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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
P1,one: 6 4171
Type of Inspection j
Date H-quested Time A.M. P.M.
Address
Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
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7,
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—400or
—----------
Presented to Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES F-1 NO
INSPECTION NOTICE
City of Tigard Buildinc,Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested
7-- via- 1�2 -Permit
Address
Owner Lot
Builder
'The followin
,g-$uilding Code defiawccies are required to be corrected:
Presented to Ll Approved
Inspeclor
�7— [approved
Date
CALL FOR REINSPECTION
RYES bNO
Building Permit No.
Location bio 2 �S ,.�• �i'?��(�� ,
Certification of Registration
With the Builders Board
s
doing business as (dba) ,
ram registered under the provisions
of ORS Chapter 701 Oregon Nomebuildcrs Law).
My Builders Board Registration Number is
Ply registration is in full force and effect and expires on
Y�
signature
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BUILDING FERMI-I APPLICATION TIGARD DATE..- 12-22-63-- -_19 " 4693
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR .'HE WORK HEREIN INDICATED BUILDER PHONE.u3�I: b3
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING���������IG�OrJS. OTINO.ER PHON 95
OWNER GUTHkiIE - JOB ADDRESS _ _. _ :
DATE INSP. TYPE INSPECTION REMARKS PLUMBING 'DATE— 1
Contractor --
J
Fixture—` — _—
Final --� ---
HEATING
t Contractor
= 5�� -o1_ Permit No.
_ Get or Oil
y�� Rough•i n
Final
-- --------------_—_-- — __—._._ SEWER
Firiol
Vi DRIVEWAY
Final--_ -- -- i
Storm Drainage
Wain Drain)Find!
Sidewalk
Curb&Street Final
BLDG. DEPT. FINAL TEMPORARY r'ERTIFI ATE OCCUPANCY
rRTIFICATE OCCUPAW Y Finnl
r' l
Land+caping
—'__ .•—�� ' Zoning Final --
BUILDING PERMIT APPLICATION TIGARD DATE_e�Q- -- t9�
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED HUILDER PHONE I�39'I363_
OR AS SHOWN AND APPROVED IN THE ACCQJP NYING PLANS AND SPE:.I1 !FI IONS. OwNEP.PHONE
//�� LOT t,O.- aSr -
c,)'t1NER lTV 4 h V" I" JOB ADDRESS / moi._ KnGc
ARCHITECT
ENGINEER
Mit ')ER CLVIA _ ADDRESS ,49S -mow'
ConC�IQ'DESIGNER
STRUCTURE (ANEW AODEL ❑ AO_D_IFION J REPAIR_ ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
2 RESIDENCE n COMM ❑ EOU!:ATIONAL ❑ GOV'T ❑ RFLIGIOUS ❑ PATIO 0 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB/❑ FENGE
OCCUPANCY LAND 3 _ LAND USE ZONE i2 `7 BLDG.TYPE =L FIRE ZONE—r PLAN CHECK BY +_ H[AT.-_sem. _
m�1�- --L?s�-�r-11, f • h�s�_ —
,. .
SEW PEIMIN
t NO.STORIES AREA I�IeiD NO.BEDROOMS .¢ va:LU
OCC.LOAD FLOOR LOAD 4(0 HEIGHT a(� _ n� r
BUIICING DEPARTMENT
SETBACKS FRONT (� REAR .` LEFT SICE aO• RIGHT SIDE G��
NG CGDE.Z0WNu
tMrmit _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE SU1LDI
_- REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT 15 HEREBY AGREED TY,l.T THE
Plan Check 30 ._ WORK WILL BE DONE IN ACCORDANCE W11H THE PLANS AND SPECIFICATIONS AND IN COfAPLIANC:
s WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUA.;CE OF THIS PERMIT DOES NOT VIAIV'
Su�fetal f91 �_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSiNES'
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBIN( AND HEATING.
'
atate- lax /y. .z 0
Total SOC G tA_
PDC# APPUCAANIT OR Ar ENT— 7
BY ------- Receipt No. G
Approved ADDRESS
PHONE
SDC
PDC
SEWER CONNECTION
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SEWER INSPECTION S
SEWER SURCHARGE S
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