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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Mail' St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested 7 Lime A.M., P.M.
—
Add,ri, 27Permit #---
–6—S2
Lot #
Owner
Builder
The following Bqilding Code deficiencies are required to be corrected:
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00
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Prevented to Approved
Inqactor Disapproved
Date 7 It?7-j
CALL FOR REINSPECTION
YES D 140
BUILDING PERMIT APPLICATION TIGARD DATE
1 HE UNDtRSIGNED HEREBY APPLES FOR A PERMIT FOR THE WORK HFHFIfJ ItJC IC;AFED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING; PI_AN::,AND SPFCIFICA !(JNS. OWNER PHONE_
t LOT N0. 39 CQj!j74.Y '- cert
illetc isAtlT. It J :i`.J
OWNI II ADDRESS -- — — - -
---
ARCHITECT
ENGINEER
BUILDER 'a_..0 _ ADDRESS
k.32"() 4'�' !�OOljCA Peery DESIGNER T.tJ"i, —
STRUCTURE J NEW Cl REMODEL ❑ ADDITIONT ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
L RESIDENCE ❑ COMM O EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS C7 PATIO ❑ CARPORT ❑—GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY __ ""'� LAND USE ZONE 17—PI) BLDG,TYPE ' FIRE ZONE_ PLAN CHECK BY (I HEAT 0"'T
Conntlr+.cr_t 3i.n:-le rarltlY Thl"ll-ifin aJ�attncl�ed T,rrra�=.�r _�
rep rorrectic'm shocit ,;ltt4Cl'Qci. 3 bedrown 2 baths
SEWER PERMIT M
OCC.LOAD FLOOR LOAD t►I I HEIGHT fir' NO.STORIES - AR_EA NO.BEDROOMS VALUE
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE.
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
,7,, •
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal RESTRICTIVE COVENANTS. CONTRACTOR AND SUB COI'T RACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWES.PLUMBING AND HEATING,
State Tax
63S.44 SDC--
Total IT Ifits.00 APPLICANTORAGENT
BY
cirn,j PDCM
_
Receipt No.
Approved ADDRESS _ PHONE
'��
WWWRP
DATE INSP. TYPE INSPECTION —_ P-MARKS PLUMBING DATE
d� 7=8J Contractor `.;!Q
Permit No.-- a Z,
Fixture
HCA-TING
Contractor
Permit No.
Gas or Oil
Rough-in -
____.__ Final
SEN ER
Final
DRIVEWAY
Final
Storm Drainage
(Rein Drain)Final
Sidewalk
Curb&Strent Final
Approach
SLOG.DEPT. FINAL TEMPORARY— CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY I is el
LAhdsz;iping
7on1rL Final
i
,I
wl N
J1A
BUILDING PERF,"„ APPLICATION TIGARD DA r ,, e`
THE UNDERSIGNED HEREBY APPLIES FOR A PER^nIT FOR THE WORK HER_IN INDICATED BUILDER PHONE
• t PANYING PLANS AND SPECIFICATIONS. OWNER PH
OR AS SH
1OWN AND APPROVED IN THE ACGn.�' L1
)'JUNER�om Aft I�' •lN JOB ADDRESS ��7Q ,�S& ®� ARCHITECT
—
�� — EG EER LUX
BUILDER 5_Awj& ADDF:ESSf Q SLG - — --
S',"RIICTURE NEW 0 REMODEL ❑ ADDITION �-0 REPAIR —__❑ RENEWAL ❑ FIRE DAMAGE L] DEMOLITION
RESIDENCE U COMM ❑ EDUCATIONAL ❑ GOGOOV'T ❑❑ RELIGIOua�L^7?ATIQ C1 CARPORT_O GARAGE G STORAGE SLAB El FENCE
O'(16 iPANCY
_LAND USE ZONE P _BLDG.TYPE A; FIRE ZONE_`—PLAN CHECK BY HEAT_-
s oz
SEWER PERMIT M __ -- i —�,� --- ---- —
OCC LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BFDF.1OMS ;3 V6.LU �SDO
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR �s _ LE_ Ff SDE 11•x^ RIGH"r SIDE �.3
Permit /�•za THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE [WILDING CODE,ZOWNG
I��// _ REGULATIONS AND A:.L APPLICABLE CODES AND ORDINANCES, AND IT IS NEI F3Y AGREED THAT THE
Plan Check Igo,
7 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODE: AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV':
Sutrtotal — 7C RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE..PERMITS RE:OUIRED FOR SEWER,PLUtdBING AND tEATING.
State Tax '
SOC
Total
:7S• —� ---- ------- __...__r-
--- PDCJf APPLICANT L7F.AGENT —
By
Receipt No. ADQRESS ���J PHONE
Approved
P D- C
S _WER CONNECTION S 0.ZS
- - 3a
SEWERItySPECTION $_
SEWER SURCHARGE 5 _
y'7S--10 or C,Sek
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