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INSPECTION NOTICE
City of Tigard Building Department
12425 S.W. Main St.
Tigaro, Oregon 97223
Phone: 839-4171
Type of Inspectior
Date Requested -
-� Time_jt!!0— A.M. P.M.
Address /�/� �- ����
1-s � Permit # _
Owner _ {
- -- .__ Lot
Builder
The •`ollowing Building Code deficiencies are required to be corrected: 1
II
Presented to
— El Approved
Inspector __ 1
❑-Disapproved
Date
CALL FOR REINSPECTION
NO
N IFIWff 1F 3F ! ■
BUILDING PERMIT APPLICATION TIGARD DATE I`!_�^ �`—,�s 3796
THE UNDERSIGNED HEREBY .APPLIES FOR A PERM ff FOR THE WORK HEREIN INDICATED BUILDER PHONE "'*"' '
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOTNO. 83031).
OWNER "QV810PIT1et)t rJODADDaESS .1 109th Avenue,
aj 404 J +Lb 97950 ARCHITECT Joe kjani_un/
ENGINEER
9UIL.DER Seri® ADDRESS SIGNER L92-8895
STRUCTURE EX NEW [.J REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE i 7 DEMOLITION
C, RESIDENCE O COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS l PATIO 7 CARPORT ❑ GARA.�'IE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY LAND USEZONE A- 22 BLDG.TYPE 5N'' _FIRE ZONE-w-� —PLAN CHECK BY d-Uth HEAT
ruct single Family dwelling w _attactiou garage. _3 8pdruow: -
-ISsue of Permit #3793 (14817 SW 109th anus) -_— — —
_._—v._ PLAN nAn
SEWERPERMITM `,378 — 1750.00
UCC.LOAD FLOOR LOAD 40 HEIGHT _23 N0.STORIES 2 AREA 1423 N0.BEDROOMS VALUE
BIIILDINGDPA
ERTMENT SETBACKS FRONT 2h REAR 1 LEFT SIDE HIGH1 SIDE
_ —_ _
Permit I J1.•OCA THIS PERMIT IS ISSUED SUBJECT 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 10.00 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 WAIVE
Sub-total 201.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICEP'ZE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax
SDC— b4UO.01,;
Total 6208.b4 PDCM Z 1t�Qv lt(� APPLICAt T RAGE Tl�� -
By 1
Receipt No. ' — ----------�._�.------ ---
Approved dwh i ADDRESS PHONE
ww
DATE IINSP. TYPE INSPECTION`• REMARKS PLL BING DATE
--} �/� _— Contractor
Rough-in _
Fixture
Finaljcz
-- —
HEATING
/�
Contractor y
Permit No.
2-1-72 ➢tel' �=`�
-� —
Gas or Oil
-- Rnjgh-in
Final
SEWER
Final ?�
DRIVEWAY
Y v Final
Strom Droii�aga
lRain Drain) sinal
Sidews!A
Curb&Street Final
Approach
EI DG. DEPT.FINAL TEMPGRARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY —
Landscaping
'- .� Zoning Final
6UIL Di NG PERMIT APPLICATION TICARD DATE_ C 19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PH0NElu 6
CDR AS SHOWN ANCI APPROVED INTH EACCOsAPANYINGPLAINS ANOH
�iSPECIFICATIONS. 0WNER PO�:E
u..1NER �J dJ�Pi� N'f 03•A R � p� OQ'.��ve. Larrro.>�3u3��2t1•/D
DD ESS -1r
/� ENEER
I ��' Vax�o� rWc E�
9UilWER �ttil>h�2 ADDRESSR�. O� y393 NG CYraV, ESIGNER
57RUCTU32 NG'lJ D REMOOEL La ADDITION REPAI ,g'`IT riENE'WAL ❑ FIRE DAMAGE ❑ DE'.501_lil:
R=SIf]ENC_ C COMM Cl EDUCATICNAL _1 GOVT ❑ RELIGIOUS u PA-NO Cl CARPORT r] GARAGE C STORAGE r SLC.._S
�� _ C � FEN
C,CZ FAiVCY '—R---.7—LANO USE ZON5 _/_d?. BLDG TYPE ,!EN—FIRE7.ON�E.-- PLAN CHECK BY Yr�E.
L 11481-7 to '�'a fig) 3
Em—WER PERMIT .��X/00
GCS..LOAD FLCOH LOAD HEIGHT �'� NO.STORKS z ARE1 14A3NO.BEDROO!dS
SUILCI,.NC CE?AATMENT SET BACKS FRONT Z 9 REAR ZI LEFTSICE_ RIGf{T 517E ZQ
191 HS PERMIT IS ISSUED S 18JECT TO THE REGULATIONS CONTAINED IN T}iS EUILDINIC COD.: ZOPI:'
!=13n Check 1 Q, OQ PECULATION'S AND ALL A.)PLICABLE CODES AND ORDINAtICES, AND IT IS HERESY GGP_ED Tr,pT T•
WORK WILL SF DONE IN ACCORCANCE W;TH THE PLAT S AND SPECIFICA-,IONS AND ITJ CO..-4,-LIAN
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THI: PERMIT DOES WAI
5 :�-t:t31 D •�d RESTRICTIVE COVET 1 AN rS. CONTRACTOR AND SU3 CON i RACTOAS TO HAVE CURRENT CIrf @"'SINE
LICENSE.SEPARATE PE9M;TS R_7UIRED FOR SEWER,PLUMBING AND HEATING.
Lia!a Tax • ,• ��
SOC — �.e 1
Total 0 .� _ _ 0 Qf'— it G lh •�
POC# APPjC-ANOF -�—
By — Receipt Na. _D6tio �� J
Approved
SOC S fop ..
roc - s Ido Ltuwe# 3
SEWER CONNECTION S 60 x,•30)
SEWER INSPECTION $ �J
SEWER SURCHARGE
i':n,-lank: W�G��DI Kf'�'O���Qi�. ti�?� lT�[�s �t�,f� �'y►+11 "I' r�/�'►1fn
&' - -- -----