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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St. �, O
Tigard,Oregon 97223
rPhone: 639-4171
�C�C
' Type of Inspection -•---� ___ �
Date Requested - P.M.
Address /�. l.f!-s[� �d_— Permit
Owner_---- —__�_— — Lot #_ r
Builder __—
I -
I The following Buil g Code deficiencies aie required to be corrected:
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Presented to ._ [ ] Approved
Inspector �w%'� *Disapprovad
I Date
CALL FOR REINSPECTION
I
E Yc8 O NO
BUILDING DEPARTMENT, TIGARU N '
O
PLUMBING PERMIT 6 '
holder of a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the Citi Inspector who shall be notified riot less than four
(4) hours orior to the tune the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors. Job
—� _ Address_A_1j.�4._4�• "�CL- Date. T'
0wner -- --- — ..
NUMSER OF TOTAL
TYPE OF PETIMIT ITEMS FEE ON EAUP _&MOUNT
R-FS4DENTrA1
Single Family-1 bath–eAch
25.00
25.00
"+1
D�tex–Each 1 bath unit —. --
Additional bathrooms–each �_ 10.00 _
15.00 't
Mcbile Nome Spae—each ---- – —
'–'—
INDIVIOUAL FIXTURES C0ffj— RCIA
1 to 50 Fixtures in 1 building–each 3.00
51 to 100 Fixtures in 1 buildir. –each 2.50
101 to 200 Fixcires in 1 building each 2.00
more Fixtures in 1 buitdin --each
h1ISCELLANELTU5—
Sevier–each additional 100 ft. 10.00
Water Service to building 5.00 _
nth?r lSpeci(yl__ _
PERMIT For Plumbing Inspection Phone 639.4171
4�,State Plumbing Contractor By f
TOTAL RECEIPT NO. ISSU'rl Ilyil-
BUILDING PERMIT APPLICATION TIGARD DATE_ Au Uat ) tg _�_ t,
THE UNDERSIGNED HEREBY APPLIES FOR A PEHMI'i FOR THE WORK HEREIN INDICATED GUILDER PHONE b21,
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFIGA TIONS. OYVNER PHONE
114.+0 4--_. LO1NO.
OWNER iOtti I)gVxs JOB ADDRESS M$l3 S.Id• 118NI1'a i;gUTC
ARCHITECT
ENGINEER
BUILDER S+i;.�+ ADDRESS t2G5U S1J {d tk. DESIGNER� iq S,�aye Lortnn
STRUCTUFE # NEW ❑ REMODELD ADDITION 11 REPAIR ❑ RENEWAL-'-*-"*L] FIRE DAMAGE ❑ DE_MOLPIONN
❑.RESIDENCE El COMM F-1EDUCATIONALC GOVT F__1RELIGIOUS 171 PATIO ElCARPORT ❑ GARAGE ❑ STORAGE O SLAB❑ FENCE
OCCUPANCY I�3___LAND USE ZONE »% BLDG.TYPE __ 5 FIRE ZONE �- _PLAN CH
_ -. _.�—HEAT G&a
_—ro„�r.r}�ct 5i��p1A ra::,ily r.1mltiav with att®chef gatrs a --ECKBY--
c� oc?rrectictt Rhe@t attached.
—'— — 3 bedrooms
-- — ? baths
SEWER PERMIT# 7I't0
OCC.LOAD FLOOR LOAD - HEIGHT 11 NO.STORIES1 AREA 1059 NO.BEDROOMS
BUILDINDEPARTM VALUE .4
ENT
--
SETBACKS FRONT 40 REAR 75 LEFT SIDE RIGHT SIDE
-- —= _—
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Permit I.A.U0 THIS PERMIT IS ISSUED SUPJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONIwG
Plan Check 'J0950REGULATIONS 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
Sub-total 271.51 WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRAcroFiS TO HAVE CURRENT CITY BUSINESS
State Tax 7.24 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total 27Q.74 SDC— $400.00 \. .s..� ._
By PDCJt $ A_4LICgN1'0n..5ENT --
_
Approved LR,RI Receipt No. , _ *�C,1 o n i k M/
ADDRESS PHONE
i
DATE INSPP, TYPE INSPECTION REMARKS PLUMBINGDATE
=� .iE Contractor
Permit No.
Rough-in
9.;�>• 7i'At - Fixture
O — Final --
/ •%fir/ As -- HE TINIG
2� -����_� Contractor
Permit No. --I
Gas or Oil
_- -------------
Final a _.
SEWER
- ---- ---- - Final fP--w ��..
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
--- - ----- Sidewalk
Curb&Street Final
_ Approach
MR
SL6J.DEPT.FINAL TEPORAY_ — CERTIFICATE OCCUPA CY
CEPTlF1CATE OCCUPANCY /L �/ C fr Final
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Lan Jscap,ng
Zoninn 'final
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