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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tig rd,Oregon Y7223
hone, 39-41 1
i
Type of Inspection
Date Requested ,t__ ime A.M. ,G I
Address " Permit #
Owno: — _ Lot #
Bu Ider-- -- -
ThE following Building Code deficiencies are required to be corrected:
5.
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I
I
Presented to ❑ Approved
Disapproved
Inspector
Date
CALL FOR REINSPECTION
C� YES 0 NO
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested me _ A.M. M. 1
JZ
14 S G�
Address _._--- _ �. C� "Z./ Permit #_
IOwner ---- — -- --- Lot #
Builder
rhe 'folloi -ing Building Code deficiencies are required to be corrected:
I
Presented toJ Approved
Inspector ❑ Disapproved
Date ---- --- � -�1
CALL FOR REINSFECTION
F1 YES eNO
Building Permit No. /'I'�
Location
[)ate
r
Certification of Registration
With the Builders Board
doing business as (dba) , -
_ am registered under, the provisions
of ORS Chapter 701 Oregon Homebuilders Law)
My Builders Board Registration Number is
My registration is in full force and effect and expires on
Signature
�1
BUILDING PERMIT APPLICATION TIGARD DATE._...._ July 6_ 19_..x!± 4 ; 07
THE UNDEHSICNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INu;CATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
., tt u S `I L_. O' LOT N0.
OWNER xy 21_ , p rr JOB ADDRESS nsia_t� Square Il
ARCHITECT
ENGINEER
BUILDER S� - AD[�NESS _.Jj fiQ SSS' g ltd. DESIGNER
STRUCTURE — NEW ❑ REMODEL ❑ ADDITION U REPAIR ❑ RENEWAL L1 FIRE DAMAGE C DEMOLITION
.RESIDENCE L_l COMM Cl EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO Li CARPORT ❑ GARAGE Li STORAGE ❑ SLAB❑ FENCE
OCCUPANCY —A-3 LAND USE ZONE BLDG.TYPE 5", FIRE ZONE PLAN CHECK BY L'rW HEAT
___.______S;9�Crr.;tc�.��z1a:.l.� fa�.�i1• � r l.i.tl�: vlat+L:�clu;�:.a �-__`_ _
__. 2 F1aaLlirUU,^ 7 bodrom, ._
SEWER PERMIT# i79 16 Gur a&e 22(1
OCC.LOAD FLOOR LOAD 4() HEIGHT 20+- NO.STORIES z— AREA 1070 NO.BEDROOMS 2 VALUE
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 233-511 THIS PERMIT IS ISSUED SUBJEC! TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZCNINGI
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY .4GREEu THAI THE
Plan Check 151.71- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS ANSI IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT )OES NOT WAIVE
Sub total �' .i.2t RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 13USINESS
State Tax 34
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
1.
SDC— $500.00
Total 3)4.h2 ; 1
PDC 150-00
By _ _ (At :::iw'. 250.00
Approved CTS Receipt No.
ADDRESS —_---
__� PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
d�
Nt Rough-in
Fixture
Firal
O'z NEATING
Contractor
Permit No.
---
--� /� e—• _ ___ _� �—__ Gas or Oil .
Rough.i n
Final ------'_
SEWER
— Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
_ _ _ Apnrnach
BLDG. DEPT.r; :. TEMPORARY CERTIFICATE OCtUFONCY
Ir CwtTIFICATEOCCUPANCY Final — —
i
+Landscaping
12om,ig Final
i
TN(i Ut`U�c11 ::�NtU N'_11LUY APr'I.ILS 14114 API_I(NI11 I )1, lilt ,-Mr, II Nva+", ., .:•� � .� .r`t!'9.a, ____
OR AS SHOWN ANO APPROVED IN THE ACCOMPApYIIt ; PLANS SP'CIFIC 1 DNS. aY/NEF?PftOtl ___.
/ • � 7 LOT IIId _—ice--
� r
_m,fEl, 1013 AL)ORES34M
ATTCt41TECT
ENGINEER
:iUl'_O.:'2 �_ `1•' Yom` _ AGURES', 7G`O ..S'LtJ. Q—s Q- j.UF.SIGNJ? ryry
STRUCrURE _ 14EW ❑Reti+nCEL r 0Aooir10^r _ �RcPnIR LJRcNE:'!AL CFIR �I
EOAMI-GE OE:.IJLI_I
RESIDENCE ❑COMM ` FOUCATIONAL CJGOV'T ORELIGIOUS❑PATIO [JCAR PORT ❑GARAGE ❑STORAGE❑SLAG UJFE
CCCLtP.>r;•_Y_X= •LANO USE 2pNe n'r D. OIOG TYPE_ PLAN CHECK OY _� _ HEAT"'
— (ON`' I; T SINGLE FIAMIL.YL_w_F_T_.I.iN1�_.W�n�I'TnrlaFn cnuncF. _
2 BATHROOM Z BEDROOM
.SEWER rERf'1I7�jc. 2 �•
1L'�_LO O� FLQ9a 1 O�Q �[J fIEIc IIT 2-6 4 NO.STORIES�r .1�f�G �.lsLry4.�7EpRO0A1S -I- VAL OOd
( — 51,1I1_17,'ING DEPARTMENT Sr.r BACKS FRONT REAR LEFT SIDE RIGHT SIDE f
THIS PERMIT IS ISSUED SUBJECT TO THE REC,ULATICGNS CONTAINED IN THE BUILDING CODE, ZOI
14'.4r; Check I REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT
I---- WORK WILL BE DONE IN ACCORDANCE WITH THE PLAN-AND SPECIFICATIONS AND IN CG1.1PL16.NCE 4
$a7•tBtJl j� 3 p S'a, ALL APPLICABLE CODES AND ORDINANCES. THc ISSUANCE OF THIS FERhI1T DOES NOT W
RFSTRICTIVE COVENANTS. CONTRACTOR AND SUB COPITRACTORS TO HAVE CURRENT CITY BuSU
Stat• Tax I LICENSE. SEPARATE PERMITS REQUIRED FCR SEWER. PLUMPINC AND HEATING.
Tutal ~� SDC —
r-- --- — PDC#
Av
APPLICANT OR AGENT
Approved Receipt N'j.
SSJ)CDC (Storm S�
SEWER CONNECTION S
SEWER INSPECTION S 3 _
SEWER SURCHARGE 8 G D /moi
v At,,
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