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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested _ �' / me A.M. P.M.
Address 1-5 /SIS �� "�/+ Permit # ^
Owner--- Lot # !�
Builder ______ _
The following Building Code deficiencies are required to be corrected:
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Presented to ] Approved
Inspertnr
Disapproved
Date e —
CALL, � /
FOR REINSPECTION
1Q YES ❑ NO
W W1 W1 WM
1
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oren-m 97223
Phos 63,,9-4171
Type of Inspection
Date Requested cT" " -� `� �-� Time /A.M. `� P.M.
Address!,�� % ��'� '�/ r� Permit
Owner Lot #
Builder_
The following Building Code deficiencies are required to be corrected:
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C?s-�—__qtr_1=��if • /
Presented to II--11
—a• <`I Approved
Inspector _ ( �
�� Disapproved
Date
CALL ,F�O/R REINSPECTION
IG1 YES 0 NO j
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested 14" ga. Time A.MlAaP.M.
-t-' ;7,7
Address Permit
Lot
Builder
The following Building Code deficiencies are required to be corrected:
..............
Presented to ZAPd
WE
ve
•
Inspector 11311upproved4/
Date
CALI, FOR REINSPECTION
E-1 YES 360
BUILDING PERMIT APPLICATION TIGARD DATE_.. �u;y 15' ' -----,19- -- 5477
THE UNDERS.LNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER f HONE 592"3615
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.__—�'�
OWNER — •yr 1:171e�r _ JOB ADDRESS 157.35 SW2iQtb ---- -s'O
Tigard ARCHITECT
fi ENGINFER
BUILDER S�Isr�_ �_ ADD_P._ESS P.G. Box 2329) _ DESIGNER
STRUCTURE 1 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMA3E ❑ DEMOLITION
%(RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
Gas
OCCUPANCY R-3 --LAND USE ZONE 12 BLDG.TYPE SN..FIRE ZONE—.PLAN CHECK BY ----HEAT-----,-
--Construct
HEAT__-_—,__Construct simAIC f4mily dwel—i—m w attacn+s s s. w limn
--- _ 2 Rat1iroom 3 Bedroom --
SEWER PERMIT# 26484 _ Gaayute 484 --- —
OCC.LOAD FLOOR LOAD :_ HEIGHT 12NO.STORIES I_ AREA 1687 NO.BEDROOMS 3 VALUs 158900U!
BUILDING DEPARTMENT SETBACKS FRONT 2U _REAR 4U LEFT SIDE 5_ RIGHT SIDE 5
Permit _ 337,00 THIS PERMIT IS ISSUED SUBJECT 1'0 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 219,05 WORK WILL BE DONE IN ACCORDANCE WITH THE PI ANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCE`.. THE ISSUANCE CF Thi; PERMIT DOES NO( WAIVE
Subtotal 556.05 RESTRICTIVE COVENANTS. CJNTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
L1CFENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stale Tax 13.48
`:, t
— 53 SDC— $500-00 __
Total 569.
"— PDCM APP1�
y19Rf IT O1_'ACiFFIT
1I $ISU.UU
Bt:Z __ _
Receipt No. ADDRE98 — -- PHONE
Approved Bl:lt
DATE INSP.I 7YPE INSPECTIO�NN REMARKri PLUMB NG DATE
Cuntractor
Permit No.
re — -- -- —"Fixture
.7 7. _r _ - Finai - -
_ ✓ —r - -
!� HEATING
'Z y_ Contra�tur13
�V-
Permit No. 34P716
-y�c.---
9 t-�t / - Ga:or Oil -- -
Rough-in --
Final
SEWER - -
— Final -
_r v-- �--- ----- DRIVEN AY
_. _-. ._._ ------------ - J Final
Storm Drainage -
I (Rain Drain)Final
Sidewalk e
Street Final
i tPPM01
77'-
BLOC:. UFPT. a't _ TCMORARY C.KRTIF;c;ATF.OCCUihNCY
P
CERTI"CATS OCCUPANCY—r gr
Final – —
i Landvnening
BUILDING RECEIPT
OAT-:
AT-. -a-----
ACCT. N DESCRIPTION AMOUNT
10-432 Building Permit Fees
10-431-600 Plumbing Permit Fees
:0-431-601 Mechanical Permit Fees s __
10-230-501 State Building Tax
10-433 Plan Check Fee S �j
30-443 Sewer Co4inection (20X)
30--202 Sewer Connection (80x)
30-114 Sewer Inspection s
51-448 Street Syst4m Dev. Charge (SDC) f �
52-A49-610 Parks I System Dev. Charge (PDC) f �_
52-449--620 Parks II System Dov. Charge (PGC)
31-450 Stoma Drainage System Dov. Chrg (SSDC) ���Q ZC�
10-230-535 TRFD (95x) s414
10--478 -RFD (5%) s
10-130-506 Washington County Firy N1 (95x)
10-478 Washington County Fire N1 (5x) f
10-22.0 Amart/Wedgewood f -- --- --
TOTAL f
(bs/1214P)
ffm
w R1f
II�f. UN0j:HSI6,1EU N_HLtl r Ar rl_ILS r ulI •k"Lllnll I r %)I'R AS SHOWN AND APPROVED IN THE ACCOMPANYING VLAfJS AND SVL(:If ICA itONS. O"I"LI' ''" '
G
LOT
J'.YI C-77>10B AOOR�SS
0n11TECT
ENGINEER
/ G)
AOORE5_, , OESIGNER
:iUl_O�•� _ _
STRUCTURE –_ YEW 0RFtiN1UEL Ja001f10'V _❑nFpAiR ORENEVIAL l_.:FIREOAmAGE ❑OE:•IGL
nESILIE"ICL (DCOItN; ❑EDUCATIONAL CJGOV'T ❑RELIGIOUSCI?ATIO OCAS PORT ❑GARAGE J J STORAGE❑SLAB ❑F
_ PLAN CHECK SY -2K-4 HEAT r'
��C.�t;Par,•Lv_Q_=�aLANO USE 20rJE-�" �..— -
_____ CDAM�S',S_S�jN , .F. FAMILY DWFI 1 TNL WjnrrnCHFD GARAGE-
>>, 7L_it�1� -
/ BATHROOM _=> BEDROOM
SEWER PERMIT
c"H NQ_5Ton; PF_>16 fL=HEL?F1i�0AIS.:, VALSI�—_,
FLOO1_Q� — HEt I I
SIBLOING OEPARrMENrSETBACKS _FRONT �2-Q REAR yL7 LEFT SIDE 3 _ RIGHT SIDS-5-
THIS PERMIT i5 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING COOT. X
1 F:1n Check Z / REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HERERY AGREED TH
(------ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COWi1lLI tNC
J�•r(�ul J! �'
0.5 ALL MPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT
RESTRICTIVE COVENANTS. COIITRACTOR ,AND SUB CONTRACTORS TO HAVE CURRErIT CITY W.
r! at+l Tax i 7 LICENSE. SEPARATE PERMITS REOUIRFD FOR SEWER.PLUMBING AND H=ATING.
Tical I S`G `i' --`�-' SDC PDC#
r—
APPLICAFIT OR AGENT
Aparovt-d Reuipt No --
Nne,Rnts �+On
51?`_' (Storn) %Z
SOC - S d=Co
PDC - S /.5
SEWER CONNECTION
SEWER INSPECTION S
SEWER SURCHARGE $
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Comments : +�
i i i WN&W
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Du i Id i ng Perm i t No.
Location
Date ------ — -
Certification of Registration
With the Builders Board
doing business as (dba) ,
am registered under the provisions
of ORS Chapter �701Oregon H ders Law) .
My Builders Board Registration dumber is
My registration is in full force and effect and expires on
r
Sign — —
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