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INSPECTION NOTICE
Cit/of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone:639-4175
Type of Inspection Lirr
Date Requested_ --- -1TInW_ A.M P.M. _
Address __� `�� = _ Permit #
Owner_. -_--- ! /1✓l.(�P Lot #
Builder
The following Building Code deficiencies are required to be corrected:
Presented to _..__+.---._ _ .__-. -_ 4--Approved
Inspector ' - �Q.�.r_, ��-_� .� L� Disapproved
Date
CALL FOR REINSPECTION
0 YES L7 NO
No-AIR
a"%am
INSPECTION NOTICE
�4��� City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phonc: 6394171
Type of inspection k
Date Requested
._____..__.__________--x{2_'5 Time—,� A.MI. P.M.
Address ._�, - f z - Lf _ -?_ — Permit
Owner _
_._...------ Lot
The following Building Code deficiencies are required u be corrected:
Presented to _- —_ Approved
Inspector _ Disapproved
Date o 2
Ste'
CALL FOR REINSN XTION
❑ YES X NO
Ilu i Id l rid 1,orm i I No
LOCat ion /-57
Cert if icat ion of Reg istrat inn
With the Builders Board
C doing business as (dba) ,
am registered under ,he provisi
of ORS Chapter 101 Oregon Homebuiiders Law) .
My Builders Board Registration Number is
MY regi;tration is in full force and effect and expires on
2
Signature
Iffm [NIP
BUILDING PERMIT APPLICATION `* TIGARD DATE �ctt�bPr '- 19 ria 5655
THE UNDERSIGNED HEREBY APPLIES FOR AWRMIT FOR T HE WORK IIEREIN INDICATED BUILDER PHONE648`9400
OR AS. HOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE Y,
OWNER Have liula;c:ttr~r _ JOB ADDRESS 15615 5P 87th
LOT NO. 13,_Chipsatttan Vo:4tYs
Hillsboro Oh 97123 ARCHITECT
ER
BUILDER aam ADDRESS 590 SW hraokwaad, DEIGN
SER
STRUCTURE ANEW ❑ REMODEL �❑_ ADDITION C7 REPAIR ❑ RENEWAL ❑ F:AE DAMAGE Cl DEMOLITION
E#RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T El RELIGIOUS ❑ PATIO 11 CCAs PORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY !(-3 --LAND USE ZONE R12 FIRE ZONE_—PLAN CHECK BY _Exw :4EAT_gas
Gcrnatru�L aixaa�e ._s11.t�Lllt1�_t�.L+�f��.h��y�_r,�,�ei�j,a.i�tta_,�E �t5241 _.�.-�—�
SEW'RPERMIT# `^ 2'i65 prr 'aid ua►ra6e 43U 2 bath
OCC.LOAD FLOOR LOAD-- + HEIGHT 6 NO.STORIES ! AREA 145 NO.BEDROOM VALLIP-UUU
BUILDING DEPARTMENT SET B;CKS FRONT— _ RFAR LEFT SIDE _ RIGHT SIDE
Permit 316.(►U THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
40.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check WORK WILL BE DONE tN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
3514.00 WITH ALL APPLICABLE CODES AND ORDINANCES. THE. ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY PUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FO'i SEWER,PLUMBING AND HE%TING.
State'rax 12.64 :i U(: :talnu S)5u'UG
SDC— 500..00
Total j 306.64 — PrJCM II $150.QU AFNL.ICANTORAGENT '
By
RecriPt No.
t Approved J ADDRESS PHONE
■ �' ■ 1
,DATE INSP. TYPE INSPECTIO'N� R—E7MARKS PLUMBING DAT;
—�
Contractor
6_�_—i PermitLT _9
Rough-in OL
Fixture t u r —/ —'
Final
—Ie�'ar?f�Lt HEATING
L
Contractor
�tEA4
Permit No.
Ga:or Oil
Rough-in
v Final
SEWER
�— -- Final —
DRIVEWAY
_�-�- �---- Final
i----_��� —— -- --
�_ —_ - Storm Drainage
(Rain Drain)Final
---_--- ------ Sidewalk
Curb&Street Final
ear,,nach
BLDG. DEPT.FINAL - T �'E O
TEMPORARY cERTIFICACCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
■� r Iws
TNi: Usti(".:RSI(�N•t Li N`_HLdY nv.�LJkS 1 ul( nNk Hn,III i•Ui( Illi- rVUlln Il..11�lr i �1...�IL�� ��,.�._.,Ln . . _.,.f/__yQ=�yoO
On, AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANO SPI.CIFICA(IUNS. owNElt:e�u/lr
LOT r10
OWN ,J�•�S:'utLJr[�� 10 C7 ADDRESS � •.'1 ••� 97 1,._
ARCHITECT
FNGINCER
p-r.C.P� LJSIG'VCR�-•� _
STRUCTURE RVNEV1— Elnk-m10ELC� �DOITIOy ❑►icP IR ❑RcVE',:�L FIrrR��EOA:AI.Gc UDEt.10
ESIUENCE ❑COlr.ti'i ❑EDUCATIONAL CIGOV'T URELIGIOW UPATIO ❑CAR('ORT ❑GARAGE u STOiiAGE❑SLAG U
CCCI P.\!;•_Y $= _,_LAND USE ZONE �� OIDG. TYPE PIAL Ci1ECK DY^!- L !— HEAT
Q NQ STRUCT SINGLE FAINLILY DWELLING w/AT'rAC14EI GARAGE.
BATEP,0(1,tl �.3 BEDROOM
3 C U E R PCRMIT it ? SC _ Garage
eov
FLOQ LOAD HT /16 -NO,STOWES / AREA N0-QfjpflQOA1S :�` VALUS/
S111LOING OEPARrmENT SEr BACKS FRONT % " REAR__, - LEFT SIDE — RIGHT SIDE �l
THIS PERMIT IS ISSUED SUSJI:CT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. 7
1% 3n �h✓i:( ' y O REGULATIONS AND ALL APPL:CABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED TH
r------- WORK WILL BE OONF N ACCORLANCE WITH THE PLANS ASND SPECIFICATIONS ANO IN CGA',PL16NC
J.7')•i0(dl Ii �' — ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES 140T
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY O(
�:at+! Tax ( / �. LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER. PLUMBING AND HEATING.
Total I C•� SDC -
-1 PDC
�-•r _.-_. .—.� APPLICANT OA AGENT --�_--�_� --
A� ppruv(•!i �I - � Receipt No
' innpFSS w �
,;J)(, (S t o T 71!
SDC - 5
PDC - ffi
SEWER CONNECTION $ 'A-�-- �..r., --,*--Ar Ir
SEWER INSPECTION $ "S.
SEWER SURCHARGE $