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JUNE 3 19 92
12160 SW 126TH AVENUE
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ADDRESS 1--,2/L,0 Og ,&, /o2 Lo '�� � PERMIT N0.l�_
PERMIT CHARGE none
OWNER �[/_�iyj,-- / a CONNECTION FEE
PAID BY
TYPE OF BUILDING .� c.L_ DATE CONNECTED
SERVICE RATE �e c0-4- INSPE=CTION FEE
L
CONTRACTOR - ___ PAID BY __ �cF- ,�,� DATE
SIZE OF CONNECTION _ 41 ASSES!)NENT _�_ µ PAID
e c c
City of Tigard
INSPECTION REQUEST
f o r
�.✓,j 4-
INSPECTION TIME: _ _ PERMIT NO. : 67
DATE: 1j1/2t DATE ISSUED : I L
OWNERS NAME ; 4%"2--
ADDRESS:,�A/4 a S.�.J, /•�� -4W
CONTRACTOR :
TEST : Air 0, Woterp , Visual 0 , Laboratory
RESULT: Approve, Disapproved 0 Pending 0
SKETCH.
OCE,
TOR DATE
rr�n1P" Attach 1V001$IMNhftl) fs
�a I
i
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f Tigard
and
City a g
INSPECTPION REQUEST
I for
INSPECTION TIME : PERMIT NO.: —
DATE :
O.: _..._DATE : r DATE ISSUED:
OWNEFcS NAME . L� tA
IADDRESS : IALG9 - - -
CONTRACTOR
ITEST*. Air ❑, Water Eli Visual ❑ , Laboratory ❑
RESULT. ApprovedDisapproved ❑ pending G
I SKETCH.
I
I
I
INSPECTOR DATE
L0TE A}tr,ch SUDPIemPr' L' dOfp her"I(I
I
I
City of Tigard
INSPECTION TION REQUEST
for
INSPECTION TIME*. _ PERMIT NO. : --
DATEAL DATE ISSUED: L- ,
I OWNERS NAME :
ADDRESS : �
CONTRACTOR : --
I
TEST* Air U, Water, Viaual`yr, Laboratory ❑
RESULT: Approved,52f Disapproved O , Pending L-j
I SKET .' ---
Y .�
Q �a '�LAr�I ! Lc�Cr
ntcnc4ILL u Idwfiu
I E OR DATE
CTlupplementul tw d�c 'o I,elei<_i
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C I TY OF
BUILDING PERMIT APPLICATION TIGARD DATE 5-2919 `I'? N° 0303
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICArED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPEC!FICATKVS, 4oNeEf 'L� , yu
OWNER D&'a Construction CO. ADDRESS 11166 S,U, 126th - BUILDrR PHONE
ENGINEER
cams ARCHITECT DESIGNER
STRUCTURE ONEW_ ❑REMODEL _ ❑ADDITION ❑REPAIR [:]RENEWAL ❑FIRE DAMAGE ❑[DEMOLITION
❑ RESII,-"XE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT []GARAGE ❑STOHAGE❑SLAB [:]FENCE
_ ❑POND ❑MOVING ❑CONDITIONAL USE El DESIGN REVIEW ❑COUNCIL APPROVED _❑SIGNS,
OCCUPANCY'—_ LAND USE ZONE— BLDG. rfs HEAT
BLDG TYPE FIRE ZONE_ PLAN CHECK BY
,_
cuilistruct 1090 ;q. Ft. pplit lwvml frame dwellinq with
attached garage according to approved plans
I
40 lb 1 2500 320000
OCC.LOAD FLOOR LOAD HEIGHT _ NO.STORIES AREA r VALUE
BUILDING DEPARTMENT SET BACKS FRONT 20 _REAR LEFT SIDE T RIGHT SIDE 15
Permit 133o00
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check M REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DON'_ IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%state LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total 200.82 I
By 9
_ APPLICANT OR AGENT
I Approved - r a Receipt No
ADDRESs PHONE
i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING – �9 DATE
_
Contracto"Ai
Permit No. O/S `�s 7
i ��7S IP � �ic�iL'� � Rough-in
_ Fixture
•—I -- Final
HEATING
Contracto
g._621-1s
Permit No. 93a
J •r. / �' ��.•i/ / �[, %/� rr� �'�, i `:, �_i Gas or Oil --
Rough in - -- - —
=�.'�] Final
SEWER - 7C LM
_ Final _
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
eke
BLDG,DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
I
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