11665 SW MANZANITA STREET 11665 SW MANZAN:I`I'A STREET .`
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested--j—=– Time
A.M. P.M.
Address Izi jljm i T'/-1. Permit 0"Z11-1
Owner Lot
Budder
The following Building Code deficiencies are required to be corrected:
—----–----7-7—
II
Prest-nted to Z;' Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
❑ YES 1?f NO
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C17YOFTIFARD (C"Y*-06',—'F"iWAV PlERM11' NO . : ME:090060
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COMMUNITY DEVELOPMENT DEPARTMENT I)M*E: :LSSUED : J.
13125 S.W.Hall Blvd..P 0 Box 23397.Tigard.Oregon 97223,(503)639AI75 Mi.I -
,A3I:3 ADDREKSS : 11.665 !:iW MANZAN-111'A '5 (
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61-TLAIWOTON r*uR1NACW.:-' <'100K A:EP HAN1: L-14 <10
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This permit 19 Issued subject to the regulations contained In Title 14 ,,,•.,,•_„-,............................................
of the TMC, state of Oregon Specialty Codes, zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done In accordance with the plans and I NAL,
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive.
covenants Contractor and subcontractors shall have current city
business tax permits.This permit will expire and become null and
void if work is not started within 180 days,or if work is suspended or
abandoned for a period 01 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required Inspections are requested and approved.
permittee Signature
— T-75
Isstied By --TT7,=7 TTT74--(7PT) 71
I SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
--<3-77
BUILDING PERMIT APPLICATION �o Y TIG,kRD DATE '
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAIDS AND SPECIFICATIONS. OWNER PHONE _
LOT NO. —
i:llurk I.ny LJ.ut1-, J'U �Ifill� I4 k. ,54.
OWNER JOB ADDRESS HOME ADDRESS _
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER CJ
STRUCTURE ❑NEW ❑REMODEL _ ADDITION C1 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMO"-.ITIC'N
❑ RESIDENCE ❑10MM ❑EDUCATIONAL 000V'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE
❑BOND ❑MOVING — ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _ ❑SIGNS
OCCUPANCY----LAND USE ZONE_-- J -BLDG.TYPE — FIRE ZONE.____ PLAN CHECK,BY_—_
to gsragj i.,jt-3riuL- par plans _
QCQ LOA __---F-L4.QPJS?ADFIEAQyff—EUBQQM5 ___VALUE
_ BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDF
THIS PERMIT IS ISSUED SUB.IF.CT 1'0 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABI..E CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE. CODES AND ORDINANCES. THE. ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE. COVENANTS. CONTRACTOR ANO SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax _ LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By ---.. ------- - - --
_... APP' (CANT OR AGEN1
Approved I Receipt No
AUD ESS --�PN(>NF
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
LA,*1^4 1 OL Contractor
bi,74- Permit No.
TA - Rough-i,,
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
Final
SEWER
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Fina!
Sidewalk
Curb&Street Final
ADproach
BLDG DEPT, FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCYFinal
Landscaping
Zoning Final
i
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CITY OP 7�3
BUILDING PERMIT APPLICATION TIGARD DATE 0 0
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE-- —_-----
OWNER°Iefss Fbalam ADDRESS 11665 S*IJ* Manzanital `f,13UILDERPHONE --
ENGINEER
BUILDER � �� >?I1�8!!1) __ ARCHITECT _ DL-SIGNER
STRUCTURE ❑NEW �-1_ ❑REMODEL — UAGDITION El REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
C3 RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOV ING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY. --LAND USE ZONE. BLDG.TYPE _FIRE ZONE_ PLAN CHECK BY- HEAT_---
FLOOR LOAD HEIGHT NO.STORIES AREA
BUILDING DEPARTMENT _ SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit - — --- — ----- --- —=� ---_-------�
— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CuNTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES 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 APPLICARLF CODES AND ORDINANCES. THE IRSUANCE OF THIS PERMIT DOES NOT WAIVE
- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO IIAVE CURRENT CITY BUSINESS
1%State l LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
BY
-- APPLICANT OR AGEN1
Approved Receipt No.
AUbpESS HONE:
i
i
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor A
Permit No.
Rough in
Fixture
Final _
HEATING
Contractor _
Permit No.
Gas or Oil
Rou h in
Final
SEWER
_ Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach _
81-013.DEPT, FINAL TEMPORARY" CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final _
Landscaping
Zoning Final
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Address/46 Permit No.
Name of Occupant_ Permit charge
Connection fee J ro
Paid by
Date connected—9—M—LY -&Z
Type of Building Inspection fee
Service Rate— Paid by Date
Contractor Assessment— ---Paid
Size of connection
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N? 1018 DATE
P:atMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID ... _................._...TIGARD SANITARY DISTRICT
f ,
By
7o-1)
CONNECTION INSPECTED AND APPOOVED
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