12198 SW MAIN STREET 12198 SW MAIN STREET
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INSPECTION NOTICE
City of Tigard Build.ny Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone.: 639-4171
�j1
Type of Inspectio, p'ly_.---
- /
Date Requested�` "tis �� Timet / A.M. P.M.
Address _
Lz1��X J1rr_/�L_< ..._ Permit
Owner _ _ _. __ Lot #
Builder ..---
—
The following Building Code deficiencies arp required to be corrected:
i
i
_ _ a
f
1 Presented to _-_ —_-_._ [kpproved
Inspector ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
CITY OF TIGARD Plumbing Permit
Building Department No. I
Redential ❑ Commercial F_J�r'
Nei Installation ❑ Replace [a" Additi,)n D Alteration 01 Date
Licensed
Plumber Owner
Address Job Address
Phone
Applicant jA �el
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
ITEM NO. FEE TOTAL ITEM N 3. FEE TOTAL
Fixtures-Traps 7.50
Sewer:First 100 ft. 30.00
Dishwasher 7.50 Each Addit.100 ft. 15.00
Garbage Disposal 7.50 Ejector Pump 7.50
Water Heater 7.50 Water-First 100 ft. 20.00
Backflow Preventer 7.50 Each Addit.200 ft, 15.00
Storm&Rain Drain:First 100 it.
_ 30.00
---Each Addit.200 ft. 15.00
'4 Mobile Home Space 25.00
Other(Specify): —Rain Drain-Single Fam.Lwelling 1500
PERMIT FEE Comments:
STATE %v,„ Issued By:
Receipt No,,& Applicant
v
TOTAL Signature
For Plumbing ftwipeoftm Phw"e 639- Il 714
CITY 0P 3u1 7fN2 0965
BUILDING PERMIT APPLICATION T11%94 ARD DATE� __._, t9
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE-
7 si i,
HONE Tali, , -..wa jobbir,
_OWNER ADDRESS JQUILDERPHONE
ENGINEER
42113W � �u �G '�"�"�i CIADDITION
DESIGNER
STRUCTURE ❑NL•W ❑RF'.'IOEL ❑ADDITION ❑REPAIR ❑RENEWAAL ❑FIRE DAMAGE ❑DEMOLITION
C1 RESIDENCE ❑COMM ❑EDU• " VAL CwOV'T ❑ L_.J
[:]RELIGIOUS ❑CARPORT LJGAGAGE SlORAGEU ❑
SLAB FENCE
E)BOND ❑MOVIN,; ❑CONUITICNAL USE C1 DESIGN REVIEW ❑Cn'"r.It.APPROVED SIGNS
OCCUPANC�—LAND USE ZONE_—_ —BLDG.TYPE .-_!� FIR_ E ZONE_. PLAN CHECK BY-_.,_=== HEAT_____
P'UrT.Aon of" I`rowe , at': r. � hL ea.Xc�l fark rtciln 4 �tA1r1.
C99. L.-LOAD FLOOR LOAD _— HEIGHT NO.STORIES _______.,_AREA VALUE
-BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit Ju
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND OkOINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WI 7'H THF.PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recc,rding ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
----- Apr AN r OR AGENT
Appioved Receipt No.
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CITY OP
BUILD114G PERMIT APPLICATION TIGARD DATE_ LJr+La .1,A 76N!,19 7 Na' 0876
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONE
main e-t,
OWNER — _ ADDRESS BUILDER PHONE
ENGINEER I
BUILDER ARCHITECTr1---11 DESIGNER
STRUCTURE `—ONEW ❑REMODEL ❑ADDITION ❑REPAIR []RENEWAL ❑FIRE DAMAGE [:]DEMOLITION❑ RES-IDENCE ❑COMM DEDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO OCAR PORT IJGARAGE ❑STORAGE❑SLAB [:]FENCE
0-BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN RFVIEW ❑COUNCIL APPROVED []SIGNS
OCCUPANCY---.LAND USE ZONES BLDG.TYPE._. FIRE ZONE_— PLA" ;HECK BY_-_. HEAT—
jn.x 9f t*; ine C:Jny ",1ej u Saar - ---
QQC, LOAD FLOOR LOAD_ HEIGHT NO.STORIES _ AREA VALUE i
BUILDING DEPARTMENT — SET BACKS FRONT HEAR LEFT SIDE RIG141 SIDE
Permit
—� 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 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 COVENANTS. CONTRACTOR AND SUB CONTRAr'TORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REnUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
— — - --- — —_ ---
------ -- ----- AP-' 'ANT OR AGENT
Approved Receipt No
w� /IDD E S PHONE —^—