11515 SW TERRACE TRAILS DRIVE 11515 SW TERRACE TRAILS DRIVE
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME' —IL.12 PERhFT NO. :---
DATE:
SO. :DATE: _Gm L!L-2�w DATE I S SUED :.—.L.L—
OWNER NAME :
ADDRESS: ll5/.S S cc.1
CONTRACTOR : .--
TEST :
ONTRACTOR : .__TEST : Air ❑, Water[] , visual q, Laboratory p
RESULT: Approved , Disapproved El , pending Ij
SKETCH: @
INSPECTOR DATE
MOTE Atrach supplemental lest dal0 hereto]
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City of Tigard
INSPECTION REOUE
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INSPECTION TIME : PERMIT NO. ;
DATE: -i�r �&4-jef
DATE ISSUED.-II ...-iOWNERS NAME : _-25; __ __ I
ADDRESS : �"
CONTRACTOR :.���� --�-c�.� TireA%f�~ Tm!�_`�-1
TF T: Air 0 , Water U , Visual D , L.aboratw
RESULT: ApprovedDisapproved L7 Peii�,�,n� ;J
SKETCH:
I
I SPECTOR DATE
[NOTF Attach supplemental test data hsrelul
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CITY OF W 0772
BUILDING PERMIT APPLICATION TIGARD
THE UNDERSIGNED HEREBY APPLIES FOR A PERMITFOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE—.---.
_Q)�LN F
_R AAQDRESS R PHONE__.
ENGINEER
=IDIR A3CHITECT DESIGNER
SfRUCTURE []NEW 0 RE MODE L OADDITION CIREPAIR EIRENEWAL DFIRE DAMAGE ODEMOLITION
0 RESILIENCE OCOMM DEDUCATIONAL OGOV'T ORELIGIOUS OPATIO OCAR PORT EIGARAGE [:]STORAGE CISLAB []FENCE
OBOND Q MOVING OCONDITIONAL USE DOESm-N REVIEW DCOUNCIL APPROVED S 1 G NS
PSgUPANCY___LAND USE ZONE__BLDG.TYPE. -FIRE ZONE PLAN CHECK BY—_ HEAI__=_.
1, 1501 Sq, )7t. f'. Mts Wel SI with full basomont,
baeumani", A-:;t.orain&0 to ti. roved Plans,
T-SV.
3uuz total 7 uut'i
pg�_; LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPTMENT
SET BACKS FRONT ',tI 1 REAR SCI LEFT SIDE f RIGHT SIDE Zp
Permit -163000 —
L--- —1 0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 11 IS HERESY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI.IANCE WITH
ReLcrdi-g ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRSNT CITY BUSINESS
State LICENSE. SEPARATE PERMITS RFQUIF,IEV FOR SEWER, PLUMBING AND HEATING.
Total
—BV APPLICANT OR AGENT
Approved Receipt No.
ADDRESS
DATE INSP. TYPE INSPECTION / , )� )r REM/JARKS PLUMBING DATE
S Jam-
14 �O t o � W _L/L_ _ , G 1 Uyt- Contractor �
s a f c?1� Permit No. --- a y �� //y/74
sv ! �,,rc� _ �,S •e.. ✓G,l� �U, Rou h-in -- --- _
Fixture
Final _ ---
j -?— _ HEATING-
Contractor
Y -
—_ Permit No. � LL'
-- — - Gas or Oil
Rou I1-in
Final
---- - ----- ---- -- 5 E W E R G-2,74 ----
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
— V ---- -'-- - Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final ^
Landscaping
C/ Zoning Final
ADDRESS Jt-,k) PERMIT
PERMIT CHARGE none
OWNER CONNECTION FEE0
PAID BY
TYPE OF BUTI.DING DATE CONNECTED
SERVICE RADE INSPECTION FEE s-
CONTRACTOR PAID BY DATE
S17F OF CONNECTION ASSESSMENT PAID
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