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I` INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone 639-4171
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Type of Inspection
_ �(1' Time__��A.M._-� P.M.
Date Requested
Permit
Address r _ -----
Owner Lot #_
Builder
The following Building Code deficiencies are required to be corrected: 1
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Presented to _ Approw-d
Inspector �., Disapproved
Date _.
CALL FOR REINSPECTION
❑ YES F1 NO
WIN
BUILDING PERMIT APPLICATION TIGARD DATE _ �=._,�s_tib 5549
I'HE UNDERSIGNED HERE3)'APPLIES FOR A PERMIT FON 'HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 62(1-11(19
OWNER --
i►„ Cum- J_O_B_A_D_DR_ESS stock 12020 SW 118th LOT NO.
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Om
ARCHITECT
Kiren er Omet. ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE 0 NEW ❑ REMODEL ❑xADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
1� RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ =LAND USE ZONE R7 BLDG.TYPE 5ca FIRE ZONE--- PLAN CHECK BY %. . HEAT
__�QriOtlt� t ad ii;t cin ta- ainglw fnmi�� ivwl l 4 n y�,� per oppcovea plums W14)"
SEWER PERMIT# none no p1b,K.
OCC.LOAD FLOOR LOAD 4U HEIGHT 16 - NO.STORIES 1 AREA 140 NO,BEDROOMS VALUE 3,M)
BUILDING DEPARTMENT - SE'PACKS FRONT See plan REAR LEFT SIDE RIGHT SIDE
Permit _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
`aUVl�3 REGULATIONS t kb ALL APPLICABLE CODES AND ORDINANCES, AN) IT IS HEREBY AGREED THAT THE
Plan Check A� WORK WILL BE DONE IIJ ACCORD,NCE WITH 1HE PLANS ANI) SPS-ir:;C:TIONS AND IN COMPLIANCE
WITH ALL APPLICABLE COPES ANo ORDINANCES. THE ISSUANCI r'.uS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTOR!, .'j HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REOUIREO FOR SEWER,PLUMBING AND HEATING
StateTFx t ...A
SDC--
Total
PDC# nPNt_IC� �ACaENi - ---
By
pec�Ipt No. --
Approved ADDRESS '-PH-05-NT--
11
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
/�" � Contractor
If Permit No.
oaz
L/ Rough-in
Fixture
Final
HEATING
Contractor
No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT. I _j_TrMp6jj_ARYCERTIFICATU OCCUPANCY
lf'FRTInCATk OCCUPANCY Final
Landscapinp
Zoning Final
BUILDING PERMIT APPLICATION TIGARD DATEZ�LL__
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE =
LOT NO.
O`NNER,�f,Y)Y4A'2��-Er-JOBAODRESS I O IlkARCHITECT
1 d / p ENGINEER
GUILDER
ADDRESS 1W n"' V DESIGNER
"
STRUCTURE EW ❑ REMOOEL AODITION REPAIR ❑ RENEWAL O FlRL DAMAGE ❑ DE►AOLI'•
RESIOENCF- ❑ COMM ❑ EDUCATIONAL I7 GOV T ❑ RELIGIOUS O PA-,1O ❑ CARPORT 0 GARAGE ❑ STORAGE ❑ SLAB❑ FE
OCCUPANCY LAND USE ZONE b�—' 7 BLDG-TYPE �—� PLAN CHECK BY HEJ1T�'
n
SEINER PERMIT MOCC.LOAD FLOOR LOAD HEIGHT /(J-} - NO STORIES AREA `, �i NO.BEDROOMS VALUE—
_
BUILDING DEPARTMENT �— SET BACKS FRONT REAR 7�' 11 LEFT IDE RIGHT SINE
ParmIt -3SX0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTPINED IN THE BUILDING CODE,Z01
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES,.ANO IT IS HEREBY AGREED THAT
P� Isn Ch�c1r, �� J WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPLfNFICAT10NS AND IN COMPLIA
WIT" ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE O, THIS PERMIT DOES NOT W
Subtotal J RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO NAVE CURRENT CITY SUSI1
LICENSE SEPARATE PERMITS REOUIRED FOR SFYVER,PLUMBING AND HEATING,
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SOC—
Total
�.� APPI.X.ANTORAGENT ---
By 1`
1 N AdORES3 - Pt10NE —
App
SSDC --- S / -_—
SOC
POC —
SEWER CONNECTION_ 5
SEWER I,JSPECTION
SEWER SURCHARGE 8
Cammamtes
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Address/�2--_Q .r�_r � .___.-- Permit No._ .5�__-- --
Name of Occupant- _ _ Permit chaTge
Cc^nAction fee L.S O
--- — Paid
-- - - - Date connected .� -a J - G 7
Type of Building __ _ Inspection iee f
Service Rate Paid by Date
Contractor. Assessment Paid
Size of connection
I
' RMI T Ta CONNECT °
Tigard Sanitary District V�),cp-
N�,
PERMIT V 9 51 DATE
PFIt\11T is GIVEN TOIA
1 — —_
OF
TO CONNECT A
TO THE SYSTEM OO"FT"TIIGARD SANITARY DISTRICT
AT
THIS ANIS MADE AND INSPECTION OF CONNECT ON ESCRIBED PREMISES
sBEENII COM-
PLETED.
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....TIGARD SANITARY pISj,RICT
FEE,FPAID '.............. .
By
ONNI:CTION INSPI:CFED AND APPROVED fftJ
— — -- Date