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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box
i igard, Oregonon 97 97223
Phone:6399--4175
Type of Inspection _ 094 z L C.eyC_
Date Requested /Time--- A.M. _P.M.
Address _ /I �`tJ C� �� 7 Permit #re d3
Owner %-/__� __/1�C�Jd�/\ - _ Lot #
BuilderThe following Building Code deficiencies are required to bq+ corrected.
Presented to Approved
Inspector — L� Disapproved
Date — -- — ��
CALL FOR REINSPECTION
❑ YES ❑ NO
W !A A Af liwi' W W lA
INSPECTION NOTICE
City of Tigard Building Department
\ 12420 S.W.Main St.
Tigard,Oregon 97223
Phone. 639-4171
Type of Inspection
Date Request/ed
D - S Time_d_ A.M._ P.M.
Address /C ! 3n �� lA/ / Permit
Owner-_.._.—__ _._— Lot # —
The following BuildivIi Cole tiefici cies ar required to be corrected:
—r�
- - i
Presented to _ _ _] Approved
Inspector �L'e'�""�� - U Disapproved
Date _
CALL FOR REINSPECTION
❑ YES ❑ NO !
Ilu i I d i ng f'vrm i t No 6Z03
Location
Date
Certification of R%gistration
With the Builders (bard
C, V1 doing business as (dba) ,
w !,i `�tO'r cj�� ✓ am registered under the provisr
of ORS Chapter 701 Oregon Homebuilders Law) .
My Builders Board Registration flumber is
fly registration is in full force and effect and expires on
gnature
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BUILDING PERMIT APPLICATIONTIGARD DATE 5603
TNF UNDERSIGNED HEWEBY APPLIES FOR?, PERMIT FOR i HE WORK HEREIN INDICATED BUILDER PHONE 639--3029 —
OR AS SHOWN AND APPROVED IN THE ACCOh PANNING PLANS AND PECIFICATIONS OWNER PHONE- _.
,W�-k A� LOT NO._-2
OWNER W) ielson 10B ADDRESS 16531 _i, 93rd Kneeland Utates
ARCHITECT
l3+ub '.c�Ixnx� 159010 sw Serena Ct. ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURF ® NEW ❑ REMODEL ❑ ADDITION U REPAIR ❑ RENEViAL C! FIRE DAMAGE ❑ DEMOLITION
EXRESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO [] CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY __R-3__ LAND I SE ZONE R-7 _BLDG.TYPE _5A_ FIRE ZONE_-__PLAN CHECK BY --HEAT
CONSTRUST SINGU FAMILY DWELLING W/ATT'AChW) GARAGE
SEWERPERMITM -------
OCC.LOAD FLOOR LOAD U HEIGHT 14 NO STORIES I AREA NO.BEDROOMS VALUE6J_9
4 BUILDING DEPARTMENT $EfBACKS FRONT �4' RFAR �� LEFTS;DE RIGHTSIDE
Permit 3+4U•UU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CCNTAINED IN THE BUILDiN0 CODE, ZONING
221.00 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan CheckWORK WILL BE DONE IN A('CORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
• WITH ALL APPLICABLE C,,.uES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
56 1
Sub-total _—�RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax
13.b01 LICENSE.SEx��A��PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
Total
5/4.6u SDC— j� 5UU*UU
TI $15u.uo
PDCN APPLICANT OR AGENT
By I
Receipt No. [ j Ci
Approved ADDRESS PHONE
GATE INSP. TYPE INSPECTION REMARKS PLUMSIN q DATE
Contractor
�Q I •h Permit No.
Rough-in
A�jr Fixture
/ myti Final
HEATING
Contractor G " j
Permit No.
Gas or Oil �t
Rough-in
Final --�--
SEWER
Final
DRIVEWAY -
-.__.r � Fina!
Storm Drainage —
__ (Rain Drain)Final -
___� Sidewalk I —
_ Curb&Street Final
___ Approach
BLDG-DEPT, 'Itlr I, TEMPORARY CERTIFICATE OCCUPANCYI Final A— — -
ICERT lFsCATE OCCUPANCY
Landsc?ping
Final
I
44
'ql
IS III rm
BUILDING PERMIT APPLICATION TIGARD DAT
THE UNnERSIGNEr,HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF _
OR ASSHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE . 4
UnNER .DQI� +1` I S c JOB ADDF E•SS �,� J jZ e, ,
LOT NO i.`. L si
I��. C S 1. r f � _� I V F
ARCHITECT
ENGINEER
BUILDER ') "741'T4U,1 ADDRESS
_ Arlo S L, Sc.'em C f— DESIGNER
STRUCTURE NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Li RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITIC
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE 0 STORAGE ❑ SUB❑ FEN(
k`ZUP! LAND USE ZONE / . ) E'LDG.TYPE .'1_�' -- PLAN CHECK BY HEAT. <<Z
041
SEWER PERMIT ,��� J.._ �— (, f 9�2�OCC.LOAD FLOOR LOAD HEIGHT 51_T NO.STORIES___L AREANO.BEDROOMS
�VALUk �
BUILDING DEPARTMENTi `
SET BACKS FRONT�� REAR , _ � LEFT SIDE �� RIGHT SIDE 1�
Pormit THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE,ZONIk
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT T1
Man Check_ r � C� ' WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANI
WITH ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIT
Subtotal `� .01; RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 96SINO
/ LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State To IPU
SDC �-
Total
PDC# AP NT OR AGENT –"
Approved Receipt No. ADDRESS N
SSDC --- •7 r • � —p�-- ----�
SDC - � `'�%
_ s x C7APO
S-
PDC
1
SEWER CONNECTION
SEWER INSPECTION S aJ f
SEWER SURCHARGE S
C r1 rr)m a I'1 t C • I
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