13143 SW LAURMONT DRIVE 13143 SW LAURMN'l.' DRIVE
EC
INSPTION NOTICE
—
O S City of Tigard Building Department !/
P.O. Box 23397 ` 'V
Tigard. O eoon 97223 \
Phone: 639-4175
Type of Inspection
Date Requested / _ -Ili �l U:r�A.M. P.M.
Address 3 `-� -` CLQ_[{r s1 I L/N 7i _ Permit #t j
Owner— — Lot #_
Builder )M2
The following Building Code deficiencies are required to be corrected:
- -
119
it
I
r
�'7 — a
Presented to
•�pn►o;ed
Inspector -_V
[� Disapproved
Date 7 —
CALL FOP REINSPECTION
f� YES 23'I 0
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INSPECTION NOTICE
City of Tigard Building Department
P.U. Box 23397
Tigard, Oregon 97223
Phoney 639-4175
y
Type of Inspection —� — - - ------------
Date Requested —,L_L-.!� C,� rime_ A.M. P.M.
Address Permit
Lot
BuiwerThe following Building Code deficiencies, aie required to be corrected: nn
WOW-
Presented to — ❑ Approved
Inspector �- Disapproved
Date ------
CALL FOR REINSPECTION
� YES ❑ NO
wi iw wax craw sv ssr
Ca `4 JU.0 Mgnr TION NOTICE
k.cm" " City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requestec'_-- % 1 0 —e Time&'V Lj A.M.__ G �P.M. /
Address 1 L'J 3 Permit �. r
Owner -_-__. �_. _ Lot
Builder ._L f�L—L –L�_S1�
The following Bui ding Code deficiencies are required to be corrPeted:
Presented to Approved
Inspector [I Disapproved
Date _ Z'` Z..m 8
CALL FOR REINSPECTION
❑ YES (] No
A
t
F6 ECTIUN NOTICE P
City of Tigard Building Department2A
i(�'
P.O. Box 23397 ;
T igard, Oreyon 97223
Phone: 639-4175 2 7
1
Type. of Inspection —
Date Requested Time_—_— A.M.___,_-_P.M.
AddressPermit
Owner- _ Lot #-
s
Builder _y� � :►�-il f
The following Building Code deficiencies are required to be corrected:
Presented to ._ -- --- — _f Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
❑ YES ONO
iNSPECTION NOTICE ,
City of Tigard Building Department
P O. Box 23397 �Y
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection —._ --.�---J-- --
Date Requested l Time_--_. A.M.
Address _____ � �„i 1 �/, _.___ Permit #
Owner_ ._ — -- Lot ---
Builder
The following Building Code deficiencies are rectuil,ed to be corrected:
Presented to ,� -- -_- __ - Approved
Inspector _. _ El Disapproved
Gate - 2
CALL FOR REINSPECTION
❑ YES C] NO
w, ris s wt iwi nri ssW
INSPECTION NOTICE
City of Tigard Building Department �1
P.U. Box 23397 J
Tigard, Oregon 97223
Phone: 639-4175
Type of InspectionJ 1�� `�` �i rC.w`-�✓
Date .7equested �� - Time .M. P.M.
Address -/3/V, 3 7 . ") /./- �)Permit
Owner k-t LK c�-)4.1 —,IT Z 2
Builder /)-C/3 o`e'll 12
1.51
The following Building Code deficiencies are required to be corrected:
Presented to Approved
In-pector -—__---1-- _ — � Disapproved
Date --
CALL FOR REINSPECTION
�7 YES ❑ NO
I
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23391
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection lF) 2-�-" ,i j I
Date Requested Z.c2 Time _ A.M. Y P.M.
Address �, L� (- CLL t /`f)1(') _ Permit # �'
Owner _ I_nt
Builder -�I —�1_�r L LL11. ;A/ ( 14 [The following Building Code deficiencies are req.uired to be corracted:
C�
Presented to ❑ Approved
Inspector Disapproved
Date / Z= gr
CALL FOR EINSPECTION
YES IA NO
INSPEM tON NOTICE p
City of "Tigard Building Department
P.O. box 23397 ( 1 1
.yard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date riequested__ //C9 Time ---A.M. P.M.
Address 7 - ��L1 / ✓) 1 G ) L. Permit #_
Owner1 _ L.ot
)) #_
Builder
The followivig Building Code deficiencies are required to be corrected:
if
Presented to nApproved
Inspector _ �'1 Disapproved
Date _—Lz --
CALL. FOUR REINSPECTION
e YE8 ❑ NO
w ss: w sssr w ass w ss, sssr asst
INSPECTION NOTICE 1
City of Tigard Building Department 1
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection — /Yl���1—'� (C/1 N--� -----
Date Requested__ 3 Time A.M.( P.M.
Address /,-2 y S 41 � —L�e-x r Permit # 7.7_
Owner __ Lot #_
BuilderThe following Buildi g Code deficiencies are required to be corrected: /
3_—. .r��iF�^'
�r
� �'1 ...��ti_ ��''-L-t.- G�c-�.Z.�_, •' 511-+0,- -
Presented to ___ -- __ — ApB oved
!nspector —_--- i Disapproved
Date ----
CALL FOR REINSPECTION
f_ ES (_7 NO
INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection Z �azcvm
Date Requested " Time A.M.._X_P.M.
c"
Address _ ( � G L "tel-�7 Permit # L
Owner Lot #
Bioilder
The following Building Code deficiencies are required to be corrected:
Presented topproved
Inspector I Disapproved
Date - - ` Z-I►— ---- -- --
CALL FOR REINSPECTION
CJ YES ❑ NO
W=-K=
C11X OF TIOA RD (a 4 .ARD sull-DING PERIVIX I
�� PERM'IT NO . 803011.569
COMMUNITY DEVELOPMENT DEPARTMENT oar GoN
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223.(503)6394175 DATE ISSUED .
dOR ADDPI-."Gq : 13143 SW 1AIMM(IINT 13114
'
TAX MAP/L.0*1' ISI 33DC: 18500 50H : UILIJAU.'.: AT SUMMd-
AAKE PARK 1...1 : ,(10 HK
LAND USI'--:: 111.V.P D
I (TV SIZE: : VAI UATTON : (361000 SEA kiIIACKS
FRONT : 20 PEIAI:4 : 6
WORK CL.ASS : NEW DWIF.-i.I.I.. .UNITS : I EFT ; 6 RT 1' 30
USE 'T'YP'E:: : SINCA-E FAMILY NO.ElVi'DROOMS Al EXT WALL CON!51'
CON!5T . 1'YPF.:.* : VN NO . EIA THS : 3 N 5 : L W
OCX'UP.Gpl:'-' . : P3 PPO'T .OPENING5 :
OCCUPY'. 1._O10113 N 5 E . W
TOTAL. APEA : R300
NO. STORIES : 2 1.5 F : 935 ROOF CONST : F'.1 RE RET
HEKTI(A-11 20 2ND 12055 AREA SEPAP-1 PATEU:
RA-5l*-.:MFK.N*T'7 3RD : OCI('11jr-1 . 5E.:PARI? RATE-*D :
Ml:::ZZAN3:Nl:::'f SASEM' T
J�.1-00P I ()Al'.): 410 GA P A(3 r:.--. 4 '0 I' IRR 151411(l P'? Al ARM'?
FLOW(GPM) DETEX.-I"? YE!,
1-46444, 1-40 A` . AGGF-i-Aili I?
V"LAN LIFIECK BY : I-It
rIF:MARKS :
REISSUE OF NO. 69EM
LAST REISSUE. 11900186113
"El!;'S :
0
w MOPISSEI-TE DON I'F:PM1 T 41 1519 7 . 0 0
N PC) "(:)X '1.952AJ PI-AN 1:1E:VJ'EIW $40 . 00
E
R pai-t1atrid FIRE'. DEPT
PHONE (50',311 2441-9314 STAI E* TAX 1.'i) f:)!)
OTHE.P
C ULLOPMEN'T LHARGES :
0 M(•(• RI S SE'J III:: DON s0t.,115 TURM) $250 .00
N
T DON MOPISSFY BUTI-DE-P"', 1NC 9 Dc"1 SIT AEL r 11 $600 . 00
R $230 . 00
A BOX 11.932141 PUL,11101 11
C p ci r,A.Lit n d $40 . 00 or 97219
T1:'
0 1:'I--I(.-)NE (.so,-4) e44-9:31-4
R REXIViONAI TON NO. 35533 TOTAL.. : $1. ,5 16.Ell5
This permit is Issued subject to the regulatinns contained in I itle 14 C?
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby 4EQU-TPED J'.NSPE('.',T-1(-.)N5
agreed that the work will be done In accordance with the plans and r:MIA:NG SE:WEFT
specificatio is and in compliance with all applicable codes and 1:70UNDATION WALL 14A:r.N MAINS
ordinances The issuance of this permit does not waive restrictive
WAIEP LINE
covenants Contractor Prid subcontractors shall have current city
business tax permits This permit will expire and become null and PL.13.UNOEIPSLAB U I T Y APPP(111-4/sw
void if work is not started within 180 days.or it work is suspended or SI.A Ei F I NAL.
abandoned for a period of 180 days any time after work has PLH. TOPOUT
commenced It shall be the responsibility of the permittee to assure C:'RAM I N(;
all re and approved F' IRr-.::I:,,L.A(A:-'
GA5SUL
I'NATION
T (*.,YP . BOARD
Permittee Signature
Issued By:
INSPI'-x(*."T'T(JN 639-41.7,w.)
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
'EWEr
CITY OF TIGA RD W . 5E.881616
(Cli7YOF TWANOD
COMMUNITY DEVELOPMENT DEPARTMENT MOON
'T L 1.0/ 6/86
13125 S W Hall Blvd..P.O Box 23397,Tigard,Oregon 97223,(503)639-4175 5
J08 ADOW:75S : 1.314*3 SW L.AUPMONT UP L.AiA INUMBE."P :
TAX MAP/11 UT i.w i. '33EX, SUB: V1:1..1...1:AGE AT 5LJMMEPL.AK1::: PAWK 1 10 8K
I AND USE.: I-0.P.P D
I 0T SYZE:
SE.CTION : 4 )'WP - 116 GING.: 1W
WORK 03 A5 5 : NE-."W
USE SINGI.J.'. F-AM111-Y
I I le ill ppT:1.(.zat 1*11, "t g retrp ill (,tj 4-_-(.1 M l:)'I y W:j.t I I M 1.1 r,1.0.011; m.rt of r,eW i.l J.at(,:I.c)n M (:r 4' t I le J.J 1*1 j. r:1.ecl
5eW"r'aJ.qr" Aqerlc�y 'The pcn-mit srxpir•t;.,�w 1.20 cliaijus fi-ain t,I,i a (:lime J "I q;1.1 W(J Me tiata].
ialricit.41-it piaicl W1.3.1 tml '111cil-11,1wi t'vecl J.-P I'l-le pwi-iri:i i. expir,ent . The Aqforic.,y ciciela 111.11, gUIRA
ant,*?e the of the t'how %i.(Ie liatei-ialm . 1A' the wewirji- J.%
riclit 1.vc:at1,49(J ilit 01rp Lhfi? MhUJ .1 pl-u%pooc-A 1*4 feat, in
all. dii-kic.-ti.cinia -Pr,rim th(v, M.Wtill.ric"o givell . :14, 110t MCI thlyl :11,110;tnCtlel- lohlail,
iiii.ncl 5:1'clei! i.hro Aqerl('-ty Wil.]
1INISTALL - TYPE 81J.1.1 I t1I4-.'.PV I OUG AREA
FJ X TUP1.5. UIS11TS 114WANT IMPPOVEMIrKINIT
DWEII L.ING UNITS
NO . OF* 41-005 . 1.
W MOW15$ETTr:':: DON $35 , 00
J: N Hr.)
E
R par-tim.ricl x!721.1.0 1 A NE 'TAG' INCTALI..
PHONE (50.3 134l 931.4
(")'I HE R
C
0
N MOP I S 45 E 11E (.)ON
T DON M(:)P:I:5r5E'TTl--* PUT) D I-- P5 I N C
R
A Pia 8OX 19"524
C p n r,t 1.m.n cl cir, 97R19
T
0 F11-TONE. 0303) 244-9311.4
R I PEG.ISTPAT ION NO, 35.153-3 TIOTAL 11111. 1 135 00
a.
This permit is issued subject to the regulations contained In Title 14 RECEIPT NE).
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby INS)PEurtuNs
agreed that the work will be done In accordance with the plans and POUGH-1N
specifications and In compliance with all applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and
void It work is not started within 160 days.or If work Is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the pVonsiblifty of the permittee to assure
all req inspectinn� q, rr,l asted and approved
0
�atu'
Permit gnature
Issued By
SEPARATE PERMITS REQUIRED FOR WORKIL OTHER THAN DESCRIBED ABOVE
PLUMBING PE RMI'T
CITY OF TIGA CM ✓
PDATE:MIT NO. : PL813161,e4
V A
0
COMMUNITY DEVELOPMENT DEPARTMENT MOM Rp DAISSUED: 10/ 6/6B
1312S S.W.Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223,(503)6394175 (C 4� PA1M . PM7' .N0. 881369
JOB' r<tDDIIE-SS : 1.31-13 SW LAURMONI' DA
51.1D. VIA L. IAGI:.:' Al' GUMMKPLAKE PAPK L.*7' :40 OK:
1, (iND USE 1:!1.
1
01 5'1:'7_k::
NO: NO:
WDRIK CLASS : NEW WA'TE*.P CAAMLY' 3 TRAP
I.Jql::: t'v*Pr.-.. STNGLL FAMILY URINAL. BKF'I..UW PRVNI'P
CONS IYPE ; VN LAVOWAI OPY 3 I*PAP PRIME P
P3 11.1181 S11-10WER R GPE-ASE MAPS
I'A"HalAWASHER I
GAPBAGE:
N0 , S7 L)P T E S . 2 WMMAINC MACHINE I
1*)Wl::.I. L . UNITS : I LAUNOWY T14AY PL OG DPAIN (01A
F''L..00P DRAIN
iiINK (F-r)
WAI'll�'A 1A1L:A'T'EP I S'TOPM/RAIN (FT
OTHEP
rat,M A 1:4 K
ci M(. P,1.S!A.T 117-.: DON PErIM11, $132 . 50
w 1;)(3 BOX 1.9524
N F)ci 1- 1,1 ill ri 0 ar 971219 r:i x*t u AF--'s
E
(503) P-141-9314 SI'Al F:- TAX $6. 63
5�11-1011 EAAWOLA)MAK
P I
N 1-101--MAKFAIS PIL.F.JIMPTNU.',
T 1.)q3 FKA P50
R
A (:P'9 t"t C1#it cii, 970E-)3
T
o HIIN N('.) . 39P2 TOTAL: $3.39. 13
RECEIP-11- NO.
Tiiic;permit is Issued subject to the regulations contained In Title 14
of the TMC State of Oregon Specialty Codes,zoning regulations INSPE"C'TIONS
and an other appl-cable codes and ordinamceS, and it is hereby F111-8 . UNDERS1 AP
aqtnPri that the work will be done In accordance with the plans and P(Ri F & OEM
s1wrifications and in compliance with all applicable codes and WAI 11-:44 1 :1.NE
rit(linances The issuance of this permit does not waive restrictive
t rivpnints Contractor and subcontractors shall have current city FOPULFT,
hiiq-noss tax permits This permit will expire and become null and 1-4,i*1N D14AIN5
vmd it work is not started within 180 days,or If viork is suspended or IF- :I:NAF..
;ihandoned for a period of 180 days any time after work has
(otTimpriced 11 shall be the responsib'lityof the permittee to assure
a!l roqitirnd inspections are requested and approved.
I
"C"00a
I-Iptmitt iqn
Nstlprl By 7 'ALI. FUR INSPECTION 639---41'7!:.)
SEPARATE PERMITS 141101.11RED FOR WORK OTHER THAN DESCRIBED ABOVE
MF.::Cll..l A_ N:I.CAI PEPM I I
CITY OFTIGrARD ( D V)I:_:'HM1t*I' W.I . MU8011
. .615
cmOF
COMMUNITY DEVELOPMENT DEPARTMENT °"°°" DAIL,. 1.0/ 6/88
13125 S.W Hall Blvd..P.O.Box 23397.Tigard.Oregon 97223,(503)639-4175 P 1:4 T M . I* M'I* . N(:) (3(31.569
,A)a ADOWESS . 1.3.1 -43 SW I AURMON F DP
'I AX :I.S11 "33CA. Sl-**+. V*.I.'I..l :I*A(.-,[:. Al !AJ(1MFJ4LAI<l' P"(1)"K Al DK
I. AND USEE:
I OT STZE. :
1 1F M NO 4(:1:
WI)PIK L;L.A55 : Nr-.*.:W F(.)PINIALIV., <:).()()I< A7J0 VIANIA 1:4 0.0
USE: 'T'YPL : S:ENGL+-.' FAM11 Y 1= )PIN1011.1ii: 1.00V4 1. A.IR FIANDLN .1 0K
CXIINST . I YPF: UN FI (.)(*.)P II-1.)PINIACE. 1::.VAP . (1(J(:)I.AKR
143 Vl-:.N'T' FAN
()E'.N'l SYS'IT.M
F31...1-1/C(7MP (314P H0(11) 1.
ULP/C.OMP 31m,lp
L)WEX.L .UNI 11*5 : 1 81-14/("'(3MV, 1"3-30HP 1 NCIINEWAT01:1((,(')M
1:1.1EL TYPE: GAS ULA/COMP 30150HP RI:!:PA*I.*P
MAX . INF UT EA-PI(Aimp 0 V FIF A
F: 1m. umpwsy GA5 PTP:I'NG L)UTLET5
I ow PPE*551?
FL.
0 MORISSF-FrTF DON PF14MU1' $10 . 00
W 1:11:1 BOX 1,9.51341 PI AN PEVTF. W $9 '75
N
E P a r-tl Pt I-)(J l3r. 9 7 2 1.Y *29 . 00
TAX $1. 1?5
R PH(:)Ni-': (503) 2,01,40314 1".
C
0
N L ING :1.*NC;.
T
R 1-11AZZA AVIF
A (..I...A(:,KAMAS 111P 9701t5
C, PHONE. (503)
T
0 PEX.,*f G1140TTON Nrl . TO.I.A.
R 11111".)0 .
PECEIPT NO.
This permit is issued subject to the regu ations contained in Title 14 ------
of the TMC. State of Oregon Specialty Codes,zoning regulations 1:.'.QtJ 1RE:1) INSPIE.CTTUNS
and all other applicable codes and o dinances, and it is hereby GAS LINE:.
agreed'hat the work will be done in ac;ordance with the plans and POST a 131-:AM
speciticatlonb and In compliance wi'h all applicable codes and ROLIGH 1.N
ordinances The issuance of this pe mit does rot waive restrictive
covenentq Contractor and subcontractors shall have current city I(NAI
business tax permits. This permit will expire and become null and
void if work Is not started within 180 days,or If work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
Rif require I inspections are r led and approved
require I gnat
4,,,e,
Permitte, nal re
lqs,tied By 'A I I... FTP 't WiPF.U,1 *1.ON 639---el 1.7,.*)
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
C17YOFTIGARD PLAN CHECK APPLICATION
UF%TnIVFA- PLAN CHECK # // ? y`
COMMUNITY 7EVELOPMENT DEPARTMENT PERMIT # 10(o ci
19125 SW IWI BW. P.O.k:'a 2x107.T1rNd.Firepo qj (609)490.4176
DATE ISSUED
JOB ADDRESS:
TAX MAP/LOT
SUB: kjLLjjj(,P r11 SD h w , LO l(w 00,L0T: v LAND USE:
/2
VALUATION:
OWNER f SPECIAL NOTES
NAME: r`� �1 REISSUE OF:
ADDRESS: —_ LAST REISSUE:
v _21.1 FLOOD PLAIN/
SENSITIVE LAND:
PHONE: ;1
APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: ENGINEERING: _
ADDRESS: FIRE DEPT _
OTHER:
PHONE: REQUIRED
LIST/SUBCONTRACTORS:
ARCH/ENGINEER BUS TAX:
NAME: CALCULATIONS:
ADDRESS: TRUSS DETAILS:
-- PARKING PLAN:
LANDSCAPE PLAN: _
PHONE: OTHER:
CO 1M[;N1 S:
�61-iii )7,Y
}s -
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
�Yl)& 10-432 00 Building Permit Fees _---
S,} [ 10-431 00 Plumbing Permit Fees L =��, •_7l
�jL.�! 10-431 01 Mechanical Permit Fees aU _ r 5Z
10--230 01 State Building Tax (5X)
Building
Plumbing_
Mech
10-433 00 Plans Check Fee
Building
Plumbing
FYI (�/G Mech' -�--
30--202_ 00 Sewer Connection
30-444 00 Sewer Inspection --1
51--448 00 Street System Dev Charge (SDC) _ Q
52 .449 01 Parks I System Dev Charge (PDC) c
52--449 02 Parks II System Dev Charge (PDC)
31--450 00 Storm Drainaa_e Syst Dev Chr•g (SSDC) J
10--230 09 TRFD
10-230 06 Washington County Fire #1 (95X)
10--220 Amart/Wedgewood c
TOTAL �: �
4� 1
REC #AT SIGNATU E
Received Ely: ^_ �
ht/3587P/18P Date Received:
C17YOFTIGARDPLAN CHECK APP;�CAT ON
COMMUNITY DEVELOPMENT DEPARTMENT
;ffy
oon PLAN CHECK # `ff
a,m 6w we eMa P.O.Boa 23W.%W,a+wn orm(50)M4176 PERMIT
DATE ISSUED
JOB ADDRESS: S l,� „L1
3 L � _ t 1-.�� MP,P/LOT
SUB: �1��.✓)c.t� ri j -k)M Lv Ori LOT: FUSE:
VALUATION:_ Go P D SETBACKS: FRONT: 0 REAR: LEFT: RIGHT:
WORK CLASS: HEIGHT: iG, TOTAL
USE TYPE: SF FLOOR LOAD: _ 1 T: 1_v L Y
CONSTR TYPE: SA/ HEAT TYPE: > 2
OCCUP GROUP: DWELL/UNITS:
OCCUP LOAD: NO BEDROOMS: ;• ASEMENT:
NO STORIES: / NO BATHS: �, GARAGE:
IMP SURFACE:
APPROVALS REQ'D SPECIAL NOTA►$_. I REQUIRED
PLANNING: REISSUE OF: =LIST
ENGINEERING: LAST REISSUE `' ��/�/K US TAX:
FIRE DEPT.: FLOOD PLAIN/ UI:ATIONS:
OTHER,. SEN IND.: USS DETAILS:
NG PLAN: _
St;APE PLAN:
PIAN CHECK BY: THER:
COMMENTS:
ACCT DESCRIPTION AMOUNT
OWNER r 10-432 00 Buil ing Permit Fees
NAME: X10-431 00 Plu inj Permit Fees ���
ADDRESS: tri I Ct 2 10-431 01 M nic.il Permit Fees 5� �5„r �i / 5U
7 ? ( 10-230 01 -State Building Tax (5%) ,'(-
10-433
5X) '(10-433 ID Plans Check Fee ' 'b Y
PHONE: y- 30-443 00 Sewer Connection (20x)
30-202 00 Sewer Connection (80x) 3
CONTRACTOR 30-444 00 Sewer Inspection ,
NAME: .51-448 00 Street System Dev, Charge (SDC)
ADDRESS: .52-449 01 Parka I System Dev. Charge (PDC) t � �
52-449 02 Parke II System Dev. Charge (PDC) --
31-450 0 0 Storm Drainage Syst Dev Chrg(SSDC) TZ' • '
PHONE: 10-230 09 TRFD (952) _
10-435 00 TRFD (5x)
ARCH/ENGINEER 10-230 06 Washington County Fire #1 (95x) s
NAME: 10-435 00 Washington County Fire #1 (52) t
ADDRESS: 10-220 00 Amart/Wedgewood f-777,♦
TOTAL �� c
PHGNE:
a,, e_ TTD 30 7 PREPAID
REC #
DALANCE DUE
APPLICANT SIGNATURE.
Received By: ��l '.,L� Date Received: ,Z /•
.eA s ar sns e. sssr �
INSPECTION NOTICE
City of Tigard Building Department
P.Q. Box 23397
Tigard, Oregon 97223
Phone: 639-4175 �-
Type of Inspection
P.M.
�1 Time A.M.
Date Requested _ —
Address
7� � � •�J _ Permit #_ 1
Owner —
Lot # _
Builder `�—
The followi,4 Building Code deficiencies are required to be corrected:
�Cx'r ---
�--- -_--
�.�
Presented to _ '—_ --- --- — ——------ � Approved
Inspector — —.---- — isapproved
Date -G--L
CALL FOR REINSPECTION
F"YES C-] NO
I