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NOTE : IF THIS MICROFILMED 12
DRAWING IS LESS CLEAR THAN —
THIS NOTICF;-`IT IS DUF TO
THE QUALITY OF THE ORIGINAL
-'DRAWING.
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10175 SW HIGHLAND DRIVE
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City of Tigard
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INSPECTION REQUEST
for
I INSPECTION TIME : PERMIT NO.: _
I DATE:_./IAL,5 DATE ISSUED:_..]
OWNERS NAME : -1
ADDRESS : _ , ,-
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CONTRACTOR :--,. L ,k'1SW
TEST: Air ❑, Water ❑ , Vieualee, Laboratory ❑
RESULT. Approved D , Dieapproved w Pending ❑
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SKETCH:
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INSPECTOR DATL
[NOTE: Attach supplemental fillt 'd0te hereto
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City of Tigard �
INSPECTION REQUEST
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for
ME: PERMIT NO. : - I
INSPECTION TIME: �---
DATE: gL'�� DATE ISSUED : Z
OWNERS NAME : 1 C
ADDRESS: _ /L� 'J J L'
CONTRACTOR :
TEST : Air 0, Wotsr-5 ', Vieual�d, Laboratory (] {
RESULT: Approved, Disapproved ❑ Pending 0
SKETCH:
INS E r70 DATE
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CITY OP
BUILDING PERMIT APPLICATION TIGARD DATE 8-2 75 N° 0464
1 FIE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER Tualatin ",ACDRESS 10175 5*iJle Highland UPJ.y6111LDER PHONE_—��._ —
ENGINEER
BUILDER Htllb• —�r—ARCHITECT DESIGNti:H —
SIRUCTURE ❑NEW ❑REMODEL OADDITION ❑REPAIR ❑RENEWA_ ❑FERE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑CrMM ❑EDUCATIONAL ❑GOV"i ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE OSTORAOE❑SLAB ❑FENCE
❑BOND —�❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY ' -LAND USE ZONE E=L,, BLDG.TYPE—_—FIRE ZONE_ PLAN CHECK BY._-.__11- ' HEAT-_j�
jo 5175 2 bedrooms
OCC. LOAD v FLOOR LOAD---- HEIGHT_ NO.STORIES 1 AREA 1429 VALUE 23"�2!1r1
BUILDING DEPARTMENT _ j 3� 70(jam 71611
_ SET BACKS FRONT REAR LEF T SIDE RIGHT SIDE.
Permit 100.00 --- ----- ---- — —
�- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS r:ONTAINFD IN THE BUILDING CODE, ZONING
Plan Check 101011 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGFIEED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOLS NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State 3,00 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tots 1 113.00
Byo® APPLICANT OR AGENT ------` --- �,�---
Approved Receipt No.
ADDRESS �F-b 1oNE
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DATE INSP. TYPE INSPECTION REMARKS - PLUMBING DATE
q-� 7s — _ _ Contractor
Permit No. z;43z,
/C-/•7� 1j ter►-� _ Rough-in
.iY -/! C �' •1:A.-r. �•�_ Fixture
Final — — — —
�Q,��-�� HEATING
Contractor -r
_— Permit N_ VAOIf-.
Gas or Oilo &'t/
Rough-in
Final
— S E W E R/o.Z?.7j �C
_ Final _
DRIVEWA
Final
Storm Drainage
-- — —_ (Rain Drain) Final
Sidewalk
—� FFinal
et Final
BLDG.DEPT. FIAIAL. TEMPORARY CERTIFICATE OCCUPANCY// CERTIFICATE OCCUPANCYg
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