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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
L f°'
I
Type of Inspection
Date Requested �/�� �y Time A.M._ P.M.
Address w -44/ Permit �—
Owner_ — Lot #
Builder
j The following Building Code deficiencies are required to be corrected:
' u
00r-
I,
Presented to ❑ Approved
Inspector ! Dlapproved
Date G — t''1-7
CALL FOR REINSPECTION
YES ❑ NO
Q
� t
BUILDING PERMIT APPLICATION TIGARD DATE__'��- � 45,69
TH7 UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INOICATFD BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT NO. 124
OWNER I.i ke ityle Prop. JOBADDRESS 12165 Sod 128th _ _ bell Vood _
Port. 97166 ARCHITECT
ENGINEER
BUILDER saim ADURESS IIJ57 W Dividion DESIGNER
STRUCTURE EY-NEW F. REMODEL ❑ ADDITION U REPAIR O RENEWAL ❑ FIRE DAMAG.- ❑ DEMOLITION
13 RESIDENCE ❑ COMM EI .:DUCATIONAL C GOVT ❑ RELIGIOUS ❑ PATIO ❑ CARPORT [..] GARAGE 0 STORAGE [I SLAB❑ FENCE
OCCUPANCY _ A-3 _LAND USE ZONE _j_L.BLDG.TYPE a FIRE ZONE PLAN CHECK BY _j_TW HEAT .—
_construct Single Family Tull i_g j!! tacked �araZ e.
3 Bedrooa 2 bat,
SEWERPERMIT# 26417.
OCC.LOAD _FLOOR LOAD 41j HEIGHT W NO STORIES _I__ AREA !1`, ! N0.BEDROOMS '% G3900L
_ BUILDING DEPARTMENT SETBACKS FRONT REAR ; L FFT SIDE 1' ' RIGHT
Permit 322.Uo THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING t—JUE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND OR.ANANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check .3U WORK WILL BE DONE IN ACCORDANCE WITH THF PLANS AND SPECIFICAT'^M"- AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF 'HIS PERMIT DOeS NOT WAIVE
Subtotal 531.3, RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINFSS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND IDEATING.
State Tex I?
544. 1 SDC-
Total _
i,
PUC# APPLICANT CAI Ac FNi
By
- Recelpt No.
Approved 0DRESS PHONF
DATE INSP, TYPE INF-I:C c ION REMARKS PLUMBING_ DATE
-.--i►- ^ —' i
Contractor -
--J----`- Paretic No.
-s-
Rough-in
Fixture
/���� • �� L — Final
r/ Z•L /-IQ� Contractor
Permit No. a ��G 1,01131f-3
Gat or Oil _
Rough-in
Final
SEWER
r�� , /mss •� —
�� Final
1
L IJRIVEWAY
- y '- Final
Storm Drainage
- --T� --- (Rein Drain?Final
Sidevalk
---- -- --�-• --�------ -- Curb 6 Street Final
T BLDG. DEPT. "INA- ���TEMPORARY CERTIFICATE OCCUi'ANCY Final
oach
r' fRTIFICAPT OCCUPANCY — -
Landscaping
II
II coning Final
f
4 �
BUILDING PERMIT APPLICATION TiGA,:!:) DATE 19
THEUNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PFtONER-Q'914�
OR AS SHOWN AND APPROVED IN THFACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER ,/a ��_ �.2I Sr�fi� I.�(�'�
LOT NO.
_
Sf(1 6 , JOB ADDRESS 1 ". a a_C
7 S4,, p/Y/S/r.& ARCHITECT
ENG(� n _ ,y 2- L G DESIGNEER
NER
GNER
BUILDER a ((�/y,(� ADDRESS r(�y'1 - 9 7
STRUCTURE NEW C1 REMODEL ❑ ADDITION ❑ REPAIR CJ RENEWAL ❑ FIRE DAMAGE CJ DEMOLITION
RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE: ❑ STORAGE ❑ SLABCI FENCE
OC%" ANCY LAND USE ZONE -BLDG.TYPEv_� �_FIRE ZONE � PLAN CHECK BY E��+tEAT
SEWER PERMIT K 5Dtaw
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA /.Vu�ry NO.BEDROOMS � VA. UE19,
BUILDING DEPARTMENT /
SFT BACKS FRONT 2 O REAR LEFT SICE /C/ � RIGHT SIDE
Pormit - 3 )A. ,06 THIS PERMIT1-S SUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, 701.1'713
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT INE
Ptan Check d �_ WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
IWITH ALL APPLICABLE COTIES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV-
Sut>-total ' .36 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
�
^ LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax /?.
SDC.
Total
PDCN APPLICANT OR AGENT
By
-------------
ved Receipt No.
Appro ---- - ---- --- - - _-
ADnRFSS 1`110M.
SDC -
PDC - � . o ,ua
SEWER CONNECTION
SEWER INSPECTION S 3�'1oa
SE'JER SURCHARGE 5 —_
A6
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