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City of Tigard
INSPECTION REQUEST
for
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INSPECTION TIME: %t' ' /�' PERMIT NO. : ._
DATE: - DATE ISSUED :-
OWNERS NAME : Z-/(:;;
ADDRESS: / S u''� --1—�ovee.�s'o!� ap
CONTRACTOR :
TEST : Air 0, Water❑ , Visual a, Laboratory p
RESULT. Approved W, Disapproved 0 Pending p
SKETCH; 74"L. T--- ,A'f�/�C�-
INSPECTOR DATE I
FN07EAttach tuut,'Pmentn.l to-it data 6es•et�
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City of T ; gard
INSPECTION FRECU EST
for
IINSPECTION TIME :� PERMIT NO. : _..
DATE: 1 r®/76DATE ;SSUED: _.1
OWNERS NAME Z
IAD DRESS . y_ �"• -
CONTRACTOR '
TEST: Air C, 'Water 0 , Visual C , Laboratory 0
RESULT. Approvsd r :);sapproved 0 , Pendiog
I SKETCH.
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INSPECTOR DATE
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IN OTE: Attach supplemental tes, data here!
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CITr OP 211 7� Na 0655
BUILDING PERMIT APPLICATION TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OWNER PHONE—
Op Ate' SHOWN AND APPROVED IN THE A�CUMPANYIN3 PLANS AND SPECIFIC 7
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�1 bl-.• t t'onwoo a.►li,ab111LDER PHONE
ADDRESS _
-
ENGINEER DESIGNER
alliLnER _ _.
�� �� r-1 rr--�� ^ ❑pEMOLITION
STRUCTURE_ LINEW ❑REMODEL _ DADDITION _—LJREPAIR— ORENEWAL FIRE DAMAGt
r� 1 ❑STORAGE❑SLAB ❑FENCE
❑ RESIDENCE COMM L.IEDUCATIONAL_IJGdV'T_�REL�GIOUSnPATIO ❑CAR PORT �GnRAGc �.c
❑BOND ❑MOVING OCONDITIONAL USE ❑DESIGN REVIEW —LICOUNCIL APPROVED ❑SIGNS
HEAT
— -- T _ — }�!7TYPE r` ---FIRE ZONE.__` PLAN;CHECK BY C8 _—--
OCCUPANCY LAND USE ZONEr--- -
construct 1520 sq. tt, frame duelling v4th C Adf- -kQ gerags
nu `)ssalment ticcording tO UNPa k.:u d plans _ -
a 6V a 3 bodroums _-
AREA VALUE"
H"IGHY NO.STORIES �p
OCC,LOAD FLOOR LOAD —
REAR LEFT SIDE RIGHT SIDE
BUILDING UEPARTMENT SET BA FRONT--
ld6.OU ZONING
__---
Permit
THIS PERMIT IS ISSUED SUBJECT TO THE pEGULATIONS CONTAINED IN THE Bt11LDING CODE,
Plan ChPck t0�Q0 WORK WILLODE DONEALL APPLICA
IN ACCORDANCE WIBLE 1r, THE PLANS ANDS SPECIES AND ORDINANCES, FICATIONS AND N COMPLIANCE IT IS HEREBY WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
AND SUR COTRACTORS To HAVE
196 State
t���� IRECENSETSEPARATE PERgIIITSO EGIAFEDRFOR SEWER PLCURRENT CITY BUSINESS
UMBING AND HEATING
Total — k� ., 7 — — —-----
By _ _ - -�_ APPLIChNT OR AGENt
Approved Receipt No. �.-----
.�___
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DATE - INSP. TYPE INSPECTION REMARKS PLUMBING UA•i F
Permit No.� " 3 -/S- 35 �i o/-7
Rough-in —
Fixture
Final
.3 0-1 `tt&-e -_ HEATING -
��'✓ ,, 3.i! -_ Contractor -„�.r•�.�-�-
.. f' -- Fey mi I No. -_—,,�5�_— /0/7G
/m 7G - ua.c �F'_ "'� v cJ�✓_� yu Gas or Oil
Rough in — ------
Final
!- SEV.ERa -/0Ib
Fina',
_ _--_--- ------- - DRIVEWAY .L C </•-g- 7G
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Slreet 'Final
-- ------ _._—.------ Approach --- - � C ,�_ i-;7(o
BLDG.Dl".FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final -- —
Landscaping
Zoning Final
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A D D R E S S _ .,�- ""K� � .,, , PERMIT N 0._.
PERMIT C!IARGE none
OWNER <• CrNhlF"CTIUN FEE cl_
PAID BY
TYPE OF 6UILOINCi/c R,x �—='-- _ DATE CONNECTED
0
SERVICE RATE INSPECTION IJE J—
('0 N T R A C T O R . _._ _ _..._ ___�..` _ . PAID BY _ DATE
SIZE OF CONNECTION ASSESSMENT PAID
�. L. LIGI-iT1
�jnstrurct;on Co.
15F90 S.W. Colony Drive / Tigard, Oreg,)n 97223 / Phone 639 8560
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