12040 SW LINCOLN AVENUE L-1 L-1 LJ.Lj"v j L-1 Lil u�
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INSPECT.!ON NOTICE
City of Tigard Budding Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
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Type of Inspection
Date Requested-_1
4 Time P.M.
r., . -707
1,4.) i.4r%(
Address -1. �_h Permit
FOwner Lot #
Builder
The following Buil-ling Code defiJencies at,? required to be corrected:
Presented to _- _ Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
[-I YES U/NO
t �
Iso
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO. :_—__— i
(`V, . DATE: H ji =/ 76 DATE ISSUED ..__L_1_
:.riAe'NERS NAME : __rSu`A __ F r Z
ADDRESS' .--. ; - (-, Y u
CONTRACTO<< c- 0. z k w ��
TEST : Air LJ, Wote•❑ , Visual ❑ , Laboratory []
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RESULT' Approved ❑ Disapproved C Pending U
C� ec9 Iry m
G�Nc.,26- �j
INSPECTOR r DATE
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BUILDING PERMIT APPLICATION o TMARD DATE 1&27-769+�
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED 13WI-DER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO
OWNER ]ohn Fri, JOB ADDRM12040 SU Lincoln
HOME ADDRESS
ARCHITECT
Pick i;�ils�n ENGINEER
BUILDIER .ADDRW DESIGNER _
STRUCTURE f�❑NEW REMODEL CIADDITION ORE-PAIR _ ❑RENEWAL ❑FIR-tE DAMAGE ❑DEMOLITION
❑RESIDENCE GCOMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSOPA-110 ❑CARPORT ❑GARAGE GSTORAGE❑SLAB CIFF.NCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
Q� UPANCiY---_.L<,N SE?ONE _BLDG.TYPE FIRE ZONE— PLAN CHECK BY HEAT_
;nater 7,i7�mit l_ _ely_winum patio CuVfar all t,vr s -
�
r-THRU, 11itinuin Awniny ;Q, InSopiection to include all ranchorn connection .
Q.QC.LOAD FLOOR LOAD _ HEIGHT NO,STORK_ AREA N0.BEDROOM __VLf►LUE 500 00
BUILDING DEPARTMENT
i SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit — - —�
-"� — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check _ REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH TtIE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RCRTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Statr Tax •1s LICE:iSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Tc,al 5.1 J
By
— APPi,ICANT OR AGENT
Approved l 7U Receipt No
AGOARSS— - --- —
.
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING
DATE
Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contra,:#or
Permit No,
Gas or Oil
Final
SEWER
Final
DRIVEWAY
Fioal
Storm Drainage —
V1 .
a— Drain) Final
Sidewalk
curb&Street Final
Approach
BLDG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
andscaping
Zoning Final
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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE "8 19 fi5 N° 0266
TI - UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE---.__-_,-._ _�_
Q,VNER John Frazee ADDRESS 1 2040 S+',9 Lincoln BUILDER PHONE
Terry OmastrlllI ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE EINEW ❑REMODEL. ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑REL.IGIOUSOPATIO [:]CARPORT ❑GARAGE ❑STORAGEIOSLAB [:]FENCE
QBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS _
OCCUPANCY_—' LAND USE ZONE
IR-7BLDG.TYPE---FIRE_FIRE ZONE - PLAN CHECK BY t�r& HEAT
rono4ruct brick firep1mcs
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE ll�Q
_BUILCING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit a. .1_O - - — — _' --
THIS PERMIT IS ISSUED SUBJECT TO Tf E REGULATIONS CONTAINErl :,'q THE BUILDING LODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CUA S AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH . '#ANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THt ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total l•I 1
BY rfa
— APPLICANT OR AGENT
Approved Receipt No.
ADDAIESS III a INC
-- -- -- —
�PTYPE�IECTION +[ �;� PLUMBING __-_ DATL
DATE INSP. �_ - 'ontractor
Permi No.
— � - _ Rou h•in
Fixtur.
-- - - Final — ----
HEATING
Contractor
Permit No.
Gas or Oil
-- �- -
Rough-in
-�- Final
_ -
SEWER
- - — --- Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
'
Sidewalk
✓z+Street Final _
ch3LOG.DEPT,FINAL CERTIICATE OCCUPANCY CERTIFICATE OCCUPANCv
Landscaping
Zoning Final
i
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ILIYy AR
BUILDING PERMIT APPLICATION TIGARD DATE 22 7-2 Is 76 N° U 0 1 0
THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE_
OWNER Juhn rrazes ADDRESS 12040 5, . Lincoln _ BUILDER PHONE
tuner ENGINEEII
BUILDER ARCHITF CT DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION CIREFAIR URENEWAL ❑FIRE D/MAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL_ ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE Ci STORAGE❑SLAB ❑FENCE
MOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW LJCOUNCIL APPROV=D ❑SIGNS
OCCUPANCY_ LAND USE ZONE —BLDG.TYPE--. FIRE ZONE` PLAN CHECK BY __ HEAT...
gawp« Roof
_— This is a duplicate for our records
OCC.LOAD FLOOR LOAD HEIGHT —_� NO.STORIES ! AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAP LEFT SIDE RIGHT SIDC
Permit a. _ --- -- _.— -THIS PERMIT IS ISSUED SUBJECT TO TI4E REGULATIONS CONTAINED IN THE BUIL'JING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERF-,Y AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THF PLANS AND SPECIFICATIONV AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE 18SUANG2 OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB C10JTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State "t LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
----- ------- APPLICANT OR AGENT
Approved Receipt No.
– — --A ADDRESS
I
DATE N4SP. TYPE INSPECTION REM^.-,,KS PLUMBING DATE
• `�.� �-� _ �r» Ll�� contractor _
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor _
Permit No.
Gas or Oil
—_--- Rough•i n— ---
_ Final
SEWER
_ Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain; Final
Sidewalk
Curb&Street Fina'
A roach
BLDF.DEPT.FINAL s TEMPOPARY CERTIFICATE OCCUPANCY Final
OCCUPANCY
Landscaping
Zoning Final
crry OF TIGARD
12420 S. W. Mein Street
TIGARD. 011FOCH 91213
APPLICATION FOR BUILDING 111.MiT
New Construction Demo 1.1 s h Addition Remodel 0 muve
ZONING DATE ISSUFD X- BUILDING PFRMIT
BUILDING FEE No.
DATE REVEIVED-- PLAN CHECK
fly VALUATION
OTHER
TOTAL 4'�-RECEIPT No.
TWO SETS OF PLANS Apn PLOT PIANS MUST BE FURNISHED WITH APPLICATION
LOT 1 MAP CENSUS TRACT JOB
Architect or
Addre ;s-..- Phone—
Owner \_I,*?
Address_
Builder S0.
Address Phone
BUILDINGUSE Single Res. Multi Ren, <nJ Comm. El Industrial[]
OCCUPANCY GROUP-----..-- No. of Stories— -- Total Area of Lot—
Type of Construction I It III IV &) Floor Area B 1 2
Set saAst Frcnt- ---- Back- L.Side- R.Si
Private Sewer Pipe Sewer Septic T
Water get-vice Pipe Si:O 9 r%� Sewer ch Drywall❑
Street and Curb Reqii i rem.n
Driveway Width_ —No. of Parking Spaces___ _ __
Sf.PARAT&JW-AtT8 REQUIRED FOR 9FWFI( AND PLUMBING
SPECIAL INFORMATTMI
ADURESS ALSIGAKU / J ( 111.)
FIELD CHECK BY -DATE 7
PERMIT AlIPPOVED
It is understood that all work will conform with applicable codes and ordinances
of the State of Oregon and the City of Tigard, Ore(jon, anti that the building will
not be occupied until a Certificate of Occupancy has been issued by the City of
Tigard Building Inspector.
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2%ddress .,1�U_�Q-_�r�"��-1-- Permit No._
_____Z
of Occupant—.— __ Pc*mit charge
O Off_ Connection fee-
------ --
Paid by---- -- — — .-.-- — _— -
�' 1
Date connected—
Type
Type of Building- 1/- �� Inspection fee----
Service
ee_-_Service Irate Paid by Date__._—_-_-
ContractorAssessment__-- ---_ Paid. -_-
Size of connection _ 1.
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