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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: :9-4171
Type of Inspection
Date Requestq — � Time --A.M. —P.M. --
Address � �5 L{� --- _ Permit
Lot # ---
Builder —
The following Building Code deficiencies are required to be corrected:
ALZ-
Presented to _
[ � Approved
7
Inspector _ � _ Disapproved
Date ---- —�- 4 _
CALL FOR REINSPECTION
Cj/YEs 0 NO i
INSPECTION NOTICE
! City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection .__— — �'"T--•� 3f zt - -t'
Date Requested 7 Time_ X A.M. P.M.
Address Permit
.'j1_c __ � !--�a 7 _ Permit #
Owner _ _ Lot #_
i
Builder _
The following Building Code deficiencies are required to be cirrected:
G J-/ �i_Y_ ��O t�J L �f r�•�� �� Cc`s
Presented to I Approved
Inspector - �� Disapproved
Date /'_: z
CALL "FOR REINSPECTION
L�I YES ❑ NO
BUILDING, PERMIT APPLICATION TIGARD DATE__,ebruar, 13 19 ti4 4737
THE.UNDERSIGNED KEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE A3-41-65 _
LO NO. -0"—30
OWNER Jawes Crutwell JOBADDRE_SS `�N11190.12115 aW 123ru Ye Uld_ iritidmill
ARCHITECT
ENGINEER
BUILDER Gray Cro:mreil ADDRESS 12665 SW 127th DESIGNER
Sl r(UCTURE 4 NEW [_1 REMODEL F] ADDITION I_l REPAIR C' RENEWAL 1:1 FIRE C :MAGE ❑ DEMOLITION
E-6RESIDENCE 1-1 COMM f_I EDUCATIONAL [..1 GOVT ❑ RELIGIOUS C7 PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY __&n1__LAND USE ZONE _I�� BLDG.TYPE FIRE ZONE_._._.__ PLAN CHECK BY BCH _HEAT.Slim
— Curtatruxc4siinly to ktjU dwelling wja arlcn i .sag,,n_
Sthject to $150.00 Leron doij its Sewer Surcharge
3 hedroo,a 2 Bathraum
SEWER PERMIT# 27107 -_Gara& t,', 1
OCG.LOAD FLOOR LOAD tt') HEIGHT_ 12 NO.STORIES _i _ hREA 1 NO.BEDROOMS 3 VALUE Fa5.0()U.
BUILDING DEPARTMENT SET BACKS_ FRONT REAR >.: LEFT SIDE RIGHT SIDE -+.
Permit
-
Perrnil 32N.0ty _ 'rHIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALI. APPLICABLE CODES AND ORDINANCE;. AND IT IS HEREBY AGREED THAT THE
Plan Check 213.70 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
Sub-total 541.20 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 11. 12
� SDC
Total 554.32
PDC# IOU 00 ApPLICANT0RAGEN1
By C11
Receipt No. --_ - - --
Approved -- — 11CK ( 1.� 83 213. ADDEiE%111,1ca IN+P. 1�75I. IZ) PHONE
i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING v j DATE
LVIWIX_60
ontractoi —�- —
L- s , Permit No. �'d 8 a• /
Rough•in ----- -L
�/ I • ' - --- Fixture -- - ---
- Final
HEATING _
iG—, a7 fly ` ��y Contractor
Por mit No. ;90 G
Gas of Oi!
11 fid= - Rough-'n
Final
---- `SEWER -
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
SidevAik
Curb&Street Final
_ Approach
MLD,: DEPT.I c!tL TEMF011111.RY CERTIFICATE OCCtrPANCV Final _
ZERTIFICATE OCCUPANCY
Landscaping
Zoning Final
- -
'"V4' y�yyy
r �,
BUILDING PERMIT APPLICATION TIGAPID DATE._—2
THE UNDERSIGNE D HEiRERY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
ORAS SHOWN AND APPROVED IN THE:. VU fii AN IN P S ANDS F:.(',IF*q OWNEP.PHONE :� _
,�,CC/ C^�L����L _t" - LOT NO.
OWNER JOB AOOR �
r -_ ARCHITE
ENGINES
� y �r!�� ADDRESS _ , -� / DESIGNER
STRUCTURE NEW ❑ REMODEL ❑ ADDITION ❑_ REPAIRG RENEWAL ❑ FIREDAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMMA ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STORAGE ❑ SLAB FENCE
--:—•-saw--- � Vii..�.
OCZUPANCY LAND USE ZONE/Cy BLDG.TYPE _ZL-G'__FIRE ZONE_ PIAN CHECK BY HEAT__
cc1%S
SEWER PERMIT NQ?16 ---
I �? a r, NO.BEDROOMS �j Yf•.LUt a,,.,
OCC.LOAD FLOORLOAO 0 HEIGHT_ NO.STORIES_ / CREAT/ ,
BUILDING DEPARTMENT SET BACKS FRONT ��' NEAR LEFT SIDE RIGHT SIDE
Mrrnit 2 — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
Z 0 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TY AT TF!E
PIa,Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPLIA14CE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
�Su;>iatal 5� RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
rr 1 UcENSE.SEPAPATE PERMITS REOUIRED FOR SEWER,PLUh181TJG AND HEATING.
-
SDC
Total �- �7VV -- - - - --------
POCA APPUCANT OR AGENT
BY
Racalpt No. ----
Approved ADDRESS
SDC - y� y
-�- ro
PDc
SEWER CONNECTTON
SEWER INSPECTIQN $ S ' pL ,-w r ` 2
/ 7
SEWER SURCHARGE S
J
m o n t C
rwl IAf
CITY OF TIGARD—12420 S.W.MAIN—TIGARD,OREGON 97223
RECEIPT
DATE: AMOUNT. 1Z
DOLLARS
NAME: Azi'-nL'j CASH:
V
ADDRESS: -
M.O.:
# OF
FOR: ACCT. # PERMITS SURCHARGE AMOUNT
SEWER BILLINGS 10-364
BUSINESS LICENSE C 5-331
PLUMBING PERMIT 05-332
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333
SEWER CONNECTION 40-363
SEWER INSPECTION 40-365
SYSTEM DEV.CHARGE 25-366
PARK DEV CHARGE #1 30-367
PARK DEV CHARGE #2 30-368
ZONINF,ADJUSTMENTS 05-362
RECEIVED BY: rOTALS
PERMIT NUMBERS AISIGNID-
Numbw Amount Numb-or, Amounf Number Amount
RECEIPT #149G3
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