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INSPECTION NOTICE
City of-Tigard Building Department
12420 S.W. Plain St.
Tigard,Oregon 97223
Phone: 6394171
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Type of Inspection _ //_ -f-fwr�,%
Date'Requested/ Time A.M. — P.M.
Address _ ,/1 > > r� �� Permit #
Owner _ _- Lot #�
Builder
The following Building Code dleficieennciie�s. are requi,ed to be corrected: � y�
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_70
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Presented to _
/
Approved
Inspector _, y -- ❑
/Disapproved
Date
CALL0b REINSPECTION
7ES ONO
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BUILDIf,,IG PERMIT APPLICATION TIGARD DA.'E___'-3nu'1-y 13 19 '14 4703
THE U'IDEPSIGAED HEREBY APPI Ir::�FOR A PERMIT FOR I ;E WORT;HC'REIN I'JDICATED BUILDER PHONE AiI9 11
ORA' SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE,.,;
LOT NO. 161_—
OWNER arlinde GaXy JOBADDRESS� !217(0 SW 128th — _ yitlw9gc4
T a ARCHITECT
ENGINEER
BUILDER (;;-1A ADDRESS 8955 St' SOtamardAal DESIGNrR,� —
STRUCTURE CkNEN ❑ PEMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL. ❑ FIRE DAMAGE ❑ DEMOLITION
Iii RESIDENCE 0 COMM ❑ EDI .JATIONAL ❑ GOWT ❑ RELIGIOUS ❑ PATIO _' CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY A-3 LAND USE ZONE _ 1-4- BLDG.TYPE - 1 _FIRE ZONE--- PLAN CHECK BY HEAT----
Construct
EAT _-_Construct single faj ily dwe]].i_,L_w/a.ttaclted garittsm. — -
2nd flos)r unfiMished not haidt:thle, Per-Atrequired to Mush
(Subject to l.rrnn NelNhts ;+15[►.UL► surch,4r.,��r ! tat! r,.o
SEWER PERMIT# 2'-,� )j Gams 440
OCC.LOAD FLOOR LOAD 4(I HEIGHT 21 NO.STORIES 2 AREA •464.) NO.BEDROOMG 2 VALU'`+7. 19
LBUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE Ric;HT SIDI
it 2337.,0u THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING C, [ONIN(-
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
Plan Check 210.07, 1 WORK WILL DE DONE IN ACCORDANCE WITH THE FLANS AND SPECIFICATIONS AND IN COMPLIANCE
— ~I WITH ALL APPLICABLE CODES AND ORDINANCES. '.HE ISSUANCE OF THIO r'ERN,1 DOES MOT WAIVE
Sub-total 5ifi.��` RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO H .VE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEJ TING.
State Tax
SDC— %UU.UU .1
Total 569.53 ✓ __
By Cli PDC# I 100.00 APPLICANT A-dE N T
Receipt No.
Approved 40t !f -Db EVS--_--- - ----- PHONE
I - I - 0
■
DATE INSP. TYPE INSF -TION REMARKS PLUMBING DATE
L - -- -
-� Contractor
Permit No.
Rough-in
Fixture
_ Final
HEATING
Contractor
14 1Af4
r Permit No. I
7r,.% Gas or Oil -- —
y� -- Rough-in
Final
SEWER
— - - --- _. Final-
-_-- ------- --- ---- --- ---- � !r � � --
DRIVEWAY
--— ---=+--- .— _—_ --`----— - Final —
Storm Drainage
(Rain Drain)Final
- I--_-----—_ _—. Sidewalk — —
Curb&Street Final
Approach
BLDG. DEPT.FI 1A TEMPORARY CERTIFICATE OCCUPANCY
CrRTWICATE OCCUPANCY Final
Landscaping
Zoning Final
BUILDING PERMITAPP;_ICATION T1GAFID OAT
THE UNDERSIGNED HEREBY APPLIES FOR A PER,AIT FOR THE WORK HEREIN INDICATED BUILDER PHONE3�--
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
Lo r N 0._jj
_ASL
ty , JOB ADDRESS /�" 7 U
ARCHITECT
-NGINEER
BUILDER ( ( � }I C'1\ r)e ESIGNER `
ADDRESS
STRUCTURE NEW ❑ REMODEL �0 ADDITION rl REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ PEMOLIVION
( FIESIDENCE C) CnM%A ❑ EDUCATIONAL l.3 GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT El GARAGE ❑ STORAGE ❑ SLAB❑ FENCi:
_ y. - BLDG.TYPE FIRE ZONE_ FU1N CHECK BY HE Ai
k4�UPANCY/7�LANOUSEZONE (_S _— v
3
SEWER PERMIT
OCG LOAD FLOOR LOAD �/o HEIGHT ,2� N_0.STORIES AREA,2 y y 0 N0.BEDROOMS VALUE
BUILDING DEPARTMENT $E7gACKS FRONT REAR LEFT SIDE RIGHTSIDE
PI'MI! >� l THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE B/IILDING CODE,ZOWN0
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Man Check Z 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 WAIV:
,Sub-tetai RESTRICTIVE COVENANTS.CGNTRACT09 AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1~-- LI,'ENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING-
;
State Tax
SOC—
Total PDCN APPLICANT OR AGF.Nr
BY
Approved �� Receipt No. AOORES� _... --- -- ------
PP PHONE
SDC - '✓ rJr
PDC --
SEWER CONNECTION 5
SEWER INSPECTION S
,"EWER EURCHARGE r
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