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INSPECTION NOTICE
Cite of Tirdrd Building Department
1242.0 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection ------..-__���'! -- ___------ —
�'3 Time A.M._ —P.M.
Datq Requested —
Address _ •-14� -- — _-- Permit #_ �=T —
owner Lot #__
I
Builder
The following Building Code deficiencies are required to be corrected:
Presented to __--_ i Approved
Inspector i `—� "= Disapproved
Date
CALL FOR REINSPECTION
YES 0 NO
i
BUILDING PERM ITAPPLIGATiON TIGARD DATE_ _. tl"tt`7f � �116,19 3 4559
THE-UNDER 3I(;14ED HEREBY APPLIES FOR A PERMI I-FOR 1 r-iE Wvi iK HEREIN INDICATED BUILDER PHONE
OR AS SHCVVN AND n FPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. 79 .—
OWNER R'en .;trued JOBADDRESS �` "w� mayaxwo+gra
` -- ARCHITECT
ENGINEER
BUIi.DER 11Ark. Conb"rtiction ADDRESS_I"� + "`� 7101 __--_ DESIGNER
STRUCTURE CJI NEW _❑ REMODEL ❑ ADDITION ❑ REPAIR — ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
[. RESIDENCE _❑_COMM L1 EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY�_Y.-3 LAND USE ZONE 1"'' BLDG.TYPE r> FIRE ZONE PLAN CHECK BY Err _ HEAT S
-- — -- — Constrttrt $inele Pa�ily IaWellin w sttacher3_jarsQe:. —
_ 3 7Sedrfmm 3 lath
SEWERPFRMITN 2,640 _.—
OCG.LOAD FLOOR LOAD dein HEIGHT .' N0STORIES ' AREA 1:;f,p NO.BEDROOMS 3 VALUE 'i t t)f1il
p
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE _RIGHT SIDE
Permit 340000 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
Plan Check 40• '" WORK WILL "E DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL, APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 330000 RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY Bli3;f+tSS i
3•G� LICENSE.SEPARATE PERMITS,AEOUfRED FOR SEWER,PLOMBING AND HEATING.
1
State Tax
SDC'— a4Of).00
;�'�� , . � Lam• •,.._..�•
Total- 193 160 Ty 1tli 000 - —
• pDCq AP LICAN ORA EN?
By
Approved !:1`► Receipt No. ADDRESS --�- PHONE
I
,
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE —_
Contractor -
---
Rough-in
[Fixture —^ _ -- ---�—
Final - ------
iv HEATING
Contractor ��Y{-`?
Permit No. � tt ]
Get or Oil
- — _--Y Final
--�- - � —SEWER -
-- ---- -- Final
DRIVEWAY
Final
Storm Drainage
- �_ -- --- --_—_ ---` (Rain Drain)Final
Sidewalk
- _ Curb E Street Final
Approach
BLDG. DEPT. +r.L— TEMPORARY CERTvriCATE OCCUPANCY
ERTIFICATE OCCLPANCY Final - -
Landscaping
2onirg Final
I
�sf s 9
BUILDING PERMIT APPLICATION TIGA?J DATE_
i
THE UNDERSIGNED HEREBY APPLIES FOR A PERIQIT FOR TI iE WORK HEREIN INDICATED BUILDER PHONE
OR AS S 0 AND APPROVED IN THE ACCOtvtPA Ijy,G PLANS AND SPECIFICATIONS. OWNER PHONE
/ l� GL/ F,t IL+ai LOT
rJ'NNER JOB ADDRESS
ARCHITECT
ENGINEER
BUILDEF��B7' ADDRESS 2 I-� y� ,-_DESIGNER
STRUCTURE Er:+EW ❑ REMODEL ❑ ADDITION L-1 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
P, l-I'ESIDENC[ J COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ SAR PORT ❑ GARAGE G STORAGE ❑ SLAB0 FENCE
OCCUPANCY LAND USE ZONE _BLDG.TYPE _� _FIRE ZONE _ PLAN CHECK BY E'T-w... HEAT
SEWERPERMITN �dti
OCC.LOAD ' FLOOR LOAD � V HEIGHT.?O-t- NO.STORIES 02- ARE%I�A U NO.BEDROOi.,S S VP,LUi� O�
_ BUILDING DEPARTMENT SET BACKS FRONT S 4 REAR .20 L EFT SICE S� RIGHT SIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIC NS CONTAINED IN THE BUILDING CODE, T.ON'.!JG
REGULATIONS AND ALL APPLICABLE CODES AND 0EDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check gL0D WORK WILL BE DONE IN ACf�orDANCE WITH T!IE ;ILANS AND SPECIFICATIONS AND IN COMPLIA14CE
�- WITH .ALL APPLICABLE :ODES AND ORDINANCES THE ISSUANCE OF THIS PEPtAIT DOES NCT WAIV=_
Sub total - y a
'04' RESTRICTIVE COVENANTS.CONTRACTOR AND SU13 CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
;State Tax 7
-
Total _ �.3 fJ
PDCJI APPLICANT OR AGENT
BY
Receipt No.
Approved dir`TIM ADDRESS PHONE
SDC � y
tj
CEWER CONNECTION S 75- _
SEWER INSPECTION $_
SELLER SURCHARGE S -
Comment 5: --_...--
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