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INSPECTION NOTICE
C;ty of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date R iquest d me ) A.M�_P.M.
7
Address -_.__1/_j;T _._��` 1 ( v l Permit # ��
{ OwnerLot #--------- --- --- -
Builder
The following Building Code deficiencies are required to ne corrected.
s
Presented to Approved
Inspector _ ''may �_-] Disapproved
Date - --- — -— —
CALL FOR REINSPECTION
❑ YES 1ZNO
I
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-417j-
Type
39-417yType of Inspection �_ _?�'✓
Date Reque•ced S / Time A.M. P.M.
Address �
—_ Permit #__ �
Owner_ Lot #---,—_—_--
Bu'ilder
Thv,i,:!lowing Building Code deficiencies are required to be corrected:
Ar
�._�r_� .r � �sZ...i11.-....–� ,ems-•.7�i.�' 6 —
Presented io _ -- Approved
/1""
Inspector ❑ Disapproved
Date ---__—-
-`� ;_Z?,
CALL FOR REINSPECTION
YES X� NO
CITY OF TI .a R� w
12755 S.W. ASH
P.0.130X 23397 i
TIGARD,OR 97223 Date ' y
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Name
A r
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dd ess i
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Lot % BlocklMap_ Subdivision/Address--
Bi
ubdivisionlAddress '
"�'. i % 1U
Permit N's Btdg• Plumb Cash Check --
Sewer Other Other Rec. B i
� Syr
t�
Acct. No.
Description Amount
10-43210.432 Building Permit Fees
10-431-606
10 431 800 Plumbing Pe►mlt Fees
10-431.601 Mechanical Permit Fees _ j
10.230.501 State 1310. . Tax
10-433 Plans Check Fee 1 r
10.435 her Licenses 8 Permits -- i r
30.443 Sewer Connection 1 ,�-
30.444 SewerIns ectlon r
24.448 Street Syst. Dev. Charge
25 449 610 !'arks I S st. Dev. Charge _
25.449-620 Parks II Syst. D_ev, Charge
31-450 Sbrm Drainage Syst. Dev. Charge
10.430 Business Tax _
10.434 Alarm Permit
10-227 Bail r --
10.455- ____ Fines • TrafficlMisdlParking —�
10.230• — CPTA TrafflclMisdlVic. Asst.
10.456 Indigent Defense a
30.446.401 Sewer Service/USA
30.446.402 Sewer ServicelCity —
31.447 Storm Drainage
46-475 Ban—croft—Prin. Pymt.
40.471 Bancroft Int. mt.
10.451 Other Char e-sfor Servicrs
TOTAL s I
0" CUSTOMER
y
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1
BUILDING PERMIT APPLICATION TIGARD DATE _tea _—'1985 5351
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH EWORK HEREIN INDICATED BUILDER PHONE 691-3615 _
OR AS SHOWN AND APPROVED IN THE A.,GOMPANYING PLANS AND SPECIFICATIONS. OWNER PHO E
LOT NO. _ (y
OWNERlay tsfllez JOB ADDRESS _ iiZU Su ikOud Iiutxl Park
P,o, riox 23291 ARCHITECT
ENGINEER
BUILDER SMt. ADDRESS _'eilard. OR 97122'_-- __DESIGNER
STRUCTURE 113 NEW —_❑ REMODEL ❑ ADDITION ❑ REPAIR LJ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
=RESIDENCE ❑ COMM ❑ EDUCATIONAL ElGOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE EJSTORAGE ❑ SLAB❑ FENCE
OCCUPANCY R-3 LAND USE ZONE �'(2 __BLDG.TYPE —SN _FIRE LONE "" PLAN CHECK 81' _ T _HEAT_ ft# -
-—
'iA)nstruct single fauaily dwelling w/attached garage
—3 bathrooms 3 bodrwms Garage 440 _
SEWER PERMIT# 26410
OCC.
— — - ------
OCC.LOAD FLOOR LOAD 40# HEIGHT 2U+ __N0.STORIES_ 2 AREA 1578 NO.BEDROOMS 7 VALUE 54*000
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR 52' LEFT SIDE 1"; _RIGHT SIDE 6
_PerrTili 295.UU __ THiS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
75 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREEC THAT THE
l91
Plan Check -: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
Sub486.75 total RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I,IG NSE.sEPAR 77 PERMITS REOUI RED FOR SEWER,PLUMBING AND HEATING.
State Tax �'" 11.80 f. �., s u. 1�
498.SS SDC— 500,00
Total2 1 S0•UU 'APPLICANT OR
-- — —� PDG#
By
— - —------- - Receipt No.
Approved--- -1T/E1'�+'.a-�7! AnDREBS _ PHONE
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DATE1112p, TYPE INSP'-,'I7:lI _ __--- ^' tE14AI,I( --' I.UItPIN
_ '
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cur.el Oil
URIVrNAY
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Sidaknik
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