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11645 SW TERRACE TRAILS DRIVE
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SPECTION REOUEST
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INSPECTION TIME : (PERMIT NO. : _.____
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OWNERS NAME :
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ITEST. Air 0, Water p , Visual)( , Laborator , []
RESULT. Approved , Disapproved 0 , Pending [�
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City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME ' _ PERMIT NO. .
DATE: —Z _L____ DATE ISSUED:_.
OWNERS NAME : ---
ADDRESS :
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CONTRACTOR :
TEST: Air 0, Water ❑ , Visual rl , Lobcirc ►ory p
RESULT. Approved 0 , Disapproved d Pending, [j
SKETCH: ase
"25 Years In Concrete"
CHUCK'S CONCRETE
6563080
Licensed & Borosd
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INSPECTOR DATE
NOTE L(tach supplemental lett date herelo1
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City of TIgorc"
INSPECTION RE0UEC1T
for
INSPECTION TIME * PERMIT
DATE: DATE I SSUEE).__-
OWNERS
ADDRESS :
CONTRACTOR
TEST' Air 0, Water Ei VisualLciborator� 0
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RESULT.-A-pproved EJ Disapproved)(,... Fending
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City of Tigard
INSPECTION REQUEST
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IN8F,E^T10N T11VIF: PERMIT NO. :
DATE: .1 s-9-7114, DATE 'SSUED
OWNERS NAME : 1/—" C "If _
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TEST : Air C , Wctertf visual ', La,oratory C
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INSPECTOR DATE
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City of Tigard
INSPECTION RU) JES"o'
for
INSPECTION PERM)-,-
DATE ' --L�.G. DATE ISSUEC, .--d./--L'—
OWNERS NAME
ADDRESS : /YYzk4s;—,—.
CONTRACTOR
VEST . Air 0 , Water 0 Visulil 0 Laboratory L
RESULT.' Approved Disapproved 0 Pend:,-,,
SKETCH'
SPEC
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;NOTE . Atlact: supplementui tell
CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE_ ' �"- 16r�—, 1s X637
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATFD
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PI ANS AND FECIFISATHNVS, OWNER PHONE_.
T J. 7 �.
HER_-- — -----�___ v---- ADDRESS —_•
ENGINEER
BUILDER _— ARCHITECT DESIGNER —_
STRUCTURE ❑NEW — QAEMODEL ❑ADDITION _ ❑REPAIR_ ❑RENEWAL []FIRE DAMAGE ❑DEMJLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL OGOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STOHAGE❑SLAB r-IFENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_ LAND USE ZONE .BLDG.TYPE—_ .FINE ZONE_ PLAN CHECK BY
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LOAD FLOOR LOAD HEIGHT NO.STORIES i AREA �.f� #c VALUE 1()f ".)O
BUILDING DEPARTMENT — 10
— SET BACKS FRONT REAR LEFI SIDE ,•� RIGHT SIDE
Permit — — —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITU" BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total r—
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---- _--_---..__-_ _-... _-- APPLICANT OR AGENT -. -
Approved Receipt No
ADDRESS +HONE
DATE T INSP. TYPE INSPE TION REMARKS PLUMBING DATE
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HEATING
Contractor
/Y.v -�-✓ �� ra' _ �c'J_— Permit No. rf �S 9%76
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Final - --
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SEWER—7-73 IL
Final
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Final
Storm Drainage
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Sidewalk L•L r-
Curb&Street Final
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Approach
BLDG.DEPT.FINAL TEMPORARY— CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
1 Zoning Final
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0 ENGINEERS JOB
PLANNERS
oEsIGNED -.-CHECKED-_
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OWNER ? ! G�•� � CONNECTION EEiC ! - `.—
PAID BY _
TYPE OF BUILOING Qa-��, �^ DATE CONNECTED _
SERVICE RATE INSPECTION FEE r '
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CONTRACTOR .. - PAID BY DATE
S I 7.E OF CONNECTION _._._,_.__
',S5FSSf'l1NT _._._. PAID
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