11444 SW TIGARD STREET _11444 SW TIGARD 3M;K (J�
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City of Tigard �
INSPECT10 REQUEST ,
for
1N8PE'riON T!44E: IAERMIT NO. :---
DATE: -el -21L-21L DATE ISSUED ' L_1_ j
UYCNEPS NAME :
t
ADDRESS.
CONTRACTOR :
TEST : Air [), 1, eter0 , Visual L-) , Laboratory C
RESULT: Approved, Disaaprove:l : Pendinj p
SKETCH;
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INSPrC'TOR DATE
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CITY OF
BUILDING PERMIT APPLICATION TIGARD
DATE�harah 8_ ,s 78 N N° 0697
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
NER Ulcots Kirkland ADDRESS 11444 re. L1. Tigard BUILDER PHONE 636-3098
J►. 3, Kilpatrick ENGINEER
BUILDER ARCHITECT DESIGNER
STRUCTURE ❑NEW OREMODEL ❑ADDITION_ ❑REPAIR _ ❑RENEWAL _ ❑FIRE DAMAGE _❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGt ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVIP G ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED - ❑SISNS _
OCCUPANCY-1—LAND USE.ZONE_ � =BLDG.TYPE FIRE ZONE 3 PLAN CHECI' BY HEAT _ '
l ompliito remodral.ing Of garage, subject to inspection and
approval of airy Orion before continuing with work* -
inspect roof for compliancm with UBC. This permit includes
remodelling of garage, fireplace, and stinks roof,
OCC' LOAD FLOOR LOAD _ HEIGHT NO.STORIES -- AREA VALUE� � }�
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit - --_ =--- - - -------------
--- -"— THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 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 OSIDINANCES. 1HE ISSUANCE OF THIS PERMITDOES NOT WAIVE
- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
"—" — - --- --'--- '— APPLICANT OR AGENT
Approved -- — - Receipt No
ADDRESS _ - _-.-------____.. -PHONE '- ----
ELM-F-W-LIFXW_
DATE INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
Contractor
Tp"mit No.
Rough-in
Fixture—______
Final
HEATING
Contractor
Permit No.
—as or Oil
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
13L!2G DCPT. FINALTEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY F inal
I andscaping
Zoning Final
M�
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT N? 1423
DATE
PERMIT IS LIVEN TO
OF
TO CONNECT A
TO THE SYSTEM OF TIGARD ERAIv►TARY DISTRICT -- —
AT
�"
THIS PERMIT MUST BF, POSTED OX TRE DESCRIBED PREMISES UNTIL CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM.
PLETED.
I'F.RMIT FEF, PAIll
•`�•• TIGA!tD SANITARY DISTRICT
v By { � �
CONNECTION INSPECTED AND APPROVED
Superintendent -.___
Address 1'/,/i Permit No. / S/ t;?,
Permit charge
Owner ( ;''i � ez, /Ln�' Connection fee 3,75`
Paid by
Type of building Date connected
Service rate Inspection fee
Contractor Paid by Date
Size of connection Assessment Paid