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INSPECTION NOTICE
City of Tigard Building DcparUnen:
12420 S.W. Main St.
Tigard,Oregon 97223
–� Phone: 639.4171 1
Type of Inspection
i
Date Requested — �l- 9 �— Time _ AN._ P.M.
Address �(J� ���/ ,Z.' � Permit # 5 7
Owner �_��._ ✓V bi � Lot #
Builder a __
The following Building Code deficiencies are required to he corrected:
17
IE
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- I
I - -
Presented to _- _ Approved
Inspector --------._____ �` [1 Disapproved
t �aate
CALL FOR REINSPECTION
❑ YES XNO I
INSPECTION NOTICE '
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 9722'
r
Phone: 639-4171
Type of Inspec•.`au
/ / T
Date Requested y JG 5�_ Time!�. A.P" P.M.
Address ._ /1 _ Permit
Owner ....... _ ����� Lot
Builder -------- . --- – ---
The following Building Code deficiencies are required 'o he corrected:
I
Presented to [J Approved
Inspector _- —U / Disapproved
Data
CALL F R REINSPECTION
YES 0 NO
INSPECTION NOTICE J
City of Tigard Building Department !�
12420 S.W. Main St.
Tigard,Oregon X7223 ;
Phone: 639-4171 !
T
ype of Inspection _ _
�/ V
Date Requested� �'� T' e L A.M.. P.M.
Address Z2 :'
Permit #�_-L f
Owner Lot #_ I
Builder
The following Building Code deficiencies are required to be corrected:
I
—J
I
Presented to — _ ❑ Approved
Inspector _ / � - Disapproved
Date
CALL FOR REINSPECTION
YES ❑ NO J
EffjUW
W N Its
INSPEC ION NOTICE {
City of Tigard Fuilding Department
12420',.W. Main St.
1-igard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested_ 1� �r .74
1� �` Time � A.M._ P.M.
Address � � C, l,(��o _a Permit
Owner Lot #
Builder -� j,. �, -::> �� — _
The following Building Code deficiencies are required to bt corrected:
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da
I
I
Presented to Approved
Inspector _ % `�
ElDisapproved
7 s
flats
CALL FOR REINSPECTION0 YES 121"'N 0
BUILDING PERMIT APPLICATION TIGARD DATE lu a, _,�s_— 5470
'THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDIC<,TED BUILDER PHONE �I�6-3fiJ3
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PH',NE _ __..-
LOT NO.___. .-_ 9_�.__.
OWNER Don hyri l4gttc JOB ADDRESS 11144 SW I09tiI --- --
k'. '�i l99 ARCHITECT
ENGINEER
BUILDER Saw _ ADDRESS 1'•(,'• Ikox 19524 DESIGNER —,
STRUCTURE _3 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR E RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
® RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT l7 RELIGIOUS ❑ PAT!o ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY "3 LAND USE ZONE R-1 BLDG.TYPE lS1x FIRE ZONE PLAN CHECK BY P:TN _ HEAT_ U
Construct sin�Ae. family�Jwe ling wlattaChOd gara�a. —
xe—Issue of k'armiLS 052C7 & 5392
2 bathroom 3 Bedroom
SEWER PERMIT N 21A 18 arab 44U _.
OCC.LOAD FLOOR LOAD 4U HEIGHT _ j9 NO.STORIES AREA 1850 NO.BEDROOMS 3 VALUE
BUILDING DEPARTMENT SETBACKS FRONT REAR �1 LEFT SIDa _ RIGHT SIDE _-
Permit_ 325#UU THIS PERMIT IS ISSUED SUBJECT TO THE R-:ULATIONS CONTA(VED IN THE BUILDING CODE, ?ONINC
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, .'ND IT IS HESEBY AGREED THAT THE
Plan Check 40.0U WORK WILL BE DONE IN ACCORDANCE W1;!; THE MANS AND SF:CIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. I OF ISSUANr f: OF THIS PERMIT DOES NOT WAIVE
Subtotal 365•UU REST RICTIV!l COVENANTS CONTRACTOR AND SUB CONTRAC'ORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,P'.UMBING AND HEATING.
State Tax 13.OU oc W5u...)u _
— 'SDC— 450U.uU 1,
Total 31d.UU , C
--
— PDCM � � �— TOR ADEN? --�-- �~
cz z �150.Uu
ey
Approved _ _
Receipt No. ` ADDRESS - — -- --- - PHONE
_ ,_
DATE INSP. TYPE INSPECTION REMARKS PLUMPING DATE
COn".L V
le
112tirmil.No.
Fixture
37cr Final
HEATING
Contractor
Permit No.
;,I I
. e77
4Gas or Oil
Rmgh-in
ni,!
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidevoilk
Curb
a Street Final
Appi-mch
BLDG. DEPT.FINAL TEMPORARYIFICATE OCCUPANCY -T
CERTIFICATE OCCUPANrY Final —
L.andwapinq
?aoing Final
BUILDING RECEIPT /
NAME:
°r OATS:
ACCT. M DESCRIPTION AMOUNT
10-432 Building Permit Fees
10-431-600 Plumbing Permit Fees $
10-431-601 Mechanical Permit Fees $
10-230-501 State Building Tax $
10-433 Plans Check Fee $
30-443 Sewer Connection (20X) $
30-202 Sewer Connection (80X) _
30-444 Sewer Inspection
51-448 Street System Day. Charge (SOC) $
52•-449-610 Parks I System Day. Charge (PDC) $
52-449-620 Parks II System Oev. Charge (PDC) $ "----
31-450 Storm Drainage System Day. Chrg (SSDC) y
10-230-505 TRFO (95x) $ ►- -- -
10-478 TRFD (5x) s
10-130-506 Washington County Fire 01 (95x) f
10-478 Washington County Fire K1 (5%) $
10-220 Amart/Wedgewood
TOTAL f ��
(be/1214P)
THL UNU!:HSI(iNtU N`_HLUV ANrLILy tuft 4k VO4MI i I kin Ii1•.
OR AS SHOWN ANO APPROVED IN THE ACCOMPANYING PLANS AND SPECIF ICA I IONS. ovMEr. ?11%3( !.
OSVNEP -Z&�///1�/AQ�� JOO
ADDRESS /( � ----
G I C ECT
FNGINAPCHIFFR
ENGINEER
:iUl�_D.;.•t r�lt-. �.�..�� NDORES; 1i��7� �/J'-� OESIG'J£R ,_.
STRUCTURE ❑AF.'%*nOEL i_❑AmriON ❑RcP^IR ❑REYEtiYAI _ FIRE DAMAGE ❑OE:•tOl
RESILE["ICC ❑COIGN C�EOUCATIONAI ❑GOV'T ❑RELIGIOUS CJiAilp CARPORT ❑GARAGE CI STORAGE❑SLAB ❑F
-- --�—— !/
CCCI Par_•�v _ LANO USE ZOPIE _OLOG. TYFF—IY— --.
Pi-AN CHECK BY— — HEAT
_ ACHED GARAGE.
r -
9--SATjJROOM -3 BEDROOM
.jEUER PERMIT ;r' ����,�,G Gara>ze t44 V
Q'- L9.=D FLOOgy0AD _ `f% N(�(LHT Ll NO_STORES '2— AREA f�S"�;V NO.80100KIS 3 VALUE
•:. DEPARTMENT a 0 °FT SIOE S / RIGHT SIDE
S111LOiN
S_T BACKS FRONT FEAR
o�rT 1t Y.7 37 _
�/ THIS PERMIT IS ISSUED SUB-JE-'T TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. Z
RZGULATIONS AND ALL APPLI,.'.ABLE COC ES AND ORDINANCES. AND 1'T IS HEREBY AGPEEO THA
T� WORK WILL BE GONE IN ACCORDANCE WIT I THE PLAN;AND SPECIFICATIONS AND IN CO WFLIF.NC
�$J7 WCJI ALL APPLICABLE CODES AND OROINAI CES_ THE ISSUANCE OF THIS PERMIT DOES NOT
j' RESTRICTIVE COVENANT'S. CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRE.PIT CITY B
Ir•atm Tax I ` ' (ICENSE. SEPARATE PERMITS REQUIRED FOR SEWER. PLUMBING ANO HEATING._ _
Tuc31 soc r PDC# _
r -
�— APPLICANT OR AGENT
'Apprw _+ ReCrlpt No.
— \rinAFSS
tD �
DC (Storm1 c�
poc
SEWER CONNECTION S C77 r
SEWER INSPECTION S
SEWER SURCHARGE s
(:r�71mr.nt a y -
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E
I
i
I
i
flu Iding Permit No.
Loca t i o n
Date
Certification of Registration
With the Builders hoard
doing business as (dba) ,
registered under the provisions
of ORS Chapter 701 Oregon Homebuil rs Law).
My Builders Hoard Registration Number is
My registration is in//--full force and effect and expires on _
g riato e