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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 91113
Phone: 639-4175
TNu,f of Ii.spection 5 7-
-quested
Dio,a Re .3 Time A.M. P.M.
Addre.qs -9
90 5 -- 15 79 Permit
Owner Lot
Builder
The follo�,ing Building Code deficiencies are required to be corrected:
Presented to Approved
Inspector Disapproves;
CALL FOR REINSPECTIM'
DYES ONO
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ADDRESS ZONLS
� B-14AOrMEET
Building Permit No.
Location
Date
Certification of Registration
With the Builders Board
r
doing business as (dba)
am registered under the provisions
of ORS Chapter 101 Oregon Homebuilders aw) .
My Bui suers Board Registration dumb it is �/ 6C 3
My registrarion is in full force and effect and expires on
Signature
■! t � t � ear� let e� #�
BUILDING PERMIT APPLICATION T1CARD rtATE_ Uctobe 1 19 '__- 5046
THE UNDERSIGNED HE.i'FBY APPLIES FORA PLRMI FOR I FIE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLAN,,,ANC'SPECIFICATIONS. OVJNER PHONE _—
LOT NO.Z2 03��+
OWNER __kUliaiu Scott , JOB ADDRESS 1r'�(15 C 15915 SW-7 th l�i���dSC
ARCHITECT
ENGINEER
BUILDER_ S-'I';. ADDRESS 92.-,5 3W atl __C_i_Zard _ DESIGNER
STRUCTURE QtNEW ❑ REMODE . ❑ ADDITION _ ❑ REPA',R C] RENEWAL ['J FIRE DAMAGE ❑ DEMOLITION
RESIDENCE El COMM FJ EDUCATIONAL [71GOV'T ElRELIGIO_US_❑ PATO C❑ CA_R PCRT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY R~3 LAND USE ZONE R-12 BLDG.TYPE _ _ 5N F',RE ZONE_._.__-.-PLAN CHECK BY 3C.Z_—HEAT— as _
Construct 'leo Story l)uplaxw/attacted zara&ese _
6 bedroom 6 1,athroom ---
_ 2 Deb
SEWER PERMIT# 21976 Zdu _ Garage 497 _
OCC.LOAD FLOOR LOAD 40 HEIGHT 21 NO.STCRIES 2 _ AREA 2801 NO.t EDROOMS G VALUE 97,&A).
BUILDING DEPARTMENT ScT BACKL FPONT 30 REAR 6t, LEFT SIDE RIGHT SIDE
Permit _ 24•Ot/ THIS PERMIT .S ISSUED SUB:ECT 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 215.60 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CO'JES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT PJES NOT WAIVE=
Sub total 699.6: RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
-- LICENSE.SEPARATE PERN,ITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 16.9L'
Total 71t)e56 --- -- 1� ——
PDCN ' .0 't)U APPLICANT OR AGENT
By - CZ •. '(I
- - _ Receipt No. - ----- -- - -- .- --- -----
Approved ACi:—^ ADDRESS PHONE
D i"E :NSP. TYPE INSPVCTION REMARKS PLUMBING DATE
/C -'� Y _ � J � ✓ � , Contractor
ermit No.
Rough-in — -----
Fixture
Final
e2/A,-, Contractor
lit. �u�I. K/ Permit No. L
5413'99T /�11Q�,- t J"-/i!( 51-1 /k Gas or 1711
ICA �v `r�{L�iT -4,r Jh•in
ir'igN (S �y Final --�
r SEWER
g^,4 Filial---
DRIVEWAY
ka
��� ��; -�1.�%•_L—__- ���t��ttt"' Fina!
Storm Drainage----- -
- (gain Dain)Final
Sidewalk
Curb&Street Final
_ Approach
BLDG. DEPT.FINAL TEMPORARY CENTIFICATE OCCUPANCY Final
-
CEFTIFICATE OCCUP•1NC f
II 1-:ntdsc:.piog
?oning Final
ltff
JL __LFJMWM
BUILDING PERMIT APPLICATION TIGARD DATE_- 1,0- 1-19-iv
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR TIME WORK HEREIN INDICATED BUILDER PHONE `r
ORA S SHOWN AND APPROVED IN THE ACCOtf PANYING PLANS AND SPECIFICATIONS. OWNEP PHONE
LOT NO._ 2-�O�Tl.�____
OWNERII �LJLa,ti _x'r; jc JOB ADDRESS I t /ln� `d/ j _-S ,C 1A7AL__ -� -
ARCHITECT
C :rL6AJ1A ENGINEER
BUILDER •9 )L1L ADDRESS `t 75�-�f.iJ. .��1 � DESIGNER
STRUCTURE 0 NEW ❑ F,':%IODEL G ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
9 RESIDENCE ❑ COMMA ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑/FENCE.
OCCUPANCY LAND USE ZONE BLDG.TYPE -`� ' FIRE ZfJNf+ PLAN CHECK BY HEAT�y
7 T\y r7 4, 2" D c/ \\/ /A r 7.4 1 NE4-7
A A IS F 0E
SEINER PERMIT N '
i -� vAr'AG6S Yui'
OCC.LOAD FLOUR LOAD 'Cj/J HEIGHT - NO.STORIES AREA,,;��40/ N0.BEDROOMS V4.LUt72C'�-'
BUILDING DEPARTMENT
SETBACKS FRONT REAR 'C _ LEFT SIDE RIGHi'SIDE_
Parmit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIOOS CONTAINED IN THE GU1_.;d4G CODE,ZON'!1
G REGULP.TIONS AND AI.L APPLICABLE CCOES AND ORDINANCES, AND IT IS HERE3Y AGREED TY.AT Th'
Plan Check f, S WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICA71014S AND IN COMPLIANC
� WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSOANCE OF THIS PERMIT DOES NOT WAIV
I Sub-total - RESTRICTIVE COVENAP 13. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFS
�� UCENSE.SEPARATE PFWAITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
Stat®Tax
SOC—
Total S --- — - ------ - ------ —
PDl-19 APPLICANT OR AGENT
By _
Receipt Na. -- ---- -- ��, -------
Approved ADDRESS PHONE
SSDC --- $ SCJ
SOCi
PDC
SEWER CONNECTION S 1 ',5_,,.
SEWER INSPECTION S 3 S
SEWER SURCHARGE S
Comment s:
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
Date Requested_— 7 9" Time AR ---P.M.
Address .__�— /� ��+�- --, Permit #_
Owner .__ Lot #
Builder_
The following 136ilding Code deficiencies are required to he corrected:
presented to — (;;rAPP roved
/
Inspector (� Disapproved
Date
CALL FOR REINSPECTION
❑ YEi 0 NO