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INSPECTION NV,'XE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
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Type of Inspection
Date Requeited.__--- L--.JL
Time_ A.M.
Address __. ( V/ rE
R,
ermit =
Owners
Builder
The followinq Building Code deficiencies are reg0ed to be conected:
Presented to — rG�p vro eu
Inspector �
I Disapprover)
Cr:LL FOR REINSPECTION
tJ YES ❑ NO
BUILDING PERMITAPPLICATIOri TiGARD DATE ' r`� !s_-__— 5C84
THE UNDERSIGNED HEREBY AP?LIES F:jrl A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 69'2360
OR AS SHOWN AND APPROVED IN TNF ACCOMPANYING,PLANS AND SPECIFICATIONS OWNFR PHONE— —
Jay e,li�Ci �.: .>w' Churchill ",t. LOTNO._ Ji.,ttOnl i'fl.rl� Ilt
OWNER JOB ADDRESS —
��11 e 2 •''- ARCHITECT
ENGINEER
BUILDER ADDRESS ��U. lSo1; � 1N,src! DESIGNER
STRUCTURE ❑ NEW 0 REMODE). ❑ ADDITION 17 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
RESIDENCE ❑ COMM ❑ SDUCATIONAL ❑ GOV'T ❑ RELIGIOUS Ll PATIO ❑ CARPORT [I GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY =__LANDUSEZONE _BLL`(3.1YPE ._ FIRE ZONE.__PLAN CHECKS'_`_-.—_HEAT -,
Construct single family dwelling w/attache6 r'arage
---iteissue of 05202
2wo2
SEWER PERMIT# garage area 44.6 bath
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES_ AREA NO.BEDROOMS VALUE
26.
BUILDING DEPARTMENT SETBACKS FRONT —� REAR 3C LEFT SIDDE t,_ RIGHT SIDE VV
Permit — — THIS PERMIT IS ISSUED �UB.IECT TO T' E REGULAIIONS CONTAINED IN THE BUILDING CODE, ZONING
40*W REGULATIONS A !D ALL APP'_ICABI- ^ODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDAlCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
136*00 WITH ALL APPLICABLE CODES At,lo ORDINANCES. THE ISSUANCE OF THIS PERMIT DOI-S NOT WAIVE
Sub-totalRESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
StMe Tax ii.92 ,,
Total - - 349*91 SDC- 50U.00
By �du
PDC# IIiSU.I►1= APPLICANT OR AGENT
bcR Recelpt No.
Approved ADDHEB -- - - PHONE-- ------
1
DATE INSP. TYPE INSPECTION REMARKS PLUMBING I DATE
I vAt,
zr_ Rid— O/E� IlPermit No.
/11dt OK F3ough-. n
�7
:1 Final
—7 HEATING
0- Contractor
Fermit
...... ......
fZ Cas or Oil
Ituph-in
Final
SEWER
71-
Final
AA DRIVEWAY
Final
Storm 3rainage
(Rain Ormin)Final
Sidewalk
I Curb&Street Final
Api,roerh
BLDG. DEPT.FINAL— TEMPORARY CERTIFICATE 66C—UPAITE—Y
CERTIMCATE OCCUPANCY v Final
t Asc6ping
Ze Final