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^!' CITY OF TIG ARD C
OREGON
Monogram Homes .......Permit No.
Ommer: ........ ...............---...........................................
Building Adcirens... _... ....... .1152D.. SW...GlenwOGd --Ct.
�� �: �•
Certificate ie hereby green this... ..........day of.........p8.nJ8ry....... 14 _77
t that said bui'ding may be occupied and I"
t. that it complies with all requirements of
,I. the Building Code for the City of Tigard,
as approved by the Tigard City Council.
4 PP t
x�
Building Inspector
1dd"
Ir. r 'R � � d�'4A,✓`i;eN�• '�K:7 4i :Z��i A�e*/''`\L f'� , `+;p'Ik'�� �" 7 ,
I
r�
INSPECTION FIEC U EST
for
Z .
INSPECT;ON TIME:_. PERMIT N� .
DATE: ? TATE iSSJ£a: ,
FANNERS NAME: "17.�c�Lt`�✓2G-1Y\ `/��cu
I ADDRESS ;
i 4 T A A w T!�R ;_
! TEST. a rte,, Ai-!?gr J , -li-w:! , -aba*a!o'Y
1 R2 ULT. .;par-,?n _'a:; rw A >»iX
I"
i
I ;A ;PE 0R DATE
A1'aah ha•a!�
City of Tigcrd
Ef-,. INSPECTION REQUEST
for
INSPECTION TIME: . <' PERMIT NO. :
DATE: (L'171,, DATEZ,1014F-s
UED ' _11_
OWNERS NAME : �r-Iz%�2+4
ADDRESS:
CONTRACTOR :
,�,/ I
TEST : Air 0, Water[] , VieuaI Laboratory []
RESULT: Approved , Disapproved ❑ , Pending []
SKETCH:
i
i
1
INSPECTOR DATE 1
N7tE Attach euppiementa! test data hereto]
C �
I
City of -I- igord
INSPECTION REQUEST
for
-- ------- -- 'r
I INSPECTION TIME :-_ PEA;MI'; NC,.: _
I' DATE: .—/ _.L__ DATE ISSUED:—:
f OWNERS NAME .'
ADDRESS : ._ ---� _ - - -
TEST. Air ❑ , Water Visual �J; Laboratory
I
^RESULT. Approved li ' , D�s:pproved El Penn, iy
SKETCH:
i
wap
INS C OR DATE
i
[NOTE A!toch 5upul. 1,entu' test data hsti lul
CITY OF N! 0768
BUILDING PERMIT APPLICATION TIGARD DATE_—___ , 19
THE UNDEFSIGNED HEREBY APPLIES FOR APERMIT FOFt rHE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATION�sj,, QWNERPFfONE
I�anag�ram Har i.2 `�20 5. Glenwood Et. CQ1
OWNER ADDRESS BUILDER PHONE T
owner ENGINEER
BUILDER ry ARCHITECT _— DESIGNER_^�
STRUCTURE LINEW ❑REMODEL ❑ADUITION ❑REPAIR ❑RENEWAL (:]FIRE DAMAGE ❑DEMOLITION
❑ P,FSIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T DRELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE C1 DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE __BLDG.TYPE_ FIRE ZONE. PLAN CHECK SY 'IEAT
rarlatv�cJ;..L J...l.c.. r. 4- rt. frame dwelling with I..,ti,ob w garage S.otri:-,- ---
3 bedroom
j10 lb 1 '1 I.t L)''i
OCC. LOAD_ FLOOR LOAD HEIGHT _ NO.STORIES AREA _ V LUE
BUILDING DEP T "NT ?1`74".. I10
_M� SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
uw — — —
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE REGUL.A'r10NS CONTAINED IN THE BUILDING CODE, ZONING
Plan Cieck REGULATIONS AND ALL APPLICABLE CODES AND JRDINANCES, AND IT IS HEREBY AGREED THAT THE
-- --- WORK WILL BE DONE. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND INCOMPLIANCE WITH
Recorra,. ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE CO':ENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE. CURRENT CITY BUSINESS
1?6 State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
971w..39
Total ,� t
By
— APPLICANT OR AGENT
Approved Receipt No
N fJ'T FATs_s PHONE
DATE INSP. TYPE'INSPECTION RcMARKS PLUMBING DATL
Contractor —
-----��- Permit No. 6 uG
Fixture
Final
lGz� HEATING
-712-q,
/� �sLctJ Contractor
Permit No.
Gas or Oil
-
- ���� Rough-in ..--
Final
SEWS -76
- ----
00
' Fin '
1 DRIVEWAY
Final
Storm Draina e
(Rain Drain) Final
Sidewa!k L C 7-
Curb&Street Final
A roach
BLDG.DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
K.
.r■.rte
PERMIT
—
A D D R E 5 5
PERMIT CHARGE none
CONNECTION F C E
0,JNER
PAID BY ? rte -
. _ _._-__..__�- P A T E CONNECTED
__,,, --_._ -------- -
i�Y P E OF BUILDING lu_s..._-------
INSPFCTI ON FEE �._-a
SERVICE RATE
_,.__�_.___------...-_--.--__-...
PAID 3 Y _.^_____._ ________ D A T E
CONTRACTOR
AS;ESSMENT PAID
SIZE OF CONNECTION ---- -��
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