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city of Tigard
INSPECTION REQUEST
for
IINSPECTION TIME : - PERMIT NO. : --
DATE: / / DATE. ISSUED:.. -1
/J4•�•_ d� �JAXX OWNERS NAME : sP�✓�,- _
IAD0REaS : G' -
uONTR.4CTOR : `" r V
e+ Water 0 � Visual C , Laboreto•y 0I
TEST' A�� fa,
Jisa roved EJ , Pending ❑
` RESULT. Appr��vad , p�
SKETCH:
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TOTE; Aliach SUPplemen"' 1e27
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(City of Tigard
INSPECTION PEQUES �I
for
IN, "ECTION TIME- ��`� , e e) PERMIT NO. :--
DAT
O. :DAT E: _ 7-- DATE 1 SSUED :___L -I
OWNERS NAME * _LQ �?.
AODRESS
C0NTRACTOR : .-J .--
TEST : Air 0, Woter G1 , visual tq, Laboratory [�
REULT: Approved Disapproved 11 , Pending p
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SKETCH.
i INS ECTOR DATE
COTE: Attorh suppler"S"ta' test data beretQj
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City of Tigard
INSPECTION REQUEST
for '
INSPECTION TIME: f mak. !�'� PERMIT NO. :---
DATE '
O. :_ _DATE: DATE ISSUED :-
OWNERS
SSUED :_OWNERS NAME : XP 74 7 Z' '•r �� 4i.
ADDRESS: ^
CONTRACTOR
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TIF.ST : Air D, Woter[1 , VisuaiLaboratory [)
RESULT: Appruved t Disapproved ❑ Pending E] I
SKETCH.
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INSPECTOR DATE
EOTEAttach suppi*mental test data beret
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME : PERMIT NO. : - -
DATE: _71 '27`:— DATE ISSLJED:.�,
OWNERS NAME '.
ADDRESS '.
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CONTRACTO R :—_..:—._._ .-- -- - --- -- -- -
TEST' Air 173, Water [p , Visual 0 , Laboratory ❑
RESULT.' Approved , Disapproved ❑ , 'ending
SKETCH:
I PECTOR DATE
OTE Attach supplemental test data herstol
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ADDRESS
CC) �1u t�> PEk".IT N0.
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PERMIT I'NARGE none
OWNERCONNECYION FEE 5-2_s
PAID BY ----
____ DATE CONNECTED
TYPE OFBUILDING `
SERVICE RATE INSPECTION FE
CONTRACTOR PAID BY � DATE
SI7_E OF CONP' -TION ASSESSMENT ^;iD --..
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CITY OF N27
BUILDING PERMIT APPLICAT!n"� TICARD DATE 19------.— 1) '�'�
THE UNDERSIGNED HEREBY APPLIES FOR AP'illli FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIOW),tO�N�PVfi” -.
Mrs. L. suntcun ' �kltil��er
UER Af�DRESS *� dUILDEN PHON
iNNE _
F. G. adidera I= ENGINEER
"ujLQ&f ARCHITECT DESIGNER r'
S1'fUCTURE (INEW ❑REMODEL ❑ADDITION ❑RE'PAIR ❑ CJ
RENEWAL ❑FIRE DAMAGE DEML,_ TION
U RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
OBOND ❑MOVING ❑CONDITIONAL USE ❑CESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_ LAND USE ZONE -� FIRE ZONE PLAN CHECK BYx°)cY -- HEAT
construct 126b sq. ft. split Enrol fvwui.* dwelling with garage --
in yeneeant _
3 bedroae
OCC'-LOAD _FLOOR LOAD ^tea X HEIGHT NO.STOP"'� AREA 2576 VALU�2a()Cl
_ BUILI,IM.±DEPARTMENTSET BACKS FRONT 2.0 REAR 5( LEFT SIDE 10 RIGHT SIDE 70 _
Permit �'� ------------ — — __._,
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTA!*!FD IN THE BUILDING COLE, ZONING
Plan Check 66.50 REGULATIONS AND ALL APPLICABLI5 CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI_IANCF WI I rl
Recording ALL APPLICABLE CODES AND OODINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO 4A%'E CURRENT CITY BUSINESS
1%State . LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total
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By
_ APPLICANT OR AGENT
Approve J Receipt No.
ADDRESS `— __ -- -- PHON
DATE INSP, TYPE. INSPECTION REMARKS _ PLUMBING DATE
Contractor L ,�•��.�-u.�_ _
^ -� Permit No. _
`p .2C., Hough-in --
Fixture _ — ----
7_D • S /- v'.��, V /�FS.�� .�/L�t tJ Final -
��' HEATING
-- -
� Contractor
�.2,2 7 ✓ Permit No.
D 8 Gas or Jil --
rou
EWER
-- --- DRIVEWAY
Final
Storm Drainage
_ (Rain Drain) Final
Sidewalk 3
Curb&Street Final
Approach J-7 i
SLUG.DEPT, FINAI TEMPORARY CERTIFICATE.OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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