11695 SW SUMMER CREST DRIVE 11695 SW SUMMER CREST DRIVE
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Cite of Tigard i
INSPECTION REQUEST
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for
INSPECTION TIME: ASA—,—P PERMIT NO. :—
DATE:
DATE: DATE ISSUED :.—L_.
OWNER i
ADDRESS. 1L:� ���. ..�., .,. �'>=_ e-"E r 7 1
CONTRACTOR : -- - ---
TEST : Air D, WnterEl , Visual* Laboratory ❑ I
RESULT* Approved" Pending p tgiq �e dr;"� !i
SKETCH. ...----
r 2 ,'301
it 1 i ri c c
INSPECTOR DATE I
[:NOtH. Attuch sup olemental test data 6ereta I
City of Tigard
INSPC.
`CTION REQUEST
for
INSPECTION TIME :� 'Lf-' PERMIT NO. :
DATE ';7W� DATE ISSUED-. Z L
OWNERS NAME *
ADDRESS : -
CONTRACTOR : - , -,-- e
TEST. Air ❑, Water [] , Visual;°l1 Laboratory p
PESULT : Approved,. , Disapproved ❑ Pending ❑
SKETCH:
INSPECTOR DATE
EOTE : Attach suppleInantal tett data hereto
1
wASri.NG-TUN COUN'T'Y DEPAR :' OF PUBLIC HEALTif _
ENVI-,,JNJMNTAL HEALTH .iFAWlCLi-PLI,f IRG INSPECTION
Telephone (48--8688, '
N 0 ,T T C E
THE PLUIMING IN THIE BUIL hr AS HAD THE
N)
INSPLOTION AND ti f BE; COVERED AFTER BUILDING
J)En. REQUIRIMENTS HAVE BEEN 'SET. PERM11 NO f
FJX DATE
P1.umLing Uspectox
WCDPIt PL 12 j j/69 (1400)