11180 SW 124TH PLACE 1
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INSPECTION NOTICE
City of Tigard Bu;lding Department
P.O. Box 23397
Tigard, Oregon 97223
Phone:639-4175
Typa of Inspection
Date Requested me�__ A.M._X P.M.
Ti
Add,sib_��Q- a � / 2 Permit #
Owner _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
_LI I E r 4,A►C.F
Presented to _ __—__ _—� Approved
Inspector �� r~ __ Disapproved
Date5 ---
CALL FOR REINSPECTION
C_] YES Y—I NO
INSPECTION NOTICE
City of Tigard Building Department '
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection
Date Requested—/-6/) a Time _ A.M. P.M.
Address �! � J / L�—�� Permit #
Owner Lot /
Builder / ! .
—SCA u_ - A%7 xl1 ,l
The following Building Code, deficiencies are required to be corrected: i
A
Presented to _ Approved
❑
I Hsps�or Disapproved
Date
CALL FOR REINSPECTION
ED YES 07 NO
BUILDING PERMIT APPLICATION TIGARD DATA
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEF EIN INDICATED BUILDER PHONE639-6310
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
OWNER ""ON h wen by I)8vNJOB ADDRESS uA�x;;B� Sc� LOT NO. t I
---_--- --- _ _ Anton 1'ar,
Newberg 91132 ARCHITECT -
ENGINEER
BUILDER Same ADDRESS Rt. 3 Lox 2531 DESIGNER
STRUCTURE _A NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
R RESIDENCE ❑ COMM ❑ EDUCATIONAL L-1 GOVT [1 RELIGIOUS 11 PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABD FENCE
OCCUPANCY _k`•3 LANs USE ZONE __ "' `i. BLDG.TYPE --Ah—FIRE ZONE PLAN CHECK BY --Wa__—HEAT_
_ CONSTRUCT SINGLE FAVILY DWLUING W/ATTACtIEU GA"zi.
S1J11J "Y TO $360.UO AoA1a/WEELx%:taK)1J + *150-01) LLRON HEIGHTS Sewer Surcharr.e
i3v,(�TCwGT!i 2 �LitlltCX)fii$
SEWERPERMIT# -
OCC.LOAD FLOOR LOAD 4U _-HEIGHT -19 NO.STORIES 2 AREA 1369 NO.BEDROOMS 3 VALUE 5 1-L I 0
BUILDING DEPARTMENT 21' 2, — -- la- —
SET BACK- FRONT REAR LEFT SIDE RIGHT SIDE
Permit 1)k' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED INT HE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check _18J•'�Cf WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
421 9U WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE. OF THIS PERMIT DOES NOT WAIVE
Subtotal __ • REST71ICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
H.44 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC- J !�+�:•l/�)
Total 4113.34
PDC# 1 $150.00
.4PLICANT OR AGENT
By
--- -- -- Receipt No
Approved ADE 8 - �- PHONE
DATL rNSR Tr EINbPECTION -- NaMAFir, PLUMCIING - CATE
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HEATING — I
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(Ram r1raln)Final
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—Curb d Street Final—
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BOG. ErT.RINAL T6ii
MI'ORAY CERTIFIC
DATEOCCIa'ANCY
f'I'IfTIFICATE l'CCUPA;...Y �Flnal- _
L And caping
Lomng Fiaul
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THE UNDERS11uNEO HEREBY APPLIES FUr; APERMIf FUN IFIL 4VUIIn IIk.WZIN INUlk.AILU LIUILULII1':AU44k
OB AS SHOWN AND APPROVEO IN THE ACCOM�,."YInG FLANS AND SPECIFICATIONS. O0 "0:-wtl-
QLVN p� ` BSC f✓ .���i��'-S!� �.t.:�-_� Q� �_'y�__�„ "" 'yC
`� p'U• y '7�3� ARCHITct_T
`,, _ ENGINEER
:iU11�O�°t `��►r AOORES3 .� 7C t-�-•-pp OEsIGrFR
STRUCTURE _ NEW M O RE,InOeL ClAm,nom ❑FIEPAIR_ C1RENEWAL ❑FIRE DAMAGE 001-
rzjnESIL%ENCE CICOMM ❑EDUCATIONAL C1GOV-T RELIGIOUS RATIO []CARPORT ❑GARAGE ❑STORAGE QSL�A
III
- tlOGTY?E-OfIE L1YIAk CHOCK 9Y ^ /L HEAT,
_ _ CONSTRUCT-SII{SrZ.F.�BMiL� A TliG-II IATTArHFD (AJ AGFA
`Ej,2P -•r-r ro'360 v -tag
^BATHRQQM BEDROOM
SEWER , PERMIT —
���D_� fLQpgl.oaD �n NEIC1►1� i `3 X0-5 RI "1= AHE3C69 NO.pFn�nr►Alti
Ii g!)ILOING OlPARTMENT ScT PACKS fRONT ,1O REAR 2 LEFT SIDE RIGHT SIDE -
THIS PERMIT I: ISSUED SUBJECT TO THF 9E'GULA':IONS CONTAINED IN THE BUILDING COOT
I Yarn C.hecY !� �Q REGULATIONS AND ALL APPLICABLE CODES OROINANCF.S, AND IT IS HERE7Y AGREED '
r WO..K WILI. sE DONE In ACCORDANCE WITH THE PLAN;AND SPECIFICATIONS ANO IN CO&IFLI t!!
$JD(Dtal0.p ALL APeLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NC
j FIESTP41CTIVE COVENANTS. CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY
! ate Tax `� LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER. PI.U8181NG AND HEATING.
I SDC'
- I y� , PDC ' ( /
/APPL.#CANTT 04 G NT
Approved 2 Receipt No C ? !J rk H��a��U
AnnRFSS
SAC (Ft:orm)
SDC – S
POC -
SEWER CONNECTION
SEWER INSPECTION S 3 S
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SEWER SURCHARGE ; E> 5
Cl mm e n t s:"
:2 � �y � ! - X29 /• �� ?2 � , � �'/
er � � no � :■r
flu i I d i ng Verm i t No.
Location
Certification of Registration
With the Builders Hoard
I, T)
AoL k1.7— doing business as (dba) ,
..sr h^v-, G- am registered uiidcr .;lc prov is ion�
cf ORS Chapter 101 regon Homebuilders law) .
M.e Builders Board Registration Humber is : y4g ,4
Fly registration is in full force and effect and expires on
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