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THIS NOTICE: IT IS DUE TO
THE QUALITY OF THE ORIGINAL
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City of Tigard
INSPECTION REOUES-17
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INSPECTION TI E PERMi-r -
D TE: DATE I S S U E.1' .
OWNERS NAME -.
ADDRESS :
r0NTRAC`1'OR :___A7
TEST' Air Cl, Water []
j , visual [7 , Labornforvo
RESULT', Approved' Disapproved 0 Pendm4
SKETCM.'
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INSpTUFA R DATt
I;PTE Attach supp!ementc, tev Jrj*o hio) ",
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City of Tigard
INSPECTION REQUEST
for
C1 , � �
INSPECTION TIME: __ PERMIT NO. :
DATE: DATE ISSUED :_..1_ /
OWNERS NAME : —. , C�
ADDRESS:
CONTRACTOR : _ JCF—'n4/J67w,- ____
�_�-/ ,-„ 77A
TEST : Air [r), Water p , Visual , Laboratory Q
RESULT: Approved Disapproved D Pending p
SKETCH.
Vrr+"
INSPECTOR IDATE
[OTE : Attach supolemental test data bereto7
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City of Tigard
I
INSPECTION REQUEST
INSPECTION TIME: 4A PERMIT NO. : I
DATE: Z 1111 Ll- DATE ISSUED : I
OWNERS NAME : 0 C ,
ADDRESS: s. l,ol 1Yc-
CONTRACTOR :
(
TEST : Air 0, Water Q , Visual p , Laboratory p I
RESULT: Approved Disapproved p , Pending p
SKETCH:
INSPECTOR DATE
ENO?E: Attach supplemental test data beret]
O.r�rjpa'rt'��aMvy: ,�.. . �t„�r+�+p�w'�►*w'+/v`w.er�r+Vitae.n-.swrw.ntmwl�IPy„ $T;'.,, .ppwnr� ,. .. ,. tiw+�N11Yr+,.. .««,.-.«.,r,,
b'v CITY OF 75 N°• 0283
BUILDING PERMIT APPLICATION TIGARD DATE ._,19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPEC,IF,_y."IJNS.1DTW^JJH.LOU SumffisfrM
OWNER Tualatin 0sup ,Apl1Ient CoAbDRESS 10335 3.41• HAghilend Dr•BUILDER PHONE
�gttilll ENGINEER
BUILDER , ARCHITECT DESIGNER
STRUCTURE CINEW ❑REMODEL ❑ADDITION ❑REPAIR ❑FIENEWAL ❑FIRE DAMAGEtt-- ❑_DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIO-US❑PATIO ❑CARFORT ❑GARAGE ❑STDRAGEL_CSLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE L..IDESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY,._,LAND U:iE ZONE BLDG.TYPE 5 __FIRE ZONE 3 PLAN CHECK BY r(P� HEAT IjAts
QAC LOA FLOOR FLOOR LOAD_____— vHEIGHT _ NO.STORIES AREA VALUE ?C}
BUILDING DEPARTMENT �"� � E3•'�
SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit O —
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BB DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRCNT CITY BUSINESS
1%State UU LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
rntal 11 I.Ot]
By sfe _
--- APPLICANT OR AGENT
Approved Receipt No,
ADOPIESS PHONE
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)ATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
s
Contractor
Liu
Permit No. o1A
�^ Rouh•in
�=q 7 //�� V ` Fixture �.
G k Fina! >
_ HEATING
Contractor a
Permit No. 7-
Gas or Oil
Rough-in
Final 1
SEWER Z.11.7�
Final
— DRIVEWAY)-)f-7�
Final
------ Storm Drainage ~
- (Rain Drain) Final
Sidewalk
-- Curb&Street_Final _
SLOG.DEPT,FINAL TEMPORARYA roach Q'( ,[,C y21 3
CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY
7',(j Final
7 Landscaping
_ Zoning Final
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