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INSPECTION Nn'rICE ��✓
`4*k City of Tigard Building Department
P O. Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
V
Date Requested Time_je- A.M. P.M.
Addre.s (� C Permit
Owner ra�se --- Lot #
Builder
The following Building Code deficiencies are required to be Corrected:
'001 10 A
Presented to Approved
Inspector / C�
/ Disapproved
Date
CALL MR REINSPECTION
C7 YEs 0 Nn
BUILDING PERMIT APPLICATION TIGARD DATE.__ _ _._ ,19 5648
THE UNDERSIGNED HEREBY APPLIES FOR A PE'1MIJ FOR THE WORK HEREIN INDICATED BUILDER PHONIP922()15
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PH ON
OWNER
Jay Killer b1dr. JOB ADDRESS blob Chur"_nf ll Gt.. LOT NO.
ARCiHII ECT
BUILDER xH"� 996. i;ax x3291, Tigem, ENGINEER
ADDRESS DESIGNER
STRUCTURE _k_NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION_
aRESIDENCE f❑ COMM ❑ EDUCATIONAL !7 GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY f�.J _LAND USE ZONE r`� '' BLDG.TYPE SN FIRE ZONE--PLAN CHECK BYVT"—HEAT'`�
—•-- l:[�r�s,t ritt aujily d4t,,llinL Wj&tCaCticu g&3 - e
SEWER PERMIT M
lb-562J-• _ arage 440
(� Y
7t + 16e.4- r _
OCC.LOAD FLOOR LOAD 40 HEIGHT _ NO.STORIES l AREA _ NO.BEDROOMS— uVALUE
BUILDING DEPARTMENT SETBACKS FRONT REAR 26 LEFT SIDE RIGHT SIDE
Permit THIS PERAIT IS ISSUED SUB iE^T TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
193�N REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES AND IT IS PEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN A.'.CORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
491.7() WITH ALL APPLICABLE CODjS AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
x'9.86 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
TotalSDC—
— L L1.SIJ
By PDC# APPLICANT OR AGENT ---
--- ----------------
Receipt No. _ —
Approved - `- -- ---` ADDRESS
-DATE INSPP, TYPE INSPELTION- r REMARKS PLUMBIN DATE
Con ractrit
21 1
(p•�' _LlrJ. __ Vr�-�✓� /� Permit No. 4
fiXtUre
incl -- — —
/' ' iHCATING
Contractor � ' //,6 V
Permit No.OA- $ b lD
Gas or oil
_r
__ --- - -- Final
SEWER -
------ tis• _
DRIVEWAY
-- ---� -final
Drainage_
"--- --- -_-.- ------II)Rain Drain)Final
----- - -_ Sidewalk
h -urh&Street Final
-- '
Approach �- -- --
BLDG. CREPT, FINAL TEMPORARY __ -EER-TIPICATIOCCUPANCY- -
CERTIFICATE OCCUPANC ,i Final
Landscaping
��-�-
__ �'oniny final
it