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INSPLCTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time A.M. P.M.
r
Address C7_- u/ / ) �, f1�-la Permit
i F
Owner . !�1 �'�i ~ �rj��, of #–----�
Builder
The following Buildir�y .ode deficiencies are required to be corrected:
i
I
I
I
I
Presented to — [-1 Approved
Inipector Disapproved
Date
CALL FOR REINSPECTION
1-1 YES ❑ NO
B';ILDIN—:, PERM;T APPLICATION TIGARD DATE_.—! T � �• is� 4390
TI IE 0NDER")16NED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 6 jj-- 3:3j-
OR AS::H;".,!N AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE ;$
LOTNO._4-� evi &t0T
OWNER �,.t�tic�}. ' �;,,ull JOBADDRESS 9630 Jkslt�,orly _ —
@lie. Tai.?n ARCHITECT — --��
Kazebre._ arshall ?5Cf35 ;;J °ls�+Ott: i� t.<f. ENGINEER rr
BUILDER ADDRESS DESIGNER WDer
STRUCTURE r!!NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL_ E_FIRE_DAMA_GE Cl DEMOLITION
11 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T Ll RELIGIOUS ❑ PATIO Cl CARPORT D GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY —I{-_3 _ LAND USE ZONE _'�'' BLDG.TYPEL' FIRE ZONE- PLAN CHECK BY `° HEAT r'A
Onstnect lw,!J� ,Aily I7v+4llinr• wflatt:tcIlell scar 8<> ___--
----— et -"PCt ion sheet attache() i 3 3edroaoisr< --
-- @$thg
SEWER PERMIT M
OCC.LOAD FLOOR LOAD HEIGHT 15 NO.STORIES AREA 1191 NO.BYDROOMS '• VALUE 7
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE _ RIGHT SIDE___
Permit 3 +'#.(1S) THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
1.l• !U REGULATIONS AND ALL APPLICABLE CODES AND ORDef4ANCES, AND IT IS HEREBY AGREED THAT THE
Pian Check WOPI< WILL BE DONE IN ACCORDANCE WITH THE. PLANS AND SPECIFICATIONS AND IN COMPLIANCE
Subtotal `� I.ttl WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR ANn 3UB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
3''
State Tax
13 s LICENSE.SEPARATE PERMITS REOU;nt-.D FOR SEWER,''LUMBING AND HEATING.
Total564.46 SDC—
9y d� j PDG# ApPL CANTOR AGENT t --
Approvsd dsri` Receipt No.
— — ADDFtE83 PHONE
DATE INSP.J TYPE INSPECTION REMARKS —fPLUMBING DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Sj Contractor
Permit No. 431�
Gas or Oil
Pntjgh in
Final
Final
DRIVEWAY'
Final
Storm Drainage
(Rain Drain)Fin,,l
Sidewalk
Curb&Ftreet Final
Approach
_7_CE_R_TI F1 C-AT E_dC_—CLN;A N C Y
BLDG. DEPT FIN Af. ---TEMPORARY �Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
■w w s +�. �r ear qeu �r �
BUILDING PERMIT APPLICATION TIGA;iD DATE-)�41 2-67- 19—U 3 '
THE UNDERSIGNED HEREBY APPLIES FOR A PEPPAIT FOR THE WORK HEREIN INDICATED BUILDER PHONE�-.✓y '+D�D��o
OR AS SHOWN
AND APPROVED
—IN
T._HE ACCOMPANYINr PLANS AND SP
ECIFIC�ATIIONS.
OWNEP PHONE
MLOT NO.
OWNER �•C 6 4 1114I1JOBAnDRESS b Od� 1.10�
V3Q- ltk� ARCHITECT
� ENGINEER
BUILDER ADDRESS,2 _035 C_ml 1 %
DESIGNER - pwwk
STRUCTURE NEW ❑_REMODEL ❑ ADDITION _ ❑ REPAIR 0 hENEWAI. ❑ FIRE DAMAG.' 7 nE►AOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT C NELRAOUS ❑ Pik-1.0 ❑ CARP091' ❑ GARAGE ❑ STORA.E ❑ SLAk3CJ FENCE
O-GUPANCY _ LAND USE ZONE SLOG.TYPE , -V—FIREZONF PLANCHECKBY _ ~ iIEAT ._
' ref t
-� 3
---- — _ _ - - - - --- - - —y'ak -
2
SEINER PERMIT K
OCG.LOAD FLOOR LOAD HEIGHT A— NO.STORIES ARNO.BEDROOMS�VALUE(*f 00
BUILDING(DEPARTMENT SET BACKS FRONT .Zf.; REAR ,?'.eo LEFT SICE RIGHT SIDE 7
Permit 1 UT•yq THIS PERMIT IS ISSUED SUBJFC'T TO THE REGULATIONS CONTAINED IN THE BU LOING CODE.ZON!'JG
-� 2 ! 7,
REGULATIONS AND ALL APPLICABLE►'.ODES AND ORDINANCES, AND IT IS HERESY AGREED THAT TPI
.
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANC!
WITH ALL APP'(CABLE CODES AND ORDINANCES.-THE ISSUANCE OF THIS PERMIT DOES NOT WAIV.
Sub-total RCS'RICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINES'
LICENSE-SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
.Itatn Tax
y� Sac-- Jnl,all
Total �
PIMA APPLICANT OR AGENT
Ry
— --�� - Rereipt No.
Approved !ADDRESS � - -! -PHONE
arc - -4o0
Ppc -
EWER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE $ � '
60
Comments: ! 1 f -g-1 ----
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20 3S" 700
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