9910 SW PEMBROOK STREET 9910 SW PEMBROOK STREET
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.4171
AddressPermit
Type of Inspection
The following Building Code deficiencies are required to 6e corrected;
__----- --•- ��+- ¢:at , we �_. .�
Presented to �_�__ _ ______ Inspector _ _—
Date
(:.ALL FOR REIWECTION
VES ❑ No
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard, Oregon 97223
Phone 639.4171
Address----- _—�_..----—------- — ----
—. Permit #_ _
Type of inopection ---- —"
The following Building Code deficiencies are required to be co:rected:
Presented Inspector ----
DateCALL FOR RE f fl-""FG7710N
D YES a NO
I
BUILDING PERMIT APPLICATION TIGARD DATE
,19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE _
LOT NO._ ---
OWNER 17riS Nuzsbaum _ JOBADDRESS9910 SW Pembrook Street _
AIACHPTIXT _
QQJGkd�Ell
BUILDER H,R,Adams Constr.SurXDDRESS 11844 SLI PBC. Hwy --DESIGNER Kniyhts
T� RUCTU IE U NEW I3 REMODEL CSS ADDITION El REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
"RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T O RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLABD FENCE_
OCCUPANCY . I�`3 LAND USE ZONE I�`7 BLDG.TYPE _SIJ FIREZONE J -PLANCHECKBY dwh HEAT___
-- Pumodel existing garage & kitchen. Add new
dor .410 0
SEWERPERMITM ZkI906 ---
OCC.LOAD FLOOR LOAD ICI _ HEIGHT NO.STORIES 1 AREA 602 N0.BEDROOMS 1 VALUE a �G•
BUILDING DEPARTMENT _ SET BACKS FRONT I11-AH LEFT SIDE_ RIGHT SIDE a
Permit 00.00 THIS PERMIT 19 ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
40•I�Q 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
120.00
i� Q� WITH ALL APPLICABLE CC DES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total • _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
2O ` LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
_ $12 3.2 f3 SDC State Tex ni' 3•
total �' L
F�P1 PDC# APPLICANT OR AGENT
ey
-Y
duh - Receipt No. -----------
Approved A DAE88- PHONE
- 0- W - - M__ I
DATE INSPP, TYPE INSPECTION REMARKS PLUMBING DATE
' !c �r f de Contractor
rL/$'srt! >�v aM►�f�' I11•�1 Saau+l O�► Si���� _ Permit No. r
Rough-in
OO li
r Fixture-� -`o Dirk �a km��t� c,
Final --
Sj.l1�-4fy HEATING
•f„ Contractor Q
Permit No. �� 8���80
Gas or Oil
Rough-in
Final
SEWER ` �331•_�'
Final
DRIVEWAY
Final _21_Po c,<
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OCCIIP�WpK--KJY Final
CERTIFICATE OCCUPANCY —
3r� I.sndscaping
Zoninp Final
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4
I
...... .. r,.. .. •+�. .�..,.-..,..�.-�-. •..-...,tom,-..�-. .�_.� ...-_....r.-..........•,,.M.- .. r .. _ j •- .. j
BUILDING PERMIT APPLICATION _- " 3Z��
TIG/' R'n DATE_ 19
THE UNDERSIGNED HER --B'{APPLIES FOR A PERMIT FOR THE WORK HEREIN IN I ATED BUILDER PHONE6����
ORASSSHOWN AND APPROVED IN i'HE A CGOMPANYING PL.ANG ANC)SPEC:IFICAT ION'S. OWNCR PHO Q,- t
OWNER
WNil}S�� JOE 1100RESS Rq�o �c���U� - LOT NOO ^� s
811ILDER Rt� I l uai�&-QA ss1f� TT_9� � _ DESIGNER Kh �t`t� we Dq:ln
STRUCTURE ❑_NEW_ REMODEL ADDITION ❑ REPAIR ❑ R EWAL CI FIRE DAMAGE U DEMOLITION
RESIDENCE I- COMM ❑ EDUCATIONAL Cl GOV'T Cl RELIGIOUS Cl PATIO ❑ CAR PORT Cl GARAGE Cl STORAGE ❑ SLAB❑ FENCE
ocGUPANCYAJ
LAND USE ZONE BLDG.TYPE s �FIRE ZONE 3--PLAN C�• CK BY 10AF HEAT- 11
SEWER PERMIT#
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES / AREA NO.BEOROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT 20 REAR LEFT SIDE _SIGHT SIDE �8
Permit 0 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONING
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 PERPAi, DOES NOT WAIVE
Sub-total i00' RESTRICTIVE COVENANTS,CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
Stats Tax •
3 O LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total ^
SDC— �eo n � ��
_�,
It pDC# APPLICANT OR AGENT
By
Receipt No.
Approved 1DDRFSS PtfONE
PDC
SEINER ClJNNECtION
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r,rUrR SLIRCHARGL S ,r
OO p�
Comments: ~30 la, 7-3
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