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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 —_
� r-
E Date Requested ' _� a A.M. P.M.
Address :��L� j )(.//l) _ Permit
Owner Lot #
Builder
The following Building Code deficiencies are required to he corrected:
- i ..��i��i�/i.�i (✓ ^�♦ i 1/�E �r�1. r-7�' `�,—"•¢tea �4'�
f Presented to . .,. _ U Approved
' Inspector =_`Z�/t' Disapproved
Date
CALL FOR REINSPECTION
0 YES ❑ NO
IRR! ii wI ! FW W
INSPECTION NOTICE i
City of Tigdid Building Department
12420 S.W. Main St. {
Tigard,Oregon 97223
Phone: 639. 171
Type of Inspection
Date Requested " V
Tiros A.M._-- P.M.
Address
Permit
Owner
_., Lot #
Builder_
rhe following Building Code deficiencies are required to be corrected: i
— ` �--•z-k' T r— t✓ cam_.r,+�.�..�i(
Presented to F] Approved
Inspector C~
Disapproved
Date
CALL FOR REINSPECTION
,eT YES ❑ NO {
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Mai„ St.
Tigard,Oregon 97223
Phone: 6394171
Type of Inspection
Date Requested ` �.� T Time v� A.M.J P.M. I
Address �.L� ��JS S� /(,�,� Permit
Owner .� 1/ � �y�.Q•'`,� Lot #_—
Builder
The following Building Code deficiencies are required to be correrted:
I
Presented to
ZApproved
Inspector _ .' Z/1 _ ❑ Dlupproved
;Date 4 . v- zJ s�!�
CALL FOR REINS ECTION
❑ YES ANO
i
Building Permit No. ! ��
Location ///loSoS'�_.-%Q - -
Date
a
Certification of Registration
With the Builders Board
doing business as (dba)
am registered under the provisions
of ORS Chapter 101 Oregon Homebuilders Law) .
My Builders Board Registration Number is 7 u
My registration is in full force and effect and expires on
Signature
BUILDING PERMIT APPLICATION TIGARD DATE 1 - ________,is 85
THE UNDERSIGNEC' HEREBY APPLIFS FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OF AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT N0. 2
OWNER Latham (fomes JOB ADDRESS 111165 SW 109th Caruhan
^,.------ ------.._---- -- L(1 97034 ARCHITECT ,
ENGINEER
BUILDER :i"e _ _ ADDRESS '189 Wembly Ct. DESIGNER —
STRUCTURE C*NEW _U REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL E] FIRE DAMAGE ❑ DEMOLITION
A RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY — 11r3 LAND USE ZONE h-4'5 BLDG.TYPE _ 511 FIRE ZONE PLAN CHECK BY 2iCR HEAT Gas
Construct single family dwelling w/att.iched garage. --
2 b:atkproom 3 bedroom
-- i
dEWERPERMIT# 28473 Garage 699
OCC.LOAD FLOOR LOAD 40 _ HEIGHT__ 12 NO.STORIES I AREA 1425 NO.t )ROOMS _3 VALUE 03rUUU.
BUILDING DEPARTMENT SET BACKS FRONT 21 _ REAR LEFT SIDE 10 RIGHT SIDE 2U
Permit 322.U() THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
209,3(1 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan CheckWORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
531,3- WITH ALL APPLiC ABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
SubtotalRESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
12.88
LICENSE.SEPAP,I T&PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
SDC— 45Uu,OU
Total 544.18 -
PDC# 1 S150.00 A P—I�UCANT OR AGENT rr
-- - — Receipt No. r
Approved f3CK AODREBS �— 4 — PHONE
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DA'f E INSP. YPE INSPECTION� RrLMARKS PLUMBING
�,3..--- �yr v'�• ._ Permit �7'�'�'�, �!►/'.� � i7�/Jr!�—
.�� Rough-in--------
�— 20 ------ Fixture
r
Final
HEATIN-.;
Contractor —
ID _ __-_ Permit No.
fisc or Oil
Rough-in
SEWER —— ----
__ -----. - Firal
�i DRIVEWAY
�- Finel---- —
Storm Drainage
(Rain Drain)Final
Sidewei k
Curb R Street Final
_ Curb
BLDG- CEPT. Frt3.,L TEMPORARY----TACERTIFICATC OCCUPANCY
-�CERTIFICATE OCCUPAN.:'f Final
I �t� ts �; _
(� 7 (_indscaping
II
Z,.��nq Fin,;'
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BUILDING RECEIPT
DATE
ACCT. M DESCRIPTION AMOUNT
10-432 Building Permit Fees f , (j'- -_—�-
10-431-600 Plumbing Permit Fees f _
10-431-601 Mechanical Permit Fees
f
10-230-501 State Building T;�x f
10-433 Plans Check Fee f _c> (2c)9 . 3L1
30-443 Sewer Connection (20%) f / ,
30-202 Sewer Connection (80X)
30-444 Sea►er Inspection
�1 1
51-448 Street System Dew. Charge (SDC) f
52-449--610 Parks I System Dew. Charge (PDC) $ o6
52-449•-620 Parks 11 System Dew. Charge (PDC) f
31-450 Storm Drainage System Oew . Chrg (SSDC) f
10-230-505 TRFD (95X) f
�. 10-478 TRFD (5X) f
10--130-506 Washington County Fire N1 (95X) f
10-478 Washington County Fire N1 (5X) f
10-22.0 Amart/Wedgewood f
TOTAL
4 4u u
-2 1 9q. 4
(b•/1214P)
t � �r[ ■rr Its � Its �
7UUIIU L 04 V.'w1'4112(f
THE uNE)ERSIGNED HER CUY AP?LIES FUII APERM I I F-OH I I I L +vUllri M-HLIN IIVUIt.AILU �OVME/`?r.pf7s
OR AS SHOWN ANO APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. X110Tr1o.-2--CAO—A amJ__.__
eJ JOB AODR S, i` AnC ITFCT
/ ,Q�j �QN DESIGNER -- —
U1r 0.;.'T �4 4, r(-ADURE:v i� rr----��
—_ >< ,yEyV - ❑Rt'k1r►OEL OADOITION URcP:.IRORENEWAL OFIREDA.MAGE UDE:.LOCI'
STRUCTURE _ --
nESIOENCE OCOFAM OEOUCATIONAI. CJGOV'TT ORELIG!O�USC��AT10 OCAR PORT OGARAGE Cl STORAGE �JSL�B C�F
—�-- -- -- � � PLAN CHECK BYHEAT
CCCL�P�r,•'�Y_$=,3-__LANO USE ZONES -:f5� CLOG.TYPE_
- v r�r rrr r r♦rr �ATTA('17F11 (:�1{ZQL;F.
- --- a LI
<- BATHROOM BEDROOM
SEUER PERMIT
Qy.C-IJQ=D — FLOOR l Q4 tl° NEIGIIT 1 NO STORtrS T AREA y-1<NO.13EDROOKIS--`> VALUE
SIALOING DEPAR�wEENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE.'
� THIS PERMIT IS ISSUED SUBJECT TO THE REG lLATION5 CONTAINED IN THE BUILDING CODE. Z
C9 3��' RCGULATIONS AND ALL APPLICABLE CODES A,1D ORDINANCES, AND IT IS HEREBY AGREED TNA
r' WORK WILL BE DONE IN ACCOROANCE WITH THI PLANS AND SPECIFICATIONS AND IN COMPLIANCE
$;Iti focal �- ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT GOES NO
' F1EST OCTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO NAVE CURRENT CITY AUS
'.Arfi Tax I Z LICENSE. SEPA.RATC PERA9ITS REOUIRED FC11 ScWER. PLUMBING AND HEATING,
SDC
Tural I ' PJC# —
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laf
APPLICANT OR AGENT
LAvpr ve-d Receipt No
�nnnFSS
SX (SLvrin
SOC - $ _
PDC -
SEWER CONNECTION $
SEWER INSPECTION $ ='
SEWER SURC14ARGE $
Comments: -------
41
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