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INSPECTIONNOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time A.M. M.
4�Address Permit
-7
Owner Lot #
Builder
a following BuildinX Code deficiencies are requir Ki�be corrected:
Code deficiencies
L
A
Presanted to Approved
Impactor Disapproved
Date
CALL FOR REINSPECTION
YES 0 NO
FjFW
INSPECTION NOTICE
City of Tigard Building Departrnem
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
4—
Type of Inspection .
Time A.M.->'(---P.M-
Address �" " Permit
Owner- f—r/'LL Lot #
Builder _
The following Building Code deficiencies are required to be corrected:
- _ 1
- —------
Presented to Approved-- --
72
Inspector Disapproved
�s-
Dow
CALL FOR REINSPECTION
❑ YES ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested �'� _—_ Time_ v� A.M. P.M.
Address � � G Uig' Permit #—
Owner__—
l.ot #
Builder
The following Building Cede deficiencies are required to be corrected:
__Ice
/..
�{- oo .
Presenters to _
i/r Approved
Inspector _ _
/ Disapproved
Date
CALL FOR REINSPECTION
❑ YES I��NO
Building Permit No. 4Z 1r
Date
Certification of Registration
With the Builders Board
7 '
doing business as (dba) ,
n
--
(,tet c,7`> . M vs nJam registered under the provisions
of ORS Chapter 701 Oreoor, iomebuilders Law).
My Builders Board Registration Number is
My registration is in full force and effect and expires on Y4 ___
Signature
5037
BUILDING PERMI APPLICATION TICARD DATA`- �`6 X19- 84 - %
THE- UNDERSIC JIii HEREBY APPLIES FOR A PERMII FOH-i hL WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPRRVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
00-v LOT NO.._
OWNER �u�s, g _ Y— ADDRESS )64()5 Skt�3rd :St. Kneeland --
* 97132 ARCHITECT
ENGINEER
BUILDER ADDRESS kt. 3 Box 2.3 DESIGNER
STRUCTURE l.XNEW ❑ REMODEL ❑ ADDITION L7 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL LI GOVT ❑ RELIGIOUS ❑ PATIO_❑ CARPORT ❑ GARAGE_❑ STORAGE 0 SLAB❑ FENCE
OCCUPANCY __K_3__LAND USE ZONE _RrLgD BLDG.TYPE _5N FIRE ZONE PLAN CHECK BY Tw_HEAT
Construct_single fl�jlj"llin,g w/attaChOd garage.
3 Bathroom 4 5edrwm
SEWER PERMIT 0 27968 Garage 472
OCC.LOAD _ FLOOR LOAD 4U HEIGHT_ 20+ NO.STORIES 2 AREA 2 144 NO.BEDROOMS 4 VALUE 74�GUU•
BUILDING DEPARTMENT SETBACKS FRONT _ 2U REAR 60+ LEFT SIDE_ I? RIGHT SIDE 7
Permit 355.OU 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 AGREED THAT THE
Plan Check 230.75 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
Subtotal 585.75 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB COATRACTORS TO HAVE CURRENT CITY BUSINESS
t4*20 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWFF,,PLUMBING AND HEATING.
State Tax 55G�.GU
SDC—
Total 599.95 11 150 eOU
POCK APPLICAN i OR
A _7�
By SSUC 2513.110
Receipt No.
_._—�--PHONE _
Approved i:I ADDRESS
r
DAT?_ INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
/
Permit No.
Rough-in
_ �. Fixture
C"O* Q V I Final — --
HEATING -----
co
_ ..
Permit No.
Gas or Oil
Rough-(n _ -
-` -- Final
SEWER --—�
__--- Final
DRIVEWAY
Final
Storm Drainage
(Rein Drain; Final
Sidewn'It
Curb&Street Final
Approach
66 DEPT.FIN!4 TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
1Landtcapinn
7oning Final
THE UNDE:RSICiNED HERLUY APPLIES 1-01i APEIINII 1 1`011I Ilt rVUllr; tlkllcltJ 1NL111 N1 LU Lrt: .luLjLLl* %x10 _
OR AS ':'HOWN AND APPRCVEQ. IN THE ACCOMPANYING PIANS AND SPECIFICATIONS, OVINEP.m-CKIf
�r
/ LOT NO___–_.
•7'.VNEfaj��,c,??rtif .�Cfc-�ir"f `ti �J08 ADDRESS / G C d �4 .'��/S�'f-f(��/�LU -
- ARCHITECT
ENGINEER
nUlr_7.:'t ��ii/'r�E ADORE^ri,/f
STnUCTLIRE vEw—_0nEkInOEL L-JAODITIOv – ❑nmmn ORENE'i/AL _ ElFmE DAMAGE 1 ❑DE:.IO1-0
nESIhC"ICC UCON.M ❑EDUCATIONAL C�GOV'T ❑RELIGIC'US❑PATIO OCAR PORT ❑GABA GE Q STORAGE C 1SLA8 [JFE
CGCUPar;.v_R= _LA•10 USE ZOrIE LOLDG.TYPEN..A v V� PLAN CHECK BY. �f — NEAT <
CONSTRUCT• SING E F MT .Y
BA 11ROOM BEDROOM
.SEDER PERMIT u �---f�-- _ Garage ? Z
Q"_L_0 - F10(0)R t OAD L! HEIGHT &NO.STDR;EsZ A n+S�VAj400U
5111LOING DFPAR rMENT SETBACKS FRONT pZ C' REAR LEFT SID _RIGHTSIDE
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZOf
I
Y;-.4q Check � ) �� REGULATIONS AND ALL APPLICAGLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT
r_ WORK WILL RE DONE IN ACCORDANCE WITH THE PLANS ANOl ECIFICATIONY AND IN Cumi'L1i.NCE 1
ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PEnmIT DOES NOT W.
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSK
!7;at.-Tax I �? _ICENSE. SEPARATE PERMITS REQUIRED FCR SEWER. PLUMBING AND HCATING.
total SDC I l � �`� —
PDC#r
�• APF)L f_A,NT OR AGENT
Appy Receipt No. —�`— —
• ir1r�R FSS HON '-
MC (SLori
Soc C4 06
5�1 �1
PDC X 2
SEWER CONNECTION
SEWER INSPECTION g
SEWER SURCHARGE
Comments :
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