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vNSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 6394171
Type of lwocti.m
Date Reque rted 11- 12— Time _-_ A.M. P.M. a
r
Add,esa Permit
Owner ,lQ(/jyy, LZ,trt1-C,'I.. Lot #
Builder
1 The following Ruildfrtg C, w deficiencies are required to be corrected:
O�v �L=lc _�. r^'``A ✓.v LJ ✓ —_—
t
-_1_'x.l..���p,E' r'�►i�.�.ice rF'i-�
Presented to ..
-- ❑ Approve•I y
r' Inspector � ' l
Disapproved �
Date
CALL FOR REINSPECTION
G ' YES 0 NO
BUILDING PERMIT APPLICATION GARD GATE_ ,luny' 19_.._._.
THE UNDERSIGNED HEREBY A rPLIES FOR A PERMIT FOR THE WORK HERE10 INDICATED BUILDER PHO14E
OR AS SHOWN AND APPROVED IN THE ACCOMPANYI'JG PLANS AND SPECIFICATIONS 'WNER PHONE
40111111110 LOT NO..----., 16
O%1V N L R
O..----.16O\NNLIIADDRESS -1s. .�y.
bvtn.9700fw ARCHITECT
ENGINEER
BUILDER Sazie ADDRESS 16795 SW Se r� Nst DESIGI',ER
STRUCTURE El NEW ❑ REMODEL El ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE 0 DEMOLITION
C1 RESIDENCE U COMM ❑ EDUCATIONAL ❑ GOVT 0 RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STOPAGF. Ll SLAB❑ FENCE
OCCUPANCY ._ -�LAND USE ZONE BLDG.TYPE __._ �FIRE ZONE _PLAN CHECK BY t1G; HEAT,Gax
c onetruct mint,1e f4w)-ty twelljn,:� w/ettachedegarnite. -
!�ub'ect to 4360.00 &cart/Bed vwe)ud Sewer Surcharge 6 $150.OU Leron
II40hSts Sewer Surcharge. 3 Itathruor. J1 Redroun
SEWER PERMIT# 279t)6 Gera ge 50t)
OCC.LOAD _ FLOOR LOAD 4U HEIGHT 16 NO.STORIES _2 AREA 2697 NO.BEDROOMS 3 VALUE IU3►uuu.
BUILDING DEPARTMENT_ SET BACKS rlloNT 71 `REAR 27 l EFT SIDE 5--6 RIGHT SIDE 4l(,
-- -
Permit 41U.') ' THIS PERMIT IS ISSUED SUBJr..T TO THE REGULATIONS CONTAINED IN THE BUILDING COOL, ZONING
REGULATIONS AND ALL APPLICABLE: CODES AND ORDINANCES. AND 11 IS HEREBY AGREED THAT THE
Plan Check Ztt6.34 _ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THF: ISSUANCE OF THIS PEFf.11T 1,3CS NOT WAIVE
Sub-total_ 690.ts4_ RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE: CURRENT CITY BUSINESS
State Tax
15•�2 — LICENSE.SEPARATE PERMITS REQUIRED FOR SEWFA,PLUMBING AND HEATING.
SDC- .�. .,. .
Total 1 1 st).U11 `".
--. I�,C�i���., - -- -- -- - -
(;11 tiSIJ[: 2S(1•UU APPLICANTORAGENTBy _
Receipt No. -
Approved ADDRESS PHONE
DATE INSP. TYPE INSPECTION --
REMARKS PLUMBING
DATE
1 Contractor �( /JJJ—
_ --
'���J��/���/" _ r I Permit No..
Rou -in
4V A�
F i x tura '--
hC final
� HEATING
W _—..
�- — Contractor
Permit No. 7�
Gas tx JII
Rough-in —
I._._._..
SEWER
Final
DFIVEWAY
- — Final
Storm Drainegn _
— (Rain Drain)Final
-- — Sidewalk
Curb d Street Final
BLDG. DEPT.FINAL TTEMPORARYAoproech
CERTIf KATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping ~
—` ---� Zoninq Final