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INSPECTION 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.
Address Permit #
Owner Lot
Builder
The following Building Le deficiencies are required to be corrected:
11tamted to Approved
Inspector U Disapproved
Date
CALL FOR REINSPECTION
El YES /I NO
----------
BWLDING PERMIT APPLICATION TIGARD D>TEoecomber 4683
THE UNDERSIGNFL)HEREBY APP It: FORA PERMIT FGR THE WORK F'EREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. '-)WNFR PHONE
OWNER Centgr " ;'I .:0,A85 ,)OBADDRES' 13290 9`49`4BrUtaa1 LOT NO.Dr. _ _ +J>j11tlti' Lake
ARCHITECT
ENGINEER
BUILDER Same ADDRESS _E7.. SFJ BV
.Vs '1f118. iwvQESIGNER`
STRUCTURE IaNEW U.REMODEL ❑ ADDITION _ ❑ REPAIR _❑_RENEWAL FIREDAMAGE ❑ DEMOLITION
Lli SESIDENCE ❑ COMM ❑ EDUCATIONAL 1-1 GOVT ❑ RELIGIOUS ❑ PATIO n CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABU FENCE
OCCUPANCY K"3 LAND USE ZONE PtLLo BLDG.TYPE _ FIRE ZONE. — PLAN CHECK BY i xis HEAT
— --Vc-istruct sin,,le ts.,a ly d,.relli.na
;to Issue of 4532
--_--__ _ -- 2 hiedrocrn 2 ; nthroou
SEWERPERMITk 26479
OCC.LOAD _FLOOR LOAD _4_.) HEIGHT ''_+— NO.STORIES _ AREA l I_-t' NO.BEDROOMS 2 VALUE 50,0,0o
_ BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 2( 3•UU THIS PERMIT IS ISSUED SUBJECT TO IHE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 40.UU 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 323.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax 11.32 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total--- 334.32 SDC- $4U0.0;
�- PDC# I I UU.0t) APPLICXN_Tt AdtNT By Gil _
Receipt No. _
Approved Px'W ADDRESS -- --- --- PHONE
s
i
I
i
- DATE IN8PI TYPE INSPECTION r RtMARKt I ►'LUM.ING- DATE
-7 1porrritNo
1903 0111
" 7 �—/" �4F ,ul —}-- -- -
�f HEATIF40
Cut nutor
_ __- _--- -- --- __
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Curb&Street Final _1.Y
81.6X;. GtPT. F 1j,— ~ CLIF ORARY� CERTIFICATE --
i- V frl CAI. OCCUPAWY lot
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