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NAME: � F C�dit' E= Ai . 7�
ADDRESS: 4 �s_ S, w, 12 q �! V e »H�NIr.6
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ADJACENT PROPERTY 40MRS WJ LL HE INFORKED OF %112 RBUUSSTUD -CJlAWfi.
1F TURS IS AN UbJiXTION, TkZ UliJw:MUN Wl" fiti ltr'LA'Y`MW TO Mild
W-.3,1 LENT ASKING ?OA THS CHANu
'UbMIT THIS FORM ; a) ACC(rinr'ANYiNu utA,11% lam) 747 THE K.C.C.A. *�
A051I NI.STHATOR.
KAJOR :.TRUCTUHAL GIIANUt� A1i.6 sUbJiXT TO Ki�� Its! by THh K.C. 'A.
BOARD OF t)IRECT( rl.i .
t1 BUILDING PiI,KN: 'r wiUjT dG UbTA114cA) Fr(Um TML' CITY OF TIUAIW FOR
1M1'rt0vLMLNT,; )TING. UVr✓k 0UU .OU. CUNTACT Eli WALL)GN 639-4171 . �
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• City of King City . 16390 S W 116th Avenue, N;ing City, Or%jon 97A24• (503) 839-4c62 •
INSPECTION NOTICE
City of Tigard Building Dep&rtmen,
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection I k-n2-IrA - --Q—
Date Requested Time A.M. P.M.
Address Permit
Owner ---- 0�70 Lot #.
Builder
The following Building Code deficiencies are required to be corrected:
_ -�% �.
4
Presented to
pproved
Inspector Disapproved
Oate.
CALL FOR REINSPECTION
DYE$ ONO
CIIYOFTIFARD
PERMl. NO.
COMMUNITY DEVELOPMENT DEPARTMENT
DATE 19S1!20:
+3125 s.w.HA Mrd.P.O.OW 2XW.TV"*O"WO To ""404as PRIM.IMT.NO.
JOB ADDRESS: S -7 �'�� _Zc— �___—_ /'f/-✓ 7 i ---
TAI MAP/10-1 _ —_. SUB: LT:
LAND USE: ��� ori
LOT SIZE: VALUATION: 4-5-6 O SETBACKS
WORK CLASS: DWELL/UNITS: -- -_-- LEFT: _ RIQ(T:
USE TYPE: _—. NO.BEDROOMS:
GIST.TYPE: -------__ -- NO.BATHS:
OCCU'P.GRP.:
OCCUP.LOAD: _
TOTAL AREA:
NO.STORIES: --__--_--_- . IST: ROOF CONST:-.. — FD.RE SET: .
HEIGHT: 2ND: _ AREA SEPAR:
BASIO(EUT: 3RD: - --- OCCUP.SEPAR:—_ -__
MEZZANINE: Y BASMVT __---_
Fikolt LOAD: _-,- --- CAME: _ FIRS SPRKI.R:
FLOW (GPM): _— - D&TXCT:
NEAT TYPE: HD(.'P.ACCESS: __. -__---- CORR: --
PLAN CHECK BY:
REISSUE OF NO.
Sams posy ?2_ LAST REISSUE _
. N
PERMIT
PLAN REVIEW
pj.Qfl�3 (p•� `�SGS �1'� --- FIRE DEPT _
-- STATE TAY _ S 1;
o Nartie s L �Sc,�S{�✓c� ��� OTHER --
N DEYEI.OPMENT CHARGES:
R Address: 7yeo S.E. SDC (STORK) -
A _C G R 7 z O 1.- SDC (STREET) _--
PDC �
o Phone: Z'5 - Y 4 8 9 _ PREPAID ,
R --
RECEIFT 140.
BEQUIRKD INS'!ECTIONS
FOOTING SEWER
DC
FOUNaom WALL. RAIN DRAINS
POST 6 BEAM WATER LINE
PLB. UNDERSLAB CITY APPRIri:N/SW
SLAT} FINA1.
PLB.TOPOUT
\ FRAMING
FI BI!PLACR
GAS LINE
�OIMaltun INSULATION
OYP.BOARV
By ----
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