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INSPECTION NOTICE
City of Tigard Building oepartment
12420 S.W. Main St.
1 iyard,Oregon 91223
Phone: 639.4 171
Type of Inspection ---
Date Requested_ -� ��� Time _ A.M.------ P.M.
Address - ��CJ —A� --C l_ a� Permit #_
Owner . _ _ �__� Lot #
Builder — --.--- --The following BuiWinq Code deficiencies are required to be corrected:
c. C--
-
Presenter) to _ __ Approved 1
Inspector _ � - � Disapproved
Date
CALL FOR REINSPECTION
0 YES ® NO
w v.r
BUILDING PERMIT APPLICATION TIGARD DATE—Lgi 1_,_ a10 19__. 428
9 i
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR If HE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
4 LOI NO
OWNER .11'CliORI'TIOBADORESS' t �) 101401 S. '. c+1 :lnt Court
ARCHITECT
B ILOER ; ',mac r 10,100 f nC. ADDRESS
STRUCTURE 0.*NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR _ ❑ RENEWAL ❑ FIRE DAMAGE_ ❑ DI-MCLmON
M RESIDENCE D COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO n CARPORT ❑ uARAGE ❑ STORAGE ❑ SLAB C! FENCE
OCCUPANCY-_- LAND USE ZONE -BLDG.TYPE FIRE ZONE PLAN CHECK BY '"1 HEAT
Rr3j,ssum Of N(-rmit 4 ( 1 1290 SIN' )kith Avf, 1 Hc_'aIr , ;•;
SEWERPERMITN
OCC.LOAD FLOOR LOAD ;1 HEIGHT le 3 NO.STORIES I AREA NO.BEDROOMS VALUE
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND If IS HEREBY AGREED THAI fHE
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
Sub-total l •!)fl RESTRICTIVE COVENANTS. CONTRACCOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Stale Tex
f LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC- 400
Total
- - PDC# r 1 00-0 El APPLIOI* f oR AGENT
By
Approved Receipt No. ADDRESS -PHONE
I
I
DATE INSP. TYPE INSPECTION REMARKS
PLUMBING 3 ' DATE
----
-y� --r rontractor
Permit No. `-
=�o v
Rough-in
Fixture -
-/�-27J I ,,. ✓ Final -- --
..3' HEATING '------
-� Contractor ,/�oA 777_pWle,
Permit No.
-ZSOy �w T
Gat or Oil
Rough-in -~-
- Final -
SEWER y —
Final //-
DRIVEWAY --
-- — - Final
Storm Drainage ---
- (Rain Drain)Final
Sidawall; - - -
- Curb&Street Final
��DG. DEPT.FINAL
Approach
�"lt7lpl MP OCCUPANCY ORARii CERTIP9CATE OCCUPANCY Final
ILandscaping
�_ Zoning Final