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City of J- igUr (A
INSPECTI ' 44 REO c & ,
for
INSPECTION TIME : PERMIT t t . , ._. . 9
!
UTE" -Z7e� DATE ISSUED".J-1- a4
OWNERS NAME : � CZ��CJ?h►'�
coh >I RAisTOR :__-.-_
f
TEST' Air 0, Water E , tiinual 7 , Laberatoty G
I RESULT: Approved EJ Disapproved C] I'elhdrt,
SKETCH:
I
INSPECI'O"�I DATE
CoTF Attach eupp!ementaI 1eii data Of
"
�rrfarrr
C", ty of Tigard
INSPECTION REQUEST
f o r
INSPECTION TIME :
PERMIT'
NC). .--.--
DATE : 4L-s 416 DATE ISSUED ,
OWNERS NAME : I
2�.1,f—git— 1'4�211`.-----.
ADDRESS: 11-32.1 "_)d(4)
CONTRACTOR
TF ST � Air [-j, Water El , Visual L ci cor(3tory [j
FOESI.,ILT: Appr�,vad Dien )pr,)ved _Fj Ponding
SXETCH.'
INSPECT(iii '4 1'E
50TS: Afto(-h -vpr-leroert�l isst Jolo bore' -1
i
i'
C
PERMIT N0.- 4.
i
PERMIT CHARGE none
OWNER _ ...... CONNECTION FEE
....�. PAID 8Y
TYKE OF i311ILDING _ DATE CONNECTED
SF:RVICF: RATE `� -�u-� lK�.� INSPI-CTION FEE
CONTRACTOR �. ��'-�� -- - PAID BY _ DATE ,., ....�
SIZE OF' CONNEGTION �._ ASSESSMEINIT PAID
V
City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME :__ PERMI'r NO. :
DATE ISSUED:..]
OWNERS NAME :
ADDRESS :
CONTRACTOR :._
TEST: AirD , Water [3 , Visuafo, Laboratory []
RESULT: Approvers t-y , Disapproved L , Pending
f
SKETCH:
I
I
I ,
I
I 'PECTOR DATE
COTE : Attach supplemental test data heret]
"'0000"0-1 WRX 04400" sm"
CITY a' Jon 19
BUILDING PERMIT APPLICATION TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR 'THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE--
A D A R'
BUIOLR PHONIL____
ENGINEERrn-3 'i ,i:le r, DESIGNER
STRUCTU'"iE C3 N[W-0 R E MODE L OADDITION Q REPAIR CIRENEWAL. OFIRE DAMAGE CIDEMOLITION
0 RESIDENCE OCOMM OEDUCATIONAL EIGOV"I DRELIGIOUS DPATIO OCARPoRi EIGARAGE 0 STORAGE DSLAB EIFENCE
0-BOND 13MOVING [:]CONDITIONAL USE LIDESIGN REVIEW 000UNCIL APPROVED
EISIGNS
OCCUPANCY---LAND USE ZONE --BLDG.TYPE—.____ _FIRE ZONE-- PLAN CHECK BY—
!%Act 114T) .!rig III t&Q.'1C 4 �,uraq;e—nci
3 br4irom
O_C�C. LOADFLOOR LOAD lb — - Ic/)6 290000
___HEI_GHI NO.STORIES AREA VALUE
BUILDING DEPARTMENT 15 1.0
SEI BACKS FRONT— REAR LEFT SIDE RIGHT SIDE
Permit )2/4.
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATI(INS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 1-GULATIONS AND CLL APPLICABLE CODES AND ORDINANCES, AND IT 13 HEREBY AGREED I HAT THE
Wl.*01<WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL :`IPIICARLF uODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
REST14wilvE COVENANTS. CONTRAC70R AND SUR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
196 State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
APPLICANT OR AGENT
Approved Receipt No.
ADDRESS
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor """
/
--5216 P v Y �— - Permit No. O 3 �- J `7'�a1j6
��' '6 Rou-vh-in
IU M6( Fixture "
►' Q' - ---- Final
L�. ��� M HEATING
Contractor
c/�30-711
r 1 Permit No.
Gas or Oil �..—
__ -k/i -^ Rou h m _V
Final
--—-- - - _- ------ -- --- - ---S E W E R J- -;*
Final _
DRIVEWAY
_ - - - Final
Storm Drainage -
(Rain Drain) Final _—
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE O)Ll ANCY - ------ --
q - -30 - 1 N{� Landscaping
QP— Zoning Final
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i MONOGfM HOMES
JAY HARRIS
6404100
11125 S. W. 2nd
NFAVEATON, 09 97005
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