12240 SW NORTH DAKOTA STREET 12240 SW NORTH DAKOTr STREET
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone:639-4175
Type of Inspection ---
Date Requested __- _�-_, %�� Time A.M. y P.M. -
Address _ �_ —� ✓ ._,! )�►���-rA Permit #_
Owner _ Lot #
Builder
The following Building Code deficiencies are required to tae corrected:
_.��.A_L=___��'•.t to i At b..z_- .ti...,'�d�C.�_� �..C7 Gam' c�
or'J'L�yc�
t
Presented to _ ,KApprowod
Inspector _ ❑ Disapproved
Date
CALL FOR REINSPECTION II
❑ YES A0
INSPECTION NOTICE
City of Tigard Building Departmery
12420 S.W. Main St.
Tigard,Oregon 97223 —
Phone: 639:`4171
Type of Inspection
Date Requested_ r� ' a._ � A.M, P.M.
♦Address ��
�1% U /Lvf /-�G /Gl_ Permit *--5,71X
Owner.----- Lot # _
—
The following Building Code deficiencies are required to be orrected:
I Presented to _ - . �/r Approved
Inspector --- �— ------- /� Disapproved
Date
CALL FOR REINSPECTION
YES ,i7l NO
BUILDING PERMIT APPLICATION TIGARD DATE___�_u�ust 17 •19 y5
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR 1 HE WORK HEREIN INDICATED BUILDER PHONE
OR AS AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE -- --
LOT NO.�_4
OWNER J; otqua H94ge_by 0,13!!LDBADDRIESS 12240 SW N. Ua1w+Ra-
97�— AFCHITECT
ENGINEER
BUILDER Satre ADDRESS Rt.3 H07t 253 DESIGNER
STRUCTURE LI:NEW Q REMODEL C-i ADDITION ❑ REPAIR ❑ RENEWAL. ❑ FIRE DAMAGE 11 DEMOLITION
® RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ OOV'T ❑ RELIGIOUS ❑ PATIO Cj ^ARPov ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUOANCY —An)-LAND USE ZONE L�"111'1BLDG.TYPE _�N_ FIRE ZONE PLAN CHECK BY HEAT
HEAT Gita
Construct iing1fdfamiiy dwelling w attact►ea --
_� Subjueteeo $360.00 Amart/Wedgeewood 6 $150.00 Leron Heigh a Sewer _
_ Surcharges. 3 dettirauru
SEWER PERMIT# 28531 i OL,, Garage4UU
OCC.LOAD FLOOR LOAD HEIGHT 18 NO.STORIES 2 AREA 1520 NO.BEDROOMS 3 VALUE 53 p000.
BUILDINu DEPARTMENT _ SET BACKS FRONT 2U REAR 4U LEFT SIDE S RIGHT SIDE 5
Permit 297.OU THIS PERMIT IS ISSUED SUBJECT TO THE REBULACIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 1-1 IS HEREBY AGREED THAT THE
Plan Check 189.80 WORK WILL 7E DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIrAi!ONS AND IN COMPLIANCE
WITH ALL APPLWABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS i,ERM1T DOES NOT WAIVE
Suu•to_tal 486.80 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB rONTRACTORS TO HAVE CURRENT CITY RUSINFSS
LI9PNSE. EP, RATE PERMI fS REQUIRED FOR SEWER,.PLUMBING AND HEATING.
State Tax 11.68 , LaU.UO r:
§5G`�l.ciU
Total 490,48SDC-
PDC# APPLICANT OR AG-EIV7
By Cz_ 1 150.Uu e) ,, } ,,,fi�rr r
Approved - -- NC1t� J Receipt No. 1, i ADDRESSc v "� ray[��_ PHONE E y ��
DATE INSR TYPE INSPECTION REM A.r.KsPLUMBING DATE
—tcontracto
Permit No. � , ?
$I,-cow Rough-in
Fixture
V_
Final
HEATING
OAA /4 1r, Contractor -_7 10 Si
y Permit No. L.
Gas or Oil
Rough-in
Final
SEWER
Pinel
-- ---------T_
_Wj Y
r.'RIVF—
Storm Drainage
(Plain Main)Final
Sidewalk
Curb&Street Final
Approach
___a:D(1. DEPT. FINAL —TEMPORARY CERTIFICATE OCCUPANCY Final
iCERTIFICATE OCCUPANC) s6 %,
I.,ndscaping
Zoning Final
4�S 63,0
FETE UtiDERSIGNEO HEREGY APPLIES FOR APERh1II FOII II`IL '+NUliK IILI(cIN INI)IL.AILU uUILUu1r:w�+4
GRA AS S40WN AND APPROV 0 IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. LUT LOT N'sI.
NQ
J .. �/ �•� � 71
�SAIN P OD $S in f,/ ..1.11 ��DA/Ci--77k
171�?) r1 ARCHft
ENGINEER
f
AooRESzJ1. OESIGNE
� � � � �G�C R 3
STRVCTl1AE HEW CIRt'h!IIDEL ❑AOOITIOV _ ❑na<Paln OREWNIAL ❑FIRE DAMAGE DOE.
nESILtENCC. ❑COMM ❑EOUCATIONAL CQGOV-T ❑RELIGIOUS[]PATIO []CAR PORT GARAGE ❑STORAGE LI SLAB
-zy$- I'-NO USE ZONE /�- ,U t1LOGTYPE_5d._�.— _ PLAN Cb+Etli 8Y NE^1L'
_ CONSTRUCT SINGLE F MLT Y DWFI T NG WIATTACHED GARACIs,,^,--.
r m �� i�4r�trE�>��.� v t /_5r> f.rn���-
l' BEDKOOM
SEUER P RMIT A - Ga>s3,gez�''
SEL:HT / PIO.STORIES -. _
HI11LOING DE_PARrmENT SfT BACKS FRONT REAR J Z.7 _LEFT SIDE ` RIGHT SIOE--f
THIS PERMIT vi ISSUED SU01JECT TO THE REGULATIONS CONTAINED IN THE BUILDING COD
I P:An Check �Q '`~' REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,ANO IT IS HEREBY At:'REED
WORK WILL BE DONE IN ACCOAOANCE WITH THE PLANS AND SPECIFICATIONS AND IN C(AtPLIA
$aa-WtJI C'
ALL APPLICABLE. CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NC
r• RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITYi
Tax 6`` LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
I Tot;l I SDC -
r---- PDC#
APPLICANT OR AGENT
(r Approvett _ Receipt No.
PHONE
SDG S C O LIII �� C7
PDC
SEWER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE
,,// ,, �,
Comments: ��Y.(r�► �� 9 �'�� 7C , f"f.7" �
)el
s
M i
Ilu i l d i ny Perm i t No
Local ion /a -24/d
Uatc
Certification of R;�gistrat ion
With the guilders Board
t t_ 5,0 Aid„ doing business as (dba) ,
_14 ,t am registered under the provisions
of ORS ChapterP2772OjOr on Nomebuilders Law) .
toy Builders Board Registration Number is
Fly registration is in full force and effect and expires on
Idlo,
ature �_
11,111 0 I NG 11'1
NAME /1 �jy� _ /�CLt+t OATF
ACCT. M DESCRIPTION AMOUNT
10-432 Building Permit Fees
10-431-600 Plumbing Permit Fees f _�
10-431-601 Mechanical Permit Fees f !_
10-230-•501 State Building Tax
'.0-433 Plans Check Fee -.� _-
10-443 Sewer Connection (20X)
30-102 Sewer Connection (90X)
30-444 Sewer Inspection f
51-448 Street Systeme Oev. Charge (SOC)
52-449-610 Parks I System Oev. Charge (PDG) f _ / GTO
52-449-1620 P%rks If System Oev. Charge (PDC) f
31-450 Storms Drainage System Oev. Chrg (SSDC) f _ ,25z J�
10-230-505 TRFO (95X) f
10-476 TRFO (5X) f —.
10-M-506 Washington County Firrm Ot (95X) f
10-478 Washington County Fire N1 (5X)
10--220 Aimart/Wedgewood f _ _�? '-'�✓
TOTAL f
7 �- y
(Gm/1214P)