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City of Tigard
INSPECTION REOUEs"r
for
I INSPECTION TIME :-- PERMIT 1,
j
DATE: - X/'i /l y_ DATE
1 OWNERS NAME :
ADDRESS .
CONTRACTOR
TEST: Air ❑, Water �] , Vieuol'O , Laboratory Lj
RESULT. Approved Iu1 , Disapproved 0 Pending il
SKETCM: --.�
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[NOTE : Atlach su
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CITY OP
BUILDING PERMIT APPLICA"T"ION TIC ARD DATE �acn 3 — 19 Tb Na 0696
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND .;P?ROVED IN THE ACCE '',-ANYING PLANS AND SPECIFICATIONS. zNERPHONE_ _
TualatineValupMont i, a 10385 fir, L, . Highland Dri,e� 7 639-3101
OWNER_ ADDRESS S LDER PHONE
ENGINEER
QUILDER ��tlat r_1 ARCHITECT _— DESIGNER
U�1t,16W
STRUCTURE LJNEW ❑REMODEL 1_f ADDITION ❑REPAIR DRENEWAL ❑FIRE DAMAGE []DEMOLITION
❑ RESIDENCE. ❑COMM [:)EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CI.R PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL'JSE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
C.
OCCUPANCY T LAND USE ZONE—_H! -BLDG.TYPE U —FIRE ZONE S PLAN CHECK BY I't a� HEAT i
i;onstruct 1.490 sq tt freme dl, ellirgj sixth attached garogv. "!o biasemont• �—
-- according to approved plans. - -- — — --
OCC. LOAD 5 FLOOR LOAD 40 lb_ HEIGHT _ NO.STORIES ! AREA 1490 VALUE52 df 1f-'f)
BUILDING JEPARTMENT 1,i,'611 516"eg"
SET BACKS FRONT REAR i EFT SIDE RIGHT SIDE
Peal-
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check • REGULATIONS AND A!.L APPLICABLE CODTS AND ORDINANCES, AND IT IS HEREBY AGREED 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 DOES NOT WAIVE
--- RESTRICTIVE CC"i NANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE. CURRENT CITY BUSINESS
t"%State LICEIII§E.#!1o%H4kTE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total •
--- % APPLICANt OR AGENT - — ---"�--
Approved — r ;3 Receipt No. '
.,........„.. AooaESess
DATE INSP. TYh INSF'FCTION REMARKS PLUMBING r DATE
ems
Contractor *k�--��`
-y� Plsrmit No. D 343 .3
V
�"����� Rough-in •� �p
S i76 (/ `►'_ Lt -�° �_ Y� "joofi Fixture - —
ARIST Final _
7IV .IEATING —_
Contractor
Permit No.
Gas or Oil
Ll SEWER
Final -- —
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
_ Curb&Street Final
_� _ A ,y
Approach !
BLDG.DEPT.FINAL TEMPORARY CEFiTIFICA•fE OCCUPANCY
G CERTIFICATE OCCUPANCY Final
Landscaping
(� Zoning f inal
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