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BUILDING PERMIT APPLICATION of TIGARD DALE __ ___-__ _ . 19--- 2!a,'Mit43-5
TNC URCERSIGNELI HEREBY APPLIES FOR APERMIT FOR (HE WORK HEREIN INDICAI-ED BJILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNr.RPHONE
Me 11111>r o LOT NO—
OWNER
JO_�---
OWNER % Paulply srf JOEI ADDRESS ---- 5l.1 �rU111JG1; 1 �OKIt)'VIE AUDFtESS
ARCHITECT
I---NGINEFR
BUILDER _
Construetion ADDRESS_+• __ y36 �!t1�7.'►d I�V{?t'!',i$ _ DESIGNER" '__
STRUCTURE ❑NEW _Cl RFM('DEL OADDI-TION REPAI
__ l1 �iUpENEW��AyyL L]FIRIcD_AMAGE FJ IEMOL1710N
O RESIDENCE OCOMM DEDUCAIIONAL _OGOV'T OREI-IGIOUSOPATIO (ICAV r'ORT L_1GARAGE _r-�STORAGE SLAB ❑FENCE
L_19UfID ❑MOVING; -]CONDITIONAL USE ❑DESIGN RF\'It:W OED
COUNCII. APPROV _ DSIGNS_ -_-`
—_ -
OCCUPANCY ft LAND USE ZONE —p f (ALDG.TN'PE_-----_FIRE 7001—. PLAN CHECK RY_-__- _ HEAT-
------po_ ger fire Vama )$I all pi r 11,600. C Ode ------ ---- _ _ - - ---
()U- QA_f?-- F 4Q09-LQ,-07 _ li€LG!�L__-.____�N�'_.&IQ�IF�fz__.----�E14:A_._--- 1121 �L'►S?9.MS_- —YAL4�1_�_
BUILDING DEPAR'fMENI _ _I FET 110,CK°, FRONT REAR LEFT SIDE RIGHT SIDE
Permit --- —..�-_-—-- �— — .-
-
12.60
'x,.41$ PERMIT IS ISSUED SUBJF-CT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE, ZONING
Plan Check • '1EGULA'TIONS AND ALL APPLICABLE CODES AND CROINANCES, AND IT IS Ht'rIEBY AGREED THAT THE
"/ORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATICNo AND IN COMPLIANCE WITH
Sub-total �h•1a 1 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PcFIMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SI.IR CONTRACIORS TO H' v'F CURRENT CITY BUSINESS
State Tax
I (] -- LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND N},ATING.
Total 3G+471 -- -
9Y P .
---
�y. / APPLICANT OR AGENT
AtlprovlT�i Receipt No.
1
I
I
City of Tigard
XtINSPECT!0N REQUEST
f o r
INSPECTION TIME :. PERMIT NO.:
DATE: AL1.'(- DATE ISSUED:_...Z
OWNERS NAME : A , ' L
ADDRESS : - L327S �hG 1 k•ro 1 Lr•ry
C 0 N'r R A C T O R :__--— _-_-__ ---- --
TEST. Air O, Water p , Visual K, Laboratory 0
RESULT: Approved , Disapproved ❑ Pending [7j
SKETCHY: . -
.77.74
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INSPECTOR _ 7
I INSPECTOR
rI 01E . Atioch supplementol taft dato he►et:0]
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City of T- ogord
SPEt"3 TION REQUEST
for
iw;PECTION TIME . PERMIT NU..
j
DATE : __ 1 >b BATF
f OWNEWS NAME '
ICONTRACTOR - - - - -
TEST' Air O , Water p , Vis al Lobo roto , ;]
I -
RESULT_ Approved _ Disapproved Pending
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SKETCH: j
IS PPROVEC)
TIGARD
DATE
(
INSPECTOR DAf E
[OTEAttach tsuppisme to test data here
j
City of Tigard
t.
("INSPECTION RE0UE %,_'N
for
IN-9rjFCT T
ION 7IME I #�-_ PERMIT
DATE _Y_LLLh(_ DATE I SSUC0._,.'--
OWNERq NAME : , 4& 7Z-
AD DR F S S : . Aw X.P".
TEST*. Air 0 , Water Ei , Visucil9l Laboratory Cj
RESULT' Approved 0 , Disupvroved )(, Pending
SKETCH �...._._._:',,,,. =----u— � !,�i�. /� �
-
ep
INSPECTOR DALE.
LOTE Ptoch supplementol fest d atu nor.,
I
1
RECUEST
fci
r
04S?E4T�OM TIME : PER"!!.'f
NATE: 3 L'/6. 4 AT E ,SSJEiD:..�
i �•� %- �' ,ti �IUnea•ia �a1' tl
A D F .,J . _ I
TEST' a:rZ , h"19T J :11 SJ [� Q'J�•7�^'V
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amity of Tigard
INSPECTIGN REQUES -F
for
INSPECTION TIME: PERMIT NU.
DATE: —=L2212-6- DATE ISSUE
L D .
OWNERS NAME
ADDRESS ' I!JJ
C 0 N T R A C T 0 R
TEST . Air 0, Water El , slisual k, Laboratory C
RESULT: Approved Disapproved 0 Pending rl
SKETCH,
IN,S)PECTOR DATE
LN C't V A f f c r f L
7A1 i AR ■R Aw � � AIR ! AR �
��00 I
City of Tigard 1
INSPECTION REQUEST
for
INSPECTION TIME: _ PERMIT NO. :—
DAT E:
O. :_DATE: .X LA/Z DATE ISSUED :-
OWNERS
SSUED :_OWNERS NAME : *------
ADDRESS:
CONTRACTOR
7EST : AirC, Woter� Weual'�, Laboratory (]
RESULT: Approve , disapproved 0 Pending p
S KETCH
I j
A
INSP CT R DATE
[NOTF : Attach suppismental test data b ;r, J
Y..irIA1Mr v�H r•..yiw.�.•..�ry�-...•w•n+..r•wW.r^...., i,y. n;aA•NMM•,ylwr;,.
CITY OP ___ �BV�
BUILDING PERMIT APPLICATION TIGARD DALE_ ,9 75 X10
THE UNDERSIGNED HEREBY APP( IES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED INT CQMPANYIN E(:IFICA IO S. OWNER PHONE
t AC ,th*M fMp � �c.� 5�3 ,artc�lowv�r� aub�s,.
>ck: Lutz R4. l.0 r _ ADDRESS � � ��IX ) + xl�l
QWNER UILDER PHONE _
ENGINEER
(1,�c1�►r
� —• __� ARCHITECT —�__. DESIGNER
�STRUCTURE ❑NEW REMODEL ❑ADDITION_ __ OREPAIR"ORENEWAL OFIRC DAMAGE. ❑_DEMOLITION
LJ RESIDENCE El Comm OEDUCAl ZONAL ❑GOVT ❑RELIGIOUS OPATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB []FENCE^DBOND ❑MOVING OCONDITIONAL USE ` —ODESIGN REVIEW ❑COUNCIL APPROVED Y_GSIGNS _
OCCUPANCY LAND USE ZONE �-7_BLDG.TYPE. 4' —F!RE ZONE—L PI AN CHECK BYE HEAT 1 _
---- -.- construct 1457 aq* ft, frame dwallifig with attachay) garage
-------_"-- no accordin to Approved plana reissus 1133 — ~
3 bedrantt l'
QQC. LDAs ,FLUOR LOAD 4(3 lb' HEIGHT _ NO.ST_OFiIES 1 AREA Jl929 VALUE �i 0 �
BUILDING DEPART"MENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 1311.00 -- -- -- --
THIS PERMIT IS ISSUED SUBJECTTO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Pian Check � A*00 REGULATIONS AND ALL A.,PL.ICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State 4.,17 LICENSE. SEPARATE PERMITS REOUIRED Fr)R SEWER, PLUMBING AND HEATING. )
Total 153.17 !
By
�._.._—..__ __ APPLICANT OR AC3ENT ..._.._...._.....
Approved Receipt No.
__ AbOrtF55 ON ----
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t
DATE INSP. T1"OE INS ECTION REMARKS PLUMBING DATE
-
_ Contractor
4,4 1 , -ISL. 7 -- Permit No.
7 Rough-in
Fixture
Ir 1115 Final
HEATING
1�+/
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Permit 1 ;l. ���' 7G
_. G=as or Oil � 2
Rough-in
Final
SEWERo7--/y-76 --
— -- ---------- Final —
ORIVEWAY
— Final
Storm Drainage
(Rain Drain) Final
—__ Sidewalk
Curb&Street_Final _ —
_— __ A roach AC ��-�7-7e
BLDIi. ':JT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
c''��g✓�� CERTIFICATE OCCUPANCY Final
l.4ndscaping
V
loning Final
li
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,1.
ADDRESS // '7 �j,.� . _�,-.�. � __.. .� ;y' PERMIT NO. P6
PERMIT CHARGE none
OWNER _ CONNECTION FEE 4S,SZJ
PAID BY
TYPE OF' BUILDING DATE CONNECTED
SERVICE RATE r q.1 c, INSPECTION FEE - S-
CONTRACTOR PAID BY GATE 51��
SIZE OF CONNECTION ASSESSMENT PAID _��
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