11720 SW HAZELWOOD LOOP-2 11720 SW HAZELWOOD LOOP
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ADDRESS 04
E R M I T N0.__
PERMIT CHARGE none
O'JNER CONNECTION FEE
PAID E3
TYPE OF BUILDING
DATE lONNCCTED
SERVICE RATE
INSPFC,rinN FEE .__.mss ---___.. __
_ _.__,L_ '-� _._.
CONTRA
-1.7Is-
CONTRACTOR
PAID BY
D A T
SIZE OF CONNECTION ASSESSMENT PAID
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City of Tigard.
INSPECTION REOUES
for
INSPECTION TIME - PERMIT C'4�"-2—
DATE*:$�� DATE ISSU
OWNERS N A M E
ADDRESS : &ZA oo*.7,044—WC10,
C.0 IN T R A C T 0 R
TEST*. Air n- , Water Visual —Ll Luborator� U
RESULT.* Approved, Disapuroved Ll Forld"ig
SKETCH:
INVE OR DATE
isupwaineriful i9al doic hftlllll
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i City of Tigard
INSPECTION REOUEST 4
for
NNSPECTION TIME :��' PERMIT NO. :
DATE: b . DATE ISSUED-
OWNERS NAME . !�)1-IZH
IADDRESS : -Z,11-7
CONTRACTOR
TFST: Air 0 , Water Visual , Laborator D
B RESUUi .' Approved , Disapproved U Pendin '
SKETCH:
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INSPEC?OR DAVE
ICOTE : Attach supplementu' tao uwo h-ietol
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City of Tigard
INSPECTION REQUEST �
for
I
INSPECTION TIME: 1/4%U PERMIT NO. :— I
DATE: /=1U/ DATE ISSUED :--L-Z_
OWNERS NAME :
ADDRESS. % i 7-c7/--
CONTRACTOR :
ic7/CONTRACTOR :
TEST : Air Q, WoterC , Visual f, , Laboratory C
RESULT: Approved. Disapproved Cl Pending O
SKETCH:
ti
NSP C'0R
DATE
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COTF: Attach euPpleme feet dop1�1, ;
CITY OF 10 76 N" 06 / 2-
1� UILDING PENMIT APPLICATION TIG ARD DATE-_- -- 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING P�. MS + Np SPECIFIC,ATIONS� OWN EAPHONE
OWNER — — _ ---- — --—-- ADDRESS -a ----- SER PHONE -- ---
ENGINEER
6RCHI'I E.QT_ — -- DESIGNER
STRUCTURE ONEW ❑I REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSL7PAT10 ❑CARPORT ❑GARAG': ❑STORAGE❑SLAB CiFENCE
❑BOND OMOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
QCCUPANCY LAND USE ZONE. 14-7 BLDG.TYPE J FIRE ZONE 3 PLAN CHECK BY_ a HEAT_'-9*
, j-lietruct 1493 eq* to from@ Split Level dwelling With attached garage*
Reissue Lot '32 & 11'44
4 bedroom
OCC.LOAD J FLOOR LOAD 40 lb HEIGHT NO.STORIES 2 AREA 103 VALUE ---
BUILDING DEPARTMENT ._ SET BACKS FRONT 20 v REAR 6C LEFT SIDE 20 RIGHT SIDE 1�
"151000
- --- - --
---+ 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 THF
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
•
111 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
7%—State LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total •
.133
By
APPI ICANT OR AGENT
Approved --�— Recrlht No -- — -- _
ADDRESS -
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No, CJ_ 3/9/76
Rough-in J--
rFixture
Ole Final
HEATING
-p_
�tAt 7J �t I �1 w r•✓ Contractor �c,a.c .�r2e
�'�7-�1tr✓ti •.Z �. ,J�r.� �.d-� 1„ r•'. Il.) t!1,,.:..,,�t. Permit No.
tA,r,n-.0 % >!e. (..r �14-4Gas or Oil
�- 6 x ` C .i►,1at a'L 1� o��.i.�►. `ft Rough-in
Final
SEWER _ ----
�_._�_ _ Finales
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach _
J J ALOGDEPT. FINAL !� TEMPORARY CERTIFICATE OCCUPANCY -- - - - -- —
CERTIFICATE OCCUPANCY Final
Land'-aping
Z
oning Final
7.0