11630 SW LOMITA AVENUE-1 11630 SW LOMTTA AVL'h`JE;
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INSPECTION NOTICE - 1
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 972222
3
Phcne: 639.4171
Type of Inspection _ 117
-- — --- ------
Date Requested — Time A.M. l� _P.M.
Address ���.T •% /)rrri�t l� --__ Permit
Owner .-..._ Lot #
aA"010.
Builder
The following Building Code deficiencies are required to be corrected:
lam '
Presented to _._T J�J Approved
li.spector __.--_---_-.. ' ❑ Disapproved
Date -
t CALL FOR REINSPECTON
` ❑ YES Q'NO
arm
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
TN,pe of Inspection
Date Requested N Ti me--- A.M. P.M.
Address Permit
Owner Lot
Builder
The folio 'ng_j3uilding Code deficiencies are required to be corrected:
Presented to Approved;;",
Inspector Disapproved
Date
CALL FOR REINS
YI NO
.. ssw M m wR asa
INSPECTION NOTICE
City of Tigard Building Department
k 12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171CL
_
4 Type of Inspection �����
Date Requested_ J LJ 5 Time A.M. P.M.
Address �[ 0 rl.�4 PermitUwner _ _ lot #_
--
Builder ---
_
The folio + luilding Code deficiencies are required tj be corr:cted:
I
t - -
Presented to J krAPpreved
Inspector _�_ l jr/ Disapproved
Date
CALL FOR REINSPECTION
C] YES L21NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4 171
Inspection
Uat- 4usste(i---- Time AM P.M.
Address Pe'mit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to Apptnved
Inspector Disapproved
Date
CALL FOR RE17NS ECTION
1-1 Yl NO
INSP►=CT1FjN NOTICE
I
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection - �/
Date Requested �'" - � Time_- A.M.. &—P.M.Y
// ,►
Address _��� � �' ---�-=�-�=��- Permit
Owner -------- ----- --- — Lot #
BuilderThe following following Building Code deficiencies are requirisd to be corrected:
I' Presented to F.1 Approved
Inspector _ ' ,,—_ �l Disapproved
Date —.—
CALL FGR REINSPF,CTION
YES Ll NO
di INSPECTION NOTICE
City of Tigard Building Department
I 12420 S.W. Main St. 1
Tigard,Oregon 97223
Phone: 639-4171
--
�` Type of Inspection 10,
E
Date Requests/d`/ �` �� ` _ A.M. '2 P.M.
IAt;dress Permit #_ ��
j Owner __—__ --_-- _-- Lot # _
` Builder— -The following Building Code deficiencies are required to be corrected:
Presented to — — _— Approved
Inspector UDisapproved
Date __—_-._. _ - G `�
1
CALL FOR RLINSPXTION i
YES JZ NO
.� .R .. wr
A
RUILDING PERMIT APPLICATION TIGARD DATE July �b 19 85 5478
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICA ED BUILDERPHONE fi_ _.___
OR AS SHOWN AND APPROVED IN THE.ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. 37��,_
OWNER _6_ JOBADDRESS 11630 lied Leta Gana 151-35
I,y<,ard ARUNITECT
ENGINEER
BUILDER t1Lrr.. ADDRESS 129U(! S� i'a. :fis tib. DESIGNER
STRUCTURE �[9 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR EJ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
EiRESIDENCE ��! COMM ❑ EDUCATIONAL Cl GOVT_❑ RELIGIOUS ❑ PATIO C1 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY 473 LAND USE ZONE —R BLDG.TYPE SN —FIRE ZONE PLAN CHECK BY _ STu HEAT.__
(construct sin a fewiLy dwelling w/attached garage.
3 Bathroom • Bedroom
SEWER PERMIT# 2d445 Garage 464
OCC.LOAD _FLOOR LOAD 4U 14EIGHT 2U+ NO.STORIES 2 AREA 26*4NO.13EDROOMS 4 VALUE 69 sem+
BUILDING DEPARTMENT SET SACKS FRONT 2u REAR 17U LEFT SIDE 5 RIGHT SIDE 5
Permit—_ 344).WTHIS PERMIT IS ISSUED SUBJECT 10 THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 11 IS HEREBY AGREED THAT THE
Plan Check 221.UU WORK WILL BE DONE IN ACLORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub total S6 1.UC► RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
SENSE.SFPARAj PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 13.6U aiK U.u:
SDC— � tix).0U
Total 5 74.6u
PDC# APPLICANT OR AGMT
Approved F.TIJ Recelpt No. j �,� ADD EI{d v PHONE'
DATE INSP. TYPE INSPECTION -_ REMARKS - PLUMB NG DATE
��ri, ,Contractor � —
iZ Permit No.
}� r , — - ------ --A Rough-in -- —_---
HEATING
�� - - — ------ .- Contrv-or .
Permit NGas or Oil
o.
F+nal i
SEWER --- -- _
Final
DRIVEWAY
---- _ _------ Final ---
Storm Drainage
{Rain Drain)Final
Sidewal k
Curb&Street Final
Approach
BLDG. DEPT.FINAr TLMPORARY CERTIriCATE OCCUPANCY
CERTIFICATE OCCUPANCY Final —i
Lanrycaping
Zoning Final _--------
S4 78 e-
IV'k UINC'`. RSIGNEO HEREBY AP?LIES [()Ii APE RNIII Furl II.IL 'rVl)IIri HEHLIN INL)IUAILU UUILUL W':IVIVL--
0i; AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANO SPECIFICATIONS, owrtcrt.►<uf1E
LOT NO—f2�—
/�( 111.� /ter ` a •• � �-t � i'S.._
�ARCIIITECT
ENGINEER
^� L/ i .' nN
r1.1GER
� _• r-�
5TRUC_TIIFlE _�EW_ QRF41nD_EL ❑ADD,TION —_-- C�RerafR__ EJ�fEYIAL El ARE DAIPA:�_[IOE:.tOl1T
RFSwC-ICC ❑CO►/.M ❑EDUCATIONAL C'GOV-T ❑RE_IGICUSDPATIO [JCARPORT ❑GARAGI. ❑STORAGFEISLAB [_]FE
` ---�— - �y7 --^- — -N ��— pLAN Cr1ECV: BY � _—NEAT l�
CCCUPANCYR.3_LAND USL [UNF_� BLDG. TYPES---• _ ___
GUN` t'L 1Sa]+I'�[1I11I+Y DWELLI�W/A'I"1'ACRED GARAGE. -- —•
BATHROOM BEDROOM _
SEWER PERMIT n
b Qcw
2Lg_0_D_—F1.49a 4 �" u FIEIG_NT c�G' 014 NO.STOR15j_+Z—�E �U�t�/ NO.BEDROONI V C
SIJILOING DEPAR rMErVT SFT BACKS Ff ONT (J REAR � 7 U LEFT SIDE RIGHT SIDE_? _
parr-lc `j �/(I)l0
THIS PERMIT IS ISSUED SUuJECT TO THE REGULATIONS CONTAINED IN THE BUILDING C'JOE, 20
I r:3n Chick 7 OlJ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT
I--- -- y WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COAIPLIANCE
JJ T Wul I 5� I l0C/ ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT GOES NOT W
i I RESTRICTIVE COVENANTS. CUNTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY SUSI
Baca Tax A �, LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tan) I 5 ( SDC -
r— POC#
AOPI_ICANT OR AGENT
f Receipt Nu.
Apprue
�nnRFSS flpcificl
SIJ(; (Storm �Ur�G //) C�S< - �� 3- 3s- 7,
POC - ffi S'�> _- l ` `a y�y -ib g fog
� � v
SEWER CONNECTION $ e�p -/ A-
SEWER
.-SEWER INSPECTION
SEWER SURCHARGE $
Communts :
I - I —
CENTREX CONSTRUCTION
• COMMERCIAL T — '-------��_ ---
• INDUSTRIAL
LIC. 41825
(803)684-0443 12900 S.W.PACIFIC HWY.
PRESTON ARNOLD TIGARD,OREGON 0223
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BUILDING RCCFIPI
GATE:
NAME: -----
AMOUNT
ACCT. M DESCRIPTION
-
10-432 Building Permit Fees ---
10-431-600 Plumbing Permit Fees -----{----
10-431-601 Mechanical Permit Fees ---
s
10•-230-501 State Building Tax ----
10-433 Plans Check Fee --
30-443 Sewer Connection (20X)
30-202 Sewer Connection (8076) —
344 Sewer Inspection
51-448 Street System Dew. Charge (SDC)
52-449•--610 Parks I System Dew. Charge (PDC)
52-449-620 Parks II System Dew. Chargw (PDC; s
31-450 Stora Drainage System Dew. Chry (SSDC) s
10-230-505 TRFD (95X) s
10-478 TRFD (5X) :
10-L30-506 Washington County Fir" 01 (95x) s
10-478 Washington County Fire N1 (5X) f --
10-220 Amart/Wedgewood S
TOTAL.
(be/1214P)
t
Hu i Id i ng Perm i ; No.
Location
Certification of Registration
With the Builders Board
doing business as (dba) ,
4r _ am registered under the provisions
f , Chapter, 701 Oregon Horne ii + lders Law) .
My Builders Board Registration (lumber is
Fly registration is in full force and effect and expires on
SigOture
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