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Mll;[CTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection ___ Pc-54-
Date Requested . 11h - 1.2& Time A.M. —P.M.
I
i Address L11;2 7� Permit
I
Owner _ ti5-CL to _ Lot
iBuilder -- - kc–&"J oa-W-
The following B ilding Coded icienciesare req fired to be c rrectedy /
I
l
Presented to Approved
f �
I Inspector LJ
___ < Disapproved
i Date cam_1 J Z -
CALL FOR REINSPECTION
( YES O NO
BUILDING PERMIT APPLICATION TIGARD DATE _ 3�2b/ .-__,,s_. 4056
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE"
R S SHOWN AN;E .APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. CiVNNER PHONE
h LOT N0. `'t ' 'Il 01'
OWNER - -- JOBADDRERS 11615 SW CIOUd COI: Et _ T, 3F�+n 7,. "`1 r' J _
ARCHITECT
ENGINEER 1aF1If'�
BUILDER >Arro,1",r�nd D4eve1• ADDRESS 15405 RV 116th DESIGNER pte rcy,. �_-
STRUCTURE (I NEW ❑ REMODEL ❑ ADDITION ` ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
F RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑_GARAGE D STORAGE_❑ SLAB f7 FENCE
OCCUPANCY LANG USE ZONE P"•3 f1 BLDG.TYPE — FIRE ZONE---.r-=-PLAN CHECK BY c3'ti*h.HEAT_—
a lwcliincY �h/attachod c'nr>''A"P* 4 r3or1romsi
+ - r+xCt Singlefn ilk _ —
i' CQT�ItLY°'T'I� . -, ",'1'�'11Ct'1'r'• ------ —
SEWERPERMITM cTrdC'r? ifi?--
OCC.LOAD FLOOR LOAD 4 O HEIGHT NO.STORIES ' AREA 41)1 ) NO.BEDROOMS 4 VALUE l''' r
BUILDING DEPARTMENT7
SET BACKS FRONT REAR I!" _LEFT SIDE I RIGHT SIDE
Permit _ THIS PERMIT IS ISSUED SUBJECT TO THE REG ILATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check �70 WORK WILL 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
Subtotal rr. /� RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tex
SDC
Total $1 r�1 r►• 11,01 ,. ,_ .._ Q. ✓ -- --- _
PDCM APPLICANT O- R AGENT
By
Approved
d wh Receipt No. ADDA S--- S--- - ONE
__
DATE INSR TYPE INSPECTION REMARKS PLUMBING DAT:
_
Contractord2•ky�
Permit No.
Rough-in
_ Fixture
Final
u HEATING
c_ —_ Contractor Os 2,5 3--7
-7 (�
Permit No. 3 1z, I!i
7-/L • z
Gas or Oil --
�/� Rough-in
F
Final
SEWER
--- - — Final d'2
--- --- - --- �' virtIVEWAY -
- Final ---
Storm Droinagr
- - (Rain Drain)Final
- S ideva,'I
--- _ �--- Curb&Street Final
---- ---— Approach
BLDG. DEPT.pl L 7EMPOEr AR f CERTIFICATE OCCUPANCY Final
CERTIFICATE_OCCUPANCY - ------
DV / Landscaping
\ , Zoning sinal