10405 SW CENTURY OAK DRIVE N
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME . �� 3y PERMIT
DATE: -JCL�-� DATE ISSUED : i
0" HERS NAME . --
ADDRESS:
CONTRACTOR : _P-016_6'0/ _ --
"i EST : rilr -a, WoterEl , V:sua�t_ab• ratury p
RESULT*. Nporoved �isapprovad G Pending p
SKETCH:
INSPECTOR DATE
NOTE: Attach supplements! to-it aaic hereto
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City of Tigard
INSPECTION REQUESTi
for
INSPECTION TIME: �_. PERMIT NO. : —__
DATE: 7,03/*2 DATE ISSUED .
OWNERS NAME : —
ADDRESS'
AME : _ADDRESS: ---
C,_,N r R A C T 0 R : _IW22AX -f�72W - ---
E ST : Water Ell, V:suai ,1*, !_abnrator,r r--i
RESULT : hp rovedDisapproved G Pendine`' j
i
SKETCH '
INSPECTOR DATE
NOTE : Attach supplemental teat data heretril
City of Tigard
INSPECTION REQUEST
f o r-
INSPECTION TIME : s' ; 0 PERMIT NO.
DATE : /_ DATE ISSUED '.
OWNERS NAME —
ADDRESS:
CONTRACTOR --
i E I;T : , 'W6ter ❑ , V:Sual I Laboratory C
RESULT- !gyp roved O , Disapproved G Pending [;
SKETCH.
-4j'°" 2•"Z..
SPECTOR DATE
NOTE: Attach supplemental test data hereto]
City of Tigard
INSPECTION REQUEST
for,
INSPECTION TIME : PERMIT NO. : _
DATE.' -"" /x/73 DATE ISSUED
OWNERS NAME : 7-D C-- _
ADDRESS: 4.e 7- d2 — —
CON-rRACTOR : TPC
+ t ?Vater❑ , V:sual , Laboratory j]
RESULT.* Ap.1rovedx , Diaapproved G Pendiog p
SKETCH: -- �
I �S
o�
13
INSPECTOR DATE
-N'IT AttocP suphiementol feet data heret�
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME . _— _ PERMIT NO. : _
DATE : .Z_f _ 7, DATE ISSUED : i
OWNERS NAME :—7-
ADDRESS- ./014 05-
CONTRACTOR :
S-CONTRACTOR :
TEST : ,%,, Water❑ , V:suai !] , i_aboratory rJ
RESULT: Ap,,roved OK, Disapproved G Pending G
SKETCH:
i SPECTOR DATE
NOTE: Attach supplemental test data berets]
i
Cit, of Tigard
i
INSPECTION REQUEST
I for
INSPEC'T10N TIME : P
ERMIT Nn . ._
DATE : . 7/i_�_ DATE ISS'
OWNERS NAME : %, 7-) ,
A D D R E S S : __LCA 4'O.-7' —
I CONTRACTOR
I TEST r ��, 'water
La' ,rater! ('i
RESULT; Approved ,—DisopproveH 1 ,
r tindlrlg J
SKETCH:
i
► I
I �PECTOR DATE
I
[NOTE : A"ach su
PPlemenfal teat auto heref]
1
PLUMBING PEWIT APPS IC
TION
'> durlsdicf i.-�n )f
Type of Fixture Permit Nc:
Permit. fee
Wate_z� i1ase (TcilFts �'=� Pe•rmit
th bs
may-a�,Oo i a s Ap-uvov ed by �_ w
Shower
.._�asn _.SE�j Bu1ld.l:lg PQrmi �3,�C�-
e.hower _f2 op Reccipt No
is rtTfiary.�_- LQ atiin of Building
n s-bar _.._..__..,.._.....
u omr� c� 'shwayher...._
MEsa�"
Name do Address r)f 0•wrIer T�►.L�.pol
Rain Drain:
utomariF vamer�
Name�P&e�Address
;i Pl!.umbe1rqF0
un a3ns�Ii�ii
un ains TKI
atfer vd
WaterSize "
1
a c -gas�ns dz`��� — __ Olt ,?re�wri�,urin er g tem
wimmin —$c,
Sprinkler S -- .fro
La. perms t becomes rul and. vt.-ld if wr,rk •. �;^{ l.-:n i.-ed is not
amenced within 60 ,Jay if ^:.�r�etr�.r '.i .r, w...:: k : :3 su.,ps�-did 4:r abandoned
a period of 120 d:ay a :ir:y {.ime oft-Wr w -k .i"
plumbing firms must be licensed by the C.I ty of T4g-
and pest, a $19000 bond,
iereby certify -ha i- .I r.av-P --ad and Pxarn�.-gid 'hl s al p; i .a `:: .:n and )snow the same
be true and c;orre,- t. A"iy pr�visiur.s f laws and rdtnan a'.verning th.'.d type
work will be - ,:mplled w; .h whether aPe�.;ifi.ed her•N,n r. '.he granting of a
vdt does na t presume, t.,:, g;.ve auth: T it y t;• � i:,la'.�: - an. •_1 !ne prcv, si;:ns
any ct' ,er state :r T'effulatJng ^: rstriv ± ' n the per frrma:'ce of
istructicm.
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JOHN E.
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i City of Tigard
INSPECTION REQUEST
for
I _- -- ------------ —ZeCa v/J -o,� -
INSPECTION TIME : PERMIT NO. : . _
i DATE. & 115173 DATE ISSUFD- LL
OWNERS NAME . —T_/�• G� -- ----
ADDRESS :
I CONTRACTOR : _ --
TEST .A r J, Water ❑ , Viscal 0 , I_a'• .rator,l Fl
I RESULT: Approved / , Disapproved 1 Poinding
I
I SKETCH:
I
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1
NSPECTOR DATE
IOTE : Attach supplemental test d ata hereto
CITY OF TICARD
19410 E. W. M dIn/fr"t
TIGARD, OREGON W=
APPLICATION FOR BUILDING PERMIT ,
New Construction ❑ Demolish ❑ Addition ❑ Remodel ❑ Move❑
ZONING P•D DATE ISSUED -7 73 BUILDING _PERMIT
DATE RECEIVED_5 Ty73 _ BUILDING FEE 71.00 No. 73 .115
BY PLAN CHECK $
OTHER $ 10.00 VALUATION
TOTAL $ 81.00 RECEIPT No.
TWO SETS OF PLANS AND PLOT PLANS MUST BE FURNISHED WITH APPLICATION
LOT A =22 °MAP 1 291 11C CENSUS TRACT w"r JOB 1
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Architect or Engineer Tualatin DerelopMnt Co.
Address --.-153M g_V_ 116th Ays- Tigard- 0=@= Phone
Owner ears
Address Phone
Builder ..�. -
Address_ Phone
BUILDING USE Single Res. ❑ Multi Res. ❑ Comm. ❑ Industrial❑
OCCUPANCY GROUP I No. of Stories_ 1 - Total Height 19' Area of Lot 4.160
Type of Construction POW V Floor Area B •-- 1 1248, 2
Sett Backs: Front 101 Back 101L.Side 5' R.SidE 51
Private Sewer Pipe Size 4" Sewer ass Septic Tank ❑
Water Service Pipe SizeStorm Sewer Q Dj ch ❑ Drywall❑
Street and Curb Requiremel,ts existing
Driveway Width 18' No. of Parking Spaces_ 2
SEPARATE PERMITS REQUIRED FOR SEWER AND PLUMBING
SPECIAL INFORMATION
ADDREI)S ASSIGNED 30405 B.N. Century oak Dr.
FIELD CHECK BY �_ DATE 54�-73 APPROVED B
It is understood that all work will conform with appliclble codes and ordinances
of the State of Oregon and the City of Tigard, Oregon, and that the building will
not be occupied until a Certificate of Occupancy has poen issued by the City of
Tigard Building Inspector.
Signature o"plicant