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:NSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 87223
Phone: 638-4171 I 1
Type of Inspection ___._.._ -tf'.� � —I
D..te Requested Time__.�A.M. PM. l �I
Address L_? L�C/� r� Permit
Owner _ of #
Builder
The following Building Core dew we.•,;;es aro required to be corrected:
/ J �
—J� ���•-'��"��� = ��.�'–GCs_–
Presented to — ❑ Approved
Inspector ! �� Disapproved
Date
CALL FOR REINSPECTION
l_/] VEt 0 NO
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INSPECTION NO FIC-
of Tigard Building Department
12420 S.W. Main St.
Tigard,Ore(Ion 97223
Phone: 639-4171
Type of Inspection
Date Requested..----..-_ - `'
` _ _ Mme_ A.M.�_PM
Address Permit -�--
Owner_
--- Lot #
Builder _
The following Building Code deficiencies are required to be corrected:
I
!Presented to --_--�� - —•_._
Approrad
Inspector '� nn
—" LJ Disapproved
Date --
CALL FOR REINSPECTION
❑ YEA I� NO
t.
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CITY OF TIGARD—12420 S.W.MAIN—TIGARD,OREGON 97223
LL// RECEIPT
DAT '�7 � AMOUNT: $ Z 7S-_� -
A^—� �- Ga ��C�G �LLARS i
NAME: CASH:
V, 1�-G
ADDRESS- _ CHE j'—
M.O.:M.O.:
r OF
FOR. ACCT. r PERMITS SURCNAR01 _ AMOUNT _
SEWER BILLINGS 40-364 _ _ $
BUSINESS LICENSE 05-331 —
PLUMBING PERMIT 05-332 S_
MECHANICAL PERMIT 05-332
BUILDING PERMIT 05-333
SEWER CONNECTION 40-363 ��Gl� oc
SEWER INSPECTION 40-365
SYSTEM DEV,CHARGE 25-366 _ AU,Cac _
PARK DEV.CHARGE #1 50-367 CO,O d
PARK DEV.CHARGE #2 30-368
ZONING ADJUSTMENTS 05-362
_33s -- ------ --- el 7ZU
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— _— TOTALS $ O•.3� S z&5---a
RECEIVED BY --___ -- -- ------- ---
PIRMIT NUMBERS ASSIGNED:
Number Amount NYmber_ Amount Number Amount
s.
sRECEIPT N 17883
I
Building Permit No.
Loc at ion _ /,�SaQ
Oate �
Certification of Registration
7
With the Builders Board
doing business as (dba) ,
i
am registered under the ;provisions
of ORS apter• 701 Oregon Homebuilder- Law) .
toy Builders Board Registration Number• is _ �� �g
My registration is in full force and effect and expires on
Signature
2–
TNI: Ut,'^ERSIGNED H'IREUY APPLIES t OR APE HNII If P011 ItIL rVUIim H,IJ,_W4 W-M.1%I U
GR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ANO SPIECIFICA]IONS, owrlElt.'ItLirl
LOT NO.—L �
AU0RE55
1)� �3 ARCHITECT
1 ENGINEER
A O U R E:L. n. ❑ ❑
rrL I�✓✓>�]-(lI r, O E 51 G 14!:R
STRUCTURE ?!EW 'kI(ICEL �
ADDITIOV _ CiRcP ITl RE'VEVIAL ❑FIRE OAMI.;E_r� ❑OE'.17LII
RESILE"ICL ❑CUA' 1 ❑EOUCr:' ONAI ❑GOy'T URELIGICU5❑,IATIO []CAA PCRT ❑GAHAGE ❑STORAGE❑SLAB ❑FEI
r
CCCI P.iLt--Y–&--3----ANO USE ZONE rY � OLOG. TYPE PLAN' CHF-CK BY NEA
,— GONSTRUCT SINGLE FAMILY ntdLI.I.ING W/ATTACHED cnkA,(;I'.,_- _
. BAj00 BFI)}00N _
SEUER PERMIT L _ Garage _
:s.�_I.O=D_--- FLp9a LOAD HEIGHT i, 5NO STOWES f AREA/ *", -`;e NQ.BEnannhtSyAt uE`
tilJllr:IN;DEPARTMENT SFT PACKS FRONT �' n "`_"^ .7 'V-,SIEPTSIOE �� RIGHT SIDE /6
( 7
THIS PERMIT IS ISSUED SU3JECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZON
I x:11 C"eCk I REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT
(�-- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS ANL)SPECIFICATIONS AND IN CC,&tPLIl-.NCE Y
$:J7•fDfdl — � ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT W<
i RESTRICTIVL COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITU BUSIt
!7;at+. Tax I LICENSE. SEPARATE PERMITS REQUIRED FCR SEWER. PLUMBING AND HEATING.
Total- — SDC -
r I PDC#
1 P.,
�- --_ APPLICANT OR AGENT'_— --
Appru:c� I Receipt NO
+—
SOC - S
PDC - $ #
SEWER CONNECTION S
SEWER INSPECTION S
SEWER SURCHARGE S
Comments :
e�
Ik- 141
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