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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St. i
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
.ry
3
s- r
Date Requested T^ - !T_...�-
Time ._� N.M. ^P M. J
Address * y ��� _ —_� Permit
1
Owner �. _ _ __ _ Lot 4
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _ _ n Appmnd
4 Inspector per/ l Dkopproved
I Date
CALL FOR REINSMCTION
,�J YES C7 NO
Iff
!K
INSPECTION NOTI^F 1
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested ~� / Time A.M._ _P M.
Address J -
Permit
Owner __ Lot # _�
{
Builder
The following Building Code deficiencies are required to be corrected:
1+
I
Presentad to _r /Approved
Inspector F C Olapprovvd
Date �
.-1-rt--e
�_ - _
CALL FOR REINSPECTION
❑ YES 0- NO j
w l® W R I� m
INSPECTION NOTSLE
City of Tigard Buildinq Deportment
12420 S.W. Main St.
Tigard,Oregon 97223
Phone 639.4171
Type of Inspection
Date Requested�__ _ ma }�-=A.M. _P.M.
Address 1�-�LG1-S � 'l --- Permit # -�
Owner-_------_ — Lot
Builder — -
%he following Buildirq Code deficiencies are required to be correcter'-
Presented to ._�— _- Approved
Inspector
El {
n ,� II
I Data
CALL FOR REINSPF,CTION
❑ YES ;--�NO I
t
BUII_DI /G EI T
NAME:
GATE
T
ACCT. M DESCRIPTION iUNT
10-432 Building Permit Fees f
10-431-600 Plumbing Permit'. Fees f
10-431-601 Mechanical Permit Fees
10-230-501 State Building Tax s
10-433 Plans Check Fee
30-443 Sewer ;onnection (20X)
30--202 Sewer Connection (80X)
30-1 4,4 Sewer Inspection
51--448 Street System Dew. Charge (SDC:)
52-449-610 Parks I System Dew. Charga (P0C) s '
52--449-620 Parks II System Dew. Charge (PW-) t �-
31-450 Stora Drainage System [ev. Crg (SSDC)
10-230-505 TRFD (95x) s —�
10--478 TRFD (5x) f
10-130-506 Washtngton County Fire 01 (95x) f
10-478 Washington County Fire #1 (5x)
10-220 Amart/Wedgewood = ---
TOT AI
(b� /1214P)
5458
BUILDING PERMIT APPI_ICATIGN TIGARD DATE �-- -19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEIiEIN INDICATED BUILDEP PHONE —U5=V65—
ORfS ,�10WN ANU APPROVED IN THF ACCOMPANYING PLANS AND SPECIFICATIONS. OWNLP PHONE
LOT NO._ 22 _
OWNER 14isrer8 Go. NW iOr¢QBADDRESF _ 15290 SW IUUth _ Cullsi.Ae Kstai:es
LO 97u.t4 ARCHITECT — --
ENGINEER
BUILDER Snnwt ADDRESS d Pit. Jeffsrson Terrace DESIGNER
STRUCTURE IN NEW ❑ REMODEL C ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE 11 DEMOLITION
EXRESIDENCE 2 COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCuIJPANCY R—J LAND USE ZONE t tZ—JP Li BLDG.TYPE _ —FIRE ZONE_ PLAN CHECK BY Clt HEAT —
Construct-_sin !1 _family dwe:linu w attached garage.
2 &athroom 3 bedroom
SEWER PERMIT#— 28412 _ —,GuruT;e 384 _ —
OCC.LOAD FLOOR LOAD 4U HEIGHT 14 NO.STORIES 1 AREA 119U N0,BEDROOMS :3 VALUE 49,000.
BUILDING DEPARTMENT SETBACKS FRDNT 12 REAR LEFT SIDE RIGHT SIDE
Permit_ _ li815u THIS PERMIT IS 1S"WED SUBJEC!TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
PlanCh9Ck 151.03 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPI_ICAIILE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 459.53 RESTRICTIVE COVEAANTS. CONTRACTOR , ND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICcENSE.S.FfARATE,PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 11.14 SbUG p.::)J.0 j
Total 41U.b% SDC—
;5OU.o
-—
6y PDC# t50.u0 APPLICANT OR AGENT
Cz I. 5
- - . .. -
Receipt No. ".+ff 7 ,
Approvnd _._._.__bc_i 1 ADDRESS NJONE
r.,hTESp. TYPE INSPECTION REMARKS PLUMBING DATE
Permit No t 1 y o�
Z5
Rough-in
Fixture
CA / C-
Co r au-wie,
Permi I W.
Cies or Oil
ntigh-i-i
cru �jj
SEWER-
DRiVEWAY
Final
Storm Draineig-
lRain Drain)F!nsl
Sidewalk
".tb&stmat r i,,ctl
Appron-4i
aLVG. DEPT.FlIl;-L E OCCUP"Cy Final
'rUPANC
CERT MICAI C nC y
Landsuapmg
ming Final
THE UNOERSIGNED HEREBY APPLIES F0I1 APERINI I FOfi ML 'VVUIIK INUR-A1LU
Cir.' AS SHOWN AND APPROVED IN THE ACCOMPANYIMG PLANS AND SPECIFICATIONS. OWNEv p►-0f1E_
iJJQH"eOR
Ess -
�y A "ITTCT
iGINEER
%;UI_-..:•ty- �(.X__ ADORES:. OESIG-IER _
iTAVCTIIAE NEW ❑AE.MnOEL ❑AOOIflq% c1IIcP.aA ❑AENE,IAL AFIRE DAMAGE
—-- -- -- --- . _— _ ❑DEMOLI
nESIOCAWE Clcomm ❑EOUCATIONAL 0GOV"r ❑RELIGIovS❑PATIO ❑CAR PORT DGARAGE C STORAGE r)SIaB []F
CGCUPar:,r $- ,ANO USE Z 0 f I E 0L0G. TY PE_;LV___. PLAT,CHECK BY NEAT
-- --_ _ CGNSTRUCT SIN.Qf E FAMILY )WI?i.i.TNG W1A( HED GARAf E,
BATHR Iom BEDROOM
SU-1 E R F R f•1 I T �r, 2, j:L _ G a r�ge ^� _
Y
NO.;TORIES
I --�LST.�fIQQAIS .,a .YALU�1
I_— S I)ILCING DEPARTMENT SET BACKS FRONT A E A n J' LEFT SIDE RIGHT SIDE
I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. I(i
11-:.4n "'f�R
it AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAI
r_.IS- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COhttllf..NCE'
IS-.1- i3u1 !/s ,
, �3
I ,_ 1 ALL APPLICABLE CODES AND ORDINeNC�4 THE ISSUANCE OF THIS PERMIT DOES NOT W
RESTRICTIVE COVENANTS. CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY BUS;
•te Tax 1 y LICENSE. SEPARATE PERMIT'S REQUIRED FOR SEWER. PLUMBING AND HEATING.
Total
SOC -
I c-
r— ------- P 0 C#
APPLICANT OR AGENT
A¢pruvEJi ' ,''" Recelpl No.
SIC (Storm)
SOC — $ C,
POC
SEWER CONNECTION $ 7
SEWER INSPECTION $ -�
SEWER S'IRCHARGE $
Comments : . 6' r7' ,,4,7 b—'Ke
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ffXMIF
�F 111111!IW
flu i ]ding Perm i t No.
Locat ion ,%sem 9e
Ta
Certification of Registration
With the Builders Board
1. r., ` _ doina business as (dba) ,
, I am registered under the provisions
of ORS Cha ter 101 (Oregon Nomebur lae�s Law).
My Builders Board Registration Number is '7-/iJ 6
My registration is in full force and effect and expires on
(4ignature -- — _-- �-