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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
T'gard,Oregon 97223
Phone: 639-4171
Type of 1--.;rection
Date Requested._._.—.--. 7= ---
Time AJ..._ P.M.
Address Permit #
Owner Lot #
Builder e ---- —The following Building Code deficiencies aro required to be corrected:
I
Presented to _ Approved
Inspector -- I Disapproved
Date, —
CALT, FOR REINSPECTION
CJ YES A NO
Building ?ermit No.
Location lam} �_Y�,,ec-Ie.l�-- i�
date --
Certification of Registration
With the Builders Board
l
(die x�
going business as (dba) ,
�.C� �� ��� _ am registered under the provisions
Of ORS r-hapter 701 Oregon liomebuiIders Law) .
r
My Builders Board Registration fiuinber is ' "'._ -�)___�_
fly registration is in full force and effect and expires on
t-
Signature -�r
BUILDING PERMIT APPLICATION TIGARD DATE `'aY 16 _ ,�s_r4 _ 4836
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INIDICATED BUILDER PHONE 638-. u2C ___
OR AS SH 'NN ,kND APPROVED IN THE ACCOMPANYING PLANS AND G)PECIFICA T IONS. OWNER PHONE
LOT NO.-.__46_---
OWNER JOB ADDRESS c a
-__ �:. .tet :.. �... __.i.3.2�._SW� Ij11@.51.AXS°i��J"_`--- __-- _ ted it 'States
ARCHITECII
ENGINEER
BUILDER - - ADDRESS 159ut1 SLI serpnia DESIGNER
STRUCTURE _11 NEW C7 REMODEL I I ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
Cjl RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS U PATIO ❑ CARPORT U GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R-3 LAND USE ZONE _ ' 6LDG.TYPE —.._ iL.FIRE ZONE___-PLAN CHECK BY _jJ HEAT___._Sii8A__.__
__..---
3 Wroo,n 2 dathroom
SEWER PERMIT 2(1535 t4raxe 450
OCC.LOAD FLOOR LOAD 40 HEIGHT 1()+ NO.STORIES AREA Ij y1j NO.BEDROOMS l VALUE 6 I,UttN.
BUILDING DEPARTMENT SETBACKS FRONT REAR 11_ LEFT SIDE RIGHT SIDE
Permit _ ,Q, THIS PERMIT IS ISSUED SUBJECT TO SHE. REGUI ATIONS CONTAINED IN THE BUILD,NG CODE, ZONING
REGULATIONS AND ALI. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 205,40 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIF-ICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal _ 52 1.40 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWEn,PLUMBING AND HEATING.
State Tax t 2:,64
- SDG _•',;.I ali `
Total 534.04
`— PDC# APPLICANT ORAGE.NT
By Gt3 LI ISU.UU �..:. : a
Vf
App-aved �I t,;rW RocolW No• 2511.to; ADD 88 - .}` RO�1 ---
� 1 NIE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING _.!!ATLr
Contractor
�
Pe,,!Il No.
Rough-in
Fixture
IF HEATING
Contractor
Permit No, 07�
C,81 at Oil
Floiigh-in
Final
Final
FIRIVEWAY
Final
Storm Drainage
Main Drain)Final
Sidewalk
Curb&Street Final
Approach
CCRTIFICATE OCCUPANCYEPT.FINAL TEMPORARY Final
CERTIFICATE.RTIFICATE Or
_CUPA qr.1 i —` i
Landscaping
II
Zonin. Final
i
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE 'WORK HEREIN INUICAILD EUILOLRPHOI-E `9
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIOfJS. aYINCPn'orlr ____
LOT NO
2WNEP'1 ` JOB Q '122E,.S5
--� ARCHITECT
`-•` �, p �-y� -� ENGINEER
ADDRESS J�1 C!U -� ( L ZlL"((.�� DESIGNER
STRUCTkIRE OffNEW ❑FIEMnOEL ❑ADOITION ❑RcP;tR - ❑A E`1E':JAL ❑FIRE DAMAGE DOE.-A0LIT1
J RESILE"ICC ❑CO►tt.I L.JEDUCATIONAL ❑GOV'T [)REt,IG1QUS❑PATIO UCAR PORT L..JGARAGE CJ STORAGE n3LA8 ❑fEt,
f��.Jn �"� FIRE ZONE PtAPLAN-Cl-;ECK BY �� T--(&.-- HEAT (J� -
CCCQPANj-'Y._,,� LAND USE 20NF j��OLOG TYPE-.___.
SEWER PERMIT
Q -7 U H NO.S RI � __841 �`�� NO.BEDROOh1S'1 VALUEk"
..s,.�..�OJa _—_FI..QA�1104Q t!-Elsa_�_. r TO E, � -�c�,��--
F )ILOIN-:; DEPAR CMENT SETBACKS FRONT r�'U REAR 1 LEFT SIDE g RIGHT SIDE L�
— - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZON
1 in :hrCk Lq,- c REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 1T IS HEREBY AGREED THAT 1
(------ WORK WILL BE BONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CCA1PLIf.NCF-W
i S.m-total S Y U ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WA
RESTRICTIVE COVENANTS. CONTROCTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSIN
;al'r! Tax LICENSE. SEPARATE PERMITS REOOIRED FOR SEWER. PLUMBING AND HEATING.
TUIJ! I OL SDC -
r — y PDC#
1 a,/
APPLICANT OR AGENT
�A I Receipt No. ----- —
�rtnRf55 _._ PHONE
_�—c7 Cj
PDC
SEWER CONNECTION $_��C — vv \, G7 _
SEWER INSPECTION $ �;S-- `''U
.`.-_EWER SURCHARGE $
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