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INSPECTION NOTICE
City of Tigard Building Departmen-
12420 S.W. Main St.
Tigard,Oregon 97223
i hone: 639417 i
Type of ;nspection _ 71
Date Requested
_ Time A.IVi. P.M.
Address _ ��, ` _C
Owner
--' — —'— Lot #
Builder_
The fc9lowing Building Oade deficiencies are required to be corrected:
'-`" :�.�� �� ��✓tom+..
--
Presented to
Approve]
inspector
❑ Disur,preved
Date �-�,._ -G
CALL FOR REINSPECTION
❑ YES A No
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
° T'gard,Oregon 97223
' Phone: 639-4171
Type of Inspection --
Date Requesste'd) '_z / A.M._ P.M.,
Permit # �—
Owner ------____-- — Lot
Builder —_
The following Building Code deficiencies are required to be corrected
j / I
I
i
Prr sent rl trr _ �I Apprnved
70 Inaltncinr —.— �< �1../ ` ❑ Disapproved
Date
CALL FOR REINSPECTKNV
YES 0 110
BUILDING PERMIT APPLICATION TIGARD DATE July 17 ,19 b4_ 4919
HE UNDLI'S*NED HEREBY APPLIES FOR A PERMIT FOR SHE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPHO V ED IN THE ACCOMPANYING PLANS AND SPECIFICP.TIONS. OWNER PHONE
LOT NO.
OWNER _��,i}�1e11ick _QjLf3,�$� ,:)DRESS 12135 SW 12Kthbclj`�umhi
fl. Lion 47066ARCHITECT
ENGINEER
BUILDER Sarre ADDRESS 22655 6t'OMn Ct. DESIGNER
STRUCTURE - N 1,C K EL ❑ ADDITION ❑ REPAIR _❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
—� L OM1 EDIAYI ❑ GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY ! LAND USE ZONE _.fi-7kU BLDG.TYPE 5N FIRE ZONE PLAN CHECK BY STN HEAT--t
Construct single family dwollim, w1attached sarxtxr.
3 6athroow 2 i4t%lruonn
SEWER PERMIT M _ — 27923
OCC.LOAD FLOOR LOAD 4*+—HEIGHT I6+ NO.STORIES 1 AREA 1406 NO.BEDROOM_ S 7 VALUE 68,LX)
BUILDING DEPARTMENT SETBACKS FRONT 4 REAR ILEFT SIDE _ RIGHT SIDE
Permit 337.01) THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
— REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 219.6S WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal `�56.U5 RESTR'CTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 13.4t. LICENSE.SEPARATE PERMITS REOU19ED FOR SEWEP.,PLUMBING AND HEATING.
SDC -- .0juU.u-
Total 5+x').53 150,Uu - -- - --
--- PDCq APPLICANT OR AGENT----
By Gil .,; t l50.11,10
Approved I'Tw Receipt No. ADDRESS PHONE
f
i.
FXN
Xw
DATE INSP. YPE INSPECTION REMARKS PLU ING DATE
-- Contractor
r 4L Permit No. f ��
a� Rough-in
edf _T Fixture —
Final
HEATING
- Contractor 1
Gas or Oil
Rough-in
-- Final
- ------------ --- ---SEWER
-_--- Final ^
-..._---_-- ---- --- _..— DRIVEWAY-
. Final
Storm Drainage
(Rain Drain)Final
- --'-�---- --- Sidewalk
Curb&Street Final
Approach
B6.Dti.DEPT.FINAL TEMPI RARY C.ERTIFIc.AT OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
l--r— Toning Final
i
Building Permit No.
Location /c,.)
Certification of Registration
With the Builders Board
doing business as (dba),
dm registered under the provisions
of ORS Chapter 70 Oregon HomebuildLrs Law).
My Builders Board Registration (,umber is
tLv registration is in full force and effect and expires on / 7� VY -
Signature-
1
1
I
I
THE LINC?EHSIGNED HLHLBY APPLILS FUH AI'LFiNII I I UH Illi .'��II�n rl:.n�l • ••� ��� � _---_ _-.�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, ovnvEr.rltvru
�OAI SIE[ e- /rte-`>�7io� ClY:' TM"r LOT
_?'NNEP JOB ADORESSL�--GyOU/J
91106gp ARCHITECT
ENGINEER
OESICINER
`�--�1 r i
TRUCTURE !�If10EL ❑A001f10N LJRcP.:IR ❑REVEV/AL C„MIRE DA:AAGc r� ❑OE:•1Oi11
FlE
i1ESILiLMCC ❑COlirtl ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSCIPATIO OCAR PORT ❑GARAGE CJ STORAGE CISLAa ❑FE
LAND USE ZONE.CLL_l_t�OLOG. TYPE �_—
SN PLAN CHECK fii 1� HEAT—
CONSTRUCT SINGLE
EAT_CONSTRUCTSINGLE FAMILY DWELLING W/ATTACHED GAf A 1,
BATHROOM BEDROOM
JL
SEWER r-ERMIT_.,, lu�_.�- _ Garage �yp_
.^s'5..10=F t14931.44D H H �'�'— r�0.�T0�: � AP_F. �N4.� �I v 0
9IJILr)ING OEPARrMENT � ”
SET BACKS FRONT REAR
J�/� LEFT SIDE V RIGHT SIDE
1` THIS PERMIT IS ISSUED ;URJECT TO THE REGULATIONS CONTAINED IN THE BUI!.OING CODE, 2n�
I I-:.in Check t U REGULATIONS AND ALI. APPLICABLE CODES AND ORDINANCES, AND IT IS H'_REB1' AGREED THAT
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IW COMPLIA_NC(:
j b:J T•tat�l ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W
r'- RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURB:=NT CITY Bt151
SatR TAIc LICENSE. SEPARATE o ERMITS REQUIRED FCR SEWER, PLUMBING AND HEATING.
•' s
�Total SOC _
PDCI
1 a,/
--, APPLICANT OR AGENT
Appru Receipt Nu
SOC (Storm
Bac - $ _ �-1 .ru x
SEWER CONNECTION $
SEWLR INSPECTION 5 AN—01
SEWER SURCHARGE
Comments : ':t'�-��,, /-�� 1't ! �_ _ Azo-
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