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1992
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME:TIME: ' PERMIT NO. : _.
DATE: Zi2-ri 7�- DATE ISSUED :_1_L__ I
OWNERS NAME : r,- -.,) C7A-y 3!�► _
ADDRESS: - _ lA� T�R� �TWAtL 5
CONTRACTOR :
TEST : Air p, WoterC , Visual Laboratory p
RESULT: Approved Dieapprovod ❑ Pending p
SKETCH;
INSPECTOR DATE
NOTE: Attach suppiementul teat data hereta]
I
City of Tigard
IN-SPEC r loll REQUEST
INSPECTION TIME " __.��.._„ PERMIT NO. :
DATE DATE DATE ISSUED
OWNERS NAME : ��
ADDRE S S: &J-3O
CONTRACTOR :
TEST * Air D, Woterp, Visuatifi , I._ohorotory p
IfESULT: Appmv-d Disopprow,d Lj P.,nding n
SKETCH:
I
I
i
/ N �CTttFf � DATE
NOTE: AI!Och ^ue• + r•!
.y..:o-:«w.:M��:n;r'y1^•ry TK�p+s•�.�7gN: .,§: -".!e. a .,,,r,.�y.y ..r�q"�r�A fMMI�
CITY OP f� 70;N2 O�G2
BUILDING PERMIT APPLICATION TIGARD DATE__ 2,16 ,I9
1HE UNDERSIGNED Ht rtEdY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPPOVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNED PHONE__ _
f ti lilyuAR
ADDRESS 11x;30 ";1,1 Torrac a ''mBUILDER PHONE
''milli BUILDER 39-6355
ENGINEER
BUILDER ARCHITECT _ DESIGNER
��STRUCTURE L"JNEW 13 REMODEL []ADDITION ❑REPAIR _❑_RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
;T
L,,.� RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T URELIGIQUSOPATIO [SCAR PORT_ ❑GARAGI_ C1 STORAGE❑SLAB ❑FENCE
RE
BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN RFVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY -LAND USE ZONE_ _BLDG.IYPE_ FIRF ZONE PLAN CHECK BY- _ HEAT _
Vu; : :.u. c. , :.ki .,r revc4. aii UuLh floure. hact6ng18 Plus lines to
oY' firs pie! 1-te nyd - toss fire furnoxce provide proper comob., air.
;I�L1 lUMa ?S1 3CA Lot 50000
D. OAD FLOOR LOAD HEIGHT— NO.STORIES AREA 3264 VALUE 4`19000
BUILDING DEPARTMENT
SET BACKS FRONT REAR LEFT SIDE RIGHT 510E
Permit 17;'„Qfl -_--_—_-- -- --------THIS PERMIT IS I',SUFD SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check Itt;•C1C! REGULATIONS PND ALL APPLICABLE CODS AND ORDINANCES, AND IT IS HEREBY AGREED THAI' THE
WORK WILL BE JONF. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL ^DPI !GABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
176Stete 14- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING,
Total
By
-� APr 'ANT OR AGENT -- --_.__.--
Approved Rrceipt No
- - -- — -
ADORf:55 r -
Offm-m
DATE INS?. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor-
Permit No.
76 Rou h-in
Fixtut,!
Final
HEATING
Contractor
Permit No. Z 71f
Gas or Oil
Final
SEWER 6-
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
BLDG.DEPT.7r TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
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PERMIT
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_ PERMIT CHARGE: _ _ none---—.---..
OWNER ',� �.c,c.a�a.�`- `w.___.r _ CONNECTION FEE
PAID By
TYPE OF BUILDING DATE CONNECTED
SF:RVIc,F RATE �� _ #�.--- _____ -_ __-•- IN511F:CTION FF:E
CONTRACT0R
PAID BY DATE __..__.._.
....�.._ r._..
5I7E OF CONNECTION A5SE.5 ,� ( __._ __-_ _.._. PAID - ..
X300 -1.!