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CITY OF T IGARD DATE iSCUED; 03/08/SG
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orooco 9722398199 (503)639.4171 r,A r c1_. : 2 0 4 n A- 0L'
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Residential Building Permit A-PP-licatian
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 2 I x((11(,
Jobsite Address:
office Use Only
Subdivision: U-11 Y Yy' Lf fir'° ` Lot #
'k Contact date _ ' I I _Initials
Valuation: c:y t .-__ ---- Result
New Construction Only: (Square Footage) Plam k/Rec #
Permit # _ OfiiL)p 1 tG e
NouS�' _ Garage __— Reissue of^
Vap & TL #
Corner Lot? Y pj) Flag Lot? Y- N ;'jne
Plat#
Owner: --
Approvals Required
Address: —
Planning Setbacks _ Solar -
_ Iliddk lam_ Engineering _
Other
Pticrip
Items Required
Contractor: % .4/3!r" /1ty»�k� n aL���� ' 7S r
Subcontractors
Address: �a G ��� x ��'b`>� Truss Details
C Other �.
d. V 7�-R►..�i t1 G� �_ J � l�� _
Notes (mil (1,W _�� � YP lir U
Phone: Yif r"C' t1�
Contractor's ' icense #
(attach copy of cc�krent 0. gon icense)
Contact Name:
Contact Phone*
Subcontractors: ArchitectlEngineer:
Plumbing: P / Address
Mechanical-
(attach
echanical(attach copy of current OR Contractors License)
Phone:
JOB DESCRIPTION:
TiUi�i' Gc�c mcµ Di�,tlrl��,�_�,iv S 'erCs� ( ) lr ?/A -7
Applicant Signature Applicant Phone number
Receivr:d by: Date Received: )
N\bOnbltY wpp
Permit.t Account Description Amount Amt. Pd. Bal. Duo
_Y Bldg. Permit (BUILD) _
Plumb. Permit (PLUMB)
Mech. Permit (MECN)
State Tax (TAX)
Bldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg:
Plumb:
Mech:
Sewer Connection (SWUSA) —
Sewer Inspection (SWINSP)
Parks ❑ev Charge (PKSCC)
Residential TIF (TIF-R) _
Mass Transit TIF (TIF-,1A i) _-
Commercial TIF (TIF-C) ��-- -- -----_.-- -
Industrial TIF (7F4)
Institutional T1F (i F•iS)
Office TIF (TIF--0) —_
`Nater Quality ('NQUAL.)
'Nater Quantity ('NCUANT)
Fire I-ITLSafety (FLS)
1-resion Cntrl Permit (ERPRMT)
E-csion PlancklUSA (ER PL AN)
:resion Planc.VCOT (EROS N) —_ `--
TOTALS:
ICITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639.4171
Footing Rain Drain Cover/Service
FINAL:
Foundation Water Line Ceiling
Post/Beam Mach. Shear/Sheath -Plumb.
Framing -Mach.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation
-Elect,
Post/Beam StrUCt, Mach. Rough-in Gyp. Bd.
-Bldg.
San. Sewer Gas Line Appr/Sdwik
Reins.
Other:
Date: —
_� A,M, .P.M. Entry:
Address: ��(�
Tenant:
Ste:-___ MST: .
Con/Own: (0 4- / (� BUP: p f
MEC:_
PLM:ELC-
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: —`
Mel
Inspector: ~\
Date:
—APPROVED " RpVEI!Y1CALL FOR REINSP.
CF CO