15635 SW QUEEN VICTORIA PLACE ADDRESS:
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INSeECTION NOTICE _
City of Tigard Building Departnant --v
1.1125 SIF Ball Bled. Tigard, Oregon 97223
Inspectio:i L1 4 (Rec•-O-Phone): 639-4175 B ss hone 639-417
Inspection: 1 (1
Footing Plbg. Underslab Mech. Rough--in Appr/Sdwlk
Found. Plbg. Top Out Gas Tine FINALS
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation / -plumb.
Plbg. Underfloor Water Line Gyp. Bd. t/ec
l
Date Requested: `� - Time:
Address• J's1 P �lC fdrr a-Perrn �G9 3 O�sO
Bulider:
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THE FOLLOWING CORRECTIONS AREREQUIRED:
Inspector: Dates
•PPROVED DISAPPROVED APPROVED SUBJECT To ABOVE
.1CA1� Call For Reinsp.
t
INSPECTION tpngg
City of Tigard Building Depact0mit /
.13125 S4 Ball Blvd_ Tigard, Oregon 97229
Inspection Line (Rec7 hone)• ] -4175 Queinesti Phones 639-4171_
Inspection:,_
Footing Plbg. Undetelab M Rough-in ,Appr/Sdwlk
Found. Plbg. Top Out Gas Line
Post/Beam Struct. Ser. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Inoulation _Plump.
Plbg. Underfloor Net r LLni�=L +� Gyp. Bd. .•MBOh.
Date Requested, L
_ —Timet _
Address: r' Q no A / Pdrsfit' ttQ lzn L,
Builders
THE FOILOWING CORRECTIONS ARE REQUIRED,
may)!j
InspectoPAPPROVED
_ Dates
DISAPPR4.WZD APPROVED SUBJECT TO AEON=
Call For Reinap.
Circ CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orogcn 97223o6199 (503)639.4171
C J T Y (IF TIGARD RF-XFJPT OF PAYMENT' RF CF I PT NO. 193---;?42366
NAME GARRON GROUNDS MGT CHECK AMOUNT 15- 75
COSH AMOUNT 0. lAo
ADDRESS PAYMFNT DATE a 07/16,193
SaUrADT V IS ION
URPOSE OF Pf4YMF--:N-r AMOIJNT PAID PURPOSE OF' f-"AYMENT nmouia i--,ATD
.....
LUMBING PERM 15. 00 ST. BUILD PF ......R 0. 75
15635 SW QUEEN VICTORIA r,:-
010L AMOUNT PAID ',. 75
----------------------------------------- ------
JUL-12—'9-7 m011 14:42 I D:CITY OF H'I NG C 1 TY FAX NO:503 639-3771 4891 PO2
KING (JITY
Ifs��
15300&W. 116th Avemie,Bing City,Oregon 97=11 Phone:639.4082
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
r7 (Instructions on reverse!
1. NAME OF APPLICANT: Phone No.-
ADDFiF'.3S:._1h/�� _ . 1 �S�iFFi�l C1-4211�
ADDRESS OF PROPOSED IMPROVEMIIV'T 5^ME --
2. TYPE OF CHANGE, IIAPROVEME`IT OR CONSTRU('rION FOR WHICH PERMIT IS REQUESTED,
DESCRIBE BRIEF''LY - ATTAC33 TWO COPIES OF PLANS OR DRAWINGS OF
PROPOSED PROJECT: 1 M`TALL ✓3AC�FL=��,�1 -
3. NAME AND ADDRESS OF CONTRACTOR_UaRpGh1 l RbL1til lM1 IPJ - Pf�4 l L TE
G77,2G 5V2 4 ILI-41AM PHONE N0.21ZL �.'3
4. PfE IGHBOR.S WHO MAY BE AFFEC1'L•:D BY THIS PROJECT WILL BE NOTIFIED BY THE CITY.
,AJ 0AJf—�E -
5. APPLICANT OR HER/HIS RFJ!RF.-giT?TATIVE KJST BE PRESENT AT THE PLANNING C344ISSION
MEETING NEXT HELD ON--_
RF=EITATIVES NAME ___WK7NE NO. _
(The King ;ty plauuiug commission Bill coasider only those applications received It least five (S) days
prior to a setting.) C�
SICNATURE �a`^
APPLICATION RECEIVED BY DATE---� q3 -
APPLICABLE FEE RECEIVED '`To/TAL—%�
PLANNING ODNVIS ON DECISICV: App oved x _ Deni ed—
OONL`ITIONS -
___ A roved applications are valid 'or sii months only
Signature
ROTE: 0 on 8amebullders Law reqs that all persons wbo contract for nark an their residence be
registered •ith the Builders Board vhich means the contractor is banded and insured on the job site.
For your protection, be certain your contractor is registered by calling City Ball ph: MAUL
NOTE: A permit mast also be obtained frun the City of Tigard Department of
Canrami`--y Development Yes __ No.
CITY OF TJGMQ-JNSPI CTICk1 R�OR-T
The above listed project has been inspected and Approved -
---Denied-Date Caments -- ---
Signature
(&Li-d-na inAPezt1vt plan.&ez xe,�ftvm onQ (1) copy to KJ-Aq CUY)
co 2 9"
APR-01-193 THU 09:11 ID:CITY OF KING CITY NC:503 639-3771 t#646 P02
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CITY OF TIGARD
COMMUNITY DEVELO�'MENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Orr,gon 87223.8199 (503)639-4171
1�
LA
I �
OF TIC ORD RR"EIr"T OF PAYMENT RE NO. tai; 4 4
AMOUNT : '216. 25
NAME t All; PRO i-wn"rihio & r4c, G(491-i AMOUNT a Ii.). 00
ADDRFSE; t VIAYMENT t)A"rt--. t 04/1711/92',
SURD f U 1 G 1.ON
PURPOSE' OF PA'vJ41-'.N'r 11MOUNT [,All) PURPOS('-' OF POYMENT AMOUNT 1-1011)
Mt"CHANICAL PU 00 )'r. wju-r) i-*:,fi 1. 25
1
15635 53W OUVI—N QWTORTA
m'rAL. AMOUNT 1111:I: