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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 63€I-4175
Type of In—oction -
Da.e Requested Z.� _ � rime -- A.M. P.M.
Adc-ess _� C'�� ---`� . �QQ� Peri ii! #
Owner Lot Lot 4
Builder ----�-----�—
The following Building Code deficiencies are requ'red to be corrected:
Presented to
Inspector � I Disapproved
--
Date g-- ZZ _
CALL FOR REINSPECTIr 1 '
CJ YES C7 NO
BUILDING PERMIT APPLICATION ICING CITY DATE .iw.:._� � ,19 1356 t
THE UNDERSIGNED HEREBY APPI IES FOH A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER W :,,]c.' J. P t:e°rsot, JOBADDRESS 12(1CI!U S6 King Jame Pjac
e
ARCHITECT Detrland. Inc.
ENGINEER
BUILDER Vie]. k.i_lis Const. Lo. ADDRESS iijou `46i "ip tad_ �; __DESIGNER
STI' JCTURE ❑ NEW REMODEL L] ADDITION ❑ REPAIR ❑ RENEWAL O FIRE DAMAGE i-] DEMOLITION
U1 RESIDENCE 11 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE CI STORAGE ❑ SLAB❑ FENCE
OCCUPANCY I{ LAND USF'nNE a BLDQ ?YPE -A—h—FIRE ZONE---PLAN CHECK BY HEAT itis
atruct aigition to 1e f auti1i dye:11rg a21 near ap r_ibumu p]ana.
mqlifte—'�e be
SEWER PERMI r#
OCC.LOAD FLOOR LOAD $(j HEIGHT 16 NO.STORIES 1_ AREA BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS F90NT see REAR LEFT SIDE RIGHT:IDE _
Permit _ ') ',jr, THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE_, ZONING
60.13 WORK
AND ALT. APPLICABLE CODES AND ORDINANCES, ANO IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE ITS ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
152.63 WITH ALL, APPI ICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total RESTRICTIVE :OVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 3.22
_ SDC–
Total 15545
PDC# APPLICANT OR AGENT
By
necalpt No.
Approved ADDRESS —� PHONE
DATE INSP. TYPE
INSPECT11,jN REMARKS PLUMBING Z)ATi
Permit No
Floujh-ln
Fixture
9-zzz.- Final
HEATING
Contractor
Permit No.
Gas or Oil
Rmigh-in
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG, DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERI WICATE OCCUPANCY Final
7-
Landscaping
7oning Final
CITE' OF TICARD Plumbing Permit
Building Department NO. _ 3
Residential r`,1 Commercial ❑
New Installation, [-] Replace Addition ❑ Alteration [� date
Licensed 1 `(l
� � `Hr . I" "I _
Plumber Owner ___afdti, ` (ter c..
Address A-0 13 d >��1 ~I r �°' glob Address. U C' %' I�'jt --
Phone — (� 5 '?c�------- -- Applicant -- i f' ----t,st(��� J -
CIT BUSINESS LICENSE REQUIRED FOR F 1-1. CONTRACTORS AND SUB-CONTRACTORS_
ITEM iNO. FEE TOTAL _ �- ITE'iA N( EE TOTAL
Fixtures-Traps _ ,- �- 7.50 _- Sewer:First 100 ft. 3000 -
Dishwasher 7.50 _Earh Addit.1 GO ft. 15.00 _
Garbage DisposalyV 7.50---- Elector Pump_ _ 7.50
Water Heater - 7.50 —� _Water:First 100 ft. ) 20.Ou_ �,
Baekflo_w Preventer _ 17.50 Each Addit.20011. 15.00
--__ - Storm R Rain Drain:First 100 ft. 30.00 -�
��- Each Addit.200 ft_ - _ 15.00
_ % Mobile Home Space 25.00
Other(Specify): r. Rain Drain-Single Fam.Dwelling 15.
PERMIT FEE --- ----_
—� - Comments: _
- --- ---
19
.., IssuedY:
STATE iReceipt NO
_ _ -Applicant
TOTAL S%�
- ---------------__
--- �_-- _-_ Signature
i-or Plumbing Inspection Phone 6'i9-4171
BUILDING DEPARTMENT, TIGARDn a I tl
PLUMBING PERMI i
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as heroih nosed to be installed in accordance with the plumbing code or
Tigard, Such installations requiri inspection by the City Inspector who shall be notified (.:)t 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-contractors. Job
',.
Owner. J-4,,s.2 l�s�(J�? � _ Add ess(�L: (—`a (�'_J 4W" Date o—� 's1..L
NUMBER OF TOTAL
TYPE OF PERMIT 11 EMS FEE ON EACH AMOUNT
Shlyse Family-1 bath-each _ _ 25.00____
Duplex-Each 1 bath unit__ _ 25.00
Additional bathrooms-each 10.00
Mobiles Home S ace-each _ i� 15.00 _~ W
INDIVIDUAL FIXIUREC.OMMERCIAL, 7 _
Ito 50 Fixtures h, 1 building+-each _ 3.00 Ar
51 to 100 Fixtures in 1 building_each _— _2.50
101 to 200 Fixtures in 1 building--each Y_— _ 2.00 _
_201 or more Fixtures in 1 building__each _ _ _ — 1.50-- __
MISCELLAN=0J3
Sewer-each additional 100 ft, _ v _—_- 10.00
Water Service to building _ �— 5.00
Ot er Sgaciry�_.
_F'ERFAIT For Plumbing Inspection Phone 639-4171
"� date �', t Plumbing Contractor By
TO-i AL _ — RECEIPT NO. J � Issued By _
I