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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 I (a Time A.M. P.M.
Address __—_—is
2 (' Cj �() 9 Permit
Owner !! Lot
—�,.) ►'! —_
Builder `^i(� �'� -----
The following Building Code deficiencies are required to be corrected:
�`- _ .�iL_ _ ♦V f _ . i w sister r
Presented to Approved
Inspector G — CI Disapproved
C
Date
CALL FOR REINSPECTION
[ YEt �.-1 NO
'l.
i
BUILDING DEPARTMENT, TIGARU
PLUMBING PERMIT
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
Til;ard. Such installations require inspection by the City Inspector who shall be notified -tot less than four
(4) hours prior to the time the installations are ready for inspection. City cf Tigard Busine:;s License required
for all contr4rtors and �,ub-contractors.
Owner- '' l _ _ Address _ Date
NUMBER OF
TOTAL PERMIT NQ.'S
TYPE OF PERMIT ITEMS 'PEE ON EACH AMCUNT !Office Use Only)
„I?ESIQENTIAL _ -- — —
Single Family-1 both—each 25.00
Du Ilex—Each 1 bath unit 25`00
I
Additional bathrooms—each 10.00
Mobile_Home Space—each 15.00 _
INDIVIDUAL FIXTURE FEES _ �^
1 to 50 Fixtures in 1 building—each 0.00
_5_1 tc 100 Fi•rtures in 1 building—each 2.50
101 to 200 Fixtures in 1 building—each ____.___2.00__
?01 or m.nrg Fixtures in 1 building each- _ 1.50
M15CELLANE0US
Building Sewer-1st 50 ft. _ _ 10.00
Sewer—each additional 100 ft. 1.0.00
Wa•er Service to building _ _ _r 5.00_
Private Water Systems—each 100 ft. _ 10.00
Other (Specify):
PERMIT For Plumbing Inspection Phone 6394171 e*
3%State ' Plumbing Contractor By _��� t' -
TOTAL' REGcIPT NO. Issued By
BUILDING PERMIT APPLICATION TIGARD DATE_----_
3471,13
THE UNDERF;GNIEDHERE13'. APPLIE2FOR APERMI: FOR I HE V�,,jRK HEREIN INDICATED
<
OR AS SHOWN AND ARPR!'.)VED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. Z'I't��-�77 _7
OWNERa. ji a JOB ADDRESS 112�U 90
5U ti'� LOT NO.f1=1Ch-Jl*1*'
U1cjq. Lic. A
ARCHITECT
ENGINEER
BUILDER Getty ADDRESS 6910 NW
DESIGNER Pyramid Deeign
STRUCTURE El NEW Cl REMODEL ADDITION 0 REPAIR 13 RENEWAL 0 FIREDAMAGE 0 DEMOLITION
0 RESIDENCE FJ COMM 11 EDUCATIONAL 0 GOV'T 0 RELIGIOUS Ll PATIO L] CARPORT E] GARAGE E) STORAGE Ei SLABO FENCE
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE---- PLAN CHECK BY _HEAT_._
,metruct now addition to existing dwelling all t)r-4r plansA rode.
Plumbing Purmit Pequict.,k, .
SEWER PERMIT
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA 377 NO.BEDROOMS VALUE
.__ BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Pe,mit 0 4•[a0
— — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 42.00 REGULATIONS AND ALL APPLICABLE CODES AMID ORDINANCES AND IT IS HERES" AGREED THAT THE
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 W11IVE
Sub-total 11 126.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTC RS TO HAVE CURRENT CITY BUSINESS
State Tax 3036 LICENSE.SEPARATE PERMITS HEQUIRED FOR SEWEI,PLUMBING AND HEATING.
Total �d 2,1).3 C SDC—
By p vu(;# KvpLlC4)4T OR AGENT
Approved Ott.$ Receipt No. 7123 PHONE
DATE INSP. TYPE INSPECTION^ _ REMARKS _ PLUMBING L` DATE
Contractor
Permit No. 3��
/ Rough-in
/ uy Fixture
t/ n J� Final
z-IJ 'Dpp I 1'IW'hR4 �e Ro J4doHP'. FiEATIN6 -
1 ttoNe C7tun�lr-,S' �. �� ��4. /Q �G OLt 1I(.!• Contractor
Permit No.
04
Gas or Oil
Rough-in
Qz /Y rt�ar �-n�Cp.�Nor-I NrnO�� �cml° 'v1'���/�.Z �AH Nft�.G✓t�� Final
SEINER
617 4 S Final _ --
DPF.'EWAY
Final
Storm DriOnage
(Rain Drain)Final
Sidewalk
�— Curb&Street Final
- ------ 'Approach
BLDG-DEP FINAL TEMPORARY CFR'tIFICATE OCCUPANCY
. 1-11181
CERTIFICATE OCCUPANCY
Landscaping
–�-- _ Zoning Final
SXWTjW
BUILDING PERMIT APPLIC.aTION DAT
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR ThE WORK HEREIN INDICATED BUILDER PHONE��_,�=�
1111 A5 SHOW NO APPROVED IN THE ACCOt.PANYING PLANS AND SPECIFICATIONS. OVVNER,fNONE
4""'ERI / -i JOB ADD ESS �� � —_ /�Cr J 7
ARCHI TECT
ENGINEER
ADDRESSER 0 DESIGNER PC /1d c
STRUCTURE ❑ NEW ❑ REMODEL _' ADDITION ❑ REPAIR G RENEWAL J IRE DAMAGE ❑ DE!(t )t_ITION
(RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T Cl RELIGIOUS;C PATIO C CARPORT Cl GARAGE C S7 (GE C SLAE❑ FENCE
CiCuuf ANCY ,__}-.t�4ND USF ZONE BLDG.TYPE Slk,FIRE ZONE PLAN CHECK BY — C�_HEAT
SEINER PERMIT M
OCC.LOAR — FLOUR LOAD HEIGHT NO "TORIES_ �'77 NO.BEDROOMS VALUE.17 0 O
But LING DEPARTMENT � I SET BACKS FRONT REAR LEFT SICE RIGH f SIDE fir'
ir-In _ Go THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE ;�UILDiNG CODE, 7GP%"!4
I y y V6, REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HE?IEBI:AGREED THAT THE
Ii'tnnCheck WORK WILL BE DONE IN ACCO DANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
+r -- } WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PER`AIT DOES t40. WAIV:
E'ut>total _ �.l�O RESTRICT',!C COVENANTS. (ONTRACTCR AND SUB CONTRACTO„S TO HAVE CUPPENT CITY BUSiN'zsz
zz
LICENSE.SEPARATE P R'dIT S REQUIRED FOR SEWER,PLUM:SING AND HEATING.
Stats Tax J r'�
Total SDC ___
pOCA APPLICANT OR AGENT
By
Receipt No. _
Approved ADDRESS ___—_— __—.--- —_-_----__-- PHONL
SDC
PoC - s #
SEWER CONNECTION
SEWER INSPECTION 8
SEWER SLIRCHARG� $
o
_... _
r
I
PERMIT TO CONNECT
City of Tigard
Permit N? 632
PE14.111 IS GOVEN
OF
TO CONNECT A-0v._.�fEll
TO THE SYSTEM OF CITY OF TIGARD
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COMPLETED.
PERMIT FEE PAID $ CITY
�OFF TTIIGAPD
By
CONNECTION INSPECTED AND APPROVED
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