11815 SW 79TH AVENUE-1 N w iff
1181.5 SW 79TH AVENUE
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INSPECTION NOTICE
Ci y of Tigard Building Department
12420 S.W. Main St.
Tigard, Ort gon 97223
Phone G.94111
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Type of Inspaotion 3
Date RequestedQ \ Time A.M. _P.M.
Address O G"A _ Permit �--
Owner—__ _ Lot #_�—
Builder
The following Bu:Iding Code deficiencies are required to be corrected:
Presented to —
V Approved
Inspector Desapproved
Date
CALL FOR REINSPECTION
❑ YEA /NO
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BUILDING PE EMIT APPLICATION TIGARD V,kTE---t4_kX 1_') , tg--8-3 - 4523 i
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE A39-6429—
OR
39-6 ti_OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 639.6397 —
LOT NO._ Tax Lot 3600
_OWNER Forest c JOBADDRE_SS 11815 SW 79th _ _. Tax M p I -36C;D
— ARCHITECT
ENGINEER
BUILDER
SaSame
ADDRESS 17902 SW Tamra Ct, DESV31NER
STRUCTURE LINEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL F GOVT ❑ RELIGIOUS ❑ PATIO CI CARPORT L5 GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USE ZONE R-1U_BLDG.TYPE _ 5N—FIRE ZONE------PLAN CHECK BY HEAT
_Constru4t detached Mrs * per plans.
SEWER PERMIT#
OCC.LOAD FLOOR LOAD HEIGHT_ NO.STORIES_ AREA 672 NO.BEDROOMS VALUE 7#5Z
BUILDING DEPARTMENT _ SET BACKS FRONT -- REAR 10 i LEFT SIDE 4,51 RIGHT SIDE 6
Permit 68.50 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY ACIREErj HAT THE
Plan Check 44.51 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IV COMPLIANCE
WITH A4.1 APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT 00_S KOT WAIVE
Subtotal 113.03 RESTR;CTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
^— 2.74 LICENSE..SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC—
Total 115.77
PDC# APOLIOANT OR Ala NT
By CH '� 'A `
Receipt No. --- -- - _. - t
Approved Jy R AbDREss— PHONE
DATE IINSP. TYPE INSPECTION REMARKS - PLUMBING _ _^ DATE
Contracm
Hough-in
Fixture --— -
- — F nal
HEATING
Contractor - 1
--- —_V Permit No.
Gas or Oil
-- -- - --- `- R mgh in -
- Final � --- -
- - — -- ------ SEWER _
- -- --- Final
DRIVEWAY
—_- `-- Final
Storm Drainage
(Hain Drain)Final
—' --- --- Sidewalk
Curb&Street Final
Appriach
bLDG. DEPT.FINAL �— TEMPORARY CERTIFICATc OCCUPANCY -
CERTIFICATE OCCUPANCY Final
i
Landscaping
�_`---- -
Zoning Final �- _
,1-523
BUILDING PERMIT APPLICATION TIGARD DATA---�
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE W.1RK HERJiy INDICATED BUILDER PHONE '3 7
OR AS SHOWN AND APPROVED IN THE ACCORAPAMVtNG PLANS AND SPECIFICATIONS. OWNER PHONE¢
LOTNO./aA,
Orrr�ER.� � JOBADDRESS //�'r/� �s -Z;,4-N, 14,,44
ARCHITECT
F EN�?INEER
BUILDER _c/���_� • •>
ADDRESSC�.:? --SGs- :testae'
DESIGNER
STRUCTURE T NEVI ❑ REMODEL G AODITION El !IEPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM Cl EDUCATIONAL ❑ GOV'T ❑ REUGIOUS ❑ PATIO ❑ CAR PORT'Q,GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY —U1ND U5E ZON[F �O BLDG.TYPE FIRE ZONE PLAN CHECK BY HEAT,_.._
IAJ
CCWF-R P1FRM1T#
OCC.LOAO FLOOR LOAD HEIGHT NO.STORIES AREA. NO 13EOROOMS VALUF?'�-s--w
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIO@ RIGHT SIDE
Portnft � THIS PERMIT IS 1�581-ED SUBJECT TO THE REGJLATIONS CONTAINED
IN THE BUILDING t;ODE,E(aNSN:
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,AND IT IS HEREBY AGREED THAT I
Plan Che.ck ` S� WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATION3 AND IN COMPUANCI
WITH ALL APPLICASLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT GOES NOT WAIVI
Sub-total / RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURREW CITY BUSINES!
LICENSE SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
Stats Tu t
..� ._.. SGC—
APPUCANT OR AGENT
ey
Receipt No. ADDRESS PHONE
Approved
SDC —
PDC — t
SEWER CONNECTION S _
SEWER INSPECTION S
SEWER SURCHARGE_ S
So
PERMIT TO CONNECT
City of Tigard AC, 1 33l
Permit No S 8 7 DA-vE
PERMIT IS GIVEN TO___ i'tl_--��G.� - -5---- �-
TO CONNECT A
TO THE SYSTEM or CITY OF TIGARD
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THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREM1516 UNTIL COW
NECTION is MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
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PERMIT FEE PAID $ ' — - CITY OF 'TIGARD
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CONHLCTIgO/N INSPECTED AND APPROVED
LY -0
` v. Q
J Date Superintendent
Address / /S^iot. ! Permit No. O 0
Name of Occupant_ Permit charge Z � �/D -/7
Connection fee
Paid by -- --
Date connected
Type of Building_ inspection fee
Service Rate _ Paid by Date_--_ -.---.--.-_
Contractor Aspessineof Paid
Size of connection