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10415 SW HIGHLAND DRIVE
City of Tigard
INSPECTION REQUEST
for
i
INSPECTION TIME: PERMIT NO. :
DATE: �.L��` �. DATE ISSUED , /
OWNERS NAME : �'-
ADDRESS: ! /S ��► -fll. -'b 7J►2.
CONTRACTOR : -
TEST
ONTRACTOR : _TEST : Air ❑, Water❑ Visual ❑ , Laboratory D
RESULT* Arm•�d r
pp D Disas lived Pending D
SKETCH.
1
PECTOR
DATR
rt�O'tL ,4•t , ti ' me'1" � �tf 1U'u 6erv!t�
City of Tigard
INSPECTION REOUEST
for
INSPECTION TIME : PERMIT NO. :
DATE: tlz lZ31Z-2'. GATE ISSUED".--/—
OWNERS NAME ' ,lam . 6-
ADDRESS :ADDRESS :
CONTRACTOR : - -- ---- --
1 EST . Air ❑, Water [:i , Visual)(, Laborator•, ❑
RESULT: Approved„ Disapproved ❑ Pending ❑
I SKETCH:
I
I
I
I
INSPECTOR DATE
IrNNOTE Attach supplemenful test data heret:03
J
1
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I
City of Tigard
I
INSPECTION REQUEST
for r
I
INSPECTION TI ME :-ZL-A-L� - PERMIT NO.: —
DATE: - e-1 -1-2,L DATE ISSUED:
OWNERS NAME : -7 r�C— /
�.,..
CONTRACTOR : —14—,Z
_ _
v y
s'z 4 of (pI/cgn n /o w/ 14,c„y[ —_.ol
LOT /7Z J
TEST: Air 0, Water p , Visual O Labor or-
RESUL;T ." Approved` , Disapproved O Pending p
SKETCH:
E
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T y �
1Sy
i I
INSPE TUIR DATE
COTE . Attach upplementu! felt ua<a hs+reto�
,. r^.•,y...wv^-arw.+rrerMMr.,y,,,,�M^�'�'X714'^^'M'�,�a"^''r'..„...�,y,«.q.�....y,.wyy�,M+'"+SNA,.,”�7�'+�'yg'AI„o"'*..a.�Nu,«a�rs��+'• +Yw.,«�,�,,.w++«r.».••
�72- CITY OP .. , r N° 0268
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 SPECIFICATIONS. OWNER PHONE _
''� . C'1ra. H. J. Campf 10415 S*W* Highlcnd Or
QWNER ADDRESS BUILDER PHONE
Tualatin 'L)vVk's?• t.,?. ENGINEER
BUILDER _ ARCHITECT DESIGNER
EI
STRUCTURE IJNEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM [-]EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO [:]CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY.—F LAND USE ZONE t+ r BLDG,T YPE 1 FIRE ZONE - PL.AN CHECK BY rr® HEAT9NG
---- 2 Ledroom 2 baths dors — ---- -
-
OCC. LOAD FLOOR LOAD HEIGHT -- - NO.STORIES AREA 66 VALUE 23,9C)n
BUIL.DING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 1013,9 00 ---- --- --
� �� THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check • REGULATIONS AND ALL APPLICABLE CODES AND URDINANCES, 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
p� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total .119.08
rT
By
----- APPLICANT OR AGENT
Approved Receipt No.
AD RISS— —'� PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE ,1-
.J Contractor
s-j1:22= Permit No. bioc> ti ��hfi
Rough-in
Fixture
G-/3 7 _ 1 Final "
HEATING
�p 7 LvV /Il�(o aj*-i G0 Contractor
Permit No. A 0 70-0 S--3"-7'
6"/ `7 Gas or Oil
Rough-in
ate' Final
SEWER WJ
_ Final Top - �B
— DRIVEWAY
Final
Storm Drainage
_ (Rain Drain) Final
Sidewalk �C 6-13--76-%
Curt,&Street Final �^�C 6-13-747
Approach
BLDG.DEPT,FINAL TEMPORARY —T CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
_-� Landsraping
Zoning Final
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