11170 SW 123RD AVENUE ,a► �►.
1 `
• '
777
+ ' • lir
cd
= ? • '
Cd
to
UD
/T
` • .. ii l
AAA i,, • t•.Y ' ��.
•
L '.
) •
\ y •1
04
1 • -1 • \
4T Ca
I ti
1 •1 9
1.4
lul
Aq '3 1
A r .
I
INSPECTION NOTICE
City of Tigard Building Department i
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection
`.s✓ fa'
Date Requested _ Time A.M.__- P.M.
Address Permit
Owner - _ Lot #---_ _`--
Builder
The following Building Code deficiencies are required to be corrected:
i
I
Presented to ❑ Approved
Inspector
/-�I Disapproved
Date
CALL FOR RENSPECTION
12"YES L] NO
INSPECTION NOTICE
City cf Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639.4171
Type of Inspection
Date RequestedTime M.1_~ P.M.
Address ( -�-' f*ermit # -
Owner — — Lot #
BuilderThe following Building Code deficiencies are required to be corrected:
A
N,
Presenod to _ Approved
Inspector Disapproved
Date .4�
CALL FOR REINSPECTION
YES fel NO
BUILDING PERMIT APPLICATION TIGARD DATE JU-4 II -lig 85_ 5471.
THE UNDERSIGNED HrTtEBY APPLIES FOR A PERMI r FOR THE WORK HEREIN INDICATED BUILDER PHONE 639-6410
OR AS SHOWN AND APPROVED IN THE.ACCOMPANYING PLANS ANR4PECIFICATIONS. OWNER PHONE
/ LOTNO'___._ _
)WNER CUOton Homes by DII'4 OB ADDRESS 1 1 170 `$1 '?Y` tl+t!'-its 'c:t3 p���(D0 lalton Park
ARCHITECT
4awbern ENGINEER
B IL^FR Sane _ ADDRESS 1,t. 3 Brix 253 _^ _ _DESIGNER
STRUCTURE 11 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR Cl RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
11 RESIDENCE ❑ COMM Ll EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY Rn3- .LAND USE ZONE _ BLDG.TYPE —51w FIRE ZONE PLAN CHECK BY F-W HEAT Gas
Construct single family dwelling w/attached garage.
3 Bathroom 3 bedroom
SEWER PERMIT# 23419 Garage 443
OCC.LOAD FLOOR LOAD 40 HEIGHT 20+ NO.STORIES 2 AREA 1938 NO_.BEDROOMS_3-_VALUE 62 Ut)U.
_ BUILDING DEPARTMENT SET BACKS FRONT ',),U `REAR 20 LEFT SIDE 5 RIGHT SIDE
Permit_ 319.UU THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE.
Plan Check 201.35 WORK WILL BE DONE. IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal 526.35 RESTRICTIVE COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
�I��j�JSE.g$f,PAR71�E PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 12.76 vv LS uWu
Total _ 5:iy.i: SDC— $500.00
PDC# j 415o.00 APPLICANT OR AGENT
By CL _ i_7 _
Receipt No. S r_j At _-rJ�(
Approved L•"CW ADDRESS PHONE
1
FXw
U.Ili
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DA7 '
Contractor
Permit No. I 4r.
Flough-in
Fixture
Final
HEATING
F-,2 Contractor 0
Permit N
Gas or Oil
Rough-in
Final
rwili
Final 0(c In W
DRIVEWA(Y
Final
76
I—StIrDrainage
(Rain Drain)Final
Sidevolk
CurU&Street Final
SLOG. DEP 1. ii;FA—L --7--'7 FL: i P-®R A-1; CF.P TIF :ATE OCCUPA.N-FV
J"rRTI"CATECCLUPANC Fire[
n l,
di"doing
aning Final
THE (JNC)!.'HSl(,NtU HtFILU V NI-rLILS I U)r A rt_tINH I I U•,
OR AS SHOWN AND APPROVEU IN THE ACCOMPANYING PLANS AND SPECIFICATIONS U�'r*+r r•%Iturle� __��
SG2� 0 LOT NO
•7'.VId EI-L'"/ �C:.l.-� ¢K,� JOD AUDRESS
ARCHITECT
ENGINEER
adv
Aoo►tEs; IL
�ul�_7
goa /yCkJDE51G`/ER.I^�/��A�L ti[D/�t'sP _
STnUCT_uaE - ONcVJI
.W ORFOEL r OADOITION OnEp-mn_ OREYEYIAL IJFIREOA?AAGE ODEMOL
XnESILIENCC OCOMM ❑EOUCATIONAL nGOV'T 0RIiLIGICUA]PAr1O ❑CAR PORT LIGARAGE ❑STORAGE OSLAS L]
CCCL'PAL.'Y+ - ANO USE 20NE OIOG, TYPE PLAN CHECK BY, HEAT
CONSIRUCT SINGLE FAMILY D a.I.TNG WIATT�IFD GARA_GF, _
BA'T'HROOM 3 BEDROOM —
-
aEUER PERMIT " 72 s /
^ f 0- P FLOOR SAO ��(J HCICINT NO.STOR;Es .Z AAS 0 BEORQQ&rS 3 VAl u[ 2.i
�' SrJILrIN•; OCIIARrmCNT Sc-T BACKS FRONT oPO REAR np O LEFT SIDE
S RIGHT SIOEa --
,- — - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 2
I:-;in C:IrckU 7 3 )'" REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERERY AGREED rH
r__ WORK WILL BE DONE IN ACCORDANCE WITH THE PLar:S AND SPECIFICATIONS AND IN CONIPLIANC
JJ'1•toulI S' Z h ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT
RESTRICTIVE COVENANTS. CONTRACTOR AND SUR CONTRACTORS TO HAVE CURRENT CITY B
`%strl Tax I LICENSE. SEPARATE_ PERMITS REQUIRED FOR SEWER. PLUMBING AND HEATING.
Total SDC
PDC# —
.�, 6— CAc.rif*" JU•Mc a ,),AOL
APPLICXNT ON c
Aavrovm Receipt No
,nnn FSs — PHONE
OC (Storm .7 s'Q BGG ��U �� •\�
SEWER CONN
ECTION $ T r. D 4
SEWERINSPECTION S L-, u / y
SEWER SURCHARGE $ _;(d i D G . 'AIA R?',
7 /
Comments :
I1
1
1
i.
-
" , 17
flu iIding Permit NO
L o c a t ion
Certification of Registration
With the Builders Board
1, ~L��,__� � ��� doing business as (dba) ,
17 vi.�w am registered under the provisions
0 bpi
of ORS Chapter 101 Oreon Nomebuilders Law) .
My Builders Board Registration Number is
I My registration is in full `,arce and effect and expires on
i ure
i
BUILDING CFIPT
DATE:
NAME: �5
ACCT. M DESCRIPTION AMOUNT
10-432 Building Permit Fees
10-431-600 Plumbing Permit Fees _
10-431-601 Mechanical Permit Fees f
10-230-501 State Building Tare
10-433 Plans Check Fee s 6712 U `
30-143 Sewer Connection (20x) C S7`
30-207 Sewer Connection (90%) f — ' eo
30-444 :ewer Inspection
51-449 Street System Dev. Charge (SOC) S lj0
52-449-610 Parks I System Dev. Charge (PDC)
52-449-620 Parks II System Dev. Charge (PDC) t �J/l�
31-450 Stora Drainage System Oev. Chrg (SSDC) f "
10-230-505 TRFO (95X) s --
10--479 TRFO (5X) s --
10-230-506 Washington County Fire 01 (95X)
10--479 Washington County Fire 01 (5X) f
10-220 Amart/Wedgewood : e D,
TOTAL ; Caz /t
(b9/1214P)