12120 SW 124TH AVENUE r ,
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NNW WIN
City of Tigard
INSPECTION REQUEST
for
Z241 I "h
INSPECTION TIME: �'z.� _ PERMIT NO. :
DATE: .0(,--�7.7 PATE ISSUED :--/—�.,,.
OWNERS NAME :
ADDR S E ..,'
.
CONTRACTOR : ,---
TEST
ONTRACTOR : ._—_TEST : Air Q, Woterc , VisuaI [] , laboratory []
RESULT: Approvedt )isopr)rovnd [I : ending
SKETCH.
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IN - GTOR SATE
[NOTE: Attach tuppiamentnl tiler I, I
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Cit of Tigard
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INSPECTION REQUEST j
for
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I INSPECTION TIME : —I/PERMIT' NO. :
I DATE: DATE ISSUED*_.!_L_
OWNERS NAME :
ADDRESS :
CONTRACTOR :—
TEST .
ONTRACTOR :_TEST . A r J , Water J , Visucl)q., La'- .ratory [1
RESULT. Approved' Disapproved _1 Pending p
SKETCH:
I ,
I SPECTOR DATE
IOTE ' Attach supplemental test data heret]
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BUILDING (PERMIT
4 CITY OF TIGARD, OREGON
Permit No.. nate..... ..... ...... ............................. j
T. Contraqlor .. .lel. ..,.. .�.. ............................... 11 lt,
Building Address.............. ......... .%. .........` ' +`� ,! ..........................
t its permit expires at 12 p.m. ................................
. 19'tf..�. � u
~-. ....,...... 19Construction mut rtart Wore.........................................................
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Notify Building Inmpector 2: hours prior to the following required inspections:
`: 1. Formq 7. Sewer Connection �.
. � 1. Excavation or H U �
2. Footing 5. 1 oindoing 9ewe T t .
' 3. Reinforcing Steel 6. F rsrne Al
Y. .. r'tt�,l.w.s ti4.. �. Aw 7•fM .v �Jj7' 'r ,...�.. A•'►T f \ 11