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City of Tigard
INSPECTION REQUEST
for
IINSPECTION IME : PERMIT N
DATE: ,---' DATE I SSJf.D:--j '
0 W N E R S NAME
` ADDRESS :,Lc/- C6
CONTRACTOR .'—
TEST .
ONTRACTOR : _TEST. Air O , Water Q , Visual C , Laboratory C
RESULT. Appr". ed , Disapproved ❑ , Pending
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PERMIT CHARGE � none
OWNER +.' i _`�`�`-- _.__.____ CONNECTION FEE
PAID 13Y
DATE CONNECTED
TYPE OF 13 U I 1.`I"'G _ 1 - �- --�-•= --
SERVICE RATE Q-t.. ,-�-e..� � INSPECTIO14 FEE -f
CONTRACTOR DATE
-_ --- _ _.__ PAID BY
AS5ESSMEN ' PAID
SITE OF CONNECTION . _. - .� _ ..
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME .' � �, PERMIT NO. :—_
DATE: /1211d; _ DATE ISSUED : LZ
OWNERS NAME : _
ADDRESS:
CONTRACTOR : .A !ta_� *oq-c
TEST : Air p, Wafer, Visual, Laboratory p
RESULT: Approve 2z , Disapproved D Pmnding p
SKETCH:
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INSM',TOR DATE
rNOTE; Attach supplemental test data bereto7
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CITY OP 9..1 i15 N° 0494
BUILDING PERMIT APPLICATION TIGARD DATE 19
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HERE114 INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.L�TN�R PHONE. —
OWNER munograon Hames ADDRESS 11400 3,U, Ironwood Ui BUILDE
_— kR PHONE
ENGINEER
BUILDER ownex ARCH17EQT _ DESIGNER —�
STRUCTL'9E ❑N:W ❑REMODEL ❑ADDITION_ ❑REPAIR ❑RENEWA.. ❑FIRE DAMAGE _❑DEMOLITION
❑ RESIDENCE ❑COMM ncDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CVNDITIONAL USE ❑DESIGN REVIEW ❑",OUNCIL APPROVED L.JSIGNS
OCCUPANCY__._LAND USE ZONE--_. BLDG. TYPE FIRE ZONE_ PLAN CHECK BY I HEAT
construct 1:;th6 sq. ft. frmmw dwelling with attached garsgG —T--
no besement
-- - — 3 l'eodraom•
---- 40 lb - I56�a ��. Iii "
UCC. LOAD_ -- FLOOR LOAD — HEIGHT NO.STORIES AREA -_ VALUE
BUILDING DEPARTMENT 60 Z
---- SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit 1k7.uo
------_— -- -
-" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check 11).�(� REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
--- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WI1 H
Recording ALL. APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND ;UB CONTRACTORS TO HAVE CURRENT CI1 Y BUSINESS
1%State 3.111 LICENSE SEPARATE PERMITS REQUIRE[) FOR SEWER, PL-MBING AND HEATING.
Total 140.01
By _
— ----- APPLICANT OR AGENT — — ---- _�
Approved r s Receipt No.
ADDRESS NON
MA
"EMARKS PLUMBING DATE
DATE INSP. TYPE INSPECTION _ --
Contracto
i Permit No. d
Fixture
Final
-� 7 — HEATING
�1 ContraENo.
s ,.
4L__ -- Permit
Gas or Oil �—
,nal —�
--- - _ SEWER 4 �
— ----- -------- ---------_--- Final _
�. _—_—.,------ -- ----- - _— DRIVEWAY/k/®.7 of
_ —___._._ ---------- Filial _. ----
Storm Drains -
- (Rain Drain) Final
—T-- ---- Sidewalk
--__-- Curb&Street Final
------ L
— FLandscaping ach I/--
BLDG.DEPT, FINAL TFhAPORARY CERTIFICATE OCCUPANCY _
CERTIFICATE OCCUPANCY �—1417- 76 /
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MONOGRAM HOMES
JAY HARRIS 4@4"4W
1930 S. W PARKW(`C)D UR
PORTLAND, ORECION X7216