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ADDRESS /��O l' � - � '. � PERI`1IT NO.
PERMIT CHARGE _ _ none__. _
OWNER A11 ___ r.oraN4 CTIDN FEES
_ PAID BY
TYPE OF BUILDING _`, ��_ DATE CONNECTED
SEFUif_E RATE � _� _.. _ INSPECTION FEE
ICONTRACTOR PAID BY .._ _.__ __.___ DATE
SIZE OF CONNECTION _ A55f_55 '1EN7 __� PAID
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City of Tigard
INSPECTION ION REQU S i,
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for
INSPECTION TIME . PERMIT
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DATE: ATE ISSUE:[
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OWNERS NAME :
ADDRESS
TEST' Air Q, eater ❑ , visua� , Laaorotory
RESULT'. Approved Disapproved 0 , Pending
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INSPECTOR DATE
COTE A'!act- supplemental tett data herei.
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City of Tigard
INSPECTION REQUEST
for
INSPECTION TIME: PERMIT NO.: —
DATE:
O.: —DATE: '' ��.11�� DATE ISSUED:..
I OWNERS NAME : _
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ADDRESS :
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CONTRACTOR ..L-m � -
E T: Air Water, VIaUQLJ I Laborc,tor
I T S d ► �I , � � Y CI ,
RESULT: ApprovedDisapproved 0 Pending []
SKETCH:
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EC OR DATE
IN0 tlach supplemomtol toot data hereto]
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CITY oa May 11 A, Ng 0820
BUILDING PERMIT APPLICATION TIGARD DATE
THE UNDERSIGNED HEREBY APPLIES FORA PERMIT rOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
r'r� U r '.=5 f.}t� :..: �r t;i •. �; � r . 1,
OWNER ADDRESSBUILDER PHONE
O1,InQjr ENGINEER
BUIL ER ARf IN TELT _-_ DESIGNER �-1 _�—
STRUCTURE ❑NEW ❑RE.MOOEL ❑ADDII�TION ❑REPAIR ❑RENEWrrA,�L ❑FIRE DAMAGE ❑DEMOLITION
❑ RR�E�1SIDENCE CICOMM ❑EDUCATIONAL LGOV'T IJRELIGIOUSOPATIO []CARPORT OGARAGE CJ STORAGE OSLAB ❑FENCE
OBONC OMOVING ❑CONDITIORAL USE ❑DESIGN REVIEW,! EICOUNCIL APPFIOVED ❑SIGNS
OCCUPANCY—LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CHPCK BY
roiwi t one st iry i "'.111G Uwfalling wath daylight boaami
u t t:�1 at lied gurwje. Reia-3—u—s--11540 yU Glonwood
i^ ruarZe
-(;- LOAD — FLOOR LOAD HEIGHT _ NO.STORIES i, AREA VALUE
.— r
BUILDING DEPARTMENT SEI BACKS °RONT REAR 'U .�y��{ LEFI SIDE �� RIGHT SIDE
Permit - -- —�— -- — — --- -- -�
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODS, ZONING
Plan Check 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 WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NCT WAIVE
„tom RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
I%State LICENSE. SEPARATE PERMITS REOUIRE:D FOR SEWER, PLUMBING AND :'EATING.
�.-. r.9. .y e
Total
By - - --- — —
---- - APPLICANT OR AGEN7
Approved Pecwpt No.
— ADDRESS - —i r1oNF
�— PLUMBING DATE
-- REMARKS _ ---
DATE INSP. TYPE INSPECTION
Contractor SS�' j6
—"----�— Permit No. 0,4/__-_•
�) Rough in
f0 �lL - ----
----.. _- - Fixture
-�
Final -
-�--- --- HEATING
Contra_tor /
- ----
Permit tNo_7`2� i� 7/'�h
Gas or Oil _— --
-, Rough in-- --- _
----•---------- Final —. _ ----_
SEWER,/, -
Final
EWERC-Final
--" — DRIVEWAY - '
- Final --_--_ -
Storm Draina
- _ (Rain Drain) Final
1%Y
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_
Sidewalk
- Curb&Street Final __-
------ -- _ Approach
TEMPORARY CERTIFICATE OCCUPANCY Final —
BLDG.DEPT.FINAL CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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