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INSPECTION N,)YICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection IK - ----------� --
Date Requested tt Time--- A.M.— ---P.M.
Address J' C> 7 -- Permit #_
Owner __ aL--_V— Lot # -----
B;rilder _-._._ ---
The following Building Q deficiencies are required to he corrected:
Presented fn Approved
i
r^s; _:�• _y -- I Disapproved
Date � '
I
CALL FOR REINSPECTION
YES U NO
a
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone 639-4175
Type of Inspection 41
Date Requested_ h Time A.M. �f P.M.
Address ' �&D` 72: Permit
Owner _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented toApproved
Inspector � _ �" �_ �� Disapproved
Date e o
CALL FOR REINSPECTION
C' YES Z) No
INSPFCi'ION NOTICE.
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _
Date Requested—_-- I _ Time __ A.M.. L"�
Address �� 3 (!)CDS ( , ) 7 `f Fj���(j Permit #
Owner ��.�• �_/L.D �—i -F
Lot # _
Builder
The followin Building Code deficiencies are required to be corrected:
� r
Al 7-
-� } �/�.F'O.-�/r�.r S•v-/�/'.7�T ,e- .G ;E'er, n,e —
Presented to _ - ---
— --- ❑ Approved
Inspector
- --" Disapproved
Date
CALL FOR REMSPECTION
,KYES U NO
W W W W W !!
1
BUILDING PERMIT APPLICATION DATE-Psr' -� �- �� I
TI IF UNDLI-io.GNED HEREBY APPLIES FOR A PERMITFOR THE WORK HEREIN INDICATED BUILDER PHONE (1 5 �4
OR AS SHOWN AND F PPROVED IN THE ACCOMPANYING PLANS AND SPE IFICATIONS. OWNER PHONE -�
7 LOT NO.
OWNER JOB ADDRESS , -
ARCHITECT
a r�-Citf]I- :'>al�ilfiC 229 a 82nd fir. ENGINEER Jbnvid A23borg
BUILDER _ ADDRESS 1 15 DESIGNER
STRUCTURE ❑ NEW ® REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL _ 11 FIRE DAMAGE ❑ DEMOLITION
U RESIDENCE ❑ COMM ❑ EDUCATIONAL_❑ GOV'T ❑ RELIGIOUS ❑ PATIO CJ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _U,1<.AND USE ZONE _ PLAN CHECK BYr-ice--HEAT _-
Piro repair and ,rumcda1 cf existing mingle familyy r1,wa: 1 ina_ _ Ay1j vnillaw
c•i19na.rtlotrC L)athr(.x= and move fro oor ^nc, tim eldr cart 4 i v n nhm:0- -
R r)n=lt uno t i r rl_
SEWER PERMIT#
OCC.LOAD FLOOR LOAD 40 iEIGHT NO.STORIES AREA NO BEDROOMS VALUE �r'
BUILDING DEPARTMENT cT BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit THIS PERMIT IS ISSUED SUBJECT TO THE REGVLAIIONS CONTAINED IN THE BUILDING CODE,ZONING
I REGULATIONS AND ALL APPLICABLE CODES A1A0 ORDINANCE:. AND IT IS HEREBY AGREED THAT T HE
Plat 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 PERMIT DOES NOT VI AIVE
Subtotal __4 RESTRIC'.IVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
— SDC—
Total , —
` - — - PDC# 'APPL NT OR ADEN T �7 ---
71 .
LBY
Approved
Receipt No. A" DORE08 / f j „ 1 PHONE - -
1
w W_X W_j tw-I W�a-j ul wow,
DATE INSP. TYPE INSPECTION REMARrz PLUMBING DATE
Contractor,�,
Permit No.
Rough-on
Fixture
Final
HEATING
0,, Contractor
2 Permit No.
Gas or Oil
Rough-in
sinal
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG, DEPT._FINAL TEMPORARY —FERTIFICATE OCCUPANCY
CENTIrICATEC3CCUPANCY Final
Landscaping
Zoning Final
somommmotimm�
CITY OF TIGARD PLUMBING
NG ��972�-
Applicants must hold Oregon Registration to conduct a plumbing PERMIT 639-4175
business or must be pr+otxvty ownerloperator not hiring outside help.
Nams of Gave optneM 5 ?d -
(r� � (� Plumbing Permit NoAdd?? %S� t.> P7'A i Ie ORS 814-2t-0i0 DUAN. PRICE MAT
Job Tax Lot Map.No.
Addreas FIXTURES _
tit Back Subdivision Sink - -- - 7,50 7•SD
ams a segs Lavatory
•�. �-�Y S c Tub or TublStwwerComb-- 7.50 's•✓�
MaikrV Address � �- � 7.50
Shower Only _
Water Closet 7.50
Owner eft/I�te1e - ---- Zp ---- ---- - u 750
Dishwasher - _ _
--- Phone Garbage Disposal _ -7_50.
-__ --- ---- - - Washiry Machine - 7_50
Name
Floor Dram — 750
-- -- - 750
Wailing A cress Phone Water Heater
Laundry Room Tray 7 50
Occudant City/State Urinal --- 7 50
-- —p �e� Other Fixtures(Spedy) 7 s
Name e -- -
JC..We,r". .. �!�A t.✓� 7.50
ess � . Phons (n�Z' T 50
7 50
Contractor � ZIP
MISCELLANEOUS -
City Bus Tax No g 1 a1 t 00 3000
-- 5— , OawM♦a.Add*.100' _ 1500
State s. date s t - - - -
(Rosklentral) Water Servtos let 100 ^- ?0 00
I two acicnowlsdpe that I have read this applk tUon,that lithe Mdoandiltfa^ Waller sa Add•t ' -- _-- 1500
wr
given is oornad.OW I am rsgisstwed with the Stan Builders Board,and also Ston"a Rain Drain tat.100'— - - 30.00 -
have a State PlumbkV Names that the numbers QK*n ars 00m0.Ihat ate orrs tl P!�►t[keit+AetidH 100' 1500
pkrmbkq work will! rd
be done in wceoanoe with appacalble pravlsim"of Ore St ---100' _ _ _ -
gon P4Mq*d Staluln C haptera 447 and W1 and emkoble model and"I Moblie l-lome SpomQ5 00
no help will be employed unless Nowwod urwlar ORS 643 (11 exempt frcxn - - -- ---- -- -
Stabs registration.please tiw reason below). Baric Flow Prevention 750
"G,WOWNERS -I hereby osrW twat I am Ow owner of Vw properly de- Doyioo 0r MIl-Poliution Day" - --- - _--
sorbed aboy%.M wl dd looadlan 1 propoes b rrwilre a pkandnp knatake&X I for Any Trap or Waris Not
my own use and properly M not bekp oonslrucled kir sale,{seas or rel Conni0ed b a Frxkxo ---- _-- _ 7.50
C4"Gasbn
kwp.of Exist_Plurr g T _ _.__- 40.00 P*Hf.
--- Sp.da Rsgtrastad -----
n - - 40.00 Parf
L
-- - — AMr of PRartbkq wahh
an Bldg1500 men
New 50g.or BuNd.AddMbn !A 00 mr 1{
Meaibo work-now[] addition) ) aho"dorl mVWf[7 d�1e7.1
ID Lig.done_ reskiential -- 'r
EsdlatlrV Leo of
bUkb a www t; _-_.�L4-_,0 -- - _ M it�L L .S
p Ls"r,, ex NII�CN�►! a!
advorpoopwtti ----- _
__��- -_ ranla� d•
ntb pttt"Oeoanea nuN and Tadd ff wait or 00nMsfotlon twlfwrlaad Is rot oon
ttltaltpw taliltYl NO tl�lltar ti o�rtrllnrclloh rr tarorM M Nlapafnded a tAtertdan4ler
a paflad a1 tiM1 Aeys to snit flrns altar moose M uotltlatMt0t10•
SAL fix"ex "- ,
,r.t�.aalttlh ..
for inspections call 639-4175 PERMIT NO.
CITY OF TIGARD 699.4171 DATE is K.-?
BUILDING PE MITCtl
P.O. Rax 2397, Tigard OR 97223 TAXMAP 1 5136 OLOTHO. �``' suea VISION
OWNER, JOBAOCRESS
601-004L 1 .57-/.4/Z y�C 1 r iL __ STATE REG.NO. 3 76� � EXP.OATE
BUILDER'S PHONE %�' 73 0 3
ARCHITECT T''' „ U / jo( PHONE 6 � '� > OTHER,
I'I Re
STRUCTURE (3 NEW ❑ REMOOEL ❑ ADDITION '0�'REPAIR ❑ MOVE ❑ Q':+ER C] DEMOLITION
RFSIDENCE ❑ COMM ❑ EDUCATION ❑ IND ❑ REUGIODUS, ❑'ACCESSORY C1GARAGE ❑OTHER ❑ FENCE
OCCUPANCY =' LAND USE ZONE A>K J SLOG.TYPE sn� FIRE Z0HE PLAN CHECK BY BEAT
SEWER PERMIT e.
OCC"..LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS VALUIV'D, GL'
r BUILDING CEPARTMENT SETBACKS FRONT REAR LEFT S!DE RIGHT SIDE
P�rndt C' JQ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUULrANG CODE.ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES.AND IT IS HEREBY AGREED 1 HAT THE
PUanChock JV3 WOItX WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPEOFICATIONS AND IN COMPLIANCE
W1TH ALL APPLICABLE CODES AND ORDINANCES.THE ISSUANCE OF TH43 PERMIT DOES NOT WAIVE
P1.Ck.F" --" RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO NAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING. o r
State Tax y �Z" SOCA Z Pmt. , ar T-� 54ar roc-4— c Ir
Total �p . JJ r_�I NT OAA N L
Prsad. 7 8 3 POG l n.-z _se .9Z"DG(, C/fc 4 . y/C d�S 73 03
RocNol No ADDAFSS
B.l.ops
— laaued BT. ._—J,oP!ov*d By--------
SSDC --- $
soC - -
RECEIPT #
POC -� � — DATE P0,
ApSCUER CONNECTION 5 AMOUNT PU.
o SEWER INSPECTION S
SEWER SURCHARGE S
ommente : ---
CITY OF TIGARD BUILDING DEPARTMENT PLAN CHECK NO. : � J
PLAN CHECK APPLICATION DATE RECEIVED:
P.O. Box 23397, Tigard OR 97223 P/C DEPOSIT PAID:q
This is to cirtify that the attached L sets of plans have been submitted for plan
check pursuant to the Oregcn Structu-�:al Code and .Fire & Life Safety Code, edition.
PROPERTY OWNER: OWNER'S OWNER'S ADDRESS:
CONTRACTOR: �� � �Qc, TELEPHONE: 7 3 D 3
JOB ADDRESS: e -75 �� 0. �_ LOT NO & MAP: /5/ ,�L� 3-5--66
DESCRIPTION OF WORK: t 3 /(�@� L�' ✓�'K ��+�wl
Approvals Required SPECIAL NOTES
OPlanning Dept. O Reissue
OEngineering Dept. O Flood Plain/Sensitive Lands
OFire District O Sewer Availability l• -
0 Other O ther
Items Required 7 q K+^-
List of subcontractors
L,C-,-- )- Business Tax
1 Calculations
OTruss Details �
O Parking Plan II 0
OLandscape Plan
0 Other
COMMENTS:
City of gard Bttilding Department
BY: 'c--