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INSPECTION NOTICE
Citv o, Tigard Building Department
12420 S.W. Main St.
Tigard Oregon 97223
Phone. 639-4171
Type of Inspection
Date RequestedTime A.M. P.M.
Address AI,U LOr)
Permit
Owner [I C, DCAI-. Lot #
Builder -e-'- 1 Ltj e r-(- O.Rvy
The following Building Code deficiencies are required to be corrected:
IlIftuntod to Approved
Inapeetor -- U DHapproved
Date
CALL FOR RE SFECTION
0 YES FIAO
,W -'IL
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Reque�jd ime�WA.M-.-P-M-
Permit
Address
lot ot #
Builder
The following Building Code deficiencies ,jr3 required to be corrected:
7-�f
Presented to Approved
Inspector Disapproved
Date
C,ALV, FOR REINSPECTION
❑ YES 1�NO
BUILDING PERMIT APPLICATION TIGARD DATE-._. t0bff_5—_—_..,19__34._ 5056
THE U",')EP'_dGNED iEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT Nu.
OWNER Sh®ibuttne Unyelyp {ADDRESS 9355 SW KA11on UrIyE' ARCHITECT
_ _ —_----______—._.._�Llttti.�✓DS��):$1rBB
LakA� iJu ENGINEER
BUILDER 5atne —_ ADDRESS 155 13 Avenue DESIGNER
r.- STRUCTURE EX NEW L7 REMODEL ❑ ADDITION ❑ REPAIR_ ❑_RENEWAL ❑ FIRE DAMAGE U DEMOLITION
[3 RESIDENCE F1 COMM CI EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO 0 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY_k"3LAND USE ZONE "7F'IdLDG.TYPE air--FIRE ZONE__-PLAN CHECK BY E rid —HEAT GY6
V.
Construct elin6ie famiiv dwe*1itv4 w/Attached garntle.
2 With rourn 3 hedrtsril7
SEWEPPERMIT# 27Y114 i,aruge 483:3
OCC.LOAD FLOOR LOAD QU HEIGHT 1i,+ N0.STORIES 1 AREA 13501 NO.BEDROOMS 3 VALUE 5690 (a.
BUILDING DEPARTMENT SET BACKS FRONT
-- -- REAR 3.1 15 LEFT SIDE _ 7 RIGHT SIDE 7 -
Permit 51111UU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, TONING
—� REGULATIONS AND ALL APPLICABLE CCOES AND ORDINANCES, AND IT IS HERERY AGREED THAT THE
Plan Check 195.65 WORK WILL BE DONE IN ACCORDANCE WITH r4E PLANS AND SPECI-(CATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORnINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 4`,16.f, RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRAG'ORS TO HAVE CURRENT CITY BUSINES'�
State Tai 12.M
1(CENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total SIJ9.C509.05I
—. -._. _ -I SDC— $5LN1.1.3(! _
— -- - FDG 1150.00 APP CANT -
By _ L1 Receipt 2.50.(HJ _
Rlp t No.
i
Approved E.rw ADDRE89 PHONE
Y
i
f
DATE
DATE PISR TY I INSPECTION REMARKS PLUMBING
Contractor
f Permit�4
Rough-in
Fixture
/Ly35-W
Final
HEATING
Contractor,
Permit No.
Flnugh-in
for w
41
Final
SEWBR
Fine'
DRIVEWA'V
Final
(Plain Drain)Final
.-.----
Sidewalk
Curb&Stret,t Filial
Approach
—__a_i,676CPT FINALTEMPORARYCERTIFICATE OCCUPANCY Final
ICERTiFICATE OCCUPANCY
Landscapi.1-.-,-
building Permit No. 4,a
Location q
Date
Certification of Registration
With tine Builders Board
doing business as (dba) ,
am registered under the provi=sions
of ORS Chapter 701 Oregon Hornebuilders Law) .
My Builders Board Registration Number is � yC5 _
My registration i; in full force and effect and expires on
Signa ture
i
BUILDING FFIT APPLICATION TIGARD DATE--
THP UNDERS iGNED HEREBY APPLIES FOR A PERMIT FOR TIME WORK HEREIN INDICATED BUILDER PHON4�: /S�q-
OR A OWN AND APPROVED IN THE,'7,GOM.PANYING PLANS ND SPECIFICATIONS. OWNER PHONE
t LOT i10.Lj
O'f1NEFi L 3 R JOB ADORESS�
M ARCHITECT
^� ex
�' �Jr�_z� ENGINEER
BUILDER yTt%'?I AaORESS i DESIGNER -
�__- _ J
STRUCTURE--- X NEW ❑ REMOOEL (3 ADDITION 7 REPAIR _- Cl RENEWAL ❑ FIRE DAMAGE Cl DEMOLITIOt,
r RESIDENCE ❑ COMM ❑ EDUC -.L ❑ GOV'T Cl RELIGIOUS Cl PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
z ��--__-*_�_•---_ Y--.�_-----�------�� �� `jam` --•- -
OCICUPANCY �__LAND USE ZONE �,P_Q BLDG.TYPE _L_!Y._FIRE ZONE PLAN CHECK BY �?` HEAT--C -
SEW[R PERMIT N ,� --•�- _ y a.0 • -�% -
IL
OCC.LOAD FLOOR LOAD ` V HEIGHT �G+- NO.STORIrS ARE) ro NO.BEDROOMS VALUiJ(/�000
BUILDINGDEPARTMENT - SETBACKS_FRONT Q REAR 5� LEFTSICE ��RIGHTSIDE
EPormlt 0 / '"• THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,70N'.N.
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TVAT THI
IP�1.n_nCheck -^ Y `tip WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMAPLIANC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WXV'
Sub-total y�• RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINE.3'
��- LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING A^:D HEATING.
9tatu Tax
SOC-
Total
pM",N APPLICANT OR AGENT
By
Receipt No.
,LPE,06 Ir
• ADDRESS PHOW"
soc Jr.
PDC - � __r Yr`D •�/ T S
44
CONNECTION
SEWER CONION
_ _---_ __ Vis.--•-- �..� a � �
SEWER INSPECTION S
SEWER SURCHARGE 5��