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11640 SW FAIRVIEW LA14E
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City of Tigard
SPEC Tlo N REQUEST
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IINSPECTIC14 TIME :��.,'� _ PERMIT NO.:
DATE: -S'14712— DATE ISSUED:_..LJ
OWNERS NA;v1E . ( `'
ADDRESS : >� ,� 22 /.�. ,
C 0 N T R A C T 0 R :_ �'�� � '�i�,,� � :�_ .",
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SULT. Approved IN Disappro, ,d ❑ , Pending [�
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I INSPECTOR DATE
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City of '-,r
Igard
IN&" ' 110N REQ%.:
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IN'tPECTION TIME . PERMIT NO.
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DATE : DATE ISSUED -J
OWNERS NAME :----
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ADDRESS .
CONTRACTOR --5—LTM
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Visual
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RESULT' Approved 0 Visa pprovf4d, ,in
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INSPECTOR OATE
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i City of Tigard
INSPECTION REOUES'-T
for
LINSPECTION TIME ' _ PERMIT NO. : ---
DATE:
O. : ___—__DATE: DATE IS S U 1=D. _ _G_
! OWNERS NAME :
ADDRESS : —&YYrs
( CONTRACTOR
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ITEST' Air ❑, Water G , Visual ❑ , Laboratory L]
RESULT: Approved , Disapproved ❑ Pending [-,;j
I SKETCH:
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INSPEef6l DATE
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CITY OP r ebrunry 76 7F i�jo (�[ f�
BUILDING PERMIT APPLICATION TIGARD DATE __ 19_N2 " 6 3
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS Ah;D SEfOFI T[ DkOlA1NER PHONE
gl�ousle-1*1dion Const. 11640 SW Fairview Lana
OWNER ADDRESS O-V ILDER
game ENGINEER
BUILnER ��-++��J _— CHITECT DESIGNER
STRUCTURE -_LNEW ❑REMODEL ❑ADDITION _ ❑REPAIR _❑_RENEWAL [:]FIRE DAMAGE _ ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE DDESIGN REVIEW ❑COUNCIL a%PPROVED ❑SIGNS
CUPANCY LAND USE ZONE f1- BLDG. TYPE_ FIRE ZONE J PLAN CHECK BY erg HEA"TW_--.^___
("'onstrurf 1670 req. t. f'reMe dwelling with +atterhivd garage and —
i►c+set"w t according i:.0 approved plans,
Reissue 11630 Sid Terrace Tr+oil@ --
y.,r.Y OVs p1 — -
10
3264
"Q. LOAD FLOOR LOAD40 lb_ HE!CHT NO.STORIES AREA VALUE _
BUILDING DEPARTMENT SETBACKS FRON:r 20 1 REAR LEFT SIDE RIGHT SIDE
Permitl. --- -----...-- ---_—— —
- -" THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND 17 IS HEREBY AGREED THAT THE
WORK,WILL BF DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State _ LICENSE. SEPARATE PERMITS RFnU1RED FOR SEWER PLUMBING AND HEATING.
S20 re 03
Total
By _
! APPLICANT OR AGENT -- --'------ "------ --- _____--
Approved � — Receipt No.
��� _•, � � ADDRESS PHONE
A
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor l -
�il+ -76
ry // --
Permit No. 4375 S 3�9✓7�'
J Z4�"' - rt_ 0�41'ur - Rou h-in —5--76
�7fU oma— Fixture ---- -
-76 (,� — _ Final
HEffING
Contractor- r-
5 Permit No. — 3h 8 8 I/A/74
�/ 2/ 7j / /✓N► L—� —,—� _----- Gas or Oil
—�_---
_ _ Final
— — — SEWER
—_ �-— 1�a—1 1 4
— ------ ---- Final _ i `
-_ —Y--------- --` - DRIVEWAY
Final
-------`-- _ —` _— Storm Drainage
(Rain urain) Final
Sidewalk /,•G S�1'�.��
Curb&Street Final
---- — -- - — _ A roach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
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ADDRESS .,1LG �0 �a,ry✓�,� yL, PERMIT N0. 9 o .y
_ PERMIT CHARGE none
OWNER �a/�� 1�:�. .� CONNECTION FEE Asa pO
PAID BY
TYPE OF BUILDING ,`-J`'S� ,��cK_ DATE CONNECTED
SERVICE RATE INSPECTION FEE °�
ONTRACTOR PAID BY DATE
SIZE OF CONNECTION _ - ASSESSMENT PAID
910 - 40
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