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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W.Main St.
Tigard,Oregon 97223
Phone: 639-.1171
Type of Inspev,on
Date Requested_ ���'�' `�J Time A.M. -1c P.M.
Address �-2 y Permit #
Owner_ — Lot #
Builder
The following Building Code deficiencies are required to be corrected:
� I
Presented to -
--�.�� Approved
Inspector
— Li Disapproved
Date !fes
CALL FOR REINSQECTION
❑ YES NC
INSPECTION NOTICE
N City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
j Phone: 639.4171
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Type of Inspection — / ��-•-2
Date Requested Tim- �_A.M. P.M.
Address -Oq � Permit #_
Owner Lot #
Builder
The following Building Code deficiencies are required to be corrected:
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t
I
I
Presented to /Approved
Inspector — _ F] Disapproved
Date
CALL FOR REINSP CTION
CJ via NO
BUILDING PERMIT APPLICATION TIGAPDoATE �)rce�eb�#Tr_/`-_�_,ts_.13 4686
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THF WORK HEREIN INDICATED 9UILDER PHONE X45--.111X3_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
LOT N O.-_.___ 1_--
OWNER _ JiLhn I,rtjKLI JOB ADDRESS 12490 SW i;ol:� _ 6ellwuod- III
ARCHITECT
ENGINEER
BUILDER 1,lrew, X ('0LLjirr Acte ADDRESS I67y5 %4 Somerset i)tive DESIGNER
STRUCTURE ❑jtNEW i REMODEL ❑ ADDITION [-J REPAIR ❑ RENEWAL ❑ FIRE DAMAGE L DEMOLITION
L RESIDENCE ❑ COMM 1-1 EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO Ll CARPORT '-1 GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _—K- LAND USE ZONE X-L BLDG.TYPE —5JL FIRE ZONE PLAN CHECK BY GTS —HEAT tLa s
!- _ _Gonetruct single fat-41y dwelling, w r►ttachtd 6:arsx*. _
2 Batiiruor, 3 rtedruola
SEWER PERMIT# I
OCC.LOA D FLOOR LOAD 4A, HEIGHT 2U+ NO.STORIES I AREA 132., NO.BEDROOMS 3- VALUE 46,000.
-- - - -
BUR.DING DEPARTMENT ,FT FiA(,KS FRONT ' REAR r• ' LEFT SIDE RIGHTSIDE �
Permit 331.00 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 ) 15. 15 WORK WILL BE DONE IN ACCORDANCE_ WITH IHE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 546. 15 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEVC-R,PLUMBING AND HEATING.
State Tax 13.24
SDC— ,,";I. .
Total 55y.3
PDC# 1 1 .00 APPLICANT OR ADEN T
Ely t;H
Approved I!.1 I'V ADDRESS PHONE
I
'ATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
1 �vat
- _ .".`, Contract
Permit No. - -- -
_ —
�� ' �J mixture
I A ,�/ _ _ final -
��ApV.�_ � HEATING
Contractor 41
—_ Permit No.
-/U Gas ni Oil 1 S
Rnugh-ir
- ------ Final
— ------- ., .—_ SEWER
Final
--- -- ------ ------- ---•— DRIVEWAY- --
- — -� Final —
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
BLUE.DEPT, FINAL �^ TEMPORARY r CERTIFICATE OCCUPANCY — i —
�a.ERTIFICA"r:OCCUt ANC'i I Final
Landscaping
Ii Zoning r-w
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Z71-
BUILDING PERMIT APPLICATION TIGARD Dt.r Ed 19
THE UNDERSIGNED HERE13Y APPLIES FOR A Pc:FimIT FOR THE'JVOfIK HEREIN INDICATED OLtLOER PHONE/
CR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFIC
1TIONS. OWNER PHONE _
T NO._ 15.
y'NNER { JOB A_DORESS
_ x _ '411
ARCHITECT
1EER
BUILDER � +�"1� AD0RE__j! � L� � �l cr�Y1�lJali--tom 1S'NER
STRUCTURE 014IEW ❑ REMODEL _Cl AOOITION Cl REPA.R Cl RENEWAL ❑ FIRE DAMAGE _CI DEMOLITIOI
RESIDENCE Ej COMM Cl EDUCATIONAL Cl GOV'T Cl RELIGIOUS Cl PATIO ❑ CAR PORT ❑ GARAGE ❑ STORAGE Cl SLAB❑ FENG
OCZUPANCY _LAND USE ZONE .1]_-L t1L.DG.TYPE ?_t!!FIRE ZONE- --PLAN'CHECK BY HEAT
4 —/
�LWERPERMIT N _ -
T T! r NO.BEDROOMS VP.LU W&'
OCC.LOAD FLOOR LOAD 't'0 HEIGHT �" NO.STORIES AR�_
BUILDING DEPARTMENT
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SETBACKS FRONT Z REAR aA LEFT SICEv i 3- RIGHT SIDE .910
-
IParmlt 3 �� 00THIS PERMIT IS ISSUED SUBJECT TU THE REGULATIONS CONTAINED IN THF GUILDfNG CODE,7OWN
REGULATIONS AND 141-1. APPLICABLE CODES AND ORDINANCES, AND IT IS HERF3Y AGREED TY.AT TI'.
IPlanCheck ��� WORK WILL DE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COIAPLIANC
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIV
Sub-tolal 5" y y RESTRICTIVE COVENANI S.CONTRACTOR AND SUS CONTRACTORS TO HAVE CURRENT CITY HU;,INE5
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�— I.ICENSE.SEPARATE PERMITS REOUIRED FOR SEWER,PLUM MING AND HEATING.
Stbts Tax
Total --- --_------ ----__
PDCA APPUCAN;-VHAGENT
By
— —--�Receipt No. ADDRESS
Approved
SoC
POC - _- .-�__ / 00
SEWER C014NECTION S 7S! S
SEWER INSPECTION S
SEWER SURCHARGEr S � Gr.►o.s�'�� �f
comlmcrll_c : �/�
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Building Permit No. ,
Location ---Z-206)
Qate .16L��,,LAI"
Certification of Registration
With the Builders Board
I, �-1 L, � L24-r:j ,� � ,, doing business as (dba) ,
am registered under the provisions
of ORS Chapte^ 701 Oregon Homebuilders Law) .
My Builders Baard Registration Number is z j'
My registratian is in full force and effect and expires on
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