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INSPECTION NOTICE
City of Tigard BL kli%Department
12420 S.W.Main ft.
Tigard,Oregon 97223
Phone: 639-4171
Type of Insprctior. JK-V--U'pt-1-a-yU
Date RequestedLzi S�E TimeC�A le
P.M.
Address LV A 19 41
Permit
Owner Lot #
Builder
The fo:lowing Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
'Z� YES ONO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
i
Type of Inspection
C I
Date Requested. d me 7/ A.M. !� P.M.
I
Address �4 / ' Permit
Owner L Lot #__
Buil:pr.�___
c {
II
The following Building Cade deficiencies are required to be corrected:
Pre.,enterl to _ — _. _ Approved i
Inspector Dhepproved
Date �� -
--tee.
CALL FOR RL'INSPFCTtON
C] YES 17.E NO 1
INSPECTION NOTWE
i —
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 9722q
Phone: 639-4171
` Chat_ -Ij
lei
lari
Type of Inspection ___ -
Date Requested!� alma .M.
Address _�_ ���___ �' ��
Permit #– /
Owner d.Cli t.�_-- Lot #._ L _
Builder -------
The following Building Code defic'ancies ere required to be corrected:
Presented to �E', Approved
Inspector f ' ` �] Disapproved
Data
CALL FOR REINSPECTION
[] YES VJ NO
CITY OF TIGARD Plumbing umbing Permit
Building Department Nu 3 11113
Residential �] 'ommercial ❑l
New Installation Replace ❑ Addition ❑ Alteration ❑ -) Date
Licensed
Plumber -'LA ..—'J --�,�—�::�1._-___ Owner
Address Job Address
Phone —_�.1�1 — - Applicant ----- -- ---- - -.. - -
_
CITY BUSINESS LICENSE REOUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
ITEM NO. FEE TOTAL _ITEM NO, FEE TOTAL_
Fixtures-Traps _ - — �_ 7.50 Sewer:First 100ft.-- _ _ -t X00
Dishwasher 7.50 Each Addit.100 ft. _ 15.00
Gaibage Disposal 7.50 Ejector Pump -- _ _ 7.50
Water Heater — — / 7.50_ Water:First 100 ft_____ / 20.00 _� 1
Backflow Preventer 7.50 Each Addit.200 ft. 15.00 _
Storm&Rain Drain:First 100 ft. 30.00
—� Each Addit.200 ft. —� 15.00_
Mobile Homs opa_ce _ 25.00
Other(Specify): — W Rain Drain-Single Fam.Dwelling 15.00
PERMIT FEE ! Comments:
ISSUed _ '
STATE fi�u (/ -'r.
T Receipof Applicant _----__---------
-i�(w
TOTAL _-^�,�❑ Signature
—.
For Plumbing Inspection Phone 639.4171
BUILDING PERMIT APPLIC#ATION TIGARD DATE ' _,19— —_'. 5149
THF UNDERSIGNE-r HFREBY APPLIES FOR A PERM11 FORTH EV40RK HEREIN INDICATED BUILDER PHONE 6+52-3053
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
LOT NO,.-
44
OWNER i t a r JOBADDRESS !. I >° . �.� ,,, real- rive .6t .K1r__
ARCHITECT
5a neGINEER
BUILDER ADDRESS 20945 SY T.V.T.`l. }awry. DESIGNER
STRUCTURE L(NEW_ ice] REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
C-I:RESIDENCE C] COMM ,EQUCATIONAL ❑ GOV'T C RELIGIOUS ❑ PATIO ❑ CARPORT IJ GARAGE ❑ STORAGE ❑ SL.AB❑ FENCE
OCCUPANCY -=�.--�'.-�LAND USE ZONE _.ci=_._BLDG.TYPE FIRE ZONE__. PLAN CHECK BY _=�HEAT
—.�r—
CONSTMICT 3VIOL19 FA'9ILY V1,%V.T ;', 11"
—Issue of 1 5079
1t •t?r1T�h�ti3
SEWER PERMIT 23291 "'•' r
OCC.LOAD FLOOR LOAD ;y. _HEIGHT ? 'NO.STORIES AREA ! x ! NO.BEDROOMS VALUE 49,°i(►C.i
BUILDING DEPAR'MENT SETBACKS FRONT t,;' REAR ' LEFT SIDE RIGHT SIDE
Permit 1.;"`�' THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINP NCES. AND IT IS HEREBY AGREED THAT THE
Plan Check WORK Wit L BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANO IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 37 '•" RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
11.37. LICENSE.SEPARATE DERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total
314.31 SDC—
- t}f"y �dtn l PDC# 1 I 150•(it! APPLICANT OR
F-y
-- Receipt No.
Approved AD0FiE9l9 -— — --- PHONE ----- --
.. .. .. - .. .. _ ... _. .. .aii.4.. dn.5.•..4.i Alllluf.u�,i;.Li1I1
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE 0
14 Contract �—
Q o I .,
/ Permit No.
Fixture
- Final
v _
HEWING
Contractor
3 Permit N
Gas of
Roughen -- _---
�— — — -- Final i
��_----- _` SEWER
Final
DRIVEWAY
Final
Storm Dralnege
(Rolm Dro—i Final
Sidev alk
Curb A Street Final
Approach
BLDG..DEPT. =64A1. TEMPORARY CERTIFICATE OCCUPANCY Final --
CEnTIFICATE OCCUPANCY
Landscaping
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