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INSPECTION' NOTICE '&J&
City of Tigard Buildirg Department
P.O Box 23397
Tigard, Cregon 9722;1
Phone.639-4175
t
Type of Inspection �'// 't
Date Requested �_ Time A.M.—__P.M.
'✓'� 6
Address Permit
Owner – l_ot
Builder
The following Building Code deficiencies are reouired to be corrected:
—
Presented to
Inspector
/ --..- ._ Disapproved
Date
CALL FOR REINSPECTION
C7 yea ONO
w w1w1Aw- w-jLw-X1
BUILDING PERM17. APPLICATION rIGARD DATE-
THE LINDEI-i�iIGN ED F I EREBY APPLIES r:OR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOVVI I AND APPROVED IN THE ACCOMPANYING PLANS AND SPZCIFICA1 IONS. OWNEF PHONE
LOT NO.
OWNER Lytle U. '4ayro JOB ADDRESS j!�db5 moIw a tlii Ave.
MilwA Ile, 09 97227 ARCHITECT
ENGINEER
BUILDER ADDRESS 15359 A oucky Lan DESIGNER
STRUCTURE L8 NEW C I REMODE _0 ADDITION [I REPAIR L1 RENEWAL EI FIFE DAMAGE El DEMOLITION
11 RESIDENCE El Comm 0 EDUCATIONAL E-] GOV'T 0 RELIGIOUS 0 PATIO '] CARPORT 0 GARAGE D STORAGE 0 SLABEI FENCE
--*,
OCCUPANCY LAND USE ZONE R7—PD BLDG.TYPE 5N FIRE ZO"�,— PL -N CH EC BY HF_
WNSTRUCI: SLNGLf FAMILY DWELLING W/ATT`�,Vh, V
2 bathroom 3 6ettroms
SEWER PERMIT# _1'repaid by d*ve1c)jmr (4 35.00 fee Insp.) Aarate 461-j__
OCC.LOAD FLOOR LOAD 40 HEIGHT 2U NO.STORIES i AREA 1341) NO.BEDROOMS 3 VALUE 53,kL!
BUILDING DEPARTMENT — SETRACKSFRONT 2ij REAR LEFT SIDE 1 RIGHT SIDE 5'
Permit HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
FiEGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT 6 HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE. ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 4b 1.80 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS 10 HAVE CURRENT CITY BUSINESS
LIFEtS$.�_Ef ARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
Total 493.46 SDC— $51J%.,.;Al
PDC# L1 *15(J.Ufi -Ai5NO�ANTORAGENT
By
Receipt No.
---
Approved 6TW PHONE
DATE INSP.1 TYPJINSPECTION REMARKS PLUMBING DATE
Contractor
!at j
Permit No.
•q. .4V346f
Rough-in
j Allo
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
le_Z Rough-in
Fine
SEWER
Final
AY_
DRIVEWi��
Final
Storm Drainage
(Pain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT._f TEMPORARY 11.74;ile ATF_OCCUPANCY Flnel
TWICATE OCCUPANCY
In,11n.1
BUILDING RECEIPT
NAME: --_--- f _ DATE: /s
ACCT. # DESCRIPTION AMOUNT
10-432 Building Permit Fees $ 00 __..
10--431-600 Plumbing Permit Fees
10-431-601 Mechanical Permit Fees
10-230-501 ,ta'e Bui. :ing Tax $ -_----- .
10-433 Plans Check Fee
30--443 Sewer Connection (20X)
30-•202 Sewer Connection (80X)
30--444 Sewer Inspection
51-448 Street System Dev. Charge (SDC)
52-449-610 Parks I System Dev. Charge (PDC)
52--449-620 Parks II System Dev. Charge (PDC)
31-450 Storm Drainage System Dev . Chra (SEDC) $ _ CQ 50.
10-230-505 TRFD (95X)
10--478 1-RFD (5X)
I 10-130--506 Washir►gton County Fire M1 (95X)
10•-478 Washington County Fire M1 (5X)
10-220 Amart/Wedgewood
TCTAL
(bs/1214P)
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i
THE I)NOERSIGNED HERFBY APPLIES FOR APERbIif I%?H ItIL '+NOHK NLItcIN IN')ILAILU UUILUL1OvmUrs 41*,'401��
OR AS SHOW1 AND APPROVED IN THE ACCOMPANYIrhG PIANS AND SPECIFICATIONS. mll
NO 1� �—
t % ��i r l/.,m .r,•
)OB ADDRESS � 7u��411�1TCCT
7,7U.clLatiut�JlSri:�l=1 T
i
AD7RES�LI`> ER
OESICNER
�iUl�-Oca r� - _.. TT
STRUCTURE NEMC ❑Rf!�►rIOEL ❑ACOItl_0N ! n—IP-a1R - RENEWAL ❑FIR£DAMAGE ❑DE:401
P0RESILsE'eCC ❑CONCH ❑EDIM,ATIONAL
❑GOV•T ❑REL1GtCUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑
CHECK BY
CG4 r;tiy 3�1,AN0 VSE ZONE f t' OLOv. TYPE,.,.K__ -
CONSTRllc'T STNGf: FAMTI•Y DD1eTF�I�TN(' WlAT4-ACHED-
�g�L' 5Z4�1 'BEDROOM
�� _ RfII �.. ,! �_ Garage 4�v j['----
R 1 AAD �id Ll �E)SLH.L _BE._ CROJAI;: VALU@)
Sil)IROINv OEP.1gfMENT c REAR iA LEFT SIDE eJ �"aa. RIGHT Slosy b
S_T BAC KS FR0 _
Permit �,�yt y
I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CO 3E•
I Y:IIn^•!beck REGIILATIONS AND ALL APPLICABLE COOET AND ORDINANCES,AND IT IS HEREBY AGREEo TNI
.. WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN C041PLIAN3
$UA-LDtJI ��t ALL APPLICABLE CODES AND ORUINAN('F.S THE ISSUANCE OF THIS PERMIT DOES NOT
• RESTRICTIVt COVENANTS. CONTRACTOR AND SUN CONTRACTORS TO HAVE CUgREr1T CITY B1:
rf ata Tan `�, LICENSE. SEPAPATE PEAWTS REOUIRED FOR SEWER•PLUMBING AND HEATING.
I =----� •IQ SDC
1 Tutal I 1 7 • PDC#
aY AoPLICl.NT UR AGENT ---
I Appru..1 Receipt Nu. t
t� ,nnnFts I Sy� / HnoN4 1,bI
SSM DC (Storm ' p = 4 K(�
SEWER CONNECTION
f
SEWER INSPECTION
SEWER SURCHARGE $
-- --- 3 s40o •