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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St,
Tigard,Oregon 97223
Phona: 639-4171
Type of Inspection
Date Regvetted Time- A.M.xP.M.
Address (4, ----- Permit
-)wner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector El Disapproved
7
Date
CALL FOR REINSPECTION
0 YES �NO
G INSPECTION NOTICE
City of Tigard Building Department
k 12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
7 j of Inspection
Date Requested__ ��O�' nm,
`S`
Address _.1' mit
Owner ---__-._. ���J —�6t # _
Builder --
V a following Building Code deficiencies are required to be corrected:
ate? .00 ►�
I
I
' Presented to Approves+
Inspectvr 1 _ V Disapproved
Date
CALL FOR REINSPECTION
YES Il NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
l Tyae of Inspection
p
I nate Requested Time A.M. _._P.M.
OKy
/address , `� --.L� S ✓ ermit #
i Owner _ Lot #
` Builder
M The following Building Code deficiencies are required to be corrected:
1000,
_ rsC..i�t-v-'�7 "'^ r:.��_".t'tsa: G.�.C'=.__,..r.�- J-•' 1._.
A
Presented to kf Approved
Inspector i -�' � [ Disapproved
Date
CA U FOR REINSPECTION
Cl YES ZNO
iNSPECTiON NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, egon 97223
P one- 63q-4111
Type of Inspection
Date Requested--.— /0 - � Time A.M. P.M.
Owner Lot
Builder --
The following Building C4jde deficiencies are required to be correlated:
—- -------- -
— --- -- aU
Presented 'to Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES Pl No
�17YOF TIGAISD No. 0390
12/55 S.W. ASH �,rf
` P.O.BOX 25397 Date
TIGAPD,OR 97223
Name
Address �-_--� � ^pp j �
Lot Block/MapSubdlvlslon/Address
1 ,tj V LJ mfr L
Permit N's Bldg, Plumb Cash Check
Sewer Other Other Rec, Bx
Acct. No. 0 Description Amount
10.432 Building Permit Fees
10.431.600 Plumbing Permit Fees
10.431.601 Mechanical Permit Fees _
-10.230.501 State BIdaTax
10.433 Plans Check Feo
10.435 Other Licenses ,& Permits
30-443 Sewer Cc nnecticn —`_ y
30.444 Sewer Inspection
24.446 Street S st. Dev. Charge _ U
25.449-610 Parks_ISyst. Dev. Charge
25.449-_620 Parks 11 Syst. Dev. Charge I
31.450 Storm DrAinage_S sy t. Dev. Charge
10.430 Business Tax
10.434 Alarm Permit
10-24 r Ball �-
10-455- ,+ Fines -Traffic/Misd/Parking
10.230• CPTA TrafflclMlsdIVIc. Asst. _
10.475_ !ndlgent D,tense
30.449.401 Sewer Selyice/USA
30.446-402 Sewer Service/City
31-447 Storm Drainage i —^
i 40.475 Bancroft Prin. Pymt, v
40.471 Bancroft Int. Pymt.
10.451 Other Charges for Services
TOTAL I�i y2
i'-' DEPT.
BOILDINGPERMIT APPLICATION TIGARD DATE.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHO''EI-1�L;
OR AS SHOWN AND APPROVED IN THE ACCOMPA,IYING PLANS AND SPECIFICATIONS. OWNER PHONE.—______.._ ... ..__
LOT
OWNER`1it�ntiF,nJ013ADD_RESS I425jL_",41 F rr.iQ�'. ' _LT__ �tl.att�y S'JL'E!'.iLd:ZL7~fl�82
i ARCHITECT
ENGINEER
BUILDER aamf? ADDRESS 2*)y45 SW T.V. DESIGNER_ `
STRUCT'JRE ANEW ❑ REMODEL Cl ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE 0 DEMOLITION
(3 RESIDENCE D COMM ❑ EDUCATIONAL Ej GOV'T Cl RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE 01 SLAB❑ FENCE
OC;UPANCY - LAND USE ZONE _. 7FD BLDG.TYPE -FIRE ZONE._ PLAN CHECK BY -_ I'•TW HEAT
H,initle tagl. G■wc li4 :_tl.L-_*34.InASI.L�iiSL_i:5 ie�{l.i,-.--.-- -----
SEWER PERMIT M 21'.1 t;',�_ -
OCC.LOAD FLOOR LOAD 4tHEIGHT 21 NO.STORIES 2 AREA 116,) NO.BEDROOMS _) VALUF 4 5 0(X),
BUILDING DEPARTMENT SETBACKS FRONT 2U REAR 6(� LEFT SIDE 22 RIGHT SIDE
Permit —_tr ,.5U THIS PERMIT 13 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGIII-ATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGRFSD THAT THE
Plan Check 4J.(A) WORK WILL BE DONE IN ACCORDA14CE WITk THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOI:S NOT WAIVE
Subtotal 3UU*50 RESTRICTIVE COVENANTS,CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
:,tate tax 10.4 2 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC— 'iuv.:)'j .
Total 31U.�2 � " '
—--- - -
PDCN ' APPI ICAN7 0 A0lcNt
By Cz 4"I.N 25U.U()
Receipt No. _
Approved I's T4! 11) AbDIVIll PHONE —
DAT! INSR T jrX INSPECTION REMARKS PL'JMBING DAT .__
Contracto -
r —�- - -- PerrrlltNo'
-•�V -- -- - Rough-In
Ir ry ' a6�j-�� Futuro - -- -- --
x44 -- ------ Final -- - ....----
I/_�C;
HEATING
Contractor
PermOf it
Gat or Oil --
Rough-in
- ------------
Final
SEWER
- — -- Final - -
DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final
Sidewalk
— Curb A Street final
-. �— -- Approach
D -
aL1) EPT,I11vt.L -T TEMPORARY CERT'IF'ICATE 6CClIPANGY Finai
r.ERTIFICATE OCCUPANCY
Landscaping
_•,._..�. _. _-� --__ -,-, __ Loning Final �
i.
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