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INSPECTION NO1ICE
City of Tigard i:,iilding Departmf nt
12420 S.V . fv;. i St.
Tigard, Oregot, 97223
Phone: 639 t 1;t
Tytli of Inspection
Dr*e Requested ✓"' _ _ Time. _.A M.
Address Permit�.-�
Owner- Lw
Builder_
The following Building Code doff-lencies are required to he corrected:
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---- �__� Disapproval
j Date
J CALL FOR REINSPECTION
CJ YES It NO
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
� Date Requested
Tae A.M. _P.M.
Address _ __ � Permit #
Owner — Lot # V
Builder
the following duilding Code deficiencies we required to be corrected:
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}Presented to Approv9d _
Inspector D sa
— pproved
Date U..1
CALL FOR REINSPECTION
1
❑ YES T NO
BUILDING PERMI i APPLICATION TIGARD DATE____"�"''��r1`�_,19�� - 4447
.. THE VNDEF' HEAEB(APPLIFS FOR A PERMIT FOR THE WOP.K HEREIN!NDICATm BUILDER PHONE —
O?AS SHO' ,A f'PROVED IN THE ACCOMPANYING PLAN;AND SPECIFICATIONS. OWNER PHONE
LOT NO._90 P P19
OWNER Pptr Zloote 131dr. JOBADORESS 9830 Mi rArnt CotirC
ARCHI i FCT
1i rip 12335 SSS' Ann 'Court DESIGNER ENGINEER St�rtiio ,.
BUILDER _ .__ ADDRESS �--
STRUCTURE 1 NEW ❑ Rt MODEL Ll ADDITION II REPAIR L RENEWAL ❑ FIRE DAMAGE ❑ DEMOL.-;Ct!
M RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOWT 0 RELIGIOUS ❑ PATIO I-] CARPORT ❑ GARAGE f.7 STORAGE 0 SLABL7 FENCE
OCCUPANCY 1M � LAND USE ZONE F°L1 BLDG.TYPE. r'+t—FIRE ZONE.__...PLAN CHECK BY _ HEAT �pta3:T
e— I;omtrut ,r nin.^.1 £ Xa= i Awa?,3.z. .MIAttaclusa- ._arm—c! -- - - — ---
Sm,� cc>'rteer_t.imi niiop.t :*ttt. fit+tfa. 3 Wroe>zw
SEWER PERMIT# 25;.34 — — ;Iaxacm 439 —
OCC.LOAD FLOOR LOAD " HEIGHT_ ' t NO.STORIES 2 AREA 20015 NO,BEDROOMS S 3 VALUE $2mt�W
BUILDING DEPPATMENT gcT BACKS FRONT I Ri AR 2' LEFT SIDE -- RIGHTSIDE
Permit y��•l�U _ THIS PERMIT IS ISSUED SUBJECT TO THE AEGI,LATIONS CONTAINED IN THE 8UH-DING CODE, ZONING
248.3n REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND I' IS HEREBY AGREED THAI IHE
Plan Check WORK WILL BE DONE IN ACCORDANCE Wl-iH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
430.30 WITH ALL APPLICABLE CODES AND ORD'N"ANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ RESTRICTIVE COVENANTS. CONTRACTON AND SUB CONTRACTORS TO HAVk CURRENT CITY BUSINESS
ry• LICENSE.SEPARATE PERMI TS RE01IIRED FOR SEWER.!'LUIMOING AF")HEATIF'G.
State Tax
1SDC— °. r / f E f
000
Total
-- PD(-,# I !. 100 010 APPLICANT OR AGENT
By ; i �: �" fir., ny V .. / iP'L%' ;.: '' r7J_.L_r
t1Ma:� Receipt No. 66 — _ PHON
Approved A
,�1� J
PLUMBING DAs"
DATE INSP. yypE INSPECTION REMARKS
ContrDCtor
t ba
Permit No.
Rough-in
Fixture
Final
Hf!ATING
Contractor
Permit No
Got of Oil
Ruugh-in
Final
SEWER
Final 16,
nFtivEWAY
Final
Storm Diainalp
;Hein Drain)Final
Sidevalk
Curb&' A111
Approach
tEFfflFICATF OCC CERTIFICATE OCCUPANCY Final
ilFMPZ;RARY
BLDG. DURf.—FINA OCCUPANCY
Ok,44— Landscaping
Ll
BUILDING PERMIT APPI_IGATiON TIGARD DAT -Z5-------',03 4? 7
,,ilee
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE -,(. 4AL
OR AS SHOWN AND APPROVFD IN TH c ACCONIPANYING P!_aNS AND SPECIFICATIONS. OWNER P ONE —_
O't1rtER Pel BIV*Ikt R14• JOB ADDRESS S V_ 1� —�-__ LOT ND. N _
y ARCHITECT QL -16
ENGINEER
BUILDER I_S.Ixm a ,5'ADDRESS 12-33 4%0 -Aopt of. DESIGNER
STRUCTURE NEW ❑ REMODEL Cl AODITION, ❑ REPAIR Cl RENEWAL G FIRE DAMAGE ❑ DEMOLITION
RESIDENCE n COMM ❑ EDUCATIONAL ❑ GOV'T Cl RELIGIOUS ❑ PATIO U CAR PORT Cl GARAGE ❑ STORAGE L] SLAB❑ FENCE
OCCUPANCY "�-.LAND USZZ-Al BLDG.T
CCUYPE FIRE ZONE-_— PLAN CHECK 0! HEAT
SEWER PERMIT M r �yfi 43 ` — -
OCC.LOAD FLOOR LOAD HEIGHT N0.STORIES AREA 20NO NO.aEDROOMS & VALU pp
BUILDING DEPARTMENT SETBACKS FRONT �� RE.±R A 3 LEFT SIDE— e RIGHT SIDE do
Pn-rmit 03492. hfp THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
/ RE-7iULATIONS AND ALL APPL4CABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TFAT THE
hlanCteck .2�i8•
WORK WILL DE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
I '--'-- WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF "PHIS PERMIT DOES NOT WAIVE
S ,b-total *3 V'3a RESTRICTIVE CUl,ENAMTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE,SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Stam Tax �✓ •�g
.p So. -
Total
— PDC# APPLICANT OR AGENT
By
—�_ --- Receipt No.
Approved ADDRESS PHONE
/ SGC - _ -- 4*p
too
SEWER CONNECTION $ 112.''r
SCW_ER INSPECTION
5EWEH SURCHARGE S ell -.g.-
so
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