13475 SW 115TH AVENUE 1•.
13475 SW 115TH AVENUE
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INSPECTION NOTICE I
City of Tigard Building Department
17.420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Tempe of Inspection
Data Requested—
/ / y - __ Time *_A.M. P.M.
Acldrrss Permit #
Owner________ _�� _ Lot #_
I
Builder —.��-
The fc+llowing Btii'. ,%g Code deciciencies are required to be corrected:
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°resented to I� Approved
9nspector L Divipproved
Date
CALL POR REINSPECTION
❑ YES ❑ NO
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CITY OF
BUILDING PERMIT APPLICATION TIGARD DATE .,,g_ N° 0 0 713
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE.
HNER ! �/1! .�c/ (�' /wt /e Z" ADDRESS „ BUILDER PHONE
Lam►" ENGINEER
BUILDE �r, r ' ` ARCHITECT DESIGNER _
STRUCTURE bN'EW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL LIFIRREDAMAGE [jDEN-OLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T DRELIGIOUS❑PATIO ❑CAR PORT OGARAGE [I STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑COND;TIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE___ EILDG�.gTYPE_ FIRE ZONE— PLAN CHECK BY_ HEAT __
1 J. X :�G 61" . / 170- J(.4. . I1.".
CC IOAD _ FLOOR LOAD HEIGHT NO.STORIES AREA VALUE /
BUILDINGOfXARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Pe,mit JZ,
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAIN' 7 IN 1`4F BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT :S HEREBY AGREED THAT THE
�— WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPI.IANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
1%State .0 , ' LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUM91NG AND HEATING.
Total 3,�, J 2
By
A-PPIICANT OR ENT9 j
Approved ! ( Receipt No I,f.CYjt'l c.)._.. '� S
—_ �.--- ADDRESS
w w w w W w
DATE INSP. TYPE INSPECTION pp REMARKS PLUMBING DATE
Contractor
3-7,,- X7Ppri-nit No.
Royinh-in
Fixture
Final
HEATING
Contractor
Permit No_
Gas or Oil
Rough in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
Curb&Street FLial
Approach
BLDG. DEPT, FINAC TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
.0ning Final
Address,' %' )� �� !/� �'� _-._. Permit No. -
Permit charge
Owner �a e�' /` /7.����1 ,,,_ Connection fee ,S�a
Paid by
Type of building_ r�� �� Date connected
Service rate �y� gS'Lo Inspection fee_— 2-s
Contractor Paid by_1�� Date
v
Size of connection �� Assessment_ L?r Pai.d`______
Sur-Char, t i'a. J[rry Jt// 1.0*e
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PERMIT TO i"ONNECT
Tigard Sanitary District
PEhMIT N? 1,153 DATE
PFRMIT IS (.IV:--,N TO
OF
TO CONNECT
TO THE SYSTEM OF TIGARD SANITARY DISTRICf
AT
THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL CON.
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED,
PERMIT FEE PAID re............... TIGARD SANITARY DISTRICT
CONNECTION INSPECTED AND APPROVED
Date Superintendent