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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St. ,
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection _
Date Requested '�a— —�G� Time A.M.� P.M.
Address /. ( j / ���/ L Permit #-�` •��
Owner h— (/Ci 11Lc.) Lot # '
Builder
The following Building de deficiencies are required to be corrected:
a
Presented to
Approved
Inspector i _ Disapproved
Dote
CALL FOR REINSPECTION
[2 YES C7 NO
iI0 !� liiWLe
INSPECTION NOTICE
Citv cf Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone. 639-4171
Type of Inspection
Q�
Date Requested
+Time A.M. P.M.
Address / L'/ V mac✓ /I �� •r
Permit #
Owner Lot #
Builder
The following Building Code deficiencies are re red to be corrected:
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ITS
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6-"
Presented to
_� ❑ Approved
Inspector y�
��I Disapproved
Date
CALL FqR RFINSPF,CTION
YFS ❑ NO
INSPECTION NOTICE
City of Tigard Building Department ,
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-417
Type of Inspection _______.__
Date Requested __ Time__ A.M. _P.M.
Address Z--2 '-20 SC✓ /.2� __._-- Permit # __
Owner.—_—_,_--- Lot #
Builder
The following Building Code deficiencies a-P required to/be corrected:
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Presented to _ _ ❑ Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
YES 0 NO
ti
BUILDING RECEIPT r
NAME: DATE: rit/ p
ACCT. k DESCRIPTION AMOUNT
10-432 Building Permit 17ees s �Y� 62
10-431-600 Plumbing Permit Fees $ _
10-431-601 Mechanical Permit Fees $
10-230-501 State Building Tax $
10-433 Plans Check Fee $
30-443 Sewer Connection (20x) $
30-202 Sewer Connection (8O%)
30-444 Sewer Inspection
51-448 Street System Dev. Charge (SDC)
52--449-610 Parks I System Dev. Chat-go (PDC) $ ��)Zl)
52-449•-620 Parks II System Dev. Charge (PDC) $
31-450 Storm Drainage System Dev. Chrg (SSDC) $ �S L' �� 1t
10-230-505 TRFD (95x) _
10-478 TRFD (5%) s
10-230-5116 Washington County Fire N1 (95%) :
10-478 Washington County Fire MI (5x) :
10-220 Amart/Wedgewood $ J
"TOTAL $ C 1c[J
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(bt/1214P) �1c, y1 �j
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BUILDING PERMIT APPLICATION TIGARD DATC. _ to 5426
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE 657-1313
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. 1-)WNER PHONE _
Lor NO _ 1160
OWl"ER eday tllgwe LieYe L. J09ADDRESS-_ _'t?.701 '7?A' 12.8th _ ellr,cx, t III __
- Clackaw a 97U 1SARCHITECT r --
ENGINEER
BUILDER Sucre ADDRESS 15431 & 82rd Dr. DESIGNER
STRUCTURE IN NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
12 RESIDENCE ❑ COMM f-1 EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY Ft 3 LAND USE ZONE L—'4 •5 BLDG.TYPE 51, —FIRE ZONE _PLAN CHECK BY F,C1t HEAT_ Gas
_ GonstrucL sir 1e fami°v dwellinr -.r/attached garane. �—
Subject to ; .UU I.L,. o, lteiglitn Sewer 'surcharge 3 Bedroom 3 Bathroom
SEWERPERMITN 2VA"02 Isar:,, v f,6U
OCC.LOAD FLOOR LOAD 4 _HEIGHT_ ZU NO.STORIES 2 AREA 1382 NO.BEDROOMS S VALUE 66,50U.
BUILDING DEPARTMENT ^— SETBACKS FRONT REAR 1 ; LEFT SIDE (P RIGHT SIDE 11
Permit 34(JeUU 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 221.oU 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 561.UO RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
t 13060LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
tate Tax
^- SDC—
Total 5v, . ') f
-
By _j CZ, PDCM f y 1�UeUU AP"'LICAN?ORAOEIVT -
- Receipt No.
Approved )5Lk A13pple88 ` --- -.— SNE._
1
i
DATE INSP, YPE INSPECTION REMARKS PLUMBING DATE
^�� — - -- ----— - Contrnctor 0 VA)
Jr
Permit Nay
Rough-in
_��6�1 �4.�1�� .�^2.�� Fixture
l-� �"-- -- --, -- ---
40 41f
,(J �Q �, /✓� A - `� ����, Final
��� -- ------ r HEATRJG
Contracto— � -
O�_Is-T��
Permit No. "4-3&�` 'l_dtrA.
Get or Oil - -- --- -
i�
Rough-in --
Final
SEWER '-
• Fir I
DRIVEWAY
-- --------- ----- --- --- proal
SrormDramage
M-- — Siem Drain)Final
Sidewalk
Curb 3t Street Final
BLDG. DEPT.FINotL 'I TEMPORARY CERTIFICATE OCCUPANCY II Finn! _
CERTIFICATE G.CU;IAW" / � iL— __
7
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/oni•iy Pinal
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BUILDING PERMIT APPLICATION TIGARD
THE UNOEASIGNEO HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INOICATEO BUILDER PHON�"�
OR AS SHOWN ANO APPROVED IN THE ACCOMPANYING PILINS AND SPECIFICATIONS. OWNER PHONE -
aNNER t- i2i�� �/►RCHIrECT
/r
C� Q ENGINEER
ADDRESS g J
,J / DESIGNER
9uIlDER 1�/I'1�.'� /r�� 1-5 r. � '
STRUCTURE ' NEW ❑ REMODEL C1 AOLMTION ❑ REP in CJ RENEWAL ❑ FIRE O�,MAGE C1OE►A
CI RESIDENCE ❑ COMM O EDUCATIONAL C1GOV'T C3 RELIGIOUS ❑ PATIO ❑ CARPORT ❑ GARAGE G STORAGE ❑ SLAB❑
-7 BLDG.TYPE ti FIRE ZONE_PLAN CHECK BY HEAT
ZU '
O� ?ANCY AL-
LAND USE ZONE,,e. , - --
SEWER PERMIT I
OCC.LOAD FLOOR LOAD
HEIGHT n i"" NO.STORIES AfiEA NO.BEDROOMS VILLUe
BUILOING DEPARTMENT FRONT f_ FEAR Leff SIDE _ RIGHT SIUE,:
SET BACKS �� ` .'; � .
THIS PEHi.°.!T IS ISSUED SUBJECT TO THE REGULATIOI:S CONTAINED IN THE [UII.DIlIO CODE,
7 •` �; REGULATION: ANO ALL AppUCABLE CODES AND ORDINANCES, AND R IS HEREBY AGREED
P1airCt►�ck �- WORK WILL. wC DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COI1
WITH All APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NO
SuS•folal T RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY B
G v LICENSE SEPARATE PERMIT'S REOUIRED FOR SEWER.PLUfAgItIG AND HEATING_
Stan Tax
C S�_'•
row Appt ANT Oft AGENT
POCI
BYYtfONE
Fkcalpt Na -�—
Approved ADDRESS
SOC
POC •- h
SEWER CONNECTION -
SEWER INSPECTION
SEWER SURCHARGE S 11l
Comments 4. el - -
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Ilui1ding Permit No.
Location J, �Z,
Ua t e ----- — . . --
Certification of Registration
With the Builders Board
[� doing business as (dba) ,
am registered under the provisions
of ORS Chapte 101 (Oregon H6mebuilders Law) .
My Builders Board Registration Number is b
Ply registration is in full force and effect and expires on
-i ture -
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