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114SPECT10"\! NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested Time A.M. P.M.
Address -Z -P*Mit
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
_mac+;
Presented to Approv,.qd
z::X/ Disapproved
Daiir,
CALL FOR REINS ECTION
E71
1 1
YES 1 NO
BUILDING PERMIT APPLICATION TIGARD DAZE March 19tg s4 4777
THE UNDERSIGNED HVREBY APPLIES FOR A PERMIT FORT 'E WORK HLHEIN INDICAI ED 'JUIL,)ER PHONE 6351-611 1_
ORAS SHOWN AND APPIilOVED IN-1'HE ACCOMPANYING Pi.ANS 6AND S^E01: ICATIONS. OWNER PHONE
LOTNO.__y_! '
OWNED ,`'@t+e liloore JOBADDRESS 16365 SW Cc24,WCj LregL_�r. _ C_oppar Creek LIL
ARCHITEC-
BUILDER t. , ENGINEER
— ADDRESS 122. 5 SW Ann DESIGNER--
STRUCTURE
ESIGNER _STRUCTURE _g NEW CJ REMODEL ❑ AC)OITIONi ❑ REPAlf _ IJ RENEWAL El FIRE DAMAGE F-1 DEMOLITION
C RESIDENCE ❑ COMM D V)UCATIONAL ❑ GOV'T Cl RELIGIOUS Cl PATIO ❑ CARPORT 1:1 GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY-_)L 3—LAND U0FZONE ::_'PU BLDG.TYPE —5M_FIREZONEPLAN CHECK BY ETW HEAT.. Gas —
__—Constrnlct mingle f84%0 Y_fJwael.liny wlat.tuched L; jna ,e.
__. Ke--issue 84717 3 t:nd 3 Hath - 4
SEWER PERMIT# 27194 _ Garage _+UPJ
OCC.LOAD FLOOR LOAD 4u HEIGHT 2U4 'v NO.STORIES 1 AREA 1770 NO.BEDROOMS V4 LUr. 14,!1!l .
—
BUILDING DEPARTMENT
SETBACKS _ LEFT SIDE 11-h RIGHT SIDE _ -•t,_
BACKS FRONT 1; REAR �r, I
Permit 355.00 THIS PERMIT IS ISSUED SUBrECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
REGULATIONS AND Af.L APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED 'HAT 'I'E
Plan Check 4U,00 WORK WILL BE JUNE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN CC%h^F..IANCF..
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES P:UI WAIVI-:
Sub-total 395.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY !j:,3INF.S;
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 14.20
SOC– ;11).' 1.V /1, Y
Total 409.20 .+ ,"0'
--By 1 PDC# 1 190.110 APPLICANT OR AGEEN
Approved — �.-k Receipt No. PHONE -
d
DATE INSP. TYPE INSPECTION REMARKS PLUMBING - DATE
Contracto
U-j- i� -- Permit No.
Rough-in
1-4Y/ 4-7 --- �'�—•�� - --- Fixture
—:[— Final
tf 2 HEATING
+1[l �r _ C Contractor k J; - _
1�sc�uw •_
Gas or Oil
-
_ Final
SEWER
Final
DRIVEWAY
Final __._----- —
-----,--.__ --- Storm Drainage
(Rein Drain)Final
Sidewalk
Curb d Street Final
Approach
SLOG. DEPT.FINAL TEMPORARY - CERTIMCATc OCCUP. tdCY Final `^
Cr'RTIPICATE OCCUPANCY I
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