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INSPECTION NOTICE
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City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection `--
Date Requested___._ 3 _ v �Time
Address // 3 l0 5� J�G- L b�drY. L Permit # _
Owner _-_— _ Lot #
Builder
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The following-wilding Code deficiencies are required to he corrected:
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Presented to "�"'� — —Approved
Inspector __ _ L_� Disapproved
Date --— � --�
l",ALL POR REINSPECTION
❑ YES ❑ No
CITY OF TIGARD Plumbing Permit
Building Department
Residential P Commercial [I
New Installation ❑ Replace Addition Alteration ❑ Date
Licensed
Plumber
Owner _j kz id OL 4 i :6.4
Address Job Address '-A
Phone Applicant
CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUB-CONTH.ACTORS
ITEM _1140. FEE TOTAL ITEM NO. FEE TOTAL
Fixtures-Traps 7.50 Sewer:First 100 ft. 30.00
Dishwasher 7.50 Each Add it.100 ft. 15.00
Garbage Disposal 1 7.50 1 Ejector Pump 7.50
Water Heater 7.50 Water:First 100 ft. 20.00
Backflo-w Preventer 7.50 Each Addit.200 ft. 15.00___ __
Storm&Rai-,Drain:First 100 ft. 30.00
:'A' Each Aridit.200 ft. 15.00
Mobile Home Space 25.00
Other(Specify): Yd,;?,Zj- Rain Drain-Single Fam.Dwelling 15.00
PERMIT FEE Com nents,
Issued By: ..........
STATE % r
Receipt No. Applicant
uro'
TOTAL sighdR
For Plumbing Inspection Phone 639.4171
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AC'DRCSS //36 o`RMI r
PERMIT CHARG7 none
OWNER
CJNNECTION F'E
TYPE OF BUILDING 1 ._ DATE CONNECTED _
SERVICE RATE �_ _ INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION _ ASSESSMENT PAID
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City of Ti card �✓
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INSPECTION REQU i� T
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INSPECTION TIME: ���� PERMIT NO, 7
DATE. - DATE ISSUED .
OWN FT, ; A'A M E
ADDRESS: _1� �_. �✓ s
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9EtiULT: Approved R', Dieopproved C Pending t
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PECTOR DATE
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UNIFIED SEWERAGE AGC NCY No. _-_11.652
WASHINGTON COUN-TY DATE
CITY OF Tigard_. ._ —_ .__ .---- ----- -- --------- —
APPLICATION FOR SEWER CONNECTION PERMIT
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OWNER: ---
OWNER'S
WNER: —_OWNER'S ADDRESS: — — _ _ ---- -- - -------- ------
STREET
_--- ---- - --- - - t
-CITY) -----STATE
BUILDING SITE: LOT,162_— BLOCK ___.—___—_ AnDITION
N _ TYPE OF OCCUPANCY - residence
TAX LOT 0. OCCUPANCY
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ADDRESS 113ffj5 SLI _C_at_t.aa610_ud La. -.__-------- -- ----- --- ------
DWELLING UNITS-- 1 --- FIXTURE UNITS
SURCHARGE IF APPI.ICABLE -- - - --- - - --- -
PERMIT FEE _ 575'_ INSPECTION FEE _`5' - -__ TOTAL DEPOSITED . 600.
(P;EW1 (EXISTING) BUILDING SEWER SYSTEM -- Far-Ino Creek
The Applicant agrees to comply with all rules and regulations of the Unified Sewerage Agency.
APPLICANT.._ ---—- ----- -- - --- -----
SEWER PERMIT
THIS °ERMIT AUTHORIZES CONNECTION TO THE SEWER SYSTEM.
LINE SIZE INSTALLER
---------_-- _�_._Y--
RECFIVED
IAGENCY✓Op ITS AGENT) �-
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COMMENTS: Bldg #129=t
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This Application and permit expires in one hundred and twenty (120) days.
The amount paid will Lie for`aited should expiration occur.
Vbti BUILDING PERMIT APPL.ICATiON COF TIGARD DATE_ 19 ^�
4
THE JKDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE X48-61 491
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE ..
LOT NO.
OWNER rauram�rK FtalAarrs JOB ADDRESS` 1,36! SI,! CottUrlwaucj W6ME ADDRESS
ARCHITECT
BUILDER ADDRESS ENGINEER
------- DESIGNER
STFIJCTUHE ❑NEW ❑REMUDEL ❑ADDITION ❑REPAIR _ ❑RENEWAL ❑ �-yFIRE DAMAGE `,DEMOLITION
❑ tR--E��SI"FNCE ❑COMM ❑EDUCATIOI, .- ❑GOV'T ❑RELIGIOLIFDPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
�L..,IBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW UCOUNCIL APPROVED ❑SIGNS
Ei t W -- --
OgCUPANCY p--LAN-)USE ZONE H r BLDG.TYPE--FIRE ZONE_ PLAN CHECK BV HEAT _
! LJnet. airlolt' family dwelling w/aLtachtL! aarf.jUlJ 3 L ti!druum i hath
t' i, l::t r rEtUc 3&0 ®q, ft.
S9Q�r_L.QAQ ") FLOQfl_LQAD _ H JQf T---- -NO.._51QRIE55- 1 AREA 1 M No.BE.R949MS� 4,LUE r
BUILDING DEPARTMENT SETBACKS FRONT 20 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 AGA
EED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
SUb•total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HA�,E CURRENT CITU BUSINESS
StatP is _ (J- j' LICENSE. SEPARATE PERMITS REOUIRED TOR SEWER, PLUMBING AND HE,AIINO.
Tocol 23%21;
By
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Ok X0PNt -.
Approved A Rereipt No
DATE INSP TYPE INSPECTION REMARKS PLUMBING DATE
ING 4, Contractor
a��G .hi6 Permit No.0S 3.j 4
Rouh-in
ca Lam% J
Fixture
JA A4 10 0—u Final
HEATING
Contractor
-- Permit No.
Gas or Oil
Rou h•in
Final
SEWER
Final
_ DRIVEWAY
r Final
Stoner Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
CLOG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
C_ I Zoning Final
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