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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
i) Type of Inspection
Date Requested ' ~��' — Time A.M.----P.M.
Address y C2--Z �� -. Y Permit
I �
I Owner __ ��_ _— �___ Lot #—._
i
Builder___ �-•---- ---
j The following Building Code deficiencies are required to be corrected:
,
Presented to I� Approved
Inspector Disapproved
Date -S"..—�tz 4E tz —
CALL FOR REINSPECTION
E?J YES D NO
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A
Building Permit No. f
Location
-F
t e
Certification of Registration
With the Builders Board
1� Z—L—�'!C) ��� •��' � doing business as (dba) ,
_ am registered under- the provisions
of ORS Chapter 70T. Oregon Nomebuilders Law) .
My Builders Board Registration Number is
My registration is in full force and effect and expires on ,
Signature
Wiwi mlw
BUIul " PE MIT APPLICATION TIGARD DATE _ , ,y_ 47
THE UNDERSIGNED HEREBN APPLIE S FOR A PERMiI Feil I HE WORK HEREIN INDICATED BUILDER PHONE ='+ ,1 a�—_•
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO.
OWNER Leon krgrieri{u- JOB ADDRESS 14lla S►� `l�,Gk:, A •;tur
--- '
_ �v� _ OcDonalui Acre,
AR,;HITECT _
BUILDER $ate ADDRESS Z17 Sd7tit1ENGINEER
� rDESGNER
STRUCTURE C�(NEW _ L7 REMODEL ❑ ADDITION ❑ REPAIR 11 RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
11 RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CAR PORT ❑ GARAGE ❑_STORAGE ❑ SLAB❑ FEN^,E
OCCUPANCY _�1-- LAND USE ZONE _IBLDG.'PYPE^ 5N FIRE ZONE __PLAN CHECK BY JiCit HEAT_
Conaltr ict rainE;l.t fa;:ilk+ dwullin w nttahced &arra&e. —
— - 3 beair«oiiss 3 Rathr000ls
SEWER PERMIT# 27 1 70 ) _ (;arabe 4b`�
OCC.LOAD FLOOR LOAD 4-..-,.,HEIGHT NO.STORIES I AREA 14 IU NO.BEDROOMS _ VALUE n7,(1(10.
_ BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SILE
Io RIGHT SIDE
24,It,
Permlt334*00 _ THI
S PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS "ZPFBY AGREFD THAT THE
Plan Check 217. IU WORK 'WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFIC:T :wS AND IN COMPLIANCE:
WITH ALL APPLICABLE CODES ANU ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal — SSI. IU ( ESTRICTIVE COVENANTS. CONTRACTOR AND SIIR cnNTRACTORS TO HAVE CURRENT CITY BUSINESS
St;.te Tex 13.36 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
SDC
lotel 564.46
PDC# I I Il)U.Ut1 APPLICANTORAGEN*By _ _ LH
Receipt Nn. _
Approved BC:IN AbbRE88 -- - — PHONE
1117
AU
DATE INSP. T PE INSPECTION REMARKS
PLUMBING DATE
hie0,ntlt.,
...........
PermitNo. 21 IVD�
Rough in
Fixtur-
HEATING
actor
..' AC L _ Gb h ✓lA•�.-.e.a.0
Gas or Oil V71
in
!�Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb IN Street Final
BLDG. DEPT. TEMPQRARY
7 CERTIFICATE-occLp�AKEV-
CEPTIFICATE OCCUPANCY Final
',andscjping
'oning Final
= Z71
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPNOfVlat�
GR AS SHOWN AND APPROVED IN THE ACCIMPANYING PLANS AND SPECIFICATIONS. (NINEPPvonF
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_7'r/NEp ! �37 ADDRC55 7L� t'I/_
I� f , /y/ �J ARCHITECT
---- ADUR. �D�/ s W. 4 t� J.�iT.�.3 EcGINEER
UI�_nc� cam. G SIGNER
$TRVCTURE- _ NEW _ ❑ C
FIC CIADOITIO�. - l_1R_EPAIR�I QRE14EVIAL. ❑FIRE DAMAGE ❑OEMOLITI
E
RESILi "!Cc ❑ ']EDUCATIONAL..,EDUCATIONAL 0GOV'T ❑hELIGIOUS DPATIO OCAR PORT ❑GARAGF L7 STORAGE EISLA3 LIFEt,
CC`CUP.�G•_Y LAND USE ZONE0LOG. TYPE-4�--N_"FIRE ZONE PLAN CHECK BY fy" HEAT
• -
,SEWER HERMIT
ysS_LO D FLOOri1,�� VL1EIGH I
5I/ICO—IN G DEPARTMENTs
r- SET BACKS FRONT a(7 REAR JS LEFT SIDE /rJ RIGHT SIDE14. �G
I Perrlt _ �.�� 41, U b
THIS PERMIT IS ISSUED SUF.JECT TO THE REGULt,' 'ONS CONTAINED IN THE BUILDING CODE, ZON
REGULATIONS AND AL1. A7PLICABLE CODES AND OROINANCL•S, AND IT IS HEREBY AGREED TIfAT 1
-- -' WORK WILL dE DONE IN ACCORDANCE WITH THE PLAN; AND SPECIFICATIONS-
AND IN CONSPLIL.NCF. Y:
S.l7•tot�I
I - 162 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF
THIS PERMIT DOES NO1 WA
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY 3USIPJ
rate Tax ILICENSE. SEPARATE PERMITS REQUIRED FCR SEWER, PLUMSiNG AND HEATING.
i lural I yG SDC - 100
r PDC#11 y0�
APCL,ICANT OR AGENT
Appru.fd I /� Receipt No.
SDC - S
PUC
SEWE'l _CONNECTION S G S•
SEXIER INSPECTION $ p ?S'•
5EWER SURCHARGE $ _
Comments : �74/ -