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-NSPEGTION NOTICE
Ci:y of Tigard Building Department
12120 S.W.Main Ot.
Tigard,Oregon 97223
Phone: 639.4171
Type cif Inspection
Date Requested Time.A —A.M. _PA.
Addresses� Permit
Owner_ _�— __ Lot #_
Builder
The following Building Code deficiencies are required to be corrected:
,.
Presented to Approved
Inspector �,�i� _ Disapproved
i
Date "; - q
CALL FOR REINSPECTION
❑ YES ONO
BUILDING PERMIT APPLICATION TIGARD DATE `1ctoh`vr 21 Ig___._ '' 4 212
THE UNDERSIGNEC HEREBY APPLIES FOR A PERMIT FORTH E WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS OWNER PHONE
LOT 1N0 _
OWNER �C.it2iie E3 �nVt?G� .JOB ADDRESS « Aie�t,' ,a31 Anc i.. fi::I
ENGINEERT
BUILDER _ +.a,:. - ADDRESS 11ortlarna, tams. 9 " '.
"' SbESIGNER ::11:;.157
. I.Lyy _REMODEL ADDITION _CAEPAIRSTRUCTUR _ _❑ RENEWAL ❑ FIRE DAMAGE Cl DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB FENCE
OCCUPANCY LAND USE ZONEBLDG.TYPE _ FIRE ZONE PLAN CHECK BY t; HEAT
un,t..r_UCt aingl(� I:W411lY r WPIlilir.' 14,1�ttc he,l r7arage.
-o-issue of Permit 4 4211 (34r)Ririnclttt Ct. ; � 3 f�pd]^Dcantt3
SEWER PERMIT# �73nJ4 4 A
OCC.LOAD FLOOR LOAD 1 r� HE!rHT ` NO.STORIES AREA 1 1111 NO,BEDROOMS 3 VALUE~
DEPART SET BACKS FRONT 1 REAR ` LEFT SIDE RIGHT SIDE
BUILDING DEPA )r}
__----- - --- - ------ ------ ----- —°-
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
0,00 AFGULATIONS AND ALL. APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check ___ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICA TIONR AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PER.'IT DOES NOT WAIVE
Subtotal _ _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1
State Tax 144 44 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total _ 3 3 '". 4 4 SDC— Y 4L—
By
Ley PDC# 1
0() n ADPPIRICM4 E'
Re-elpt No.Approved lh
1
-
ONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit "NO
nough-in
Fixture
Final
HEATING
Contractor
2 7-3
Permit No.
Gas or Oil
Flatigh-i'n—_
Final
SFWE:R
Final ZA=o
DRIVEWAY
Final
St ret Drainage
(Rain )rain)Final
Slclev,!l
Curb PA S treat Final
Aopr 'ja'h
PT.
FINAL
Tr-MPORARY r CERTIFICATE OCCUPANCY Final
ICER,riricATE OCCUPANCY
Landscaping
Zoning Final
a�,�-. 2 r
BUILDING PERMIT APPLICATION TIGARD DATE- 1g=-t=
THE UNDERSIGNED 4EREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN ANC APPROV D IN TH ;;CCQO�tpJ PANYING PLANS AND SPE1CIFICyTIONS. OWNER PHO
G -mV-j:B boRt. TAT .�_ 5w La//1a GIA0. GT. LUTLa 1AAncAa NO. — _.
O'NNER ��' _Q��P, JOB ADDR_(_SS
kRCITECT
ENGINEER QL
BUILDERS _ ADDRES3'T&1!; DESIGNER 100 1
STRUCTURE MEW ❑ REMODEL _❑ ADDITION �❑❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE Cl DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ HELIGIOUS ❑ PA710 ❑ CAR PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
C 7ZOPANCY '✓^LAND USE ZONE -i1=Z�BLDG.TYPETT_-+1_1—FIREZ_ON/E--- .P(.ANCHECK 13Y _HEAT.
01
NAM or
_ 2 13a�i',a
tnaw�11
*"—1 4 1�,—�-v a--
SEWER PERMIT R*
OGC.LOAD FLOOR LOAD _ F EIGHT_ �.� NO.STORIES I AREA NO.BE()FlOOMS VALUr_5 10OA
R"P—
BUIL ING DEPARTMENTSET BAFRONT REAR '� —LEFTSIDE �S� RIGHT SIDE y� _
--� _—
Permit • �0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULAT10N5 C,'ONTAINED IN THE BUILDNNG CODE,ZON'.NG
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
I�P'dn Check • CPO WORK 'HILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
SuStotal 00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURFitNT CITY BUSINESS
C--- 17 LICENSE SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
: Tax
Total
----- � 5DC
By 33'T�4
—
pDGN APPLICANT OR AGENT
_ 4'
Approved
Receipt No. ACOIiESS - P"ONE
30C
;EWER CONNECTION
SEWER INSPECTION
SEWER SURCHARGE 5
13 Go
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