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INSPECTION NOTICE
f City of Tigard Building Department
I' 12420 S.W.Main St.
Tigard,Oregon 97223
I Phone: 639.4171
Type of Inspection ` J
Date Requested- — Time A.M. P.M.
Address
Owner —_ —_ —__- Lot #
Builder
The following Bi ing Code deficiencies are required to be corrected: ,
yr•-e.�-_... �_ $-`` ,..P.�.-.�6f~_'-fit+--.-'z-i- .--
l Presented to ._ -
-. ❑ Approved
Inspector � s [ Disapproved
Date —
CALL F')R REINSPECTION
Er YES Ll NO
BUILDING D PARTMENT, TIGARD NTo
PLUMBING PERMIT
holder of a valid plumbing contractors license is hereby
authorized to c.,iuse plumbing work; as herein noted to be installed in accordance with the plumbing code of
Tigard. Such installations require inspection by the City Inspector who shall ba notified not less than four
(4) hours prior to the time the installations are ready for inspection. City of Tigard Business License required
for all contractors and sub-contractors.
Job `� C� Sc� C�
O�.vner_�'`� - D- S _ Address__.�.y_. _ Date-_
NUMBER OF TOTAL
TYPE- OF PER.RMT I I PAS FEE ON EACH AMOUNT
R ULD E M T I A L _ri -
SiUle Fad-1 bath--each _ _25.00
_Oyplex--Each 1 bath unit _ - _ _ 25.0
m _0 _
Additional bathrooms-each _ _ - t
10.00
tilobiia Herne Spice ea. _ 15,00
INDIVIDUAL FIXTURES C0MMERCIA ___
1 to 50 Fixtures in 1 building-cath 3.00
51 to 100 Fixtures In 1 buildir. -each 4,50 '-
101 to 200 Fixtures in 1 building-each _
201 or more Fixtures in t 1.50
buildin -each —� `-
M I5CELLAN SOUS "---
Sevier-each additional 100 It. 10.00
1'hter Se! ito to buildin ` _ 5.00 -
PERMIT � For Plumbing Inspection Phone 639.4 1/1 � !�
4`o State Plumbing Contractor Fy '
TOTAL ---_—
I -- -- clrrFlaT n�� -----
BUILDING PERMIT APPLICATION TIGARD DATE_— A1v,,Unt 10 ,19— +il .3874
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE _0_2Qf!9_4J6
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. (DINER PHON� R E_
OWNER .1011 VaViS JOB ADDRESS S+J+ Down's Court: LOT NO.
ARCHITECT
:it9l we 126110 qVI Watkins Ave. ENGINEER
BUILDER ADDRESS DESIGNER Studio 5/1)ave Lorton
STRUCTURE X�NEW L_] REMODEL 1-1 ADDITION ❑ REPAIR ❑ RENEWAL U FIRE DAMAGE ❑ DEMOLITION
IKRESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T C] RELIGIOUS ❑ PATIO C CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _—LAND USE ZONE tL BLDG.TYPE Si+ FIRE ZONE "=_PLAN CHECK BYE HEAT
Construct Sin*;ly Fanit Inaatling with attacbed_gaTa"
^eissue of Permit #3872 (AMM 11-W Dawn's Court) 3 beftoom
1.100 2 bath
SEWER PERMIT N 2 13 12
OCC.LOAD FLOOR LOAD :IGHT 11 N0.STORIES 1 AREA " 159 NO.BEDROOMS 3 VALUE 43,0ou
BUILDING DEPARTMENT SET BACKS FRONT REAR I f) LF 17T SIDE 1 RIGHT SIDE
Permit lul&oo_Y THIS PERMIT IC ISSUED SUBJECT TO THE REG111 Ali IONS CONTAINED IN THE BUILDING CODE, ?ONING
REGULATIONS AND ALL APPLICABLE COOLS AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
PlanC_hecklu0oO _ WORK WILL BE DONE IN ACCORDANCE WITH THE ^I ANS AND SPECIFICATIONS AND IN COMPLIANCE
— WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
_Sub-total_ 191100 _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PcRMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 4A 7.24
Z
Total 1913.24 SDC—1 (100. 00 `� "-~ .,�
�— PDCN AAPPL ANT OR AGENT
ey .•
- -- Re-,oipt Ni. '
! aA, ) ( ►
Approved MITI ADDRESS � PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
i Contractor
�. ---- — — -- Permit No.
Rough-In
�p --
Fixture
Final
HE TING
Contractor
Permit No.
26194(17/ Q-
f
Gas or Oil
Rough-in
Final --
- ----------- -- SEWER
Final
--- � DRIVEWAY —
_ Final c ,_—�
i _
Storm Drainage
(Rain Drain)Final
Sidtrwal k
—` Curb&Street Final
--- — —^,---- ---
Approach
BLDG--DEPT. FINAL TEMPORARY J CERT
E TR IFICATE OCCCY Final
CERTIFICATE OCCUPANCY (Tl
qLandscaping
(i Zoning Final —