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CITY 4F TIGARD
BUILDING DIVISION PERMIT p:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Inspection Requests (24 Hrs): (503) 639-4175 j
INSPECTION WORKSHEET FOR DATE: 11ME: PAGE:
SITE ADnHESS: I Z3 Dq 15W kl/I view 01f, CLASS OF WORK:
SUBDIVISION: LOT#: TYPE OF USE:
PROJECT NAME:
DESCRIPTION w1
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OWNER: y�///}�l�t N w
CONTRACTOR: Pt-!ONE k.�� 4y
Inspection Request Scheduled Fc r: Dote: Pour Time:
Code # Inspection Description Confirm 01 Contact # Message
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Corrections/Comments/Instructio S.
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[PASS PARTIAL APPROV/'L w f� ::ANCEL i [� NO ACCESS
R"tIL [] CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: . Date: V _ Phone #: (543) 718- .