIONAL_ ❑GOV'T ❑RELIGIOUSCIPAI'IO OCAR PORT OGARAGE r�STORAGE TOSLAB ❑FENCE
OBOND LJMOVING OCONDITIONAL USE ❑DESIC,N REVIEW ❑COUNCIL APPROVED OSIGNS _
r -------- — �� Tu
---- - -------- i
OCCUPANCY_..L.AND USE ZONE — BLDG.TYPE._ FIRE ZONE.— PLAN CHECK BY _ HEAT
.uisjL. sigq1e faml..ly duelling L!/attechad 3 timidoom 2 with
t, 4U3 60
5
�•
-..-FL94P�4-F1(?---__�ti�LGt�1______,___��IQ$LF�___ AREA_ Q.rQ 3� NQ,-vLDa QMS VALUE -__ ---- ---
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR T) LEFT SIDE 17 RIGHT SIDE 7
Permit —.—.1�'UrF � �_—.— -____ �� .--
THtS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULAIIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED T4AT THE
-- WORK WILL BE DONE_ IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
-- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURP.ENT CITY BUSINESS
State TeX L.ICFNSE, SEPARATE PERMITS REOUIREO FOR SEWER, PLUMBING AND HEATING.
Total
BY nn��AN1 OR AC3FJ1
Approved ` �_---� Rrce;ht No.
-- AoDRE.SS —��.-- - -.._---------- MUNE
1
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
eL
Contractor _—
Permit No. °7/61-1
out-h.in - -
Fixture
Final y
HEATING
C
Contractor
w r'4:&CL f-It� . i Permit Na:
= (, Gas or Oil
Rough-in _—
Final
SEWER
Final
DRIVEWAY 12-
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
_
Approach)
Z-
BL.DG DEPT.FINAL TEMPORARY CFRTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
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