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IN£PBCTION�IOT�C�
City of Tigsnd Building Depsrtjwnt
13125 SW Ha11 Blvd. Tigsrd, Oregon 97223
Inspection Line (Rec-n_Phune): 639-4175 Buelnene phone: 639-4171
Footing
Plbg.L'Age1ndarsla Mech. Rough-i•, A r
pp /Sdwlk
Found.
111bg. Top out Can Line
FINAL:
Past/Beam Struct. San. Sewer
Framing �
Poet/Beam Nash. Rain Drain
Inaulation -Plumb
Plbg. Underfloor Water Line
Gyp. Ud. -Rech.
Date Reyuosted: _ AH ___PN
Tlme:
Address:_
Bulldert__ 7_J
THF FOLLOWING MRRECTIONS ARE REQUIRED:
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INSPECTION NOTICE
City of Tigarc Building Department
P.O. Dox 23397 C---
Tigard,
Tigard, Oregon 97223
Phone: 639-4175 T &
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Type of Inspection _.�
Date Requested �� 'y Me A.M._--_P.M.
Address _.___1�2 Permit
Owner _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to `1 '
_ - - --- � 1 Approved
Inspector — -- Disapproved
Date
CALL FOR REINSPECTION
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YES EJ NO
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C'1Y OF TINA BUIL-DING PER111T
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COMMUNITY DEVELOPMENT DEPARTMENT 0111119001
13125 S.W.Hall Blvd..P.O.Box 23397 Tigard.Oregon 97223.(503)634-4175 DATE 1551JED: 9/ .1*3hay
MUM PMT R-9,PJ4JL2-4------1
%JOB ADORES$ : 1.0975 SW 741TH AVE
MAP/1 OT 1.53. 36DU 1200 5LI8. LT : HK :
LAN13 USE;
LOT S3:7..E: VALUATION: qi 9 , 000 SETBACKS
f;*AoN`T : REAR .
WORK CLASS : -4001140N DWEI L ,LIWITS : LEFT: PIGHT :
USE TYPE(`—IGAA-4.1l NO. BEDROOMS : EXT.WALL CONST
(UINST.TYPE: VN NO . SATHS : N : S : E: W1
OCC,L)P. (*.,PP. : MI PPOT .OPEN111SIGS :
OCCUP. I OAD N: 5 E: W:
TOTAL AREA
NO . STOPIES : I J.FT: POOF CONST : C FIFE PET7
HF,*1:(*.,FI'T' : 1A 2ND: AREA SEPAR7 RATED'.
11ASEMENT7 ;5R1): OCCUP. 5EPAP? PATED:
Ml:;:1ZANI:NE7 8A5r-.:M'T
1::,l (ion LOAD. ('3APAGE: 500 FIRE S.PPKILP7 441-APM7
FLOW(UPM)
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LAST PE15SUE
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N 1.0975 faw 7411.1.1 five PLAN W."ViEW ♦A a 7
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R tigard r1r, 97,r--!23 FIW' DEPT
PHONE (503) 6P0-1.5-'1H STA1%'- 'TAX $3. 73
OTHER
C I)FVEL0PMIR:N'T CHARUCKS :
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PE(:A-, IPT No.
This permit Is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances. and It Is hereby 1NSPECT1ONS
agreed that the work will be done in accordance with the plans and FOO TTIN11L.'s
specifications and In compliance with all applicable codes and crl AF)
ordinances The Issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have Current city FRAM I NG
business tax permits This permit will expire and become null and F 1:NAL,
void if work is not started within 180 days or if work 14 suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
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Permittee Signature
Issued By
'All FOP TWWE.CTION 639-41*7!J
SEPARATE PEAmrrS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
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CRYoFFTWARD PLAN CHECK N „,��
COMMUNITY UEV'ELOPMENT DEPARTMENT " PERMIT 9 �
1312SS.W.NdBlvd-P.O.5092]1Ar,Tig"-O.ryx+9T?:7,("Ol)G19�175 � DATE ISSUED
JOB ADDRESS: /C %73 S id �'� •`•i �' TAX Mr%P/LOT
SUB: LOT: LAND USE:
VALUATION: � 9.as v
OWER SPECIAL NOTES
NAME: _ (,+1.. _/A�/ c: REISSUE OF: ---- _
LAST REISSUE:
ADDRESS: GC 9
JS' S4 7y FLOOD PLAIN/
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SENSITIVE LAND:
PHONE: rc2�- /Sl/� arTr- �,., _
APPROVALS REQUIRED
CONTRACTOR PLANNING: _
NAME: ENGINEERING: _
ADDRESS: _ FIRE DEPT
OTHER: _
PHONE: _ _ ITEMS REQUIRED
LIST/SUBOONTRACTORS:
ARCH/ENGINEER BUS TAX:
NAME: CALCULATIONS:
ADDRESS: TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN:
PHONE: ,C ` OTHER:
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. ! 4�'ruiYr c ', //
c"ENTs: .T r r co
634
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PERMIT N ACCT N DESCnTPTION AMOUNT AMOUNT P0. BAL. DUE
10-432 00 8tiilding Permit Fees Sv
10--431 00 Plumbiog Permit Fees _.
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%)Building _3_Z3 _
Plumbing
Mech
10--433 00 Plans Check Fee
Building !Lq Yj
Plumbing
Mech _
_ 30--202. 00 +r Connection
30-444 00 ,r Inspection
51-448 00 Street System Oev Charge
52-449 JO Parks System Oev Charge (POC) ------
31-450 OO Storm Drainage Syst Dev C1, , (SSDC)
10-230 09 TRFD
10-230 06 Washington County Fire N1 (95%) _
10-7.20 00 AmarL/Wedgewood --
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APPLICANT SIGNAT
Received By: _ _ Date Received: l
cn/3587P/18P