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INSPECTION NOTICE
City of Tigard Building Department C'1
12420 S.W. Main St.
Tigard,Oregon 97223 i
Phone: 639-4171
Type of Inspection
Date Requested ",-zr��J ✓�1'�, / Time -- A.M. .M.
Address _� U G/fit[12-- -- Permit
Owner—. - Lot #
^I
Builder I
The following Building Code deficiencies are required to be corrected:
Presented to _ _ IVApproved
DInspector `J
Disapproved
Date
CALL FOR REINSPECTION
0 YEs ❑ NO
BUILDING PERMIT APPLICATION TMARD DArE - 1r�- --' i9- r'' 5639
THE UNDEASICNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PI SONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER FHYTEvwr9vnx.?„____—
// &o LOT NO.
OWNER _.._—
.ron JOB ADDRESS
.norissctte i �o 2"-endon Loop ea�ova —
ARCHITECT
saw p e. hox 19524 ENGIAEER
BUILDER ADDRESS — DESIGNER —_
STRUCTURE IN NEW REMODEL U ADDITION ❑ REPAIR ❑ RENEWAL O FIRE DAMAGE f-] DEMGLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑ RELIGIOUS I❑ PATIO ❑ CARPORT CJ GARAGE ❑ STORAGE n SLABO FENCE
OCCUPANCY LAND USE ZONE R25 —BLDG TYPESK FIRE ZONE__FLAN CHECK BY ll.B.`HEAT._AA _-
Y t XUet
.Suhiget prim Wrtigi,ts symer x"sairm-hargpand $360.00 Amart _
SEWER PERMIT 0 28577 -- — --- ---` `..... —
_OCC.LOAD FLOOR LOAD 140 HEIGHT 1:' " NO.STORIES I_ _ AREA 1120 NO.BEDROOMS 3 VALUE48,000
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 3U LEFTSIDE S RIGHT SIDE 6
I ,rmit �2/4.('U THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE
4�x.tU WITH ALL. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
11�.gfl�
LICENSE.gSLE$ARATk PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax _
.f�b SDC— 541U.UU
70fa1 _ PDCN I 1,50.00 PPOEANT OR AGENT
By _
Receipt No. "I A ADDRE99
Approved PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DA-rt
ev Contrq!�tor
ITU[)_/j/U2-_kS
e-,2 Parmit No
Rough-in
Fixture
Z,&Z/ f Final
P
HEATING
Contractor —
Permit No.
Gat:or Oil
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb R Street Final
Approach
DEPT.
r L
I N'01TEMPORARY CeRflnCATE OCCUPANCY
:ERTIFICATE OCCIJPANCY Final
Landscaping
70mina Final
-- v
BUILDING PERM iT APC'LIGATION TIGARD DATE -2�___
19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 13UILDER PHONE z4 803_ _
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE ---------
LOT
–___-LOT NO. L _
OWNS JOB ADDRESS _ 12A Z(7 S-V S t.�. ?.�c Ldp _
ARCHITECT
ENGINEER
BUILDER _ _J�r 1�-�– ADDRESS_4^r= 7�/�DESIGNER _
STRUCTURE A NEW Ll REMODEL 17 ADDITION ❑ REPAIR ❑ RENEWAL O FIRE DAMAGE O DEMOLITION
J[a RESIDENCE ❑ CO►!r'A ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT X GARAGE ❑ STORAGE ❑ SLAB 13 FENCE
OCCUPANCY _LAND USE ZONE BLDG.TYPE ,ft!FIRE ZONE__PLAN CHECK BY _HEAT_ —
SEWER PERMIT#2 / r lG i _ JoD
OCC.LOAD FLOOR LOAD U HEIGHT (�'�' NO.STORIES AREA 1j,)6 NO.BEDROOMS VAL
BUILDING DEPARTMENT
n�1 SET BACKS FRONT , _ REAM_- LEFT SIDE _ RIGHT SIDE
Permit ! THIS PERMIT IS ISSUED SUB.'ECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
'71, REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check d WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE 'SSIIANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 4 RESTRICTIVE COVENANTS. CONTRACTUR AND SUB COVIRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tar 'Q ,
SDc -
Total
By
PDC# APPLICAN"OR AOENT
� Receipt No.
Appr — __ ADDRESS �— PHONE
r` �S U rC)0 t r
Sad (Storm) ;�--
SOC -- $ '' SUO�0 e
PDC
SEWER CONNECTION S
;EWER INSPECTION S J'S r ea
SEWER SURCHARGE ,
CIO
Comments: AP1