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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 6�3/9-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Spriok. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. an. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing Plumb.
Alarm Water Line Insulation Mech.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested:_ t I ( ( ' lS Time: /
AM f: OOPM
Address:
Builder: Permit tF
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: / Date: ���
APPROVED DISAPPROVED _APPROVED SUB J 'T TO ROVE
—Gail For Reinsp.
CITY OF T I CARD SEWER CONNE'CT'ION
COMMUNITY DEVELOPMENT DEPARTMENT PERM I T
13125 311V Hall Blvd.Tigard,Orejor 97223*8199 (503)639-4;71 PERM17 #. . . . . . . .• SWR951-0zl-"
DATE MG(.JL,.,. 0.1/17/95 7-71
11
PARCEL: IS1361)i)-00200
ITE* ADDRESS, 1 .1550 SW 671-H A V E
.UBDIVISION. . . . wEs-r POR-I'LANE, HE I SKI S ZONING- C-F1
. . . . . . . . . . . LOT. . . . . . . . . . . . . . 4
f--'NANT NAME. .
73A NO. . . . . . . . . . : PIXTURE UNI*rS. . .
LASS OF WORK. . . :NEW DWELL.I NG UN i TS. . : I
YPIL OF USE. . . :SF NO. OF' BUILDIN(55-
-1
V31,01-1- TYPE. . . . :BU S 114 R 011"ERV SURF-AC1.-.. . : Sf
�mar-k-, : CONNECT EXTSTIN6 HOUSE 'FO SEWER. SEPT I C 7 ANK MUS"f BE PUMPED, I`- I L, P1.),
�iSPECJ"ED.
F'EES
4NE type alnolll. by date recpt
'JO) UW PENDLE.T'01\1 Ur PIRMT $ 2200. 012A JG 01/17/95 -
INGF, 1. 3,5. 00 JG 01/17P)n --
.1k i LAND
.1kil-AND OR 97al
'-worle #:
or-it ract ot-.
Al.�.'.`UN & OLE') CON;;-'( RUCI'lOhl
J40b SW P.IL.LASnNT V(-ILLEY RD
!-AVERTLIN UR
00 T3'TnL
------- REDU I PEI) 11\1SPECI-IONS
IS APPliU-1 dq,^l?e5 to colply with all the rules and regulations bewe), Inspect iorl
the Unified Sewage Agency. The p'rm expires 180 days fron Sewer, lr)"Pf�r-,tioy,
date issued. The total anount paid will he forfeited if the ScIptic "I 'Ank Fill
reit expires. Toe Agency does not guarantee the accuracy of the
�je sewer laterals. If the iemer is not locate), at the measurevent
*,r,,, the installer %hall prospect I feet in all directions froe
e distance given. It not so located, the installer shall purchase
Tap and Side Sewer" Perslit and the Agency will install a lateral,
I-m i t t e t
i!-�Lsd LAY ,,
L'All fm- irisc)ectiori 639-4175
' Residential Bui;rding Permit Application
City of Tigard
13125SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171
Jobsite Address: 721r
Sub,lIvlsion: Lot # Ofitce Use Only
Valuation:
(C)l) Planck/Rec #
��
Cornet Lot? Y N Pel mit #
Flag Lot? Y N Reissue of `
Map & 7L
owner! %�' -��/ � Approvals Required
Address: e,L'�'9 %� ,/,�.>,_ , � '' e-k"r Planning
7-2 ay Engineering
Phone: ,y 5 - ,
�- Other
Contractor: Items Required
� y
Address: Subcontractors
� , f ftr, err
//-.-.--- suss Details _
Phons : Z n Other
Contracts.is License #
(attach copy of current Oregon license)
Contact Name & Phone:
Subcontractors: Architect/Engineer:
c Plumbing: _ Address:
a
V) Mech finical: _
(attach copy of current OH Contractor's License)
�- Phone:
w
LO
LL, JOB DESCRIP710N:
Applicant Signature & Phone number
Received by: — Date Received:_
N mCAD\COMDEV\RESAPP
Permit# Account Description Amount Amt. Pd. Bal. Due -
_ Bldg. Permit (BUILD)
Plumb. Permit (PLUMB) _
Mech. Permit (MECH)
State Tax (TAX) _
Rldg:
Plumb:
Mech:
Plan Check (PLANCK)
Bldg: _
Plumb:
Mech:
Sewer Cr, action (SWUSA)
Sever Insliection (SWINSP)
Parks Dev Charge (PKSDC)
Residential TIF (TIF-R)
I
Mass Transit TIF ITIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (i IF-13)
Office TIF {TIF-C '
Water Quality (WQUAL)
a Water Quantity (WQUANT)CY
Fire Life Safety (FLS)
cn ----------- — ^.�-- -
�= Erosion Cntrl Permit (ERPRMT) _
J
cc Erosion PlancklUSA (ERPLAN)
cs
Erosion Planck/COT (EROSN) _
TOTALS: