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ity of Tigard
i NS-sP CTION REQUEST
for
INSPECTION TIME: � ' PERMIT NO. :..______..
DATE ISSUED '._.__I
OWNERS
CONTRACTOR : -
TEST : Air
ONTRACTOR : _TEST : Air rj, Woter r] , vieuol '; , i.oborotory C
F+ESt,iI.T' Apprcvoe, Disupprov,�d r Dending [�
.._...__ - 7--...__
SKETCH.
'lit'..PE".CTnFt DATE
Cyr 7I. Attaco *up"cli v ,r.l ; l:' :fo.a b,-
City of Tigard
INSPECTION REQUEST'
for
INSPECTION TIM."' _. � PERMIT NU. :_
^,ATE : La23/7�„ DATE ISSUED .—..1_L__
OWN ERS NAME :
ADDRE 7;: _-
TEST ' Air Cj, Water � , visljc 41 I..oboratory p �--�
RESULT' Approved Disapproved 0 Pending ['I
SKETCH; _
I
I PtCTOR DATE
I
i City of Tigard
INSDECTIOM REOUEST
for
I INSPECTION TIMEPERMIT NO.: ._._,_
i
DATE: DATE ISSUED:--,
OWNERS NAME :
ADDRESS : /-C, 'i `� 1/l366
I CONTRACTC-)R : H /a�f_/c'N
js/-ih L—
1 TEST: Ai► D, Water p , Vieuc:l X , Laboratory,-:,:,_,,
RESULT: Aaprnved , Diaaprroved s/,, Spend,
SKETCH: 12,00�T,ZWi- 6� �'' • ��i�h7a'K",�;�
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INSPECTOR DATE
CNOTE : Attach supplemental toot data heret�
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, «..... y .- . w• ve>. ny,yyy/MYIV��i....pr:t,MM1M _, .. _ - .ahy.y�p� ,gw�Iw M►.�Ur•�'�'M...'ir'"•.,.1.. �Ipl/Nb'A�ss.,
CITY Oar +� ?'j�'� 11607
BUILDING PERMIT APPLICATION 'TIG ARD DATE
THE UNDERSIGNED UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATE!.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE .—_--_
NER_ _ ADQRES''i __-_— ^� —.BUILDER PHONE
ENGINFEIi
flUILDER ff--11 __—��_.ARCHIT� T ,_.f_-7���_, _ t—DESIGNER ��`t�!
tS�T�RUCTURE L�Nc'.': ❑REMODEL []ADDITION _IRFPAIR ❑RENT`"'AL UFIrR�EDAMAGE CIDEMOLITION
6,.,1 RrET;IDENIE ❑COMM []EDUCATIONAL DGOV'T ❑RELIGIOUS[]PATIO DCAR PART OGARAGE []STORAGE[]SLAB CIFENCE
L.IDOND ❑MOVING []_CONDITIONAL USE _ IJDESIGN REVIEW 000UNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE—__FIRE ZONE__- PLAN CHECK BY HEAT—.._,,..__
_
construct 1439 sc,• ft, frame dwii icing with atttmchsd �iarxyo
bessment according to aaporowe" plans
3beac a s-- --
QCC, LOAD FLUOR LOAD HEIGHT_ _ _ t,'O.STORIES AREA VA,UE
BUILDING DEPARTMENT SET BACKS FRONT " REAR AMLEFT SIDE 1 RIGHT SIDE
Permit X39,:136•r(--`^�----- --_- -
Flan Check 6 • _—
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULAT:rvNS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE-
WORK
HEWORK WILL dE DONE IN ACCORDANCE WITH THE PLANC AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND OhDINANCES. THE !S;UANCE OF THIS PERMIT DOES NOT WAIVE
1%State ` 4sos RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
UCiEN,'E, SEPARATE. PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
�Q Q
Total _ • 8
By
------- ---r f's — APPLICANT OR AGEN1 —^u ----�—
Approved Reumpt No.
. ._ tJurauwwwr•e.a..,. ADt)RESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractorlti
Permit No.
o. 03
11,
h,)u h in
Fixture Final
->—G
Jc��r�.�-- �-- ------- - HEA'IkU
Contractor rite _
---- �. _. -- Permit No. -
Lias orOi���1 '�]• 2 A—
Rou t in ,--_
Finai
-- -----_---- _.—. SEWER,/-237G
Final _
-._ — -- _.-- DRIVEWAY 74
Final
Storm Drainage _
- (Rain Drain) Final ^
Sidewalk
�— Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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ADRESS 3 ov ✓`•.,;=_ PERMIT 6"s-
Dc�
PERMIT CHARGE. none
OWNER CONNECTION FEE
PAID 1IY
TYPE U UILDING
DATE CONNECTED
B _
SERVICE RATE __ _�_ INSPECTION FEE
►PAID 8Y DATE/
CONTRACTOR
SII_E OF CONNECTION _ _�,..__ ASSESSMENT _ _ PATO
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