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10290 SW 6ROOKSIDE COURT
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INSPECTION NOTICE
Cit, of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
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Type of Inspection
Date Requested P.
%04A L) 'i� *5�4--5—
Address AdP&W
Owner Lot
Builder
The following Buildine Code deficiencies are required to be corrected:
-4.I'—
Presentad to Approved
Inspector — _ [� Disapproved
Date
CALL FOR REIN7SECTION
El YES NO
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AN A
BUILDING PERMIT APPLICATION TIGARD DATE 119 -�-_ 5413
THF UNDERSIGNED HEREBY APPLIES FOR A.PLRMrf FOR 1 HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNER PHONE-k3-9-!k9-4-8--
LOT NO. -
OWNER s,iurLiu Edvards JOB^DDRESS 10290 SW DR'001 sid4 Ct._ _ 2s 1-•2LC
ARCHITECT
ENGINEER
BUILDER bad ADDRESS _ DESIGNER
STRUCTURE ❑ NEW ❑ REMODEL_ AADqITION ❑ REPAIR—_❑ RENEWAL C FIRE DAMAGE ❑ DEMOLITION
It RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS F-1 PATIO ❑_CARPORT ❑ GARAGE n STORAL-E ❑ SLAB_._] FENCE
OCCUPANCY _ t i LAND USE ZONE - Er!4-A BLDG.TYPE --AN—FIRE ZONE PLAN CHECK BY !C HEAT _.
r
SEWER PERMIT#
OCC.LOAD FLOOR LOAD_COW:.HEIGHT NO.STORIES 1 AREA 4 QQ__N0:_8EDROOMB VALUE S,�(10.
_ BUILDING DEPARTMENT SET BACKS FRONI REAR _ 6 LEFT SIDE +Q RIGHT EIDE_ -
Permit 50.50 I THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT fHE
Plan Check 32.83 WOCK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATION!) AND IN COMPLIANCE
WtTI ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal a3*33 REST 11CTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINEw
�u 1 LICEI�SE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEA1ING.
State Tax 2•U2
SC
Total 85.35 1. .
PDC# iki'M u:ANTOR ADEN-
By Cz
Receipt No.
Approved Bat ADDl1Et38
DATE JINSP. TTPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
1wzdj_-f-—6tg Rough-in
Fixture
Final
T
7�N__
HEA1
Contractor
Permit Na.
Got or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
— Storm Dralnepa
(linin Drain)Final
Sidevvelk
Curb&Street F Inal
Appras!!h
t
HLno. Drolt. rMI.I. TEMPORARY CENTIFICATL OCCUPANCY Final
MRTIVICATE OCCUPANLY
Landwaping
7,),%lnV Fimil
441
Ad�iress "qj2.hit d3atre�r r.u C h Permit No.
Name of Occupant Permit charge
�- Connection fee_
Paid by
Date connected_ /-2
Type of Building ______�— Inspection
Service Rate _ Paid by _ -__Date_
Contractor _ _ Assessment--_- __Paid
Size of connection____._.__
PE'FIMIT TO CONNECT
Tigard Sanitary District
r.0e.
PERMIT No 9(2 DATI: -
PERMIT IS GIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DOSTRICT
AT
THIS PERMIT MITST BE POSTED ON THE DESCRIBED PREM119E8 UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $..... .........................TIGARDSANITARY DISTRICT
By
�fw��iGraww�ww
CONNECTION INSPECTED AND APPROVED
Date Superintendent