11860 SW TIGARD STREET 11850 Sod TIGARD SWiDqL (�P
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City of -� i Bard
IN ECT10N REE0UEST
1 '41 for
1 INSPECTION P£RM, r NO.: —
DATE:;- lr�
O.: —
DDATE:; L-!,� DATE '.SSUED:.—
OWNERS NAMF-:,s
A D D F E S S : LL.klt
CONTRACTOR :— ^—_---
I FEST. Air 0, Water ❑ , Visual C , Laboratory 0
R SU�.T. Apprave 0;aapproved FJ pending O
SKETCH:
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I I P CTOR DATE
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BUILDING PERMIT A!'"LICATION TIGARD
DATE February 3 ,s"iu N2 �(,`;3
THE UNDERSIGNED HEREBY APPLIES FOR APE P7AIT FOR THE WORK HEREIN INDICATFD 6,39-8201
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
OWNERRobert 1R• 5mith ADDRESS 11a6a ).w. nigard or, BUILDER PHONE
-�-_
ENGINEEII
BUILD R � ARCHITECT DESIGNER
STP.UCTURF. ❑NFW_ ❑REMODEL _❑_ADD,rIUiv QREPA IR ❑RENEWAL ❑FIRE DAMAGE _ ODEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAN PORT ❑GARAGE ❑ ':. C PAGE E1SLAB L--11r:WCE
UBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY—LAND USE ZONE.` BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT._
L ont,itrtdcl. nnpi fiyi ipllace in uxistiny house — masonry
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEP\RTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit $5.00 �- _---- ----
—` -- "THIS PERMIT IS ISSUED SUBJECT TO THF REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND %Lt APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT HE
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 CONTHALTORS TO HAVE CURRENT CITY BUSINESS
1 State * LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING LAND HEATING.
Total
By
AP 'ANT OR AGENT _
Approved _ l Receipt No
ADDRESS - ------ -- HIS -----
DATE INSP. TYPE INSPECTION
------ - �` --_- REMARKS PLUMBING
--_-_- __ DATE
---- ---- -------- ___ _._-__ Contractor
-- -- - _._ - -.-- - -- Permit No.
-- - - --- -.- Rou h-in
-- Fixture
- Final
HEATING -
-- Contractor
--- -- -------- ---- Permit No.
---- ---- --. _--- Gas or Oil - - --
- -- --- - -- ---___ Rou h-in-
-------- ---- .-__------- Final - --_-
- --- --- -- -- SEWER--
---- -__- -_- Final -- --.
_ --_-- DRIVEWAY -
____- Final _ --
---- -- ----- `- Storm Drainage -(RainDrain)Drain) Final
------- -------- Sidewalk -
------- - - -- - Curb&Street Final -
BLDG. REPT. FINA - TEMPORARY - - - A roach-- -
CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY -----
r .� Final ------ _
J ( I Landscaping
Zoning Final
- IT TO CONNECT es ��✓
PER1vi
Tigard Sanitary District
PERMIT N° 1401 DATE
PERMIT IS GIVEN TO ^
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITART DISTRICT
ATTHIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF r_ONNECTION HAS BEEN COM-
PLE-ED.
PERMIT FEE PAID $... ............................TIGARD SANITARY DISTRICT
By -
CONNECTION INSPECTED AND APPROVED
�A
Ad d re F;s / r .�.,. � , _._.:._._.� P e r m i t N o e ` �_� ---------
Permi t charge________
owner `Vo!!;k V•Ivrf—a_ } . { / .dC Ld�t�,¢ Connection fee 37S'�
t � L� _.__ Paid by --
Type of building L1>r,j Date connected )-Or 2�i L
Service rate Inspection fee o)n a0
Contractor Paid by Date
Size of connection 1�` _ Asse:ssment� Paid _.---