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INSPECTION NuTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-4171
T-/pe of Inspection
Date RequestedTime
r 2A. P.M.
Address 4" A Permit :3
Owner Lot
Builder_
The following Buildi g ode deficiencies are required to be corrected: Ii
3
Presented toApproved
Inspector Disapproved
e
Date ,- I 47,-
CALL FOR REINSPECTION
YES NO
BUILDING DEPARTMENT, TIGARD
PLUMBING ERMIT M
holder of a valid plumbing contractors license is hereby
authorized to Cause 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 be 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 t
Address.��14 AU 6« Com___ Dais
Nu.,.isEin or TOTAL
TYPE OF PERMIT ITEMS FEE ON EACH X-10UNT
R D-ENIcow
lA1.—
Sin to Famill+-1 hath—each i w 25.00
Duplex—Each 1 bath unit 25.00
Ad:iitional bathrooms each_ _ 10.00
Mobile Home S�ac�each — —_ 15.00
INDIVIDUAL FIXTURES
_1 to 50 Fixtures in 1 building—each_ 3.00 — q
51 to 100 Fixtures In 1 buitdir. _each_ _ 2.50`
101 to 200 Fixtures in 1 building—each 2.0n� .-
201 or more Fixtures in 1 buildin —each
1.11SCELLAN EOUS +� —
Sevier—each additional 1Uo 1t.
Wat►.r Service to building _ 5.0.0_
Other (s_cify):
��E_ ,PERMIT for Plumbing lnrne:tion Phone 639 4171
Plumbing ContrActor By —
TOTAL PrrrIPr n!n ---
BUILDING PERMIT APPLICATION TIGARD DATE._._ Auyu_st 20—_,19�1_ 3873
1 HE ONDERBJGNED HERESY APPL ICS FOR A PERMIT FOP i FiF WORK HEREIN INDICATED BUILDER PHONE 62U-9436
ORAS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS, OWNER PHONE
11'a u LOT NO.?--i�M�m*s-_Inlat_
OWNER .Tan Daviel JOB ADDRESS 1:l<M SW Down's Court
_._ --- ARCHITECT -- -•
5tlnnel 126GO SW Watkins Ale. ENGINEER Sttidio S/r'atvet 'Norton
BUILDER ADDRESS DESIGNER
STRUCTURE P41NEW ❑ REMODEL 11 ADDITION U REPAIR U RENEWAL. ❑ FIRE DAMAGE E-1 DEMOLITION
W RESIDENCE ❑ COMM C7 EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS f] PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _B•�._ LAND USE ZONE -_ L_BLDG.TYPE S..__. FIFE ZONE,-—.PLANCHECK BY �); HEAT_Gat
- _ Construct Sirtgle Family IVelling with attached Optra�e -- _ _.
Raaissue of Per-tit 03872 _ (W23 SW Dawn's Cbtirt) --- ------ - 3 tx!drooa.ts
SEWER PERMIT# 231111
OCC.LOAD FLOOR' AD 40 HEIGHT 11 NO.STORIES 1 AREA 1039 NO.BEDROOMS 3 VALUE 48#000
BUILDING DEPARTMENT 1 gE7 FIA KS FRONT REAR 17 LEFT SIDE 16 RIGHT SIDE 10
Perml: 11.00 THIS HERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
to t10 Kr-(:ULATIONS AND ALL APPLICABLE CODFS ANO ORDINANCES. AND IT IS HEREBY AG14EED THAT THE
Plan Check • WORK WILL bE DONE IN ACCORDAVI •' WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
1910() WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DUES NOT WAIVE
Sub .
total RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
4 7.74 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total
14 3.24 SDC— y40t).1;.1
.� t.. . ...,.,,.
- PDC# T $10O.()O APPLICANT OR AGENT — —By
Receipt No. --� r - (t./ .• ar � If V �—
Approved 911411 _— �. ADDRESS PHONE
DATE TYPE INSPECTION REMARKS PLUMBIN DATE
--- ---. _
Contractor
Permit No. �O
�e-�—�✓ ��,ey L y0��,�`S Fxturo
ib—iG �jt ��T Final ---
HEATING
�..w Cuntractor
Permit No. .7q7
y
Gas or Oil
- — — --- - ------
Rough-in - -----
Final
SEWER ---
- ------- TFinall
DRIVEWAY
Storm Drainage
(Rain Drain)Final
-- A
Sidewalk
_. Curb&Streit Fins,
_ Approach `
BLDG. DEPT.FINAL T—TEMPORARY CERTIMCATE OCCUP CY
CERTIFICATE OCCUPANCY Final
Landxcaping
Zoning Final
S t.